Common use of SURRENDER PROVISIONS Clause in Contracts

SURRENDER PROVISIONS. 12 Distribution at Time of Death Provisions 14 Calculation of the Death Benefit Provisions 14 Settlement Provisions 17 Annuity Tables 20 LA-VA99 Page 2 PRINTED IN U.S.A. R390R0.FRM CONTRACT SPECIFICATIONS CONTRACT NUMBER [SPECIMEN] CONTRACT ISSUE DATE [FEBRUARY 8, 1999] NAME OF ANNUITANT [▇▇▇▇▇ ▇▇▇▇▇] ANNUITY COMMENCEMENT DATE [JANUARY 1, 2029] AGE OF ANNUITANT [35] INITIAL PREMIUM PAYMENT [$1,000] SEX OF ANNUITANT [MALE] MINIMUM SUBSEQUENT PAYMENT $500 CONTINGENT ANNUITANT [▇▇▇▇ ▇▇▇▇▇] MINIMUM FIXED ACCOUNT INTEREST RATE 3% DESIGNATED BENEFICIARY [▇▇▇ ▇▇▇▇▇] (APPLIES TO ACCUMULATION PERIOD ONLY) CONTRACT OWNER [▇▇▇▇▇ ▇▇▇▇▇] DESCRIPTION OF BENEFITS INDIVIDUAL FLEXIBLE PREMIUM VARIABLE ANNUITY CONTRACT SEPARATE ACCOUNT: [HARTFORD LIFE INSURANCE COMPANY SEPARATE ACCOUNT TWO] ANNUAL WITHDRAWAL AMOUNT CONTRACT YEARS 1-7 ------------------ 15% OF PREMIUM PAYMENTS ON A NONCUMULATIVE BASIS AFTER CONTRACT YEAR 7 ------------------ 100% OF THE CONTRACT VALUE REDUCED BY THE TOTAL OF ANY PREMIUM PAYMENTS MADE DURING THE 7 YEARS PRIOR TO WITHDRAWAL; AND 15% OF PREMIUM PAYMENTS MADE DURING THE 7 YEARS PRIOR TO WITHDRAWAL ON A NONCUMULATIVE BASIS. ANNUAL MAINTENANCE FEE: $0 IF THE CONTRACT VALUE IS $50,000 OR MORE ON THE CONTRACT ANNIVERSARY. $30 IF THE CONTRACT VALUE IS LESS THAN $50,000 ON THE CONTRACT ANNIVERSARY.

SURRENDER PROVISIONS. 12 Distribution at Time of Death Provisions 14 Calculation of the Death Benefit Provisions 14 Settlement Provisions 17 Annuity Tables 20 LAHL-VA99 Page 2 PRINTED IN U.S.A. R390R0.FRM R378R0.FRM CONTRACT SPECIFICATIONS CONTRACT NUMBER [SPECIMEN] CONTRACT ISSUE DATE [FEBRUARY 8, 1999] NAME OF ANNUITANT [▇▇▇▇▇ ▇▇▇▇▇] ANNUITY COMMENCEMENT DATE [JANUARY 1, 2029] AGE OF ANNUITANT [35] INITIAL PREMIUM PAYMENT [$1,000] SEX OF ANNUITANT [MALE] MINIMUM SUBSEQUENT PAYMENT $500 CONTINGENT ANNUITANT [▇▇▇▇ ▇▇▇▇▇] MINIMUM FIXED ACCOUNT INTEREST RATE 3% DESIGNATED BENEFICIARY [▇▇▇ ▇▇▇▇▇] (APPLIES TO ACCUMULATION PERIOD ONLY) CONTRACT OWNER [▇▇▇▇▇ ▇▇▇▇▇] DESCRIPTION OF BENEFITS INDIVIDUAL FLEXIBLE PREMIUM VARIABLE ANNUITY CONTRACT SEPARATE ACCOUNT: [HARTFORD LIFE INSURANCE COMPANY SEPARATE ACCOUNT TWOTHREE] ANNUAL WITHDRAWAL AMOUNT CONTRACT YEARS 1-7 ------------------ 15% OF PREMIUM PAYMENTS ON A NONCUMULATIVE BASIS AFTER CONTRACT YEAR 7 ------------------ --------------------- 100% OF THE CONTRACT VALUE REDUCED BY THE TOTAL OF ANY PREMIUM PAYMENTS MADE DURING THE 7 YEARS PRIOR TO WITHDRAWAL; AND 15% OF PREMIUM PAYMENTS MADE DURING THE 7 YEARS PRIOR TO WITHDRAWAL ON A NONCUMULATIVE BASIS. ANNUAL MAINTENANCE FEE: $0 IF THE CONTRACT VALUE IS $50,000 OR MORE ON THE CONTRACT ANNIVERSARY. $30 IF THE CONTRACT VALUE IS LESS THAN $50,000 ON THE CONTRACT ANNIVERSARY.

SURRENDER PROVISIONS. 12 Distribution at Time of Death Provisions 14 Calculation of the Death Benefit Provisions 14 Settlement Provisions 17 Annuity Tables 20 LAHL-VA99 Page 2 PRINTED IN U.S.A. R390R0.FRM R378R0.FRM CONTRACT SPECIFICATIONS CONTRACT NUMBER [SPECIMEN] CONTRACT ISSUE DATE [FEBRUARY 8, 1999] NAME OF ANNUITANT [▇▇▇▇▇ ▇▇▇▇▇] ANNUITY COMMENCEMENT DATE [JANUARY 1, 2029] AGE OF ANNUITANT [35] INITIAL PREMIUM PAYMENT [$1,000] SEX OF ANNUITANT [MALE] MINIMUM SUBSEQUENT PAYMENT $500 CONTINGENT ANNUITANT [▇▇▇▇ ▇▇▇▇▇] MINIMUM FIXED ACCOUNT INTEREST RATE 3% DESIGNATED BENEFICIARY [▇▇▇ ▇▇▇▇▇] (APPLIES TO ACCUMULATION PERIOD ONLY) CONTRACT OWNER [▇▇▇▇▇ ▇▇▇▇▇] DESCRIPTION OF BENEFITS INDIVIDUAL FLEXIBLE PREMIUM VARIABLE ANNUITY CONTRACT SEPARATE ACCOUNT: [HARTFORD LIFE INSURANCE COMPANY SEPARATE ACCOUNT TWO] ANNUAL WITHDRAWAL AMOUNT CONTRACT YEARS 1-7 ------------------ 15% OF PREMIUM PAYMENTS ON A NONCUMULATIVE BASIS AFTER CONTRACT YEAR 7 ------------------ --------------------- 100% OF THE CONTRACT VALUE REDUCED BY THE TOTAL OF ANY PREMIUM PAYMENTS MADE DURING THE 7 YEARS PRIOR TO WITHDRAWAL; AND 15% OF PREMIUM PAYMENTS MADE DURING THE 7 YEARS PRIOR TO WITHDRAWAL ON A NONCUMULATIVE BASIS. ANNUAL MAINTENANCE FEE: $0 IF THE CONTRACT VALUE IS $50,000 OR MORE ON THE CONTRACT ANNIVERSARY. $30 IF THE CONTRACT VALUE IS LESS THAN $50,000 ON THE CONTRACT ANNIVERSARY.