<Page>
PLEASE READ THIS CONTRACT CAREFULLY
THE DEATH BENEFIT AND CONTRACT VALUE, WHEN BASED ON THE INVESTMENT PERFORMANCE
OF THE VARIABLE ACCOUNT, MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO A
FIXED DOLLAR AMOUNT. PLEASE REFER TO THE VARIABLE ACCOUNT AND DEATH BENEFIT
SECTIONS FOR ADDITIONAL INFORMATION. WE AGREE TO PAY THE BENEFITS OF THIS
CONTRACT IN ACCORDANCE WITH ITS TERMS.
RIGHT TO CANCEL
We want you to be satisfied with the contract you have purchased and we urge you
to examine it closely. If for any reason you are not satisfied, you may return
the contract to us or an authorized representative within 10 days after receipt
of the contract.
If you return the contract, it will be void from the Date of Issue, and you will
receive a refund equal to the total of:
1. the difference between any payments made, including fees or any other
charges, and the amounts allocated to the Variable Account;
2. the value of the amounts in the Variable Account on the date the
returned contract is received at our Principal Office; and
3. any fees or other charges imposed on amounts in the Variable Account.
ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY
Home Office: Dover, Delaware
Principal Office: 440 Lincoln Street, Worcester, Massachusetts 01653
This is a legal contract between Allmerica Financial Life Insurance and Annuity
Company and the owner. It is issued in consideration of the payment shown on the
Specifications Page.
President Secretary
MODIFIED SINGLE PAYMENT VARIABLE LIFE INSURANCE CONTRACT
NON-PARTICIPATING
FORM 1036-96
<Page>
TABLE OF CONTENTS
<Table>
SPECIFICATIONS 3
DEFINITIONS 7
GENERAL TERMS 9
INFORMATION ABOUT YOU AND THE BENEFICIARY 11
WHAT YOU SHOULD KNOW ABOUT:
THE PAYMENTS 12
YOUR CONTRACT VALUE 14
THE VARIABLE ACCOUNT 16
THE FIXED ACCOUNT 19
TRANSFERS 21
BORROWING FROM YOUR CONTRACT 22
SURRENDERS AND PARTIAL WITHDRAWALS 23
THE DEATH BENEFIT 25
THE BENEFIT OPTIONS 26
</Table>
2
<Page>
SPECIFICATIONS
Contract Number: Specimen
<Table>
[First] Insured: John Doe [First] Insured's Sex: Male
[First] Insured's Age: 35 [First] Insured's Underwriting Risk Class: Non-Smoker
- ---------------------------------------------------------------------------------------------------------------------------
[ Second Insured:] [ Second Insured's Sex:]
[Second Insured's Age:] [Second Insured's Underwriting Risk Class:]
- ---------------------------------------------------------------------------------------------------------------------------
Date of Issue: 08/20/96 Contract Plan: Modified Single
Payment Variable Life
Insurance Contract
Face Amount: $318,554 Monthly Processing Date: 1st of each month
Owner(s): John Doe Rider: Living Benefits Rider
Beneficiary at Issue: Mary Doe Rider Date of Issue: 08/20/96
- ---------------------------------------------------------------------------------------------------------------------------
Payment: $50,000
Maximum Payment: The greater of [$50,000]
or [$4,123.06] times the
current contract year.
Final Payment Date: 08/20/60
Initial Payment Allocation:
</Table>
VARIABLE SUB-ACCOUNTS
<Table>
Select Emerging Markets Allmerica Equity Index
FT VIP Templeton Foreign Securities Fidelity VIP Growth
Oppenheimer Global Securities FT VIP Franklin Large Cap Growth
Select International Equity Oppenheimer Capital Appreciation
AIM V.I. Aggressive Growth Select Aggresssive Growth
AllianceBernstein Small Cap Value Select Growth
Fidelity VIP Value Strategies AIM V.I. Basic Value
FT VIP Small Cap AllianceBernstein Value
FT VIP Small Cap Value Securities Alliance Growth & Income
MFS New Discovery Fidelity VIP Contrafund
Select Strategic Growth Fidelity Equity Income
Mid Cap Equity MFS Total Return
AIM V.I. Capital Development MFS Utilities
</Table>
FORM 9030-96
3
<Page>
<Table>
Fidelity VIP III Mid Cap Oppenheimer Main Street Growth & Income
FT VIP Mutual Shares Securities Oppenheimer Multiple Strategies
MFS Mid Cap Growth Select Growth & Income
Select Capital Appreciation Oppenheimer High Income
Select Value Opportunity Fixed Income
AIM V.I. Blue Chip Allmerica Government Securities
AIM V.I. Premier Equity Select Investment Grade Income
Alliance Technology Select Strategic Income
Allmerica Core Equity Alliance Premier Growth Allmerica Money Market
</Table>
FIXED ACCOUNT:
10% Initial Interest Rate: [4%]
3.1
<Page>
SPECIFICATIONS (continued)
[First Insured: John Doe Contract Number: Specimen
[Second Insured:]
<Table>
Minimum Additional Payment: [$10,000]
Minimum Fixed Account Interest Rate: [4% of value not subject to Outstanding Loan]
[4% of value securing Outstanding Loan - not preferred loan]
[5 1/2% of value securing Outstanding Loan - preferred loan]
Outstanding Loan Interest Rate [6%]
Maximum Loan Amount: 90% of Surrender Value
Minimum Loan Amount: [$1.000]
Minimum Balance After Withdrawal: [$25,000]
Free Withdrawal Amount: [10% of Contract Value]
</Table>
<Table>
<Caption>
FEES AND DEDUCTIONS: CURRENT GUARANTEED
- ------------------- ------- ----------
Administration Charge: [0.25%] Annually (1) [0.25%] Annually (1)
Distribution Fee (Contract Years 1 - 10): [1.15%] Annually (1) [1.15%] Annually (1)
Federal & State Payment Tax Charge (Contract years 1 - 10): [1.75%] Annually (1) [1.75%] Annually (1)
Insurance Protection Charge: [0.50%] Annually (1) See Page 5
Mortality & Expense Risk Charge: [0.90%] Annually (2) [0.90%] Annually (2)
Monthly Maintenance Fee: [$5.00] Monthly (3) [$5.00] Monthly (3)
</Table>
(1) This charge is deducted monthly from the Contract Value on a Pro Rata
basis. The monthly charge is equal to one-twelfth of this factor times the
Contact Value.
(2) This charge is deducted daily from the Variable Accounts on a pro rata
basis.
(3) This charge is deducted only when the Contract Value is less than
[$25,000.]
If you have any questions, need information about your coverage or require
assistance, please call our Principal Office. The number is [(508)855-1000].
4
<Page>
SPECIFICATIONS (continued)
[First] Insured: John Doe Contract Number: Specimen
[Second Insured:]
GUARANTEED MAXIMUM MONTHLY INSURANCE PROTECTION RATE TABLE
<Table>
<Caption>
[AGE] [AGE]
[AGE YOUNGER INSURANCE PROTECTION [AGE YOUNGER INSURANCE PROTECTION
INSURED] RATE PER $1,000 INSURED] RATE PER $1,000
----------------------- --------------------------- -------------------------- --------------------------
35 0.14 65 1.87
36 0.15 66 2.07
37 0.16 67 2.29
38 0.17 68 2.53
39 0.18 69 2.79
40 0.19 70 3.09
41 0.21 71 3.44
42 0.22 72 3.83
43 0.24 73 4.29
44 0.26 74 4.79
45 0.28 75 5.33
46 0.31 76 5.90
47 0.33 77 6.51
48 0.36 78 7.15
49 0.39 79 7.84
50 0.42 80 8.62
51 0.46 81 9.49
52 0.51 82 10.50
53 0.56 83 11.62
54 0.62 84 12.86
55 0.68 85 14.17
56 0.75 86 15.56
57 0.83 87 17.00
58 0.91 88 18.48
59 1.01 89 20.04
60 1.11 90 21.69
61 1.23 91 23.48
62 1.36 92 25.50
63 1.51 93 27.96
64 1.69 94 31.38
95 36.79
96 46.58
97 67.04
98 83.33
99 83.33
</Table>
[Note: Single life, Male, Age 35, Non-smoker]
[Based on 1980 CSO Age Last Birthday Table]
5
<Page>
SPECIFICATIONS (continued)
[First] Insured: John Doe Contract Number: Specimen
[Second Insured:]
GUIDELINE MINIMUM SUM INSURED TABLE
<Table>
<Caption>
[AGE] [AGE]
[YOUNGER INSURED [YOUNGER INSURED
AGE] PERCENTAGE AGE] PERCENTAGE
----------------------- ------------------------ --------------------- -------------------
[thru 40 250% 60 130%
41 243% 61 128%
42 236% 62 126%
43 229% 63 124%
44 222% 64 122%
45 215% 65 120%
46 209% 66 119%
47 203% 67 118%
48 197% 68 117%
49 191% 69 116%
50 185% 70 115%
51 178% 71 113%
52 171% 72 111%
53 164% 73 109%
54 157% 74 107%
55 150% 75 thru 90 105%
56 146% 91 104%
57 142% 92 103%
58 138% 93 102%
59 134% 94 101%
95 and over 100%]
</Table>
SURRENDER CHARGE TABLE (PERCENT OF TOTAL PAYMENTS WITHDRAWN)
<Table>
<Caption>
CONTRACT CONTINGENT DEFERRED UNRECOVERED TOTAL
YEAR* SALES LOAD PAYMENT TAX SURRENDER CHARGE
------------------------ ----------------------- -------------------- ---------------------
[1 7.5% 2.25% 9.75%
2 7.5% 2.00% 9.50%
3 6.0% 1.75% 7.75%
4 6.0% 1.25% 7.50%
5 4.5% 1.25% 5.75%
6 4.5% 1.00% 5.50%
7 3.0% 0.75% 3.75%
8 3.0% 0.50% 3.50%
9 1.5% 0.25% 1.75%
10 0% 0% 0%]
</Table>
*For a contract that lapses and is restored, see Reinstatement provisions.
6
<Page>
DEFINITIONS
AGE means how old the Insured is on his/her
last birthday measured on the Date of
Issue and each contract anniversary.
APPLICATION is the form you complete to apply for
this contract. It contains your payment,
payment allocation and other information
that enable us to prepare this contract.
If a medical questionnaire or other
forms are required, they become a part
of the application. It is signed by you
and the Insured and becomes a part of
this contract.
ASSIGNEE is the person to whom you have
transferred your ownership of this
contract.
COMPANY means Allmerica Financial Life Insurance
and Annuity Company, also referred to as
we, our, and us.
CONTRACT CHANGE means any change in the Underwriting
Risk Class or the addition or deletion
of a Rider.
CONTRACT VALUE is the sum of your values in the
Variable Account and the Fixed Account.
DATE OF ISSUE is stated on the Specifications Page.
Contract months, years and anniversaries
are measured from this date.
EARNINGS means the amount by which the Contract
Value exceeds the sum of the payments
made less any payments that were
previously considered withdrawn.
Earnings are calculated on each Monthly
Processing Date.
EVIDENCE OF INSURABILITY is the information, including medical
information, that we use to decide the
Underwriting Risk Class of the Insured.
FACE AMOUNT is the amount of insurance coverage. The
Face Amount is shown on the
Specifications P e death benefit is
based on the Face Amount; see the Death
Benefit section.
FINAL PAYMENT DATE is the contract anniversary before the
insured's (younger insured's) 100th
birthday. This date is shown on the
Specifications Page. The net death
benefit after this date will equal the
Contract Value minus any Outstanding
Loan.
FIXED ACCOUNT is the part of the Company's General
Account to which all or a portion of a
payment or transfer may be allocated.
FUND is a separate investment series for
investment by a Sub-Account of the
Variable Account.
GENERAL ACCOUNT is the assets of the Company that are
not allocated to a Separate Account.
INSURANCE PROTECTION is the death benefit minus the Contract
AMOUNT Value.
INSURED is the person or persons covered as
indicated on the Specifications Page. If
more than one person is named, all
provisions of the Contract that are
based on the death of the "Insured" will
be based on the date of death of the
last survivor of the persons named.
FORM 1030-96
7
<Page>
MONTHLY INSURANCE is the amount of money that we deduct
PROTECTION CHARGE from the Contract Value each month to
pay for the insurance.
MONTHLY PROCESSING DATE is the date the monthly charges are
deducted from the Contract Value. This
date is shown on the Specifications
Page. If the Company is not open on this
date, the Monthly Processing Date will
be the next business date.
OUTSTANDING LOAN means all unpaid contract loans plus
interest due or accrued on such loans.
PRINCIPAL OFFICE is the Company's office at 440 Lincoln
Street, Worcester, Massachusetts, 01653.
PRO RATA refers to an allocation among the
Sub-Accounts of the Variable Account and
the Fixed Account. A Pro Rata allocation
will be in the same proportion that the
Contract Value in each Sub-Account of
the Variable Account and the Contract
Value in the Fixed Account (other than
value that is subject to Outstanding
Loan) have to the total Contract Value.
RIDER is an optional benefit that may be added
to your contract.
SEPARATE ACCOUNT is a segregated account established by
the Company. The assets are not
commingled with the Company's general
assets.
SPECIFICATIONS PAGES contain information specific to your
contract and are located after the Table
of Contents.
SUB-ACCOUNTS are subdivisions of the Variable Account
investing exclusively in the shares of
one or more Funds.
UNDERWRITING RISK CLASS means the insurance risk classification
that we assign to the Insured based on
the information in the Application and
any other Evidence of Insurability we
obtain. The Underwriting Risk Class
affects the Monthly Insurance Protection
Charge.
VARIABLE ACCOUNT is the Company's Separate Account,
consisting of Sub-Accounts that invest
in the underlying Funds.
WRITTEN REQUEST is a request you make in written form
that is satisfactory to us and filed at
our Principal Office.
YOU OR YOUR means the owner of this contract as
shown in the Application or in the
latest change filed with us.
8
<Page>
GENERAL TERMS
ENTIRE CONTRACT This contract, with a copy of the
Application, and any attached
endorsements, is the entire contract
between you and us. The entire contract
also includes: a copy of any Application
to change to a better Underwriting Risk
Class, any new Specifications Pages, and
any supplemental pages issued.
We assume that the information you and
the Insured provide in any Application
is accurate and complete to the best of
your knowledge. If we contest this
contract or deny a claim, we may use
only the information you and the Insured
provided in an Application. Our
representatives are not permitted to
change this contract or extend the time
for making payments. Only our President,
a Vice President or Secretary may change
the provisions of this contract, and
then only in writing.
RIGHT TO CONTEST THE A contest is any action taken by us to
CONTRACT IS LIMITED cancel your insurance or deny a claim
based on untrue or incomplete answers in
your Application. We cannot contest the
Face Amount of the contract if it has
been in force for two years from the
Date of Issue and the Insured is alive
at the end of this two-year period.
If the Underwriting Risk Class is
changed at your request, we cannot
contest the change after it has been in
force for two years from its effective
date and the Insured is alive.
NON-PARTICIPATING No insurance dividends will be paid on
this contract.
ADJUSTMENT OF INTEREST We determine the Fixed Account interest
RATES rates used to calculate the Contract
Value, subject to the guarantees on the
Specifications Page. Any changes in
these rates will be based on changes in
our future expectations for our
investment earnings.
SUICIDE EXCLUSION If an Insured, while sane or insane,
commits suicide within two years of the
Date of Issue of this contract, we will
not pay a death benefit. The beneficiary
will receive only the total amount of
payments made to us less any Outstanding
Loan and amounts withdrawn.
NOTICE OF FIRST TO DIE In the case of second-to-die insurance,
upon the death of the Insured who dies
first, the owner agrees to mail to the
Principal Office, within 90 days of the
date of death, or as soon thereafter as
is reasonably possible, proof of death.
MISSTATEMENT OF AGE OR On the date of death of the insured, the
SEX death benefit will be reduced or
increased if the Age or sex is
misstated. The adjustment will be based
upon the ratio of the Maximum Payment
for this contract to the Maximum Payment
for the contract issued at the correct
Age or sex.
PROTECTION OF BENEFITS To the extent allowed by law, the
benefits provided by this contract
cannot be reached by the beneficiary's
creditors. No beneficiary may assign,
transfer, anticipate, or encumber the
Contract Value or benefit unless you
give them this right.
PERIODIC REPORT We will mail a report to you at your
last know address at least once a year.
This report will provide the following
information:
- Contract Values in each Sub-Account
and in the Fixed Account;
- the value of the contract if
surrendered;
9
<Page>
- payments made by you and charges
deducted by us since the last report;
- the Outstanding Loan and any other
information required by law; and
- the death benefit.
10
<Page>
INFORMATION ABOUT YOU AND THE BENEFICIARY
OWNER The owner of the contract is shown on
the Specifications Page. The owner may
change the ownership of this contract
without the consent of any beneficiary.
However, an irrevocable beneficiary must
agree to the change in writing.
ASSIGNMENT You may change the ownership of this
contract by sending us a Written
Request. An absolute assignment will
transfer ownership of the contract from
you to another person called the
Assignee.
You may also assign this contract as
collateral to a collateral Assignee. The
limitations on your ownership rights
while a collateral assignment is in
effect are specified in the assignment.
An assignment will take place only when
the Written Request is recorded at our
Principal Office. When recorded, it will
take effect on the date it was signed by
you. Any rights created by the
assignment will be subject to any
payments made or actions taken by us
before the change is recorded. We are
not responsible for assuring that any
assignment or any Assignee's interest is
valid.
BENEFICIARY You name the beneficiary to receive the
net death benefit. The beneficiary's
interest will be affected by any
assignment you make. If you assign this
contract as collateral, all or a portion
of the net death benefit will first be
paid to the collateral Assignee; any
money left over from the amount due the
Assignee will go to those otherwise
entitled.
Your choice of beneficiary may be
revocable or irrevocable. You may change
a revocable beneficiary at any time by
Written Request; but an irrevocable
beneficiary must agree to any change in
writing. You will also need an
irrevocable beneficiary's permission to
exercise other rights and options
granted by this contract. Unless you
have asked otherwise, the beneficiary
will be revocable.
Any change of the beneficiary must be
made while the Insured is living. This
change will take place on the date the
request is signed, even if the Insured
is not living on the day we receive it
at the Principal Office. Any rights
created by the change will be subject to
any payments made, or actions taken,
before we receive the Written Request.
If a beneficiary dies before the
Insured, his or her interest in this
contract will pass to any surviving
beneficiaries in proportion to their
share in the net death benefit, unless
you have requested otherwise. If all
beneficiaries die before the Insured,
the net death benefit will pass to you
or your estate.
COMMON DISASTER The common disaster option may be
OPTION elected by Written Request. If the
common disaster option is in effect on
the date of the Insured's death, the
beneficiary must be alive a certain
number of days following the Insured's
date of death in order to be entitled to
receive a benefit. Otherwise, we will
pay the net death benefit as though the
beneficiary died before the Insured. The
number of days that the beneficiary must
live after the Insured's death is
selected by you when you elect the
common disaster option.
11
<Page>
WHAT YOU SHOULD KNOW ABOUT THE PAYMENTS
PAYMENTS This contract will not be in force until
the payment is made to us. The payment
must be sent to either our Principal
Office or an authorized representative.
If you request it in writing, we will
send you a signed receipt after the
payment is received.
Additional payments under the contract
will be permitted prior to the Final
Payment Date only under the following
circumstances:
1. An additional payment is required
to keep the contract in force
subject to the Grace Period
provisions.
2. An additional payment is required
for reinstatement.
3. Additional payments may be made at
any time provided total payments do
not exceed the Maximum Payment shown
on the Specifications Page. The
minimum amount of the additional
payment is indicated on the
Specifications Page. We may require
Evidence of Insurability if the
additional payment would increase
the net death benefit. A payment
received while there is an
Outstanding Loan on the contract
will be considered a loan repayment
rather than an additional payment.
This contract will terminate 62 days
after a Monthly Processing Date on which
the surrender value is less than zero.
The 62 day period is a grace period. At
least 61 days before the end of the
grace period, we will mail the owner and
any Assignee written notice of the
amount of payment that will be required
to continue this contract in force. The
required payment will be no greater than
the amount required to pay the monthly
deductions for three months as of the
day the grace period began. If that
payment is not paid by the end of the
grace period, the contract will
terminate without value.
The death benefit during the grace
period will be reduced by any overdue
charges. The contract will lapse if the
amount shown in the notice remains
unpaid at the end of the grace period.
The contract terminates on the date of
lapse.
REINSTATEMENT If this contract has lapsed or
foreclosed for failure to pay loan
interest and has not been surrendered,
it may be restored (called "reinstate"
in this contract) within three years
after the date of default or
foreclosure. We will reinstate the
contract on the Monthly Processing Date
following the day we receive all of the
following items:
- a written Application for
reinstatement;
- Evidence of Insurability showing the
Insured is insurable according to our
underwriting rules at that time;
- a payment sufficient to cover the cost
of all contract charges that were due
and unpaid during the grace period;
- a payment large enough to keep the
contract in force for three months;
and
- a payment or reinstatement of any
loans against the contract that
existed at the end of the grace
period.
12
<Page>
Your reinstatement payment will be
allocated to the Fixed Account until we
approve your Application. At that time,
we will transfer the reinstatement
payment, plus accrued interest, as you
directed in your last payment allocation
request.
The Contract Value on the reinstatement
date is:
- the payment to reinstate the contract,
including the interest earned from the
date we receive your payment; plus
- an amount equal to the Contract Value
less any Outstanding Loan on the
default date; less
- the monthly deductions due on the
reinstatement date.
For the purpose of measuring the
surrender charge period, the contract
will be reinstated as of the date of
default. The surrender charge on the
reinstatement date is the charge that
was in effect on the date of default.
13
<Page>
WHAT YOU SHOULD KNOW ABOUT YOUR CONTRACT VALUE
Your Contract Value is the sum of the
Variable Account value and the Fixed
Account value.
ALLOCATION OF INITIAL If you make a payment with your
PAYMENTS Application or at any time before your
right to examine the contract expires,
we may put that payment into the Money
Market Fund Sub-Account on the date it
is received at our Principal Office or
the Date of Issue, if later. We will
transfer the Contract Value as you
directed in your Application, or by
later request, no later than the
expiration of the period during which
you may exercise your right to cancel
the contract.
MONTHLY DEDUCTION Beginning on the date this contract is
issued and on every Monthly Processing
Date until the Final Payment Date, we
will deduct the following monthly
charges Pro Rata from the Contract
Value:
- the Administration Charge;
- the Distribution Fee;
- the Federal & State Payment Tax
Charge;
- the Insurance Protection Charge; and
- the Monthly Maintenance Fee.
These amounts are shown on the
Specifications Page.
Charges allocated to the Fixed Account
will be deducted on a last-in, first-out
basis. This means that we use the most
recent payments to pay the fees.
ADMINISTRATION CHARGE The Administration Charge compensates us
for the cost of providing administrative
services attributable to this Contract.
DISTRIBUTION FEE The Distribution Fee compensates us for
distribution expenses.
FEDERAL & STATE PAYMENT This charge compensates us for federal,
TAX CHARGE state and local taxes we must pay.
INSURANCE PROTECTION The Insurance Protection Charge
compensates us for the cost of providing
a death benefit in excess of the
Contract Value. This charge will not
exceed the guaranteed maximum Insurance
Protection Charge. The guaranteed
maximum Insurance Protection Charge for
any contract month is equal to (a) times
(b), where:
(a) is the rate shown in the Guaranteed
Maximum Monthly Insurance Protection
Table shown on the Specifications
Page, and
(b) is the Insurance Protection Amount.
The insurance protection rates actually
charged will usually be lower than, and
never will be higher than, the
guaranteed rates. We may change the
monthly insurance protection rate from
time to time based on our expectations
as to future experience for mortality,
expenses, taxes, or persistency. Any
change in insurance protection rates
will apply to all individuals in the
same Underwriting Risk Class as the
Insured. We will review the actual
insurance protection rates for
14
<Page>
this contract whenever we change these
rates for new contracts. In any event,
rates will be reviewed no more often
than once each year, but not less than
once in a five-year period.
MONTHLY MAINTENANCE FEE The Monthly Maintenance Fee shown on the
Specifications page will be deducted on
each Monthly Processing Date.
15
<Page>
WHAT YOU SHOULD KNOW ABOUT THE VARIABLE ACCOUNT
VARIABLE ACCOUNT The value of your contract will vary if
it is funded through investments in the
Sub-Accounts of the Variable Account.
This account is separate from our Fixed
Account. We have exclusive and absolute
ownership and control of all assets,
including those in the Variable Account.
However, the portion of assets in the
Variable Account equal to the reserves
and liabilities of the contracts that
are supported by this account will not
be charged with liabilities that arise
out of any other business we conduct.
This account, established to support
variable life insurance contracts, is
registered with the Securities and
Exchange Commission (SEC) as a unit
investment trust under the Investment
Company Act of 1940. It is also governed
by the laws of the State of Delaware.
This account has several Sub-Accounts.
Each Sub-Account invests its assets in a
separate series of a registered
investment company (called a "Fund"). We
reserve the right, when the law allows,
to change the name of the Variable
Account or any of its Sub-Accounts. A
list of the available Sub-Accounts in
which you may choose to invest is on the
Application.
VARIABLE ACCOUNT The portion of the payment you make to
CONTRACT VALUE us which is not allocated to the Fixed
Account will be allocated to the Money
market Fund Sub-Account on the date we
receive the payment or the Date of
Issue, if it occurs after the date we
receive the payment. This value will be
transferred to the Sub-Accounts in
accordance with your payment allocation
no later than the expiration of the
period during which you may exercise
your right to cancel the contract.
Payments made thereafter that are
allocated to the Sub-Accounts will
purchase additional units of the
Sub-Accounts.
The number of units purchased in each
Sub-Account is equal to the portion of
the payment allocated to the
Sub-Account, divided by the value of the
applicable unit as of the valuation date
the payment is received at our Principal
Office, or on the valuation date that
value is transferred to the Sub-Account
from another Sub-Account or the Fixed
Account.
The number of units will remain fixed
unless (1) changed by a subsequent split
of unit value, or (2) reduced because of
a transfer, contract loan, partial
withdrawal, partial withdrawal
transaction charge, monthly deductions,
surrender or surrender charge allocated
to the Sub-Account. Any transaction
described in (2) will result in the
cancellation of an appropriate number of
units. On each valuation date, we will
value the assets of each Sub-Account
where activity has occurred. The
Contract Value in a Sub-account at any
time is equal to the number of units
this contract then has in that
Sub-Account multiplied by the
Sub-Account's unit value. The value of a
unit for any Sub-Account for any
valuation period is determined by
multiplying that Sub-Account's unit
value for the immediately preceding
valuation period by the net investment
factor for the valuation period for
which the unit value is being
calculated. The unit value will reflect
the investment advisory fee and other
expenses incurred by the registered
investment companies.
NET INVESTMENT FACTOR This measures the investment performance
of a Sub-Account during the valuation
period that has just ended. The net
investment factor is the result of (a)
plus (b), divided by (c), minus (d)
where:
(a) is the net asset value per share of
a Fund share held in the Sub-Account
determined at the end of the current
valuation period, plus
16
<Page>
(b) is the per share amount of any
dividend or capital gain
distributions made by the Fund on
shares held in the Sub-Account if
the "ex-dividend" date occurs during
the current valuation period.
(c) is the net asset value per share of
a Fund share held in the Sub-Account
determined as of the end of the
immediately preceding valuation
period.
(d) is a charge for mortality and
expense risks in the valuation
period.The current mortality and
expense risk charge is shown on the
Specifications Page. This charge may
be increased or decreased, but will
never exceed the maximum mortality
and expense risk charge shown on the
Specifications Page. Expense and
mortality results may not adversely
affect this maximum charge.
Since the net investment factor may be
more or less than one, the unit value
may increase or decrease. You bear the
investment risk. We reserve the right,
subject to any required regulatory
approvals, to change the method we use
to determine the net investment factor.
VALUATION DATES AND A valuation date is each day that the
PERIODS New York Stock Exchange (NYSE) is open
for business and any other day that
there is enough trading in the Variable
Account's underlying portfolio
securities to materially affect the
value of the Variable Account. A
valuation period is the period between
valuation dates.
ADDITION, DELETION OR We may not change the investment policy
SUBSTITUTION OF INVESTMENTS of the Variable Account without the
approval of the Insurance Commissioner
of Delaware. This approval process is on
file with the Commissioner of your
state.
We reserve the right, subject to
compliance with applicable law, to add,
delete, or substitute the shares of a
Fund that are held by the Variable
Account or that the Variable Account may
purchase. We also reserve the right to
eliminate the shares of any Fund if they
are no longer available for investment,
or if we believe investing more in any
Fund is no longer appropriate for the
purposes of the Variable Account.
We will notify you before we substitute
any of your shares in the Variable
Account. This will not, however, prevent
the Variable Account from buying other
shares of underlying securities for
other series or classes of policies, or
from permitting a conversion between
series or classes of policies or
contracts when requested by the contract
owner.
We reserve the right to establish other
Sub-Accounts, and to make them available
to any class or series of policies as we
think appropriate. Each new Sub-Account
would invest in a new investment company
or in shares of another open-end
investment company. We also reserve the
right to eliminate or combine existing
Sub-Accounts of the Variable Account and
to transfer the assets between
Sub-Accounts, when allowed by law.
If we make any substitutions or changes
that we believe are necessary or
appropriate, we may make changes in this
contract by written notice to reflect
the substitution or change. If we think
it is in the best interests of our
contract owners, we may operate the
Variable Account as a management company
under the Investment Company Act of
1940, or we may de-register it under
that Act if registration is no longer
required. We may also combine it with
other Separate Accounts.
17
<Page>
FEDERAL TAXES If we must pay taxes on the Variable
Account, we will charge you for that
tax. Although the Variable Account is
currently not taxable, we reserve the
right to charge for taxes if it becomes
taxable.
SPLITTING OF UNITS We reserve the right to split the value
of a unit, to either increase or
decrease the number of units. Any
splitting of units will have no material
effect on contract benefits.
18
<Page>
WHAT YOU SHOULD KNOW ABOUT THE FIXED ACCOUNT
FIXED ACCOUNT The Fixed Account is part of our General
Account. The General Account consists of
all assets owned by us, other than those
in the Variable Account and other
Separate Accounts. Except as limited by
law, we have sole control over the
investment of these General Account
assets. You do not share directly in the
investment experience of the General
Account, but are allowed to allocate and
transfer funds into the Fixed Account.
FIXED ACCOUNT INTEREST The interest rate credited to Contract
RATES Value in the Fixed Account is set by us.
We will review this interest rate from
time to time, at least once a year. The
following guarantees apply to money in
the Fixed Account.
- The interest rate in effect on the
Date of Issue is guaranteed until the
next contract anniversary, unless you
borrow money from that Contract Value.
- The interest rate in effect on the day
funds are transferred from a
Sub-Account of the Variable Account to
the Fixed Account is guaranteed until
the next contract anniversary, unless
you borrow from that Contract Value.
- The interest rate in effect on a
contract anniversary is guaranteed for
one year for those Contract Values in
the Fixed Account on the contract
anniversary as long as those values
remain in the Fixed Account and are
not borrowed.
- The interest rate(s) we use for that
portion of the Contract Value that
equals the Outstanding Loan will be at
least the minimum rates shown on the
Specifications Page. One of the rates
shown is the Preferred Loan Rate which
applies only to the portion of the
Outstanding Loan that is secured by
Earnings.
FIXED ACCOUNT CONTRACT On each Monthly Processing Date, the
VALUE Contract Value of the Fixed Account is
equal to:
- the Contract Value in this account on
the preceding Monthly Processing Date
increased by one month's interest,
plus
- payments received since the last
Monthly Processing Date that are
allocated to the Fixed Account plus
the interest accrued from the date the
payments are received by us, plus
- Variable Account Contract Value
transferred to the Fixed Account from
any Sub-Accounts since the preceding
Monthly Processing Date, increased by
interest from the date the Contract
Value is transferred, minus
- Contract Value transferred from the
Fixed Account to a Sub-Account since
the preceding Monthly Processing Date
and interest accrued on these
transfers from the transfer date to
the Monthly Processing Date, minus
- partial withdrawals from the Fixed
Account, partial withdrawal
transaction charges and surrender
charges since the last Monthly
Processing Date, interest accrued on
these withdrawals, and charges from
the withdrawal date to the Monthly
Processing Date, minus
- the portion of the Monthly Deductions
allocated to the Contract Value in the
Fixed Account.
19
<Page>
During any contract month the Fixed
Account Contract Value will be
calculated on a consistent basis.
BASIS OF VALUE OF THE We base the minimum surrender value in
FIXED ACCOUNT the Fixed Account on the minimum Fixed
Account interest rates and mortality
table shown on the Specifications Page.
Actual Contract Values are based on
interest and insurance protection rates
that we set. We have filed a detailed
description of the way we determine this
value with the State Insurance
Department. All values equal or exceed
the minimums required by law in the
state in which this contract is
delivered.
20
<Page>
WHAT YOU SHOULD KNOW ABOUT TRANSFERS
While the contract is in force, you may
transfer amounts between the Fixed
Account and the Sub-Accounts or among
Sub-Accounts on request.
You may transfer, without charge, all of
the Contract Value in the Variable
Account to the Fixed Account once during
the first 24 months after the contract
is issued in order to convert to a
fixed-only product. If you do so, future
payments will be allocated to the Fixed
Account unless you specify otherwise.
All other transfers are subject to the
following rules and will be permitted
with our approval.
We will determine the minimum and
maximum amounts that may be transferred
according to the rules that are in
effect at the time of the transfer.
We also reserve the right to limit the
number of transfers that can be made in
each contract year and set other
reasonable rules controlling transfers.
If a transfer would reduce the Contract
Value in a Sub-Account to less than the
current minimum balance required for
such accounts, we reserve the right to
include the remaining value in the
amount transferred.
You will not be charged for the first
twelve transfers in a contract year, but
a transfer charge of up to $25 may be
made on each additional transfer. Any
transfer charge will be deducted from
the amount that is transferred. There is
no charge for transfers that result from
a contract loan or repayment of a loan.
21
<Page>
WHAT YOU SHOULD KNOW ABOUR BORROWING FROM YOUR CONTRACT
To borrow form this contract, the only
collateral you will need is the contract
itself.
AMOUNT YOU MAY BORROW The maximum loan amount is 90% of the
Contract Value less the surrender
charge. You may borrow an amount subject
to the minimum shown on the
Specifications Page, up to the maximum
loan amount minus any Outstanding Loan.
If you do not specify from which
accounts you want to borrow, we will
allocate the loan Pro Rata. In order to
secure the Outstanding Loan, we will
transfer the Contract Value in each
Sub-Account equal to the contract loan
allocated to each Sub-Account to the
Fixed Account.
LOAN INTEREST You will pay interest on your loan at an
annual rate indicated on the
Specifications Page. Interest accrues
daily and is payable at the end of each
contract year. Any interest that is not
paid on time will be added to the loan
principal and bear interest at the same
rate. If this makes the principal higher
than the Contract Value in the Fixed
Account, we will offset this shortfall
by transferring funds from the
Sub-Accounts to the Fixed Account. We
will allocate the transferred amount
among the Sub-Accounts in the same
proportion that the value in each
Sub-Account has to the total value in
all of them.
REPAYING THE You may repay the Outstanding Loan at
OUTSTANDING LOAN any time before this contract lapses.
When you repay it, we will transfer the
Contract Value that is securing the loan
in the Fixed Account to the various
Sub-Accounts and increase the value in
them. You may tell us how to allocate
repayments. Otherwise, we may allocate
them according to the most recent
payment allocation choices you have
made. Loan repayments made to the
Variable Account cannot be higher than
the amounts you transferred to secure
the Outstanding Loan.
FORECLOSURE If at any time the amount of the
Outstanding Loan is higher than the
Contract Value minus the surrender
charge, we will terminate the contract.
We will mail a notice of this
termination to the last known address of
you and any Assignee. If the excess
Outstanding Loan is not paid within 62
days after this notice is mailed, the
contract will terminate with no value.
You may reinstate this contract
according to the Reinstatement
provision.
22
<Page>
WHAT YOU SHOULD KNOW ABOUT SURRENDERS AND PARTIAL WITHDRAWALS
SURRENDER You may cancel this contract and receive
its surrender value as long as the
Insured is living on the date we receive
your Written Request at our Principal
Office. The contract will be canceled on
that day. You may choose to receive the
surrender value in a lump sum or under a
benefit option.
SURRENDER VALUE The surrender value equals the Contract
Value minus the Outstanding Loan and
surrender charge. You will find the
surrender charge on the Specifications
Page.
PARTIAL WITHDRAWALS You may withdraw part of the surrender
value on Written Request. Each
withdrawal must be at least $1,000. We
will deduct a 2% withdrawal transaction
charge (maximum $25) from the Contract
Value each time you make a partial
withdrawal.
We will not permit a partial withdrawal
if it reduces the Contract Value amount
to less than the minimum amount shown on
the Specifications Page.
The Face Amount will be reduced
proportionately based on the ratio of
the amount of the partial withdrawal and
charges to the Contract Value on the
date of withdrawal. The Contract Value
will be reduced by the amount of the
partial withdrawal, the partial
withdrawal transaction charge and any
applicable surrender charges.
If you do not allocate a partial
withdrawal and its charges between the
Fixed Account and each Sub-Account, we
will automatically allocate them Pro
Rata.
FREE WITHDRAWAL AMOUNT The free withdrawal amount will not be
subject to the surrender charge as
described on the Specifications Page.
This amount equals (a) minus (b), where:
(a) is the free withdrawal amount shown
on the Specifications Page, and
(b) is the total of the withdrawals (or
portions of them) made in the same
contract year that were exempt from
the surrender charge.
The free withdrawal amount is first
deducted from Earnings. Withdrawals in
excess of the free withdrawal amount are
deducted from payments not previously
considered withdrawn on a last-in,
first-out basis. Surrender charges
applicable to the excess withdrawal are
described on the Specifications Page.
POSTPONEMENT OF We may postpone any transfer from the
PAYMENT Variable Account, or payment of any
amount payableon:
- surrender
- partial withdrawal
- transfer
- contract loan
- death of the Insured
The postponement will continue during
any period when:
- trading on the New York Stock Exchange
is restricted as determined by the
Securities and Exchange Commission, or
the New York Stock Exchange is closed
for days other than weekends and
holidays, or
23
<Page>
- the Securities and Exchange Commission
by order has permitted such
suspension, or
- the Securities and Exchange Commission
has determined that such an emergency
exists that disposal of portfolio
securities or valuation of assets is
not reasonably practical.
We also may postpone any transfer from
the Fixed Account or payment of any
portion of the amount payable on a
surrender, partial withdrawal or
contract loan from the Fixed Account for
not more than six months form the day we
receive your Written Request and your
contract, if it is required. If we
postpone those payments for 30 days or
more, the amount postponed will earn
interest during that period of not less
than 3% per year or such higher rate as
required by law. We will not postpone
payments to make payments on our
policies.
24
<Page>
WHAT YOU SHOULD KNOW ABOUT THE DEATH BENEFIT
NET DEATH BENEFIT If the Insured dies before the Final
Payment Date, we will pay the net death
benefit upon receipt at the Principal
Office of proof of the Insured's death.
The net death benefit is the Face Amount
at the time of death or the guideline
minimum sum insured, if greater, reduced
by any Outstanding Loan, rider charges
and monthly deductions due and unpaid
through the contract month in which the
Insured dies, as well as any partial
withdrawals and surrender charges. We
will pay interest from the date of death
to the date the net death benefit is
paid. If the Insured dies after the
Final Payment Date, we will pay the
Contract Value minus any Outstanding
Loans. We will pay interest from the
date we receive the death certificate.
If you choose a lump sum payment, the
interest rate will be at least 3% a
year, or the minimum rate set by law, if
greater.
REQUIRED MINIMUM In order to qualify as "life insurance"
AMOUNT OF DEATH BENEFIT under the federal tax law, this contract
must provide a minimum death benefit.
This is called the "guideline minimum
sum insured" in the tax code. This is
calculated by multiplying the Contract
Value by the percentages shown on the
Specifications Page. The guideline
minimum sum insured varies by Age. The
amounts shown in the Table are
determined according to federal tax law,
and will be adjusted according to any
changes in that law.
25
<Page>
WHAT YOU SHOULD KNOW ABOUT THE BENEFIT OPTIONS
BENEFIT OPTIONS You may choose one of the following
options for receiving the surrender
value or the net death benefit. We will
give the payee a certificate describing
the benefit option you selected. If you
make no choice, we will pay the benefits
in a single, lump sum.
We will pay all benefits from the Fixed
Account. Benefits may not be allocated
to the Variable Account. The amounts
payable under these options, for each
$1,000 applied, will be:
(a) the rate per $1,000 of benefit based
on our non-guaranteed current
benefit option rates for this class
of contracts, or
(b) the rate in this contract for the
applicable benefit option, whichever
is greater.
If you choose a benefit option, the
beneficiary may, when filing a proof of
claim, pay us any amount that otherwise
would be deducted from the proceeds.
OPTION A: BENEFITS FOR A We will make equal payments for any
SPECIFIED NUMBER OF selected number of years up to 30 years.
YEARS (TABLE A) These payments may be made annually,
semi-annually, quarterly or monthly,
whichever your choose.
OPTION B: LIFETIME Benefits are based on the age of the
MONTHLY BENEFIT (TABLE B) person who receives the money (called
the payee) on the date the first payment
will be made. You may choose one of the
three following options to specify when
benefits will cease:
- when the payee dies with no further
benefits due (Life Annuity);
- when the payee dies but not before the
total benefit payments made by us
equals the amount applied under this
option (Life Annuity with Installment
Refund); or
- when the payee dies but not before 10
years have elapsed from the date of
the first payment (Life Annuity with
Payments Guaranteed for 10 years).
OPTION C: INTEREST We will pay interest at a rate we
BENEFITS determine each year. It will not be less
than 3% per year. We will make payments
annually, semi-annually, quarterly, or
monthly, whichever is preferred. These
benefits will stop when the amount left
has been withdrawn. If the payee dies,
any unpaid balance plus accrued interest
will be paid in a lump sum.
OPTION D: BENEFITS FOR A Interest will be credited to the unpaid
SPECIFIED AMOUNT balance and we will make payments until
the unpaid balance is gone. We will
credit interest at a rate we determine
each year, but no less than 3%. We will
make payments annually, semi-annually,
quarterly, or monthly, whichever is
preferred. The benefit level chosen must
provide for an annual benefit of at
least 8% of the amount applied.
OPTION E: LIFETIME We will pay a benefit jointly to two
MONTHLY BENEFITS FOR TWO payees during their joint lifetime.
PAYEES (TABLE E) After one payee dies, the benefits to
the survivor will be:
- the same as the original amount, or
- in an amount equal BETA of the
original amount.
26
<Page>
Benefits are based on the payees' ages
on the date the first payment is due.
Benefits will end when the second payee
dies.
SELECTING BENEFIT The amount we apply under any one option
OPTIONS for any one payee must be at least
$5,000, and the periodic payment for any
one payee must be at least $50.
You may change any option you select
before the net death benefit is paid,
subject to the Owner and Beneficiary
provisions. If you make no selection,
the beneficiary may choose an option
when the benefits become payable.
If the amount of monthly income benefits
under Option B for the age of the payee
is the same for different periods
certain, the payee will be entitled to
the longest period certain for the
payee's age.
You may give the beneficiary the right
to change from Option C or D to any
other option at any time. If Option C or
D is chosen by the payee when this
contract becomes a claim, the payee may
reserve the right to change to any other
option. The payee who elects to change
options must be the payee under the
option selected.
ADDITIONAL DEPOSITS An additional deposit may be added to
any proceeds when they are applied under
Option B and E. We reserve the right to
limit the amount of any additional
deposit. We may levy a charge of no more
than 3% on any additional deposits.
RIGHTS AND LIMITATIONS A payee has no right to assign any
amount payable under any option, nor to
demand a lump sum benefit in place of
any amount payable under Options B or E.
A payee will have the right to receive a
lump sum in place of installments under
Option A. The payee must provide us with
a Written Request to reserve this right.
If the right to receive a lump sum is
exercised, we will determine the lump
sum benefit at the same interest rates
used to calculate the installments. The
amount left under Option C and any
unpaid balance under Option D, may be
withdrawn only as noted in the Written
Request selecting the option.
A corporate or fiduciary payee may
select only Option A, C or D, subject to
our approval.
BENEFIT DATES The first payment under any option,
except Option C, will be due on the date
this contract matures, by death or
otherwise, unless another date is
designated. Benefits under Option C
begin at the end of the first benefit
period.
The last payment under any option will
be made as stated in the option's
description. However, if a payee under
Options B or E dies before the due date
of the second monthly payment, the
amount applied, minus the first monthly
payment, will be paid in a lump sum or
under any option other than Option E.
This payment will be made to the
surviving payee under Option E or the
succeeding payee under Option B.
BENEFIT RATES The Benefit Option Tables show benefit
amounts for Option A, B and E. If you
choose one of these options, either
within five years of the date of
surrender or the date the proceeds are
otherwise payable, we will apply either
the benefit rates listed in the Tables,
or the rates we use on the date the
proceeds are paid, whichever is more
favorable. Benefits that begin more than
five years after that date, or as a
result of additional deposits, will be
based on the rates we use on the date
the first benefit is due.
27
<Page>
BENEFIT OPTIONS
TABLE A
BENEFITS FOR SPECIFIED NUMBER OF
YEARS
Payment for Each $1,000 of Contract Value
Applied
[These tables are based on an annual interest rate of 3 1/2%.]
<Table>
<Caption>
SEMI-
YEARS ANNUAL ANNUAL QUARTERLY MONTHLY
========= =========== ============ ========== =============
[1 1000.00 504.30 253.23 84.65
2 508.60 256.49 128.79 43.05
3 344.86 173.91 87.33 29.19
4 263.04 132.65 66.61 22.27
5 213.99 107.92 54.19 18.12
6 181.32 91.44 43.92 15.35
7 158.01 79.69 40.01 13.38
8 140.56 70.88 35.59 11.90
9 127.00 64.05 32.16 10.75
10 116.18 58.59 29.42 9.83
11 107.34 54.13 27.18 9.09
12 99.98 50.42 25.32 8.46
13 93.78 47.29 23.75 7.94
14 88.47 44.62 22.40 7.49
15 83.89 42.31 21.24 7.10
16 79.89 40.29 20.23 6.76
17 76.37 38.51 19.34 6.47
18 73.25 36.94 18.55 6.20
19 70.47 35.54 17.85 5.97
20 67.98 34.28 17.22 5.75
21 65.74 33.15 16.65 5.56
22 63.70 32.13 16.13 5.39
23 61.85 31.19 15.66 5.24
24 60.17 30.34 15.24 5.09
25 58.62 29.56 14.85 4.96
26 57.20 28.85 14.49 4.84
27 55.90 28.19 14.15 4.73
28 54.69 27.58 13.85 4.63
29 53.57 27.02 13.57 4.53
30 52.53 26.49 13.3 4.45]
</Table>
28
<Page>
BENEFIT OPTIONS (CONTINUED)
LIFE INCOME OPTION TABLES
MONTHLY ANNUITY BENEFIT PAYMENT
FOR EACH $1,000 OF CONTRACT VALUE APPLIED
TABLE B
<Table>
<Caption>
AGE LIFE ANNUITY WITH LIFE LIFE ANNUITY
NEAREST PAYMENTS GUARANTEED ANNUITY WITH INSTALLMENT
BIRTHDAY FOR 10 YEARS REFUND
- ------------------- --------------------------------- ---------------- -------------------
[50 4.22 4.24 4.14
51 4.28 4.31 4.19
52 4.34 4.37 4.25
53 4.41 4.44 4.31
54 4.48 4.52 4.37
55 4.55 4.59 4.43
56 4.63 4.68 4.50
57 4.71 4.76 4.57
58 4.80 4.86 4.65
59 4.89 4.96 4.73
60 4.98 5.06 4.82
61 5.08 5.18 4.90
62 5.19 5.30 5.00
63 5.30 5.43 5.10
64 5.42 5.56 5.20
65 5.55 5.71 5.31
66 5.68 5.87 5.43
67 5.81 6.04 5.55
68 5.96 6.22 5.68
69 6.11 6.41 5.81
70 6.26 6.62 5.96
71 6.43 6.84 6.11
72 6.60 7.08 6.27
73 6.77 7.34 6.44
74 6.95 7.62 6.62
75 7.13 7.91 6.81]
</Table>
[These tables are based on an annual interest rate of
3 1/2% and the 1983(a) Individual Mortality Table using a blend
reflecting 40% of the male rate and 60% of the female rate.]
29
<Page>
BENEFIT OPTIONS (CONTINUED)
MONTHLY ANNUITY BENEFIT PAYMENT
FOR EACH $1,000 OF CONTRACT VALUE APPLIED
<Table>
<Caption>
TABLE E1 TABLE E2
-------------------------------------------------------- -----------------------------------------------------------
JOINT AND SURVIVOR LIFE ANNUITY JOINT AND TWO-THIRDS SURVIVOR LIFE ANNUITY
OLDER AGE OLDER AGE
-------------------------------------------------------- -----------------------------------------------------------
50 55 60 65 70 75 80 50 55 60 65 70 75 80
------- ------- ------- ------- -------- ------- ------- ------- -------- ------- ------- -------- -------- --------
Y [50 3.91 3.97 4.02 4.05 4.07 4.09 4.10 4.25 4.40 4.57 4.76 4.96 5.18 5.39
O
U 55 4.18 4.26 4.32 4.36 4.39 4.41 4.60 4.80 5.02 5.26 5.50 5.75
N
G 60 4.54 4.65 4.73 4.78 4.81 5.08 5.35 5.63 5.92 6.21
E
R 65 5.04 5.19 5.29 5.35 5.74 6.10 6.46 6.82
70 5.75 5.95 6.08 6.67 7.15 7.62
A
G 75 6.77 7.06 8.04 8.69
E
80 8.29 10.05]
</Table>
[These tables are based on an annual interest rate of 3 1/2%
and the 1983(a) Individual Mortality Table using a proportional
blend of 50% male and 50% female.]
MODIFIED SINGLE PAYMENT VARIABLE LIFE INSURANCE CONTRACT
NON-PARTICIPATING
30