Common use of YOU HAVE THE RIGHT TO RETURN THIS CONTRACT Clause in Contracts

YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within ten (10) days after you receive it by returning the Contract to our Administrative Office or to the Agent who sold it to you with a written request for cancellation. Return of this Contract by mail is effective on being post-marked and properly addressed with postage paid. We will promptly return the Contract Value plus any amount deducted from the Purchase Payments or the Contract Value. This may be more or less than the Purchase Payments. If this Contract replaced a life insurance policy or another annuity contract, you may cancel this Contract within sixty (60) days after you receive it. { Xxxxx X. Xxxxxxxx { Xxxxxxx X. Xxxx THIS IS A LEGALLY BINDING CONTRACT - READ IT CAREFULLY Administrative Office: PROTECTIVE LIFE AND ANNUITY INSURANCE COMPANY { P. O. Box 10648 Birmingham, Alabama 35202-0648 (000) 000-0000 } This Page Intentionally left blank. SCHEDULE CONTRACT NUMBER EFFECTIVE DATE { AFVA-000000001 } { May 1, 2008 } OWNER 1 BIRTH DATE OF OWNER 1 { Xxxx X. Xxx } { March 30, 1953 } OWNER 2 BIRTH DATE OF OWNER 2 { Xxxx X. Xxx } { April 15, 1958 } ANNUITANT BIRTH DATE OF ANNUITANT { Xxxx X. Xxx } { March 30, 1953 } BENEFICIARY ANNUITY COMMENCEMENT DATE As contained in our records { March 30, 2048 } INITIAL PURCHASE PAYMENT: { $100,000.00 } LATEST AGE FOR PURCHASE PAYMENTS: { 85 } MINIMUM GUARANTEED INTEREST RATE FOR THE GUARANTEED ACCOUNT: { 3.00% } ANNUAL EFFECTIVE INTEREST RATES ON THE EFFECTIVE DATE: DCA FIXED ACCOUNT 1 - { 4.00% } DCA FIXED ACCOUNT 2 - { 3.50% } MORTALITY AND EXPENSE RISK CHARGE { 1.40% } per annum. ADMINISTRATION CHARGE { 0.15% } per annum. DEATH BENEFIT { Return of Purchase Payments } DEATH BENEFIT COST CALCULATION METHOD { CoverPay® - A Benefit Based Fee } { CONTRACT MAINTENANCE FEE: $30 The contract maintenance fee is deducted prior to the Annuity Commencement Date on each Contract Anniversary, and on any day that the Contract is surrendered other than the Contract Anniversary. The contract maintenance fee will be deducted from the Allocation Options in the same proportion as their values are to the Contract Value. The contract maintenance fee will be waived by the Company in the event the Contract Value or the aggregate Purchase Payments reduced by surrenders equals or exceeds $50,000 on the date the contract maintenance fee is to be deducted. } { TRANSFER FEE $25 per transfer in excess of 12 transfers in any Contract Year. } ALLOCATION OPTIONS AVAILABLE ON THE EFFECTIVE DATE Protective Life Guaranteed Account DCA Fixed Account 1 DCA Fixed Account 2 Protective Variable Annuity Account A { Fidelity VIP Contrafund® Service Class 2 VIP Equity-Income Service Class 2 VIP Growth Service Class 2 VIP Index 500 Service Class 2 VIP Investment Grade Bond Service Class 2 VIP Mid Cap Service Class 2 Xxxxxxxx Xxxxxxxxx Xxxxxxxx Flex Cap Growth Class 2 Franklin Income Class 2 Franklin Rising Dividends Class 2 Franklin Small-Mid Cap Growth Class 2 Franklin U. S. Government Class 2 Mutual Shares Class 2 Xxxxxxxxx Foreign Class 2 Xxxxxxxxx Global Income Securities Class 2 Xxxxxxxxx Growth Class 2 Xxxxxxx Xxxxx Capital Growth Growth and Income Strategic International Equity Structured Small Cap Equity Structured U. S. Equity Xxxx Xxxxxx America’s Value Bond-Debenture Growth and Income Growth Opportunities Mid-Cap Value MFS Investment Management Emerging Growth Service Class Investors Growth Stock Service Class Investors Trust Service Class New Discovery Service Class Research Service Class Total Return Service Class Utilities Service Class OppenheimerFunds Capital Appreciation Service Class Global Securities Service Class High Income Service Class Main Street® Service Class MidCap Service Class Money Strategic Bond Service Class Xxx Xxxxxx Aggressive Growth Class II Xxxxxxxx Class II Enterprise Class II Government Class II Growth and Income Class II Strategic Growth Class II UIF Equity and Income Class II } TABLE OF CONTENTS DEFINITIONS 7 PARTIES TO THE CONTRACT 8 Company 8 Owner 8 Change of Owner 8 Beneficiary 8 Change of Beneficiary 8 Annuitant 8 Change of Annuitant 8 Payee 9 GENERAL PROVISIONS 9 Entire Contract 9 Modification of Contract 9 Incontestability 9 Assignment 9 Written Notice 9 Error in Age or Gender 9 Settlement 9 Receipt of Payment 10 Protection of Proceeds 10 Premium Tax 10 Non-Participating 10 Minimum Values 10 Application of Law 10 Reports 10 PURCHASE PAYMENTS 10 Purchase Payments 10 Allocation of Purchase Payments 10 No Default 10 VARIABLE ACCOUNT 11 General Description 11 Sub-Accounts of the Variable Account 11 Variable Account Value 12 Accumulation Unit Values 12 TRANSFERS 13 Transfers 13 Dollar Cost Averaging 13 SURRENDERS 14 Full and Partial Surrenders 14 Suspension or Delay in Payment of Surrender 14 DEATH BENEFIT 14 Death of an Owner 14 Death of the Annuitant 14 Death Benefit 14 Payment of the Death Benefit 15 Suspension of Payment 15 ANNUITIZATION 15 Annuity Commencement Date 15 Annuity Income Payments 15 Fixed Income Payments 16 Variable Income Payments 16 Annuity Unit Values 16 Selection of Annuity Option 17 Annuity Options 17 Minimum Amounts 17 Guaranteed Purchase Rates 17 FIXED ANNUITY TABLES 18 VARIABLE ANNUITY TABLES 18 DEFINITIONS

YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within ten (10) days after you receive it by returning the Contract it to our Administrative Office administrative office, or to the Agent agent who sold it to you you, with a written request for cancellation. Return If you return it by mail, effective date of this Contract the cancellation will be determined by mail is effective the postmark date on being post-marked and the properly addressed with postage paidand postage-paid return package. We will promptly return the Contract Value plus any amount amounts deducted from the Purchase Payments or the Contract Value. This The amount returned may be more or less than the your Purchase Payments. If this Contract replaced a life insurance policy or another annuity contractXxxxxxx X. Xxxxxx, you may cancel this Contract within sixty (60) days after you receive it. { President Xxxxx X. Xxxxxxxx { Xxxxxxx X. Xxxx Xxxxxxxx, Secretary THIS IS A LEGALLY BINDING CONTRACT - READ IT CAREFULLY Home and Administrative Office: PROTECTIVE LIFE AND ANNUITY INSURANCE COMPANY { xxx.Xxxxxxxxxx.xxx 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 P. O. Box 10648 1928, Birmingham, Alabama 3520235282-0648 8238 (000) 000-0000 } This Page Intentionally left blank. SCHEDULE CONTRACT NUMBER EFFECTIVE DATE { AFVA-000000001 } { May 1, 2008 } OWNER 1 BIRTH DATE OF OWNER 1 { Xxxx X. Xxx } { March 30, 1953 } OWNER 2 BIRTH DATE OF OWNER 2 { Xxxx X. Xxx } { April 15, 1958 } ANNUITANT BIRTH DATE OF ANNUITANT { Xxxx X. Xxx } { March 30, 1953 } BENEFICIARY ANNUITY COMMENCEMENT DATE As contained in our records { March 30, 2048 } INITIAL PURCHASE PAYMENT: { $100,000.00 } LATEST AGE FOR PURCHASE PAYMENTS: { 85 } MINIMUM GUARANTEED INTEREST RATE FOR THE GUARANTEED ACCOUNT: { 3.00% } ANNUAL EFFECTIVE INTEREST RATES ON THE EFFECTIVE DATE: DCA FIXED ACCOUNT 1 - { 4.00% } DCA FIXED ACCOUNT 2 - { 3.50% } MORTALITY AND EXPENSE RISK CHARGE { 1.40% } per annum. ADMINISTRATION CHARGE { 0.15% } per annum. DEATH BENEFIT { Return of Purchase Payments } DEATH BENEFIT COST CALCULATION METHOD { CoverPay® - A Benefit Based Fee } { CONTRACT MAINTENANCE FEE: $30 The contract maintenance fee is deducted prior to the Annuity Commencement Date on each Contract Anniversary, and on any day that the Contract is surrendered other than the Contract Anniversary. The contract maintenance fee will be deducted from the Allocation Options in the same proportion as their values are to the Contract Value. The contract maintenance fee will be waived by the Company in the event the Contract Value or the aggregate Purchase Payments reduced by surrenders equals or exceeds $50,000 on the date the contract maintenance fee is to be deducted. } { TRANSFER FEE $25 per transfer in excess of 12 transfers in any Contract Year. } ALLOCATION OPTIONS AVAILABLE ON THE EFFECTIVE DATE Protective Life Guaranteed Account DCA Fixed Account 1 DCA Fixed Account 2 Protective Variable Annuity Account A { Fidelity VIP Contrafund® Service Class 2 VIP EquityNY-Income Service Class 2 VIP Growth Service Class 2 VIP Index VDA-A-2006-500 Service Class 2 VIP Investment Grade Bond Service Class 2 VIP Mid Cap Service Class 2 Xxxxxxxx Xxxxxxxxx Xxxxxxxx Flex Cap Growth Class 2 Franklin Income Class 2 Franklin Rising Dividends Class 2 Franklin Small-Mid Cap Growth Class 2 Franklin U. S. Government Class 2 Mutual Shares Class 2 Xxxxxxxxx Foreign Class 2 Xxxxxxxxx Global Income Securities Class 2 Xxxxxxxxx Growth Class 2 Xxxxxxx Xxxxx Capital Growth Growth and Income Strategic International Equity Structured Small Cap Equity Structured U. S. Equity Xxxx Xxxxxx America’s Value Bond-Debenture Growth and Income Growth Opportunities Mid-Cap Value MFS Investment Management Emerging Growth Service Class Investors Growth Stock Service Class Investors Trust Service Class New Discovery Service Class Research Service Class Total Return Service Class Utilities Service Class OppenheimerFunds Capital Appreciation Service Class Global Securities Service Class High Income Service Class Main Street® Service Class MidCap Service Class Money Strategic Bond Service Class Xxx Xxxxxx Aggressive Growth Class II Xxxxxxxx Class II Enterprise Class II Government Class II Growth and Income Class II Strategic Growth Class II UIF Equity and Income Class II } 12/11 TABLE OF CONTENTS SCHEDULE A DEFINITIONS 7 1 PARTIES TO THE CONTRACT 8 2 Company 8 2 Owner 8 2 Change of Owner 8 2 Beneficiary 8 2 Change of Beneficiary 8 2 Annuitant 8 2 Change of Annuitant 8 3 Payee 9 3 GENERAL PROVISIONS 9 3 Entire Contract 9 3 Modification of the Contract 9 3 Non-Participating 3 Incontestability 9 3 Application of Law 3 Form Approval 3 Assignment 9 Written Notice 9 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 9 4 Settlement 9 4 Receipt of Payment 10 Protection of Proceeds 10 4 Premium Tax 10 Non-Participating 10 Minimum Values 10 Application of Law 10 Reports 10 4 Written Notice 4 PURCHASE PAYMENTS 10 5 Purchase Payments 10 5 Allocation of Purchase Payments 10 No Default 10 5 VARIABLE ACCOUNT 11 5 General Description 11 5 Sub-Accounts of the Variable Account 11 5 Variable Account Value 12 6 Accumulation Unit Values 12 6 Net Investment Factor 7 TRANSFERS 13 7 Transfers 13 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 13 7 SURRENDERS 14 Full and Partial AND WITHDRAWALS 8 Surrenders 14 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender 14 or Withdrawal 8 DEATH BENEFIT 14 8 Death of an Owner 14 8 Death of the Annuitant 14 8 Death Benefit 14 8 Payment of the Death Benefit 15 9 Suspension or Delay in Payment of Payment 15 ANNUITIZATION 15 Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Commencement Date 15 9 Annuity Income Payments 15 9 Fixed Income Payments 16 9 Variable Income Payments 16 10 Annuity Unit Values 16 10 Selection of Annuity Option 17 10 Annuity Options 17 11 Minimum Amounts 17 11 Guaranteed Purchase Rates 17 11 FIXED ANNUITY TABLES 18 12 VARIABLE ANNUITY TABLES 18 DEFINITIONS12 THIS IS A PLACEHOLDER FOR THE SCHEDULE INSERT.

YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within ten (10) days after you receive it by returning the Contract it to our Administrative Office administrative office, or to the Agent agent who sold it to you you, with a written request for cancellation. Return If you return it by mail, effective date of this Contract the cancellation will be determined by mail is effective the postmark date on being post-marked and the properly addressed with postage paidand postage-paid return package. We will promptly return the Contract Value plus any amount amounts deducted from the Purchase Payments or the Contract Value. This The amount returned may be more or less than the your Purchase Payments. If this Contract replaced a life insurance policy or another annuity contractXxxxxxx X. Xxxxxx, you may cancel this Contract within sixty (60) days after you receive it. { President Xxxxx X. Xxxxxxxx { Xxxxxxx X. Xxxx Xxxxxxxx, Secretary THIS IS A LEGALLY BINDING CONTRACT - READ IT CAREFULLY Home and Administrative Office: PROTECTIVE LIFE AND ANNUITY INSURANCE COMPANY { xxx.Xxxxxxxxxx.xxx 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 P. O. Box 10648 1928, Birmingham, Alabama 3520235282-0648 8238 (000) 000-0000 } This Page Intentionally left blank. SCHEDULE CONTRACT NUMBER EFFECTIVE DATE { AFVA-000000001 } { May 1, 2008 } OWNER 1 BIRTH DATE OF OWNER 1 { Xxxx X. Xxx } { March 30, 1953 } OWNER 2 BIRTH DATE OF OWNER 2 { Xxxx X. Xxx } { April 15, 1958 } ANNUITANT BIRTH DATE OF ANNUITANT { Xxxx X. Xxx } { March 30, 1953 } BENEFICIARY ANNUITY COMMENCEMENT DATE As contained in our records { March 30, 2048 } INITIAL PURCHASE PAYMENT: { $100,000.00 } LATEST AGE FOR PURCHASE PAYMENTS: { 85 } MINIMUM GUARANTEED INTEREST RATE FOR THE GUARANTEED ACCOUNT: { 3.00% } ANNUAL EFFECTIVE INTEREST RATES ON THE EFFECTIVE DATE: DCA FIXED ACCOUNT 1 - { 4.00% } DCA FIXED ACCOUNT 2 - { 3.50% } MORTALITY AND EXPENSE RISK CHARGE { 1.40% } per annum. ADMINISTRATION CHARGE { 0.15% } per annum. DEATH BENEFIT { Return of Purchase Payments } DEATH BENEFIT COST CALCULATION METHOD { CoverPay® - A Benefit Based Fee } { CONTRACT MAINTENANCE FEE: $30 The contract maintenance fee is deducted prior to the Annuity Commencement Date on each Contract Anniversary, and on any day that the Contract is surrendered other than the Contract Anniversary. The contract maintenance fee will be deducted from the Allocation Options in the same proportion as their values are to the Contract Value. The contract maintenance fee will be waived by the Company in the event the Contract Value or the aggregate Purchase Payments reduced by surrenders equals or exceeds $50,000 on the date the contract maintenance fee is to be deducted. } { TRANSFER FEE $25 per transfer in excess of 12 transfers in any Contract Year. } ALLOCATION OPTIONS AVAILABLE ON THE EFFECTIVE DATE Protective Life Guaranteed Account DCA Fixed Account 1 DCA Fixed Account 2 Protective Variable Annuity Account A { Fidelity VIP Contrafund® Service Class 2 VIP Equity-Income Service Class 2 VIP Growth Service Class 2 VIP Index 500 Service Class 2 VIP Investment Grade Bond Service Class 2 VIP Mid Cap Service Class 2 Xxxxxxxx Xxxxxxxxx Xxxxxxxx Flex Cap Growth Class 2 Franklin Income Class 2 Franklin Rising Dividends Class 2 Franklin Small-Mid Cap Growth Class 2 Franklin U. S. Government Class 2 Mutual Shares Class 2 Xxxxxxxxx Foreign Class 2 Xxxxxxxxx Global Income Securities Class 2 Xxxxxxxxx Growth Class 2 Xxxxxxx Xxxxx Capital Growth Growth and Income Strategic International Equity Structured Small Cap Equity Structured U. S. Equity Xxxx Xxxxxx America’s Value Bond-Debenture Growth and Income Growth Opportunities Mid-Cap Value MFS Investment Management Emerging Growth Service Class Investors Growth Stock Service Class Investors Trust Service Class New Discovery Service Class Research Service Class Total Return Service Class Utilities Service Class OppenheimerFunds Capital Appreciation Service Class Global Securities Service Class High Income Service Class Main Street® Service Class MidCap Service Class Money Strategic Bond Service Class Xxx Xxxxxx Aggressive Growth Class II Xxxxxxxx Class II Enterprise Class II Government Class II Growth and Income Class II Strategic Growth Class II UIF Equity and Income Class II } TABLE OF CONTENTS SCHEDULE A DEFINITIONS 7 2 PARTIES TO THE CONTRACT 8 3 Company 8 3 Owner 8 3 Change of Owner 8 3 Beneficiary 8 3 Change of Beneficiary 8 3 Annuitant 8 3 Change of Annuitant 8 4 Payee 9 4 GENERAL PROVISIONS 9 4 Entire Contract 9 4 Modification of the Contract 9 4 Non-Participating 4 Incontestability 9 4 Application of Law 4 Form Approval 4 Assignment 9 Written Notice 9 4 Protection of Proceeds 5 Minimum Values 5 Reports 5 Error in Age or Gender 9 5 Settlement 9 5 Receipt of Payment 10 Protection of Proceeds 10 5 Premium Tax 10 Non-Participating 10 Minimum Values 10 Application of Law 10 Reports 10 5 Written Notice 5 PURCHASE PAYMENTS 10 6 Purchase Payments 10 6 Allocation of Purchase Payments 10 No Default 10 6 VARIABLE ACCOUNT 11 6 General Description 11 6 Sub-Accounts of the Variable Account 11 6 Variable Account Value 12 7 Accumulation Unit Values 12 7 Net Investment Factor 8 TRANSFERS 13 8 Transfers 13 8 Limitation on Frequent Transfers 8 Dollar Cost Averaging 13 8 SURRENDERS 14 Full and Partial AND WITHDRAWALS 9 Surrenders 14 9 Withdrawals 9 Surrender Value 9 Suspension or Delay in Payment of Surrender 14 or Withdrawal 9 DEATH BENEFIT 14 9 Death of an Owner 14 9 Death of the Annuitant 14 9 Death Benefit 14 9 Payment of the Death Benefit 15 10 Suspension or Delay in Payment of Payment 15 ANNUITIZATION 15 Death Benefit 10 ANNUITY INCOME PAYMENTS 10 Annuity Commencement Date 15 10 Annuity Income Payments 15 10 Fixed Income Payments 16 10 Variable Income Payments 16 11 Annuity Unit Values 16 11 Selection of Annuity Option 17 11 Annuity Options 17 12 Minimum Amounts 17 12 Guaranteed Purchase Rates 17 12 FIXED ANNUITY TABLES 18 13 VARIABLE ANNUITY TABLES 18 13 DEFINITIONS

YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within ten (10) [ 10 ] days after you receive it by returning the Contract it to our Administrative Office administrative office, or to the Agent agent who sold it to you you, with a written request for cancellation. Return If you return it by mail, effective date of this Contract the cancellation will be determined by mail is effective the postmark date on being post-marked and the properly addressed with postage paidand postage-paid return package. We will promptly return the Contract Value plus any amount amounts deducted from the Purchase Payments or the Contract Value. This The amount returned may be more or less than the your Purchase Payments. If this Contract replaced a life insurance policy or another annuity contract, you may cancel this Contract within sixty (60) days after you receive it. { [ ] [ ] [ Xxxxx X. Xxxxxxxx { ] [ Xxxxxxx X. Xxxx ] [ President ] [ Secretary ] THIS IS A LEGALLY BINDING CONTRACT - READ IT CAREFULLY Home and Administrative Office: PROTECTIVE LIFE AND ANNUITY INSURANCE COMPANY { [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 P. O. Box 10648 1928, Birmingham, Alabama 3520235282-0648 8238 (000) 000-0000 } This Page Intentionally left blank. SCHEDULE CONTRACT NUMBER EFFECTIVE DATE { AFVA-000000001 } { May 1, 2008 } OWNER 1 BIRTH DATE OF OWNER 1 { Xxxx X. Xxx } { March 30, 1953 } OWNER 2 BIRTH DATE OF OWNER 2 { Xxxx X. Xxx } { April 15, 1958 } ANNUITANT BIRTH DATE OF ANNUITANT { Xxxx X. Xxx } { March 30, 1953 } BENEFICIARY ANNUITY COMMENCEMENT DATE As contained in our records { March 30, 2048 } INITIAL PURCHASE PAYMENT: { $100,000.00 } LATEST AGE FOR PURCHASE PAYMENTS: { 85 } MINIMUM GUARANTEED INTEREST RATE FOR THE GUARANTEED ACCOUNT: { 3.00% } ANNUAL EFFECTIVE INTEREST RATES ON THE EFFECTIVE DATE: DCA FIXED ACCOUNT 1 - { 4.00% } DCA FIXED ACCOUNT 2 - { 3.50% } MORTALITY AND EXPENSE RISK CHARGE { 1.40% } per annum. ADMINISTRATION CHARGE { 0.15% } per annum. DEATH BENEFIT { Return of Purchase Payments } DEATH BENEFIT COST CALCULATION METHOD { CoverPay® - A Benefit Based Fee } { CONTRACT MAINTENANCE FEE: $30 The contract maintenance fee is deducted prior to the Annuity Commencement Date on each Contract Anniversary, and on any day that the Contract is surrendered other than the Contract Anniversary. The contract maintenance fee will be deducted from the Allocation Options in the same proportion as their values are to the Contract Value. The contract maintenance fee will be waived by the Company in the event the Contract Value or the aggregate Purchase Payments reduced by surrenders equals or exceeds $50,000 on the date the contract maintenance fee is to be deducted. } { TRANSFER FEE $25 per transfer in excess of 12 transfers in any Contract Year. } ALLOCATION OPTIONS AVAILABLE ON THE EFFECTIVE DATE Protective Life Guaranteed Account DCA Fixed Account 1 DCA Fixed Account 2 Protective Variable Annuity Account A { Fidelity VIP Contrafund® Service Class 2 VIP Equity] NY-Income Service Class 2 VIP Growth Service Class 2 VIP Index 500 Service Class 2 VIP Investment Grade Bond Service Class 2 VIP Mid Cap Service Class 2 Xxxxxxxx Xxxxxxxxx Xxxxxxxx Flex Cap Growth Class 2 Franklin Income Class 2 Franklin Rising Dividends Class 2 Franklin SmallVDA-Mid Cap Growth Class 2 Franklin U. S. Government Class 2 Mutual Shares Class 2 Xxxxxxxxx Foreign Class 2 Xxxxxxxxx Global Income Securities Class 2 Xxxxxxxxx Growth Class 2 Xxxxxxx Xxxxx Capital Growth Growth and Income Strategic International Equity Structured Small Cap Equity Structured U. S. Equity Xxxx Xxxxxx America’s Value Bond-Debenture Growth and Income Growth Opportunities Mid-Cap Value MFS Investment Management Emerging Growth Service Class Investors Growth Stock Service Class Investors Trust Service Class New Discovery Service Class Research Service Class Total Return Service Class Utilities Service Class OppenheimerFunds Capital Appreciation Service Class Global Securities Service Class High Income Service Class Main Street® Service Class MidCap Service Class Money Strategic Bond Service Class Xxx Xxxxxx Aggressive Growth Class II Xxxxxxxx Class II Enterprise Class II Government Class II Growth and Income Class II Strategic Growth Class II UIF Equity and Income Class II } A-2006C-475WX [ 12/11 ] TABLE OF CONTENTS SCHEDULE A DEFINITIONS 7 1 PARTIES TO THE CONTRACT 8 2 Company 8 2 Owner 8 2 Change of Owner 8 2 Beneficiary 8 2 Change of Beneficiary 8 2 Annuitant 8 2 Change of Annuitant 8 3 Payee 9 3 GENERAL PROVISIONS 9 3 Entire Contract 9 3 Modification of the Contract 9 3 Non-Participating 3 Incontestability 9 3 Application of Law 3 Form Approval 3 Assignment 9 Written Notice 9 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 9 4 Settlement 9 4 Receipt of Payment 10 Protection of Proceeds 10 4 Premium Tax 10 Non-Participating 10 Minimum Values 10 Application of Law 10 Reports 10 4 Written Notice 4 PURCHASE PAYMENTS 10 5 Purchase Payments 10 5 Allocation of Purchase Payments 10 No Default 10 5 VARIABLE ACCOUNT 11 5 General Description 11 5 Sub-Accounts of the Variable Account 11 5 Variable Account Value 12 6 Accumulation Unit Values 12 6 Net Investment Factor 7 TRANSFERS 13 7 Transfers 13 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 13 7 SURRENDERS 14 Full and Partial AND WITHDRAWALS 8 Surrenders 14 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender 14 or Withdrawal 8 DEATH BENEFIT 14 8 Death of an Owner 14 8 Death of the Annuitant 14 8 Death Benefit 14 8 Payment of the Death Benefit 15 9 Suspension or Delay in Payment of Payment 15 ANNUITIZATION 15 Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Commencement Date 15 9 Annuity Income Payments 15 9 Fixed Income Payments 16 9 Variable Income Payments 16 10 Annuity Unit Values 16 10 Selection of Annuity Option 17 10 Annuity Options 17 11 Minimum Amounts 17 11 Guaranteed Purchase Rates 17 11 FIXED ANNUITY TABLES 18 12 VARIABLE ANNUITY TABLES 18 DEFINITIONS12 NY-VDA-A-2006C-475WX [ 12/11 ]

YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within ten (10) days after you receive it by returning the Contract it to our Administrative Office administrative office, or to the Agent agent who sold it to you you, with a written request for cancellation. Return If you return it by mail, effective date of this Contract the cancellation will be determined by mail is effective the postmark date on being post-marked and the properly addressed with postage paidand postage-paid return package. We will promptly return the Contract Value plus any amount amounts deducted from the Purchase Payments or the Contract Value. This The amount returned may be more or less than the your Purchase Payments. If this Contract replaced a life insurance policy or another annuity contract, you may cancel this Contract within sixty (60) days after you receive it. { Xxxxx X. Xxxxxxxx { President Xxxxxxx X. Xxxx Secretary THIS IS A LEGALLY BINDING CONTRACT - READ IT CAREFULLY Home and Administrative Office: PROTECTIVE LIFE AND ANNUITY INSURANCE COMPANY { xxx.Xxxxxxxxxx.xxx 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 P. O. Box 10648 1928, Birmingham, Alabama 3520235282-0648 8238 (000) 000-0000 } This Page Intentionally left blank. SCHEDULE CONTRACT NUMBER EFFECTIVE DATE { AFVA-000000001 } { May 1, 2008 } OWNER 1 BIRTH DATE OF OWNER 1 { Xxxx X. Xxx } { March 30, 1953 } OWNER 2 BIRTH DATE OF OWNER 2 { Xxxx X. Xxx } { April 15, 1958 } ANNUITANT BIRTH DATE OF ANNUITANT { Xxxx X. Xxx } { March 30, 1953 } BENEFICIARY ANNUITY COMMENCEMENT DATE As contained in our records { March 30, 2048 } INITIAL PURCHASE PAYMENT: { $100,000.00 } LATEST AGE FOR PURCHASE PAYMENTS: { 85 } MINIMUM GUARANTEED INTEREST RATE FOR THE GUARANTEED ACCOUNT: { 3.00% } ANNUAL EFFECTIVE INTEREST RATES ON THE EFFECTIVE DATE: DCA FIXED ACCOUNT 1 - { 4.00% } DCA FIXED ACCOUNT 2 - { 3.50% } MORTALITY AND EXPENSE RISK CHARGE { 1.40% } per annum. ADMINISTRATION CHARGE { 0.15% } per annum. DEATH BENEFIT { Return of Purchase Payments } DEATH BENEFIT COST CALCULATION METHOD { CoverPay® - A Benefit Based Fee } { CONTRACT MAINTENANCE FEE: $30 The contract maintenance fee is deducted prior to the Annuity Commencement Date on each Contract Anniversary, and on any day that the Contract is surrendered other than the Contract Anniversary. The contract maintenance fee will be deducted from the Allocation Options in the same proportion as their values are to the Contract Value. The contract maintenance fee will be waived by the Company in the event the Contract Value or the aggregate Purchase Payments reduced by surrenders equals or exceeds $50,000 on the date the contract maintenance fee is to be deducted. } { TRANSFER FEE $25 per transfer in excess of 12 transfers in any Contract Year. } ALLOCATION OPTIONS AVAILABLE ON THE EFFECTIVE DATE Protective Life Guaranteed Account DCA Fixed Account 1 DCA Fixed Account 2 Protective Variable Annuity Account A { Fidelity VIP Contrafund® Service Class 2 VIP EquityNY-Income Service Class 2 VIP Growth Service Class 2 VIP Index VDA-A-2006-500 Service Class 2 VIP Investment Grade Bond Service Class 2 VIP Mid Cap Service Class 2 Xxxxxxxx Xxxxxxxxx Xxxxxxxx Flex Cap Growth Class 2 Franklin Income Class 2 Franklin Rising Dividends Class 2 Franklin Small-Mid Cap Growth Class 2 Franklin U. S. Government Class 2 Mutual Shares Class 2 Xxxxxxxxx Foreign Class 2 Xxxxxxxxx Global Income Securities Class 2 Xxxxxxxxx Growth Class 2 Xxxxxxx Xxxxx Capital Growth Growth and Income Strategic International Equity Structured Small Cap Equity Structured U. S. Equity Xxxx Xxxxxx America’s Value Bond-Debenture Growth and Income Growth Opportunities Mid-Cap Value MFS Investment Management Emerging Growth Service Class Investors Growth Stock Service Class Investors Trust Service Class New Discovery Service Class Research Service Class Total Return Service Class Utilities Service Class OppenheimerFunds Capital Appreciation Service Class Global Securities Service Class High Income Service Class Main Street® Service Class MidCap Service Class Money Strategic Bond Service Class Xxx Xxxxxx Aggressive Growth Class II Xxxxxxxx Class II Enterprise Class II Government Class II Growth and Income Class II Strategic Growth Class II UIF Equity and Income Class II } 12/11 TABLE OF CONTENTS SCHEDULE A DEFINITIONS 7 1 PARTIES TO THE CONTRACT 8 2 Company 8 2 Owner 8 2 Change of Owner 8 2 Beneficiary 8 2 Change of Beneficiary 8 2 Annuitant 8 2 Change of Annuitant 8 3 Payee 9 3 GENERAL PROVISIONS 9 3 Entire Contract 9 3 Modification of the Contract 9 3 Non-Participating 3 Incontestability 9 3 Application of Law 3 Form Approval 3 Assignment 9 Written Notice 9 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 9 4 Settlement 9 4 Receipt of Payment 10 Protection of Proceeds 10 4 Premium Tax 10 Non-Participating 10 Minimum Values 10 Application of Law 10 Reports 10 4 Written Notice 4 PURCHASE PAYMENTS 10 5 Purchase Payments 10 5 Allocation of Purchase Payments 10 No Default 10 5 VARIABLE ACCOUNT 11 5 General Description 11 5 Sub-Accounts of the Variable Account 11 5 Variable Account Value 12 6 Accumulation Unit Values 12 6 Net Investment Factor 7 TRANSFERS 13 7 Transfers 13 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 13 7 SURRENDERS 14 Full and Partial AND WITHDRAWALS 8 Surrenders 14 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender 14 or Withdrawal 8 DEATH BENEFIT 14 8 Death of an Owner 14 8 Death of the Annuitant 14 8 Death Benefit 14 8 Payment of the Death Benefit 15 9 Suspension or Delay in Payment of Payment 15 ANNUITIZATION 15 Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Commencement Date 15 9 Annuity Income Payments 15 9 Fixed Income Payments 16 9 Variable Income Payments 16 10 Annuity Unit Values 16 10 Selection of Annuity Option 17 10 Annuity Options 17 11 Minimum Amounts 17 11 Guaranteed Purchase Rates 17 11 FIXED ANNUITY TABLES 18 12 VARIABLE ANNUITY TABLES 18 DEFINITIONS12

YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within ten (10) [ 10 ] days after you receive it by returning the Contract it to our Administrative Office administrative office, or to the Agent agent who sold it to you you, with a written request for cancellation. Return If you return it by mail, effective date of this Contract the cancellation will be determined by mail is effective the postmark date on being post-marked and the properly addressed with postage paidand postage-paid return package. We will promptly return the Contract Value plus any amount amounts deducted from the Purchase Payments or the Contract Value. This The amount returned may be more or less than the your Purchase Payments. If this Contract replaced a life insurance policy or another annuity contract, you may cancel this Contract within sixty (60) days after you receive it. { [ ] [ ] [ Xxxxx X. Xxxxxxxx { ] [ Xxxxxxx X. Xxxx ] [ President ] [ Secretary ] THIS IS A LEGALLY BINDING CONTRACT - READ IT CAREFULLY Home and Administrative Office: PROTECTIVE LIFE AND ANNUITY INSURANCE COMPANY { [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 P. O. Box 10648 1928, Birmingham, Alabama 3520235282-0648 8238 (000) 000-0000 } This Page Intentionally left blank. SCHEDULE CONTRACT NUMBER EFFECTIVE DATE { AFVA-000000001 } { May 1, 2008 } OWNER 1 BIRTH DATE OF OWNER 1 { Xxxx X. Xxx } { March 30, 1953 } OWNER 2 BIRTH DATE OF OWNER 2 { Xxxx X. Xxx } { April 15, 1958 } ANNUITANT BIRTH DATE OF ANNUITANT { Xxxx X. Xxx } { March 30, 1953 } BENEFICIARY ANNUITY COMMENCEMENT DATE As contained in our records { March 30, 2048 } INITIAL PURCHASE PAYMENT: { $100,000.00 } LATEST AGE FOR PURCHASE PAYMENTS: { 85 } MINIMUM GUARANTEED INTEREST RATE FOR THE GUARANTEED ACCOUNT: { 3.00% } ANNUAL EFFECTIVE INTEREST RATES ON THE EFFECTIVE DATE: DCA FIXED ACCOUNT 1 - { 4.00% } DCA FIXED ACCOUNT 2 - { 3.50% } MORTALITY AND EXPENSE RISK CHARGE { 1.40% } per annum. ADMINISTRATION CHARGE { 0.15% } per annum. DEATH BENEFIT { Return of Purchase Payments } DEATH BENEFIT COST CALCULATION METHOD { CoverPay® - A Benefit Based Fee } { CONTRACT MAINTENANCE FEE: $30 The contract maintenance fee is deducted prior to the Annuity Commencement Date on each Contract Anniversary, and on any day that the Contract is surrendered other than the Contract Anniversary. The contract maintenance fee will be deducted from the Allocation Options in the same proportion as their values are to the Contract Value. The contract maintenance fee will be waived by the Company in the event the Contract Value or the aggregate Purchase Payments reduced by surrenders equals or exceeds $50,000 on the date the contract maintenance fee is to be deducted. } { TRANSFER FEE $25 per transfer in excess of 12 transfers in any Contract Year. } ALLOCATION OPTIONS AVAILABLE ON THE EFFECTIVE DATE Protective Life Guaranteed Account DCA Fixed Account 1 DCA Fixed Account 2 Protective Variable Annuity Account A { Fidelity VIP Contrafund® Service Class 2 VIP Equity] NY-Income Service Class 2 VIP Growth Service Class 2 VIP Index 500 Service Class 2 VIP Investment Grade Bond Service Class 2 VIP Mid Cap Service Class 2 Xxxxxxxx Xxxxxxxxx Xxxxxxxx Flex Cap Growth Class 2 Franklin Income Class 2 Franklin Rising Dividends Class 2 Franklin SmallVDA-Mid Cap Growth Class 2 Franklin U. S. Government Class 2 Mutual Shares Class 2 Xxxxxxxxx Foreign Class 2 Xxxxxxxxx Global Income Securities Class 2 Xxxxxxxxx Growth Class 2 Xxxxxxx Xxxxx Capital Growth Growth and Income Strategic International Equity Structured Small Cap Equity Structured U. S. Equity Xxxx Xxxxxx America’s Value Bond-Debenture Growth and Income Growth Opportunities Mid-Cap Value MFS Investment Management Emerging Growth Service Class Investors Growth Stock Service Class Investors Trust Service Class New Discovery Service Class Research Service Class Total Return Service Class Utilities Service Class OppenheimerFunds Capital Appreciation Service Class Global Securities Service Class High Income Service Class Main Street® Service Class MidCap Service Class Money Strategic Bond Service Class Xxx Xxxxxx Aggressive Growth Class II Xxxxxxxx Class II Enterprise Class II Government Class II Growth and Income Class II Strategic Growth Class II UIF Equity and Income Class II } A-2006C-475WW [ 12/11 ] TABLE OF CONTENTS SCHEDULE A DEFINITIONS 7 1 PARTIES TO THE CONTRACT 8 2 Company 8 2 Owner 8 2 Change of Owner 8 2 Beneficiary 8 2 Change of Beneficiary 8 2 Annuitant 8 2 Change of Annuitant 8 3 Payee 9 3 GENERAL PROVISIONS 9 3 Entire Contract 9 3 Modification of the Contract 9 3 Non-Participating 3 Incontestability 9 3 Application of Law 3 Form Approval 3 Assignment 9 Written Notice 9 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 9 4 Settlement 9 4 Receipt of Payment 10 Protection of Proceeds 10 4 Premium Tax 10 Non-Participating 10 Minimum Values 10 Application of Law 10 Reports 10 4 Written Notice 4 PURCHASE PAYMENTS 10 5 Purchase Payments 10 5 Allocation of Purchase Payments 10 No Default 10 5 VARIABLE ACCOUNT 11 5 General Description 11 5 Sub-Accounts of the Variable Account 11 5 Variable Account Value 12 6 Accumulation Unit Values 12 6 Net Investment Factor 7 TRANSFERS 13 7 Transfers 13 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 13 7 SURRENDERS 14 Full and Partial AND WITHDRAWALS 8 Surrenders 14 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender 14 or Withdrawal 8 DEATH BENEFIT 14 8 Death of an Owner 14 8 Death of the Annuitant 14 8 Death Benefit 14 8 Payment of the Death Benefit 15 9 Suspension or Delay in Payment of Payment 15 ANNUITIZATION 15 Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Commencement Date 15 9 Annuity Income Payments 15 9 Fixed Income Payments 16 9 Variable Income Payments 16 10 Annuity Unit Values 16 10 Selection of Annuity Option 17 10 Annuity Options 17 11 Minimum Amounts 17 11 Guaranteed Purchase Rates 17 11 FIXED ANNUITY TABLES 18 12 VARIABLE ANNUITY TABLES 18 DEFINITIONS12 NY-VDA-A-2006C-475WW [ 12/11 ]

YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within ten (10) [ 10 ] days after you receive it by returning the Contract it to our Administrative Office administrative office, or to the Agent agent who sold it to you you, with a written request for cancellation. Return If you return it by mail, effective date of this Contract the cancellation will be determined by mail is effective the postmark date on being post-marked and the properly addressed with postage paidand postage-paid return package. We will promptly return the Contract Value plus any amount amounts deducted from the Purchase Payments or the Contract Value. This The amount returned may be more or less than the your Purchase Payments. If this Contract replaced a life insurance policy or another annuity contract, you may cancel this Contract within sixty (60) days after you receive it. { [ ] [ ] [ Xxxxx X. Xxxxxxxx { ] [ Xxxxxxx X. Xxxx ] [ President ] [ Secretary ] THIS IS A LEGALLY BINDING CONTRACT - READ IT CAREFULLY Home and Administrative Office: PROTECTIVE LIFE AND ANNUITY INSURANCE COMPANY { [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 P. O. Box 10648 1928, Birmingham, Alabama 3520235282-0648 8238 (000) 000-0000 } This Page Intentionally left blank. SCHEDULE CONTRACT NUMBER EFFECTIVE DATE { AFVA-000000001 } { May 1, 2008 } OWNER 1 BIRTH DATE OF OWNER 1 { Xxxx X. Xxx } { March 30, 1953 } OWNER 2 BIRTH DATE OF OWNER 2 { Xxxx X. Xxx } { April 15, 1958 } ANNUITANT BIRTH DATE OF ANNUITANT { Xxxx X. Xxx } { March 30, 1953 } BENEFICIARY ANNUITY COMMENCEMENT DATE As contained in our records { March 30, 2048 } INITIAL PURCHASE PAYMENT: { $100,000.00 } LATEST AGE FOR PURCHASE PAYMENTS: { 85 } MINIMUM GUARANTEED INTEREST RATE FOR THE GUARANTEED ACCOUNT: { 3.00% } ANNUAL EFFECTIVE INTEREST RATES ON THE EFFECTIVE DATE: DCA FIXED ACCOUNT 1 - { 4.00% } DCA FIXED ACCOUNT 2 - { 3.50% } MORTALITY AND EXPENSE RISK CHARGE { 1.40% } per annum. ADMINISTRATION CHARGE { 0.15% } per annum. DEATH BENEFIT { Return of Purchase Payments } DEATH BENEFIT COST CALCULATION METHOD { CoverPay® - A Benefit Based Fee } { CONTRACT MAINTENANCE FEE: $30 The contract maintenance fee is deducted prior to the Annuity Commencement Date on each Contract Anniversary, and on any day that the Contract is surrendered other than the Contract Anniversary. The contract maintenance fee will be deducted from the Allocation Options in the same proportion as their values are to the Contract Value. The contract maintenance fee will be waived by the Company in the event the Contract Value or the aggregate Purchase Payments reduced by surrenders equals or exceeds $50,000 on the date the contract maintenance fee is to be deducted. } { TRANSFER FEE $25 per transfer in excess of 12 transfers in any Contract Year. } ALLOCATION OPTIONS AVAILABLE ON THE EFFECTIVE DATE Protective Life Guaranteed Account DCA Fixed Account 1 DCA Fixed Account 2 Protective Variable Annuity Account A { Fidelity VIP Contrafund® Service Class 2 VIP Equity] NY-Income Service Class 2 VIP Growth Service Class 2 VIP Index 500 Service Class 2 VIP Investment Grade Bond Service Class 2 VIP Mid Cap Service Class 2 Xxxxxxxx Xxxxxxxxx Xxxxxxxx Flex Cap Growth Class 2 Franklin Income Class 2 Franklin Rising Dividends Class 2 Franklin SmallVDA-Mid Cap Growth Class 2 Franklin U. S. Government Class 2 Mutual Shares Class 2 Xxxxxxxxx Foreign Class 2 Xxxxxxxxx Global Income Securities Class 2 Xxxxxxxxx Growth Class 2 Xxxxxxx Xxxxx Capital Growth Growth and Income Strategic International Equity Structured Small Cap Equity Structured U. S. Equity Xxxx Xxxxxx America’s Value Bond-Debenture Growth and Income Growth Opportunities Mid-Cap Value MFS Investment Management Emerging Growth Service Class Investors Growth Stock Service Class Investors Trust Service Class New Discovery Service Class Research Service Class Total Return Service Class Utilities Service Class OppenheimerFunds Capital Appreciation Service Class Global Securities Service Class High Income Service Class Main Street® Service Class MidCap Service Class Money Strategic Bond Service Class Xxx Xxxxxx Aggressive Growth Class II Xxxxxxxx Class II Enterprise Class II Government Class II Growth and Income Class II Strategic Growth Class II UIF Equity and Income Class II } A-2006C-500WW [ 12/11 ] TABLE OF CONTENTS SCHEDULE A DEFINITIONS 7 1 PARTIES TO THE CONTRACT 8 2 Company 8 2 Owner 8 2 Change of Owner 8 2 Beneficiary 8 2 Change of Beneficiary 8 2 Annuitant 8 2 Change of Annuitant 8 3 Payee 9 3 GENERAL PROVISIONS 9 3 Entire Contract 9 3 Modification of the Contract 9 3 Non-Participating 3 Incontestability 9 3 Application of Law 3 Form Approval 3 Assignment 9 Written Notice 9 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 9 4 Settlement 9 4 Receipt of Payment 10 Protection of Proceeds 10 4 Premium Tax 10 Non-Participating 10 Minimum Values 10 Application of Law 10 Reports 10 4 Written Notice 4 PURCHASE PAYMENTS 10 5 Purchase Payments 10 5 Allocation of Purchase Payments 10 No Default 10 5 VARIABLE ACCOUNT 11 5 General Description 11 5 Sub-Accounts of the Variable Account 11 5 Variable Account Value 12 6 Accumulation Unit Values 12 6 Net Investment Factor 7 TRANSFERS 13 7 Transfers 13 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 13 7 SURRENDERS 14 Full and Partial AND WITHDRAWALS 8 Surrenders 14 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender 14 or Withdrawal 8 DEATH BENEFIT 14 8 Death of an Owner 14 8 Death of the Annuitant 14 8 Death Benefit 14 8 Payment of the Death Benefit 15 9 Suspension or Delay in Payment of Payment 15 ANNUITIZATION 15 Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Commencement Date 15 9 Annuity Income Payments 15 9 Fixed Income Payments 16 9 Variable Income Payments 16 10 Annuity Unit Values 16 10 Selection of Annuity Option 17 10 Annuity Options 17 11 Minimum Amounts 17 11 Guaranteed Purchase Rates 17 11 FIXED ANNUITY TABLES 18 12 VARIABLE ANNUITY TABLES 18 DEFINITIONS12 NY-VDA-A-2006C-500WW [ 12/11 ]