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AXA EQUITABLE LIFE INSURANCE COMPANY
FORM OF FUNDING AGREEMENT SPECIFICATION APPLICATION TERM SHEET
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Owner: | | [ABC Company]1[ABC Bank FBO ABC Company]1 |
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Escrow Agent: | | [N/A]1[ABC Bank FBO ABC Company]1 |
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Beneficial Owner | | [N/A]1[ABC Company]1 |
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Interested Party: | | [XYZ Company]1 &2[former securityholders of XYZ Company]1&2 |
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Authorized Representative: | | [DEF Consultants]1 |
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Funding Agreement No.: | | FA-[12345]1 |
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Effective Date: | | [December 15, 2016]1 |
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Maturity Date: | | [March 1, 2020]1 |
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General Escrow ([$100,000 minimum | | |
Purchase Payment per Tranche]4) | | |
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Tranche 1 | | |
Purchase Payment: | | [$2,000,000]1 |
Expiry Date: | | [September 1, 2017]1 |
Initial Crediting Rate: | | [0.55%]5 |
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[Tranche 2 | | |
Purchase Payment: | | [$1,000,000]1 |
Expiry Date: | | [September 1, 2018]1 |
Initial Crediting Rate:] | | [0.65%]5 |
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[Tranche 3 | | |
Purchase Payment: | | [$1,000,000]1 |
Expiry Date: | | [March 1, 2019]1 |
Initial Crediting Rate:] | | [0.75%]5 |
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[Tranche 4 | | |
Purchase Payment: | | [$1,000,000]1 |
Expiry Date: | | [September 1, 2019]1 |
Initial Crediting Rate:] | | [0.85%]5 |
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[Tranche 5 | | |
Purchase Payment: | | [$1,000,000]1 |
Expiry Date: | | [March 1, 2020]1 |
Initial Crediting Rate:] | | [0.95%]5 |
APP-MA2016
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[Special Escrow | | [N/A]1 |
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Purchase Payment: | | [$1,000,000]1 |
Initial Crediting Rate:] | | [0.15%]5 |
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Maximum Total of all Purchase Payments: | | [$50,000,000]6 |
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Potential Subsequent Purchase Payments: | | [$100,000]1 [N/A]1 |
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Account Administrator: | | [DEF Company]1 |
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State of Issue: | | [Georgia]7 |
IMPORTANT:
The amounts and rates above are subject to change and are determined as of the date a Purchase Payment is made, and will be reflected on the Final Term Sheet.
A Purchase Payment must occur and the Funding Agreement must be issued no later than 60 days after the date this Application is signed.
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Executed at: [ ]8 | | Date: |
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[If Escrow Agent Is Applicable: | | |
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By: | | , the Escrow Agent, as Owner |
| | (Signature and Title)]9 | | |
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[If Escrow Agent Is Not Applicable: | | |
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By: | | , the Owner |
| | (Signature and Title) | | |
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By: | | , the Interested Party (or Authorized Representative) |
| | (Signature and Title)]10 | | |
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By: | | , AXA Equitable |
| | (Signature and Title) | | |
APP-MA2016