Exhibit 4(j)
[FARMERS INSURANCE GROUP LOGO] F A R M E R S
LIFE INSURANCE
Home Office: 0000 00xx Xxx. SE, Mercer Island, Washington 98040/(000) 000-0000
A STOCK COMPANY
ANNUITANT XXXX XXX 001234567 Contract Number
INDIVIDUAL FLEXIBLE PREMIUM VARIABLE ANNUITY CONTRACT
In this contract "we," "us," and "our" refer to Farmers New World Life Insurance
Company. "You" and "your" refer to the Owner of this contract.
This contract is a legal contract between you and us. PLEASE READ YOUR CONTRACT
CAREFULLY.
Your benefits under this contract, the amount of the premium, and other contract
data are shown as the Contract Specifications on the last page of this contract.
SURRENDER CHARGE INFORMATION MAY BE FOUND ON PAGE 10 OF THIS CONTRACT.
The amount of the death benefit may increase or decrease as described in this
contract, depending on the investment experience of the subaccounts.
The contract value of this contract may increase or decrease daily depending on
the investment experience of the subaccounts. There is no guaranteed minimum
contract value with respect to amounts allocated to the variable account.
IMPORTANT
YOU HAVE PURCHASED A VARIABLE ANNUITY CONTRACT. CAREFULLY REVIEW IT FOR
LIMITATIONS.
THIS POLICY MAY BE RETURNED WITHIN 30 DAYS FROM THE DATE YOU RECEIVED IT.
DURING THAT 30-DAY PERIOD, YOUR MONEY WILL BE PLACED IN A FIXED ACCOUNT OR
MONEY-MARKET FUND, UNLESS YOU DIRECT THAT THE PREMIUM BE INVESTED IN A
STOCK OR BOND PORTFOLIO UNDERLYING THE CONTRACT DURING THE 30-DAY PERIOD.
IF YOU DO NOT DIRECT THAT THE PREMIUM BE INVESTED IN A STOCK OR BOND
PORTFOLIO, AND IF YOU RETURN THE POLICY WITHIN THE 30-DAY PERIOD, YOU WILL
BE ENTITLED TO A REFUND OF THE PREMIUM AND POLICY FEES. IF YOU DIRECT THAT
THE PREMIUM BE INVESTED IN A STOCK OR BOND PORTFOLIO DURING THE 30-DAY
PERIOD, AND IF YOU RETURN THE POLICY DURING THAT PERIOD, YOU WILL BE
ENTITLED TO A REFUND OF THE POLICY'S ACCOUNT VALUE ON THE DAY THE POLICY
IS RECEIVED BY THE INSURANCE COMPANY OR AGENT WHO SOLD YOU THIS POLICY,
WHICH COULD BE LESS THAN THE PREMIUM YOU PAID FOR THE POLICY. A RETURN OF
THE POLICY AFTER 30 DAYS RESULT IN A SUBSTANTIAL PENALTY, KNOWN AS A
SURRENDER CHARGE.
/s/ X. Xxxx Xxxxxx /s/ Xxxx X. Xxxxxx
X. Xxxx Xxxxxx Xxxx X. Xxxxxx
President Secretary
FARMERS NEW WORLD LIFE INSURANCE COMPANY
2000-398 NONPARTICIPATING INDIVIDUAL FLEXIBLE PREMIUM DEFERRED VARIABLE
ANNUITY. MONTHLY INCOME BEGINS ON ANNUITY START DATE. DEATH BENEFIT
PAYABLE BEFORE ANNUITY START DATE. ALL PAYMENTS AND VALUES PROVIDED
BY THIS CONTRACT, WHEN BASED ON THE INVESTMENT EXPERIENCE OF A
SUBACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED.
