Common use of RIGHT TO EXAMINE CONTRACT Clause in Contracts

RIGHT TO EXAMINE CONTRACT. The Owner may cancel this contract by returning it to the Company or one of its authorized representatives within ten days after receipt. If returned, the Company will refund an amount equal to the Accumulated Value, after application of any Market Value Adjustment, plus any fees or other charges imposed. If, however, the contract is issued as an Individual Retirement Annuity (IRA), the Company will refund the greater of the above or gross payments. ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY Home Office: Dover, Delaware Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000 This is a legal contract between Allmerica Financial Life Insurance and Annuity Company (the Company) and the Owner and is issued in consideration of the Initial Payment shown on the Specifications page. Additional Payments are permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account or Guarantee Period Accounts. While this contract is in effect, the Company agrees to pay annuity benefit payments beginning on the Annuity Date or to pay a Death Benefit to the Beneficiary if an Owner dies prior to the Annuity Date. /s/ Xxxxxxx X. Xxxxxx /s/ Xxxxxxx X. Xxxxxx President Secretary Flexible Payment Deferred Variable and Fixed Annuity Annuity Benefit Payments Payable on the Annuity Date Death Benefit Payable to Beneficiary if Owner Dies prior to Annuity Date Non-Participating Form A3036-01 1 BACS11 TABLE OF CONTENTS SPECIFICATIONS ............................................................. 3 DEFINITIONS ................................................................ 9

RIGHT TO EXAMINE CONTRACT. The Owner may cancel this contract by returning it to the Company or one of its authorized representatives within ten days after receipt. If returned, the Company will refund an amount equal to the sum of (1) gross payments, less any amounts allocated to the Variable Account, (2) the Accumulated Value, after application Value of any Market Value Adjustment, plus amounts allocated to the Variable Account on the date the returned contract is received at the Principal Office and (3) any fees or other charges imposedimposed on the amounts allocated to the Variable Account. If, however, the contract is issued as an Individual Retirement Annuity (IRA), the Company will refund the greater of the above or the gross payments. FIRST ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY Home Office: DoverWorcester, Delaware Massachusetts Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000 This is a legal contract between First Allmerica Financial Life Insurance and Annuity Company (the Company) and the Owner and is issued in consideration of the Initial Payment initial payment shown on the Specifications page. Additional Payments payments are permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account or Guarantee Period Accounts. While this contract is in effect, the Company agrees to pay annuity benefit payments benefits beginning on the Annuity Date or to pay a Death Benefit death benefit to the Beneficiary if an Owner dies prior to the Annuity Date. /s/ Xxxxxxx X. Xxxxxx /s/ Xxxxxxx X. Xxxxxx President Secretary Flexible Payment Deferred Variable and Fixed Annuity Annuity Benefit Payments Payable on the Annuity Date Death Benefit Payable to Beneficiary if Owner Dies prior to Annuity Date NonFLEXIBLE PAYMENT DEFERRED VARIABLE AND FIXED ANNUITY NON-Participating Form A3036-01 PARTICIPATING 1 BACS11 TABLE OF CONTENTS SPECIFICATIONS ............................................................. SPECIFICATIONS........................................................... 3 DEFINITIONS ................................................................ 9DEFINITIONS.............................................................. 5

RIGHT TO EXAMINE CONTRACT. The Owner may cancel this contract by returning it to the Company or one of its authorized representatives within ten days after receipt. If returned, the Company will refund an amount equal to the sum of (1) gross payments, less any amounts allocated to the Variable Account, (2) the Accumulated Value, after application Value of any Market Value Adjustment, plus amounts allocated to the Variable Account on the date the returned contract is received at the Principal Office and (3) any fees or other charges imposedimposed on the amounts allocated to the Variable Account. If, however, the contract is issued as an Individual Retirement Annuity (IRA), the Company will refund the greater of the above or the gross payments. ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY Home Office: Dover, Delaware Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000 This is a legal contract between Allmerica Financial Life Insurance and Annuity Company (the Company) and the Owner and is issued in consideration of the Initial Payment initial payment shown on the Specifications page. Additional Payments payments are permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account or Guarantee Period Accounts. While this contract is in effect, the Company agrees to pay annuity benefit payments benefits beginning on the Annuity Date or to pay a Death Benefit death benefit to the Beneficiary if an Owner dies prior to the Annuity Date. /s/ Xxxxxxx X. Xxxxxx Xxxxxxx /s/ Xxxxxxx X. Xxxxxx Xxxxxxxxx --------------------- ---------------------- President Secretary Flexible Payment Deferred Variable and Fixed Annuity Annuity Benefit Payments Payable on the Annuity Date Death Benefit Payable to Beneficiary if Owner Dies prior to Annuity Date NonFLEXIBLE PAYMENT DEFERRED VARIABLE AND FIXED ANNUITY NON-Participating Form A3036-01 1 BACS11 PARTICIPATING TABLE OF CONTENTS SPECIFICATIONS ............................................................. SPECIFICATIONS........................................................... 3 DEFINITIONS ................................................................ 9DEFINITIONS.............................................................. 5

RIGHT TO EXAMINE CONTRACT. The Owner may cancel this contract by returning it to the Company or one of its authorized representatives within ten days after receipt. If returned, the Company will refund an amount equal to the Accumulated Value, after application of any Market Value Adjustment, plus any fees or other charges imposed. If, however, the contract is issued as an Individual Retirement Annuity (IRA), the Company will refund the greater of the above or the gross paymentspayment. ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY Home Office: Dover, Delaware Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000 This is a legal contract between Allmerica Financial Life Insurance and Annuity Company (the Company) and the Owner and is issued in consideration of the Initial Payment shown on the Specifications page. Additional Payments are permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account or Guarantee Period Accounts. While this contract is in effect, the Company agrees to pay annuity benefit payments beginning on the Annuity Date or to pay a Death Benefit to the Beneficiary if an Owner dies prior to the Annuity Date. /s/ Xxxxxxx X. Xxxxxx /s/ Xxxxxxx X. Xxxxxx President Secretary Flexible Payment Deferred Variable and Fixed Annuity Annuity Benefit Payments Payable on the Annuity Date Death Benefit Payable to Beneficiary if Owner Dies prior to Annuity Date Non-Participating Form A3036FORM A3035-01 00 1 BACS11 TABLE OF CONTENTS Table of Contents SPECIFICATIONS ............................................................. .................................................................................3 DEFINITIONS ................................................................ 9DEFINITIONS.....................................................................................7

RIGHT TO EXAMINE CONTRACT. The Owner may cancel this contract by returning it to the Company or one of its authorized representatives within ten days after receipt. If returned, the Company will refund an amount equal to the Accumulated Value, after application of any Market Value Adjustment, plus any fees or other charges imposed. If, however, the contract is issued as an Individual Retirement Annuity (IRA), the Company will refund the greater of the above or gross payments. ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY Home Office: Dover, Delaware Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000 This is a legal contract between Allmerica Financial Life Insurance and Annuity Company (the Company) and the Owner and is issued in consideration of the Initial Payment shown on the Specifications page. Additional Payments are permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account or Guarantee Period Accounts. While this contract is in effect, the Company agrees to pay annuity benefit payments beginning on the Annuity Date or to pay a Death Benefit to the Beneficiary if an Owner dies prior to the Annuity Date. /s/ Xxxxxxx X. Xxxxxx /s/ Xxxxxxx X. Xxxxxx President Secretary Flexible Payment Deferred Variable and Fixed Annuity Annuity Benefit Payments Payable on the Annuity Date Death Benefit Payable to Beneficiary if Owner Dies prior to Annuity Date Non-Participating Form A3036-01 1 BACS11 TABLE OF CONTENTS SPECIFICATIONS ............................................................. 3 DEFINITIONS ................................................................ 99 OWNER, ANNUITANT AND BENEFICIARY ........................................... 11

RIGHT TO EXAMINE CONTRACT. The Owner may cancel this contract by returning it to the Company or one of its authorized representatives within ten days after receipt. If returned, the Company will refund an amount equal to the sum of (1) gross payments, less any amounts allocated to the Variable Account, (2) the Accumulated Value, after application Value of any Market Value Adjustment, plus amounts allocated to the Variable Account on the date the returned contract is received at the Principal Office and (3) any fees or other charges imposedimposed on the amounts allocated to the Variable Account. If, however, the contract is issued as an Individual Retirement Annuity (IRA), the Company will refund the greater of the above or the gross payments. ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY Home Office: Dover, Delaware Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000 This is a legal contract between Allmerica Financial Life Insurance and Annuity Company (the Company) and the Owner and is issued in consideration of the Initial Payment initial payment shown on the Specifications page. Additional Payments payments are permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account or Guarantee Period Accounts. While this contract is in effect, the Company agrees to pay annuity benefit payments benefits beginning on the Annuity Date or to pay a Death Benefit death benefit to the Beneficiary if an Owner dies prior to the Annuity Date. /s/ /s/Xxxxxxx X. Xxxxxx /s/ Xxxxxxx X. Xxxxxx Xxxxxxxxx President Secretary Flexible Payment Deferred Variable and Fixed Annuity Annuity Benefit Payments Payable on the Annuity Date Death Benefit Payable to Beneficiary if Owner Dies prior to Annuity Date Non-Participating Form A3036-01 1 BACS11 TABLE OF CONTENTS SPECIFICATIONS ............................................................. SPECIFICATIONS...............................................3 DEFINITIONS ................................................................ 9DEFINITIONS..................................................5

RIGHT TO EXAMINE CONTRACT. The Owner may cancel this contract by returning it to the Company or one of its authorized representatives within ten days after receipt. If returned, the Company will refund an amount equal to the Accumulated Value, after application of any Market Value Adjustment, plus any fees or other charges imposed. If, however, the contract is issued as an Individual Retirement Annuity (IRA), the Company will refund the greater of the above or the gross payments. ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY Home Office: Dover, Delaware Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000 This is a legal contract between Allmerica Financial Life Insurance and Annuity Company (the Company) and the Owner and is issued in consideration of the Initial Payment shown on the Specifications page. Additional Payments are permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account or Guarantee Period Accounts. While this contract is in effect, the Company agrees to pay annuity benefit payments beginning on the Annuity Date or to pay a Death Benefit to the Beneficiary if an Owner dies prior to the Annuity Date. /s/ Xxxxxxx X. Xxxxxx /s/ Xxxxxxx X. Xxxxxx President Secretary Flexible Payment Deferred Variable and Fixed Annuity Annuity Benefit Payments Payable on the Annuity Date Death Benefit Payable to Beneficiary if Owner Dies prior to Annuity Date Non-Participating Form A3036A3033-01 00 1 BACS11 TABLE OF CONTENTS SPECIFICATIONS ............................................................. SPECIFICATONS ........................................................3 DEFINITIONS ................................................................ 9DEFINITIONS...........................................................7

RIGHT TO EXAMINE CONTRACT. The Owner may cancel this contract by returning it to the Company or one of its authorized representatives within ten days after receipt. If returned, the Company will refund an amount equal to the sum of (1) gross payments, less any amounts allocated to the Variable Account, (2) the Accumulated Value, after application Value of any Market Value Adjustment, plus amounts allocated to the Variable Account on the date the returned contract is received at the Principal Office and (3) any fees or other charges imposedimposed on the amounts allocated to the Variable Account. If, however, the contract is issued as an Individual Retirement Annuity (IRA), the Company will refund the greater of the above or the gross payments. ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY Home Office: Dover, Delaware Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000 This is a legal contract between Allmerica Financial Life Insurance and Annuity Company (the Company) and the Owner and is issued in consideration of the Initial Payment initial payment shown on the Specifications page. Additional Payments payments are permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account or Guarantee Period Accounts. While this contract is in effect, the Company agrees to pay annuity benefit payments benefits beginning on the Annuity Date or to pay a Death Benefit death benefit to the Beneficiary if an Owner dies prior to the Annuity Date. /s/ Xxxxxxx X. Xxxxxx /s/ Xxxxxxx X. Xxxxxx President Secretary Flexible Payment Deferred Variable and Fixed Annuity Annuity Benefit Payments Payable on the Annuity Date Death Benefit Payable to Beneficiary if Owner Dies prior to Annuity Date NonFLEXIBLE PAYMENT DEFERRED VARIABLE AND FIXED ANNUITY NON-Participating Form A3036-01 PARTICIPATING 1 BACS11 TABLE OF CONTENTS SPECIFICATIONS ............................................................. SPECIFICATIONS........................................................... 3 DEFINITIONS ................................................................ 9DEFINITIONS.............................................................. 5