ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK
FLEXIBLE PREMIUM DEFERRED
VARIABLE ANNUITY CONTRACT
ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK, A Stock Company,
Home Office: Huntington Station, New York
This Contract is issued to the owner in consideration of the application, a copy
of which is attached, and the initial purchase payment. Allstate Life Insurance
Company of New York will pay the benefits of this Contract, subject to its terms
and conditions.
Throughout this Contract,"you" and "your" refer to the Contract's owner. "We",
"us" and "our" refer to Allstate Life Insurance Company of New York.
This flexible premium deferred variable annuity provides a cash withdrawal
benefit and a death benefit during the accumulation phase and periodic income
payments beginning on the payout start date.
The maximum charges are $30 per contract per contract year and 1.35% per year
(assessed daily) of the variable account assets. The smallest annual rate of
net investment return on the variable account assets required to keep variable
annuity income payments from decreasing is 4.5%.
This Contract does not pay dividends.
THE DOLLAR AMOUNT OF INCOME PAYMENTS OR OTHER VALUES PROVIDED BY THIS CONTRACT,
WHEN BASED ON THE INVEST-MENT EXPERIENCE OF THE VARIABLE ACCOUNT, VARY TO
REFLECT THE PERFORMANCE OF THE VARIABLE ACCOUNT.
PLEASE READ YOUR CONTRACT CAREFULLY
RETURN PRIVILEGE
If you are not satisfied with this Contract for any reason, you may return it to
us within 10 days after you re-ceive it. We will refund any purchase payments
allocated to the variable account, adjusted to reflect invest- ment gain or loss
from the date of allocation to the date of cancellation; plus any purchase
payments allocated to the fixed account.
/s/ Xxxxxxx X. Xxxxxxx /s/ Xxxxx X. Xxxxx, II
Secretary President
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TABLE OF CONTENTS
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ANNUITY DATA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3
THE PERSONS INVOLVED . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
ACCUMULATION PHASE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
PAYOUT PHASE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
GENERAL PROVISIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
INCOME PAYMENT TABLES. . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
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ANNUITY DATA
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CONTRACT NUMBER:........................................................44444444
ISSUE DATE:..........................................................May 7, 1996
INITIAL PURCHASE PAYMENT:.............................................$10,000.00
Non-Qualified
OWNER:..................................................................Xxxx Xxx
ANNUITANT:..............................................................Xxxx Xxx
AGE AT ISSUE:.............................................................35
SEX:....................................................................Male
PAYOUT START DATE:..................................................July 1, 2041
(May be changed by notifying us no
later than 30 days prior to this date)
INCOME PLAN:................................................Life with 10 years -
Unless Changed by Owner
ADMINISTRATOR:.......................Allstate Life Insurance Company of New York
P.O. Box 9095
Farmingville, NY 11738-9095
INITIAL ALLOCATION OF PURCHASE PAYMENTS:
QUALITY INCOME PLUS:....................................................50%
DIVIDEND GROWTH:........................................................50%
OWNER'S RELATIONSHIP
BENEFICIARY TO OWNER PERCENTAGE
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Xxxx Xxx Son 100%
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THE PERSONS INVOLVED
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OWNER. Unless changed, the person(s) named at the time of application is (are)
the owner (joint owners) of this Contract. The owner has all rights, title and
inter- est in this Contract. As owner, you will receive any income payments made
under an income plan.
You may exercise all rights and options stated in this Contract, subject to the
rights of any irrevocable ben-eficiary.
You may change the owner or beneficiary at any time while the annuitant is
alive. You may not change the annuitant under this Contract.
Once we have received a satisfactory written request for a change of owner or
beneficiary, the change will take effect as of the date you signed it. We are
not li-able for any payment we make or other action we take before receiving any
such written request from you.
You may not assign an interest in this Contract as collateral or security for a
loan. Otherwise, you may assign benefits under this Contract prior to the
payout start date. No beneficiary may assign benefits under the Contract until
they are due. No assignment will bind us unless it is signed by you and filed
with us. We are not responsible for the validity of an assign-ment.
If the owner is more than one person:
"owner" as used in this Contract means any and all persons named as the
owner, unless otherwise indicated;
any assignment or request for a change must be signed by all the persons
named as the owner; and
on the death of any one person named as owner, ownership rights, title and
interest shall be re-tained by the surviving person(s) named as the owners.
See the section titled Accumulation Phase for the details concerning the
death of an owner.
ANNUITANT. The annuitant is the person whose life may affect the timing or
amount of the payout under this Contract. The owner is the annuitant unless a
dif- ferent annuitant has been designated.
BENEFICIARY. The death benefit is payable to the beneficiary if the sole
surviving owner dies during the accumulation phase, subject to any prior claims.
Details, including the special treatment of a beneficiary who is the owner's
spouse, are stated in the section titled Accumulation Phase.
If the owner dies during the payout phase the surviving owner(s) will become the
payee of any income pay-ments scheduled to continue after the owner's death. If
there are no surviving owner(s) the beneficiary will be the payee of any such
payments.
The beneficiary is as named in the most recent written request we have received
from you. If you do not name a beneficiary or if the beneficiary named by you
is no longer living when the death benefit becomes payable, the beneficiary will
be:
your spouse if living; otherwise
your children equally if living; otherwise
your estate.
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ACCUMULATION PHASE
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ACCUMULATION PHASE DEFINED. The accumulation phase is the first of two phases
in the life of your Con-tract. During this period your cash value results from
purchase payments made, investment experience of the variable account, interest
credited to the fixed ac-count, and charges deducted. Any withdrawals you make
and associated charges, if any, will reduce your cash value.
The accumulation phase begins on the issue date stated on the Annuity Data page.
This phase will con-tinue until the payout start date unless the Contract is
terminated before that date. Time during the accumu-lation phase is measured in
contract years. Contract years are those years that begin with the issue date
or an anniversary of the issue date.
Your Contract will stay in force until the payout start date, unless your cash
value is reduced to zero.
PURCHASE PAYMENTS. Purchase payments may be made at any time during the
accumulation phase. While this contract allows purchase payments after the
initial purchase payment, they are not required. Pur-chase payments after the
first purchase payment can-not exceed $1,000,000. We will invest the purchase
payments in the investment alternatives you select. You may allocate any
portion of your purchase pay-ment in whole percents from 0% to 100% to any of
the investment alternatives. The total allocation must equal 100%. For each
purchase payment, the mini- mum amount that may be allocated to the fixed ac-
count is $500.
Allocation of your purchase payments will be made as you requested at the time
of application. You may change the allocation of subsequent purchase pay-ments
at any time, without charge, simply by giving us written notice. Any change
will be effective at the time we receive this notification.
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INVESTMENT ALTERNATIVES. Investment alternatives are the sub-accounts of the
variable account and the fixed account.
VARIABLE ACCOUNT. The variable account for this Contract is the Allstate Life
of New York Variable An-nuity Account II. This variable account is our separate
investment account to which we allocate certain assets contributed under this
and other contracts. These as-sets remain our property but will not be charged
with liabilities arising from any other business we may have.
SUB-ACCOUNTS. The variable account is divided into sub-accounts. Each
sub-account invests solely in the shares of the mutual fund(s) underlying that
sub-ac-count.
FIXED ACCOUNT. The fixed account for this Contract is the Allstate Life of New
York general account. The general account consists of all assets of the
company, other than those in any separate accounts. Money in the fixed account
will earn interest at the current rate in effect at the time of allocation or
transfer to the fixed account for a period of one year. After the first year, a
renewal rate will be declared. Subsequent renewal dates will be on
anniversaries of the first renewal date. The current rate and the renewal
rate(s) will never be less than 4.5%.
Interest is credited to the fixed account daily during the accumulation phase.
The rates we quote when refer-ring to interest credits are effective annual
interest rates. "Effective annual rate" means the yield earned when interest
credits at the underlying daily rate have compounded for a full year.
CASH VALUE. Your cash value is equal to the sum of:
the number of accumulation units you hold in each sub-account of the
variable account multiplied by the accumulation unit value for that
sub-account on the most recent valuation date; plus
the total value you have in the fixed account.
ACCUMULATION UNITS. Amounts which you allocate to a sub-account of the variable
account are used to purchase accumulation units in that sub-account. The
accumulation unit value for each sub-account at the end of any valuation period
is calculated by multiplying the prior value by the sub-account's net investment
factor for the valuation period. The accumulation unit values may go up or
down. Additions or transfers to sub-accounts of the variable account will
increase the number of accumulation units for that sub-account. Withdrawals or
transfers from sub-accounts of the variable account will result in cancellation
of accumu-lation units from that sub-account.
VALUATION PERIOD. A valuation period is the time interval between the closing
of the New York Stock Exchange on consecutive valuation dates. A valuation date
is any date the New York Stock Exchange is open for trading except for days in
which there is insufficient trading in the variable account's portfolio
securities such that the value of accumulation or annuity units might not be
materially affected by changes in the va-xxx of the portfolio securities.
NET INVESTMENT FACTOR. For each sub-account of the variable account, the net
investment factor for a valuation period is (A) divided by (B), minus (C) where:
(A) is the sum of:
(1)the net asset value per share of the mutual fund(s) underlying the
sub-account determined at the end of the current valuation period,
plus
(2)the per share amount of any dividend or capital gain distributions
made by the mutual fund(s) underlying the sub-account during the
current valuation period.
(B) is the net asset value per share of the mutual fund(s) underlying the
sub-account determined as of the end of the immediately preceding valuation
period.
(C) is the sum of the annualized administrative expense and the annualized
mortality and expense risk charges divided by 365 and then multiplied by
the number of calendar days in the current valuation period.
TRANSFERS. Prior to the payout start date, you may transfer amounts between
investment alternatives. You may make 12 transfers per contract year without
charge. Each transfer after the 12th transfer in any contract year will be
assessed a $25 transfer fee. Transfers are subject to the following
restrictions:
the minimum amount that may be transferred from an investment alternative
is $100; if the total amount in an investment alternative is less than
$100, the entire amount may be transferred;
the minimum transfer to the fixed account is $500;
the maximum amount which may be transferred from the fixed account to
the variable account in any contract year is limited to 25% of the value in
the fixed account on the most recent contract an- niversary. If 25% of the
most recent value is greater than zero but less than $1000, then up to
$1000 may be transferred;
If the first renewal interest rate is less than the
current rate that was in effect at the time money was
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allocated or transferred to the fixed account, the 25% transfer restriction for
both that money and the accumulated interest thereon will be waived during the
60 day period following the first renewal date.
CHARGES. The charges for this Contract include taxes as defined below, contract
maintenance charges, administrative expense charges, and mortality and expense
risk charges. If withdrawals are made, the Contract may be subject to early
withdrawal charges.
TAXES. Any premium taxes or other taxes imposed on amounts relating to this
Contract may be deducted from purchase payments or cash values when the tax is
incurred or at a later time.
CONTRACT MAINTENANCE CHARGE. The contract maintenance charge will be deducted
each year from your cash value to reimburse us for the expenses of maintaining
this Contract. This charge will never be greater than $30 per contract year.
Prior to the payout start date, the contract maintenance charge will be
deducted from your cash value on each contract anniversary. The charge will be
deducted on a pro-rata basis from each investment alternative in the proportion
that your investment in each bears to your cash value. The contract maintenance
charge will also be deducted in full if the Contract is surrendered on any date
other than a contract anniversary.
ADMINISTRATIVE EXPENSE CHARGE. Both before and after the payout start
date, we will deduct an administrative expense charge from the assets in the
variable account on a daily basis. The administrative expense charge is to
reimburse us for administrative expenses incurred in maintaining this
Contract that are not covered by the contract maintenance charge. The
annualized administrative expense charge will never be greater than 0.10%.
(See the calculation under Net Investment Factor). This charge will also be
reflected in the net interest rate credited to assets in the fixed account.
MORTALITY AND EXPENSE RISK CHARGE. Both before and after the payout start
date, we will deduct a mortality and expense risk charge from the assets in the
variable account on a daily basis. The annualized mortality and expense risk
charge will never be greater than 1.25%. (See the calculation under Net
Investment Factor). This charge will also be reflected in the net interest rate
credited to assets in the fixed account.
Our expense and mortality experience will not adversely affect the dollar
amount of variable benefits or other contractual payments or values under this
Contract.
XXXXXXXXXX AND SURRENDER. You have the right to make a partial withdrawal or
full surrender at any time during the accumulation phase. You must specify the
investment alternative(s) from which you wish to make a withdrawal. The amount
of any withdrawal you request, plus an early withdrawal charge and premium
taxes when applicable, will reduce your cash value.
Any withdrawal must be at least $500. If a withdrawal would leave a cash value
of less than $500, we will treat the request as a full surrender.
If you surrender your Contract, we will pay you its cash value, less any
applicable early withdrawal charges and premium taxes, and the Contract will
terminate.
EARLY WITHDRAWAL CHARGE. An early withdrawal charge may be applied to a full
surrender or partial withdrawal of cash value in excess of the withdrawal amount
without early withdrawal charge. For the pur-pose of accessing an early
withdrawal charge, with-drawals are assumed to come from purchase payments
first, beginning with the oldest payment.
Early withdrawal charges will be based on the age(s) of the purchase payment(s)
associated with the withdrawal according to the following schedule:
Maximum
Complete Contract Withdrawal
Years since Purchase Charge
Payment was made Percent
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0 6%
1 5%
2 4%
3 3%
4 2%
5 1%
6 or more 0%
Once all purchase payments have been withdrawn, additional withdrawals will not
be assessed an early withdrawal charge. The maximum aggregate early withdrawal
charge is 6% of your purchase payments.
WITHDRAWAL AMOUNT WITHOUT EARLY WITHDRAWAL CHARGE. A withdrawal amount without
early withdrawal charge will be available in each contract year. This
withdrawal amount without early withdrawal charge may be withdrawn over the
course of the contract year without incurring early withdrawal charges. The
withdrawal amount without early withdrawal charge is 15% of the amount of
purchase payments as of the issue date or the most recent contract anniversary,
whichever is later.
As with all withdrawals, the withdrawal amount without early withdrawal charge
will be assumed to come from the oldest remaining purchase payments first.
With-drawal amounts without early withdrawal charge not withdrawn in a contract
year are not carried over to increase the withdrawal amount without early
with-drawal charge in a subsequent contract year.
Withdrawal amounts without early withdrawal charge are not subject to early
withdrawal charges, but may be subject to tax or penalty imposed by the Internal
Revenue Service.
DEATH OF OWNER OR ANNUITANT. Upon the death of the first owner prior to the
payout start date, the new owner will be the surviving joint owner(s). If
there is (are) no surviving joint owner(s), the new owner will be the
beneficiary(ies). The new owner will have the options described in the
Options of New Owner sub-section below.
For the purposes of distribution required by the Internal Revenue Code Section
72(s), the new Owner is con-
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sidered the designated beneficiary.
If the new owner is a corporation, trust, or other nonnatural person, the
Contract will terminate, the death benefit as described below will be paid to
the new owner, and the new owner will not have the options described below.
If the annuitant, not also an owner, dies prior to payout start date, we will
pay you the death benefit described below, the Contract will terminate, and you
will not have the options described below.
OPTIONS OF NEW OWNER. If the sole new owner is your spouse:
Your spouse may elect, within 60 days of the date of your death, to receive
the death benefit described below.
If your spouse does not make this election, then the accumulation phase
continues as if the death had not occurred. All ownership rights under the
Contract are then available to your spouse as the new owner.
If the new owner is not your spouse, then this new owner has the following
options:
The new owner may elect, within 60 days of the date of your death, to
receive the death benefit described below.
The new owner may elect, within 60 days of the date of your death, to
receive the settlement value payable in a lump sum within 5 years of your
date of death. An annuitant is necessary to continue the Contract between
the date of your death and the payment of the settlement value. If there
is no annuitant at that time, the new annuitant will be the oldest new
owner.
The new owner may elect, within one year of the date of your death, to
receive the settlement value paid out under one of the income plans
described in the Payout Phase section. The payout start date must be
within one year of your date of death. Income payments must be over the
life of the new owner or over a period not to exceed the life expectancy
of the new owner.
If the new owner does not make one of the above described elections, the
settlement value will be paid to the new owner on the mandatory
distribution date 5 years after your date of death. An annuitant is
necessary to continue the Contract between the date of your death and the
payment of the settlement value. If there is no annuitant at that time,
the new annuitant will be the oldest new owner.
Under any of these options, all ownership rights are available to the new owner
from the date of your death to the date on which the death benefit or settlement
value is paid.
DEATH BENEFIT. The death benefit is the greater of:
the sum of all purchase payments, less any withdrawals, applicable early
withdrawal charges and premium tax; or
the cash value on the date we receive due proof of death; or
the cash value on the most recent death benefit anniversary, less any
withdrawals, applicable early withdrawal charges and premium tax de-ducted
from the cash value since that anniversary.
The death benefit anniversaries are those contract anniversaries that are
multiples of 6 contract years, beginning with the 6th contract anniversary. For
example, the 6th, 12th and 18th contract anniversaries are the first three
death benefit anniversaries.
We will calculate the value of the death benefit at the end of the valuation
period coinciding with our receipt of a complete request for payment of the
death benefit. A complete request includes due proof of death.
SETTLEMENT VALUE. The settlement value is the cash value less any applicable
early withdrawal charges and premium tax. We will calculate the settlement
value at the end of the valuation period coinciding with the receipt of a
request for payment or on the manda-tory distribution date of 5 years after the
date of death.
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PAYOUT PHASE
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PAYOUT PHASE DEFINED. The payout phase is the second of the two phases in the
life of your Contract. During this period the cash value is applied to the
income plan you choose and is paid out as provided under that plan.
The payout phase begins on the payout start date. It continues until we make
the last payment as provided by the income plan chosen.
PAYOUT START DATE. The anticipated payout start date is shown on the Annuity
Data page. You may change the payout start date by writing to us at least 30
days prior to the payout start date.
The latest payout start date is the later of:
the annuitant's 85th birthday; or
the 10th anniversary of this Contract's issue date.
Unless changed as described above, we will use the payout start date shown on
the Annuity Data page.
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INCOME PLANS. An income plan is an arrangement for disbursing the cash value in
installments. The cash value on the payout start date, less any applicable
premium tax, will be applied to your choice of income plan from the following
list:
1. LIFE INCOME WITH 120 MONTHS GUARANTEED. We will make monthly payments for
as long as the annuitant lives. If the annuitant dies before 120 monthly
payments have been made, we will pay the remainder of the 120 guaranteed
monthly payments to the owner.
2. JOINT AND SURVIVOR LIFE INCOME. We will make monthly payments for as long
as either the annui-tant or any joint annuitant named by you lives. No
income payments will be made after the deaths of both the annuitant and the
joint annuitant.
3. PAYMENTS FOR A SPECIFIED PERIOD. We will make monthly payments beginning
on the payout start date for a specified period. These payments do not
depend on the annuitant's life. Income payments for less than 120
months may be subject to early withdrawal charges. If payments for a
Specified Period are chosen and the proceeds are derived from the variable
account, the owner (or the beneficiary if the sole owner dies) may
sur-render the Contract at any time by notifying the Company in writing.
We reserve the right to accept other income plans.
INCOME PAYMENTS. Income payments may be based on the variable account, the
fixed account or both. Your initial income payment will be based on the
division of your cash value between the investment alternatives on the payout
start date. Each income payment represents a sum of payments derived from
each investment alternative in which you have an in-terest.
A portion of the contract maintenance charge will be deducted from each income
payment.
VARIABLE ACCOUNT. Income payments attributable to sub-accounts of the variable
account will vary in ac-cordance with the investment results of the mutual funds
underlying the sub-accounts.
The amount of the first income payment from a subaccount of the variable
account is calculated by ap-plying the portion of cash value allocated to the
sub-account, less any applicable premium tax, to the Income Payment Tables.
Subsequent income payments are based on the num- ber of annuity units derived
from dividing the first in-come payment by the sub-account's annuity unit value
on the payout start date. The number of annuity units will remain the same
unless a transfer is made be-tween sub-accounts or the fixed account.
Variable account income payments after the first will be equal to the number of
annuity units for each sub-account multiplied by the corresponding annuity unit
value on the date of payment.
Expenses actually incurred, other than taxes on the investment return, and
mortality actually experienced will not affect the dollar amount of income
payments once payments based on the variable account have commenced.
ANNUITY UNIT VALUE. The annuity unit value for each sub-account of the variable
account at the end of any valuation period is calculated by:
multiplying the prior value by the sub-account's net investment factor
during the period; and then
dividing the product by 1.000 plus the assumed investment rate for the
period. The assumed investment rate is an effective annual rate of 3%.
FIXED ACCOUNT. Income payment amounts derived from the fixed account are
guaranteed for the duration of the income plan. Cash value from the fixed
account, less any applicable premium tax, will be used to purchase a Single
Premium Immediate Annuity from us. Income payments from the fixed account will
at least be equal to an amount determined from the Income Payment Tables.
TRANSFERS. After the payout start date, no transfers may be made from the fixed
account. Transfers between sub-accounts of the variable account, or from the
variable account to the fixed account may not be made for six months subsequent
to the payout start date. Transfers may be made once every six months
thereafter. Transfers out of a sub-account of the variable account after the
payout start date will cancel annuity units from that sub-account.
PAYOUT TERMS AND CONDITIONS. The income payments are subject to the following
terms and conditions:
Income payments will start on the first day of the calendar month that
coincides with or next follows the payout start date.
If we do not receive a written choice of income plan from you at least 30
days before the payout start date, we will use the income plan listed on
the Annuity Data page.
If you choose an income plan which depends on any person's life, we
may require proof of age and sex before income payments begin.
We may require proof that the annuitant or joint annuitant is still alive
before we make any payment that depends on their continued life.
After the cash value has been applied to an income plan on the payout start
date, the income plan cannot be changed and no withdrawals can be made.
If no purchase payments have been received for three full years and the
cash value is less than $2,000, or is not enough to provide an initial
payment of at least $20, we reserve the right to:
change the payment frequency to make the payment at least $20, or
terminate the Contract and pay you the cash value in a lump sum.
If the owner dies on or after the payout start day and before the entire
interest in this contract is
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distributed, the remaining portion of such interest will be distributed at least
as rapidly as under the method of distribution being used at the date of death.
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GENERAL PROVISIONS
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THE ENTIRE CONTRACT. The entire contract consists of this Contract, the
attached application, and any attached endorsements.
All statements made in written applications are representations and not
warranties. No statement will be used by us in defense of a claim or to void a
Contract unless it is included in a written application.
Only our officers may change the Contract or waive a right or requirement. No
other individual may do this.
Any such change or waiver must be in a written endorsement and will be subject
to approval by the Superintendent of Insurance of the State of New York.
We may not modify this Contract without your consent, except to make it comply
with any changes in the Internal Revenue Code or as required by any other
applicable law.
INCONTESTABLE. We will not contest the validity of this Contract after the
issue date.
MISSTATEMENT OF AGE OR SEX. If any age or sex has been misstated, we will pay
the amounts which would have been provided at the correct age or sex.
If we find the misstatement of age or sex after the income payments begin, we
will:
pay promptly the sum of all amounts that we underpaid plus due interest; or
stop payments until the total of the omitted payments at the corrected
amount plus due interest is equal to the total of the overpayment plus due
interest.
For purposes of the Misstatement of Age or Sex provision, due interest will be
calculated at an effective annual rate of 6%.
ANNUAL STATEMENT. At least once a year, prior to the payout start date, we will
send you a statement containing information required by any applicable law.
SETTLEMENTS. We may require that this Contract be returned to us prior to any
settlement. We must receive due proof of death of the owner or annuitant prior
to settlement of a death claim. Due proof of death is one of the following:
a copy of a certified death contract; or
a copy of a certified decree of a court of competent jurisdiction as to a
finding of death; or
any other proof acceptable to us.
Any cash surrender or death benefit under this Contract will not be less than
the minimum benefits required by any statute of the state in which the Contract
is delivered.
DEFERMENT OF PAYMENTS. We will pay any amounts due from the variable account
under this Contract within seven days, unless:
the New York Stock Exchange is closed for other than usual weekends or
holidays, or trading on such Exchange is restricted;
an emergency exists as defined by the Securities and Exchange Commission;
or
the Securities and Exchange Commission permits delay for the protection of
Contract holders.
We reserve the right to postpone payments or transfers from the fixed account
for up to six months.
VARIABLE ACCOUNT MODIFICATIONS. We reserve the right, subject to applicable
law, to make additions to, deletions from, or substitutions for the mutual fund
shares underlying the sub-accounts of the variable account. We will not
substitute any shares attributable to your interest in a sub-account of the
variable account without notice to you and prior approval of the Superintendent
of Insurance of the State of New York and the Securities and Exchange
Commission, to the extent required by the Investment Company Act of 1940.
We reserve the right to establish additional sub-accounts of the variable
account, each of which would invest in shares of another mutual fund. You may
then instruct us to allocate purchase payments to such sub-accounts, subject
to any terms set by us or the mutual fund.
In the event of any such substitution or change, we may by endorsement, make
such changes as may be necessary or appropriate to reflect such substitution
or change.
If we deem it to be in the best interests of persons having voting rights under
the contracts, the variable account may be operated as a management company
under the Investment Company Act of 1940 or it may be deregistered under such
Act in the event such registration is no longer required. Any such change in
the operation of the variable account would be subject to the prior approval of
the Superintendent of Insurance of the State of New York.
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INCOME PAYMENT TABLES
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The Income Payment Tables show the initial monthly income payment per $1,000 of
cash value applied for each of the income plans listed in the Payout Phase
section. The Income Payment Tables are based on 3% interest and the 1983 Table
a Annuity Mortality Tables with the following age adjustment. The age(s) of the
annuitant and any joint annuitant at his or her last
birthday on or prior to the payout start date will be set back one year for each
six full years between January 1, 1983 and the payout start date. Income
payments for ages not shown in this section will be determined on a basis
consistent with that used to determine those that are shown.
INCOME PLAN 1 - LIFE WITH 120 MONTHS GUARANTEED
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First Income Payment for Each $1,000 of Cash Value
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Annuitant's Annuitant's Annuitant's
Age Male Female Age Male Female Age Male Female
------------------------------------------------------------------------------------------------------------------------------
35 $ 3.43 $ 3.25 49 $ 4.15 $ 3.82 63 $5.52 $4.97
36 3.47 3.28 50 4.22 3.88 64 5.66 5.09
37 3.51 3.31 51 4.29 3.94 65 5.80 5.22
38 3.55 3.34 52 4.37 4.01 66 5.95 5.35
39 3.60 3.38 53 4.45 4.07 67 6.11 5.49
40 3.64 3.41 54 4.53 4.14 68 6.27 5.64
41 3.69 3.45 55 4.62 4.22 69 6.44 5.80
42 3.74 3.49 56 4.71 4.29 70 6.61 5.96
43 3.79 3.53 57 4.81 4.38 71 6.78 6.13
44 3.84 3.58 58 4.92 4.46 72 6.96 6.31
45 3.90 3.62 59 5.02 4.55 73 7.13 6.50
46 3.96 3.67 60 5.14 4.65 74 7.31 6.69
47 4.02 3.72 61 5.26 4.75 75 7.49 6.88
48 4.08 3.77 62 5.39 4.86
------------------------------------------------------------------------------------------------------------------------------
INCOME PLAN 2 - JOINT AND SURVIVOR
---------------------------------------------------------------------------------------------------
Male First Income Payment for Each $1,000 of Cash Value
Annuitant's --------------------------------------------------------------------------------------
Age Female Annuitant's Age
35 40 45 50 55 60 65 70 75
---------------------------------------------------------------------------------------------------
35 $3.09 3.16 3.23 3.28 3.32 3.36 3.39 3.41 3.42
40 3.13 3.22 3.31 3.39 3.46 3.52 3.56 3.59 3.62
45 3.17 3.28 3.39 3.50 3.60 3.69 3.76 3.82 3.86
50 3.19 3.32 3.45 3.60 3.74 3.87 3.99 4.08 4.14
55 3.21 3.35 3.51 3.68 3.87 4.06 4.23 4.38 4.49
60 3.23 3.37 3.55 3.75 3.98 4.23 4.48 4.71 4.91
65 3.24 3.39 3.58 3.80 4.07 4.38 4.72 5.06 5.38
70 3.24 3.40 3.60 3.84 4.13 4.50 4.92 5.40 5.89
75 3.25 3.41 3.61 3.86 4.18 4.58 5.08 5.68 6.37
---------------------------------------------------------------------------------------------------
Page 10
INCOME PLAN 3 - PAYMENTS FOR A SPECIFIED PERIOD
------------------------------------------------------------------
First Income Payment for Each
Specified Period $1,000 of Cash Value
------------------------------------------------------------------
10 Years $9.61
11 Years 8.86
12 Years 8.24
13 Years 7.71
14 Years 7.26
15 Years 6.87
16 Years 6.53
17 Years 6.23
18 Years 5.96
19 Years 5.73
20 Years 5.51
------------------------------------------------------------------
Page 10
ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK
(HEREIN CALLED "WE" OR "US")
FIXED ACCOUNT AMENDATORY ENDORSEMENT
THE FOLLOWING REPLACES THE FIXED ACCOUNT SUBSECTION IN THE ACCUMULATION PHASE
SECTION OF YOUR CONTRACT:
FIXED ACCOUNT. The fixed account for this Contract is the Allstate Life of New
York general account. The general account consists of all assets of the company,
other than those in any separate accounts. Money in the fixed account consists
of all assets of the company, other than those in any separate accounts. Money
in the fixed account will earn interest at the current rate in effect at the
time of allocation or transfer to the fixed account for the guarantee period.
We will offer initial guarantee periods of 1 year and 6 years. After the
initial guarantee period, a renewal rate will be declared annually. Subsequent
renewal dates will be on anniversaries of the first renewal date. The current
rate and the renewal rate(s) will never be less than 3%.
Interest is credited to the fixed account daily during the accumulation phase.
The rates we quote when referring to interest credits are effective annual
interest rates. "Effective annual rate" means the yield earned when interest
credits at the underlying daily rate have compounded for a full year.
THE FOLLOWING REPLACES THE TRANSFERS SUBSECTION IN THE ACCUMULATION PHASE
SECTION OF YOUR CONTRACT:
TRANSFERS. Prior to the payout start date, you may transfer amounts between
investment alternatives. You may make 12 transfers per contract year without
charge. Each transfer after the 12th transfer in any contract year will be
assessed a $25 transfer fee. Transfers are subject to the following
restrictions:
the minimum amount that may be transferred from an investment alternative
is $100; if the total amount in an investment alternative is less than
$100, the entire amount may be transferred;
the minimum transfer to any one guarantee period of the fixed account is
$500;
the maximum amount which may be transferred from the fixed account to the
variable account or between guarantee periods of the fixed account in any
contract year is limited to the greater of:
25% of the value in the fixed account on the most recent contract
anniversary. If 25% of the most recent value is greater than zero but
less than $1,000, then up to $1,000 may be transferred; or
25% of the sum of purchase payments allocated to the fixed account and
transfers to the fixed account, all as of the most recent contract
anniversary.
if the first renewal interest rate is less than the current rate that was
in effect at the time money was allocated or transferred to the fixed
account, the 25% transfer restriction for both that money and the
accumulated interest thereon will be waived during the 60 day period
following the first renewal date.
/s/ Xxxxxxx X. Xxxxxxx /s/ Xxxxx X. Xxxxx, II
Secretary President
ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK
HEREIN CALLED ("WE OR US")
AMENDATORY ENDORSEMENT
I. The third and fourth paragraphs in the Owner provision on page 4 of your
Contract are deleted and replaced by the following:
You may change the owner or beneficiary at any time. If you are a natural
person, you may change the annuitant prior to the Payout Start Date. Once
we have received a satisfactory written request for an owner, beneficiary
or annuitant change, the change will take effect as of the date you signed
it. We are not liable for any payment we make or other action we take
before receiving any written request from you. We are not responsible for
the tax consequences of an owner, beneficiary or annuitant change.
II. The fourth paragraph in the Death of Owner or Annuitant provision on page 7
of your Contract is deleted and replaced by the following:
If any annuitant dies who is not also an owner, the owner must elect an
applicable option listed below. If the option selected is 1(a) or 1(b)(ii)
below, the new annuitant will be the youngest owner, unless the owner names
a different annuitant.
1. IF THE OWNER IS A NATURAL PERSON:
a. The owner may choose to continue this Contract as if the death had
not urred; or
b. If we receive due proof of death within 180 days of the date of
the annuitant's death, then the owner may alternatively choose to:
i. Receive the Death Benefit in a lump sum; or
ii. Apply the Death Benefit to an Income Plan which must begin within
one year of the date of death and must be for a period equal to or
less than the life expectancy of the owner.
2. IF THE OWNER IS A NON-NATURAL PERSON:
The owner must receive the Death Benefit in a lump sum.
III. The following provision is added to the Withdrawal Amount without Early
Withdrawal Charge provision on page 6 of your Contract:
Withdrawal charges will be waived on partial withdrawals taken to satisfy
qualified plan required minimum distribution rules as described in the
Internal Revenue Code. This waiver is permitted only for withdrawals which
satisfy distributions resulting from this Contract.
Except as amended, the Contract remains unchanged.
/s/ Xxxxxxx X. Xxxxxxx /s/ Xxxxx X. Xxxxx, II
Xxxxxxx X. Xxxxxxx Xxxxx X. Lower, II
Secretary President
ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK
(HEREIN CALLED "WE" OR "US")
AMENDATORY ENDORSEMENT FOR IRA PLANS
The following provisions are added to your Contract and will take precedence
over any other provision to the contrary in your Contract:
1. The owner of this Contract must be the annuitant.
2. You may not:
a. transfer;
b. sell;
c. assign;
d. discount; or
e. pledge
this Contract for any other purpose.
3. Your rights in this Contract are nonforfeitable. This Contract is for
the exclusive benefit of you and your benefi-ciaries.
4. Except as described below, the annual premium under the Contract shall not
exceed the lesser of $2,000 or 100% of compensation. In the case of a
spousal IRA, the maximum contribution shall not exceed the lesser of
$2,250 or 100% of compensation, but no more than $2,000 can be paid to
either spouse's IRA. The exceptions are:
a. The above limits shall not apply to "rollover contributions" as that
term is described in Sections 402(a)(5), 402(a)(6), 402(a)(7),
403(a)(4), 403(b)(8) and 408(d)(3), or for a contribution made in
accord with a Simplified Employee Pension (SEP) as described in
Section 408(k) of the Internal Revenue Code.
b. In addition to any amounts you contribute, your employer can
contribute annually up to the lesser of 15% of your compensation or
$30,000 under 408(k) of the Internal Revenue Code, as part of a
qualified SEP.
c. If any or all of the above contribution limits change due to a change
in such limits in the Internal Revenue Code, a new endorsement will be
issued after approval by the Internal Revenue Service and the Super-
intendent of Insurance of the State of New York.
5. Your entire interest must be or begin to be distributed by April 1
following the calendar year in which you reach age 70 1/2. You must take
distributions in accordance with the requirements of Section 401(a)(9) of
the Internal Revenue Code and the regulations thereunder. The
distribution may be made in a single sum or in periodic payments
over:
a. your life; or
b. the lives of you and your "designated beneficiary"; or
c. a period certain not extending beyond your life expectancy; or
d. a period certain not extending beyond the life expectancy of you and
your "designated beneficiary".
For purposes of this endorsement "designated beneficiary" is the joint
annuitant that you may name prior to the payout start date.
6. If your spouse is the "designated beneficiary", the minimum amount you are
required to receive for any tax year is at least equal to:
a. the value of the Contract at the end of the prior year; divided by
b. your life expectancy (or the joint life and last survivor expectancy
of you and your "designated beneficiary") using the age(s) as of your
birthday(s) in that year.
7. If your spouse is not the "designated beneficiary":
a. the minimum amount you are required to receive beginning with the
first calendar year for which distributions are required, and each
year thereafter, is:
1) the value of the Contract at the end of the prior year; divided
by
2) the lesser of:
a) the applicable life expectancy; or
b) the applicable divisor contained in 1.401(a)(9)-2 of the
Proposed Income Tax Regulations.
b. if payments are made in the form of a period certain annuity, the
maximum period certain at the required beginning date is defined in
Q & A -4 of 1.401(a)(9)-2.
c. if the payments are made in the form of a joint and survivor annuity,
the payment to the survivor must not exceed the applicable percentage
as defined in 1.401(a)(9)-2.
8. For purposes of calculating the minimum annual distribution from this
Contract, life expectancies are determined by the return multiples
contained in Tables V and VI of section 1.72-9 of the Income Tax
Regulations. Life expectancies of you and your spouse (if your spouse is
the "designated beneficiary") may be recalculated annually. The life
expectancy of a non-spousal "designated beneficiary" may not be
redetermined.
Your life expectancy and any spousal "designated beneficiary's" life
expectancy will be redetermined annually using 1.72-9 unless you elect
otherwise prior to the start of the required distributions.
If you elect not to have life expectancies redetermined annually, or if
your beneficiary is not your spouse, then life expectancies will be
calculated only once, at the time of the first payment, and will thereafter
decrease at the rate of 1 year per year elapsed. If made, this election is
irrevocable and will apply to all subsequent years.
9. If you die before distribution has begun and your beneficiary is your
surviving spouse, your spouse must elect one of the following forms of
distribution:
a. a life annuity; or
b. one or more certain payments over a period no longer than his/her own
life expectancy; or
c. treat the account as his/her own IRA.
If the form of distribution elected is a. or b. above, equal or
substantially equal payments will be made over your spouse's life or life
expectancy. The form of distribution must be elected within five years
after your death or the calendar year in which you would have attained age
70 1/2, whichever is earlier. If the form of distribution is a. or b.
above, payments must commence within one year of your death or the year in
which you would have at-tained age 70 1/2, whichever is later. If your
surviving spouse makes a regular IRA contribution to the account, makes a
rollover to or from the account, or fails to elect any of the three forms
of distribution listed above, then c. above is deemed to have been elected.
Any amount paid to a child of the owner will be treated as if it were
paid to the surviving spouse if the remainder of the interest becomes
payable to the surviving spouse when the child reaches age of majority.
10. If you die before distribution has begun and your beneficiary is not your
surviving spouse, the beneficiary must either:
a. start receiving payments within one year of your death as a life
annuity or one or more certain payments over a period not longer than
his/her life expectancy; or
b. have the proceeds totally distributed within five years of your death,
if a. above has not been elected.
Distribution will be made in equal or substantially equal payments over the
life or life expectancy of your bene-ficiary.
11. For the purpose of the distribution rules described in the two preceding
sections, the payments to be received by your beneficiary will be computed
using the return multiples specified in Tables V and VI of section 1.72-9
of the Income Tax Regulations. Life expectancies of a surviving spousal
beneficiary may be recalculated annually. The life expectancy of a
non-spousal beneficiary may not be redetermined.
If the beneficiary is your spouse, his/her life expectancy will be
redetermined annually using 1.72-9 unless he/she elects otherwise prior to
the start of the required distributions.
If your spouse is the beneficiary and does not elect to have life
expectancies redetermined annually, or if your beneficiary is not your
spouse, then life expectancies will be calculated only once, at the time of
the first payment, and will thereafter decrease at the rate of 1 year per
year elapsed. If made, this election is irrevocable and will apply to all
subsequent years.
12. If you die after distribution has begun, any remaining payments shall
continue to be paid to your beneficiaries at least as rapidly as under the
method of distribution in effect.
13. Distributions after your death shall be made using the applicable life
expectancy as the relevant divisor without regard to proposed regulation
1.401(a)(9)-2.
/s/ Xxxxxxx X. Xxxxxxx /s/ Xxxxx X. Xxxxx, II
Secretary President
ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK
(HEREIN CALLED "WE" OR "US")
AMENDATORY ENDORSEMENT FOR UNISEX PLANS
All references to sex are deleted from your contract.
The Income Payment Tables show the initial monthly income payment per $1,000 of
cash value applied for each of the income plans listed in the Payout Phase
section. The tables below are to be used in place of "Income Plan 1 - Life with
120 Months Guaranteed" and "Income Plan 2 - Joint and Survivor" tables in the
Income Payment Tables section. The Unisex Income Payment Tables below are based
on 3% interest and an 80% female, 20% male blend of the sex distinct 1983 Table
a Annuity Mortality Tables with the following age adjustment. The age(s) of the
annuitant and any joint annuitant at his or her last birthday on or prior to the
payout start date will be set back one year for each six full years between
January 1, 1983 and the payout start date. Income payments for ages not shown
in this section will be determined on a basis consistent with that used to
determine those that are shown.
INCOME PLAN 1 - LIFE WITH 120 MONTHS GUARANTEED
-----------------------------------------------------------------------------------------
First Income Payment for Each $1,000 of Cash Value
-----------------------------------------------------------------------------------------
Annuitant's Annuitant's Annuitant's
Age Amount Age Amount Age Amount
-----------------------------------------------------------------------------------------
35 3.29 49 3.89 63 5.08
36 3.32 50 3.95 64 5.20
37 3.35 51 4.01 65 5.34
38 3.38 52 4.08 66 5.47
39 3.42 53 4.15 67 5.61
40 3.46 54 4.22 68 5.77
41 3.50 55 4.30 69 5.93
42 3.54 56 4.37 70 6.09
43 3.58 57 4.47 71 6.26
44 3.63 58 4.55 72 6.44
45 3.68 59 4.64 73 6.63
46 3.73 60 4.75 74 6.81
47 3.78 61 4.85 75 7
48 3.83 62 4.97
-----------------------------------------------------------------------------------------
INCOME PLAN 2 - JOINT AND SURVIVOR
-------------------------------------------------------------------------------------------------------------
First Income Payment for Each $1,000 of Cash Value
Annuitant's ----------------------------------------------------------------------------------------
Age Joint Annuitant's Age
35 40 45 50 55 60 65 70 75
-------------------------------------------------------------------------------------------------------------
35 $3.07 3.12 3.17 3.20 3.23 3.25 3.26 3.27 3.28
40 3.12 3.20 3.26 3.32 3.36 3.39 3.42 3.44 3.45
45 3.17 3.26 3.35 3.44 3.51 3.56 3.61 3.64 3.66
50 3.20 3.32 3.44 3.55 3.66 3.75 3.82 3.88 3.91
55 3.23 3.36 3.51 3.66 3.81 3.95 4.07 4.17 4.23
60 3.25 3.39 3.56 3.75 3.95 4.16 4.34 4.50 4.62
65 3.26 3.42 3.61 3.82 4.07 4.34 4.62 4.88 5.09
70 3.27 3.44 3.64 3.88 4.17 4.50 4.88 5.27 5.63
75 3.28 3.45 3.66 3.91 4.23 4.62 5.09 5.63 6.20
-------------------------------------------------------------------------------------------------------------
/s/ Xxxxxxx X. Xxxxxxx /s/ Xxxxx X. Xxxxx, II
Secretary President
ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK
(HEREIN CALLED "WE" OR "US")
AMENDATORY ENDORSEMENT FOR SECTION 403(b) ANNUITIES
This CONTRACT is changed as follows:
1. The owner of this contract must be the ANNUITANT.
2. You may not:
a. transfer;
b. sell;
c. assign;
d. discount; or
e. pledge
this CONTRACT either as collateral for a loan or as security for the
performance of an obligation or for any other purpose, to any person but
us.
3. Account balances accruing after December 31, 1986 must begin to be paid out
by the April 1 after the calendar year in which you reach age 70 1/2. The
distribution may be made in a single sum or in periodic payments. The
payments must be over:
a. your life;
b. the lives of you and your beneficiary;
c. a period certain not extending beyond your life expectancy; or
d. a period certain not extending beyond the life expectancy of you and
your beneficiary.
The minimum amount you are required to receive for any tax year is:
a. the value of the CONTRACT at the end of the prior year, divided by;
b. your life expectancy (or the joint and last survivor expectancy of you
and your beneficiary) using the age(s) as of your birthday(s) in that
year.
4. Life expectancies are determined by the return multiples contained in
1.72-9 of the Income Tax Regulations. Your life expectancy or your
spouse's life expectancy may be redetermined annually using 1.72-9.
However, the life expectancy of a beneficiary who is not your spouse is
determined by 1.72-9 only once - at the time of the first payment
- and thereafter decreases at the rate of one year per year elapsed.
5. For account balances accruing after December 31, 1988 distributions of
contributions made under a salary reduction agreement may only occur upon:
a. attainment of age 59 1/2;
b. separation from service;
c. death;
d. disability (as defined in Internal Revenue Code Section 72(m)(7)),
which states an individual shall be considered to be disabled if he is
unable to engage in any substantial gainful activity by reason of any
medically determinable physical or mental impairment with can be
expected to result in death or to be of long-continued and indefinite
duration. An individual shall not be considered to be disabled unless
he furnishes proof of the existence thereof in such form and manner
as the Secretary of the Treasury may require); or
e. hardship (as defined in Regulation Section 1.401(k)-1(d)(2) ).
In the case of hardship distributions:
1) Income due to these contributions cannot be withdrawn; and
2) The plan must contain provisions allowing hardship withdrawals
and may define hardship more restrictively than the Internal
Revenue Code Regulations. In the event that the provisions of
the plan are inconsistent with the Internal Revenue Code and
Regulations, then the plan provisions are controlling.
For the purpose of this endorsement, "account balances" includes:
1. any contributions to the CONTRACT after the specified date:
a. December 31, 1986; or
b. December 31, 1988
whichever is applicable; and
2. all earnings credited to the CONTRACT after the specified date.
You are permitted to directly rollover to an eligible retirement plan (i.e.,
IRA, 401(a), or 403(b)) all or a portion of any eligible rollover distribution
which you receive. In the case of an eligible rollover distribution to your
surviving spouse, an eligible retirement plan is limited to an IRA.
An eligible rollover distribution is any distribution from your account except:
1. one of a series of payments pursuant to a life or a joint life income
option, or
2. one of a series of payments pursuant to a period certain income option
based on your life expectancy (or joint life expectancy of you and your
designated beneficiary), or
3. one of a series of substantially equal periodic payments for a specified
period of ten years or more, or
4. one that qualifies as a required minimum distribution as defined by section
401(a)(9) of the Internal Revenue Code.
/s/ Xxxxxxx X. Xxxxxxx /s/ Xxxxx X. Xxxxx, II
Secretary President
