Common use of RIGHT TO CANCEL THIS CONTRACT Clause in Contracts

RIGHT TO CANCEL THIS CONTRACT. This contract may be returned within 10 days after You receive it. It can be mailed or delivered to either Us or Our agent. Return of this contract by mail is effective as of the date of its postmark, properly addressed and postage pre-paid. The returned contract will be treated as if We had never issued it. We will promptly refund the Contract Value as of the date of return; this may be more or less than the Premium paid. This is a variable annuity contract. Annuity payments and Contract Value may increase or decrease depending on the experience of the Variable Account identified in the Contract Schedule. Signed by the Company: /s/ Xxxxxxxxx X. Xxxx /s/ X X X'Xxxxxxx Xxxxxxxxx X. Xxxx X X X'Xxxxxxx Secretary President INDIVIDUAL VARIABLE ANNUITY NONPARTICIPATING TABLE OF CONTENTS PAGE CONTRACT SCHEDULE 3 DEFINITIONS 4 GENERAL PROVISIONS 5 OWNERSHIP PROVISIONS 6 BENEFICIARY PROVISIONS 6 PREMIUM PROVISIONS 6 VARIABLE ACCOUNT 7 GUARANTEED ACCOUNT 7 TRANSFERS 8 MARKET VALUE ADJUSTMENT 9 CONTRACT CHARGES 9 ANNUITY PROVISIONS 10 ANNUITY OPTIONS 10 DEATH BENEFIT 12 SURRENDER PROVISIONS 13 DELAY OF PAYMENTS 13 FIXED OPTIONS TABLE 14 VARIABLE OPTIONS TABLE 15 CONTRACT SCHEDULE CONTRACT NUMBER: ( ) INITIAL PREMIUM: ($5,000) OWNER(S): (XXXX XXX) MINIMUM SUBSEQUENT PREMIUM: ($1,000) ANNUITANT: (XXXX XXX) BENEFICIARY: (XXXX XXX) EFFECTIVE DATE: ( ) ANNUITY DATE: ( )

RIGHT TO CANCEL THIS CONTRACT. This contract may be returned within 10 days after You receive it. It can be mailed or delivered to either Us or Our agent. Return of this contract by mail is effective as of the date of its postmark, properly addressed and postage pre-paid. The returned contract will be treated as if We had never issued it. We will promptly refund the Contract Value less any Premium Enhancement and any fees paid as of the date of return; this may be more or less than the Premium paid. For Individual Retirement Annuities, a refund of the Premium(s) may be required. Therefore, We reserve the right to allocate Your Premium(s) and any Premium Enhancement to the Money Market Portfolio until the end of the Right To Cancel period. Thereafter, allocations will be made as shown on the application. This is a variable annuity contract. Annuity payments The value of amounts allocated to the Separate Account during the accumulation and Contract Value may annuity periods is not guaranteed and will increase or decrease depending on based upon the investment experience of the investments underlying the Variable Account identified in the Contract ScheduleAccount(s) You choose. Signed by the Company: /s/ Xxxxxxxxx Xxxxx /s/Xxx X. Xxxx /s/ X X X'Xxxxxxx Xxxxxxxxx X. Xxxx X X X'Xxxxxxx Xxxxxxx -------------------- ------------------- Secretary President INDIVIDUAL VARIABLE ANNUITY NONPARTICIPATING TABLE OF CONTENTS PAGE CONTRACT SCHEDULE 3 DEFINITIONS 4 GENERAL PROVISIONS 5 OWNERSHIP PROVISIONS 6 BENEFICIARY PROVISIONS 6 PREMIUM PROVISIONS 6 7 PREMIUM ENHANCEMENT 7 CONTRACT CHARGES 7 VARIABLE ACCOUNT 7 8 GUARANTEED ACCOUNT 7 8 TRANSFERS 8 MARKET VALUE ADJUSTMENT 9 CONTRACT CHARGES 9 ANNUITY PROVISIONS 10 ANNUITY OPTIONS 10 DEATH BENEFIT 12 SURRENDER PROVISIONS 13 DELAY OF PAYMENTS 13 FIXED ANNUITY OPTIONS TABLE 14 VARIABLE ANNUITY OPTIONS TABLE 15 CONTRACT SCHEDULE CONTRACT NUMBER: ( ) 5678 INITIAL PREMIUM: ($5,000) OWNER(S): (5,000 OWNER: XXXX XXX) XXX MINIMUM SUBSEQUENT PREMIUM: ([$1,000) ANNUITANT] JOINT OWNER: (XXXX XXX) BENEFICIARY: (XXXX XXX) XXX EFFECTIVE DATE: ( ) Xxxxx 0, 0000 XXXXXXXXX: XXXX XXX ANNUITY DATE: ( )March 1, 2032 BENEFICIARY: XXXX XXX

RIGHT TO CANCEL THIS CONTRACT. This contract may be returned within 10 days after You receive it. It can be mailed or delivered to either Us or Our agent. Return of this contract by mail is effective as of the date of its postmark, properly addressed and postage pre-paid. The returned contract will be treated as if We had never issued it. We will promptly refund the Contract Value and any fees paid as of the date of return; this may be more or less than the Premium paid. For Individual Retirement Annuities, a refund of the Premium(s) may be required. Therefore, We reserve the right to allocate Your Premium(s) to the Money Market Portfolio until the end of the Right To Cancel period. Thereafter, allocations will be made as shown on the application. This is a variable annuity contract. Annuity payments and Contract Value may increase or decrease depending on the experience of the Variable Account identified in on the Contract Schedule. Signed by the Company: /s/ Xxxxxxxxx X. Xxxxx /s/ Xxxx /s/ X X X'Xxxxxxx X. Xxxxx -------------------------------------- ---------------------------------------- Xxxxxxxxx X. Xxxxx Xxxx X X X'Xxxxxxx X. Xxxxx Secretary President INDIVIDUAL VARIABLE ANNUITY NONPARTICIPATING TABLE OF CONTENTS PAGE CONTRACT SCHEDULE 3 DEFINITIONS 4 GENERAL PROVISIONS 5 OWNERSHIP PROVISIONS 6 BENEFICIARY PROVISIONS 6 PREMIUM PROVISIONS 6 7 CONTRACT CHARGES 7 VARIABLE ACCOUNT 7 8 GUARANTEED ACCOUNT 7 8 TRANSFERS 8 MARKET VALUE ADJUSTMENT 9 CONTRACT CHARGES 9 ANNUITY PROVISIONS 10 ANNUITY OPTIONS 10 11 DEATH BENEFIT 12 SURRENDER PROVISIONS 13 DELAY OF PAYMENTS 13 FIXED ANNUITY OPTIONS TABLE 14 VARIABLE ANNUITY OPTIONS TABLE 15 CONTRACT SCHEDULE CONTRACT NUMBER: ( ) 5678 INITIAL PREMIUM: ($5,000) OWNER(S): (5,000 OWNER: XXXX XXX) XXX MINIMUM SUBSEQUENT PREMIUM: ([$1,000) ANNUITANT] JOINT OWNER: (XXXX XXX) BENEFICIARY: (XXXX XXX) XXX EFFECTIVE DATE: ( ) December 1, 2000 ANNUITANT: XXXX XXX ANNUITY DATE: ( )December 1, 2030 BENEFICIARY: XXXX XXX [CONTRACT MAINTENANCE CHARGE: [$30.00] each Contract Year. [Before the Annuity Date, this charge may be waived for each year that the Contract Value exceeds $50,000 on the Contract Anniversary.]

RIGHT TO CANCEL THIS CONTRACT. This contract may be returned within 10 days after You receive it. It can be mailed or delivered to either Us or Our agent. Return of this contract by mail is effective as of the date of its postmark, properly addressed and postage pre-paid. The returned contract will be treated as if We had never issued it. We will promptly refund the Contract Value and any fees paid as of the date of return; this may be more or less than the Premium paid. For Individual Retirement Annuities, a refund of the Premium(s) may be required. Therefore, We reserve the right to allocate Your Premium(s) to the Money Market Portfolio until the end of the Right To Cancel period. Thereafter, allocations will be made as shown on the application. This is a variable annuity contract. Annuity payments and Contract Value may increase or decrease depending on the experience of the Variable Account identified in on the Contract Schedule. Signed by the Company: /s/ /s/Xxxxxxxxx Xxxxx /s/Xxx X. Xxxx /s/ X X X'Xxxxxxx Xxxxxxxxx X. Xxxx X X X'Xxxxxxx Xxxxxxx ------------------ ----------------- Secretary President INDIVIDUAL VARIABLE ANNUITY NONPARTICIPATING TABLE OF CONTENTS PAGE CONTRACT SCHEDULE 3 DEFINITIONS 4 GENERAL PROVISIONS 5 OWNERSHIP PROVISIONS 6 BENEFICIARY PROVISIONS 6 PREMIUM PROVISIONS 6 7 CONTRACT CHARGES 7 VARIABLE ACCOUNT 7 8 GUARANTEED ACCOUNT 7 8 TRANSFERS 8 MARKET VALUE ADJUSTMENT 9 CONTRACT CHARGES 9 ANNUITY PROVISIONS 10 ANNUITY OPTIONS 10 11 DEATH BENEFIT 12 SURRENDER PROVISIONS 13 DELAY OF PAYMENTS 13 FIXED ANNUITY OPTIONS TABLE 14 VARIABLE ANNUITY OPTIONS TABLE 15 CONTRACT SCHEDULE CONTRACT NUMBER: ( ) 5678 INITIAL PREMIUM: ([$5,000) OWNER(S): (100,000] OWNER: XXXX XXX) XXX MINIMUM SUBSEQUENT PREMIUM: ([$1,000) ANNUITANT] JOINT OWNER: (XXXX XXX) BENEFICIARY: (XXXX XXX) XXX EFFECTIVE DATE: ( ) December 1, 2000 ANNUITANT: XXXX XXX ANNUITY DATE: ( )December 1, 2030 BENEFICIARY: XXXX XXX [SEPARATE ACCOUNT CHARGE: Equal on an annual basis to [1.00%] of the average daily net assets of the Variable Account.]

RIGHT TO CANCEL THIS CONTRACT. This contract may be returned within 10 days after You receive it. It can be mailed or delivered to either Us or Our agent. Return of this contract by mail is effective as of the date of its postmark, properly addressed and postage pre-paid. The returned contract will be treated as if We had never issued it. We will promptly refund the Contract Value as of the date of return; this may be more or less than the Premium paid. This is a variable annuity contract. Annuity payments and Contract Value may increase or decrease depending on the experience of the Variable Account identified in the Contract Schedule. Signed by the Company: /s/ Xxxxxxxxx X. Xxxx /s/ X X X'Xxxxxxx Xxxxxxxxx X. Xxxx X X X'Xxxxxxx /s Xxxxxx Xxxxxxx Secretary President INDIVIDUAL VARIABLE ANNUITY NONPARTICIPATING TABLE OF CONTENTS PAGE CONTRACT SCHEDULE 3 DEFINITIONS 4 GENERAL PROVISIONS 5 OWNERSHIP PROVISIONS 6 BENEFICIARY PROVISIONS 6 PREMIUM PROVISIONS 6 VARIABLE ACCOUNT 7 GUARANTEED ACCOUNT 7 TRANSFERS 8 MARKET VALUE ADJUSTMENT 9 CONTRACT CHARGES 9 ANNUITY PROVISIONS 10 ANNUITY OPTIONS 10 DEATH BENEFIT 12 SURRENDER PROVISIONS 13 DELAY OF PAYMENTS 13 FIXED OPTIONS TABLE ANNUITY OPTION TABLES 14 VARIABLE OPTIONS TABLE ANNUITY OPTION TABLES 15 CONTRACT SCHEDULE CONTRACT NUMBER: ( ) INITIAL PREMIUM: ($5,00010,000) OWNER(S): (XXXX XXX) MINIMUM SUBSEQUENT PREMIUM: ($1,000) ANNUITANT: (XXXX XXX) BENEFICIARY: (XXXX XXX) EFFECTIVE DATE: ( ) ANNUITY DATE: ( )

RIGHT TO CANCEL THIS CONTRACT. This contract may be returned within 10 days after You receive it. It can be mailed or delivered to either Us or Our agent. Return of this contract by mail is effective as of the date of its postmark, properly addressed and postage pre-paid. The returned contract will be treated as if We had never issued it. We will promptly refund the Contract Value and any fees paid as of the date of return; this may be more or less than the Premium paid. For Individual Retirement Annuities, a refund of the Premium(s) may be required. Therefore, We reserve the right to allocate Your Premium(s) to the Money Market Portfolio until the end of the Right To Cancel period. Thereafter, allocations will be made as shown on the application. This is a variable annuity contract. Annuity payments The value of amounts allocated to the Separate Account during the accumulation and Contract Value may annuity periods is not guaranteed and will increase or decrease depending on based upon the investment experience of the investments underlying the Variable Account identified in the Contract ScheduleAccount(s) You choose. Signed by the Company: /s/ Xxxxxxxxx X. Xxxx /s/ X X X'Xxxxxxx Xxxxxxxxx X. Xxxx X X X'Xxxxxxx Christine Nixon /s/Jay S. Wxxxxxxx ------------------- ------------------- Secretary President INDIVIDUAL VARIABLE ANNUITY NONPARTICIPATING TABLE OF CONTENTS PAGE CONTRACT SCHEDULE 3 DEFINITIONS 4 GENERAL PROVISIONS 5 OWNERSHIP PROVISIONS 6 BENEFICIARY PROVISIONS 6 PREMIUM PROVISIONS 6 7 CONTRACT CHARGES 7 VARIABLE ACCOUNT 7 8 GUARANTEED ACCOUNT 7 8 TRANSFERS 8 MARKET VALUE ADJUSTMENT 9 CONTRACT CHARGES 9 ANNUITY PROVISIONS 10 ANNUITY OPTIONS 10 DEATH BENEFIT 12 SURRENDER PROVISIONS 13 DELAY OF PAYMENTS 13 FIXED ANNUITY OPTIONS TABLE 14 VARIABLE ANNUITY OPTIONS TABLE 15 CONTRACT SCHEDULE CONTRACT NUMBER: ( ) 5678 INITIAL PREMIUM: ($5,000) OWNER(S): (XXXX XXX) 5,000 OWNER: JOHN DOE MINIMUM SUBSEQUENT PREMIUM: ([$1,000) ANNUITANT] JOINT OWNER: (XXXX XXX) BENEFICIARY: (XXXX XXX) JANE DOE EFFECTIVE DATE: ( ) Xxcember 1, 2000 ANNUITANT: JOHN DOE ANNUITY DATE: ( )Xxcember 1, 2030 BENEFICIARY: JANE DOE

RIGHT TO CANCEL THIS CONTRACT. This contract may be returned within 10 days after You receive it. It can be mailed or delivered to either Us or Our agent. Return of this contract by mail is effective as of the date of its postmark, properly addressed and postage pre-paid. The returned contract will be treated as if We had never issued it. We will promptly refund the Contract Value and any fees paid as of the date of return; this may be more or less than the Premium paid. For Individual Retirement Annuities, a refund of the Premium(s) may be required. Therefore, We reserve the right to allocate Your Premium(s) to the Money Market Portfolio until the end of the Right To Cancel period. Thereafter, allocations will be made as shown on the application. This is a variable annuity contract. Annuity payments and Contract Value may increase or decrease depending on the experience of the Variable Account identified in on the Contract Schedule. Signed by the Company: /s/ Xxxxxxxxx X. Xxxx /s/ X X X'Xxxxxxx Xxxxxxxxx X. Xxxx X X X'Xxxxxxx /s/Christine Nixon /s/Jay S. Wintrob ------------------ ----------------- Secretary President INDIVIDUAL VARIABLE ANNUITY NONPARTICIPATING TABLE OF CONTENTS PAGE CONTRACT SCHEDULE 3 DEFINITIONS 4 GENERAL PROVISIONS 5 OWNERSHIP PROVISIONS 6 BENEFICIARY PROVISIONS 6 PREMIUM PROVISIONS 6 7 CONTRACT CHARGES 7 VARIABLE ACCOUNT 7 8 GUARANTEED ACCOUNT 7 8 TRANSFERS 8 MARKET VALUE ADJUSTMENT 9 CONTRACT CHARGES 9 ANNUITY PROVISIONS 10 ANNUITY OPTIONS 10 11 DEATH BENEFIT 12 SURRENDER PROVISIONS 13 DELAY OF PAYMENTS 13 FIXED ANNUITY OPTIONS TABLE 14 VARIABLE ANNUITY OPTIONS TABLE 15 CONTRACT SCHEDULE CONTRACT NUMBER: ( ) 5678 INITIAL PREMIUM: ($5,000) OWNER(S): (XXXX XXX) 5,000 OWNER: JOHN DOE MINIMUM SUBSEQUENT PREMIUM: ([$1,000) ANNUITANT0,000] JOINT OWNER: (XXXX XXX) BENEFICIARY: (XXXX XXX) JANE DOE EFFECTIVE DATE: ( ) Xxxember 1, 2000 ANNUITANT: JOHN DOE ANNUITY DATE: ( )Xxxember 1, 2030 BENEFICIARY: JANE DOE