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EXHIBIT 4
ANCHOR NATIONAL
Life Insurance Company [LOGO] Anchor National
▇▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇ ▇ ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇
▇▇▇ ▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇
This is an annuity contract on the life of the Annuitant. We will make periodic
annuity payments beginning on the Annuity Date, as set forth in this Contract.
This Contract is owned by you, the Contract Owner.
This Contract has been issued in return for the attached application and for the
initial Purchase Payment made.
TEN-DAY FREE LOOK
To be sure that you are satisfied with this Contract, you have a ten-day free
look. Within ten days of the day you receive this Contract, it may be returned
by delivering it or mailing it to us at our Annuity Service Office listed on the
Contract Data Page, or to the agent through whom it was purchased. Within seven
days of receipt of this Contract by us, we will pay you the Contract Value
computed at the end of the Valuation Period during which this Contract is
received by us.
Signed for the Company.
/s/ ▇▇▇▇▇ ▇. ▇▇▇▇▇▇ /s/ ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇
-------------------------- ------------------------------
▇▇▇▇▇ ▇. ▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇
Secretary President
INDIVIDUAL FLEXIBLE PURCHASE PAYMENT
DEFERRED VARIABLE ANNUITY CONTRACT
NONPARTICIPATING
NO DIVIDENDS
ANNUITY PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT ARE VARIABLE AND ARE NOT
GUARANTEED AS TO DOLLAR AMOUNT.
PLEASE READ THIS CONTRACT CAREFULLY, IT DEFINES YOU LEGAL RIGHTS AND IS A
CONVENIENT SOURCE OF INFORMATION AND REFERENCE IN HELPING YOU FULLY UNDERSTAND
AND BENEFIT FROM YOUR CONTRACT.
THE VARIABLE PROVISIONS OF THIS CONTRACT
CAN BE FOUND ON PAGES 6 AND 9.
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CONTRACT DATA PAGE
ANNUITANT: CONTRACT NUMBER:
▇▇▇▇ ▇. ▇▇▇▇▇ 009000001
ISSUE DATE: CONTRACT OWNER:
APRIL 25, 1990 ▇▇▇▇ ▇. ▇▇▇▇▇
ANNUITY DATE: INITIAL PURCHASE PAYMENT:
AUGUST 01, 2016 $3,000.00
NON-QUALIFIED PLAN
ANNUITY SERVICE OFFICE:
ANCHOR NATIONAL LIFE INSURANCE COMPANY
ADMINISTRATIVE SERVICES
P.O. BOX 1600
DENVER, CO 80201-1600
MONEY MARKET PORTFOLIO
GOVERNMENT AND QUALITY BOND PORTFOLIO
FIXED INCOME PORTFOLIO
GROWTH PORTFOLIO
HIGH YIELD PORTFOLIO
AGGRESSIVE GROWTH PORTFOLIO
FOREIGN SECURITIES PORTFOLIO
CONVERTIBLE SECURITIES PORTFOLIO
MULTI-ASSET PORTFOLIO
AGGRESSIVE MULTI-ASSET PORTFOLIO
NATURAL RESOURCES PORTFOLIO
TARGET '98 PORTFOLIO
GENERAL ACCOUNT
A TOTAL WITHDRAWAL OR A PARTIAL WITHDRAWAL IN EXCESS OF THE FREE WITHDRAWAL
AMOUNT WILL BE SUBJECT TO A WITHDRAWAL CHARGE ON PURCHASE PAYMENTS WITHDRAWN
BEFORE THE END OF THE FIFTH CONTRIBUTION YEAR. THE WITHDRAWAL CHARGE IS 5% IN
THE FIRST CONTRIBUTION YEAR AND REDUCES BY 1% EACH FOLLOWING CONTRIBUTION YEAR,
SO THAT THERE IS NO CHARGE IN THE SIXTH AND LATER CONTRIBUTION YEARS.
FOR USE WITH
VARIABLE ANNUITY ACCOUNT ONE
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DEFINITIONS
ACCUMULATION PERIOD - The period between the Issue Date of this Contract and the
Annuity Date, the build-up phase of this Contract.
ACCUMULATION UNIT - A unit of measurement which we use to calculate the Contract
Value during the Accumulation Period.
ANNUITANT - The person designated in the Application and shown on the Contract
Data Page to receive or who is actually receiving annuity payments.
ANNUITIZATION - The process by which an Owner converts from the Accumulation
Period to the Annuity Period. That is, you convert your Contract from the
build-up phase to the phase during which the Annuitant receive periodic annuity
payments.
ANNUITY DATE - The date on which annuity payments are to begin.
ANNUITY PERIOD - The period starting on the Annuity Date.
ANNUITY UNIT - A unit of measurement we use to calculate the amount of Variable
Annuity payments.
BENEFICIARY - The person designated to receive any benefits under this Contract
upon the death of the Annuitant during the Accumulation Period. If the Owner
dies during the Accumulation Period, the Beneficiary will, unless the Owner has
elected otherwise, become the Owner of this Contract.
CONTRACT OWNER OR OWNER - You, the person having the privileges of ownership
defined in this Contract. If the Owner dies during the Accumulation Period, the
Beneficiary will, unless the Owner has elected otherwise, become the Owner of
this Contract.
CONTRACT VALUE - The sum of the values of your interest in the Separate Account
Divisions.
CONTRACT YEAR - The period between anniversaries of the Issue Date of this
Contract.
CONTRIBUTION YEAR - Each Contract Year in which a Purchase Payment is made and
each succeeding year measured from the end of the Contract Year during which
such Purchase Payment was made.
DIVISION OR SEPARATE ACCOUNT DIVISION - A Division of the Separate Account
invested wholly in shares of one of the Eligible Portfolios.
ISSUED DATE - The date shown on the Contract Data Page on which the first
Contract Year and first Contribution Year begin.
NON-QUALIFIED PLAN - A retirement plan which does not receive favorable tax
treatment under Section 401, 403(b), 408 or 457 of the Internal Revenue Code.
PORTFOLIOS - One of the Portfolios shown on the Contract Data Page.
PURCHASE PAYMENTS - Amounts you pay to us under this Contract.
QUALIFIED PLAN - A retirement plan which receives favorable tax treatment under
Sections 401, 403(b), 408 or 457 of the Internal Revenue Code.
SEPARATE ACCOUNT OR ACCOUNT - A segregated investment account entitled,
"Variable Annuity Account One", established by us.
VALUATION DATE - Monday through Friday except New Year's Day, Washington's
Birthday, Good Friday, Memorial Day, Independence Day, Labor Day, Thanksgiving,
and Christmas Day.
VALUATION PERIOD - The interval between two consecutive Valuation Dates measured
from 5:00 P.M. New York time.
WITHDRAWAL CHARGE - The charge assessed against certain withdrawals or
annuitizations of Accumulation Units in their first five (5) Contribution Year.
WITHDRAWAL VALUE - The Contract Value, less any premium tax payable if the
Contract is being annuitized, minus any applicable withdrawal Charge.
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PURCHASE PAYMENTS
Purchase Payments are flexible. This means that you, subject to the minimums and
maximums given below, may change the amount and the frequency or timing of
Purchase Payments. The minimum initial Purchase Payment we will accept for a
Contract issued pursuant to a Non-Qualified Plan is $1,000. Subsequent Purchase
Payments must be at least $500.
The minimum initial Purchase Payment we will accept for a Contract issued
pursuant to a Qualified Plan is $100. Purchase Payments will be allocated to one
or more Separate Account Divisions. At least $500 must be allocated to each
Division selected before an allocation can be made to an additional Division. If
the Contract Value is less than $500, and no Purchase Payments have been made
during the previous three full calendar years, we reserve the right, after 60
days written notice to you, to terminate this Contract and distribute the
Withdrawal Value to you.
ACCUMULATION PERIOD
PURCHASE PAYMENTS AND CONTRACT VALUE - We will credit a Contract with the number
of Accumulation Units in a Division which results from dividing the Purchase
Payment(s) allocated to that Division, or the amount transferred into the
Division, by the Accumulation Unit Value for that Division at the end of the
Valuation Period next concluding after the allocation or transfer.
The Contract Value for any Valuation Period is determined by multiplying the
number of Accumulation Units credited to each Division by the Accumulation Unit
Value for that Division at the end of the Valuation Period and then adding the
resultant values.
ACCUMULATION UNIT VALUE - The Accumulation Unit Value of a Separate Account
Division for any Valuation Period is calculated by subtracting (2) from (1) and
dividing the result by (3) where:
(1) is the total value of the assets of the Separate Account Division minus
total liabilities;
(2) is the cumulative unpaid charge for assumption of mortality and expense
risks;
(3) is the number of Accumulation Units outstanding at the end of such
Valuation Period.
During the Accumulation Period, each Separate Account Division is assessed with
a daily charge for mortality and expense risks. The charge will equal an
aggregate of 1.25% per annum of the average daily net asset value of each
Division. Net asset value of each Division for any Valuation Period is
calculated by dividing (1) above by (3) above.
The Accumulation Unit Value may increase or decrease from Valuation Period to
Valuation Period.
RECORDS MAINTENANCE CHARGE - During the Accumulation Period, a Records
Maintenance Charge of $30 is assessed each Contract Year against each Contract
in force on the anniversary of the Issue Date. If a total surrender of Contract
Value is made, the charge will be assessed as of the date of surrender. If the
Contract participates in more than one Separate Account Division, an equal share
of the $30 charge will be made against each Division. The number of Accumulation
Units representing your Contract's interest in the affected Separate Account
Divisions will be reduced to reflect the Records Maintenance Charge.
ADMINISTRATIVE EXPENSE CHARGE - During the Accumulation period, each Separate
Account Division is assessed with a daily charge for mortality and expense
risks. The charge will equal an aggregate of .15% per annum of the average daily
net asset value of each Division. Net asset value of each Division for any
Valuation Period is calculated dividing (1) by (3) as described in the
Accumulation Unit Value provision. This charge will be reduced to the extent it
exceeds that required for administrative expenses.
TRANSFERS DURING ACCUMULATION PERIOD - You may transfer all or part of the
Contract Value among Separate Account Divisions subject to the following
conditions:
(1) the minimum amount which may be transferred from a Division is $500 or,
the remaining Contract Value in a Separate Account Division if less
than $500;
(2) no partial transfer can be made if your remaining Contract Value in a
Separate Account Division will be less than $500 after the transfer;
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(3) transfers will be honored on the Valuation Date next following receipt
by us of a written direction (containing all required information);
(4) if you make a transfer within 30 days of the Issue Date, a transfer fee
of $25 ($10 in Pennsylvania and Texas) will be charged.
We reserve the right to at any time suspend, modify, or terminate the transfer
privilege at any time with notice.
The Accumulation Units credited to a Separate Account Division will be reduced
based on the Accumulation Unit Value at the end of the Valuation Period next
following the Valuation Period during which we receive a completely detailed
request for a transfer. Accumulation Units will be credited to the Contract
Value in the Separate Account Division to which the transfer is being made at
the same time.
TOTAL WITHDRAWAL DURING THE ACCUMULATION PERIOD - You may, during the
Accumulation Period, withdraw all the Contract Value remaining after deduction
of the Withdrawal Charge, if any.
An election for total withdrawal must be made in writing to us at our Annuity
Service Office. Payment made to us in honoring an election for total withdrawal
prior to receipt by us of notice of the death of the Annuitant or the Owner will
discharge our obligations under this Contract.
PARTIAL WITHDRAWALS DURING THE ACCUMULATION PERIOD - You may, during the
Accumulation Period, withdraw portions of the Contract Value, subject to the
following conditions:
(1) each partial withdrawal must be for an amount which is not less than
$500 or, if smaller, the remaining value in a Separate Account
Division;
(2) the remaining value in each Separate Account Division from which a
partial withdrawal is requested must be at least $500 after the partial
withdrawal is completed;
(3) an election to make a partial withdrawal must be made in writing to us
at our Annuity Service Office;
(4) the election must indicate the amount(s) and the Separate Account
Division(s) from which the partial withdrawal is requested;
(5) the maximum amount of a partial withdrawal will be equal to the
Contract Value in the Division minus the amount of the Withdrawal
Charge, if any; and
(6) you have the right to specify the Division from which a withdrawal is
to be made.
Any payment made by us for partial withdrawal prior to receipt by us of notice
of the death of the Annuitant or the Owner will discharge our obligation under
this Contract to the extent of the payment.
IF A WITHDRAWAL CHARGE IS APPLICABLE. THE REDUCTION IN THE CONTRACT VALUE
REQUIRED TO PRODUCE THE AMOUNT F THE PARTIAL WITHDRAWAL REQUESTED WILL BE
GREATER THAN THE AMOUNT ACTUALLY PAID BY US TO YOU. THE ACTUAL DOLLAR AMOUNT OF
A PARTIAL WITHDRAWAL REQUESTED WILL BE THE AMOUNT PAID TO YOU.
FREE WITHDRAWAL AND WITHDRAWAL CHARGES -
(1) all Purchase Payments in a given Contract Year are totalled and are
used separately in calculating applicable Withdrawal Charges.
(2) all withdrawals will be assessed first against Purchase Payments in the
earliest Contract Years.
(3) The amount which may be withdrawn in any Contract Year without a
Withdrawal Charge is 10% of the aggregate Purchase Payments made as of
the date of the partial withdrawal, less prior withdrawals. A free
withdrawal can be made only once per Contract Year and must be the
first withdrawal in that Contract Year. No free withdrawal is permitted
during the first Contract Year.
(4) any amount withdrawn which exceeds the limitations specified in (3)
above will be subject to a Withdrawal Charge in accordance with the
Withdrawal Charge Table.
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WITHDRAWAL CHARGE TABLE
CONTRIBUTION YEAR RATE
----------------- ----
First 5%
Second 4%
Third 3%
Fourth 2%
Fifth 1%
Sixth and later 0%
The Rate applies to Purchase Payments.
WITHDRAWAL PROCEDURES - The Accumulation Units credited to a Contract in a
Separate Account Division will be reduced based on the Accumulation Unit Value
at the end of the Valuation Period during which an election of withdrawal
completely contained all required information is received by us at our Annuity
Service Office. An amount withdrawn will be paid within seven calendar days
after the date proper written election is received by us, except as provided
below.
SUSPENSION OF WITHDRAWAL PRIVILEGES - We may suspend the right of withdrawal
privileges or delay payment more than seven calendar days:
(1) during any period when the New York Stock Exchange is closed (other
than customary weekend and holiday closings);
(2) when trading in the markets the Account or a Portfolio normally
utilizes is restricted or an emergency exists as determined by the
Securities and Exchange Commission so that disposal of the Account's or
Portfolio's investments or determination of Accumulation Unit Value is
not reasonably practicable; or
(3) for such other periods as the Securities and Exchange Commission by
order may permit for protection of the Contract Owners.
DEATH BENEFIT
The Death Benefit is equal to the greater of:
(1) the Contract Value at the end of the Valuation Period during which Due
Proof of death and an election of the type of payment by the
Beneficiary is received by us at our Annuity Service Office; or
(2) the total dollar amount of Purchase Payments minus the total dollar
amount of partial withdrawals and applicable withdrawal charges; and
(3) after the firth Contract Year, the Contract Value at the last Contract
Anniversary minus the total dollar amount of partial withdrawals made
since that anniversary.
Payment of the Death Benefit may be made in one lump sum or applied under one of
the Annuity Options.
Due Proof of death means a certified copy of a death certificate or a certified
copy of a decree of a court of competent jurisdiction as to a finding of death,
or written statement by a Doctor of Medicine who attended the deceased at time
of death, or any other proof satisfactory to us.
DEATH OF ANNUITANT - The Death Benefit will be payable to the Beneficiary upon
receipt by us of Due Proof of the Annuitant's death during the Accumulation
Period.
DEATH OF OWNER
The following section applies only if this Contract is issued on a non-qualified
basis and if either of the two following conditions exist:
(A) The Owner and the Annuitant are the same individual and that individual
dies during the Accumulation Period; or
(B) The Owner and Annuitant are different persons and the Owner dies during
the Accumulation Period prior to the Annuitant's death.
If either of the above conditions occur, the following provisions apply:
(1) If the Beneficiary is the spouse of the Owner, then the Beneficiary
becomes the Owner and this Contract remains in full force and effect.
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(2) If the Beneficiary is a natural person and not the spouse of the Owner,
the Beneficiary becomes the Owner. The Beneficiary becomes the Owner.
The Beneficiary can elect to have the existing Contract Value paid
under one of the Annuity Options set forth in this Contract over a
period not extending beyond the life expectancy of the Beneficiary at
the time of the election: however, payments under any Annuity Option
selected must begin not later than one year after the date of death of
the previous Owner.
Alternatively, the Beneficiary may elect to receive a lump sum
distribution of the greater of: (a) the current Contract Value at the
time of election; or (b) the total amount of Purchase Payments made
under the Contract less the aggregate dollar amount of any partial
withdrawals. Under this alternative election, the lump sum must be paid
to the Beneficiary within five years of the previous Owner's death.
(3) If there is no Beneficiary or if the Beneficiary is not a natural
person, then the entire Contract Value must be paid out within five
years of the Owner's death.
ANNUITY PERIOD
ELECTION OF ANNUITY OPTION AND ALLOCATION OF ANNUITY PAYMENTS - Election of an
Annuity Option must be made by written notice to us at our Annuity Service
Office. The election may be made:
(1) by the Owner prior to the Annuity Date and ▇▇▇▇▇▇▇▇▇'s death;
(2) by the Annuitant on the Annuity Date unless the Owner has restricted
the right to make an election; or
(3) by the Beneficiary upon the Annuitant's death unless the Owner has
restricted the right to make an election.
If the Contract Value to be applied is less than $5,000, we may make payment in
one lump sum. If the amount of the first scheduled payment is less than $50, we
may increase the interval between payments to a quarterly, semi-annual or annual
payment to make the first payment at least $50. Option 3 may be elected only if
the Contract Value to be applied is at least $20,000. Payment must be made to a
natural person referred to as the payee.
The amount we use in determining annuity payments under Options 1, 2, and 3,
subject to adjustment for any applicable Withdrawal Charge and premium taxes, is
the Contract Value at the end of the Valuation Period immediately preceding the
Valuation Period which includes the Annuity Date. If Option 1 or 2 is elected,
no Withdrawal Charge will apply.
Payment under Option 3 or in accordance with the Other Settlement Arrangements
section may subject the Contract Value to a Withdrawal Charge. If Option 3 is
elected, the Contract Value may be subject to a Withdrawal Charge in accordance
with the Withdrawal Charge Table.
If no other Annuity Option is elected, the amount payable will be made under
Option 1 with a 10 year period certain.
ANNUITY OPTIONS - The amount payable may be paid under one of the following
options or in any other manner agreed to by us:
OPTION 1 - LIFE ANNUITY WITH INSTALLMENTS GUARANTEED - We will make monthly
payments for the guaranteed period elected and then for the remaining lifetime
of the payee. The period elected may be only 10 or 20 years. If the payee dies
before the end of the guaranteed period, the present value, based on a 5% annual
interest rate, of remaining guaranteed payments will be paid to the payee's
estate or the Beneficiary.
OPTION 2 - JOINT AND SURVIVOR ANNUITY - We will pay the full monthly income
while both payees are living. Upon the death of either payee, income will
continue during the lifetime of the surviving payee at the percentage of such
full amount chosen when this option was elected.
OPTION 3 - INCOME FOR SPECIFIED PERIOD - We will make monthly payments for the
period elected but not less than 5 years or more than 30 years. The election
must be made for full twelve-month periods.
OTHER SETTLEMENT ARRANGEMENTS - Our agreement is necessary for other payment
methods.
VARIABLE ANNUITY - The Contract Value at the end of the Valuation Period
immediately preceding the Valuation Period which includes the Annuity Date will
first be reduced by the dollar amount of any Withdrawal Charge and then by any
applicable premium taxes. The remaining value will be used to calculate the
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first monthly annuity payment. For Annuity Options 1, 2 and 3, the first monthly
annuity payment will be based upon the Annuity Option elected and the
appropriate Annuity Option Table.
With respect to Options 1, 2 and 3, the number of Annuity Units for each
Separate Account Division for purposes of determining subsequent annuity
payments is determined by dividing the amount of the first monthly annuity
payment attributable to the Contract Value in that Separate Account Division by
the Annuity Unit Value for the Division at the end of the Valuation Period which
includes the Annuity Date. The number of Annuity Units per payment will remain
fixed unless a transfer is made. The amount of any subsequent annuity payments
will be determined by multiplying the number of Annuity Units per payment in
each Separate Account Division by the Annuity Unit Value for that Division at
the end of the Valuation Period immediately preceding the valuation Period which
includes the date on which payment is to be made and then adding the resultant
values. The Annuity Unit Value may increase or decrease from Valuation Period to
Valuation Period.
We guarantee that the dollar amount of each annuity payment after the first will
not be adversely affected by variations in actual expenses or by variations in
mortality experience from the expense and mortality assumptions on which the
first payment is based.
The Annuity Tables are based on the 1983 Table A, projected at Scale G with
interest at the rate of 5% per annum and assume births in year 1942. The amount
of each annuity payment will depend upon the sex and adjusted age of the
Annuitant, he joint annuitant, if any, or other payee. The adjusted age is
determined from the actual age nearest birthday at the time the first monthly
annuity payment is due according to the Table A below.
TABLE A
Adjustment Adjustment
Calendar to Actual Calendar to Actual
Year of Birth Age Year of Birth Age
--------------- ------------ -------------- ----------
1899-1905 +6 1946-1951 -1
1906-1911 +5 1952-1958 -2
1912-1918 +4 1959-1965 -3
1919-1925 +3 1966-1972 -4
1926-1932 +2 1973-1979 -5
1933-1938 +1 1980-1985 -6
1939-1945 0
ANNUITY UNIT VALUE - For each Separate Account Division, the value of an Annuity
Unit at the end of any Valuation Period is determined by multiplying the Annuity
Unit Value for the immediately preceding Valuation Period by the net investment
factor for the Valuation Period for which the Annuity Unit Value is being
calculated, and multiplying the result by an interest factor of .999866337 per
calendar day of such Valuation Period to offset the effect of the assumed rate
of 5.00% per annum in the Annuity Option Table.
The net investment factor for each Division for any Valuation Period is
determined by dividing:
(1) the value of an Accumulation Unit of the applicable Division as of the
end of the current Valuation Period: by
(2) the value of an Accumulation Unit of the applicable Division as of the
end of the immediately preceding Valuation Period.
TRANSFERS DURING THE ANNUITY PERIOD - During the Annuity Period, the payee(s)
may transfer the Contract Value in the Separate Account Divisions. To do so,
send a written request to our Annuity Service Office. A transfer may be made
subject to the following:
(1) a transfer may be made once each Contract Year;
(2) a request for a transfer must be received by us at our Annuity Service
Office at least 45 days before the Contract Anniversary as of which the
transfer will take effect;
(3) a transfer will be effected at the next Annuity Unit Value calculated
after we receive the transfer request;
(4) no transfer may be made during the first year of the Annuity Period;
(5) the entire interest in a Separate Account Division must be transferred.
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The number of Annuity Units per payment attributable to a Separate Account
Division to which a transfer(s) is made, determined as of the effective date of
the transfer, will be equal to the number of Annuity Units per payment in the
Division from which the transfer(s) is being made multiplied by the Annuity Unit
Value for that Division, the amount being divided by the Annuity Unit Value for
the Separate Account Division to which transfer is being made.
We reserve the right at any time and without prior notice to any party to
terminate, suspend or modify the transfer privileges described above.
SUPPLEMENTARY ANNUITY AGREEMENT - An Annuity Agreement will be issued to reflect
payments to be made under an Annuity Option. If settlement is a result of
▇▇▇▇▇▇▇▇▇'s death or the Owner's death, the effective date of the Annuity
Agreement will be the date of receipt of Due Proof of death, as defined above.
Otherwise, the effective date will be the date specified in the Annuity
Agreement.
CHANGE OF ANNUITY DATE - You may elect to change the Annuity Date during the
lifetime of the Annuitant. An election to change the Annuity Date must be in
written form received by us at our Annuity Service Office at least 7 days before
the Annuity Date then reflected on our records.
EVIDENCE OF AGE, SEX AND SURVIVAL - We may require satisfactory evidence of:
(1) the age and sex of any person(s) on whose life the annuity payments are
to be based; and
(2) the continued survival of any person(s) on whose life the annuity
payments are based.
DISBURSEMENT OF FUNDS UPON DEATH OF PAYEE - At the payee's death, unless
otherwise provided in the Annuity Agreement, the commuted value, based on 5.00%
interest of any remaining unpaid guaranteed installments, will be paid in one
sum to the Beneficiary. The value (to be commuted) of the remaining installments
will be determined by using (for all payments) the Annuity Unit Value next
determined after Due Proof of death is received by us.
PROTECTION OF BENEFITS - Unless otherwise provided in the Annuity Agreement, the
payee may not commute, anticipate, assign, alienate or otherwise encumber any
payment to be made.
CREDITORS - Proceeds under this Contract and any payment under any of the above
options will exempt from the claims of creditors and from legal process to the
extent permitted by law.
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TABLES OF MONTHLY INSTALLMENTS UNDER OPTION 1
Monthly installments for ages not shown will be furnished on request.
OPTION 1 Life Annuity with Installments Guaranteed
Guaranteed Period - 10 Years
Adjusted Monthly Installment Adjusted Monthly Installment
Age for each $1,000 of Age for each $1,000 of
Male Female Amount Applied Male Female Amount Applied
------------- ------------------- ------------ -------------------
40 46 $4.74 58 64 $5.63
41 47 4.77 59 65 5.70
42 48 4.81 60 66 5.79
43 49 4.84 61 67 5.87
44 50 4.88 62 68 5.96
45 51 4.92 63 69 6.06
46 52 4.96 64 70 6.15
47 53 5.00 65 71 6.26
48 54 5.05 66 72 6.36
49 55 5.09 67 73 6.48
50 56 5.14 68 74 6.59
51 57 5.19 69 75 6.71
52 58 5.24 70 6.84
53 59 5.30 71 6.97
54 60 5.36 72 7.10
55 61 5.42 73 7.23
56 62 5.49 74 7.37
57 63 5.56 75 7.51
------------------------------------------------------------------------
OPTION 1 Life Annuity with Installments Guaranteed
Guaranteed Period - 20 Years
Adjusted Monthly Installment Adjusted Monthly Installment
Age for each $1,000 of Age for each $1,000 of
Male Female Amount Applied Male Female Amount Applied
------------- ------------------- ------------ -------------------
40 46 $4.69 58 64 $5.39
41 47 4.72 59 65 5.44
42 48 4.75 60 66 5.49
43 49 4.78 61 67 5.54
44 50 4.81 62 68 5.59
45 51 4.84 63 69 5.65
46 52 4.87 64 70 5.70
47 53 4.91 65 71 5.75
48 54 4.95 66 72 5.81
49 55 4.98 67 73 5.86
50 56 5.02 68 74 5.91
51 57 5.06 69 75 5.96
52 58 5.11 70 6.01
53 59 5.15 71 6.06
54 60 5.19 72 6.10
55 61 5.24 73 6.15
56 62 5.29 74 6.19
57 63 5.34 75 6.22
------------------------------------------------------------------------
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TABLE OF MONTHLY INSTALLMENTS UNDER OPTION 2
Monthly installments for ages or combination of ages not
shown will be furnished on request.
OPTION 2 Joint and Survivor Annuity
Adjusted Age
of Other Payee Adjusted Age of Annuitant
-------------- --------------------------------------------------------------
Male 51 56 58 61 63 66 71
Female 57 62 64 67 69 72 77
-------------- --------------------------------------------------------------
50 56 $4.72 $4.80 $4.84 $4.88 $4.91 $4.95 $5.01
55 61 4.81 4.92 4.96 5.03 5.07 5.13 5.23
57 63 4.84 4.97 5.02 5.09 5.14 5.21 5.32
60 66 4.89 5.04 5.10 5.19 5.25 5.34 5.47
62 68 4.93 5.08 5.15 5.25 5.32 5.42 5.58
65 71 4.97 5.15 5.23 5.35 5.43 5.55 5.75
70 76 5.04 5.25 5.35 5.50 5.60 5.77 6.05
--------------------------------------------------------------------------------
TABLE OF MONTHLY INSTALLMENTS UNDER OPTION 3
OPTION 3 Income for Specified Period
Monthly Monthly
Specified Installment Specified Installment
Period for each $1,000 of Period for each $1,000 of
(Years) Amount Applied (Years) Amount Applied
----------- ------------------- ---------- --------------------
5 $18.74 18 $6.94
6 15.99 19 6.71
7 14.02 20 6.51
8 12.56 21 6.33
9 11.42 22 6.17
10 10.51 23 6.02
11 9.77 24 5.88
12 9.16 25 5.76
13 8.64 26 5.65
14 8.20 27 5.54
15 7.82 28 5.45
16 7.49 29 5.36
17 7.20 30 5.28
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GENERAL PROVISIONS (Continued)
THE CONTRACT - This Contract and the attached Application are the entire
contract between the parties. All statements made in the Application are, in the
absence of fraud, deemed representations and not warranties. No statement will
void this Contract or be used as a defense to a claim unless it is contained in
the Application.
MODIFICATION OF CONTRACT - Only our President or Secretary may approve a change
or waive the provisions of this Contract. Any change or waiver must be in
writing. No agent has authority to change or waive the provisions of this
Contract.
INCONTESTABILITY - This Contract will not be contestable after it has been in
force for a period of two years from the Issue Date.
MISSTATEMENT OF AGE OR SEX - If a payee's age or sex is misstated, we will
adjust any amount to be paid based upon the corrected age or sex; the date of
the first payment will not be changed. Any underpayment will be paid
immediately. Any overpayment will be deducted from payments subsequently
accruing.
BENEFICIARY - You may designate a Beneficiary to receive any amount payable on
death. The original Beneficiary will be named in the Application. You may change
the Beneficiary by filing a written request with us at our Annuity Service
Office unless an irrevocable Beneficiary designation was previously filed with
us. Any change will take effect when recorded by us. However, any change will
take effect as of the date such request was signed, except as to any payment
made or other action taken by us before the change was recorded.
If there is more than one Beneficiary, the interest of any Beneficiary who
predeceases the Annuitant will pass to the survivor of survivors, share and
share alike, unless otherwise provided in the Beneficiary designation. If no
designated Beneficiary survives the Annuitant, the Beneficiary will be the
Annuitant's estate.
CHANGE OF OWNERSHIP - NOTE: A CHANGE OF OWNERSHIP MAY BE A TAXABLE EVENT, YOU
SHOULD FIRST CONSULT WITH YOUR TAX ADVISOR.
OWNERSHIP - If no designated Beneficiary who is a natural person survives the
Owner, the Owner's estate will become the new Owner.
Ownership may be change at any time during the Annuitant's lifetime. A change
must be made by written notice from the Owner sent to us at our Annuity Service
Office with information sufficient to clearly identify the new Owner to us. No
change will take effect until received by us. Upon being received, any change
will take effect as of the date it was signed, except for action taken by us
before the change was received. We reserve the right to require this Contract
for endorsement of a change.
ASSIGNMENT - No assignment of this Contract is binding until received by us at
our Annuity Service Office. We assume no responsibility for the validity of any
assignment.
NOTE: AN ASSIGNMENT MAY CONSTITUTE A TAXABLE EVENT. YOU SHOULD FIRST CONSULT
WITH YOUR TAX ADVISOR.
Any claim under an assignment is subject to proof of the extent of interest. If
this Contract is assigned, your rights and the Beneficiary's rights are subject
to the rights of any assignee of record.
OWNERSHIP OF THE SEPARATE ACCOUNT ASSETS - We have exclusive ownership and
control of all assets in the Separate Account.
LIABILITIES OF SEPARATE ACCOUNTS - The assets held in the Separate Account will
not be charged with liabilities arising out of any other business we may
conduct. The assets are held and applied exclusively for the benefit of Owners,
Annuitants, Beneficiaries or payees of the Variable Annuity Contracts.
NONPARTICIPATION IN SURPLUS - This Contract does not share in our profits or
surplus.
DELAY OF PAYMENTS - We may defer making any payments for up to six months.
SUSPENSION OF PAYMENTS - We may suspend or postpone payments if any of the
following occur;
(1) during any period when the New York Stock Exchange is closed (other
than customary weekend and holiday closings);
13
(2) when trading in the markets the Account or a portfolio normally
utilizes is restricted, or an emergency exists as determined by the
Securities and Exchange Commission so that disposal of the Account's or
a Portfolio's investment or determination of Accumulation Unit Value is
not reasonably practicable; or
(3) for such other periods as the Securities and Exchange Commission by
order may permit for protection of the Contract Owners.
REPORTS - Once each Contract Year, we will furnish you with an Annual Report of
the Separate Account and a statement showing the Contract Value.
ADDITION, SUBSTITUTION AND CONVERSION - We reserve the right to add additional
Eligible Portfolios from time to time. If additional Eligible Portfolios are
added, we will notify you in writing. If shares of a Portfolio are not available
for purchase or if, in our judgment, further investment in the shares is no
longer appropriate in view of the purposes of the Separate Account, shares of or
interests in another investment portfolio or company may be substituted for
Portfolio shares held or to be purchased by future Purchase Payments or
transfers under this Contract.
Further, if we deem it to be in the best interests of the Owners, the Separate
Account may be operated as a management company under the Investment Company Act
of 1940 or it may be deregistered under the Act in the event such registration
is no longer required or advisable. In the event any such substitution or change
occurs, we will promptly notify the Owners.
CHANGES IN THE LAW - If laws governing this Contract or the taxation of benefits
under this Contract change, we will amend this Contract to comply with these
changes.
14
INDIVIDUAL FLEXIBLE PURCHASE PAYMENT
DEFERRED VARIABLE ANNUITY CONTRACT
NONPARTICIPATING
NO DIVIDENDS
ANCHOR NATIONAL
Life Insurance Company
▇▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇
▇▇▇ ▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇ a SunAmerica Company
