ANNUITANT XXXX XXX 35-MALE AGE AND SEX
CONTRACT NUMBER 999999988 MAY 01, 2003 ISSUE DATE
The Guardian A Stock Company
Insurance & Annuity Incorporated in the
Company, Inc. State of Delaware
Customer Service Office:
[LOGO] P.O. Box 26210
Lehigh Valley PA 18002-6210
Read this contract carefully. This contract is a legal contract between the
owner and The Guardian Insurance & Annuity Company, Inc. (GIAC).
GIAC will pay the benefits provided by this contract in accordance with its
provisions. The entire contract consists of the Basic Contract and any attached
endorsements and additional benefit riders. This contract is issued by GIAC at
its Customer Service Office on the Issue Date. GIAC's home office is 0000 Xxxxxx
Xxxxxx, Xxxxxxxxxx, Xxxxxxxx 00000. However, GIAC receives all communications at
its Customer Service Office.
/s/ [ILLEGIBLE] /s/ Xxxxx X. Xxxx
Secretary President
Checked by
Under the Basic Contract, flexible premium payments may be made before the
Annuity Commencement Date. On the Annuity Commencement Date, GIAC will begin to
make monthly annuity payments. Benefits depend, among other things, on the
number and value of Accumulation Units and the annuity payout option elected.
Death benefit proceeds are payable before the Annuity Commencement Date.
ALL VALUES PROVIDED BY THIS CONTRACT WHICH ARE BASED ON THE INVESTMENT
EXPERIENCE OF A SEPARATE ACCOUNT ARE VARIABLE, MAY INCREASE OR DECREASE DAILY,
AND ARE NOT GUARANTEED. SEE "ACCUMULATION VALUE" ON PAGE 12 AND "PAYMENT OF
CONTRACT PROCEEDS" ON PAGE 15 FOR A DESCRIPTION OF THE VARIABLE VALUES AND
PAYMENTS PROVIDED UNDER THIS CONTRACT.
RIGHT TO CANCEL:
The owner has the right to examine this contract and return it for cancellation
to GIAC's Customer Service Office or to the agent from whom it was purchased
within 10 days after receiving it. The contract and a cancellation notice must
be delivered or mailed to cancel this contract. Any cancellation notice given by
mail is effective upon being postmarked, properly addressed, and postage
prepaid. If this contract is returned during this period, GIAC will pay to the
owner an amount equal to the sum of:
o the difference between any premium(s) paid, including any contract
fee or contingent deferred sales charge, and the amounts allocated
to the contract's Allocation Options; and
o the Accumulation Value of the contract on the date GIAC receives the
returned contract and cancellation notice at its Customer Service
Office.
The contract will be void from the beginning.
Individual Flexible Premium Deferred Variable Annuity Contract
o Premiums payable before the Annuity Commencement Date, in accordance
with contract provisions
o Annuity payments begin on the Annuity Commencement Date
o Benefits based on the investment experience of a Separate Account
are variable and are not guaranteed
o Provides for a Fixed-Rate Option
o Non-participating - No dividends payable
IVA-2060
GUIDE TO CONTRACT PROVISIONS
1. Definitions
2. Owner and Beneficiary
3. Annuity Benefit
4. Spousal Continuation
5. Death Benefits
6. Premiums
7. The Separate Account
8. The Fixed-Rate Option
9. Transfers
10. Accumulation Value
11. Surrenders and Withdrawals
12. Payment of Contract Proceeds
13. General Provisions
Any endorsements and additional benefit riders that are attached to this
contract follow.
An Index appears on the inside of the back cover.
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CONTRACT DATA
(CONTINUED ON PAGE 3.1)
ANNUITANT [ANNUITANT NAME] [AGE-SEX] AGE - SEX
CONTRACT NUMBER [CONTRACT NUMBER] [ISSUE DATE] ISSUE DATE
ANNUITY COMMENCEMENT DATE [ANNUITY COMMENCEMENT DATE]
OWNER [OWNER NAME]
BENEFICIARY THE BENEFICIARY(IES) NAMED BY THE OWNER AT ISSUE,
UNLESS SUBSEQUENTLY CHANGED.
** PREMIUMS**
INITIAL CONTRACT PREMIUM [$25,000.00]
ADDITIONAL CONTRACT PREMIUMS MAY BE PAID TO GIAC BEFORE THE ANNUITY COMMENCEMENT
DATE IN ACCORDANCE WITH "PREMIUMS" ON PAGE 9.
* * INITIAL NET PREMIUM ALLOCATION INFORMATION * *
THE INITIAL NET PREMIUM IS THE INITIAL CONTRACT PREMIUM, LESS ANY APPLICABLE
ANNUITY TAXES. THE INITIAL NET PREMIUM IS ALLOCATED AS FOLLOWS:
Please see Exhibit A, which contains a list of all available
Allocation Options. Those Allocation Options elected by the
owner will be listed on this page at issue.
CONTRACT DATA
* * ADDITIONAL BENEFIT RIDERS * *
[The following appears only if the Contract Anniversary Enhanced Death Benefit
rider is attached to a contract:
THIS CONTRACT INCLUDES A CONTRACT ANNIVERSARY ENHANCED DEATH BENEFIT RIDER. SEE
"CONTRACT CHARGES AND EXPENSES" BELOW FOR ADDITIONAL INFORMATION.
PAGE 3
IVA-2060
CONTRACT DATA, CONTINUED
* * CONTRACT CHARGES AND EXPENSES * *
CONTINGENT DEFERRED SALES CHARGES: IF THE OWNER MAKES A PARTIAL WITHDRAWAL OR
SURRENDERS THE CONTRACT, A CONTINGENT DEFERRED SALES CHARGE MAY BE APPLIED
AGAINST WITHDRAWALS OR SURRENDERS OF UNLIQUIDATED PREMIUMS THAT HAVE BEEN IN THE
CONTRACT FOR LESS THAN SEVEN (7) YEARS.
THE MAXIMUM CONTINGENT DEFERRED SALES CHARGE WHICH GIAC MAY IMPOSE WILL BE EQUAL
TO 8% OF THE TOTAL OF ALL PREMIUM PAYMENTS MADE WITHIN SEVEN YEARS PRIOR TO THE
DATE OF THE REQUEST FOR WITHDRAWAL OR SURRENDER. SEE "CONTINGENT DEFERRED SALES
CHARGES" ON PAGE 14 FOR ADDITIONAL INFORMATION.
DAILY CHARGES: GIAC WILL ASSESS A DAILY CHARGE OF .000040016 OF THE VALUE OF THE
ASSETS ALLOCATED TO EACH VARIABLE INVESTMENT OPTION. ON AN ANNUAL BASIS, THIS
CHARGE IS EQUAL TO 1.45% OF THE VALUE OF THE ASSETS ALLOCATED TO THESE VARIABLE
INVESTMENT OPTIONS. MORTALITY AND EXPENSE RISKS ASSUMED BY GIAC ACCOUNT FOR
1.25% OF THIS CHARGE AND ADMINISTRATIVE EXPENSES INCURRED BY GIAC ACCOUNT FOR
..20% OF THIS CHARGE. SEE "NET INVESTMENT FACTOR" ON PAGE 12 FOR ADDITIONAL
INFORMATION.
[The following appears only if the Contract Anniversary Enhanced Death Benefit
rider is attached to a contract: GIAC WILL ASSESS A DAILY CHARGE OF .000013733
OF THE VALUE OF THE ASSETS ALLOCATED TO EACH VARIABLE INVESTMENT OPTION FOR
EXPENSES RELATED TO THE PROVISION OF THIS BENEFIT. ON AN ANNUAL BASIS, THIS
CHARGE IS EQUAL TO .50% OF THE VALUE OF THE ASSETS ALLOCATED TO THESE VARIABLE
INVESTMENT OPTIONS. SEE THE CONTRACT ANNIVERSARY ENHANCED DEATH BENEFIT RIDER
FOR ADDITIONAL INFORMATION.]
CONTRACT FEE: GIAC WILL DEDUCT AN ANNUAL CONTRACT FEE OF $35 ON EACH CONTRACT
ANNIVERSARY ON OR BEFORE THE ANNUITY COMMENCEMENT DATE. IF A CONTRACT IS
SURRENDERED ON A DATE OTHER THAN ON A CONTRACT ANNIVERSARY, GIAC WILL DEDUCT THE
CONTRACT FEE ON THE DATE OF SURRENDER. SEE "CONTRACT FEE" ON PAGE 13 FOR
ADDITIONAL INFORMATION.
TRANSFER CHARGE: GIAC RESERVES THE RIGHT TO CHARGE A MAXIMUM OF $25 FOR ANY
TRANSFER TRANSACTION.
* * *
ALL COMMUNICATIONS WITH GIAC SHOULD BE DIRECTED TO THE CUSTOMER SERVICE OFFICE
ADDRESS SHOWN ON THE FRONT COVER.
TO OBTAIN INFORMATION ABOUT YOUR COVERAGE YOU MAY CALL YOUR AGENT, OR GIAC AT:
[0-000-000-0000]
PAGE 3.1
IVA-2060
1. DEFINITIONS
Certain important terms used in this contract are defined below. Additional
terms, not explained here, are defined in other parts of this contract.
Accumulation Unit: A unit of measure used to determine the value of the owner's
interest under this contract that is attributable to the Variable Investment
Options before the Annuity Commencement Date.
Accumulation Value: The value attributable to this contract. The Accumulation
Value is the sum of the values attributable to the Variable Investment Options
and the Fixed-Rate Option.
Allocation Options: This contract's Allocation Options consist of the Variable
Investment Options and the Fixed-Rate Option.
Annuity Commencement Date: The date on which annuity payments under this
contract begin. The Annuity Commencement Date is shown on page 3.
Annuity Unit: A unit of measure used to determine the amount of any variable
annuity payment.
Basic Contract: This contract excluding any additional benefit riders or
endorsements.
Contingent Annuitant: A Contingent Annuitant is the person named by the owner at
issue to become the annuitant if the annuitant dies before the Annuity
Commencement Date. The Contingent Annuitant, if any, is shown on page 3.
Contract Anniversary: The annual anniversary measured from this contract's Issue
Date.
Good Order: Notice from any party authorized to initiate a contract transaction
under this contract, received at the Customer Service Office in a format
satisfactory to GIAC, that includes all information and documents required by
GIAC to process a transaction under this contract.
Internal Revenue Code: The Internal Revenue Code of 1986, as amended, and the
rules and regulations thereunder, and successor provisions thereto.
Issue Date: The date this contract is issued by GIAC at its Customer Service
Office. The Issue Date is shown on page 3. Contract years are measured from the
Issue Date.
Net Premium: A premium paid by the owner to GIAC in accordance with this
contract's provisions, less annuity taxes, if any.
Valuation Date: A date on which Accumulation Unit values are determined.
Accumulation Unit values are determined on each date on which the New York Stock
Exchange or its successor is open for trading. Valuations for any date other
than a Valuation Date will be determined on the next Valuation Date.
Valuation Period: The period between two successive Valuation Dates, beginning
after 4:00 P.M. New York City time on each Valuation Date and ending at 4:00
P.M. New York City time on the next succeeding Valuation Date.
Variable Investment Options: The investment divisions of The Guardian Separate
Account R.
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IVA-2060
2. OWNER AND BENEFICIARY
Owner
The owner is the person to whom this contract is issued, or is named as the
owner in any later change shown in GIAC's records. While the annuitant is
living, prior to the Annuity Commencement Date, and subject to any assignment on
file with GIAC, the owner alone has the right to receive all benefits and
exercise all rights this contract grants or GIAC allows. After the death of the
annuitant, the beneficiary becomes the new owner.
Joint Owners
If this contract is issued to more than one person or more than one person is
named as owner in any later change, as shown in GIAC's records, GIAC considers
them to be joint owners.
Each joint owner will possess an undivided interest in the contract. Any written
request for a contract transaction must be signed by each joint owner named in
GIAC's records. Unless otherwise provided, if a joint owner dies, ownership
passes to the surviving joint owner(s). When the last joint owner dies,
ownership passes to the beneficiary. If no beneficiary is named, ownership
passes to the estate of the last surviving joint owner. If there are joint
owners, all references to "owner" are deemed to include all joint owners, unless
otherwise specified.
Annuitant
The annuitant is the person named on page 3 or named as the annuitant in any
later change shown in GIAC's records, on whose life the annuity payments are
based. Any change of annuitant is subject to GIAC's limitations or other
restrictions in effect at the time of the request.
Contingent Annuitant
The owner may name a Contingent Annuitant only at issue. If a Contingent
Annuitant is shown in GIAC's records and the annuitant dies prior to the Annuity
Commencement Date, the Contingent Annuitant will become the annuitant.
The owner's right to name a Contingent Annuitant may be restricted under the
provisions of a retirement or deferred compensation plan for which this contract
is issued. A Contingent Annuitant may be named only if the owner and annuitant
are not the same person, and if permitted by the laws of the jurisdiction in
which this contract is issued.
Beneficiary
The beneficiary is named by the owner(s) at issue, as shown on page 3, or is the
beneficiary named in any later change shown in GIAC's records. If the annuitant
dies before the Annuity Commencement Date, GIAC will pay the death benefit to
the beneficiary, as described in "Death Benefits" on page 7. If the annuitant
dies on or after the Annuity Commencement Date, any remaining benefit payable
under Options V-2, V-3 or V-4 of "Variable Annuity Payout Options" or Options
F-2, F-3 or F-4 of "Fixed Annuity Payout Options" that falls due after the
annuitant's death will be paid to the beneficiary. Unless otherwise provided, in
order to receive the death benefit at the annuitant's death, a beneficiary must
be living on the earlier of:
o the date proof of the annuitant's death and all related documents
are received in Good Order at GIAC's Customer Service Office; or
o the 15th day after the death of the annuitant.
Unless otherwise provided, if no named beneficiary is living on such earlier
date, the owner is the beneficiary.
Contingent Beneficiary
A numbered sequence may be used to name contingent beneficiaries. The
beneficiary is the living person(s) designated by the lowest number in the
sequence.
Concurrent Beneficiary
If more than one person is named with no number or the same number, GIAC
considers them to be concurrent beneficiaries. Shares are equal, unless
otherwise specified. If shares are equal, the share of a concurrent beneficiary
who predeceases both the owner and the annuitant will be shared equally by the
surviving concurrent beneficiaries. If unequal shares are specified and a
concurrent beneficiary predeceases both the owner and the annuitant, the
beneficiary of that share will be the owner.
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IVA-2060
OWNER AND BENEFICIARY, cont'd
Change of Owner or Beneficiary
Before the Annuity Commencement Date, the owner may change the ownership of this
contract by a written request in Good Order. Such change may be subject to state
and federal gift taxes, federal income taxes and penalty taxes. Subject to any
existing assignment, the owner may change the beneficiary during the lifetime of
the annuitant. The change will take effect as of the date the request is signed,
whether or not the owner or annuitant is living when GIAC receives the request
in Good Order at its Customer Service Office. However, the change will not apply
to any payments made or actions taken by GIAC before the request is received.
Assignment
No assignment will bind GIAC unless it is received at GIAC's Customer Service
Office in Good Order and is accepted by GIAC. An assignment must be signed and
dated by both the assignor and the assignee and, as applicable, by the
beneficiary. The rights of any owner or beneficiary and the entire contract, as
defined in "The Contract" on page 23, will be subject to the assignment. GIAC
will rely solely on the assignee's statement as to the amount of the assignee's
interest. GIAC will not be responsible for any tax consequences arising from or
the validity of any assignment, or for any actions taken in reliance on the
validity of the assignment.
Unless otherwise provided, the assignee may exercise all rights this contract
grants except:
o the right to change the owner or beneficiary; and
o the right to elect an annuity payout option.
Assignments are subject to all payments made or actions taken by GIAC on or
before the date GIAC accepts the assignment at its Customer Service Office.
3. ANNUITY BENEFIT
Annuity Benefit
GIAC will make annuity payments to the owner starting on the Annuity
Commencement Date shown on page 3 if:
o the annuitant is then living; and
o this contract is in force on that date.
The Annuity Commencement Date cannot be later than the annuitant's 90th
birthday. On the Annuity Commencement Date, the amount of the first monthly
annuity payment will be calculated by applying the contract's Accumulation
Value, less annuity taxes, if any, under Option V-2 of "Variable Annuity Payout
Options" on page 16, with payments guaranteed for a period of 120 months, unless
another option is elected. The payment amounts will vary according to the
annuitant's age and sex. If the annuitant dies before the end of the guaranteed
period, GIAC will pay the balance of the payments to the beneficiary for the
remainder of that period, unless the beneficiary elects to be paid the present
value of the then current dollar amount of the remaining annuity payments in a
lump sum. The present value will be calculated at an interest rate equal to the
interest rate used to compute the annuity payments. GIAC will begin making such
payment(s) to the beneficiary upon GIAC's receipt at its Customer Service Office
of proof of the annuitant's death in Good Order. See "Payment of Contract
Proceeds" on page 15 for an explanation of how annuity payments are determined.
Change of Annuity Commencement Date or Annuity Payout Option
If GIAC consents, the owner may change the Annuity Commencement Date to a date
not later than the annuitant's 90th birthday. The owner may also change any
elected annuity payout option before the Annuity Commencement Date. In order to
effect either of these changes, unless GIAC agrees otherwise, GIAC must receive
the owner's request in Good Order at its Customer Service Office at least 60
days before the Annuity Commencement Date.
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IVA-2060
4. SPOUSAL CONTINUATION
Spousal continuation means that the surviving spouse of a deceased owner
qualifies to continue the contract and become the owner, and elects (or is
deemed to have elected, as described below) to do so.
GIAC must receive written notice in Good Order of the election of spousal
continuation by the end of the 90th day after GIAC receives proof in Good Order
of the owner's death at its Customer Service Office. If the surviving spouse
qualifies for spousal continuation, as described below, and has not elected a
method of payment of the death benefit by the end of the 90 day period, spousal
continuation will be deemed to have been elected on the 90th day. This contract
may be continued under spousal continuation if:
(a) there are two joint owners; and
o one of the owners dies before the Annuity Commencement Date
and the other joint owner survives; and
o the two joint owners were married to each other on the date of
the deceased owner's death; and
o both joint owners were the only named concurrent beneficiaries
on the date of the deceased owner's death;
or
(b) the owner dies and the owner's spouse is the only named beneficiary
on the date of the owner's death.
If this contract is continued under spousal continuation, the death benefit
proceeds will be treated as the initial Accumulation Value for the continued
contract. If the death benefit proceeds that would have been paid to the
beneficiary on the death of the owner exceed the Accumulation Value of the
contract at that time, GIAC will credit to the contract an amount equal to the
difference between the death benefit proceeds and the Accumulation Value of the
contract. Such amount will be credited to the Allocation Option that invests in
The Guardian Cash Fund, Inc. If the deceased owner had been the annuitant, the
surviving spouse will become the annuitant. If the deceased owner had been the
Contingent Annuitant, the surviving spouse will become the Contingent Annuitant.
If this contract is continued under spousal continuation, the death benefit
payable on the continued contract will be the Accumulation Value as of the end
of the Valuation Period during which GIAC received proof of death of the
surviving spouse and all required documents in Good Order.
If the annuitant is changed under spousal continuation, the Annuity Commencement
Date will then be the annuitant's 90th birthday, unless otherwise elected by the
owner. If the owner surrenders a contract or makes a partial withdrawal after
spousal continuation, all premium payments made prior to spousal continuation
will not be subject to a contingent deferred sales charge. All provisions of
this contract with respect to contingent deferred sales charges will apply to
the partial withdrawal or surrender of any premium payments made after spousal
continuation.
5. DEATH BENEFITS
Notwithstanding any provision of this contract to the contrary, no payment of
benefits provided under the contract will be allowed that does not satisfy the
requirements of section 72(s) of the Internal Revenue Code, as amended from time
to time, for contracts issued with a non-qualified status.
Death of Annuitant Before Annuity Commencement Date
If the annuitant dies before the Annuity Commencement Date, a death benefit
becomes payable to the beneficiary, unless the owner has named a Contingent
Annuitant. If a Contingent Annuitant is named, the death benefit is payable
prior to the Annuity Commencement Date upon the death of the later to survive of
the annuitant and Contingent Annuitant.
If the beneficiary predeceases the annuitant, then the death benefit will be
paid to the contingent beneficiary, if any. If no contingent beneficiary(ies) is
named, then the death benefit will be paid to the owner or, if the owner is no
longer living, to the owner's estate. GIAC will make such payment upon receipt
at its Customer Service Office of proof that the death occurred before the
Annuity Commencement Date and all required documents are received in Good Order.
If the annuitant is age 79 or younger on the Issue Date, then the death benefit
payable will be the greater of:
o the Accumulation Value as of the end of the Valuation Period during
which GIAC received proof of death and all required documents in
Good Order, less annuity taxes, if any; or
o the total amount of premiums paid, less an adjusted amount for each
partial withdrawal.
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DEATH BENEFITS, cont'd
The adjusted amount for each partial withdrawal is determined by:
(i) dividing the amount of each partial withdrawal, including any
applicable contingent deferred sales charges and annuity taxes, by
the Accumulation Value immediately before that withdrawal; and
(ii) multiplying the result of (i) by the death benefit immediately prior
to the withdrawal.
If the annuitant is age 80 or older on the Issue Date, then the death benefit
payable will be the Accumulation Value as of the end of the Valuation Period
during which GIAC received proof of death and all required documents in Good
Order, less annuity taxes, if any.
The death benefit will be paid in one sum unless:
o the owner has elected an annuity payout option for the death benefit
that is received at GIAC's Customer Service Office in Good Order at
least three business days prior to the date the proceeds are paid;
or
o the owner has not otherwise elected an annuity payout option and the
beneficiary has elected an annuity payout option for the death
benefit, that is:
o received at GIAC's Customer Service Office in Good Order at
least three business days prior to the date the proceeds are
paid; and
o received at GIAC's Customer Service Office in Good Order
within one year of the annuitant's death.
If the death benefit proceeds will not be paid in one lump sum and the death
benefit proceeds exceed the Accumulation Value of the contract as of the end of
the Valuation Period during which GIAC received proof of death in Good Order,
GIAC will credit to the contract an amount equal to the difference between the
death benefit proceeds and the Accumulation Value of the contract. Such amount
will be credited to the Allocation Option that invests in The Guardian Cash
Fund, Inc.
If an owner and the annuitant are the same person, and such person dies before
the Annuity Commencement Date, then the death benefit becomes payable to the
beneficiary, as described above, except that the death benefit proceeds must be
distributed in accordance with the "Special Rules" described below.
Death of an Owner When the Owner is Not the Annuitant
If an owner and the annuitant are not the same person and any owner dies before
the Annuity Commencement Date, the death benefit, if paid in one lump sum, is
the Accumulation Value as of the end of the Valuation Period during which GIAC
received proof of death and all required documents in Good Order, less annuity
taxes, if any. The contract's entire interest must be distributed in accordance
with the Special Rules described below. The joint owner(s), if any, will become
the new owner(s). If no joint owner(s) is named, then the beneficiary becomes
the new owner.
Special Rules
If any owner dies before the Annuity Commencement Date, this contract's entire
interest must be distributed within five years of that owner's date of death. If
any owner dies on or after the Annuity Commencement Date but before the entire
interest in this contract has been distributed, the remaining portion must be
distributed at least as rapidly as under the method of distribution in effect as
of the date of such owner's death. The distribution requirements set forth above
will be considered satisfied as to any portion of the deceased owner's interest
which:
o is payable to or for the benefit of any new owner; and
o will be distributed over the life of any such new owner, or over a
period not extending beyond the life expectancy of any new owner;
provided such distributions begin within one year of the deceased owner's death.
In addition, if any new owner is the surviving spouse of the deceased owner,
these distribution rules will be applied by treating the spouse as the owner if
the surviving spouse elects (or is deemed to have elected) to continue the
contract and become the owner, as described in "Spousal Continuation" on page 7.
If the owner is not an individual, the annuitant will be treated as owner for
purposes of these distribution requirements, and any change in or death of the
annuitant will be treated as the death of an owner.
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IVA-2060
6. PREMIUMS
Under the Basic Contract, GIAC will accept premiums under this contract at any
time before the Annuity Commencement Date while the annuitant and all owners are
living. All premiums are payable at GIAC's Customer Service Office. Upon
request, GIAC will give the owner a receipt signed by one of its officers. The
initial contract premium shown on page 3 is due on the Issue Date and is payable
in advance.
The minimum amount of any additional premium payment is $100, unless this
contract is purchased by or in connection with an employer-sponsored plan or
through employee payroll deductions. In such cases, there is no minimum
additional premium payment amount. The maximum amount of total premiums paid in
any contract year after the first is $1,000,000. This maximum may only be
exceeded with GIAC's written consent.
Allocation of Net Premiums
The owner may allocate all or part of a Net Premium to this contract's
Allocation Options. GIAC reserves the right to limit the number of Allocation
Options into which the value of this contract and any Net Premiums paid may be
invested at a given time. GIAC reserves the right, in its reasonable discretion,
to limit, modify, restrict, suspend or eliminate an owner's right to allocate
premiums to one or more of the Allocation Options.
Allocation will be based on the percentages chosen by the owner, or as
subsequently changed by the owner. GIAC will change the allocation percentages
applicable to future payments of Net Premiums upon receipt of the owner's
request in Good Order at its Customer Service Office.
7. THE SEPARATE ACCOUNT
The Guardian Separate Account R
The Variable Investment Options under this contract are funded by The Guardian
Separate Account R (Account R). Account R is a separate investment account
established by GIAC under the laws of the state of Delaware. Account R is
subject to the laws of the jurisdiction in which this contract is issued.
Account R is registered as a unit investment trust with the Securities and
Exchange Commission (SEC) under the Investment Company Act of 1940 (the 1940
Act).
Account R is treated as a division of GIAC and is used to provide values and
benefits for variable annuity contracts only. GIAC owns the assets in Account R.
The assets in Account R are kept separate from:
o GIAC's general account; and
o GIAC's other separate accounts.
Assets equal to the reserves and contract liabilities of Account R will not be
charged with liabilities that arise from any other business GIAC may conduct.
GIAC may transfer assets in excess of the reserves and contract liabilities of
Account R to the general account. Xxxxxx and realized and unrealized gains and
losses from assets in each Variable Investment Option in Account R are credited
to or charged against such Variable Investment Option without regard to income
and realized and unrealized gains or losses in Account R's other Variable
Investment Options or GIAC's general account or other separate accounts. The
valuation of all assets in Account R will be determined in accordance with all
applicable laws and regulations.
Investment Divisions
Account R consists of several investment divisions or Variable Investment
Options. Each investment division of Account R invests in shares of a registered
investment company. Such a company may include a mutual fund or a separate
investment portfolio of a mutual fund, each of which is managed by an investment
adviser registered under the Investment Advisers Act of 1940.
The investment divisions available on the Issue Date are listed in the then
current prospectus for Account R as it relates to this contract. Each underlying
investment company is more fully described in a separate prospectus. Any
investment adviser's fee, if applicable, is described in the appropriate
prospectus.
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THE SEPARATE ACCOUNT - cont'd
Rights Reserved
GIAC reserves the right to take certain actions which it deems:
o necessary to serve the best interests of the owner and any
beneficiary; and
o appropriate to carry out the purposes of this contract.
GIAC will exercise its reserved rights only when permitted by applicable law.
When required by law, GIAC will obtain approval by the owner, the SEC, or any
appropriate regulatory authority. Examples of actions GIAC may take include:
o deregistering Account R under the 1940 Act;
o operating Account R in any form permitted under the 1940 Act, or in
any other form permitted by law;
o taking any action necessary to comply with or obtain and continue
any exemptions from the 1940 Act;
o transferring any assets in an investment division:
o into another investment division; or
o into one or more separate accounts; or
o into GIAC's general account;
o adding, combining, or removing investment divisions in Account R;
o substituting, for the contract values held in any investment
division, the shares of another class issued by a mutual fund in
which such values are invested or the shares of another investment
company or any other investment permitted by law;
o making any other necessary technical changes in this contract in
order to conform with any action this provision permits GIAC to
take;
o adding an Allocation Option to, or removing an Allocation Option
from, the contract at any time, in GIAC's reasonable discretion;
o modifying, adding to, eliminating, or suspending the owner's ability
to allocate Net Premiums or transfer Accumulation Value amounts into
any Allocation Option; and
o modifying this contract as necessary in order to preserve the
favorable tax treatment currently accorded this contract, including
to prevent the owner from being considered the owner of the assets
in Account R.
GIAC will notify the owner if any of these actions results in a material change
in the underlying investments of any investment division to which part of this
contract's Accumulation Value is allocated. Details of any such change in the
underlying investments of an investment division of Account R will be filed with
any regulatory authority where required and will be subject to any required
approval.
8. THE FIXED-RATE OPTION
The Fixed-Rate Option is funded by GIAC's general account. The owner may:
o allocate all or part of any Net Premiums to the Fixed-Rate Option;
or
o transfer all or part of the Accumulation Value attributable to the
Variable Investment Options into the Fixed-Rate Option (for
restrictions on transfers from the Fixed-Rate Option, see page 11).
GIAC will credit interest on any amounts allocated or transferred to the
Fixed-Rate Option. Interest will accrue daily at a minimum guaranteed effective
annual rate equal to the lowest minimum guaranteed effective annual interest
rate required by law on the Issue Date of this contract in the jurisdiction in
which this contract is delivered. GIAC may credit an interest rate greater than
the minimum guaranteed rate.
Any portion of a Net Premium allocated to the Fixed-Rate Option on the Issue
Date will earn interest at the then current rate as set by GIAC. This interest
rate will be guaranteed until the next Contract Anniversary.
After the Issue Date, GIAC will credit interest on any amounts allocated or
transferred to the Fixed-Rate Option at the interest rate then in effect on the
date of allocation or transfer. This rate will be guaranteed for the remainder
of the contract year, until the next Contract Anniversary.
On each Contract Anniversary, GIAC will credit interest on any portion of the
Accumulation Value attributable to the Fixed-Rate Option at the interest rate
then in effect. Such rate will be guaranteed for such portion of the
Accumulation Value until the next Contract Anniversary.
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9. TRANSFERS
The owner may transfer all or a portion of this contract's value among the
Allocation Options, subject to the restrictions described below. GIAC must
receive the owner's request for transfer at its Customer Service Office in Good
Order. Transfers are subject to the following:
o GIAC reserves the right to limit an owner's transfers among the
Allocation Options to once every 30 days; and
o GIAC reserves the right to charge an owner for each transfer. The
maximum amount of any transfer charge is $25. GIAC will deduct any
transfer charge on a pro rata basis from the Allocation Options from
which the amounts were transferred.
GIAC also reserves the right, in its reasonable discretion, to limit, modify,
restrict, suspend or eliminate an owner's right to make transfers. A limitation
or modification could be applied to transfers to, or from, one or more of the
Variable Allocation Options and the Fixed-Rate Option and could include, but is
not limited to:
o requiring the owner's transfer requests to be made by the owner
through the U.S. Postal Service or otherwise restricting electronic
or telephonic transaction privileges;
o refusing or otherwise restricting any transfer request by an owner
which XXXX believes alone or with a group of transfer requests may
have a detrimental effect on Account R or the underlying Variable
Investment Options; or if GIAC is informed by any registered
investment company of a Variable Investment Option that the purchase
or redemption of shares to execute a transfer request would have a
detrimental effect on the applicable Variable Investment Option(s).
Transfers Before the Annuity Commencement Date
During the period up to 30 days before the Annuity Commencement Date, the owner
may transfer all or a portion of the Accumulation Units credited under this
contract among the Variable Allocation Options and the Fixed-Rate Option,
subject to any restrictions set forth below and to the limit set by GIAC on the
number of Allocation Options into which the Accumulation Value of the contract
may be invested, if any.
GIAC permits transfers of Accumulation Units from the Fixed-Rate Option to one
or more of the Variable Investment Options only once each year on or within 30
days after a Contract Anniversary. Transfers from the Fixed-Rate Option will be
made in the same order as such amounts were allocated or transferred to the
Fixed-Rate Option. The maximum amount that may be transferred from the
Fixed-Rate Option each contract year is the greater of:
o 33 1/3% of the portion of the Accumulation Value attributable to the
Fixed-Rate Option as of the Contract Anniversary; or
o $10,000; or
o (a) multiplied by (b), where:
o (a) is the total dollar amount transferred from the Fixed-Rate
Option in the previous contract year; and
o (b) is 1.15.
Transfers After the Annuity Commencement Date
After the Annuity Commencement Date, if the owner has elected a variable annuity
payout option, the owner may transfer all or a portion of the Annuity Units
credited under such option among the Variable Investment Options. Transfers may
be made only once each month. GIAC must receive transfer instructions in Good
Order at least 15 days before the due date of the first variable annuity payment
to which the transfer will apply.
The number of additional Annuity Units credited to a newly elected Variable
Investment Option will be equal to (a) divided by (b), where:
(a) is the dollar amount of the monthly variable annuity payment that is
to be transferred as of the transfer date; and
(b) is the value of an Annuity Unit in the newly elected Variable
Investment Option as of the transfer date.
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10. ACCUMULATION VALUE
Accumulation Value
The portion of the Accumulation Value attributable to a particular Variable
Allocation Option is determined by multiplying (a) by (b), where:
(a) is the number of Accumulation Units credited to this contract for
that particular Allocation Option; and
(b) is the then current Accumulation Unit value for that Allocation
Option.
The portion of the Accumulation Value attributable to the Fixed-Rate Option is
expressed as a dollar amount. The portion of the Accumulation Value attributable
to the Fixed-Rate Option is the sum of all amounts allocated to the Fixed-Rate
Option, plus any applicable interest (as described on page 10), less the amount
of any withdrawals, transfers, or contract fee deductions from this Option.
Amounts allocated or transferred to the Fixed-Rate Option before the Annuity
Commencement Date will increase the dollar amount of the portion of the
Accumulation Value attributable to this Option. The portion of the Accumulation
Value attributable to the Fixed-Rate Option will be reduced by the amount of any
withdrawals, transfers or contract fee deductions from this Option.
This contract does not have any Accumulation Value on or after the Annuity
Commencement Date.
GIAC guarantees that the dollar amount of the Accumulation Value will not be
adversely affected by the actual administrative expenses it incurs or variations
in mortality experience.
Accumulation Units
Amounts allocated or transferred to a Variable Investment Option before the
Annuity Commencement Date are used to purchase variable Accumulation Units.
Accumulation Units are redeemed and cancelled when amounts are deducted,
withdrawn, or transferred from a Variable Investment Option. The number of
Accumulation Units purchased or redeemed in a Variable Investment Option equals
(a) divided by (b), where:
(a) is the dollar value of the transaction; and
(b) is the value of an Accumulation Unit for the applicable Variable
Investment Option as of the Valuation Date on which the transaction
is processed.
Accumulation Unit Value for a Variable Investment Option
The Accumulation Unit value for a Variable Investment Option depends on the
investment experience of that option and therefore may increase or decrease
daily.
GIAC determines the Accumulation Unit value for each Variable Investment Option
for every Valuation Period. The Accumulation Unit value for a Variable
Investment Option for any Valuation Period is (a) multiplied by (b), where:
(a) is the Accumulation Unit value for that Variable Investment Option
for the immediately preceding Valuation Period; and
(b) is the net investment factor, as described below, for the current
Valuation Period.
Net Investment Factor
GIAC will assess a daily charge of .000040016 of the value of the assets
allocated to each Variable Investment Option This charge is used in determining
the net investment factor for each Variable Investment Option. On an annual
basis, this charge is equal to 1.45% of the value of the assets allocated to
these Variable Investment Options. Mortality and expense risks account for 1.25%
of this charge and administrative expenses incurred by GIAC account for .20% of
this charge.
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ACCUMULATION VALUE - cont'd
The net investment factor is used to calculate the value of an Accumulation Unit
in any Variable Investment Option for a Valuation Period. The net investment
factor is determined by dividing the sum of (a) and (b) by (c), and subtracting
(d) from the result, where:
(a) is the net asset value per share of the investments held by the
Variable Investment Option for the current Valuation Period;
(b) is the per share amount of any dividends or other distributions made
by the investments held by the Variable Investment Option during the
current Valuation Period;
(c) is the net asset value per share of the investments held by the
Variable Investment Option for the immediately preceding Valuation
Period; and
(d) is the sum of the daily charges GIAC deducts from the Variable
Investment Options for:
o the mortality and expense risks and administrative expenses
assumed by GIAC; and
o annuity taxes, if any.
The net investment factor may be less than 1.00 since it is based on the
investment experience of Account R.
Contract Fee
On each Contract Anniversary on or before the Annuity Commencement Date, GIAC
will deduct a contract fee of $35 from the Accumulation Value of this contract.
This fee will be deducted from each Allocation Option in proportion to the
portion of the Accumulation Value attributable to each particular Allocation
Option on that Contract Anniversary. However, if this contract is surrendered on
a date other than a Contract Anniversary, GIAC will deduct the contract fee on
the date of surrender. GIAC will waive the contract fee if the Accumulation
Value on the Contract Anniversary or upon total surrender is $100,000 or more.
Tax Charge
In jurisdictions in which a tax is payable when premium payments are received,
GIAC will deduct the amount of tax payable from the contract's Accumulation
Value when it is applied under a payout option, upon surrender or upon death.
In jurisdictions that do not require payment of a tax, the above paragraph will
not apply.
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11. SURRENDERS AND WITHDRAWALS
Surrender of Contract
Before the Annuity Commencement Date and while the annuitant is living, the
owner may surrender this contract for its surrender value as defined below. The
contract will then terminate. The owner's request for such surrender must be
received in Good Order by GIAC at its Customer Service Office. This contract
must be sent to GIAC's Customer Service Office for cancellation.
The surrender value is determined by deducting (b), (c) and (d) from (a), where:
(a) is the Accumulation Value as of the Valuation Date on which GIAC
receives the owner's written request for surrender in Good Order;
(b) is any applicable contingent deferred sales charge, as described
below;
(c) is any applicable contract fee; and
(d) is annuity taxes, if any.
Partial Withdrawals
Before the Annuity Commencement Date and while the annuitant is living, the
owner may withdraw part of this contract's Accumulation Value, subject to the
conditions described below. The owner's request for any partial withdrawal must
be received in Good Order by GIAC at its Customer Service Office.
Any partial withdrawal payment will take into account any contingent deferred
sales charges (described below) and any applicable annuity taxes. The amount of
any partial withdrawal and any applicable contingent deferred sales charge and
annuity taxes, if any, will be deducted from the Variable Investment Options in
proportion to the amount of the Accumulation Value attributable to each Variable
Investment Option as of the Valuation Date on which GIAC receives the owner's
written request for withdrawal in Good Order. The portion of a partial
withdrawal and any applicable contingent deferred sales charge and annuity taxes
that exceed the Accumulation Value attributable to the Variable Investment
Options will be deducted from the Fixed-Rate Option.
The total Accumulation Value remaining after a partial withdrawal must be at
least $2,000. If a partial withdrawal results in the Accumulation Value falling
below $2,000, then GIAC reserves the right to cancel the contract and pay the
surrender value to the owner.
Contingent Deferred Sales Charges
If the owner makes a partial withdrawal or surrenders the contract, a contingent
deferred sales charge may be applied against withdrawals or surrenders of
unliquidated premiums that have been in the contract for less than seven (7)
years.
The amount of the contingent deferred sales charge, if any, will be a
percentage, as shown in the table below, of the amount of the withdrawal or
surrender that is attributable to unliquidated premiums that have been in the
contract for less than seven (7) years:
Number of Years Contingent
Completed from the Date Deferred Sales Charge
of the Premium Payment Percentage
0 8%
1 7%
2 6%
3 5%
4 4%
5 3%
6 2%
7 and later 0%
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SURRENDERS AND WITHDRAWALS - cont'd
Unliquidated premiums that have been in the contract for less than seven years
are the total amount of such premiums that have not been withdrawn, as
calculated pursuant to the rules described below in "Free Withdrawal Amount and
Calculations of Amount Subject to a Contingent Deferred Sales Charge."
Free Withdrawal Amount and Calculations of Amount Subject to a Contingent
Deferred Sales Charge
In the case of a partial withdrawal, the amount that may be withdrawn from the
contract without incurring a contingent deferred sales charge is equal to the
sum of the following:
o the excess of the Accumulation Value over the unliquidated premiums
that have been in the contract for less than seven (7) years on the
date of withdrawal; plus
o 10% of premium payments that have been in the contract for less than
seven (7) years minus the aggregate amount of all prior free partial
withdrawals of such premium payments under this provision made
during the current contract year. This privilege is referred to as
the 10% free withdrawal provision.
For the purpose of calculating the contingent deferred sales charge on the
unliquidated premiums that have been in the contract for less than seven (7)
years:
(i) all amounts withdrawn are deemed to be taken out on a
first-in-first-out basis, that is, all amounts taken out are deemed
to have come first from the oldest premium of the unliquidated
premiums that have been in the contract for less than seven (7)
years;
(ii) any free withdrawal amounts taken under the 10% free withdrawal
provision will not be considered to be a reduction of the
unliquidated premiums that have been in the contract for less than
seven (7) years; and
(iii) partial withdrawals without a contingent deferred sales charge using
the excess of the Accumulation Value over the unliquidated premiums
that have been in the contract for less than seven (7) years on the
date of withdrawal are not considered to be withdrawals of premium
payments for purposes of calculating the amount of unliquidated
premiums that have been in the contract for less than seven (7)
years.
All withdrawal amounts that are not greater than the excess of the Accumulation
Value over the unliquidated premiums that have been in the contract for less
than seven (7) years on the date of withdrawal will be considered a withdrawal
of such excess amount and will not be considered to have been a withdrawal under
the 10% free withdrawal provision.
The 10% free withdrawal provision is non-cumulative and is only available on a
contract year basis. Any free withdrawal amounts under the 10% free withdrawal
provision not taken during any given contract year cannot be taken as free
amounts in a subsequent contract year.
In the case of a surrender of the contract: (i) the amount that may be withdrawn
from the contract without incurring a contingent deferred sales charge is equal
to the excess of the Accumulation Value on the date of surrender over the
unliquidated premiums that have been in the contract for less than seven (7)
years; and (ii) the 10% free withdrawal provision is not applicable.
In the event a contract has been continued under spousal continuation, see
Section 4 on page 7 for calculating any applicable contingent deferred sales
charges if an owner makes a partial withdrawal or surrenders the contract.
12. PAYMENT OF CONTRACT PROCEEDS
Annuity Payments
If the annuitant is living and this contract is in force on the Annuity
Commencement Date, GIAC will make variable annuity payments to the owner under
Variable Annuity Payout Option V-2, with payments guaranteed for a period of 120
months, as stated in "Annuity Benefit" on page 6, or, if elected, one or more of
the other annuity payout options. Payment of any annuity benefit or death
benefit may be made under either a fixed or variable annuity payout option or a
combination of both. If annuity payout option F-3 or V-3 is chosen, the owner
must also select a joint annuitant during the annuitant's lifetime.
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PAYMENT OF CONTRACT PROCEEDS - cont'd
All annuity payments are based on:
o the sex and age of the annuitant at the birthday nearest the date
payments are to begin; and
o the annuity payout option elected.
The Annuity Payout Option Tables are based on the Annuity 2000 Mortality Table.
Payees
While the annuitant is living, the owner may name or change one or more
beneficiaries who will be the payee or payees under an annuity payout option
after the death of the annuitant.
Only individuals who are to receive payments in their own behalf may be named as
payees, unless XXXX agrees otherwise.
Variable Annuity Payout Options
The amount of any variable annuity payments after the first will increase or
decrease according to the value of the variable Annuity Units, which reflect the
investment experience of the Variable Investment Option(s) elected.
The amount of each variable annuity payment under a variable annuity payout
option depends upon an assumed investment return (AIR) chosen by the owner. The
effective annual AIR chosen can be:
o 0%; or
o 3 1/2%; or
o 5%, if allowed by applicable law or regulation.
If no choice is made, an AIR of 3 1/2% will be used. The variable annuity payout
rates shown on page 21 for the variable annuity payout options are based on the
3 1/2% AIR. The amount of the first monthly payment for the 3 1/2% AIR payout
options will be based on rates not less than the rates shown in the Variable
Annuity Payout Option Tables on page 21. The interest rate used to compute the
present value of any remaining unpaid payments will be the AIR.
If Variable Annuity Payout Option V-2 is elected, and if, before the end of the
guaranteed period, the annuitant dies under Option V-2, GIAC will pay the
balance of the payments to the beneficiary for the remainder of the guaranteed
period, unless the beneficiary elects to be paid the present value of the
current dollar amount of the then remaining annuity payments in a lump sum. If
the beneficiary dies while receiving such payments, the present value of the
remaining number of variable annuity payments will be paid in one sum to the
beneficiary's estate.
Option V-1 - Life Annuity without Guaranteed Period
GIAC will make variable annuity payments during the lifetime of the annuitant.
GIAC does not guarantee a minimum number of annuity payments under this option.
This option does not provide a death benefit to any beneficiaries upon the
annuitant's death.
Option V-2 - Life Annuity with Guaranteed Period
GIAC will make variable annuity payments during the lifetime of the annuitant.
The owner may elect payments that are guaranteed for a period of 60, 120, 180 or
240 months, depending upon the life expectancy of the annuitant. The amount of a
monthly payment for a guaranteed period of 120 months is based on the Option V-2
table on page 21.
Option V-3 - Joint and Survivor Annuity
GIAC will make payments while the annuitant and the joint annuitant are living
and during the survivor's remaining lifetime. Under a Joint and Survivor
Variable Annuity, payments will continue while both annuitants are alive and
during the lifetime of the survivor. When an annuitant dies, variable payments
will continue for the lifetime of the survivor, based on a percentage of the
amount that would be payable if both annuitants were living, as chosen at the
time of election of this option. The amount of a monthly payment for a Joint and
Two-Thirds Survivor Annuity is based on the Option V-3 table on page 21.
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PAYMENT OF CONTRACT PROCEEDS - cont'd
Option V-4 - Variable Annuity Payments to Age 100
GIAC will make variable annuity payments, which will continue for a whole number
of years. The number of years will equal 100 minus the annuitant's age on the
Annuity Commencement Date. If the annuitant dies before age 100, GIAC will pay
the balance of the payments to the beneficiary for the remainder of that period,
unless the beneficiary elects to be paid the present value of the current dollar
amount of the then remaining payments in a lump sum. If the beneficiary dies
while receiving such payments, the present value of the remaining number of
payments will be paid in one sum to the beneficiary's estate.
Under this option, the payee has the right to change to Option V-1, the Life
Annuity without Guaranteed Period option. The present value of the remaining
payments will be applied to a Life Annuity without Guaranteed Period.
Under Option V-4, the payee also has the right to withdraw all or a portion of
the present value of the remaining payments. This would result in a reduction in
future payments. The following conditions apply to partial withdrawals:
o the payee may not withdraw less than $500;
o after making a partial withdrawal, the present value of the
remaining payments must be at least $2,000 and the remaining monthly
payment must be at least $20 (or $60 quarterly, $120 semi-annually
or $240 annually); and
o one partial withdrawal is permitted each quarter without an
administrative charge, and additional withdrawals are permitted at
an administrative charge not to exceed the lesser of $25 or 2% of
the amount withdrawn.
If a partial withdrawal request does not meet the conditions stated in the
second bullet above, GIAC will promptly attempt to contact the owner for
additional instructions. If GIAC does not receive revised instructions that
comply with the conditions stated in the second bullet above in Good Order at
its Customer Service Office within five Valuation Dates of the original request,
GIAC will pay the owner the present value of the remaining payments and cancel
the contract. This withdrawal is subject to any applicable contract charges and
contingent deferred sales charges, and may have tax consequences.
If a contingent deferred sales charge was applicable, but was waived at the time
the contract proceeds were applied to this payout option, the amount withdrawn
or surrendered will be reduced by a portion of the contingent deferred sales
charge applicable at that time. The reduction in the amount withdrawn or
surrendered will be (a) times ((b) divided by (c)) times (d):
(a) the contingent deferred sales charge that was applicable at the time
the contract proceeds were applied to this payout option;
(b) the number of whole months of any remaining unpaid payments until
the contingent deferred sales charge would have expired;
(c) the number of whole months remaining when the contract proceeds were
applied to the payout option until the contingent deferred sales
charge would have expired;
(d) the amount of the present value of payments withdrawn divided by the
total present value of the payments.
Fixed Annuity Payout Options
If Fixed Annuity Payout Option F-2 is elected, and if, before the end of the
guaranteed period, the annuitant dies under Option F-2, GIAC will pay the
balance of the payments to the beneficiary for the remainder of the guaranteed
period, unless the beneficiary elects to be paid the present value of the
current dollar amount of the then remaining annuity payments in a lump sum. If
the beneficiary dies while receiving such payments, the present value of the
remaining number of annuity payments will be paid in one sum to the
beneficiary's estate. The present value will be calculated at an interest rate
equal to the interest rate used to compute the annuity payments.
Option F-1 - Life Annuity without Guaranteed Period
GIAC will make fixed annuity payments during the lifetime of the annuitant. GIAC
does not guarantee a minimum number of annuity payments under this option. This
option does not provide a death benefit to any beneficiaries upon the
annuitant's death. The amount of a monthly payment is based on the Option F-1
table on page 22. The guaranteed monthly payments shown in the Option F-1 table
include interest at a rate of 3% a year.
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PAYMENT OF CONTRACT PROCEEDS - cont'd
Option F-2 - Life Annuity with Guaranteed Period
GIAC will make fixed annuity payments during the lifetime of the annuitant. The
owner may elect payments that are guaranteed for a period of 60, 120, 180 or 240
months, depending upon the life expectancy of the annuitant. Guaranteed payments
include interest at a rate of 3% a year. The amount of a monthly payment for a
guaranteed period of 120 months is based on the Option F-2 table on page 22.
Option F-3 - Joint and Survivor Annuity
GIAC will make fixed annuity payments while the annuitant and the joint
annuitant are living and during the survivor's lifetime. Under a Joint and
Survivor Annuity, payments will continue while both annuitants are alive and
during the lifetime of the survivor. When an annuitant dies, fixed payments will
continue for the lifetime of the survivor, based on a percentage of the amount
that would be payable if both annuitants were living, as chosen at the time of
election of this option. The amount of a monthly payment for a Joint and
Two-Thirds Survivor Annuity is based on the Option F-3 table on page 22.
Option F-4 - Annuity Payments to Age 100
GIAC will make payments, which will continue for a whole number of years. The
number of years will equal 100 minus the annuitant's age on the Annuity
Commencement Date. If this option is chosen, it will earn interest at the then
current rate as set by GIAC. GIAC will declare a new interest rate for this
option on January 1st of each year. This interest rate will remain in effect
through December 31st of that calendar year. During the first calendar year in
which contract proceeds are applied to this option, GIAC will credit interest to
this contract through December 31st of that calendar year at the interest rate
that is declared on January 1st of that year. The amount of any payments will
increase if the credited rate is greater than the guaranteed interest rate of
3%.
If the annuitant dies before age 100, GIAC will pay the balance of the payments
to the beneficiary for the remainder of that period, unless the beneficiary
elects to be paid the present value of the current dollar amount of the then
remaining annuity payments in a lump sum. If the beneficiary dies while
receiving such payments, the present value of the remaining number of annuity
payments will be paid in one sum to the beneficiary's estate. The interest rate
used to compute the present value of any remaining unpaid payments will be the
guaranteed interest rate of 3%.
Under this option the payee has the right to change to Option F-1, the Life
Annuity without Guaranteed Period Option. The present value of the remaining
payments will be applied to a Life Annuity without Guaranteed Period.
Under Option F-4, the payee has the right to withdraw all or a portion of the
present value of the remaining payments. This would result in a reduction in
future payments. The following conditions apply to partial withdrawals:
o the payee may not withdraw less than $500;
o after making a partial withdrawal, the present value of the
remaining payments must be at least $2,000 and the remaining monthly
payment must be at least $20 (or $60 quarterly, $120 semi-annually
or $240 annually); and
o one partial withdrawal is permitted each quarter without an
administrative charge, and additional withdrawals are permitted at
an administrative charge not to exceed the lesser of $25 or 2% of
the amount withdrawn.
If a partial withdrawal request does not meet the conditions stated in the
second bullet above, GIAC will promptly attempt to contact the owner for
additional instructions. If GIAC does not receive revised instructions that
comply with the conditions stated in the second bullet above in Good Order at
its Customer Service Office within five Valuation Dates of the original request,
GIAC will pay the owner the present value of the remaining payments and cancel
the contract. This withdrawal is subject to any applicable contract charges and
contingent deferred sales charges, and may have tax consequences.
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PAYMENT OF CONTRACT PROCEEDS - cont'd
If a contingent deferred sales charge was applicable, but was waived at the time
the contract proceeds were applied to this payout option, the amount withdrawn
or surrendered will be reduced by a portion of the contingent deferred sales
charge applicable at that time. The reduction in the amount withdrawn or
surrendered will be (a) times ((b) divided by (c)) times (d):
(a) the contingent deferred sales charge that was applicable at the time
the contract proceeds were applied to this payout option;
(b) the number of whole months of any remaining unpaid payments until
the contingent deferred sales charge would have expired;
(c) the number of whole months remaining when the contract proceeds were
applied to the payout option until the contingent deferred sales
charge would have expired;
(d) the amount of the present value of payments withdrawn divided by the
total present value of the payments.
Determination of Annuity Payments
On the Annuity Commencement Date, GIAC will determine the Accumulation Value.
The portion of the Accumulation Value attributable to each Variable Investment
Option is determined by multiplying (a) by (b), and deducting (c) from the
result, where:
(a) is the Accumulation Unit value on the Valuation Date 10 days before
the date the first annuity payment is due;
(b) is the number of Accumulation Units credited to the owner's account
as of the date the first annuity payment is due; and
(c) is any applicable annuity taxes not previously deducted.
The portion of the Accumulation Value attributable to the Fixed-Rate Option, if
any, is added to the amount calculated above to determine the Accumulation
Value.
The Variable Annuity Payout Option Tables on page 21 indicate the dollar amount
of the first guaranteed monthly annuity payment for each Variable Annuity Payout
Option which can be purchased with each $1,000 of Accumulation Value. The Fixed
Annuity Payout Option Tables on page 22 indicate the dollar amount of the
guaranteed monthly annuity payment for each Fixed Annuity Payout Option which
can be purchased with each $1,000 of Accumulation Value. The first guaranteed
variable annuity payment and guaranteed fixed annuity payments are determined by
multiplying (a) by (b), where:
(a) is the amount shown in the applicable table for the annuitant's sex
and age on the Annuity Commencement Date; and
(b) is the number of thousands of dollars of Accumulation Value.
Annuity Unit Values
If a Variable Annuity Payout Option has been elected, the Accumulation Value of
this contract will be applied to purchase Annuity Units. Annuity Units are used
to determine the amount of each variable annuity payment after the first.
The value of an Annuity Unit is determined independently for each Variable
Investment Option. The dollar value of Annuity Units may increase or decrease
depending upon the investment experience of the Variable Investment Option(s)
selected.
The value of an Annuity Unit in each Variable Investment Option was established
at $1.00 on the date operations began for each such Variable Investment Option.
The value of an Annuity Unit at the end of any subsequent Valuation Period is
equal to (a) multiplied by (b), where:
(a) is the Annuity Unit value for the immediately preceding Valuation
Period; and
(b) is the annuity change factor for the current Valuation Period.
The annuity change factor is equal to the net investment factor (as described in
"Net Investment Factor" on page 12) for the same Valuation Period, adjusted to
recognize the AIR used in determining the amounts of variable annuity payments.
The valuation of all assets in Account R will be determined in accordance with
all applicable laws and regulations.
Page 19
IVA-2060
PAYMENT OF CONTRACT PROCEEDS - cont'd
Determination of Variable Annuity Payments After the First
The amount of each variable annuity payment made after the first is determined
by multiplying (a) by (b), where:
(a) is the number of Annuity Units in each Variable Investment Option;
and
(b) is the appropriate Annuity Unit value as of the Valuation Date 10
days prior to the date the variable annuity payment is due.
The number of Annuity Units in each option is determined by dividing (a) by (b),
where:
(a) is the amount of the first variable annuity payment for each
Variable Investment Option; and
(b) is the value of the Annuity Unit on the date the first variable
annuity payment is made.
The number of Annuity Units remains fixed during the annuity payment period,
provided no transfers among Variable Investment Options are made or partial
withdrawals are taken from Option V-4 or there is a conversion from Option V-4
to Option V-1.
GIAC guarantees that the dollar amount of each variable annuity payment after
the first will not be adversely affected by:
o the actual administrative expenses it incurs; or
o variations in mortality experience from the mortality assumptions
upon which the first payment is based.
Annuity Payout Options: General Provisions
o At least $2,000 must be applied under an Annuity Payout Option.
Proceeds of a smaller amount will be paid to the owner in one sum
and the contract will be cancelled.
o GIAC reserves the right to change the frequency of payment if
monthly annuity payments are or become $20 or less.
o GIAC requires satisfactory proof in Good Order of the age and sex of
the annuitant prior to the date annuity payments begin.
o The annuity payout options will not be available with respect to any
part of the proceeds payable to an assignee or to other than a
natural person entitled to receive proceeds, except with the consent
of GIAC.
o The owner or any payee does not have the right to advance or assign
payments made under an annuity payout option.
o To the extent permitted by law, the death benefit and the payments
made under an annuity payout option will not be subject to
encumbrance, or to the claims of creditors or legal process.
o The greater of the guaranteed settlement option rates or the current
rates in use by GIAC at the time of annuitization are to be used.
Page 20
IVA-2060
VARIABLE ANNUITY PAYOUT OPTION TABLES
DOLLAR AMOUNT OF THE FIRST MONTHLY VARIABLE ANNUITY PAYMENT PURCHASED
WITH EACH $1,000 OF PROCEEDS APPLIED
Option V-1 Option V-2 Option V-3 Joint and Two-Thirds Option V-4
Survivor Annuity
Nearest Life Life Nearest Nearest Age of Female Variable
Age of Annuity Annuity Age of Annuitant at Date of Annuity Payments
Annuitant No period 10 years Male First Payment to Age 100
at Date of certain certain Annuitant
First at Date of
Payment First
Payment
M F M F Age 10 Age 5 Same Age 5 Age Years
Yrs Yrs Age Yrs to 100
Less Less Older
40 3.65 3.49 3.65 3.49 40 3.39 3.44 3.50 3.57 40 60 3.28
41 3.69 3.52 3.68 3.51 41 3.41 3.46 3.52 3.59 41 59 3.30
42 3.72 3.54 3.72 3.54 42 3.43 3.49 3.55 3.63 42 58 3.31
43 3.76 3.57 3.75 3.57 43 3.46 3.51 3.58 3.66 43 57 3.33
44 3.80 3.60 3.79 3.60 44 3.48 3.54 3.61 3.69 44 56 3.35
45 3.84 3.63 3.83 3.63 45 3.50 3.57 3.64 3.73 45 55 3.37
46 3.88 3.67 3.87 3.66 46 3.53 3.59 3.68 3.77 46 54 3.39
47 3.93 3.70 3.92 3.70 47 3.55 3.63 3.71 3.81 47 53 3.41
48 3.98 3.74 3.96 3.73 48 3.58 3.66 3.75 3.85 48 52 3.44
49 4.03 3.78 4.01 3.77 49 3.61 3.69 3.78 3.89 49 51 3.46
50 4.08 3.82 4.06 3.81 50 3.64 3.73 3.83 3.94 50 50 3.49
51 4.13 3.86 4.11 3.85 51 3.67 3.76 3.87 3.99 51 49 3.51
52 4.19 3.90 4.17 3.89 52 3.71 3.80 3.91 4.04 52 48 3.54
53 4.25 3.95 4.22 3.94 53 3.74 3.84 3.96 4.09 53 47 3.57
54 4.31 4.00 4.28 3.99 54 3.78 3.89 4.01 4.15 54 46 3.60
55 4.38 4.05 4.35 4.04 55 3.82 3.93 4.06 4.21 55 45 3.64
56 4.45 4.11 4.41 4.09 56 3.86 3.98 4.11 4.27 56 44 3.67
57 4.52 4.16 4.48 4.15 57 3.90 4.03 4.17 4.33 57 43 3.71
58 4.60 4.22 4.56 4.21 58 3.95 4.08 4.23 4.41 58 42 3.75
59 4.68 4.29 4.63 4.27 59 4.00 4.14 4.30 4.48 59 41 3.79
60 4.77 4.36 4.71 4.33 60 4.05 4.19 4.36 4.56 60 40 3.83
61 4.86 4.43 4.80 4.40 61 4.10 4.26 4.44 4.64 61 39 3.88
62 4.96 4.51 4.89 4.48 62 4.16 4.32 4.51 4.73 62 38 3.92
63 5.07 4.59 4.99 4.55 63 4.22 4.39 4.59 4.83 63 37 3.98
64 5.18 4.67 5.09 4.64 64 4.28 4.46 4.68 4.93 64 36 4.03
65 5.30 4.77 5.20 4.72 65 4.35 4.54 4.77 5.04 65 35 4.09
66 5.43 4.86 5.31 4.81 66 4.42 4.62 4.87 5.15 66 34 4.15
67 5.57 4.97 5.42 4.91 67 4.49 4.71 4.97 5.28 67 33 4.22
68 5.71 5.08 5.55 5.01 68 4.57 4.80 5.08 5.41 68 32 4.29
69 5.87 5.20 5.67 5.12 69 4.65 4.90 5.20 5.55 69 31 4.37
70 6.04 5.33 5.81 5.24 70 4.74 5.01 5.33 5.70 70 30 4.45
71 6.22 5.46 5.95 5.36 71 4.83 5.12 5.46 5.87 71 29 4.53
72 6.40 5.61 6.09 5.49 72 4.93 5.24 5.61 6.04 72 28 4.63
73 6.60 5.77 6.24 5.62 73 5.03 5.36 5.76 6.22 73 27 4.73
74 6.82 5.94 6.39 5.76 74 5.14 5.50 5.92 6.42 74 26 4.84
75 7.04 6.12 6.55 5.91 75 5.26 5.64 6.10 6.63 75 25 4.96
76 7.28 6.32 6.71 6.07 76 5.38 5.79 6.29 6.86 76 24 5.09
77 7.54 6.53 6.87 6.23 77 5.51 5.96 6.49 7.10 77 23 5.24
78 7.81 6.76 7.04 6.40 78 5.65 6.13 6.70 7.35 78 22 5.39
79 8.10 7.01 7.21 6.58 79 5.80 6.31 6.93 7.63 79 21 5.56
80 8.41 7.27 7.38 6.76 80 5.96 6.51 7.18 7.93 80 20 5.75
The variable income rates shown above are based on an effective annual AIR of 3
1/2% per year. The dollar amount of the monthly annuity payment purchased for
ages and AIRs not shown in the tables is available upon request.
Page 21
IVA-2060
FIXED ANNUITY PAYOUT OPTION TABLES
DOLLAR AMOUNT OF THE MONTHLY ANNUITY PAYMENT PURCHASED
WITH EACH $1,000 OF PROCEEDS APPLIED
Option F-1 Option F-2 Option F-3 Joint and Two-Thirds Option F-4
Survivor Annuity
Nearest Life Life Nearest Nearest Age of Female
Age of Xxxxxxx Xxxxxxx Age of Annuitant at Date of Annuity Payments
Annuitant No period 10 years Male First Payment to Age 100
at Date of certain certain Annuitant
First at Date of
Payment First
Payment
M F M F Age 10 Age 5 Same Age 5 Age Years
Yrs Yrs Age Yrs to 100
Less Less Older
40 3.35 3.18 3.34 3.18 40 3.08 3.13 3.19 3.26 40 60 2.96
41 3.38 3.21 3.38 3.20 41 3.10 3.15 3.21 3.29 41 59 2.98
42 3.42 3.24 3.41 3.23 42 3.12 3.17 3.24 3.32 42 58 3.00
43 3.46 3.26 3.45 3.26 43 3.14 3.20 3.27 3.36 43 57 3.02
44 3.50 3.30 3.49 3.29 44 3.16 3.23 3.30 3.39 44 56 3.04
45 3.54 3.33 3.53 3.33 45 3.19 3.26 3.34 3.43 45 55 3.06
46 3.58 3.36 3.57 3.36 46 3.21 3.29 3.37 3.47 46 54 3.09
47 3.63 3.40 3.62 3.39 47 3.24 3.32 3.41 3.51 47 53 3.11
48 3.68 3.44 3.66 3.43 48 3.27 3.35 3.45 3.55 48 52 3.13
49 3.73 3.48 3.71 3.47 49 3.30 3.39 3.48 3.59 49 51 3.16
50 3.78 3.52 3.76 3.51 50 3.33 3.42 3.53 3.64 50 50 3.19
51 3.83 3.56 3.82 3.55 51 3.37 3.46 3.57 3.69 51 49 3.22
52 3.89 3.61 3.87 3.60 52 3.40 3.50 3.62 3.74 52 48 3.25
53 3.95 3.65 3.93 3.65 53 3.44 3.54 3.66 3.80 53 47 3.28
54 4.02 3.70 3.99 3.69 54 3.48 3.59 3.71 3.85 54 46 3.31
55 4.08 3.76 4.06 3.75 55 3.52 3.63 3.77 3.92 55 45 3.34
56 4.16 3.81 4.12 3.80 56 3.56 3.68 3.82 3.98 56 44 3.38
57 4.23 3.87 4.19 3.86 57 3.60 3.73 3.88 4.05 57 43 3.42
58 4.31 3.93 4.27 3.92 58 3.65 3.79 3.94 4.12 58 42 3.46
59 4.39 4.00 4.35 3.98 59 3.70 3.84 4.01 4.19 59 41 3.50
60 4.48 4.07 4.43 4.05 60 3.75 3.90 4.08 4.27 60 40 3.55
61 4.57 4.14 4.52 4.12 61 3.80 3.96 4.15 4.36 61 39 3.60
62 4.67 4.22 4.61 4.19 62 3.86 4.03 4.23 4.45 62 38 3.65
63 4.78 4.30 4.71 4.27 63 3.92 4.10 4.31 4.54 63 37 3.70
64 4.89 4.39 4.81 4.35 64 3.98 4.17 4.39 4.65 64 36 3.76
65 5.01 4.48 4.92 4.44 65 4.05 4.25 4.49 4.75 65 35 3.82
66 5.14 4.58 5.03 4.53 66 4.12 4.34 4.58 4.87 66 34 3.88
67 5.28 4.68 5.15 4.63 67 4.19 4.42 4.69 5.00 67 33 3.95
68 5.43 4.80 5.27 4.74 68 4.27 4.52 4.80 5.13 68 32 4.02
69 5.58 4.92 5.40 4.84 69 4.36 4.62 4.92 5.27 69 31 4.10
70 5.75 5.04 5.53 4.96 70 4.44 4.72 5.05 5.42 70 30 4.18
71 5.93 5.18 5.67 5.08 71 4.54 4.83 5.18 5.58 71 29 4.27
72 6.11 5.33 5.82 5.21 72 4.64 4.95 5.32 5.76 72 28 4.37
73 6.31 5.49 5.97 5.35 73 4.74 5.08 5.48 6.94 73 27 4.47
74 6.53 5.66 6.12 5.49 74 4.85 5.21 5.64 6.14 74 26 4.59
75 6.75 5.84 6.28 5.64 75 4.97 5.35 5.82 6.35 75 25 4.71
76 6.99 6.04 6.44 5.80 76 5.09 5.51 6.00 6.57 76 24 4.84
77 7.24 6.25 6.61 5.97 77 5.22 5.67 6.21 6.81 77 23 4.99
78 7.51 6.48 6.78 6.14 78 5.36 5.84 6.42 7.07 78 22 5.15
79 7.81 6.72 6.95 6.31 79 5.51 6.03 6.65 7.35 79 21 5.32
80 8.12 6.99 7.13 6.50 80 5.67 6.23 6.89 7.64 80 20 5.51
The dollar amount of the monthly annuity payment purchased for ages not shown in
the tables is available upon request.
Page 22
IVA-2060
13. GENERAL PROVISIONS
The Contract
The entire contract consists of the Basic Contract and any attached endorsements
or additional benefit riders. GIAC relied upon the statements made by the
applicant in issuing this contract. All statements made by the applicant are
assumed to be true to the best knowledge and belief of the person(s) making
them. These statements are representations and not warranties.
Only the President, a Vice President, or the Secretary of GIAC may make or
modify this contract, and then only in writing. No agent is authorized to:
o change this contract;
o waive any of GIAC's requirements; or
o waive an answer to any question in the application(s).
GIAC will not be bound by any promise or statement made by any agent or other
person except as stated above.
GIAC may at any time make any change in this contract to the extent that such
change is required in order to make this contract conform with any law or any
regulation issued by any governmental authority to which it is subject.
Any paid-up annuity benefit, surrender value, or death benefit payable under
this contract is not less than the minimum required by the jurisdiction in which
this contract is issued.
Age and Sex
If the age or sex of the annuitant has been misstated, GIAC will adjust any
benefit payable under this contract, based on the correct age and sex.
Overpayments made by GIAC because of such misstatement, with interest at 6% a
year, compounded annually, will be charged against benefits falling due after
the adjustment. If underpayments are made by GIAC because of such misstatement,
GIAC will pay the balance immediately, with 6% interest, compounded annually.
Proof of Age and Survival
GIAC has the right to require satisfactory proof:
o of the age of the payee or payees; and
o that a payee is living when a payment is contingent upon the payee's
survival.
GIAC has the right to discontinue annuity payments until proof in Good Order is
received by GIAC at its Customer Service Office.
Communications with GIAC
GIAC receives all communications only at its Customer Service Office. Please
include the contract number, full names of any owner(s) and annuitant, and each
owner's current address in all correspondence with GIAC.
Payments by GIAC
Any payment by GIAC under this contract is payable at its Customer Service
Office. GIAC reserves the right to require surrender of this contract prior to
payment of the death benefit.
Nonparticipating
This contract is not eligible for dividends and will not share in the surplus
earnings of GIAC.
Ownership of the Assets
GIAC shall have ownership and control of its assets, including all assets
allocated to Account R and the Fixed-Rate Option.
Page 23
IVA-2060
GENERAL PROVISIONS, cont'd
Inactive Contract
GIAC may terminate the contract by paying the owner the Accumulation Value in
one sum, if prior to the Annuity Commencement Date:
o the owner makes no premium payments for two consecutive years;
o the total amount of premium payments made, less any partial
withdrawals, is less than $2,000; and
o the Accumulation Value on or after the end of such two year period
is less than $2,000.
Taxes
GIAC will not be responsible for any tax consequences arising out of any
transactions or ownership of this contract.
Deferment
GIAC will ordinarily pay any partial withdrawals or surrender proceeds within
seven (7) days after the date the owner's request for withdrawal or surrender is
received in Good Order by GIAC at its Customer Service Office. However, when
permitted by law, GIAC may defer payment of any partial withdrawals or surrender
proceeds for up to 6 months after written request for such withdrawal or
surrender is received in Good Order by GIAC at its Customer Service Office.
The amount payable will be determined as of the date written request is received
by GIAC in Good Order at its Customer Service Office. Interest will accrue
daily, starting on the date deferment begins, at the rate of 3% on any amount
deferred 30 days or more.
GIAC may defer calculation or payment of any partial withdrawals or surrender
proceeds or the transfer of amounts based on separate account performance if:
o the New York Stock Exchange is closed for trading or trading has
been suspended; or
o the Securities and Exchange Commission restricts trading or
determines that a state of emergency exists which may make such
calculation, payment, or transfer impracticable.
Reports to the Owner
GIAC will provide a written report to the owner once each contract year while
this contract has an Accumulation Value. GIAC will also provide a written
confirmation to the owner when any annuity payments are made under this
contract.
The annual report will include the following information as of the most recent
Contract Anniversary:
o the Accumulation Value;
o the surrender value; and
o the annual interest rate credited on amounts held in the Fixed-Rate
Option on the Contract Anniversary during the current contract year,
if applicable.
The report will also include any other information required by the jurisdiction
in which this contract is delivered.
Page 24
IVA-2060
ENDORSEMENTS
ALPHABETICAL INDEX
Subject.....................................................................Page
Accumulation Units.........................................................4, 12
Accumulation Unit Value for a Variable Investment Option......................12
Accumulation Value.........................................................4, 12
Age and Sex................................................................3, 23
Allocation of Net Premiums.....................................................9
Annuity Benefit................................................................6
Annuity Commencement Date...................................................3, 4
Annuity Payments..............................................................15
Annuity Unit Values...........................................................19
Assignment.....................................................................6
Beneficiary....................................................................5
Change of Owner or Beneficiary.................................................6
Change of Annuity Commencement Date or Annuity Payout Option...................6
Communications with GIAC......................................................23
Xxxxxxxxxx Xxxxxxxxx........................................................4, 5
Contingent Deferred Sales Charges.............................................14
Contract Anniversary...........................................................4
Contract Data..................................................................3
Contract Fee..................................................................13
Contract, The.................................................................23
Death Benefits.................................................................7
Death of Annuitant Before Annuity Commencement Date............................7
Death of an Owner When the Owner is Not the Annuitant..........................8
Deferment.....................................................................24
Definitions....................................................................4
Determination of Annuity Payments.............................................19
Determination of Variable Annuity Payments After the First....................20
Fixed Annuity Payout Options..................................................17
Fixed Annuity Payout Option Tables............................................22
Fixed-Rate Option.............................................................10
Guardian Separate Account R....................................................9
Inactive Contract.............................................................24
Investment Divisions...........................................................9
Issue Date..................................................................3, 4
Joint Owners...................................................................5
Net Investment Factor.........................................................12
Nonparticipating..............................................................23
Owner.......................................................................3, 5
Ownership of the Assets.......................................................23
Partial Withdrawals...........................................................14
Payees........................................................................16
Payments by GIAC..............................................................23
Payment of Contract Proceeds..................................................15
Premiums.......................................................................9
Proof of Age and Survival.....................................................23
Reports to the Owner..........................................................24
Rights Reserved...............................................................10
Special Rules..................................................................8
Spousal Continuation...........................................................7
Surrender of Contract.........................................................14
Taxes.........................................................................24
Transfers After the Annuity Commencement Date.................................11
Transfers Before the Annuity Commencement Date................................11
Page 25
IVA-2060
ALPHABETICAL INDEX - Cont'd
Valuation Date.................................................................4
Valuation Period...............................................................4
Variable Annuity Payout Options...............................................16
Variable Annuity Payout Option Tables.........................................21
Page 26
IVA-2060
The Guardian A Stock Company
Insurance & Annuity Incorporated in the
Company, Inc. State of Delaware
[LOGO]
Customer Service Office:
P.O. Box 26210
Lehigh Valley, PA 18002-6210
Individual Flexible Premium Deferred Variable Annuity Contract
o Premiums payable before the Annuity Commencement Date, in accordance
with contract provisions
o Annuity payments begin on the Annuity Commencement Date
o Benefits based on the investment experience of a Separate Account
are variable and are not guaranteed
o Provides for a Fixed-Rate Option
o Non-participating - No dividends payable
IVA-2060
