0000836658-18-000006 Sample Contracts

GOLDEN AMERICAN DEFERRED COMBINATION LIFE INSURANCE VARIABLE AND FIXED COMPANY ANNUITY CONTRACT
Important Terms • February 2nd, 2018 • VOYA INSURANCE & ANNUITY Co • Life insurance

This is a legal Contract between its Owner and us. Please read it carefully. In this Contract you or your refers to the Owner shown above. We, our or us refers to Golden American Life Insurance Company. You may allocate this Contract's Accumulation Value among the Variable Separate Account, the General Account and the Fixed Account shown in the Schedule.

Annuitant Owner [Thomas J. Doe] [John Q. Public] Initial Premium Annuity Option Annuity Commencement Date [$10,000] [Life 10 Year Certain] [January 1, 2053] Separate Account(s) Contract Number [Separate Account B ] [123456]
Your Contract Benefits • February 2nd, 2018 • VOYA INSURANCE & ANNUITY Co • Life insurance

This is a legal Contract between its Owner and us. Please read it carefully. In this Contract you or your refers to the Owner shown above. We, our or us refers to Golden American Life Insurance Company. You may allocate this Contract's Accumulation Value among the Separate Account Divisions shown in the Schedule.

Annuitant Owner [THOMAS J. DOE] [JOHN Q. DOE] Initial Premium Annuity Option Annuity Commencement Date [$10,000] [LIFE 10-YEAR CERTAIN] [JANUARY 1, 2026] Separate Account(s) [SEPARATE ACCOUNT B] Contract Number [123456]
Important Terms • February 2nd, 2018 • VOYA INSURANCE & ANNUITY Co • Life insurance

When a distribution is made from an investment portfolio underlying a Separate Account Division in which reinvestment is not available, we will allocate the amount of the distribution to the [Liquid Asset Division] unless you specify otherwise.

Annuitant Owner [Thomas J. Doe] [John Q. Public] Initial Premium Annuity Option Annuity Commencement Date [$10,000] [Life-10 Year Certain] [January 1, 2024] Separate Account(s) Contract Number [Separate Account B and the Fixed Account] [123456]
Your Contract • February 2nd, 2018 • VOYA INSURANCE & ANNUITY Co • Life insurance

[IF DEATHBEN="1": The Death Benefit is the greatest of (i) the Accumulation Value, (ii) the Guaranteed Death Benefit, (iii) the Cash Surrender Value, and (iv) the sum of premiums paid, less any partial withdrawals.

Annuitant Owner | | [THOMAS J. DOE] [JOHN Q. DOE] | | Initial Premium Annuity Option | |Annuity Commencement Date | | [$10,000] [LIFE 10-YEAR CERTAIN] [JANUARY 1, 2026]| | Separate Account(s) Contract Number | | [SEPARATE ACCOUNT B] [123456] |
Your Contract • February 2nd, 2018 • VOYA INSURANCE & ANNUITY Co • Life insurance

This is a legal Contract between its Owner and us. Please read it carefully. In this contract you or your refers to the Owner shown above. We, our or us refers to Golden American Life Insurance Company. You may allocate this Contract's Accumulation Value among the Divisions of the Variable Separate Account and the General Account shown in the Schedule.

SERVICE AGREEMENT
Service Agreement • February 2nd, 2018 • VOYA INSURANCE & ANNUITY Co • Life insurance • Delaware

This Service Agreement (hereinafter called "Agreement") is made effective as of the 1st day of January 1994, by and between Directed Services, Inc., a New York Corporation (hereinafter called "DSI"), and Golden American Life Insurance Company, a Delaware Insurance Corporation (hereinafter called "Golden American"). WHEREAS, DSI has extensive experience in the distribution of variable insurance business; and WHEREAS, Golden American is an affiliate of DSI and desires DSI to perform certain marketing, sales and other services (hereinafter called "Services") for Golden American in its insurance operations and desires further to make use in its day-to-day operations of certain personnel, property, equipment, and facilities (hereinafter called "Facilities") of DSI as Golden American may request; and WHEREAS, DSI desires Golden American to perform certain managerial, supervisory, treasury, accounting, financial reporting, systems, legal and tax-related tasks for DSI in its securities oper

Contractholder Group Contract Number GOLDEN INVESTORS TRUST G000012-OE Annuitant Owner [THOMAS J. DOE] [JOHN Q. DOE] Initial Premium Annuity Option Annuity Commencement Date [$10,000] [LIFE 10-YEAR CERTAIN] [JANUARY 1, 2053] Separate Account(s)...
Golden American • February 2nd, 2018 • VOYA INSURANCE & ANNUITY Co • Life insurance

When a distribution is made from an investment portfolio underlying a Variable Separate Account Division in which reinvestment is not available, we will allocate the amount of the distribution to the [Liquid Asset Division] unless you specify otherwise.