Annuity Contract Schedule Page between John Doe and [Issuer]

Contract Categories: Business Finance › Purchase Agreements
Summary

This contract schedule outlines the terms for an annuity agreement between John Doe (and joint owner Jane Doe, if applicable) and the issuing company. It specifies purchase payment requirements, transfer and withdrawal rules, contract charges, and annuity payment options. The contract includes details such as minimum and maximum payment amounts, fees, withdrawal penalties, and guaranteed annuity rates based on age and selected options. The agreement is effective as of April 15, 2010, with annuity payments scheduled to begin on April 1, 2065, and is subject to the terms and conditions set by the issuer.

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EX-4.C 3 schedulepages40875.htm CONTRACT SCHEDULE PAGE S40875-ADV

EX-4c. Contract Schedule Page (Base)-S40875-ADV

Contract Schedule

Owner:
[John Doe]
Contract Number:
[??687456]
[Joint Owner:
[Jane Doe]]
Issue Date:
[04/15/10]
Annuitant:
[John Doe]
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
  
Product Fee:
[0.25]%
Contract Maintenance Charge:
$[50.00] each Contract Year
Designated Amount:
Contract Value must be $[100,000.00] to waive the Contract Maintenance Charge
   
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
6.50%
1
6.00%
2
5.00%
3
4.00%
4
3.00%
5
2.00%
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]%

Riders:
[The applicable riders based on the information from the application will populate this area.]



S40875-ADV 3


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 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]

S40875-ADV [3A]