[EQUITABLE LOGO]
GROUP TAX SHELTERED ANNUITY CONTRACT
GROUP ANNUITY CONTRACT NO. AC 5904
CONTRACT HOLDER: UNITED STATES TRUST COMPANY OF NEW YORK
REGISTER DATE: December 1, 1983
EFFECTIVE DATE:
This contract ("Contract") is issued in consideration of the payment to
Equitable of the contributions made under this Contract.
Equitable will issue to each Participant an individual certificate setting
forth a statement in substance of the benefits to which such Participant is
entitled under the Contract.
The provisions on the following pages are part of the Contract.
FOR THE CONTRACT HOLDER FOR THE EQUITABLE
By By
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President
Title By
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Vice President & Secretary
Dated By
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Assistant Register
Date of Issue At New York, New York
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At ----------------------------------
(Head Office)
ASSETS HELD IN CONNECTION WITH THE CONTRACT MAY BE HELD IN ONE OR MORE SEPARATE
ACCOUNTS MAINTAINED BY EQUITABLE AND MAY INCREASE OR DECREASE IN VALUE AS
DESCRIBED IN THE CONTRACT.
No. 15,000 AC 5904 Page 1
This Page (2) is reserved
for information in connection with
the issuance of certificates under
this Contract
No. 15,000 AC 5904 Page 2
This Page (3) is reserved
for information in connection with
the issuance of certificates under
this Contract
No. 15,000 AC 5904 Page 3
PART I -- DEFINITIONS
SECTION 1.01 EMPLOYER
The term "Employer" means (i) an educational organization employing a regular
faculty which is a State, a political division of a State, or an agency or
instrumentality of any one or more of the foregoing (within the meaning of
Section 170(b)(1)(A)(ii) of the Internal Revenue Code of 1954, as amended (the
"Code"), and (ii) an organization described in Section 501(c)(3) of the Code
which is exempt from Federal income tax under Section 501(c) of the Code, which
has entered into an Administrative Agreement as described on page 3 of the
certificate issued to Participants pursuant to Section 5.09.
SECTION 1.02 PLAN
The term "Plan" means a defined contribution pension plan established by an
Employer described in clause (ii) of Section 1.01 which has been determined by
the Internal Revenue Service to meet the requirements for qualification under
Section 401(a) of the Code and which permits or requires amounts contributed
thereunder to be applied under the Contract on behalf of the employees covered
under the Plan.
SECTION 1.03 SALARY REDUCTION AGREEMENT
The term "Salary Reduction Agreement" means (i) an agreement between an
Employer and an employee of the Employer with the meaning of Section
1.403(b)-1(b)(3) of the Federal income tax regulations, under which the
employee agrees to accept a reduction in salary or to forego an increase in
salary and to have such amounts applied under the contract for the employee's
behalf and (ii) any program or arrangement (other than by use of agreements
described above) pursuant to which an Employer makes contributions to the
purchase of an annuity meeting the requirements of Section 403(b) of the Code.
SECTION 1.04 ANNUITY
The term "Annuity" means an annuity purchased in accordance with the terms of
the Salary Reduction Agreement or the Plan to the extent the Salary Reduction
Agreement and the annuity purchased pursuant thereto meets the requirements of
Section 403(b) of the Code or the Plan meets the requirements of Section 401(a)
of the Code, whichever is applicable.
SECTION 1.05 PARTICIPANT
The term "Participant" means a person who has been enrolled by Equitable under
the Contract through an Administrative Agreement and for whom the Employer has
purchased an annuity under the Contract. A person shall become enrolled under
the Contract upon receipt by Equitable of an enrollment form made available by
Equitable or the Employer and completed in a manner satisfactory to Equitable.
No. 15,000 AC 5904 Page 4
SECTION 1.06 ADMINISTRATIVE AGREEMENT
The term "Administrative Agreement" means a written understanding between the
Employer and Equitable which, among other things, may describe,
(i) procedures for facilitating the enrollment of Participants under the
Contract,
(ii) procedures pursuant to which contributions may be made under the
Contract on behalf of Participants,
(iii) procedures for facilitating the communication to Participants of
information prepared by Equitable concerning the Contract and
enrollment and contributions thereunder, and
(iv) the extent to which the Employer will perform any services in
connection with the Contract which would otherwise be performed by
Equitable.
SECTION 1.07 RETIREMENT DATE
The term "Retirement Date" means the date on which the Participant will attain
the retirement age specified in the Participant's enrollment form. Any time
prior to reaching this Retirement Date, the Participant may elect to change the
Retirement Date to another Retirement Date, which may be the first day of any
calendar month after the filing of the election. Any election for such change
must be made in writing by the Participant and shall not take effect until
received by Equitable at: Equitable Retirement Products Center, P.O. Box 1910,
Boston, MA 02115 or any other address that Equitable designates in written
notice to the Participant.
If no age has been specified in the enrollment form, the Retirement Date will
be deemed the first day of the calendar month following the month the
Participant attains age 65, or, if later, the Retirement Date provided under
the Plan. No Retirement Date shall be earlier than the date of attainment of
age 55.
SECTION 1.08 DEFINITIONS RELATING TO THE GUARANTEED RATE ACCOUNT
GUARANTEES: Each contribution allocated to a Participant's Guaranteed Rate
Account will be assigned to one or more of a group of Guarantees, each of which
will be distinguished by,
(i) its Contribution Quarter, as defined below,
(ii) its Duration, as defined below, and
(iii) its Guarantee Rate, as defined below.
No. 15,000 AC 5904 Page 5
CONTRIBUTION QUARTER: The Contribution Quarter for a particular Guarantee is
that calendar quarter during which Participant contributions may be assigned to
that Guarantee. After the expiration of the Contribution Quarter for a
Guarantee, no further contributions may be assigned to that Guarantee.
DURATION: The Duration for a Guarantee commences on the first day of the
Contribution Quarter for that Guarantee and ends on the last day of a calendar
quarter that is specified at the time the applicable Guarantee Rate (as defined
below) is established, as described below.
GUARANTEE RATE: The Guarantee Rate for a particular Guarantee is the effective
annual rate of interest applicable throughout the Duration of that Guarantee.
Equitable will establish and announce the Guarantee Rate at least 15 days prior
to commencement of the Contribution Quarter. The Guarantee Rate will never be
less than 3% per annum.
GUARANTEE ACCRUED VALUE: A Participant's Accrued Value with respect to a
particular Guarantee will be equal to the sum of that Participant's
contributions assigned to that Guarantee, including transfers, plus the amount
of interest credited with respect to that Guarantee, minus the sum of the
withdrawals made with respect to that Guarantee, including transfers and
Withdrawal Charges, defined below, and any applicable Participant Service
Charges, as set forth in Section 3.08. Such Accrued Value will be credited with
interest daily at an annual effective rate of interest equal to the Guarantee
Rate.
GUARANTEE WITHDRAWAL CHARGE: Any transfers or withdrawals with respect to a
Guarantee prior to the end of the Duration of that Guarantee, except for
withdrawals for Participant Service Charges as set forth in Section 3.08, or
for death or disability benefits as set forth in Section 3.10, or upon the
election of an Annuity Benefit pursuant to Section 4.03 will be subject to a
Withdrawal Charge. The Withdrawal Charge will be equal to the lesser of (i) 7%
of the amount transferred or withdrawn (including the amount of such Withdrawal
Charge), and (ii) the "interest attributable" to the amount transferred or
withdrawn, defined as (a) times the excess of (b) over (c), where
(a) is the amount transferred or withdrawn from a Guarantee divided by the
Participant's Accrued Value with respect to that Guarantee;
(b) is such Accrued Value; and
(c) is the excess to date of (i) the Participant's Contributions, including
transfers, assigned to that Guarantee over (ii) "Net Withdrawals" with
respect to that Guarantee.
The "Net Withdrawals" with respect to a Guarantee are the actual amounts
credited to a Participant through transfers with respect to that Guarantee
pursuant to Section 3.05, and the actual amounts paid to a
No. 15,000 AC 5904 Page 6
participant through partial withdrawals with respect to that Guarantee pursuant
to Section 3.06, exclusive of any withdrawal charge assessed. Withdrawals of
Participant Service Charges from a Guarantee are not included in Net
Withdrawals.
SECTION 1.09 STATE PREMIUM TAXES
The term "State Premium Taxes" means any premium tax applicable to the purchase
of annuities.
No. 15,000 AC 5904 Page 7
PART II -- THE SEPARATE ACCOUNTS
SECTION 2.01 SEPARATE ACCOUNTS
The term "Separate Accounts" means the following separate accounts maintained
by Equitable to which portions of its assets have been allocated for the
Contract and certain other contracts:
NAME INVESTMENTS
----
Separate Account No. 301: Primarily in short-term money market instruments.
Separate Account No. 302: Primarily in common stocks.
Separate Account No. 303: Primarily in publicly-traded debt securities.
Separate Account No. 304: Primarily in publicly-traded common stocks,
publicly-traded debt securities, and short-term
money market instruments.
It is contemplated that investments in the Separate Accounts will, at most
times, consist of the investments indicated above. Equitable may, however, at
its discretion invest the assets of a Separate Account in any investment
permitted by applicable law. Equitable may rely conclusively on the opinion of
counsel (including attorneys in its employ) as to what investments it is
permitted by law to make. The assets of each Separate Account may be
temporarily held uninvested for such periods as Equitable may determine.
In lieu of making such investments directly, Equitable reserves the right,
subject to applicable law, to operate any Separate Account as a "unit
investment trust" under the Investment Company Act of 1940, or in any other
form permitted by law, which invests all or part of its assets in shares or
units of a fund the investment adviser of which may be Equitable or controlled
by Equitable. The fund assets would be invested as provided above with respect
to the Separate Account.
All income and all gains and losses, whether or not realized, from assets
allocated to a Separate Account will be credited to or charged against that
Separate Account without regard to the other income, gains, or losses of the
Equitable.
Equitable reserves the right, subject to compliance with applicable law
including approval of the Contract Holder or Participants if required, (1) to
create new separate accounts, (2) to combine any two or more Separate Accounts,
(3) to transfer assets determined by Equitable to be attributable to the class
of contracts to which the Contract belongs from any of the Separate Accounts to
another separate account by withdrawing the same percentage of
No. 15,000 AC 5904 Page 8
each investment in that Account with appropriate adjustments to avoid odd lots
and fractions, (4) to cause the registration or deregistration of a Separate
Account under the Investment Company Act of 1940, (5) to operate a Separate
Account under the direction of a committee, and to discharge such committee at
any time, and (6) to restrict or eliminate any voting right of Participants or
other persons who have voting rights as to a Separate Account.
Assets of the Separate Accounts are subject to charges, to be made as described
in the Net Assets provision of Section 2.02.
The assets of each of the Separate Accounts are the property of Equitable;
however, the portion of the assets of each Separate Account equal to the
reserves and other contract liabilities with respect to such Separate Account
shall not be chargeable with liabilities arising out of any other business
Equitable may conduct. Equitable reserves the right to transfer assets of the
Separate Account in excess of such reserves and contract liabilities to the
general account of Equitable.
SECTION 2.02 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS
VALUATION PERIOD: The Valuation Period for Separate Account No. 301 starts from
the close of trading on the New York Stock Exchange and ends at the
corresponding time on the next Business Day. A Business Day for Separate
Account No. 301 is any day on which the New York Stock Exchange is open for
trading.
The Valuation Period for each Separate Account except Separate Account No. 301
starts from the close of trading on all the National Securities Exchanges on a
Business Day and ends at the corresponding time on the next Business Day. A
Business Day is any day on which any National Securities Exchange is open for
trading. A National Securities Exchange is one that is registered as such under
the Securities Exchange Act of 1934.
NET ASSETS: For a Separate Account, the Net Assets equal the value of the
assets in the Separate Account at the close of business of a Valuation Period,
minus the sum of (1) Expenses, and (2) any amount charged against the Separate
Account in such Valuation Period for taxes or for amounts set aside by
Equitable as a reserve for taxes attributable to the maintenance or operation
of the Separate Account.
NET INVESTMENT FACTOR: For a Separate Account, the Net Investment Factor for a
Valuation Period is the Net Assets at the close of business of that Valuation
Period (but before giving effect to any amounts allocated or amounts withdrawn
during that Valuation Period), divided by the Separate Account's Net Assets at
the close of business of the preceding Valuation Period.
UNIT: The Unit is a Unit used in determining the value of the interest of a
Participant's Investment Account in a Separate Account while an Account for
such participant is being maintained under the Contract.
No. 15,000 AC 5904 Page 9
UNIT VALUE: The Unit Value for each Separate Account was initially established
at $10.00 on February 5, 1982. The Unit Value with respect to a Separate
Account for each subsequent Valuation is the Unit Value for the immediately
preceding Valuation Period multiplied by the Net Investment Factor for such
subsequent Valuation Period.
EXPENSES: The Expenses which may be charged to a Separate Account for a
Valuation Period are as follows:
(1) Any amount charged against the Separate Account by Equitable during such
Valuation Period to cover certain expenses incurred in the organization
and operation of the Separate Account, including, but not limited to
taxes, interest, brokerage fees and commissions, if any, fees of the
Separate Account Committee members who are not affiliated with Equitable,
Committee meeting costs, Securities and Exchange Commission fees and
certain related expenses including printing of registration statements
and amendments, charges relating to custody of securities, certain
insurance premiums, outside auditing and legal expenses, and certain of
the costs of maintaining participant services.
(2) The daily charge against the Separate Account for each day in such
Valuation Period for administrative expense charges, calculated on the
basis of an effective annual rate of 0.25% of the value of the assets in
the Separate Account.
(3) The daily charge against the Separate Account for each day in such
Valuation Period for investment management services, calculated on the
basis of an effective annual rate of:
(i) as to Separate Account No. 301 and Separate Account No. 303,
0.35% of the first $250 million, 0.325% of the next $250
million, and 0.30% of any excess over $500 million of the
value of the assets then in the Separate Account, and
(ii) as to Separate Account No. 302 and Separate Account No. 304,
0.50% of the first $250 million, 0.45% of the next $250
million, and 0.40% of any excess over $500 million of the
value of the assets then in the Separate Account.
If the aggregate expenses of the Separate Account for a calendar year
(including the charges described in sub-paragraphs (1), (2), and (3) of this
definition but excluding interest, taxes, brokerage and, with the consent of
appropriate state regulatory authorities, extraordinary expenses) should exceed
a charge determined on the basis of an effective annual rate of (i) 1.0%, as to
Separate Account No. 301, or (ii) 1.5%, as to Separate Account No. 302,
Separate Account No. 303, and Separate Account No. 304, of the assets in such
Separate Account during such calendar year, then Equitable shall reimburse the
Separate Account for the excess.
The value of the assets in the Separate Accounts, shall be taken at their
market value, or where there is no readily available market, their fair value,
as determined in accordance with accepted accounting practices, and applicable
laws and regulations.
No. 15,000 AC 5904 Page 10
PART III -- PARTICIPANT'S ACCOUNT
SECTION 3.01 ACCOUNTS
Equitable will maintain at least one Account under the Contract for each
Participant. Each such Account will contain one or more sub-accounts,
hereinafter called "Investment Accounts." The Employer will designate in the
Administrative Agreement the investment media to be made available for
Investment Accounts for the Employer's Participants, which must include the
Money Market Investment Account. Such designated Investment Accounts will
appear on page 3 of the certificates to be issued to the Employer's
Participants pursuant to Section 5.09. Any amounts allocated to an Investment
Account will either become part of the general assets of Equitable ("General
Account"), which support the guarantees of the Contract and other contracts, or
part of a Separate Account applicable to that Investment Account, as follows:
Investment Accounts Applicable Investment Medium
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Money Market Investment Account Separate Account No. 301
Stock Investment Account Separate Account No. 302
Bond Investment Account Separate Account No. 303
Balanced Investment Account Separate Account No. 304
Guaranteed Rate Account General Account
Any amounts withdrawn from these Investment Accounts will no longer be part of
the General Account or the applicable Separate Accounts.
SECTION 3.02 ACCOUNT BALANCES OF INVESTMENT ACCOUNTS
On any day, the Account Balance of a Participant's Investment Account, other
than the Guaranteed Rate Account, will be equal to the product of the number of
Units in that Investment Account on that date and the Unit Value for the
applicable Separate Account for the Valuation Period which includes that date.
The number of Units in such an Investment Account on any date will be equal to
the sum of any Units credited to that Investment Account minus the sum of any
Units charged against that Investment Account. On any Valuation Date when a
designated amount is allocated to or withdrawn from such an Investment Account,
the Investment Account will be credited or charged, as the case may be, with a
number of Units determined by dividing the designated amount by the applicable
Unit Value for the Valuation Period which includes that date.
On any day, the Account Balance of a Participant's Guaranteed Rate Account will
be equal to the sum of the Accrued Values, on such day, with respect to all the
Guarantees to which contributions of that Participant have been allocated. On
any day, a Participant's Cash Value with respect to a particular Guarantee will
be equal to the Accrued Value with respect to that Guarantee minus any
applicable Guarantee Withdrawal Charge, as set forth in Section 1.08.
No. 15,000 AC 5904 Page 11
SECTION 3.03 CONTRIBUTIONS
The Employer is to make contributions from time to time on such dates and in
such amounts as determined by the Employer pursuant to the Participant's Salary
Reduction Agreement, or, if applicable, the terms of the Plan. The Employer is
to specify the Participant with respect to whom each contribution is being made
and the amount to be allocated to each Investment Account as designated by the
Participant.
Contributions made under the Contract are subject to the following conditions:
1. Any contribution made for the Participant by any means other than
through payroll deduction may be made only subject to Equitable's rules
then in effect. Each contribution made other than through payroll
deduction must be at least $250 or, if applicable, such greater amount
as may be required by the terms of the Plan. This minimum Contribution
amount will be stated on page 3 of the certificates issued pursuant to
Section 5.09. The $250 minimum Contribution requirement shall not be
applicable if it would prevent the Participant from contributing up to
the maximum deductible contribution allowed the Participant in the
Participant's then current tax year.
2. A contribution may be made under the Contract for a Participant
consisting of amounts derived from a plan or a "Tax Sheltered Annuity"
meeting the requirements of Section 403(b) of the Internal Revenue Code
in which the Participant had an interest.
3. Any contribution allocated to a Participant's Guaranteed Rate Account
which is not made by payroll deduction must be received by Equitable
during the first fifteen calendar days of the Contribution Quarter for
the Guarantee Period to which the allocation is assigned. That portion
of any contribution received after the first such fifteen calendar days
which is allocated to the Guaranteed Rate Account will be deemed a
contribution made without appropriate direction and allocated in
accordance with subsection 3 of Section 3.04.
4. Equitable reserves the right:
(a) to refuse to accept a contribution for a Participant's
taxable year if such contribution would bring the aggregate
amount of contributions for such taxable year to more than
the maximum amount allowed by the applicable Sections of the
Code.
(b) Upon the advance written request of the Participant's
Employer, to establish a minimum contribution requirement
with respect to contributions made by the Participant through
payroll deduction by the Participant's Employer pursuant to
an Administrative Agreement.
(c) to change the $250 minimum contribution requirement in
subsection 1 of this Section, and
(d) to change the contribution timing requirement in subsection 3
of this Section.
No. 15,000 AC 5904 Page 12
5. Any contribution will be deemed by Equitable to be made for the
Participant's current taxable year unless the Participant specifies in
writing to Equitable, subject to applicable requirements of the Internal
Revenue Code and regulations thereunder, that such contribution is for
the Participant's prior taxable year.
No. 15,000 AC 5904 Page 13
SECTION 3.04 ALLOCATIONS
Each Contribution made with respect to a Participant pursuant to Section 3.03
will be allocated to the Participant's Investment Accounts, subject to the
following conditions:
1. The direction of the allocation of Contributions to the Participant's
Investment Accounts shall be in terms of whole percentages.
2. Allocations will be made as of the date on which Equitable receives the
contribution as provided in the Administrative Agreement in the case of
payroll deductions or at the address shown on page 3 of the certificate
to be issued to the Participant pursuant to Section 5.09 in the case of
Contributions other than through payroll deductions.
3. Any Contribution made without appropriate direction as to its
allocation will be allocated to the Money Market Investment Account.
4. The Participant may change the allocation of future Contributions upon
written notice to Equitable at the address shown on page 3 of the
Certificate to be issued to the Participant pursuant to Section 5.09.
Except with respect to allocations to the Guaranteed Rate Account which
must be received within the first fifteen calendar days of a
Contribution Quarter, if a Contribution made other than through payroll
deduction accompanies the written notice, the change shall be effective
as of the date of the receipt of the Contribution. Allocation changes
unaccompanied by a check shall be effective as the date of the first
Contribution received after Equitable's receipt of the Participant's
written notice. Equitable reserves the right to limit, upon at least 90
days advance notice to the Participant, the number of such changes
allowed in a calendar year, and with respect to the Guaranteed Rate
account, the timing and effective date of such allocation changes.
5. If Equitable offers more than one Guarantee during a Contribution
Quarter, Contributions allocated to the Participant's Guaranteed Rate
Account during that Contribution Quarter will be allocated among the
Guarantees receiving contributions during such Contribution Quarter in
accordance with the instructions of the Participant. If Contributions
are received with instructions for allocation to Guarantee Period whose
Durations differ from those being offered during that Contribution
Quarter, the part of the Contribution which cannot be allocated in
accordance with those instructions will be assigned to the Guarantee
with the next shorter Duration to which Contributions are being assigned
during that Contribution Quarter, or, if Contributions are not being
assigned to a Guarantee with a shorter Duration than that requested,
then to the Guarantee of the shortest Duration that is being offered.
SECTION 3.05 TRANSFERS
A Participant may transfer amounts among the Investment Accounts maintained for
the Participant under the Contract, subject to the following conditions:
1. The request for the transfer must be made in writing and will be
effective as of the later of the date specified in such request and the
date Equitable receives such request at the address shown on page 3 of
the certificate to be issued to the Participant pursuant to Section
5.09, except as set forth in subsection 4 below. Telephone transfers may
also be permitted if authorized by the Participant in writing.
No. 15,000 AC 5904 Page 14
2. The amount so transferred will be allocated as of the date of transfer
to the Investment Account, or among the Investment Accounts, selected by
the Participant, except as set forth in subsection 4 below.
3. If only a part of the amount in an Investment Account is to be
transferred, such transfer will be made only if the amount to be
transferred is at least $250. Upon at least 90 days advance notice to
the Participant, Equitable may change the dollar amount appearing in the
immediately preceding sentence.
4. A transfer to the Guaranteed Rate Account from any of the other
Investment Accounts may be made only during the first fifteen calendar
days of a Contribution Quarter. Transfers may not be made from one
Guarantee in the Guaranteed Rate Account to another. Transfers from a
Guarantee in the Guaranteed Rate Account may not be made during the
Contribution Quarter with respect to that Guarantee, except that amounts
assigned to that Guarantee from a Guarantee ending on the last day of
the previous contribution Quarter may be transferred from the new
Guarantee during the first fifteen calendar days of the new Contribution
Quarter. Any other transfer may be made at any time.
5. Upon at least 90 days advance notice to the Participant, Equitable may
limit the number of the transfers that a Participant may make in any
twelve month period.
6. Transfers from the Guaranteed Rate Account are subject to the Guarantee
Withdrawal Charge described in Section 1.09.
SECTION 3.06 PARTIAL WITHDRAWALS
A Participant may elect by written notice to Equitable to make a partial
withdrawal from the Participant's Investment Accounts on or before such
Participant's Retirement Date. Partial withdrawals are subject to any
applicable restrictions under the terms of the Plan and to Equitable's advance
written consent if such withdrawal is for an amount of less than $250. If the
election would result in the sum of the amounts then in the Participant's
Investment Accounts being less than $10, Equitable will deem such election to
be instead an election by the Participant to terminate participation under the
Contract and will make the payment described in Section 3.09 in lieu of any
payment under this Section unless the Participant requests that the certificate
issued pursuant to Section 5.09 be permitted to remain in effect and Equitable
agrees.
Upon partial withdrawal, Equitable will pay to the Participant the lesser of
(i) the sum of the Account Balances of his Investment Accounts other than the
Guaranteed Rate Account, minus a $5 processing charge, and the Cash Value of
the Guaranteed Rate Account, or (ii) the amount of partial withdrawal requested
minus a $5 processing charge.
No. 15,000 AC 5904 Page 15
Unless Equitable is otherwise directed by the Participant, the amount so paid
will be withdrawn from the Participant's Investment Accounts in proportion to
the amount of the Participant's Account Balance in each such Investment
Account. The $5 processing charge will be withdrawn from the Investment
Accounts other than the Guaranteed Rate Account. Unless otherwise directed by
the Participant, withdrawals from the Guaranteed Rate Account will be made from
the Guarantee with the most recent Contribution Quarter of each Duration (that
is, one year, three year and so forth) represented in the Participant's
Guaranteed Rate Account in the same proportion that the sum of the Accrued
Values of the Participant's Guarantees of each Duration bears to the Account
Balance of the Participant's Guaranteed Rate Account, or, if such Accrued
Values prove insufficient from the Guarantee or Guarantees with the next most
recent Contribution Quarter.
Notwithstanding anything to the contrary in this Section, withdrawals pursuant
to this Section may not be made from a Guarantee in the Guaranteed Rate Account
during its Contribution Quarter.
Upon any payment to a Participant pursuant to this Section, Equitable will be
released from any and all liability for payments with respect to the
contributions from which the amounts so withdrawn arose.
Payments to the Participant pursuant to this Section may be deferred by
Equitable in accordance with the provisions of Section 5.06.
SECTION 3.07 EXPIRATION OF THE GUARANTEE
At the end of the Duration of a Guarantee, Equitable will assign the Accrued
Value with respect to that Guarantee (i) to the Guarantee of similar Duration
to which contributions are being assigned during the Contribution Quarter next
following, (ii) if no Guarantee of similar Duration is being offered, to the
Guarantee with the shortest Duration being offered, or (iii) as elected by the
Participant pursuant to instructions received on or before the end of the
Guarantee.
SECTION 3.08 PARTICIPANT SERVICE CHARGE
Amount:
At least once in each calendar quarter, Equitable will withdraw from each
Participant's Account a Participant Service Charge for administrative expenses.
The amount of such charge shall be determined by Equitable with respect to each
Employer but will not be more than a maximum charge of $7.50 for each
Participant in each calendar quarter. The amount determined by Equitable with
respect to each Employer will be based on such factors as (i) the method by
which contributions are being made under the Contract (payroll deduction,
direct contribution or other), (ii) the number of Participants contributing
through the same payroll deduction facility or Employer, (iii) the total
contributions Equitable estimates will be made pursuant to the Administrative
Agreement, (iv) the nature of the Employer, (v) the extent to which, as
determined by Equitable, the Employer provides services pursuant to the
Administrative Agreement that Equitable would otherwise provide, (vi) any other
circumstances having an impact on Equitable's administrative expenses, and
(vii) whether the Participant is then receiving payments under the periodic
distribution option described in Section 4.04.
No. 15,000 AC 5904 Page 16
Each such charge will be withdrawn from the Participant's Investment Accounts
in proportion to the amount the Account Balance in each Investment Account
bears to the sum of the Account Balances of the Participant's Investment
Accounts. Such withdrawals will reduce (i) the Participant's Accrued Values
with respect to the Guarantees with the most recent Contribution Quarter of
each Duration (that is, one year, three year and so forth) represented in the
Participant's Guaranteed Rate Account in the same proportion that the sum of
the Participant's Accrued Values with respect to the Guarantees of each
Duration bears to the Account Balance of the Participant's Guaranteed Rate
Account, or, if such Accrued Values prove insufficient, from the Guarantee or
Guarantees with the next most recent Contribution Quarter and so on until
sufficient amounts have been withdrawn, and (ii) the number of Units in the
Participant's other Investment Accounts.
The initial Participant Service Charge for a Participant shall be stated on
page 3 of the certificate issued to the Participant pursuant to Section 5.09.
Equitable reserves the right to withdraw the Participant Service Charge more or
less frequently than once each calendar quarter, but the amount will never
exceed $30 per annum. The Participant Service Charge is deducted first from
Contributions to the Guaranteed Rate Account, including transfers from other
Investment Accounts, and then from accrued interest. If Contributions to the
Guaranteed Rate Account are less than the applicable Participant Service Charge
in any year, the total Participant Service Charge for that year will not exceed
the amount of interest in excess of 3% which is credited to the Guaranteed Rate
Account in the absence of a service charge.
Employer Payment:
Pursuant to the terms of the Administrative Agreement the Employer may make a
contribution of an amount equal to the Participant Service Charge then due for
all the Employer's Participants covered by Equitable's TSA program. If such a
Contribution is made, no withdrawal from the Participant's Account will then be
made pursuant to this Section.
SECTION 3.09 TERMINATION OF PARTICIPATION
Subject to any applicable restrictions under the terms of the Plan, and on or
before a Participant's Retirement Date, the Participant may elect by written
notice to terminate participation under the Contract. Written notification must
be received at the address on page 3 of the certificate to be issued to the
Participant pursuant to Section 5.09. As of the date of receipt of such notice,
Equitable will determine and, subject to Section 5.06, pay the Participant the
Account Balances of the Participant's Investment Accounts other than the
Guaranteed Rate Account, minus a $5 processing charge and the Cash Value of the
Participant's Guaranteed Rate Account, less the then applicable Participant
Service Charge.
Equitable may elect to terminate the Participant's participation under the
Contract if no contribution has been made by or on behalf of the Participant
for at least three years from the date of the last contribution to the
Participant's Account and if the sum of the Account Balances of the
Participant's Investment Accounts does not exceed $2,000 or would, if it were
then the Participant's Retirement Date, provide an Annuity Benefit of less than
$20 per month. Upon so electing, the Equitable will determine and, subject to
Section 5.06, pay to the Participant the sum of the Account
No. 15,000 AC 5904 Page 17
Balances of the Participant's Investment Account other than the Guaranteed Rate
Account, and the Cash Value of the Participant's Guaranteed Rate Account minus
the then applicable Participant Service Charge.
Upon payment pursuant to this Section, Equitable will be released from any and
all liability for payments with respect to the Contributions from which the sum
of the amounts then in the Participant's Investment Accounts arose.
SECTION 3.10 DEATH OR DISABILITY BENEFIT
If a Participant dies or becomes disabled while an Account for such Participant
is being maintained under the Contract, Equitable, upon receipt of due proof of
such death or disability, will pay, in a single sum to the Participant or the
beneficiary designated by the Participant to receive such payment, the sum of
the Account Balances of the Participant's Investment Accounts as of the date of
such proof is received, minus any Participant Service Charge then applicable.
Due proof of such death or disability must be received by Equitable at:
Equitable Retirement Products Center, P.O. Box 1910, Boston MA 02110.
Payment to the Participant or the beneficiary may be deferred by Equitable in
accordance with the provisions of Section 5.06.
Upon any payment made pursuant to this Section, Equitable will be released from
any and all liability for payment with respect to the contributions made for
the Participant.
SECTION 3.11 OPTIONAL MODES OF SETTLEMENT
Any Participant may elect that all or any part of any amount that would
otherwise be payable to the Participant's beneficiary in a single sum be paid
to such beneficiary under an optional mode of settlement, subject to
Equitable's rules in effect at the time of the election. The beneficiary may
make such an election after the Participant's death if no such election made by
the Participant is then in effect.
Any payee under an optional mode of settlement elected pursuant to this Section
may designate (with the right to revoke or to change such designation) a
beneficiary to receive any amount that, in the absence of such designation,
would be payable to such payee's executors or administrators.
Any election of an optional mode of settlement may be revoked or changed by the
Participant at any time before a payment is made thereunder. Any election,
designation, revocation, or change shall be effective as of the date written
notice thereof is filed with Equitable the address shown on page 3 of the
certificate to be issued to the Participant pursuant to Section 5.09.
No. 15,000 AC 5904 Page 18
PART IV -- ANNUITY BENEFITS
SECTION 4.01 ANNUITY BENEFIT
The term "Annuity Benefit" means a series of monthly payments with respect to a
specified person or persons payable in a specified dollar amount.
The term "Annuity Value" means the amount, determined on the Participant's
Retirement Date, equal to the sum of the Account Balances of the Participant's
Investment Accounts.
The term "Amount Applied" means the portion of the Annuity Value which the
Participant elects to apply toward an Annuity Benefit pursuant to Section 4.02,
less any applicable State Premium Tax as determined by Equitable, less an
administrative fee of $175.
Each monthly payment under an Annuity Benefit under the Contract will be the
amount provided pursuant to Section 4.03.
The Normal Form of an Annuity Benefit under the Contract is the Full Cash
Refund Annuity form which provides for equal monthly payments to the
Participant beginning on the Participant's Retirement Date and ending with the
last monthly payment due before the Participant's death, and, upon receipt by
Equitable of due proof of the Participant's death, a single sum payment to the
beneficiary designated to receive such payment of an amount equal to the
excess, if any, of the Amount Applied over the sum of all the annuity payments
that have been paid to the Participant under the Contract.
SECTION 4.02 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS
As of a Participant's Retirement Date, provided such Participant is then
living, the Participant's Annuity Value shall be applied to provide an Annuity
Benefit on the Normal Form, unless such Participant elects as of such
Retirement Date to (i) terminate participation under the Contract and receive
the Cash Values of the Participant's Guaranteed Rate Account and the Account
Balances of the Participant's other Investment Accounts as a single sum, (ii)
have payments made under the periodic distribution option described in Section
4.04, (iii) have an Annuity Benefit provided pursuant to Section 4.03 or any
other annuity form or combination of forms offered by Equitable subject to
Equitable's rules then in effect, or (iv) have any combination of the three
preceding options.
Notwithstanding anything to the contrary in the preceding paragraph, Equitable
reserves the right to pay the Participant's Annuity Value to the Participant in
a single sum if less than $2,000 would be applied to provide an Annuity Benefit
or less than $20 per month would be payable under the Annuity Benefit or
periodic distribution option.
Equitable will provide appropriate notice and election forms to a Participant
[not more than six months or less than three months] before such Participant's
Retirement Date.
Equitable has the right to require the Participant to furnish pertinent facts
and determinations before providing an Annuity Benefit, and will be fully
protected in relying on such information and need not inquire as to the
accuracy or completeness thereof.
No. 15,000 AC 5904 Page 19
SECTION 4.03 AMOUNT OF ANNUITY BENEFITS
If a Participant elects an Annuity Benefit, the Amount Applied will be applied
as of the Participant's Retirement Date to provide the Annuity Benefit.
[The Amount Applied shall provide the Annuity Benefit on the basis of either
(i) the Table of Guaranteed Annuity Payments shown in Section 4.05, (ii)
Equitable's current group annuity rates for payment of proceeds for the same
class of annuitants, or (iii) Equitable's current group rates for a single
consideration immediate annuity for the same class of annuitants, whichever
rates would provide the largest benefit to the payee.] If current group annuity
rates are used, such Participant's certificate will be replaced by an Equitable
supplemental certificate.
The Table of Guarantee Annuity Payment set forth the minimum amount of monthly
income that $1,000 of Participant's Amount Applied will provide under the
Contract on the Full Cash Refund Annuity Form. The amounts of income provided
under the Annuity Benefit are based on [3% interest and the 1983 Mortality
Table and Projection Scale G.] The amounts of income for ages and annuity forms
not shown in the table will be calculated on the same basis.
Equitable may change, by an amendment to the Contract, the monthly income
amounts contained in the Table of Guaranteed Annuity Payments and the basis for
determining such amounts, for new Participants, upon advance notice to the
Contract Holder.
SECTION 4.04 PERIODIC DISTRIBUTION OPTION
The Participant may elect pursuant to Section 4.02 to receive the Account
Balance of each of the Participant's Investment Accounts, other than the
Guaranteed Rate Account, under the periodic distribution option. Such option,
subject to the conditions set forth in the following paragraphs, provides a
series of monthly installment payments over a number of whole years beginning
as of the Participant's Retirement Date, or as soon thereafter as is
practicable. The number of whole years will be the lesser of (i) the number of
whole years designated by the Participant before the Participant's Retirement
Date and (ii) the number of years equal to the greater of the life expectancy
of the Participant, and the joint and last survivor expectancy of the
Participant and the Participant's spouse as of the Participant's Retirement
Date, rounded to the next lower year.
Conditions:
1. No payments may be made under the periodic distribution option from the
Guaranteed Rate Account, and no amounts may be retained in the Guaranteed
Rate Account while payments are being made under the periodic distribution
option.
2. The monthly amount of installment payments shall be computed by Equitable
monthly, beginning on the date as of which monthly installment payments
commence and, thereafter, as of the first day of each succeeding month.
The amount of each such monthly installment payment shall be determined by
dividing the sum of the Account Balances of the Participant's Investment
Accounts as of the first day of each such month by the number of months
then remaining under the periodic distribution option, less a monthly
transaction charge of $1.50 which will be deducted from the payment.
No. 15,000 AC 5904 Page 20
3. Each monthly installment payment before deduction of the $1.50 transaction
charge will be withdrawn from the Participant's Investment Accounts in
proportion to the amount of the Participant's interest in each such
Investment Account immediately before such payment is made.
4. The Participant Service Charge will continue to be withdrawn from the
Participant's Account in accordance with Section 3.08; during the last
whole year of installment payments such charge shall be deducted as
necessary from the last monthly installment payments made.
5. While monthly installment payments are being made,
(a) the participant may transfer amounts among the Investment
Accounts other than the Guaranteed Rate Account maintained for
the Participant pursuant to Section 3.01, but
(b) no Contributions may be made for or by the Participant.
6. The Participant may elect by advance written notice to have Equitable cease
making monthly installment payments and instead pay in a single sum to the
participant the sum of the Account Balances of the Participant's
Investment Accounts minus a $5 processing charge. Upon making such payment
Equitable will be released from any and all liability for payments with
respect to the Contributions made for the Participant from which the
payment arose.
7. No monthly installment payment shall be of an amount greater than the sum of
the Account Balances of the Participant's Investment Accounts immediately
before the due date of such payment.
8. If the Participant dies while monthly installment payments are being made, a
single sum death benefit will be paid to the Participant's beneficiary
pursuant to Section 3.10. Upon payment of such death benefit, Equitable
will be released from any and all liability for payments with respect to
the Contributions made for the Participant from which the death benefit
payment arose.
SECTION 4.05 PAYMENT OF BENEFITS
Evidence of each payee's survival must be furnished to Equitable either by
personal endorsement of the check drawn for payment or by other means
satisfactory to Equitable.
If a benefit payable under the Contract was based on information about the
Participant's age or identity that is subsequently found to be incorrect,
such benefit will not be invalidated, but an adjustment on the basis of the
correct information will be made in the amount of the benefit payments, or
any amount used to provide the benefit, or any combination thereof. Such
adjustment, with interest at the rate of 6% per year, will be added to any
payments thereafter falling due under the Contract with respect to the
payee.
The liability of Equitable with respect to a payee is limited to the
correct information and the actual amounts used to provide the benefits
then in force with respect to the payee under the Contract.
No. 15,000 AC 5904 Page 21
With respect to any other statements required as a condition of issuing a
certificate to a Participant pursuant to Section 5.09, except statements
relating to the disability benefit in Section 3.10, the certificate shall be
incontestable after it has been in force during the lifetime of the participant
for two years.
If Equitable receives evidence satisfactory to it that (i) a payee entitled to
receive any payment under the Contract is physically or mentally incompetent to
receive such payment or is a minor, (ii) another person or an institution is
then maintaining or has custody of such payee, and (iii) no guardian,
committee, or other representative of the estate of such payee has been
appointed, Equitable may make the payments (in the case of a minor, in an
amount not exceeding $50 a month) to such other person or institution, and will
thereupon be fully discharged from all liability with respect thereto.
If an annuity form made available by Equitable provides for payment for a
period certain, such as 120 or 180 months, and thereafter during the remaining
lifetime of one person, or of at least one of two persons, a payee for payments
thereunder may elect, without the concurrence of any other person, to receive
the commuted value of any remaining payments, provided no person upon whose
life the income depends is surviving.
Upon election by a Participant pursuant to Section 4.02 of an annuity form
providing payments for a period certain, such Participant may designate (with
the right to change such designation) a person or persons to receive any
payments that may become due after the death of the person or persons upon
whose life or lives the income may depend.
Payments under annuity forms with life contingencies terminate with the last
payment due before the death of the person or persons upon whose life the
income depends or the end of the certain period, whichever is later.
Equitable will require satisfactory evidence of the age of any person up whose
life an annuity form depends.
No. 15,000 AC 5904 Page 22
TABLE OF GUARANTEED ANNUITY PAYMENTS
(Based on Age Nearest Birthday on Due Date of First Payment)
Annuity Benefit Payable On The Full Cash Refund Annuity Form
(Minimum Monthly Income Per $1,000 of Amount Applied)
Age Xxxxxxx Xxxxxxx
------ ----------------
60 4.18
61 4.26
62 4.34
63 4.43
64 4.52
65 4.62
66 4.73
67 4.83
68 4.95
69 5.07
70 5.20
Amounts applicable for ages or for annuity forms not shown will be calculated
by Equitable on the same actuarial basis.
No. 15,000 AC 5904 Page 23
PART V -- GENERAL PROVISIONS
SECTION 5.01 CONTRACT
The Contract constitutes the entire contract between the parties and the
provisions of the Contract alone will govern with respect to the rights and
obligations of Equitable. The provisions of the Contract will be applied
separately with respect to each Participant. Nothing in the enrollment form
referred to in Section 1.05, the administrative agreement referred to in
Section 1.06, the trust agreement referred to in Section 5.08 nor any
modification, amendment, or supplement to any such documents will in any way be
construed to enlarge, change, vary or in any other way affect the obligations
of Equitable as expressly provided in the Contract.
The Contract may not be modified as to Equitable, nor may any of Equitable's
rights or requirements be waived, except in writing and by an authorized
officer of Equitable. The Contract may be changed by amendment or replacement
upon agreement between the Contract Holder and Equitable without the consent of
any other person provided that such change does not reduce any Cash Value,
Account Balance, Annuity Value, or Annuity Benefit provided before such change
and provided that no rights, privileges or benefits which have accrued to any
Participant under the Contract may be reduced or forfeited except by the
express consent of such Participant.
SECTION 5.02 STATUTORY COMPLIANCE
Equitable reserves the right to amend the Contract without the consent of any
other person in order to comply with applicable laws and regulations. Such
right shall include, but shall not be limited to, the right to conform the
Contract and any certificate to reflect changes in the Internal Revenue Code,
or in regulations or published rulings of the Internal Revenue Service, so that
each such certificate will continue to be an Annuity covered under Section 72
of the Internal Revenue Code.
Any Annuity Benefit, Accrued Values, Account Balance or death or disability
benefit available under a certificate issued pursuant to the Contract shall not
be less than the minimum benefits required by any statute of the state in which
the certificate is delivered.
SECTION 5.03 ASSIGNMENTS AND NON-TRANSFERABILITY
The entire interest of any Participant under the Contract is nonforfeitable.
No interest of a Participant under the Contract may be sold, assigned,
discounted, or pledged as collateral for a loan or as security for the
performance of an obligation or for any other purpose to any person other than
Equitable.
No amount payable under the Contract may be assigned or encumbered by the payee
and, to the extent permitted by law, no such amount will in any way be subject
to any claim against such payee.
No. 15,000 AC 5904 Page 24
SECTION 5.04 BENEFICIARY
Each Participant, as of such Participant's Enrollment Date, is to provide
Equitable with an initial designation of a beneficiary or beneficiaries
entitled to receive any payment with respect to such participant becoming due
under the Contract after the death of the Participant. The Participant may
change such designation from time to time. Any such designation or change will
be made by written notice on a form satisfactory to Equitable. A change will,
upon receipt at a designated Equitable Office, take effect as of the time the
written notice was signed, whether or not the Participant is living on the date
of receipt, but without further liability as to any payment or other settlement
made by Equitable before receipt of such change.
Unless otherwise specified in the designation, if a Participant has designated
two or more persons as beneficiary, the beneficiary will be the designated
person or persons who survive the Participant, and if more than one survive
they will share equally.
If upon the death of a person there is no designated beneficiary then living
entitled to receive any single sum payment or any remaining periodic payments
then becoming due to a beneficiary with respect to a Participant, Equitable
shall pay such single sum payment or the commuted values of such periodic
payments to the first surviving class of the following classes of successive
preference beneficiaries: (a) the Participant's surviving spouse, (b) the
Participant's surviving children, (c) the executors or administrators of the
person upon whose death the payment becomes due.
Any commuted value shall be determined on the basis of compound interest at the
rate determined by Equitable as consistent with the actuarial basis used in
providing the annuity benefits.
If the Participant so elects in writing, any amount that would otherwise be
payable to the beneficiary in a single sum may be applied to provide an Annuity
Benefit, on the form of annuity elected by the Participant with respect to the
beneficiary, subject to Equitable's rules then in effect. If at the death of a
Participant there is no election in effect to apply the Death Benefit to
provide an Annuity Benefit, the beneficiary may make such an election.
SECTION 5.05 FUTURE PARTICIPANTS
Equitable reserves the right at its sole discretion to curtail or prohibit
further enrollment as Participants under the Contract of any individuals who
are not currently participating under the Contract as of such date of
curtailment or prohibition.
SECTION 5.06 DEFERMENT
Except as provided in this Section, payments by Equitable from the
Participant's Account pursuant to the provisions of Sections 3.06, 3.09, and
Section 3.10 will be made within seven days after receipt of a written request
for such surrender or withdrawal, or receipt of due proof of death or
disability of the Participant.
No. 15,000 AC 5904 Page 25
During any period when (i) the sale of securities or the determination of the
Unit Value is not reasonably practicable because an emergency, defined by the
Securities and Exchange Commission, exists, or the New York Stock Exchange is
closed or trading on such Exchange is restricted, or (ii) the Securities and
Exchange Commission may by order permit postponement for the protection of
persons having interests in a Separate Account, Equitable reserves the right:
(a) to defer payment of the Account Balance of a Participant's
Investment Account other than the Guaranteed Rate Account;
(b) to defer payment of any portion of a death or disability benefit
arising from an amount in a Participant's Investment Accounts
other than the Guaranteed Rate Account, or
(c) in the event of (a) above, to defer application of such amounts
to provide any Annuity Benefit permitted under the Contract.
Payments by Equitable from the Guaranteed Rate Account pursuant to Section
3.06, Section 3.09 or Section 3.10 or any commuted payments arising from an
annuity pursuant to Section 4.05 may be deferred for up to six months after
receipt of a written request for such withdrawal or termination, receipt of due
proof of disability or death of the Participant, or receipt of due
documentation for such commutation. Interest at the applicable Guarantee Rate
for the amount withdrawn will be allowed on any payment deferred for 30 days or
more.
SECTION 5.07 ANNUAL NOTICE
As soon as practicable after the end of each calendar year Equitable, provided
an Account is being maintained for the Participant at the end of such calendar
year, will furnish the Participant with a notice showing as of a specified
recent date (1) the total number of Units credited to each Investment Account
other than the Guaranteed Rate Account, (2) the Unit Value of such Investment
Accounts, (3) the Account Balance of each Investment Account, (4) the sum of
the Account Balances of each Investment Account, and (5) the Cash Value of the
Guaranteed Rate Account.
SECTION 5.08 CONTRACT HOLDER RESPONSIBILITY
The sole responsibility of the Contract Holder is to serve as party to the
Contract. The Contract Holder will have no responsibility for the
administration of any plan, for payments to the Accounts, for any payments,
distributions or duties thereunder. Equitable will deal with the Contract
Holder in accordance with the terms and conditions of the trust agreement
pursuant to which the Contract Holder agreed to act as such and with the
Contract and in such manner as the Contract Holder and Equitable may agree,
without the consent of any other person.
No. 15,000 AC 5904 Page 26
SECTION 5.09 CERTIFICATE
Equitable will issue to each Participant an individual certificate setting
forth a statement in substance of the benefits to which such Participant is
entitled under the Contract. Nothing in the Contract will invalidate or impair
any rights granted to a Participant in such certificates or under the New York
Insurance Law.
SECTION 5.10 DISQUALIFICATION
In the event that an annuity purchased hereunder with respect to a Participant
fails to qualify as an Annuity as described in Section 1.04, Equitable shall
have the right, upon receiving notice of such fact before the Retirement Date,
to terminate participation with respect to such Participant under the Contract
and pay to that Participant the sum of the Cash Values of the Participant's
Guaranteed Rate Account and the Account Balances of the Participant's other
Investment Accounts less a deduction for any applicable Participant Service
Charge and for the appropriate part attributable to such Participant of any
Federal income tax payable by Equitable which would not have been payable if
such Participant had not had any annuity under the Contract.
SECTION 5.11 PARTICIPATION IN SURPLUS
The Contract and all other contracts in the same class of contracts shall be
combined for the purpose of ascertaining the annual surplus of Equitable to be
apportioned among such contracts as a dividend. Equitable shall determine the
portion of such dividend to be allocated to the Contract; however, the amount
thereof is expected to be minimal. Any amount allocated to the Contract shall
be payable as of January 1 of the calendar year in which a dividend is
apportioned. Dividends will be payable to the Participant's Account and
allocated in accordance with the Account Balances in the Guaranteed Rate
Accounts maintained for Participants under this Contract. Dividends will be
assigned to the Guarantee of the shortest Duration to which contributions are
being assigned during the Contribution Quarter when the dividend is paid.
No. 15,000 AC 5904 Page 27
APPLICATION FOR GROUP ANNUITY CONTRACT
To:
The EQUITABLE Life Assurance Society of the United States
UNITED STATES TRUST COMPANY OF NEW YORK
--------------------------------------------------------------------------------
(hereinafter called the Applicant)
00 Xxxx Xxxxxx, Xxx Xxxx, Xxx Xxxx 00000
of
------------------------------------------------------------------------------
(Applicant's Head Office Address)
XXXXXX APPLIES for a Group Annuity Contract in the form attached, and approves
and accepts the terms of such Group Annuity Contract. This application
supersedes any application for the said contract previously signed by the
Applicant.
This contract will take effect as of --------------------- 1, 1983.
Dated
at
--------------------------------
Signature of
Applicant
------------------------------
---------------------------------------
---------------------------------------
---------------------------------------
Official
Title
----------------------------------
No. 15,000 AC 5904 Page 28
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Effective as of the dates specified below, or your Participation Date,
whichever is later, we have amended Group Annuity Contract AC 5904 as follows:
1. The Equitable office address on page 3 is amended as of November 1, 1985 to
read as follows:
"The Equitable Life Assurance Society
P.O. Box 2509
General Post Office
New York, New York 10116."
2. Section 1.02 entitled "Plan" is amended, as of January 1, 1985, to read as
follows:
"The term "Plan" means a program established by an Employer described in
clause (ii) of Section 1.01, for the purchase of Annuities on behalf of
employees under the Contract, which program is not exempt under 29 Code
of Federal Regulations Section 2510.3-2(f) and is therefore an
"employee pension benefit plan" subject to the requirements of Title I
of the Employee Retirement Income Security Act of 1974 ("ERISA") as it
may be amended from time to time."
3. Section 1.04 entitled "Annuity" is amended, as of January 1, 1985, to read
as follows:
"The term "Annuity" means an annuity purchased in accordance with the
terms of the Salary Reduction Agreement, program or Plan which annuity
meets the requirements of Section 403(b) of the Code."
4. In Section 1.07 entitled "Retirement Date" the following amendments are
made:
A. As of November 1, 1985 the third sentence of the first paragraph is
amended to read as follows:
"Any election for such change must be made in writing by the
Participant and shall not take effect until received by Equitable at:
The Equitable Life Assurance Society, P.O. Box 2509, General Post
Office, New York, New York 10116, or any other address that Equitable
designates in written notice to the Participant."
B. As of January 1, 1985 a new third paragraph is added to read as
follows:
2
"If participation under the Contract is pursuant to the terms of a
Plan, the designation of, and any election to change the Retirement
Date under this Section 1.07 shall be made by the Participant in
accordance with this Section 1.07 and the terms of the Plan."
5. In Section 1.08 entitled "Definitions Relating to Guaranteed Rate Account"
the following amendments are made:
A. The definition of "Guarantee Rate" in the fourth paragraph thereof is
amended as of February 1, 1986 by deleting the phrase "15 days" and
placing in lieu thereof the phrase "10 days".
B. The following last sentence is added to the definition of "Guarantee
Withdrawal Charge" in the sixth paragraph thereof, as of January 1,
1986, to read as follows:
"The Withdrawal Charge will be deducted from the remaining amounts in
the Participant's Guarantee after the withdrawal payment is
processed; except the Withdrawal Charge may be deducted from the
withdrawal payment if there is an insufficient amount in the
Participant's Guarantee to pay such charge."
3
6. In Section 3.03 entitled "Contributions" condition number 3 is amended as of
February 1, 1986 by deleting the phrase "fifteen calendar days" both
places it appears and by placing in lieu thereof the phrase "twenty
calendar days."
7. In Section 3.04 entitled "Allocations" condition number 4 is amended as of
February 1, 1986 by deleting the phrase "fifteen calendar days" in the
second sentence thereof and by placing in lieu thereof the phrase "twenty
calendar days."
8. In Section 3.05 entitled "Transfers" condition number 4 is amended as of
February 1, 1986 by deleting the phrase "fifteen calendar days" in both
places it appears and by placing in lieu thereof the phrase "twenty
calendar days."
9. In Section 3.06 entitled "Partial Withdrawals" the third paragraph is
amended as of January 1, 1986 to read as follows:
"Upon partial withdrawal, Equitable will pay the Participant the lesser
of (i) the amount of partial withdrawal requested or (ii) the sum of the
Account Balances of his Investment Accounts other than the Guaranteed
Rate Account. A processing charge of $5 will be deducted from the
remaining Account Balances of the Participant's Investment Accounts
after the partial withdrawal
4
payment is processed; however, the processing charge may instead be
deducted from the partial payment."
10. In Section 3.09 entitled "Termination of Participation" the first sentence
is amended as of January 1, 1985 to read as follows:
"Subject to any applicable restrictions under the terms of an Employer's
program or Plan, and on or before a Participant's Retirement Date, the
Participant may elect by written notice to terminate participation under
the Contract."
11. In Section 3.10 entitled "Death or Disability Benefit" the last sentence of
the first paragraph is amended as of November 1, 1985 to read as follows:
"Due proof of such death or disability must be received by Equitable at:
The Equitable Life Assurance Society, P.O. Box 2509, General Post
Office, New York, New York 10116, or any other address Equitable
designates in written notice to the Participant."
12. In Section 4.04 entitled "Periodic Distribution Option" the following
amendments are made as of January 1, 1986:
A) The last sentence of Condition number 2 is amended
5
by deleting it and replacing it with the following two sentences:
"2. The amount of each such monthly installment payment shall be
determined by dividing the sum of the Account Balances of the
Participant's Investment Accounts as of the first day of each
such month by the number of months then remaining under the
periodic distribution option. A monthly transaction charge of
$1.50 will be deducted proportionately from the remaining Account
Balances of the Participant's Investment Accounts after each such
monthly installment payment is determined, provided, however,
that the transaction charge of $1.50 may be deducted from the
last payment made."
B. Condition number 3 is amended to read as follows:
"3. Each monthly installment payment will be withdrawn from the
Participant's Investment Accounts in proportion to the amount of
the Participant's interest in each such Investment Account
immediately before such payment is made."
6
13. New Section 4.06 is added as of January 1, 1985 to read as follows:
"Section 4.06 SPECIAL ANNUITY AND SPOUSAL
CONSENT PROVISIONS APPLICABLE
TO PLANS
"If participation under the Contract is pursuant to the terms of a Plan, then
the provisions of this Section 4.06 shall supersede any contrary provisions in
the Contract and Certificate.
"Unless a married Participant and his or her spouse elect otherwise in
accordance with the terms of the Plan and as provided in this Section 4.06,
Account Balances payable pursuant to the terms of the Contract shall be paid to
the Participant in the form of a "Qualified Joint and Survivor Annuity." A
"Qualified Joint and Survivor Annuity" is an Annuity Benefit in which the
Amount Applied is applied to provide an annuity for the life of the Participant
with a survivor annuity for the life of the Participant's spouse which is not
less than 50% and not more than 100% of the annuity which is payable during the
joint lives of the Participant and his or her spouse. If the Participant is
unmarried and does not elect otherwise, the Amount Applied shall be applied to
provide an annuity for his or her life.
7
"In addition, unless a contrary election is made pursuant to the terms of the
Plan and this Section 4.06, if a married Participant dies before payment of his
or her Account Balances have commenced, then the Amount Applied shall be
applied to purchase an annuity for the life of the Participant's spouse.
"The Participant may elect, on a form acceptable to Equitable, within the 90
consecutive day period before the date as of which payment of the value of the
Account Balances is to commence, not to have the Amount Applied applied to
provide a Qualified Joint and Survivor Annuity, or if he or she is not married,
a life annuity, in which case he or she may elect any other form of payment
available under the terms of the Plan and the Contract. The Participant may
also elect, on a form acceptable to Equitable, on the first day of the Plan
year in which he or she turns age 35 (or if he or she ceases to work for the
Employer prior to that Plan year, as of the date he or she ceases to work for
the Employer) for a beneficiary other than the spouse to receive payment of the
value of the Account Balances in the event of his or her death (less any
applicable charges and taxes as determined by Equitable). An election under
either of the two preceding sentences must be consented to by the Participant's
spouse, if applicable, in writing before a notary or a representative of the
Plan and must be limited to a benefit for a specific alternate beneficiary.
However, no spousal consent will be required if the Participant
8
can prove to the satisfaction of the Employer and Equitable, that he or she has
no spouse or else that he or she cannot locate the spouse. Each election to
designate a beneficiary other than the Participant's spouse must be consented
to by the spouse and any election made under this paragraph to waive the
spouse's benefits may be revoked without the consent of the spouse at any time
prior to the date as of which payments commence. Any consent to waive the
spouse's benefits shall be valid only with regard to the spouse who signs it.
Any new waiver or change of beneficiary shall require new spousal consent.
"The provisions requiring spousal consent in this Section 4.06 shall also apply
with regard to a Participant's election to withdraw his or her Account Balances
pursuant to Sections 3.06 or 3.09. A spouse's written consent, witnessed by a
representative of the Plan or notary, must be given on a form acceptable to
Equitable within the 90 consecutive day period prior to such withdrawal unless
the Participant can show that he or she is not married or his or her spouse
cannot be located.
"The foregoing notwithstanding, if the present value of the Participant's
Account Balances on the date payment is to commence is less than $2,000,
Equitable may choose to make payment in a single sum rather than in the form of
a Qualified
9
Joint and Survivor Annuity or life annuity as described herein.
"Upon any payment made pursuant to this Section 4.06, Equitable will be
released from any and all liability for payment with respect to the
contributions made for the Participant."
/s/ Xxxxxx X. Xxxxxx /s/ Xxxx X. Xxxxxx
---------------------------- ----------------------------
Vice President and Secretary President
10
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Effective as of the dates specified below, or your Participation Date,
whichever is later, we have amended the Certificate issued under Group Annuity
Contract AC 5904 as follows:
1. The Equitable office address on page 3 is amended as of November 1, 1985 to
read as follows:
"The Equitable Life Assurance Society
P.O. Box 2509
General Post Office
New York, New York 10116."
2. Section 1.02 entitled "Plan" is amended, as of January 1, 1985, to read as
follows:
"The term "Plan" means a program established by an Employer described in
clause (ii) of Section 1.01, for the purchase of Annuities on behalf of
employees under the Contract, which program is not exempt under 29 Code
of Federal Regulations Section 2510.3-2(f) and is therefore an
"employee pension benefit plan" subject to the requirements of Title I
of the Employee Retirement Income Security Act of 1974 ("ERISA") as it
may be amended from time to time."
3. Section 1.04 entitled "Annuity" is amended, as of January 1, 1985, to read
as follows:
"The term "Annuity" means an annuity purchased in accordance with the
terms of the Salary Reduction Agreement, program or Plan which annuity
meets the requirements of Section 403(b) of the Code."
4. In Section 1.07 entitled "Retirement Date" the following amendments are
made:
A. As of November 1, 1985 the third sentence of the first paragraph is
amended to read as follows:
"Any election for such change must be made in writing by the
Participant and shall not take effect until received by Equitable at:
The Equitable Life Assurance Society, P.O. Box 2509, General Post
Office, New York, New York 10116, or any other address that Equitable
designates in written notice to the Participant."
B. As of January 1, 1985 a new third paragraph is added to read as
follows:
2
"If participation under the Contract is pursuant to the terms of a
Plan, the designation of, and any election to change the Retirement
Date under this Section 1.07 shall be made by the Participant in
accordance with this Section 1.07 and the terms of the Plan."
5. In Section 1.08 entitled "Definitions Relating to Guaranteed Rate Account"
the following amendments are made:
A. The definition of "Guarantee Rate" in the fourth paragraph thereof is
amended as of February 1, 1986 by deleting the phrase "15 days" and
placing in lieu thereof the phrase "10 days".
B. The following last sentence is added to the definition of "Guarantee
Withdrawal Charge" in the sixth paragraph thereof, as of January 1,
1986, to read as follows:
"The Withdrawal Charge will be deducted from the remaining amounts in
the Participant's Guarantee after the withdrawal payment is
processed; except the Withdrawal Charge may be deducted from the
withdrawal payment if there is an insufficient amount in the
Participant's Guarantee to pay such charge."
3
6. In Section 3.03 entitled "Contributions" condition number 3 is amended as of
February 1, 1986 by deleting the phrase "fifteen calendar days" both places
it appears and by placing in lieu thereof the phrase "twenty calendar days."
7. In Section 3.04 entitled "Allocations" condition number 4 is amended as of
February 1, 1986 by deleting the phrase "fifteen calendar days" in the
second sentence thereof and by placing in lieu thereof the phrase "twenty
calendar days."
8. In Section 3.05 entitled "Transfers" condition number 4 is amended as of
February 1, 1986 by deleting the phrase "fifteen calendar days" in both
places it appears and by placing in lieu thereof the phrase "twenty calendar
days."
9. In Section 3.06 entitled "Partial Withdrawals" the third paragraph is
amended as of January 1, 1986 to read as follows:
"Upon partial withdrawal, Equitable will pay the Participant the lesser
of (i) the amount of partial withdrawal requested or (ii) the sum of the
Account Balances of his Investment Accounts other than the Guaranteed
Rate Account. A processing charge of $5 will be deducted from the
remaining Account Balances of the Participant's Investment Accounts
after the partial withdrawal
4
payment is processed; however, the processing charge may instead be
deducted from the partial payment."
10. In Section 3.09 entitled "Termination of Participation" the first sentence
is amended as of January 1, 1985 to read as follows:
"Subject to any applicable restrictions under the terms of an Employer's
program or Plan, and on or before a Participant's Retirement Date, the
Participant may elect by written notice to terminate participation under
the Contract."
11. In Section 3.10 entitled "Death or Disability Benefit" the last sentence of
the first paragraph is amended as of November 1, 1985 to read as follows:
"Due proof of such death or disability must be received by Equitable at:
The Equitable Life Assurance Society, P.O. Box 2509, General Post
Office, New York, New York 10116, or any other address Equitable
designates in written notice to the Participant."
12. In Section 4.04 entitled "Periodic Distribution Option" the following
amendments are made as of January 1, 1986:
A) The last sentence of Condition number 2 is amended
5
by deleting it and replacing it with the following two sentences:
"2. The amount of each such monthly installment payment shall be
determined by dividing the sum of the Account Balances of the
Participant's Investment Accounts as of the first day of each
such month by the number of months then remaining under the
periodic distribution option. A monthly transaction charge of
$1.50 will be deducted proportionately from the remaining Account
Balances of the Participant's Investment Accounts after each such
monthly installment payment is determined, provided, however,
that the transaction charge of $1.50 may be deducted from the
last payment made."
B. Condition number 3 is amended to read as follows:
"3. Each monthly installment payment will be withdrawn from the
Participant's Investment Accounts in proportion to the amount of
the Participant's interest in each such Investment Account
immediately before such payment is made."
6
13. New Section 4.06 is added as of January 1, 1985 to read as follows:
"Section 4.06 SPECIAL ANNUITY AND SPOUSAL
CONSENT PROVISIONS APPLICABLE
TO PLANS
"If participation under the Contract is pursuant to the terms of a Plan, then
the provisions of this Section 4.06 shall supersede any contrary provisions in
the Contract and Certificate.
"Unless a married Participant and his or her spouse elect otherwise in
accordance with the terms of the Plan and as provided in this Section 4.06,
Account Balances payable pursuant to the terms of the Contract shall be paid to
the Participant in the form of a "Qualified Joint and Survivor Annuity." A
"Qualified Joint and Survivor Annuity" is an Annuity Benefit in which the
Amount Applied is applied to provide an annuity for the life of the Participant
with a survivor annuity for the life of the Participant's spouse which is not
less than 50% and not more than 100% of the annuity which is payable during the
joint lives of the Participant and his or her spouse. If the Participant is
unmarried and does not elect otherwise, the Amount Applied shall be applied to
provide an annuity for his or her life.
7
"In addition, unless a contrary election is made pursuant to the terms of the
Plan and this Section 4.06, if a married Participant dies before payment of his
or her Account Balances have commenced, then the Amount Applied shall be
applied to purchase an annuity for the life of the Participant's spouse.
"The Participant may elect, on a form acceptable to Equitable, within the 90
consecutive day period before the date as of which payment of the value of the
Account Balances is to commence, not to have the Amount Applied applied to
provide a Qualified Joint and Survivor Annuity, or if he or she is not married,
a life annuity, in which case he or she may elect any other form of payment
available under the terms of the Plan and the Contract. The Participant may
also elect, on a form acceptable to Equitable, on the first day of the Plan
year in which he or she turns age 35 (or if he or she ceases to work for the
Employer prior to that Plan year, as of the date he or she ceases to work for
the Employer) for a beneficiary other than the spouse to receive payment of the
value of the Account Balances in the event of his or her death (less any
applicable charges and taxes as determined by Equitable). An election under
either of the two preceding sentences must be consented to by the Participant's
spouse, if applicable, in writing before a notary or a representative of the
Plan and must be limited to a benefit for a specific alternate beneficiary.
However, no spousal consent will be required if the Participant
8
can prove to the satisfaction of the Employer and Equitable, that he or she has
no spouse or else that he or she cannot locate the spouse. Each election to
designate a beneficiary other than the Participant's spouse must be consented
to by the spouse and any election made under this paragraph to waive the
spouse's benefits may be revoked without the consent of the spouse at any time
prior to the date as of which payments commence. Any consent to waive the
spouse's benefits shall be valid only with regard to the spouse who signs it.
Any new waiver or change of beneficiary shall require new spousal consent.
"The provisions requiring spousal consent in this Section 4.06 shall also apply
with regard to a Participant's election to withdraw his or her Account Balances
pursuant to Sections 3.06 or 3.09. A spouse's written consent, witnessed by a
representative of the Plan or notary, must be given on a form acceptable to
Equitable within the 90 consecutive day period prior to such withdrawal unless
the Participant can show that he or she is not married or his or her spouse
cannot be located.
"The foregoing notwithstanding, if the present value of the Participant's
Account Balances on the date payment is to commence is less than $2,000,
Equitable may choose to make payment in a single sum rather than in the form of
a Qualified
9
Joint and Survivor Annuity or life annuity as described herein.
"Upon any payment made pursuant to this Section 4.06, Equitable will be
released from any and all liability for payment with respect to the
contributions made for the Participant."
/s/ Xxxxxx X. Xxxxxx Vice /s/ Xxxx X. Xxxxxx
------------------------- ------------------
President and Secretary President
10
