Contract Schedule |
Owner: [John Doe] Contract Number: [??687456]
[Joint Owner: [Jane Doe]] Issue Date: [04/15/10]
Annuitant: [John Doe]
Annuitant's Age
and Gender: [35 Male] Scheduled Annuity Date: [04/01/65]
Determining Life (Lives): | [John Doe] | Maximum Issue Age: | [80] |
[Jane Doe]
Purchase Payments
Initial Purchase Payment: $[10,000.00]
Minimum Additional Purchase Payment: $[50.00]
Maximum Total Purchase Payments: $[1 million; higher amounts may be accepted with our approval]
Transfers
Number of Free Transfers Permitted: [12] each Contract Year
Transfer Fee: $[25.00] for each transfer in excess of the free transfers permitted
Transfer Index Anniversary: Every [Sixth] Index Anniversary
Contract Charges
Mortality and Expense Risk Charge: [1.25]% of the Variable Options' net asset value
Contract Maintenance Charge: $[50.00] each Contract Year
Entire Contract Value: Equals the sum of the Contract Value of each [Index Advantage NF] contract
Contract Maintenance Charge Waiver Minimum: | $[100,000.00] |
Withdrawals
Minimum Partial Withdrawal: $[100.00]
Minimum Required Value: $[2,000.00]
Free Withdrawal Amount: [10]% of total Purchase Payments
Withdrawal Charge Percentages Table
Number of Complete Years Since Receipt of Purchase Payment | Charge | ||||||
[0 | 8.50% | ||||||
1 | 8.00% | ||||||
2 | 7.00% | ||||||
3 | 6.00% | ||||||
4 | 5.00% | ||||||
5 | 4.00% | ||||||
6 years or more | 0%] |
Annuity Payments
Minimum Annuity Payment: $[100.00]
Annuity Mortality Table: | [Annuity 2000 Mortality Table] |
Minimum Annual Annuity Payment Rate: | [1.00]% |
Contract Schedule continued from the previous page |
Guaranteed Purchase Rate Table
Upon request, we will furnish rates for ages and guaranteed periods not shown.
Annuity Options - Guaranteed monthly annuity payments per $1,000 | ||||||||||
Option 1 | Option 2 | Option 3 | Option 4 | Option 5 | ||||||
10-year guaranteed period | 20-year guaranteed period | 100% joint and survivor | 10-year guaranteed period | |||||||
Age of Annuitant on Annuity Date | Male | Female | Male | Female | Male | Female | Male & Female Same Age | Male & Female Same Age | Male | Female |
30 | [2.08 | 1.97 | 2.08 | 1.97 | 2.07 | 1.97 | 1.84 | 1.84 | 2.00 | 1.92 |
40 | 2.45 | 2.29 | 2.45 | 2.29 | 2.42 | 2.28 | 2.10 | 2.10 | 2.29 | 2.19 |
50 | 3.02 | 2.78 | 3.00 | 2.77 | 2.92 | 2.73 | 2.49 | 2.49 | 2.70 | 2.57 |
60 | 3.95 | 3.57 | 3.87 | 3.53 | 3.59 | 3.37 | 3.12 | 3.11 | 3.29 | 3.14 |
70 | 5.66 | 5.03 | 5.28 | 4.83 | 4.24 | 4.13 | 4.22 | 4.20 | 4.18 | 4.00 |
80 | 8.93 | 8.09 | 7.07 | 6.79 | 4.55 | 4.53 | 6.37 | 6.04 | 5.54 | 5.38 |
90 | 15.24 | 14.64 | 8.36 | 8.30 | 4.59 | 4.59 | 10.68 | 7.98 | 7.66 | 7.50] |