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 and less any Payment Credits. These values are determined as of the date the contract is returned to the Company. If, however, the contract is issued as an Individual Retirement Annuity (IRA), the Company will refund 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 benefits payments beginning on the Annuity Date or to pay a Death Benefit to the Beneficiary if an Owner dies prior to the Annuity Date. 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 A3028-99 TABLE OF CONTENTS SPECIFICATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 DEFINITIONS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 imposed and less any Payment Credits. These values are determined as of on the date the contract is returned amounts allocated to the CompanyVariable 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: 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 permittedpermitted and may be made either to the Principal Office or to an authorized representative of the Company. Payments may be allocated to Variable Sub-Sub- Accounts, the Fixed Account or Guarantee Period Accounts. While this contract is in effect, the Company agrees to pay annuity benefits payments to the Annuitant beginning on the Annuity Date or to pay a Death Benefit death benefit to the Beneficiary if an either the Owner or Annuitant dies prior to the Annuity Date. 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/s/ Xxxx X. X'Xxxxx /s/ Xxxxxxx X. Xxxxx President Secretary FLEXIBLE PAYMENT DEFERRED VARIABLE AND FIXED ANNUITY NON-Participating FORM A3028-99 PARTICIPATING TABLE OF CONTENTS SPECIFICATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 DEFINITIONS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. 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 imposed and less any Payment Credits. These values are determined as of on the date the contract is returned amounts allocated to the CompanyVariable 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 benefits payments 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. 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/s/Xxxxxxx X. Xxxxx /s/Xxxxxxx X. Xxxxxxxxx President Secretary FLEXIBLE PAYMENT DEFERRED VARIABLE AND FIXED ANNUITY NON-Participating FORM A3028-99 PARTICIPATING TABLE OF CONTENTS SPECIFICATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 .3 DEFINITIONS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.5

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 imposed and less any Payment Credits. These values are determined as of on the date the contract is returned amounts allocated to the CompanyVariable 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: 000 400 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 permittedpermitted and may be made either to the Principal Office or to an authorized representative of the Company. Payments may be allocated to Variable Sub-Sub- Accounts, the Fixed Account or Guarantee Period Accounts. While this contract is in effect, the Company agrees to pay annuity benefits payments to the Annuitant beginning on the Annuity Date or to pay a Death Benefit death benefit to the Beneficiary if an either the Owner or Annuitant dies prior to the Annuity Date. 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/s/ Rxxxxxx X. Xxxxxx /s/ ??????????????? President Secretary FLEXIBLE PAYMENT DEFERRED VARIABLE AND FIXED ANNUITY NON-Participating FORM A3028-99 PARTICIPATING TABLE OF CONTENTS SPECIFICATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 DEFINITIONS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. 5