Index Options Contract Schedule

          


    

    

    Owner: [John Doe] Contract Number: [??687456]

    Owner’s Age Issue Date: [04/15/10]

    and gender: [35 Male] Annuitant: [John Doe]

    [Joint Owner: [Jane Doe]] Annuitant’s Age

    [Joint Owner’s and gender: [35 Male]

    Age and gender: [35 Female]]

    

    

    Alternate Minimum Value

    AMV Factor: [87.50]%

    AMB Factor: [87.50]%

    Alternate Interest Rate: [1.00]%

    

    

    Allocation Guidelines:

    [1. Currently, you can select up to [5] of the Index Protection Strategy with Declared Protection Strategy Credit Index
        Options.

    2. Currently, you can select up to [5] of the Index Protection Strategy with Cap Index Options.

    3. Currently, you can select up to [5] of the Index Performance Strategy Index Options.

    4. Currently, you can select up to [5] of the Index Guard Strategy Index Options.

    5. Currently, you can select up to [5] of the Index Precision Strategy Index Options.

    6. Allocations must be made in whole percentages.]

    

    

    Index Options:

    

    

    [Part [A] Index Option Rider(s):]

    [Index Performance Strategy Index Options

    	
            Index

          	
            Buffer for all Index Years

          	
            Minimum Cap for all Index Years

          
	
            [S&P 500® Index

          	
            [10.00]%

          	
            [3.00]%]

          
	
            [Nasdaq-100® Index

          	
            [10.00]%

          	
            [3.00]%]

          
	
            [Russell 2000® Index

          	
            [10.00]%

          	
            [3.00]%]

          
	
            [EURO STOXX 50®

          	
            [10.00]%

          	
            [3.00]%]

          
	
            [iShares® MSCI Emerging
                Markets ETF

          	
            [10.00]%

          	
            [3.00]%]]

          


    [Index Guard Strategy Index Options

    	
            Index

          	
            Floor for all Index Years

          	
            Minimum Cap for all Index Years

          
	
            [S&P 500® Index

          	
            [-10.00]%

          	
            [3.00]%]

          
	
            [Nasdaq-100® Index

          	
            [-10.00]%

          	
            [3.00]%]

          
	
            [Russell 2000® Index

          	
            [-10.00]%

          	
            [3.00]%]

          
	
            [EURO STOXX 50®

          	
            [-10.00]%

          	
            [3.00]%]

          
	
            [iShares® MSCI Emerging
                Markets ETF

          	
            [-10.00]%

          	
            [3.00]%]]

          


    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    
      
        S40877-IAI-01                                                                           [Admin Tracking Identifier]

      

      
        


      
        

        

      

    

    

    

    	
            Index Options Contract Schedule continued from the previous page

          


    

    

    [Index Precision Strategy Index Options

    	
            Index

          	
            Buffer for all Index Years

          	
            Minimum Precision Rate for all Index Years

          
	
            [S&P 500® Index

          	
            [10.00]%

          	
            [3.00]%]

          
	
            [Nasdaq-100® Index

          	
            [10.00]%

          	
            [3.00]%]

          
	
            [Russell 2000® Index

          	
            [10.00]%

          	
            [3.00]%]

          
	
            [EURO STOXX 50®

          	
            [10.00]%

          	
            [3.00]%]

          
	
            [iShares® MSCI Emerging
                Markets ETF

          	
            [10.00]%

          	
            [3.00]%]]

          


    

    

    [Part [B] Index Option Rider(s):]

    [Index Protection Strategy with Declared Protection Strategy

     Credit Index Options

    	
            Index

          	
            Minimum Declared Protection Strategy Credit for all Index Years

          
	
            [S&P 500® Index

          	
            [0.50]%]

          
	
            [Nasdaq-100® Index

          	
            [0.50]%]

          
	
            [Russell 2000® Index

          	
            [0.50]%]

          
	
            [EURO STOXX 50®

          	
            [0.50]%]

          
	
            [iShares® MSCI Emerging
                Markets ETF

          	
            [0.50]%]]

          


    

    

    [Index Protection Strategy with Cap Index Options

    	
            Index

          	
            Minimum Cap for all Index Years

          
	
            [S&P 500® Index

          	
            [0.50]%]

          
	
            [Nasdaq-100® Index

          	
            [0.50]%]

          
	
            [Russell 2000® Index

          	
            [0.50]%]

          
	
            [EURO STOXX 50®

          	
            [0.50]%]

          
	
            [iShares® MSCI Emerging
                Markets ETF

          	
            [0.50]%]]

          


    

    

    
      
        S40877-IAI-01                                                                           [Admin Tracking Identifier]

      

      
        


      
        

        

      

    

    

    

    	
            Index Options Contract Schedule continued from the previous page

          


    

    

    [The S&P 500® Index is comprised of 500 stocks representing major U.S. industrial sectors.

    

    

    S&P® is a registered trademark of Standard & Poor’s Financial Services LLC (“S&P”). This
        trademark has been licensed for use by S&P Dow Jones Indices LLC. S&P marks are trademarks of S&P. These trademarks have been sublicensed for certain purposes by Allianz Life Insurance Company of North America (“Allianz”). The S&P
        500® Index (“the Index”) is a product of S&P Dow Jones Indices LLC and/or its affiliates and have been licensed for use by Allianz.

    

    

    Allianz products are not sponsored, endorsed, sold, or promoted by S&P Dow Jones Indices LLC, Dow
        Jones, S&P, or any of their respective affiliates (collectively, “S&P Dow Jones Indices”). S&P Dow Jones Indices make no representation or warranty, express or implied, to the owners of the Allianz products or any member of the public
        regarding the advisability of investments generally or in Allianz products particularly or the ability of the Index and Average to track general market performance. S&P Dow Jones Indices’ only relationship to Allianz with respect to the Index
        and Average is the licensing of the Index and Average and certain trademarks, service marks, and/or trade names of S&P Dow Jones Indices and/or its third-party licensors. The Index and Average are determined, composed, and calculated by S&P
        Dow Jones Indices without regard to Allianz or the products. S&P Dow Jones Indices have no obligation to take the needs of Allianz or the owners of the products into consideration in determining, composing, or calculating the Index and Average.
        S&P Dow Jones Indices are not responsible for and have not participated in the design, development, pricing, and operation of the products, including the calculation of any interest payments or any other values credited to the products. S&P
        Dow Jones Indices have no obligation or liability in connection with the administration, marketing, or trading of products. There is no assurance that investment products based on the Index and Average will accurately track index performance or
        provide positive investment returns. S&P Dow Jones Indices LLC and its subsidiaries are not investment advisors. Inclusion of a security or futures contract within an index is not a recommendation by S&P Dow Jones Indices to buy, sell, or
        hold such security or futures contract, nor is it considered to be investment advice. Notwithstanding the foregoing, CME Group Inc. and its affiliates may independently issue and/or sponsor financial products unrelated to products currently being
        issued by Allianz, but which may be similar to and competitive with Allianz products. In addition, CME Group Inc., an indirect minority owner of S&P Dow Jones Indices LLC, and its affiliates may trade financial products which are linked to the
        performance of the Index and Average. It is possible that this trading activity will affect the value of the products.

    

    

    S&P DOW JONES INDICES DO NOT GUARANTEE THE ADEQUACY, ACCURACY, TIMELINESS, AND/OR THE COMPLETENESS OF
        THE INDEX AND AVERAGE OR ANY DATA RELATED THERETO OR ANY COMMUNICATION, INCLUDING BUT NOT LIMITED TO, ORAL OR WRITTEN COMMUNICATION (INCLUDING ELECTRONIC COMMUNICATIONS) WITH RESPECT THERETO. S&P DOW JONES INDICES SHALL NOT BE SUBJECT TO ANY
        DAMAGES OR LIABILITY FOR ANY ERRORS, OMISSIONS, OR DELAYS THEREIN. S&P DOW JONES INDICES

    

    

    MAKE NO EXPRESS OR IMPLIED WARRANTIES, AND EXPRESSLY DISCLAIM ALL WARRANTIES, OF MERCHANTABILITY OR
        FITNESS FOR A PARTICULAR PURPOSE OR USE OR AS TO RESULTS TO BE OBTAINED BY ALLIANZ, OWNERS OF THE PRODUCTS, OR ANY OTHER PERSON OR ENTITY FROM THE USE OF THE INDEX AND AVERAGE OR WITH RESPECT TO ANY DATA RELATED THERETO. WITHOUT LIMITING ANY OF THE
        FOREGOING, IN NO EVENT WHATSOEVER SHALL S&P DOW JONES INDICES BE LIABLE FOR ANY INDIRECT, SPECIAL, INCIDENTAL, PUNITIVE, OR CONSEQUENTIAL DAMAGES INCLUDING BUT NOT LIMITED TO, LOSS OF PROFITS, TRADING LOSSES, LOST TIME, OR GOODWILL, EVEN IF
        THEY HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES, WHETHER IN CONTRACT, TORT, STRICT LIABILITY, OR OTHERWISE. THERE ARE NO THIRD-PARTY BENEFICIARIES OF ANY AGREEMENTS OR ARRANGEMENTS BETWEEN S&P DOW JONES INDICES AND ALLIANZ OTHER THAN
        THE LICENSORS OF S&P DOW JONES INDICES.]

    

    

    [The NASDAQ-100 Index® includes 100 of the largest domestic and international non-financial securities
        listed on The NASDAQ Stock Market® based on market capitalization.

    

    

    The Product(s) is not sponsored, endorsed, sold or promoted by Nasdaq, Inc. or its affiliates (Nasdaq,
        with its affiliates, are referred to as the “Corporations”).  The Corporations have not passed on the legality or suitability of, or the accuracy or adequacy of descriptions and disclosures relating to, the Product(s).  The Corporations make no
        representation or warranty, express or implied to the owners of the Product(s) or any member of the public regarding the advisability of investing in securities generally or in the Product(s) particularly, or the ability of the Nasdaq-100 Index® to
        track general stock market performance.  The Corporations' only relationship to Allianz Life Insurance Company of North America (“Licensee”) is in the licensing of the NASDAQ®, and Nasdaq-100 Index® registered trademarks, and certain trade names of
        the Corporations and the use of the Nasdaq-100 Index® which is determined, composed and calculated by NASDAQ without regard to Licensee or the Product(s).  Nasdaq has no obligation to take the needs of the Licensee or the owners of the Product(s)
        into consideration in determining, composing or calculating the Nasdaq-100 Index®.  The Corporations are not responsible for and have not participated in the determination of the timing of, prices at, or quantities of the Product(s) to be issued or
        in the determination or calculation of the equation by which the Product(s) is to be converted into cash.  The Corporations have no liability in connection with the administration, marketing or trading of the Product(s).

    
      
        S40877-IAI-01                                                                           [Admin Tracking Identifier]

      

      
        


      
        

        

      

    

    

    

    	
            Index Options Contract Schedule  continued from the previous page

          


    THE CORPORATIONS DO NOT GUARANTEE THE ACCURACY AND/OR UNINTERRUPTED CALCULATION OF THE NASDAQ-100 INDEX®
        OR ANY DATA INCLUDED THEREIN.  THE CORPORATIONS MAKE NO WARRANTY, EXPRESS OR IMPLIED, AS TO RESULTS TO BE OBTAINED BY LICENSEE, OWNERS OF THE PRODUCT(S), OR ANY OTHER PERSON OR ENTITY FROM THE USE OF THE NASDAQ-100 INDEX® OR ANY DATA INCLUDED
        THEREIN.  THE CORPORATIONS MAKE NO EXPRESS OR IMPLIED WARRANTIES, AND EXPRESSLY DISCLAIM ALL WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE OR USE WITH RESPECT TO THE NASDAQ-100 INDEX® OR ANY DATA INCLUDED THEREIN.  WITHOUT
        LIMITING ANY OF THE FOREGOING, IN NO EVENT SHALL THE CORPORATIONS HAVE ANY LIABILITY FOR ANY LOST PROFITS OR SPECIAL, INCIDENTAL, PUNITIVE, INDIRECT, OR CONSEQUENTIAL DAMAGES, EVEN IF NOTIFIED OF THE POSSIBILITY OF SUCH DAMAGES.]

    

    

    [The Russell 2000® Index is an equity index that measures the performance of the 2,000 smallest companies
        in the Russell 3000® Index, which is made up of 3, 000 of the biggest U.S. stocks.  The Russell 2000® Index is constructed to provide a comprehensive and unbiased small-cap barometer and is completely reconstituted annually to ensure larger stocks
        do not affect the performance and characteristics of the true small-cap index.

    

    

    The Russell 2000® Index (the “Index”) is a trademark of Frank Russell Company (“Russell”) and has been
        licensed for use by Allianz Life Insurance Company of North America (“Allianz”). Allianz products are not in any way sponsored, endorsed, sold or promoted by Russell or the London Stock Exchange Group companies (“LSEG”) (together the “Licensor
        Parties”) and none of the Licensor Parties make any claim, prediction, warranty or representation whatsoever, expressly or impliedly, either as to (i) the results to be obtained from the use of the Index (upon which the Allianz product is based),
        (ii) the figure at which the Index is said to stand at any particular time on any particular day or otherwise, or (iii) the suitability of the Index for the purpose to which it is being put in connection with the Allianz product. None of the
        Licensor Parties have provided or will provide any financial or investment advice or recommendation in relation to the Index to Allianz or to its clients. The Index is calculated by Russell or its agent. None of the Licensor Parties shall be (a)
        liable (whether in negligence or otherwise) to any person for any error in the Index or (b) under any obligation to advise any person of any error therein.]

    

    

    [The EURO STOXX 50®, Europe's leading Blue-chip index for the Eurozone, provides a blue-chip
        representation of supersector leaders in the Eurozone.  The index covers 50 stocks from 12 Eurozone countries: Austria, Belgium, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Portugal and Spain.

    

    

    STOXX Limited, Deutsche Börse Group and their licensors, research partners or data providers have no
        relationship to Allianz Life Insurance Company of North America (“Allianz”), other than the licensing of the EURO STOXX 50® and the related trademarks for use in connection with Allianz products.

    STOXX, Deutsche Börse Group and their licensors, research partners or data providers do
        not:

    • sponsor, endorse, sell or promote Allianz products.

    • recommend that any person invest in Allianz products or any other securities.

    • have any responsibility or liability for or make any decisions about the timing, amount or pricing of
        Allianz products.

    • have any responsibility or liability for the administration, management or marketing of Allianz
        products.

    • consider the needs of Allianz products or the owners of Allianz products in determining, composing or
        calculating the EURO STOXX 50 or have any obligation to do so.

    STOXX, Deutsche Börse Group and their licensors, research partners or data providers give no warranty, and exclude any liability (whether in negligence or otherwise), in connection with the Allianz products or their performance.

    STOXX does not assume any contractual relationship with the purchasers of Allianz products or any other
        third parties.

    Specifically,

    • STOXX, Deutsche Börse Group and their licensors, research partners or data providers do not give any
        warranty, express or implied, and exclude any liability about:

    • The results to be obtained by Allianz products, the owner of Allianz products or any other person in
        connection with the use of the EURO STOXX 50 and the data included in the EURO STOXX 50;

    • The accuracy, timeliness, and completeness of the EURO STOXX 50 and its data;

    • The merchantability and the fitness for a particular purpose or use of the EURO STOXX 50 and its data;

    • The performance of Allianz products generally.

    • STOXX, Deutsche Börse Group and their licensors, research partners or data providers give no warranty
        and exclude any liability, for any errors, omissions or interruptions in the EURO STOXX 50 or its data;

    • Under no circumstances will STOXX, Deutsche Börse Group or their licensors, research partners or data
        providers be liable (whether in negligence or otherwise) for any lost profits or indirect, punitive, special or consequential damages or losses, arising as a result of such errors, omissions or interruptions in the [relevant index] or its data or
        generally in relation to Allianz products, even in

    circumstances where STOXX, Deutsche Börse Group or their licensors, research partners or data providers
        are aware that such loss or damage may occur.

    

    

    
      
        S40877-IAI-01                                                                           [Admin Tracking Identifier]

      

      
        


      
        

        

      

    

    

    

    	
            Index Options Contract Schedule  continued from the previous page

          


    

    

    The licensing Agreement between Allianz and STOXX is solely for their benefit and not for the benefit of
        the owners of Allianz products or any other third parties.]

    

    

    [The iShares® MSCI Emerging Markets ETF distributed by BlackRock Investments, LLC. iShares®, BLACKROCK®,
        and the corresponding logos are registered trademarks of BlackRock, Inc. and its affiliates (“BlackRock”) and are used under license. These trademarks have been licensed for certain purposes by Allianz Life Insurance Company of North America
        ("Allianz") and its wholly-owned subsidiaries. Products offered by Allianz or its wholly-owned subsidiaries are not sponsored, endorsed, sold or promoted by BlackRock, and purchasers of such products do not acquire any interest in the iShares® MSCI
        Emerging Markets ETF  nor enter into any relationship of any kind with BlackRock. BlackRock makes no representations or warranties, express or implied, to the owners of any products offered by Allianz or its wholly-owned subsidiaries, or any member
        of the public regarding the advisability of purchasing a product from Allianz or its wholly-owned subsidiaries. BlackRock has no obligation or liability for any errors, omissions, interruptions or use of the iShares MSCI Emerging Markets ETF or any
        data related thereto, or with the operation, marketing, trading or sale of any products or services offered by Allianz and its wholly-owned subsidiaries.]

    

    

    

      
        
          S40877-IAI-01                                                                           [Admin Tracking Identifier]

           

            

           

            

           

            

           

            

          

            

            

            

            

            

            

        

        
          


        
          

          

        

      

      

        

        

        	
                Index Options Contract Schedule Addendum

              


        

        

        Owner: [John Doe] Contract Number: [??687456]

        Owner’s Age Issue Date: [04/15/10]

        and gender: [35 Male] Annuitant: [John Doe]

        [Joint Owner: [Jane Doe]] Annuitant’s Age

        [Joint Owner’s and gender: [35 Male]

        Age and gender: [35 Female]]

        

        

        

        

        The following is replacing the applicable “Allocation Guidelines” section of the Index Options
            Contract Schedule.

        

        

        Allocation Guidelines:

        [1. Currently, you can select up to [5] of the Index Protection Strategy with Declared Protection Strategy Credit Index Options.

        2. Currently, you can select up to [5] of the Index Protection Strategy with Cap Index Options.

        3. Currently, you can select up to [5] of the Index Performance Strategy Index Options.

        4. Currently, you can select up to [5] of the Index Guard Strategy Index Options.

        5. Currently, you can select up to [5] of the Index Precision Strategy Index Options.

        6. Allocations must be made in whole percentages.]

        

        

        The following is added to your Index Options shown on your Index Options Contract Schedule.

        

        

        Index Options:

        

        

        [Part [A] Index Option Rider(s):]

        [Index Performance Strategy Index Options

        	
                Index

              	
                Buffer for all Index Years

              	
                Minimum Cap for all Index Years

              
	
                [iShares® MSCI
                    Emerging Markets ETF

              	
                [10.00]%

              	
                [3.00]%]]

              


        [Index Guard Strategy Index Options

        	
                Index

              	
                Floor for all Index Years

              	
                Minimum Cap for all Index Years

              
	
                [iShares® MSCI
                    Emerging Markets ETF

              	
                [-10.00]%

              	
                [3.00]%]]

              


        

        

        

        

        

        

        

        

        

        

        

        

        

        

        

        

        

        

        [Index Precision Strategy Index Options

        	
                Index

              	
                Buffer for all Index Years

              	
                Minimum Precision Rate for all Index Years

              
	
                [iShares® MSCI
                    Emerging Markets ETF

              	
                [10.00]%

              	
                [3.00]%]]

              


        

        

        
          
            S40877-IAI-ADD                                                                           [Admin Tracking Identifier]

          

          
            


          

        

        

        

        

        

        	
                Index Options Contract Schedule Addendum continued from the previous page

              


        

        

        [Part [B] Index Option Rider(s):]

        [Index Protection Strategy with Declared Protection Strategy

         Credit Index Options

        	
                Index

              	
                Minimum Declared Protection Strategy Credit for all Index Years

              
	
                [iShares® MSCI
                    Emerging Markets ETF

              	
                [0.50]%]]

              


        

        

        [Index Protection Strategy with Cap Index Options

        	
                Index

              	
                Minimum Cap for all Index Years

              
	
                [iShares® MSCI
                    Emerging Markets ETF

              	
                [0.50]%]]

              


        

        

        

        

        [The iShares® MSCI Emerging Markets ETF distributed by BlackRock Investments, LLC. iShares®,
            BLACKROCK®, and the corresponding logos are registered trademarks of BlackRock, Inc. and its affiliates (“BlackRock”) and are used under license. These trademarks have been licensed for certain purposes by Allianz Life Insurance Company of
            North America ("Allianz") and its wholly-owned subsidiaries. Products offered by Allianz or its wholly-owned subsidiaries are not sponsored, endorsed, sold or promoted by BlackRock, and purchasers of such products do not acquire any interest in
            the iShares® MSCI Emerging Markets ETF  nor enter into any relationship of any kind with BlackRock. BlackRock makes no representations or warranties, express or implied, to the owners of any products offered by Allianz or its wholly-owned
            subsidiaries, or any member of the public regarding the advisability of purchasing a product from Allianz or its wholly-owned subsidiaries. BlackRock has no obligation or liability for any errors, omissions, interruptions or use of the iShares
            MSCI Emerging Markets ETF or any data related thereto, or with the operation, marketing, trading or sale of any products or services offered by Allianz  and its wholly-owned subsidiaries.]

        

        

        

        

        
          S40877-IAI-ADD                                                                           [Admin Tracking Identifier]