Document:

Form of 2007 Equity Incentive Plan Restricted Stock Award Agreement for Director

 Exhibit 10.7 
 CELL THERAPEUTICS, INC. 
 2007 EQUITY INCENTIVE PLAN 

DIRECTOR RESTRICTED STOCK AWARD AGREEMENT 
 THIS DIRECTOR RESTRICTED STOCK AWARD AGREEMENT (this “Award Agreement”) is dated as of
[                , 20    ] (the “Award Date”) by and between Cell Therapeutics, Inc., a Washington
corporation (the “Company”), and [                        ] (the
“Director”). 
 W I T N E S S E T H 

WHEREAS, pursuant to the Cell Therapeutics, Inc. 2007 Equity Incentive Plan (the “Plan”), the Company hereby
grants to the Director, effective as of the date hereof, a restricted stock award (the “Award”), upon the terms and conditions set forth herein and in the Plan. 

NOW THEREFORE, in consideration of services rendered and to be rendered by the Director, and the mutual promises made herein and
the mutual benefits to be derived therefrom, the parties agree as follows: 
 1. Defined Terms. Capitalized
terms used herein and not otherwise defined herein shall have the meaning assigned to such terms in the Plan. 
 2.
Grant. Subject to the terms of this Award Agreement, the Company hereby grants to the Director an Award with respect to an aggregate of
[                    ] restricted shares of common stock of the Company (the “Restricted Shares”). 

3. Vesting; Forfeiture. 
 (a) Vesting. Subject to Sections 3(b) and (c) below, the Award shall vest and become nonforfeitable with respect to
[                ] percent of the total number of Restricted Shares subject to the Award (subject to adjustment under Section 4.3 of the Plan)
on each of [                        ]; provided that if a Change in Control occurs, any Restricted Shares
subject to the Award that are outstanding and unvested immediately prior to the Change in Control shall accelerate and become vested upon (or, to the extent necessary to give effect to the acceleration, immediately prior to) the Change in Control.

 (b) Termination Date. Notwithstanding any other provision herein, upon the date on which the Director
ceases to provide services to the Company or a Subsidiary as a member of the Board of Directors (regardless of the reason for such termination of services, whether with or without cause, voluntarily or involuntarily, or due to death or disability)
(the “Termination Date”), the Director’s Restricted Shares (and related Restricted Property as defined in Section 8 hereof), to the extent such shares have not become vested pursuant to Section 3(a) as of the
Termination Date, shall be forfeited to the Company as provided in Section 3(c) upon the Termination Date. 

(c) Forfeiture Procedures. Upon the occurrence of any forfeiture of Restricted Shares pursuant to
Section 3(b), such unvested, forfeited shares and related Restricted Property shall be automatically transferred to the Company as of the applicable forfeiture date without any 

 
other action by the Director (or the Director’s beneficiary or personal representative in the event of the Director’s death or disability, as applicable). No consideration shall be paid
by the Company with respect to such transfer. The Company may exercise its powers under Section 7(d) hereof and take any other action necessary or advisable to evidence such transfer. The Director (or the Director’s beneficiary or personal
representative in the event of the Director’s death or disability, as applicable) shall deliver any additional documents of transfer that the Company may request to confirm the transfer of such unvested, forfeited shares and related Restricted
Property to the Company. 
 4. Continuance of Service. The vesting schedule requires continued service
through each applicable vesting date as a condition to the vesting of the applicable installment of the Award and the rights and benefits under this Award Agreement. Service for only a portion of the vesting period, even if a substantial portion,
will not entitle the Director to any proportionate vesting or avoid or mitigate a termination of rights and benefits upon or following a termination of services as provided in Section 3 above. 

Nothing contained in this Award Agreement or the Plan constitutes a continued service commitment by the Company or interferes in any way
with the right of the Company or any of its Subsidiaries at any time to terminate such services, or affects the right of the Company or any of its Subsidiaries to increase or decrease the Director’s other compensation or benefits. Nothing in
this paragraph, however, is intended to adversely affect any independent contractual right of the Director without his or her consent thereto. 
 5. Dividend and Voting Rights. After the Award Date, the Director shall be entitled to cash dividends and voting rights with respect to the Restricted Shares subject to the Award even
though such shares are not vested; provided, however, that such rights shall terminate immediately as to any Restricted Shares that are forfeited pursuant to Section 3 above; and provided, further, that the Director agrees that promptly
following any such forfeiture of Restricted Shares, the Director will make a cash payment to the Company equal to the amount of any cash dividends received by the Director in respect of any such unvested, forfeited shares. To the extent the shares
are forfeited after the record date and before the payment date for a particular dividend, the Director shall, promptly after the dividend is paid, make a cash payment to the Company equal to the amount of any such cash dividend received by the
Director in respect of such forfeited shares. 
 6. Restrictions on Transfer. Prior to the time that they
have become vested pursuant to Section 3 hereof, neither the Restricted Shares, nor any interest therein, amount payable in respect thereof, or Restricted Property (as defined in Section 8 hereof) may be sold, assigned, transferred,
pledged or otherwise disposed of, alienated or encumbered, either voluntarily or involuntarily. The transfer restrictions in the preceding sentence shall not apply to (a) transfers to the Company, or (b) transfers by will or the laws of
descent and distribution. 
 7. Stock Certificates. 

(a) Book Entry Form. The Company shall issue the Restricted Shares subject to the Award either: (a) in
certificate form as provided in Section 7(b) below; or (b) in book entry 

 
form, registered in the name of the Director with notations regarding the applicable restrictions on transfer imposed under this Award Agreement. 

(b) Certificates to be Held by Company; Legend. Any certificates representing the Restricted Shares that may be
delivered to the Director by the Company prior to vesting shall be redelivered to the Company to be held by the Company until the restrictions on such shares shall have lapsed and the shares shall thereby have become vested or the shares represented
thereby have been forfeited hereunder. Such certificates shall bear the following legend and any other legends the Company may determine to be necessary or advisable to comply with all applicable laws, rules, and regulations: 

“The ownership of this certificate and the shares of stock evidenced hereby and any interest therein are subject to substantial
restrictions on transfer under an Agreement entered into between the registered owner and Cell Therapeutics, Inc. A copy of such Agreement is on file in the office of the Secretary of Cell Therapeutics, Inc.” 

(c) Delivery of Certificates Upon Vesting. Promptly after the vesting of any shares of Restricted Stock pursuant to
Section 3 hereof and the satisfaction of any and all related tax withholding obligations, the Company shall, as applicable, either remove the notations on any Restricted Shares issued in book entry form which have vested or deliver to the
Director a certificate or certificates evidencing the number of Restricted Shares which have vested. The Director (or the beneficiary or personal representative of the Director in the event of the Director’s death or disability, as the case may
be) shall deliver to the Company any representations or other documents or assurances as the Company or its counsel may determine to be necessary or advisable in order to ensure compliance with all applicable laws, rules, and regulations with
respect to the grant of the Award and the delivery of Shares in respect thereof. The Shares so delivered shall no longer be Restricted Shares hereunder. 
 (d) Stock Power; Power of Attorney. Concurrently with the execution and delivery of this Award Agreement, the Director shall deliver to the Company an executed stock power in the form attached
hereto as Exhibit A, in blank, with respect to the Restricted Shares. The Company shall not deliver any share certificates in accordance with this Award Agreement unless and until the Company shall have received such stock power executed by
the Director. The Director, by acceptance of the Award, shall be deemed to appoint, and does so appoint by execution of this Award Agreement, the Company and each of its authorized representatives as the Director’s attorney(s)-in-fact to effect
any transfer of unvested forfeited shares (or shares otherwise reacquired by the Company hereunder) to the Company as may be required pursuant to the Plan or this Award Agreement and to execute such documents as the Company or such representatives
deem necessary or advisable in connection with any such transfer. 
 8. Adjustments upon Specified Events.
Upon the occurrence of certain events relating to the Company’s stock contemplated by Section 4.3 of the Plan, the Committee shall make adjustments in accordance with such section in the number and kind of securities that may become vested
under the Award. If any adjustment is made under Section 4.3 of the Plan and the Restricted Shares are not fully vested upon such event or prior thereto, the restrictions applicable to such Restricted Shares shall continue in effect with
respect to any consideration, property or 

 
other securities (the “Restricted Property” and, for the purposes of this Award Agreement, “Restricted Shares” shall include “Restricted Property”, unless the
context otherwise requires) received in respect of such Restricted Shares. Such Restricted Property shall vest at such times and in such proportion as the Restricted Shares to which the Restricted Property is attributable vest, or would have vested
pursuant to the terms hereof if such Restricted Shares had remained outstanding. To the extent that the Restricted Property includes any cash (other than regular cash dividends), such cash shall be invested, pursuant to policies established by the
Committee, in interest bearing, FDIC-insured (subject to applicable insurance limits) deposits of a depository institution selected by the Committee, the earnings on which shall be added to and become a part of the Restricted Property. 

9. Notices. Any notice to be given under the terms of this Award Agreement shall be in writing and addressed to the
Company at its principal office to the attention of the Secretary, and to the Director at the Director’s last address reflected on the Company’s payroll records. Any notice shall be delivered in person or shall be enclosed in a properly
sealed envelope, addressed as aforesaid, registered or certified, and deposited (postage and registry or certification fee prepaid) in a post office or branch post office regularly maintained by the United States Government. Any such notice shall be
given only when received, but if the Director is no longer a member of the Board of Directors, shall be deemed to have been duly given five business days after the date mailed in accordance with the foregoing provisions of this Section 9.

 10. Plan. The Award and all rights of the Director under this Award Agreement are subject to the terms
and conditions of the provisions of the Plan, incorporated herein by reference. The Director agrees to be bound by the terms of the Plan and this Award Agreement. The Director acknowledges having read and understanding the Plan, the Prospectus for
the Plan, and this Award Agreement. Unless otherwise expressly provided in other sections of this Award Agreement, provisions of the Plan that confer discretionary authority on the Board or the Committee do not (and shall not be deemed to) create
any rights in the Director unless such rights are expressly set forth herein or are otherwise in the sole discretion of the Board or the Committee so conferred by appropriate action of the Board or the Committee under the Plan after the date
hereof. 
 11. Entire Agreement. This Award Agreement and the Plan constitute the entire agreement and
supersede all prior understandings and agreements, written or oral, of the parties hereto with respect to the subject matter hereof. The Plan may be amended pursuant to Section 10.1 of the Plan. This Award Agreement may be amended by the
Committee from time to time. Any such amendment must be in writing and signed by the Company. Any such amendment that materially and adversely affects the Director’s rights under this Award Agreement requires the consent of the Director in
order to be effective with respect to the Award. The Company may, however, unilaterally waive any provision hereof in writing to the extent such waiver does not adversely affect the interests of the Director hereunder, but no such waiver shall
operate as or be construed to be a subsequent waiver of the same provision or a waiver of any other provision hereof. 
 12.
Counterparts. This Award Agreement may be executed simultaneously in any number of counterparts, each of which shall be deemed an original but all of which together shall constitute one and the same instrument. 

 13. Section Headings. The section headings of this Award Agreement are
for convenience of reference only and shall not be deemed to alter or affect any provision hereof. 
 14. Governing
Law. This Award Agreement shall be governed by and construed and enforced in accordance with the laws of the State of Washington without regard to conflict of law principles thereunder. 

[Remainder of page intentionally left blank] 

 IN WITNESS WHEREOF, the Company has caused this Award Agreement to be executed on its
behalf by a duly authorized officer and the Director has hereunto set his or her hand as of
                            , 20    . 

 

			
	 CELL THERAPEUTICS, INC.,
 a Washington corporation

		
	By:	 	 
	[Name]	 	
	[Title]	 	
	
	DIRECTOR
	
	 
	Signature
	
	 
	Print Name

 EXHIBIT A 
 STOCK POWER 
 FOR VALUE RECEIVED and pursuant to that certain
Director Restricted Stock Award Agreement between Cell Therapeutics, Inc., a Washington corporation (the “Company”), and the individual named below (the “Individual”) dated as of
                    , 20    , the Individual, hereby sells, assigns and transfers to the Company, an
aggregate                  Shares of the Company, standing in the Individual’s name on the books of the Company and represented by stock certificate
number(s)                              to which this instrument is attached, and hereby irrevocably
constitutes and appoints
                                        
as his or her attorney in fact and agent to transfer such shares on the books of the Company, with full power of substitution in the premises. 

Dated
                        ,              

 

			
	 
	Signature
	
	 
	Print Name

 (Instruction: Please
do not fill in any blanks other than the signature line. The purpose of the assignment is to enable the Company to exercise its sale/purchase option set forth in the Director Restricted Stock Award Agreement without requiring additional signatures
on the part of the Individual.)Exhibit (4)(z)

 EXHIBIT (4)(z)
 FORM OF RIDER 
 (RIM) 

			
	
 

	 	Home Office:
 4333 Edgewood Road N.E.

Cedar Rapids, Iowa 52499

(319)355-8511

	 A Stock Company (Hereafter called the Company, we, our or us)
	 	

 RETIREMENT INCOME MAXSM RIDER 

This rider is issued as a part of the policy (contract) to which it is attached. Policy refers to the individual policy if the rider is attached to an
individual annuity or the group certificate if the rider is attached to a group annuity. 
 All provisions of the policy that do not conflict
with this rider apply to this rider. In the event of any conflict between the provisions of this rider and the provisions of the policy, the provisions of this rider shall prevail over the provisions of the policy. 

 

			
	 Rider Data Specification

	 Policy Number:
	  	12345
	 Rider Date:
	  	01/02/201
	 Growth Rate Percentage:
	  	5.00%
	 Initial Rider Fee Percentage:
	  	1.00%
	 Annuitant:
	  	John Doe
	 Annuitant’s Issue Age/Sex:
	  	35 / Male

  

 
 ARTICLE I

 You may cancel this rider before midnight of the thirtieth calendar day after you received it and no rider fees will be assessed.

 If you elect this rider, 100% of your policy value must be in one or more of the designated investment options. 

You can generally transfer between the designated investment options as permitted under your policy; however, you cannot make transfers as provided for in
the policy to a non-designated investment option while this rider is in force. If you wish to make a transfer to a non-designated investment option, this rider must be terminated, as described in Article IV, prior to making the transfer. 

DEFINITIONS: 
 Terms used that are not
defined in this rider shall have the same meaning as those in your policy. 
 Designated Investment Options 

Investment options authorized for use with this rider and identified by us as designated investment options. 

Excess Withdrawal 
 The excess of a gross
partial withdrawal over the rider withdrawal amount remaining prior to the withdrawal, if any. 
 Gross Partial Withdrawal 

The amount which will be deducted from your policy value as a result of each partial withdrawal. 

 

							
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	  	(1)                        	  	 	(Income-Single)	  

 ARTICLE I CONTINUED 
 Rider Anniversary 
 The anniversary of the rider date. 

Rider Fee 
 The fees charged for the
benefits under this rider. The fees will be charged on a rider quarterly basis by the Company. 
 Rider Monthiversary 

The same day of the month as the rider date, or the next business day if our Administrative Office or the New York Stock Exchange are closed. If a certain
date does not exist in a given month, the first day of the following month will be used. 
 Rider Quarter 

Each three-month period beginning on the rider date. 
 Rider Withdrawal Amount 
 The maximum amount that can be withdrawn from the policy each
rider year without causing an excess withdrawal under the terms of this rider and thus reducing the withdrawal base. This amount will change if the withdrawal base changes. 
 Rider Year 
 Each twelve-month period following the rider date. 

Withdrawal Base 
 The amount used to
calculate the rider withdrawal amount and the rider fee. This amount cannot be taken as a lump sum. 
 ARTICLE II 

RIDER FEE 
 The rider fee is deducted on
each rider quarter in arrears. The fee is calculated and stored at issue and at each subsequent rider quarter for the upcoming quarter. It will be deducted automatically from each investment option on a pro rata basis at the end of each rider
quarter. The initial rider fee percentage is shown on page 1, in the Rider Data Specification section. The rider fee percentage will not change during the first rider year, and will only change thereafter due to an automatic step-up. You will be
notified of any increase in the rider fee percentage. A portion of this fee will also be deducted when the rider is terminated based on the number of days that have elapsed since the previous rider quarter. 

The stored fee will be adjusted if the withdrawal base is adjusted during the rider quarter. 
 The quarterly fee is calculated as follows: 
 Multiply (1) by (2) by (3). 

 

	1)	Withdrawal Base; 

  

	2)	Rider Fee Percentage; 

  

	3)	Number of days remaining in the rider quarter divided by the number of days within the applicable rider year. 

 

							
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	  	(2)                        	  	 	(Income-Single)	  

 ARTICLE III 
 GUARANTEED LIFETIME WITHDRAWAL BENEFIT 
 Under this rider, we guarantee that you can receive
up to the rider withdrawal amount each rider year, regardless of the policy value, (first as withdrawals from your policy value and, if necessary, as payments from us) until the annuitant’s death. 

The withdrawal percentage is determined by the attained age (age at last birthday) of the annuitant at the time of the first withdrawal of any amount
from the policy value taken on or after the rider anniversary following the annuitant’s 59th birthday. Once the withdrawal percentage is established, it may only be changed by an automatic step-up. Upon automatic step-up, the withdrawal
percentage will be reset based on the attained age at the time of the automatic step-up. The withdrawal percentages are shown in the table below. 
  

			
	Attained Age	  	Withdrawal Percentage
	 0 - 58
	  	0.0%
	 59 - 64
	  	4.5%
	 65 - 74
	  	5.5%
	 75 +
	  	6.5%

 If the annuitant is not yet 59 on the
rider date, the withdrawal percentage will be zero until the rider anniversary following the annuitant’s 59th birthday. Withdrawals prior to age 59 1/2 will be subject to the 10% penalty tax. 

Withdrawals will reduce the policy value of the policy to which this rider is attached. If the policy value equals zero, you cannot make subsequent
premium payments and all other policy features, benefits and guarantees are no longer available. Also, if the policy value equals zero, you will need to request payments by selecting the amount and frequency in accordance with the policy provisions
to which this rider attaches, equal to the rider withdrawal amount. Once the payment amount and frequency are established, they cannot be changed and no additional withdrawals will be allowed. 

ISSUE AGE AND SURVIVAL 
 The benefits
under this rider depend on the annuitant being alive at the time of withdrawal and the amount of the benefit depends on the issue age of the annuitant. Proof of survival and the issue ages may be required by the Company. 

If the annuitant’s age has been misstated, this rider’s fees and benefits will be adjusted to the amounts which would have been calculated for
the correct age. However, if this rider would not have been issued had the age not been misstated, the rider is treated as if it never existed, and any fees charged for this rider would be returned. If withdrawals under the provisions of the rider
have already commenced and the misstatement caused the rider withdrawal amount to be overstated, any withdrawal in excess of the correct rider withdrawal amount will be considered an excess withdrawal and will impact the withdrawal base and rider
withdrawal amount. If overpayments occurred when the sum of the accumulated values in all the investment options was zero, the amount of that overpayment will be deducted from one or more future payments until this amount is paid in full.

 RIDER WITHDRAWAL AMOUNT 
 The
rider withdrawal amount will be equal to the greater of 1) and 2), where: 
  

	1)	is the withdrawal percentage multiplied by the withdrawal base; 

	2)	is an amount equal to the minimum required distribution amount, if any. Prior to the 1st rider anniversary, this amount is based on the initial policy value on the
rider date. After this time, the minimum required distribution is calculated based on the rules established by the IRS. The minimum required distribution may only be used if all of the following are true: 

	 	A)	the policy to which this rider is attached is a tax-qualified policy for which IRS minimum required distributions are required, 

	 	B)	the minimum required distributions do not start prior to the annuitant’s attained age 70 1/2, 

	 	C)	the minimum required distributions are based on either the Uniform Lifetime table or the Joint Life and Last Survivor Expectancy table, 

	 	D)	the minimum required distributions are based on age of the living annuitant. The minimum required distributions can not be based on the age of someone who is deceased,

	 	E)	the minimum required distributions are based only on the policy to which this rider is attached, and 

	 	F)	the minimum required distributions are only for the current rider year. Amounts carried over from past rider years are not considered. 

 

							
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	  	(3)                        	  	 	(Income-Single)	  

 ARTICLE III CONTINUED 
 If any of the above are not true, then 2) is equal to zero and it is not available as a rider withdrawal amount. 
 If you withdraw less than the rider withdrawal amount in a rider year, the unused portion cannot be carried over to the next rider year. 
 WITHDRAWAL BASE 
 The withdrawal base is used to calculate the rider withdrawal amount. On
the rider date, the initial withdrawal base is equal to the policy value (less any premium enhancements if the rider is added in the first policy year). During any rider year, the withdrawal base is increased by subsequent premium payments (not
including premium enhancements, if any), and is reduced for excess withdrawals. 
 On each rider anniversary, the withdrawal base will be set to
the greatest of: 
  

	 	1)	The current withdrawal base; 

	 	2)	The policy value on the rider anniversary; 

	 	3)	The highest policy value on a rider monthiversary for the current rider year; or 

	 	4)	The current withdrawal base immediately prior to rider anniversary processing increased by the growth rate percentage. 

Item 3) above will be zero if there have been any excess withdrawals in the current rider year. Item 4) above will be zero after the 10th rider
anniversary or if there have been any withdrawals in the current rider year. 
 AUTOMATIC STEP-UP FEATURE 

The rider receives an automatic step-up on the rider anniversary if the withdrawal base is set equal to the policy value or the highest policy value on a
rider monthiversary. This feature does not require the termination of the existing rider. This rider will continue with the same rider date and features. The rider fee and withdrawal percentages may be changed due to an automatic step-up. Beginning
with the first rider anniversary, the rider fee percentage may be increased if there is an automatic step-up, but will not increase more than 0.75% from the initial rider fee percentage shown on page 1. 

You have the right to reject an automatic step-up within 30 days following a rider anniversary, if the rider fee percentage increases. If you reject an
automatic step-up, you must notify us in a manner which is acceptable to us, however you are eligible for future automatic step-ups. Changes as a result of the automatic step-up feature will be reversed. Any increase in the rider fee or withdrawal
percentages will also be reversed. 
 WITHDRAWAL BASE ADJUSTMENTS 
 Gross partial withdrawals, taken in a rider year, less than or equal to the rider withdrawal amount will not reduce the withdrawal base. Excess withdrawals will reduce the withdrawal base by the
withdrawal base adjustment. The withdrawal base adjustment is the greater of 1) and 2), where: 
  

	1)	is the excess withdrawal amount; and 

	2)	is the result of (A multiplied by B), divided by C, where: 

  

	 	A)	is the excess withdrawal; 

	 	B)	is the withdrawal base prior to the excess withdrawal amount; and 

	 	C)	is the policy value after the rider withdrawal amount has been withdrawn, but prior to the withdrawal of the excess withdrawal amount. 

 

							
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	  	(4)                        	  	 	(Income-Single)	  

 ARTICLE IV 
 CONTINUATION 
 In the case of spousal joint owners where one spouse is the annuitant, if the
spouse who is not the annuitant dies and the surviving spouse is the sole beneficiary, the rider continues. In the case of spousal joint owners where one spouse is the annuitant, if the spouse who is the annuitant dies, this rider will terminate.

 In the case of non-spousal joint owners where an owner who is not the annuitant dies, the surviving owner (who is also the sole designated
beneficiary) may elect to receive lifetime income payments under this rider instead of receiving any benefits applicable to the policy. The lifetime income payments must begin no later than 1 year after the owner’s death and will be equal to
the rider withdrawal amount divided by the number of payments made per year. Once the payments begin, no additional premium payments will be accepted and no additional withdrawals will be paid. 

ANNUITIZATION 
 On the maximum annuity
commencement date, as described in your policy, you will have the option to receive lifetime income payments that are no less than your rider withdrawal amount each year. 
 TERMINATION 
 This rider will terminate upon the earliest of: 

 

	1)	the date the policy to which this rider is attached terminates; 

	2)	the date the policy to which this rider is attached is assigned or if the owner is changed without our approval; 

	3)	the date of the annuitant’s death; 

	4)	the date you elect to receive annuity payments under your policy; and 

	5)	the date you notify us in writing of your intention to terminate this rider (this date must be within 30 days after the fifth rider anniversary and every fifth rider
anniversary thereafter). 

 Termination of the rider will result in the loss of all benefits provided by the rider. 

 

			
	Signed for us at our home office.
	
	
 

	 	

	 SECRETARY
	 	PRESIDENT

  

							
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	  	(5)                        	  	 	(Income-Single)	  

			
	
 

	 	Home Office:
 4333 Edgewood Road N.E.

Cedar Rapids, Iowa 52499

(319)355-8511

	 A Stock Company (Hereafter called the Company, we, our or us)
	 	

 RETIREMENT INCOME MAXSM RIDER 

This rider is issued as a part of the policy (contract) to which it is attached. Policy refers to the individual policy if the rider is attached to an
individual annuity or the group certificate if the rider is attached to a group annuity. 
 All provisions of the policy that do not conflict
with this rider apply to this rider. In the event of any conflict between the provisions of this rider and the provisions of the policy, the provisions of this rider shall prevail over the provisions of the policy. 

 

			
	 Rider Data Specification

	 Policy Number:
	  	12345
	 Rider Date:
	  	01/02/2011
	 Growth Rate Percentage:
	  	5.00%
	 Initial Rider Fee Percentage:
	  	1.00%
	 Annuitant:
	  	John Doe
	 Annuitant’s Issue Age/Sex:
	  	35 / Male
	 Annuitant’s Spouse:
	  	Jane Doe
	 Annuitant’s Spouse’s Issue Age/Sex:
	  	35 / Female

  

 
 ARTICLE I

 You may cancel this rider before midnight of the thirtieth calendar day after you received it and no rider fees will be assessed.

 If you elect this rider, 100% of your policy value must be in one or more of the designated investment options. 

You can generally transfer between the designated investment options as permitted under your policy; however, you cannot make transfers as provided for in
the policy to a non-designated investment option while this rider is in force. If you wish to make a transfer to a non-designated investment option, this rider must be terminated, as described in Article IV, prior to making the transfer. 

The annuitant’s spouse as of the rider date is hereafter referred to as the annuitant’s spouse. As it pertains to the benefits of this rider,
the annuitant’s spouse cannot be changed. The annuitant’s spouse must be the sole primary beneficiary and/or a joint owner. The only living owners allowed on the policy to which this rider is attached are the annuitant and the
annuitant’s spouse. 
 DEFINITIONS: 
 Terms used that are not defined in this rider shall have the same meaning as those in your policy. 

Designated Investment Options 

Investment options authorized for use with this rider and identified by us as designated investment options. 

Excess Withdrawal 
 The excess of a gross
partial withdrawal over the rider withdrawal amount remaining prior to the withdrawal, if any. 
  

							
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	  	(1)                        	  	 	(Income-Joint)	  

 ARTICLE I CONTINUED 
 Gross Partial Withdrawal 
 The amount which will be deducted from your policy value as a
result of each partial withdrawal. 
 Rider Anniversary 
 The anniversary of the rider date. 
 Rider Fee 

The fees charged for the benefits under this rider. The fees will be charged on a rider quarterly basis by the Company. 

Rider Monthiversary 
 The same day of the
month as the rider date, or the next business day if our Administrative Office or the New York Stock Exchange are closed. If a certain date does not exist in a given month, the first day of the following month will be used. 

Rider Quarter 
 Each three-month period
beginning on the rider date. 
 Rider Withdrawal Amount 
 The maximum amount that can be withdrawn from the policy each rider year without causing an excess withdrawal under the terms of this rider and thus reducing the withdrawal base. This amount will change
if the withdrawal base changes. 
 Rider Year 
 Each twelve-month period following the rider date. 
 Withdrawal Base 

The amount used to calculate the rider withdrawal amount and the rider fee. This amount cannot be taken as a lump sum. 

ARTICLE II 
 RIDER FEE

 The rider fee is deducted on each rider quarter in arrears. The fee is calculated and stored at issue and at each subsequent rider quarter
for the upcoming quarter. It will be deducted automatically from each investment option on a pro rata basis at the end of each rider quarter. The initial rider fee percentage is shown on page 1, in the Rider Data Specification section. The rider fee
percentage will not change during the first rider year, and will only change thereafter due to an automatic step-up. You will be notified of any increase in the rider fee percentage. A portion of this fee will also be deducted when the rider is
terminated based on the number of days that have elapsed since the previous rider quarter. 
 The stored fee will be adjusted if the withdrawal
base is adjusted during the rider quarter. 
 The quarterly fee is calculated as follows: 

Multiply (1) by (2) by (3). 
  

	1)	Withdrawal Base; 

  

	2)	Rider Fee Percentage; 

  

	3)	Number of days remaining in the rider quarter divided by the number of days within the applicable rider year. 

 

							
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	  	(2)                        	  	 	(Income-Joint)	  

 ARTICLE III 
 GUARANTEED LIFETIME WITHDRAWAL BENEFIT 
 Under this rider, we guarantee that you can receive
up to the rider withdrawal amount each rider year, regardless of the policy value, (first as withdrawals from your policy value and, if necessary, as payments from us) until the annuitant’s or the annuitant’s spouse’s death, whichever
is later. 
 The withdrawal percentage is determined by the attained age (age at last birthday) of the younger of the living spouses at the time
of the first withdrawal of any amount from the policy value taken on or after the rider anniversary following the younger of the living spouse’s 59th birthday. Once the withdrawal percentage is established, it may only be changed by an
automatic step-up. Upon automatic step-up, the withdrawal percentage will be reset based on the attained age of the younger of the living spouses at the time of the automatic step-up. The withdrawal percentages are shown in the table below.

  

			
	Attained Age	  	Withdrawal Percentage
	 0 - 58
	  	0.0%
	 59 - 64
	  	4.1%
	 65 - 74
	  	5.1%
	 75 +
	  	6.1%

 If the younger of the annuitant and
the annuitant’s spouse is not yet 59 on the rider date, the withdrawal percentage will be zero until the rider anniversary following the younger of the living spouse’s 59th birthday. Withdrawals prior to age 59 1/2 will be subject to the
10% penalty tax. 
 Withdrawals will reduce the policy value of the policy to which this rider is attached. If the policy value equals zero, you
cannot make subsequent premium payments and all other policy features, benefits and guarantees are no longer available. Also, if the policy value equals zero, you will need to request payments by selecting the amount and frequency in accordance with
the policy provisions to which this rider attaches, equal to the rider withdrawal amount. Once the payment amount and frequency are established, they cannot be changed and no additional withdrawals will be allowed. 

ISSUE AGE AND SURVIVAL 
 The benefits
under this rider depend on the annuitant or annuitant’s spouse being alive at the time of withdrawal and the amount of the benefit depends on the issue age of the annuitant and annuitant’s spouse. Proof of survival and the issue ages may
be required by the Company. 
 If the younger of the spouses’ ages has been misstated, this rider’s fees and benefits will be adjusted
to the amounts which would have been calculated for the correct age. However, if this rider would not have been issued had the age not been misstated, the rider is treated as if it never existed, and any fees charged for this rider would be
returned. If withdrawals under the provisions of the rider have already commenced and the misstatement caused the rider withdrawal amount to be overstated, any withdrawal in excess of the correct rider withdrawal amount will be considered an excess
withdrawal and will impact the withdrawal base and rider withdrawal amount. If overpayments occurred when the sum of the accumulated values in all the investment options was zero, the amount of that overpayment will be deducted from one or more
future payments until this amount is paid in full. 
 RIDER WITHDRAWAL AMOUNT 
 The rider withdrawal amount will be equal to the greater of 1) and 2), where: 
  

	1)	is the withdrawal percentage multiplied by the withdrawal base; 

	2)	is an amount equal to the minimum required distribution amount, if any. Prior to the 1st rider anniversary, this amount is based on the initial policy value on the
rider date. After this time, the minimum required distribution is calculated based on the rules established by the IRS. The minimum required distribution may only be used if all of the following are true: 

	 	A)	the policy to which this rider is attached is a tax-qualified policy for which IRS minimum required distributions are required, 

	 	B)	the minimum required distributions do not start prior to the annuitant’s attained age 70 1/2, 

	 	C)	the minimum required distributions are based on either the Uniform Lifetime table or the Joint Life and Last Survivor Expectancy table, 

 

							
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 ARTICLE III CONTINUED 

 

	 	D)	the minimum required distributions are based on age of the living annuitant or the annuitant’s spouse if the annuitant is deceased. The minimum required
distributions can not be based on the age of someone who is deceased, 

	 	E)	the minimum required distributions are based only on the policy to which this rider is attached, and 

	 	F)	the minimum required distributions are only for the current rider year. Amounts carried over from past rider years are not considered. 

If any of the above are not true, then 2) is equal to zero and it is not available as a rider withdrawal amount. 

If you withdraw less than the rider withdrawal amount in a rider year, the unused portion cannot be carried over to the next rider year. 

WITHDRAWAL BASE 
 The withdrawal base is
used to calculate the rider withdrawal amount. On the rider date, the initial withdrawal base is equal to the policy value (less any premium enhancements if the rider is added in the first policy year). During any rider year, the withdrawal base is
increased by subsequent premium payments (not including premium enhancements, if any), and is reduced for excess withdrawals. 
 On each rider
anniversary, the withdrawal base will be set to the greatest of: 
  

	 	1)	The current withdrawal base; 

	 	2)	The policy value on the rider anniversary; 

	 	3)	The highest policy value on a rider monthiversary for the current rider year; or 

	 	4)	The current withdrawal base immediately prior to rider anniversary processing increased by the growth rate percentage. 

Item 3) above will be zero if there have been any excess withdrawals in the current rider year. Item 4) above will be zero after the 10th rider
anniversary or if there have been any withdrawals in the current rider year. 
 AUTOMATIC STEP-UP FEATURE 

The rider receives an automatic step-up on the rider anniversary if the withdrawal base is set equal to the policy value or the highest policy value on a
rider monthiversary. This feature does not require the termination of the existing rider. This rider will continue with the same rider date and features. The rider fee and withdrawal percentages may be changed due to an automatic step-up. Beginning
with the first rider anniversary, the rider fee percentage may be increased if there is an automatic step-up, but will not increase more than 0.75% from the initial rider fee percentage shown on page 1. 

You have the right to reject an automatic step-up within 30 days following a rider anniversary, if the rider fee percentage increases. If you reject an
automatic step-up, you must notify us in a manner which is acceptable to us, however you are eligible for future automatic step-ups. Changes as a result of the automatic step-up feature will be reversed. Any increase in the rider fee or withdrawal
percentages will also be reversed. 
 WITHDRAWAL BASE ADJUSTMENTS 
 Gross partial withdrawals, taken in a rider year, less than or equal to the rider withdrawal amount will not reduce the withdrawal base. Excess withdrawals will reduce the withdrawal base by the
withdrawal base adjustment. The withdrawal base adjustment is the greater of 1) and 2), where: 
  

	1)	is the excess withdrawal amount; and 

	2)	is the result of (A multiplied by B), divided by C, where: 

  

	 	A)	is the excess withdrawal; 

	 	B)	is the withdrawal base prior to the excess withdrawal amount; and 

	 	C)	is the policy value after the rider withdrawal amount has been withdrawn, but prior to the withdrawal of the excess withdrawal amount. 

 

							
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 ARTICLE IV 
 CONTINUATION 
 In the case of spousal joint owners where one spouse is the annuitant, if the
spouse who is not the annuitant dies and the surviving spouse is the sole beneficiary, the rider continues. In the case of spousal joint owners where one spouse is the annuitant, if the spouse who is the annuitant dies and the surviving spouse is
the sole beneficiary, the rider continues if the policy to which this rider is attached is continued until the death of the surviving spouse. 

ANNUITIZATION 
 On the maximum annuity
commencement date, as described in your policy, you will have the option to receive lifetime income payments that are no less than your rider withdrawal amount each year. 
 TERMINATION 
 This rider will terminate upon the earliest of: 

 

	1)	the date the policy to which this rider is attached terminates; 

	2)	the date the policy to which this rider is attached is assigned or if the owner is changed without our approval; 

	3)	the later of the annuitant’s or annuitant’s spouse’s death; 

	4)	the date you elect to receive annuity payments under your policy; and 

	5)	the date you notify us in writing of your intention to terminate this rider (this date must be within 30 days after the fifth rider anniversary and every fifth rider
anniversary thereafter). 

 Termination of the rider will result in the loss of all benefits provided by the rider. 

 

			
	Signed for us at our home office.
	
	
 

	 	

	 SECRETARY
	 	PRESIDENT

  

							
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