Common use of Designation of Beneficiary Clause in Contracts

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record the change or addition. Any such change or addition will not impact any payment made or other action taken by us before the change or addition was received and recorded by us at our Service Center.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if any Owner, or Annuitant in the Annuitant or Owner case of a Non-Natural Owner, dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Owner, or Annuitant or in the case of a Non-Natural Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – — You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of any Owner, or Annuitant in the Annuitant or case of a Non-Natural Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition addition, unless otherwise specified by the Owner, will generally take effect only when we receive all necessary documents and record on the date the notice of change or addition. Any such change or addition will not impact is signed by the Owner, subject to any payment payments made or other action actions taken by us before prior to receipt of the change or addition was received and recorded by us at our Service Centernotice.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – — You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record the change or addition. Any such change or addition will not impact any payment made or other action taken by us before the change or addition was received and recorded by us at our Service Center.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – — You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record the change or addition. Any such change or addition will not impact any payment made or other action taken by us before the change or addition was received and recorded by us at our Service Center.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – — You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record on the date the notice of change or addition. Any such change or addition will not impact is signed by the Owner, subject to any payment payments made or other action actions taken by us before prior to our receipt of the change or addition was received and recorded by us at our Service Centernotice.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – — You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record the change or additionnotice is signed, subject to our receipt. Any such change or addition will not impact any payment made or other action taken by us before the change or addition was received and recorded by us at our Service Center.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – — You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition addition, unless otherwise specified by the Owner, will generally take effect only when we receive all necessary documents and record on the date the notice of change or addition. Any such change or addition will not impact is signed by the Owner, subject to any payment payments made or other action actions taken by us before prior to our receipt of the change or addition was received and recorded by us at our Service Centernotice.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – — You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record on the date the notice of change or addition. Any such change or addition will not impact is signed by the Owner, subject to any payment payments made or other action actions taken by us before prior to our receipt of the change or addition was received and recorded by us at our Service Centernotice.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record the change or additionnotice is signed, subject to our receipt. Any such change or addition will not impact any payment made or other action taken by us before the change or addition was received and recorded by us at our Service Center.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – — You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record on the date the notice of change or addition. Any such change or addition will not impact is signed by the Owner, subject to any payment payments made or other action actions taken by us before prior to our receipt of the change or addition was received and recorded by us at our Service Center.notice. ICC10:10-1185

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – — You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record the change or addition. Any such change or addition will not impact be subject to any payment made or other action taken by us before the change or addition was received and recorded by us at our Service Center.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – — You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record on the date the notice of change or addition. Any such change or addition will not impact is signed by the Owner, subject to any payment payments made or other action actions taken by us before prior to our receipt of the change or addition was received and recorded by us at our Service Center.notice. ICC10:10-1180

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – - You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, Beneficiary subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record the change notice is signed, subject to any payments made or additionany actions taken by us prior to our receipt of the notice. Any such change or addition will not impact any payment made or other action taken by us before the change or addition was received and recorded by us at our Service Center.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – — You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record on the date the notice of change or addition. Any such change or addition will not impact is signed by the Owner, subject to any payment payments made or other action actions taken by us before prior to receipt of the change or addition was received and recorded by us at our Service Center.notice. ICC11:10-1212

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record on the date the notice of change or addition. Any such change or addition will not impact is signed by the Owner, subject to any payment payments made or other action actions taken by us before prior to receipt of the change or addition was received and recorded by us at our Service Center.notice. 10-2225 20

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – — You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record the change notice is signed, subject to any payments made or additionany actions taken by us prior to our receipt of the notice. Any such change or addition will not impact any payment made or other action taken by us before the change or addition was received and recorded by us at our Service Center.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s 's right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s 's estate. Adding or Changing Your Beneficiary – - You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record the change or addition. Any such change ANNUITY PROVISIONS Choice of Annuity Date - Unless otherwise changed as provided below, the Annuity Date is shown in the Contract Specifications. We assigned the Annuity Date based on the Contract Type chosen and the Annuitant's Age shown in the application for this Contract. If there are Joint Annuitants, the Annuity Date was based on the younger Annuitant's birthday. The Annuity Date may be changed by providing proper notice to us at least ten (10) Business Days prior to the current Annuity Date or addition will new Annuity Date, whichever is earlier, subject to any applicable state law or the Code. The new Annuity Date may not impact any payment made be earlier than the first Contract Anniversary and must occur on or other action taken by us before the change day the Annuitant reaches his or addition was received and recorded her 100th birthday, or earlier, as required by us at our Service Centerany applicable state law or the Code. If there are Joint Annuitants, the Annuity Date will be based on the younger Annuitant's birthday. You may be subject to additional restrictions under your Qualified Plan. You should consult with your Qualified Plan administrator before you elect an Annuity Date.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the any Owner or Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Owner or Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – — You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the any Owner or Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiaryrequest. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record on the date the notice of change or addition. Any such change or addition will not impact is signed by the Owner, subject to any payment payments made or other action actions taken by us before prior to receipt of the change or addition was received and recorded by us at our Service Centernotice.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record on the date the notice of change or addition. Any such change or addition will not impact is signed by the Owner, subject to any payment payments made or other action actions taken by us before prior to our receipt of the change or addition was received and recorded by us at our Service Centernotice.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record the change notice is signed, subject to any payments made or additionany actions taken by us prior to our receipt of the notice. Any such change or addition will not impact any payment made or other action taken by us before the change or addition was received and recorded by us at our Service Center.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – — You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record on the date the notice of change or addition. Any such change or addition will not impact is signed by the Owner, subject to any payment payments made or other action actions taken by us before prior to receipt of the change or addition was received and recorded by us at our Service Centernotice.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record the change or additionnotice is signed, subject to our receipt. Any such change or addition will not impact any payment made or other action taken by us before the change or addition was received and recorded by us at our Service Center. Exhibit 4(a) ANNUITY PROVISIONS Choice of Annuity Date – Unless otherwise changed as provided below, the Annuity Date is shown in the Contract Specifications. If you did not select an Annuity Date in the application for this contract, we assigned the Annuity Date based on the Contract Type chosen and the Annuitant’s Age shown in the application for this Contract. If there are Joint Annuitants, the Annuity Date was based on the younger Axxxxxxxx’s birthday. The Annuity Date may be changed by providing proper notice to us at least ten (10) Business Days prior to the current Annuity Date or new Annuity Date, whichever is earlier, subject to any applicable state law or the Code. The new Annuity Date may not be earlier than the first Contract Anniversary and must occur on or before the later of the Annuitant’s 90th birthday or the tenth (10th) Contract Anniversary, or earlier, as required by any applicable state law or the Code. If there are Joint Annuitants, the Annuity Date will be based on the younger Axxxxxxxx’s birthday. You may be subject to additional restrictions under your Qualified Plan. You should consult with your Qualified Plan administrator before you elect an Annuity Date.

Designation of Beneficiary. The NOTE: ANY AMOUNT REMAINING IN THE ACCOUNT THAT IS NOT DISPOSED OF BY A PROPER DESIGNATION OF BENEFICIARY WILL BE DISTRIBUTED TO YOUR ESTATE (UNLESS OTHERWISE REQUIRED BY THE LAWS OF YOUR STATE OF RESIDENCE). YOU MAY CHANGE THE BENEFICIARY(IES) NAMED BELOW AT ANYTIME BY FILING A NEW DESIGNATION OF BENEFICIARY WITH THE CUSTODIAN. ANY SUBSEQUENT DESIGNATION FILED WITH THE CUSTODIAN WILL REVOKE ALL PRIOR DESIGNATIONS, EVEN IF THE SUBSEQUENT DESIGNATION DOES NOT DISPOSE OF YOUR ENTIRE ACCOUNT. As Depositor, I hereby make the following designation of beneficiary in accordance with the Xxxxxx Street Funds Traditional Individual Retirement Custodial Account or Xxxx Individual Retirement Custodial Account: In the event of my death, pay any interest I may have under my Account to the following Primary Beneficiary is or Beneficiaries who survive me. Make payment in the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds proportions specified below (or any remaining annuity payments) equally, unless otherwise in equal proportions if no different proportions are specified). If any Primary Beneficiary predeceases me, his share is to be divided among the Annuitant or Owner, that Primary Beneficiaries who survive me in the relative proportions assigned to each such surviving Primary Beneficiary’s interest will go . PRIMARY BENEFICIARY OR BENEFICIARIES: Print Full Name Relationship Date of Birth Address City State Zip financial obligations. Due to any other possible consequences of giving up my community or marital property interest in this IRA, I have been advised to see a tax professional or legal adviser. I hereby consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequence that may result. No tax or legal advice was given to me by the Custodian or Sponsor. SIGNATURE OF SPOUSE DATE Social Security Number Proportion % X Print Full Name Relationship Date of Birth Address City State Zip SIGNATURE OF WITNESS FOR SPOUSE DATE 5 | Information and Certifications Concerning Tax Withholding BY SIGNING THIS FORM, THE DEPOSITOR CERTIFIES THAT HE/SHE IS A U.S. PERSON (A U.S. CITIZEN OR A RESIDENT ALIEN) OR A FOREIGN PERSON (A NONRESIDENT ALIEN), AS INDICATED BY CHECKING THE APPROPRIATE BOX BELOW, AND MAKES THE RELATED CERTIFICATIONS. Depositor is (check one) Social Security Number Proportion % � A U.S. Person. Depositor certifies that the number shown in Part 1 If none of the Primary Beneficiaries namedsurvives me, according pay any interest I may have under my Account to their respective interests, unless otherwise the following Alternate Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If you leave any Alternate Beneficiary predeceases me, his share is to be divided among the Alternate Beneficiaries who survive me in the relative proportions assigned to each such surviving Alternate Beneficiary. ALTERNATE BENEFICIARY OR BENEFICIARIES: Print Full Name Relationship Date of Birth Address City State Zip of this Adoption Agreement is the Depositor’s correct Social Security number (or the Depositor is waiting to be issued a Social Security number); and Depositor is not subject to backup withholding because: (a) the Depositor is exempt from backup withholding, or (b) the Depositor has not been notified by the Internal Revenue Service (IRS) that the Depositor is subject to backup withholding as a result of failure to report all interest or dividends, or (c) the IRS has notified the Depositor that the Depositor is no surviving Beneficiarylonger subject to backup withholding. (NOTE: Cross out this sentence if the Depositor has been notified by the IRS that the Depositor is currently subject to backup withholding because of failure to report all interest and dividends on the Depositor’s tax return.) � A Foreign Person. Depositor acknowledges that the IRS does not require consent to any provisions of this document other than the Form W-8BEN certification required to avoid backup withholding and qualify for a tax treaty rate Social Security Number Proportion % of withholding (see IRS Publication 515). Print Full Name Relationship Date of Birth Address City State Zip 6 | Bank Information (Optional) COMPLETE THIS SECTION IF YOU INTEND TO MAKE ACH AND WIRE REDEMPTIONS OR UTILIZE THE AUTOMATIC INVESTMENT OR SYSTEMATIC WITHDRAWAL PLANS. To exercise these investment and redemption privileges, your estate may receive bank account information must be on file. Please attach a voided check or deposit slip for the death benefit proceedsbank account you wish to use AND complete the section below. If Social Security Number Proportion % IMPORTANT: THIS DESIGNATION OF BENEFICIARY MAY HAVE IMPORTANT TAX OR ESTATE PLANNING EFFECTS. IF YOU CANNOT ACCOMPLISH BANK NAME BRANCH OFFICE (IF APPLICABLE) YOUR ESTATE PLANNING OBJECTIVES BY USING THIS PART 4 TO DESIGNATE YOUR BENEFICIARY(IES) (FOR EXAMPLE, IF YOU WISH TO PROVIDE THAT THE SURVIVING CHILDREN OF A BENEFICIARY WHO BANK ADDRESS (DO NOT USE P.O. BOX) PREDECEASES YOU SHOULD TAKE THAT BENEFICIARY’S SHARE BY RIGHT OF REPRESENTATION), YOU MAY SUBMIT ANOTHER FORM OF WRITTEN BENEFICIARY DESIGNATION TO THE CUSTODIAN. ALSO, IF YOU CITY STATE ZIP ARE MARRIED AND RESIDE IN A COMMUNITY PROPERTY OR MARITAL PROPERTY STATE (ARIZONA, CALIFORNIA, IDAHO, LOUISIANA, NEVADA, NEW MEXICO, TEXAS, WASHINGTON OR WISCONSIN), YOU MAY NEED TO NAME(S) ON YOUR BANK ACCOUNT OBTAIN YOUR SPOUSE’S CONSENT IF YOU HAVE NOT DESIGNATED YOUR SPOUSE AS PRIMARY BENEFICIARY FOR AT LEAST HALF OF YOUR ACCOUNT. SEE YOUR LAWYER OR OTHER TAX PROFESSIONAL FOR ADDITIONAL INFORMATION AND ADVICE. SPOUSAL CONSENT: (THIS SECTION SHOULD BE REVIEWED IF THE DEPOSITOR IS MARRIED AND DESIGNATES A BENEFICIARY OTHER THAN THE SPOUSE. IT IS THE DEPOSITOR’S RESPONSIBILITY TO DETERMINE IF THIS SECTION APPLIES. THE DEPOSITOR MAY NEED TO CONSULT WITH LEGAL COUNSEL. NEITHER THE CUSTODIAN NOR THE SPONSOR ARE LIABLE FOR ANY CONSEQUENCES RESULTING FROM A FAILURE OF THE DEPOSITOR TO PROVIDE PROPER SPOUSAL CONSENT.) I am the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death spouse of the Annuitant or Owner, by providing us with above-named Depositor. I acknowledge that I have received a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent full and reasonable disclosure of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming my spouse’s property and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record the change or addition. Any such change or addition will not impact any payment made or other action taken by us before the change or addition was received and recorded by us at our Service Center.BANK ACCOUNT NUMBER BANK ABA NUMBER Account Type (check one): � Checking � Savings

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record the change notice is signed, subject to any payments made or additionany actions taken by us prior to our receipt of the notice. Any such change or addition will not impact any payment made or other action taken by us before the change or addition was received and recorded by us at our Service Center.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – — You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record on the date the notice of change or addition. Any such change or addition will not impact is signed by the Owner, subject to any payment payments made or other action actions taken by us before prior to our receipt of the change or addition was received and recorded by us at our Service Centernotice.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record on the date the notice of change or addition. Any such change or addition will not impact is signed by the Owner, subject to any payment payments made or other action actions taken by us before prior to receipt of the change or addition was received and recorded by us at our Service Center.notice. ICC12:10-1225 20

Designation of Beneficiary. Designation of Beneficiary — The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – Adding or Changing Your Beneficiary — You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record the change or addition. Any such change or addition will not impact any payment made or other action taken by us before the change or addition was received and recorded by us at our Service Center.

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Annuitant or Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of the Annuitant or Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record on the date the notice of change or addition. Any such change or addition will not impact is signed by the Owner, subject to any payment payments made or other action actions taken by us before prior to our receipt of the change or addition was received and recorded by us at our Service Center.notice. 10-2180

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if any Owner, or Annuitant in the Annuitant or case of a Non-Natural Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Owner, or Annuitant or in the case of a Non-Natural Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of any Owner, or Annuitant in the Annuitant or case of a Non-Natural Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record on the date the notice of change or addition. Any such change or addition will not impact is signed by the Owner, subject to any payment payments made or other action actions taken by us before prior to receipt of the change or addition was received and recorded by us at our Service Center.notice. 10-2253

Designation of Beneficiary. The NOTE: ANY AMOUNT REMAINING IN THE ACCOUNT THAT IS NOT DISPOSED OF BY A PROPER DESIGNATION OF BENEFICIARY WILL BE DISTRIBUTED TO YOUR ESTATE (UNLESS OTHERWISE REQUIRED BY THE LAWS OF YOUR STATE OF RESIDENCE). YOU MAY CHANGE THE BENEFICIARY(IES) NAMED BELOW AT ANYTIME BY FILING A NEW DESIGNATION OF BENEFICIARY WITH THE CUSTODIAN. ANY SUBSEQUENT DESIGNATION FILED WITH THE CUSTODIAN WILL REVOKE ALL PRIOR DESIGNATIONS, EVEN IF THE SUBSEQUENT DESIGNATION DOES NOT DISPOSE OF YOUR ENTIRE ACCOUNT. As Depositor, I hereby make the following designation of beneficiary in accordance with the Xxxxxx Street Funds Traditional Individual Retirement Custodial Account or Xxxx Individual Retirement Custodial Account: In the event of my death, pay any interest I may have under my Account to the following Primary Beneficiary is or Beneficiaries who survive me. Make payment in the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if the Annuitant or Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds proportions specified below (or any remaining annuity payments) equally, unless otherwise in equal proportions if no different proportions are specified). If any Primary Beneficiary predeceases me, his share is to be divided among the Annuitant or Owner, that Primary Beneficiaries who survive me in the relative proportions assigned to each such surviving Primary Beneficiary’s interest will go . PRIMARY BENEFICIARY OR BENEFICIARIES: Print Full Name Relationship Date of Birth Address City State Zip financial obligations. Due to any other possible consequences of giving up my community or marital property interest in this IRA, I have been advised to see a tax professional or legal adviser. I hereby consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequence that may result. No tax or legal advice was given to me by the Custodian or Sponsor. SIGNATURE OF SPOUSE DATE Social Security Number Proportion % X Print Full Name Relationship Date of Birth Address City State Zip SIGNATURE OF WITNESS FOR SPOUSE DATE 5 | Information and Certifications Concerning Tax Withholding BY SIGNING THIS FORM, THE DEPOSITOR CERTIFIES THAT HE/SHE IS A U.S. PERSON (A U.S. CITIZEN OR A RESIDENT ALIEN) OR A FOREIGN PERSON (A NONRESIDENT ALIEN), AS INDICATED BY CHECKING THE APPROPRIATE BOX BELOW, AND MAKES THE RELATED CERTIFICATIONS. Depositor is (check one) Social Security Number Proportion % � A U.S. Person. Depositor certifies that the number shown in Part 1 If none of the Primary Beneficiaries namedsurvives me, according pay any interest I may have under my Account to their respective interests, unless otherwise the following Alternate Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If you leave any Alternate Beneficiary predeceases me, his share is to be divided among the Alternate Beneficiaries who survive me in the relative proportions assigned to each such surviving Alternate Beneficiary. ALTERNATE BENEFICIARY OR BENEFICIARIES: Print Full Name Relationship Date of Birth Address City State Zip of this Adoption Agreement is the Depositor’s correct Social Security number (or the Depositor is waiting to be issued a Social Security number); and Depositor is not subject to backup withholding because: (a) the Depositor is exempt from backup withholding, or (b) the Depositor has not been notified by the Internal Revenue Service (IRS) that the Depositor is subject to backup withholding as a result of failure to report all interest or dividends, or (c) the IRS has notified the Depositor that the Depositor is no surviving Beneficiarylonger subject to backup withholding. (NOTE: Cross out this sentence if the Depositor has been notified by the IRS that the Depositor is currently subject to backup withholding because of failure to report all interest and dividends on the Depositor’s tax return.) � A Foreign Person. Depositor acknowledges that the IRS does not require consent to any provisions of this document other than the Form W-8BEN certification required to avoid backup withholding and qualify for a tax treaty rate Social Security Number Proportion % of withholding (see IRS Publication 515). Print Full Name Relationship Date of Birth Address City State Zip 6 | Bank Information (Optional) COMPLETE THIS SECTION IF YOU INTEND TO MAKE ACH AND WIRE REDEMPTIONS OR UTILIZE THE AUTOMATIC INVESTMENT OR SYSTEMATIC WITHDRAWAL PLANS. To exercise these investment and redemption privileges, your estate may receive bank account information must be on file. Please attach a voided check or deposit slip for the death benefit proceedsbank account you wish to use AND complete the section below. If Social Security Number Proportion % IMPORTANT: THIS DESIGNATION OF BENEFICIARY MAY HAVE IMPORTANT TAX OR ESTATE PLANNING EFFECTS. IF YOU CANNOT ACCOMPLISH YOUR ESTATE PLANNING OBJECTIVES BY USING THIS PART 4 TO DESIGNATE YOUR BENEFICIARY(IES) (FOR EXAMPLE, IF YOU WISH TO PROVIDE THAT THE SURVIVING CHILDREN OF A BENEFICIARY WHO PREDECEASES YOU SHOULD TAKE THAT BENEFICIARY’S SHARE BY RIGHT OF REPRESENTATION), YOU MAY SUBMIT ANOTHER FORM OF WRITTEN BENEFICIARY DESIGNATION TO THE CUSTODIAN. ALSO, IF YOU ARE MARRIED AND RESIDE IN A COMMUNITY PROPERTY OR MARITAL PROPERTY STATE (ARIZONA, CALIFORNIA, IDAHO, LOUISIANA, NEVADA, NEW MEXICO, TEXAS, WASHINGTON OR WISCONSIN), YOU MAY NEED TO OBTAIN YOUR SPOUSE’S CONSENT IF YOU HAVE NOT DESIGNATED YOUR SPOUSE AS PRIMARY BENEFICIARY FOR AT LEAST HALF OF YOUR ACCOUNT. SEE YOUR LAWYER OR OTHER TAX PROFESSIONAL FOR ADDITIONAL INFORMATION AND ADVICE. SPOUSAL CONSENT: (THIS SECTION SHOULD BE REVIEWED IF THE DEPOSITOR IS MARRIED AND DESIGNATES A BENEFICIARY OTHER THAN THE SPOUSE. IT IS THE DEPOSITOR’S RESPONSIBILITY TO DETERMINE IF THIS SECTION APPLIES. THE DEPOSITOR MAY NEED TO CONSULT WITH LEGAL COUNSEL. NEITHER THE CUSTODIAN NOR THE SPONSOR ARE LIABLE FOR ANY CONSEQUENCES RESULTING FROM A FAILURE OF THE DEPOSITOR TO PROVIDE PROPER SPOUSAL CONSENT.) I am the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death spouse of the Annuitant or Owner, by providing us with above-named Depositor. I acknowledge that I have received a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent full and reasonable disclosure of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming my spouse’s property and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record the change or addition. Any such change or addition will not impact any payment made or other action taken by us before the change or addition was received and recorded by us at our Service Center.BANK NAME BRANCH OFFICE (IF APPLICABLE) BANK ADDRESS (DO NOT USE P.O. BOX) CITY STATE ZIP NAME(S) ON YOUR BANK ACCOUNT BANK ACCOUNT NUMBER BANK ABA NUMBER Account Type (check one): � Checking � Savings

Designation of Beneficiary. The Beneficiary is the person you name who may receive any death benefit proceeds, or any remaining annuity payments after the Annuity Date, if any Owner, or Annuitant in the Annuitant or case of a Non-Natural Owner dies. The Owner can name more than one Beneficiary. Multiple Beneficiaries will share the death benefit proceeds (or any remaining annuity payments) equally, unless otherwise specified. If any Beneficiary predeceases the Owner, or Annuitant or in the case of a Non-Natural Owner, that Beneficiary’s interest will go to any other Beneficiaries named, according to their respective interests, unless otherwise specified. If you leave no surviving Beneficiary, your estate may receive the death benefit proceeds. If the Beneficiary is a trustee, we will neither be responsible for verifying a trustee’s right to receive any death benefit proceeds, nor for how the trustee disposes of any death benefit proceeds. If before payment of any death benefit proceeds, we receive proper notice that the trust has been revoked or is not in effect, then any death benefit proceeds payable will be paid to the Contingent Beneficiary, if living; if not to the Owner’s estate. Adding or Changing Your Beneficiary – You may add, change, or remove any Beneficiary, other than an irrevocable Beneficiary, subject to the terms of any assignment, at any time prior to the death of any Owner, or Annuitant in the Annuitant or case of a Non-Natural Owner, by providing us with a request in a form satisfactory to us. However, if you have named an irrevocable Beneficiary, you may not add any new Beneficiary, or remove or change the irrevocable Beneficiary, without obtaining his or her written consent in a form acceptable to us. You may remove any non-irrevocable Beneficiary without obtaining the consent of the irrevocable Beneficiary. Qualified Contracts may have additional restrictions on naming and changing Beneficiaries. Any change or addition will generally take effect only when we receive all necessary documents and record on the date the notice of change or addition. Any such change or addition will not impact is signed by the Owner, subject to any payment payments made or other action actions taken by us before prior to receipt of the change or addition was received and recorded by us at our Service Center.notice. 10-2252