Document:

<Page>
                       PLEASE READ THIS CONTRACT CAREFULLY

Annuity benefit payments and other values provided by this contract, when based
on the investment performance of the Variable Account, may increase or decrease
and are not guaranteed as to fixed dollar amount. Please refer to the Value of
the Variable Account section for additional information.

VALUES REMOVED FROM A GUARANTEE PERIOD ACCOUNT PRIOR TO THE END OF ITS GUARANTEE
PERIOD MAY BE SUBJECT TO A MARKET VALUE ADJUSTMENT THAT MAY INCREASE OR DECREASE
THE VALUES. A NEGATIVE MARKET VALUE ADJUSTMENT WILL NEVER BE APPLIED TO THE
DEATH BENEFIT. A POSITIVE MARKET VALUE ADJUSTMENT, IF APPLICABLE, WILL BE ADDED
TO THE DEATH BENEFIT WHEN THE BENEFIT PAID IS THE CONTRACT'S ACCUMULATED VALUE.
A TRANSFER, WITHDRAWAL OR SURRENDER FROM A GUARANTEE PERIOD ACCOUNT AFTER THE
EXPIRATION OF ITS GUARANTEE PERIOD WILL NOT BE SUBJECT TO A MARKET VALUE
ADJUSTMENT. PLEASE REFER TO THE MARKET VALUE ADJUSTMENT SECTION FOR ADDITIONAL
INFORMATION.

                            RIGHT TO EXAMINE CONTRACT

FOR NON-INDIVIDUAL RETIREMENT ANNUITIES (IRAs): The Owner may cancel this
contract by returning it to the Company or one of its authorized representatives
within ten days (or sixty days if this contract replaces an existing contract)
after receipt. If returned, the Company will refund an amount equal to the
Accumulated Value, after application of the Market Value Adjustment, plus any
fees or other charges imposed.

FOR IRAs: The Owner may cancel this contract by returning it to the Company or
one of its authorized representatives within ten days (or sixty days if this
contract replaces an existing contract) after receipt. If returned, the Company
will refund gross payments. In a replacement situation, if the contract is
returned after ten days but prior to sixty days after receipt, the Company will
refund an amount equal to the Accumulated Value, after application of any Market
Value Adjustment, plus any fees or other charges imposed.

                FIRST ALLMERICA FINANCIAL LIFE INSURANCE COMPANY

Home Office:               Worcester, Massachusetts
Principal Office:          440 Lincoln Street, Worcester, Massachusetts 01653

This contract is a legal contract between First Allmerica Financial Life
Insurance Company (the Company) and the Owner and is issued in consideration of
the Initial Payment shown on the Specifications page. Additional Payments are
permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account
or Guarantee Period Accounts. While this contract is in effect, the Company
agrees to pay annuity benefit payments beginning on the Annuity Date or to pay a
Death Benefit to the Beneficiary if an Owner dies prior to the Annuity Date.

Sub-Account Charges: Mortality and Expense Risk Charge of 1.60%; and
Administrative Charge of .15%; both charges on an annual basis of the daily
value of the Sub-Account assets; if a rider was selected, additional charges may
apply. See Specifications Page for further information.

A Monthly Variable Annuity Benefit Payment will not decrease if the annual
performance of the applicable Sub-Account(s) is 4.75% (with a 3% Assumed
Investment Return).

   /s/ John F. O'Brien                            /s/ Charles F. Cronin
        President                                        Secretary

  Flexible Payment Deferred Variable, Fixed and Market Value Adjusted Annuity
              Annuity Benefit Payments Payable on the Annuity Date
    Death Benefit Payable to Beneficiary if Owner Dies prior to Annuity Date
                                Non-Participating

Form A3037-02NY                        1                                   NYLS1
<Page>
                                TABLE OF CONTENTS

SPECIFICATONS ...............................................    3

DEFINITIONS .................................................    9

OWNER, ANNUITANT AND BENEFICIARY ............................   12

THE ACCUMULATION PHASE

         PAYMENTS ...........................................   14

         VALUES .............................................   14

         TRANSFER ...........................................   16

         WITHDRAWAL AND SURRENDER ...........................   16

         DEATH BENEFIT ......................................   20

THE PAYOUT PHASE

         ANNUITY BENEFIT ....................................   22

         TRANSFER ...........................................   24

         WITHDRAWAL .........................................   24

         PRESENT VALUE OF ANNUITY BENEFIT PAYMENTS ..........   25

         DEATH OF THE ANNUITANT .............................   25

         ANNUITY BENEFIT PAYMENT OPTIONS ....................   26

         ANNUITY LIFE GUARANTEE OPTIONS .....................   26

         ANNUITY OPTION RATE TABLES .........................   26

GENERAL PROVISIONS ..........................................   30

Form A3037-02NY                        2                                   NYLS1
<Page>
                                 SPECIFICATIONS
                        (TO BE ISSUED ON THE ISSUE DATE)

<Table>
<S>                        <C>              <C>                                         <C>
Contract Type:             Non-Qualified    Contract Number:                            zz00600000
Issue Date:                01/01/02         Annuity Date:                               01/01/2040
                                            (Must be at least 30 days after issue date)

Owner:                     John Doe         Owner Date of Birth:                        01/01/1950
Joint Owner:               Jack Doe         Joint Owner Date of Birth:                  01/01/1950

Annuitant:                 John Doe         Annuitant Date of Birth:                    01/01/1950
Joint Annuitant:           Jack Doe         Joint Annuitant Date of Birth:              01/01/1950

Annuitant Sex:             Male             Beneficiary(ies):
Joint Annuitant Sex:       Male             Primary:                                    Surviving Joint Owner, if any
                                            1st Contingent:                             Mary Doe
                                            2nd Contingent:                             Sue Doe

Minimum Fixed Account                       Minimum Additional Payment
Guaranteed Interest Rate:  3%               Amount:                                     $50.00

Guarantee Period Account                    Guarantee Period Account
Minimum Interest Rate:     3%               Minimum Allocation Amount:                  $1,000.00

Minimum Withdrawal                          Maximum Alternative Annuity Date:           01/01/2040
Amount:                    $100.00          (Must be at least 30 days after issue date)

Minimum Annuity
Benefit Payment:           $20.00
</Table>

<Table>
<Caption>
Surrender Charge Table:
                                    YEARS FROM                 SURRENDER CHARGE AS A
                                    DATE OF PAYMENT            PERCENT OF THE PAYMENTS
                                    TO DATE OF WITHDRAWAL      WITHDRAWN
                                    <S>                                 <C>
                                    Less Than:       1                  7%
                                                     2                  6%
                                                     3                  4%
                                            Thereafter                  0%
</Table>

Withdrawal Without Surrender Charge Percentage: 10% of Gross Payment Base
(reduced by any prior Withdrawal Without Surrender Charge in the same calendar
year)
Mortality and Expense Risk Charge: 1.60% on an annual basis of the daily value
of the Sub-Account assets.
Administrative Charge: .15% on an annual basis of the daily value of the
Sub-Account assets.
Contract Fee: $30, if the Accumulated Value is less than $75,000.00. Waived for
401(k)s.
Principal Office: 440 Lincoln Street, Worcester, Massachusetts 01653
[(1-800-782-8380)]

Form A8037-02NY                        3                                   NYLS2
<Page>
                                 SPECIFICATIONS
                        (TO BE ISSUED ON THE ISSUE DATE)
<Table>
<S>               <C>                                <C>                <C>
Owner:            John Doe                           Contract Number:   zzz0000000

Joint Owner:      Jack Doe

Initial Payment:  $10,000.00
</Table>

Payment Allocation: The Initial Payment is allocated in the following manner:

<Table>
<Caption>
         VARIABLE SUB-ACCOUNTS:
         <S>                                            <C>
         [Select Emerging Markets Fund                  Fidelity VIP Growth Portfolio
         Select International Equity Fund               Select Growth Fund
         Oppenheimer Global Securities Fund VA          Allmerica Core Equity Fund
         FT VIP Templeton Foreign Securities Fund       Allmerica Equity Index Fund
         MFS New Discovery Series                       AIM V.I. Blue Chip Fund
         AIM V.I. Aggressive Growth Fund                FT VIP Franklin Large Cap Growth Securities Fund
         FT VIP Small Cap Fund                          Alliance Growth & Income Portfolio
         Select Strategic Growth Fund                   MFS Total Return Series
         AllianceBernstein Small Cap Value Portfolio    MFS Utilities Series
         Fidelity VIP Value Strategies Portfolio        Oppenheimer Main Street Growth & Income Fund VA
         FT VIP Small Cap Value Securities Fund         Fidelity VIP Contrafund
         MFS Mid Cap Growth Series                      AIM V.I. Basic Value Fund
         Fidelity VIP III Mid Cap Portfolio             Oppenheimer Multiple Strategies Fund VA
         AIM V.I. Capital Development Fund              Fidelity Equity Income Fund
         Select Capital Appreciation Fund               AllianceBernstein Value Portfolio
         FT VIP  Mutual Shares Securities Fund          Select Growth & Income Fund
         Select Value Opportunity Fund                  Oppenheimer High Income Fund VA
         Alliance Premier Growth Portfolio              Select Investment Grade Income Fund
         Alliance Technology Portfolio                  Select Strategic Income Fund
         Oppenheimer Capital Appreciation Fund VA       Allmerica Government Bond Fund
         AIM V.I. Premier Equity Fund                   Allmerica Money Market Fund]
         Select Aggressive Growth Fund
</Table>

<Table>
<Caption>
         FIXED ACCOUNT
         <S>                                                                            <C>
         Initial Interest Rate (applies only to Initial Payment)                        [3.0%]
</Table>

Form A8037-02NY                        4                                   NYLS2
<Page>
                           SPECIFICATIONS (CONTINUED)
                        (TO BE ISSUED ON THE ISSUE DATE)

<Table>
<S>                        <C>                       <C>               <C>
Owner:                     John Doe                  Contract Number:  zz00000000

Joint Owner:               Jack Doe
</Table>

         GUARANTEE PERIOD ACCOUNTS:

<Table>
<Caption>
         GUARANTEE PERIOD                   INTEREST RATE              EXPIRATION DATE
         <S>                                       <C>                      <C>
         [2 years                                  [3.00%                   [1/01/2004
         3 years                                    3.40%                    1/01/2005
         4 years                                    3.85%                    1/01/2006
         5 years                                    4.35%                    1/01/2007
         6 years                                    4.60%                    1/01/2008
         7 years                                    4.85%                    1/01/2009
         8 years                                    5.05%                    1/01/2010
         9 years                                    5.15%                    1/01/2011
         10 years]                                  5.20%]                   1/01/2012]
</Table>

A Market Value Adjustment may apply to withdrawals or transfers from a Guarantee
Period Account prior to the expiration of the Guarantee Period. This adjustment
may increase or decrease the values removed from the Guarantee Period Account.
See the "Market Value Adjustment" section for additional information.

--------------
     100%             TOTAL OF ALL ACCOUNTS

Form A8037-02NY                        5                                   NYLS2
<Page>
                           SPECIFICATIONS (CONTINUED)
                        (TO BE ISSUED ON THE ISSUE DATE)

<Table>
<S>               <C>                                <C>                <C>
Owner:            John Doe                           Contract Number:   zzz0000000

Joint Owner:      Jack Doe
</Table>

--------------------------------------------------------------------------------
APPLICABLE RIDER(S) AND/OR ENDORSEMENT(S):

[Annual Ratchet Enhanced Death Benefit Rider]

         [See Rider for Benefit and Charge]

[15% Breakthrough Enhanced Death Benefit Rider]

         [See Rider for Benefit and Charge]

[Enhanced Automatic Transfers (Dollar Cost Averaging) Program Endorsement]

[Unisex Contract Endorsement]

[403(b) Tax Sheltered Annuity Endorsement]

[Individual Retirement Annuity Plan Endorsement]

[Roth Individual Retirement Annuity Plan Endorsement]

Form A8037-02NY                        6                                   NYLS2
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Form A8037-02NY                        7                                   NYLS2
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                       THIS PAGE INTENTIONALLY LEFT BLANK

Form A8037-02NY                        8                                   NYLS2
<Page>
                                   DEFINITIONS

Accumulated                         Value The aggregate value of all accounts in
                                    this contract before the Annuity Date. As
                                    long as the Accumulated Value is greater
                                    than zero, the contract will stay in effect.

Accumulation Unit                   A measure used to calculate the value of a
                                    Sub-Account before annuity benefit payments
                                    begin.

Annuitant                           On and after the Annuity Date, the person
                                    upon whose continuation of life annuity
                                    benefit payments involving life contingency
                                    depend. Joint Annuitants are permitted and
                                    unless otherwise indicated, any reference to
                                    Annuitant shall include Joint Annuitants.

Annuity Date                        The date annuity benefit payments begin. The
                                    Annuity Date is shown on the Specifications
                                    page. The Annuity Date is based on the age
                                    of the oldest Owner. If there is a
                                    non-natural Owner, the Annuity Date is based
                                    upon the age of the oldest Annuitant. The
                                    Annuity Date can be changed to the maximum
                                    alternative Annuity Date (see Specifications
                                    page), which can be no later than the later
                                    of the oldest Owner's age ninety or ten
                                    years after the Issue Date.

Annuity Unit                        A measure used to calculate annuity benefit
                                    payments under a variable annuity option.

Beneficiary                         The person, persons or entity entitled to
                                    the Death Benefit prior to the Annuity Date
                                    or any annuity benefit payments upon the
                                    death of the Owner on or after the Annuity
                                    Date.

Company                             First Allmerica Financial Life Insurance
                                    Company.

Contract Year                       A one-year period based on the issue date or
                                    an anniversary thereof.

Effective Valuation Date            The Valuation Date on or immediately
                                    following the day a Payment, request for
                                    transfer, withdrawal or surrender, or Proof
                                    of Death is received at the Principal
                                    Office.

Fixed Account                       The part of the Company's General Account to
                                    which all or a portion of a Payment or
                                    transfer may be allocated.

Fund                                Each separate investment company, investment
                                    series or portfolio eligible for investment
                                    by a Sub-Account of the Variable Account.

General Account                     All assets of the Company that are not
                                    allocated to a Separate Account.

Gross Payment Base                  Total gross payments made to the contract
                                    reduced by withdrawals which exceed the
                                    Withdrawal Without Surrender Charge amount.

Guarantee Period                    The number of years that a Guaranteed
                                    Interest Rate may be credited to a Guarantee
                                    Period Account. The Guarantee Period may
                                    range from two to ten years.

Guarantee Period Account            An account which corresponds
                                    to a Guaranteed Interest Rate for a
                                    specified Guarantee Period and is supported
                                    by assets in a Separate Account. The Owner
                                    may only invest in a Guarantee Period
                                    Account prior to the Annuity Date.

Form A3037-02NY                        9                                   NYLS1
<Page>

Guaranteed Interest Rate            The annual effective rate of interest, after
                                    daily compounding, credited to a Guarantee
                                    Period Account.

Market Value Adjustment             A positive or negative adjustment to
                                    earnings in a Guarantee Period Account
                                    assessed if any portion of a Guarantee
                                    Period Account is withdrawn or transferred
                                    prior to the end of its Guarantee Period.

Owner                               The person, persons or entity entitled to
                                    exercise the rights and privileges of
                                    ownership under this contract. Joint Owners
                                    are permitted and unless otherwise
                                    indicated, any reference to Owner shall
                                    include joint Owners.

Pro Rata                            How a Payment or withdrawal may be
                                    allocated among the accounts. A Pro Rata
                                    allocation or withdrawal will be made in the
                                    same proportion that the value of each
                                    account bears to the Accumulated Value.

Proof of Death                      The date on which both the death
                                    certificate and all necessary claim
                                    paperwork, as determined by the Company,
                                    have been received at the Principal Office.

Request                             A request or notice made by the Owner, in a
                                    manner consistent with the Company's current
                                    procedures, which is received by the
                                    Company.

Separate Account                    A segregated account established by the
                                    Company. The assets in a Separate Account
                                    are owned by the Company and are not
                                    commingled with the Company's general assets
                                    and obligations. The assets of a Separate
                                    Account are not subject to claims arising
                                    out of any other business the Company may
                                    conduct. The amount of assets held in the
                                    Separate Account will have a value at least
                                    equal to the Accumulated Value of the
                                    contracts that apply to the Separate Account
                                    and the reserves for annuities in the course
                                    of payment that vary with the experience of
                                    the Separate Account for those contracts.

State                               The state or jurisdiction in which the
                                    contract is issued.

Sub-Account                         A Variable Account subdivision that invests
                                    exclusively in shares of a corresponding
                                    Fund.

Surrender Value                     The amount payable to the Owner on
                                    full surrender equal to the Accumulated
                                    Value after application of any Market Value
                                    Adjustment and less any surrender charge and
                                    Contract Fee.

Survivor Annuity Benefit            The number of Annuity Units (under a
Percentage                          variable joint life annuitization option) or
                                    the dollar value of the annuity benefit
                                    payments (under a fixed joint life
                                    annuitization option) paid during the
                                    surviving Annuitant's life may be less than
                                    or equal to the number of Annuity Units paid
                                    when both individuals are living. The
                                    Survivor Annuity Benefit Percentage is the
                                    percentage of total Annuity Units or dollars
                                    paid in each annuity benefit during the
                                    survivor's life. For example, with a Joint
                                    and Two-thirds Survivor Option, the Survivor
                                    Annuity Benefit Percentage is 66 2/3%. This
                                    percentage is only applicable after the
                                    death of the first Annuitant.

Valuation Date                      A day the values of all units are
                                    determined. Valuation Dates occur on each
                                    day the New York Stock Exchange is open for
                                    trading, or such other dates when there is
                                    sufficient trading in a Fund's portfolio
                                    securities such that the current unit value
                                    may be materially affected.

Valuation Period                    The interval between two consecutive
                                    Valuation Dates.

Form A3037-02NY                       10                                   NYLS1
<Page>

Variable Account                    The Company's Separate Account,
                                    consisting of Sub-Accounts that invest in
                                    the underlying Funds.

Form A3037-02NY                       11                                   NYLS1
<Page>
                        OWNER, ANNUITANT AND BENEFICIARY

Owner                   When the contract is issued, the Owner will be as shown
                        on the Specifications page. The Owner may be changed in
                        accordance with the terms of this contract. Upon the
                        death of an Owner prior to the Annuity Date, a Death
                        Benefit is paid and the contract will no longer
                        continue. The Maximum Alternative Annuity Date is based
                        upon the age of the oldest Owner.

                        The Owner may exercise all rights and options granted in
                        this contract or by the Company, subject to the consent
                        of any irrevocable Beneficiary. Where there are joint
                        Owners, the consent of both is required in order to
                        exercise any ownership rights.

Assignment              Prior to the Annuity Date and prior to the death of an
                        Owner, the Owner may be changed at any time. Only the
                        Owner may assign this contract. An absolute assignment
                        will transfer ownership to the assignee. This contract
                        may also be collaterally assigned as security. The
                        limitations on ownership rights while the collateral
                        assignment is in effect are stated in the assignment.
                        Additional limitations may exist for contracts issued
                        under provisions of the Internal Revenue Code.

                        An assignment will take place only when the Company has
                        actually received a written Request at the Principal
                        Office. The Company will not be deemed to know of the
                        assignment until such time. When received, the
                        assignment will take effect as of the date it was
                        signed. The assignment will be subject to payments made
                        or actions taken by the Company before the change was
                        received.

                        The Company will not be responsible for the validity of
                        any assignment nor the extent of any assignee's
                        interest. The interests of the Beneficiary will be
                        subject to any assignment.

Annuitant               When the contract is issued, the Annuitant will be as
                        shown on the Specifications page. The Annuitant may be
                        changed in accordance with the terms of this contract.
                        Prior to the Annuity Date, an Annuitant may be replaced
                        or added unless the Owner is a non-natural person. At
                        all times there must be at least one Annuitant. If the
                        Annuitant dies and a replacement is not named, the Owner
                        will be considered to be the new Annuitant. Upon the
                        death of an Annuitant prior to the Annuity Date, a Death
                        Benefit is not paid unless the Owner is a non-natural
                        person. If an annuitant is also an Owner and dies, then
                        the Owner death benefit will apply.

                        A change of Annuitant will take place only when the
                        Company has actually received a Request indicating the
                        change at the Principal Office. The Company will not be
                        deemed to know of the change of Annuitant until such
                        time. When received, the change of Annuitant will take
                        effect as of the date it was signed. The change of
                        Annuitant will be subject to payments made or actions
                        taken by the Company before the change was received.

Form A3037-02NY                       12                                   NYLS1
<Page>

Beneficiary             The Beneficiary is as named on the Specifications page
                        unless subsequently changed. The Owner may declare any
                        Beneficiary to be revocable or irrevocable. A revocable
                        Beneficiary may be changed at any time prior to the
                        Annuity Date and before the death of an Owner or after
                        the Annuity Date and before the death of the Annuitant.
                        An irrevocable Beneficiary must consent in writing to
                        any change. Unless otherwise indicated, the Beneficiary
                        will be revocable.

                        A Beneficiary change must be made in writing on a
                        Beneficiary designation form and will be subject to the
                        rights of any assignee of record. When the Company
                        receives the form, the change will take place as of the
                        date it was signed, even if an Owner or the Annuitant
                        dies after the form is signed but prior to the Company's
                        receipt of the form. Any rights created by the change
                        will be subject to payments made or actions taken by the
                        Company before the change was received.

                        All benefits payable to the Beneficiary under this
                        contract will be divided equally among the surviving
                        Beneficiaries of the same class, unless the Owner
                        directs otherwise. If there is no surviving Beneficiary
                        in a particular class (e.g., 1st Contingent Beneficiary,
                        see Specifications page), then the benefit is divided
                        equally among the surviving Beneficiaries of the next
                        class. If there is no surviving Beneficiary, the
                        deceased Beneficiary's interest will pass to the Owner
                        or the Owner's estate. At the death of the first joint
                        Owner prior to the Annuity Date, the surviving joint
                        Owner is the sole, primary Beneficiary notwithstanding
                        that the designated Beneficiary may be different.

                        The Beneficiary can not assign, transfer, commute,
                        anticipate or encumber the proceeds or payments unless
                        given that right by the Owner.

Protection of Proceeds  To the extent allowed by law, this contract and any
                        payments made under it will be exempt from the claims of
                        creditors.

Form A3037-02NY                       13                                   NYLS1
<Page>
                        THE ACCUMULATION PHASE

                        PAYMENTS

Payments                Each Payment is equal to the gross payment applied to
                        the contract.

Initial Payment         The Initial Payment is shown on the Specifications page.

Additional Payments     Prior to the Annuity Date and before the death of an
                        Owner, the Owner may make additional Payments of at
                        least the Minimum Additional Payment Amount (see
                        Specifications page). Total Payments made may not exceed
                        $2,000,000 without the Company's consent.

Payment Allocations     Payments will be allocated in accordance with the
                        Payment Allocation, shown on the Specifications page.
                        Each subsequent Payment will be allocated in the same
                        manner unless allocation instructions accompany the
                        Payment or the Payment Allocation is changed by the
                        Owner.

                        The minimum amount that may be allocated to the
                        Guarantee Period Account is shown on the Specifications
                        page. If the Owner requests an allocation less than the
                        minimum amount, the Company will apply that amount to
                        the money market Sub-Account.

                        VALUES

Value of the Variable   The value of a Sub-Account on a Valuation Date is
Account                 determined by multiplying the Accumulation Units in that
                        Sub-Account by the Accumulation Unit Value as of the
                        Valuation Date.

                        Accumulation Units are purchased when an amount is
                        allocated to a Sub-Account. The number of Accumulation
                        Units purchased equals that amount divided by the
                        applicable Accumulation Unit Value as of the Valuation
                        Date.

Accumulation Unit       The value of a Sub-Account Accumulation Unit as of any
Values                  Valuation Date is determined by multiplying the value of
                        an Accumulation Unit for the preceding Valuation Date by
                        the Net Investment Factor for that Valuation Period.

Net Investment Factor   The Net Investment Factor measures the investment
                        performance of a Sub-Account from one Valuation Period
                        to the next. This factor is equal to 1.000000 plus the
                        result (which may be positive or negative) from dividing
                        (a) by (b) and subtracting (c) and (d) where:

                            (a)  is the investment income of a Sub-Account for
                                 the Valuation Period, including realized or
                                 unrealized capital gains and losses during the
                                 Valuation Period, adjusted for provisions made
                                 for taxes, if any;

                            (b)  is the value of that Sub-Account's assets at
                                 the beginning of the Valuation Period;

                            (c)  is the Mortality and Expense Risk Charge
                                 applicable to the current Valuation Period (see
                                 Specifications page) plus any applicable Rider
                                 charges; and

Form A3037-02NY                       14                                   NYLS1
<Page>
                            (d)  is the Administrative Charge applicable to the
                                 current Valuation Period (see Specifications
                                 page).

                        The Company assumes the risk that its actual mortality
                        and expense experience may exceed the amounts provided
                        under the contract. The Company guarantees that the
                        charge for mortality and expense risks and the
                        administrative charge will not be increased. Subject to
                        applicable State and federal laws, these charges may be
                        decreased or the method used to determine the Net
                        Investment Factor may be changed.

Value of the Fixed      Amounts allocated to the Fixed Account receive interest
Account                 at rates periodically set by the Company. The Company
                        guarantees that the initial rate of interest in effect
                        when an amount is allocated to the Fixed Account will
                        remain in effect for that amount for one year or until
                        such amount is transferred out of the Fixed Account,
                        whichever is sooner. Thereafter, the rate of interest
                        for that amount will be the Company's current interest
                        rate, but no less than the Minimum Fixed Account
                        Guaranteed Interest Rate (see Specifications page).

                        The value of the Fixed Account on any date is the sum of
                        amounts allocated to the Fixed Account plus interest
                        compounded and credited daily at the rates applicable to
                        those amounts. The value of the Fixed Account will be at
                        least equal to the minimum required by law in the State.

Value of the Guarantee  A Guarantee Period Account will be established on the
Period Accounts         date a net Payment or transfer is allocated to a
                        specific Guarantee Period. Amounts allocated to the same
                        Guarantee Period Account on the same day will be treated
                        as one Guarantee Period Account. The interest rate in
                        effect when an amount is allocated to a Guarantee Period
                        Account is guaranteed for the duration of the Guarantee
                        Period. Additional amounts allocated to Guarantee
                        Periods of the same or different durations will result
                        in additional Guarantee Period Accounts, each with its
                        own Guaranteed Interest Rate and expiration date.

                        The value of a Guarantee Period Account on any date is
                        the sum of amounts allocated to that Guarantee Period
                        Account plus interest compounded and credited daily at
                        the rate applicable to that amount.

Guaranteed Interest     The Company will periodically set Guaranteed Interest
Rates                   Rates for each available Guarantee Period. These rates
                        will be guaranteed for the duration of the respective
                        Guarantee Periods. A Guaranteed Interest Rate will never
                        be less than the Guarantee Period Account Minimum
                        Interest Rate (see Specifications page).

Renewal Guarantee       At least 15 days (but not more than 45 days) prior to
Periods                 the end of a Guarantee Period, the Company will notify
                        the Owner in writing of the expiration of that Guarantee
                        Period and of the right to reallocate and/or withdraw
                        amounts without any Market Value Adjustment during the
                        30 day period following the expiration date. Following
                        receipt of the Guarantee Period Account expiration
                        notice, the Owner may submit a written Request to
                        withdraw the monies in the account and/or to transfer
                        amounts to the Sub-Accounts, the Fixed Account and/or to
                        a new Guarantee Period Account of any duration then
                        offered by the Company. Guaranteed Interest Rates
                        corresponding to the available Guarantee Periods may be
                        higher or lower than the previous Guaranteed Interest
                        Rate. The Owner's reallocation is to be the date
                        following the Guarantee Period Account's expiration
                        date. If the Owner's reallocation/withdrawal request is
                        not received at the Principal Office by the expiration
                        date of a Guarantee Period Account, then the day
                        following the expiration date of the Guarantee Period
                        Account, the value will be automatically applied to a
                        new Guarantee Period Account with the same duration as
                        the expired Guarantee Period Account unless:

Form A3037-02NY                       15                                   NYLS1
<Page>

                            (a)  the Guarantee Period Account value is less than
                                 the Guarantee Period Account Minimum Allocation
                                 Amount (see Specifications page) on its
                                 expiration date; or

                            (b)  the Guarantee Period would extend beyond the
                                 Annuity Date or is no longer available.

                        In such cases, the Guarantee Period Account value will
                        be transferred to the money market Sub-Account. If,
                        however, a reallocation/withdrawal request for the prior
                        Guarantee Period Account is received within 30 days
                        after being automatically applied to a new Guarantee
                        Period Account, the Company will transfer and/or
                        withdraw the payment as requested without applying a
                        Market Value Adjustment.

Contract Fee            Prior to the Annuity Date on each contract Anniversary
                        and when the contract is surrendered, the Company will
                        deduct a Contract Fee (see Specifications page) Pro
                        Rata.

                        TRANSFER

                        Prior to the Annuity Date, the Owner may transfer
                        amounts among accounts by Request to the Principal
                        Office. Transfers to a Guarantee Period Account must be
                        at least equal to the Guarantee Period Account Minimum
                        Allocation Amount (see Specifications page). If the
                        Owner requests the transfer of a smaller amount to the
                        Guarantee Period Account, the Company will transfer that
                        amount to the money market Sub-Account.

                        Any transfer from a Guarantee Period Account prior to
                        the end of its Guarantee Period will be subject to a
                        Market Value Adjustment.

                        There is no charge for the first twelve transfers per
                        contract year. A transfer charge of up to $25 may be
                        imposed on each additional transfer.

                        The contract is not designed for use by individuals,
                        professional market timing organizations, or other
                        entities that do "market timing," programmed transfers,
                        frequent transfers, or transfers that are large in
                        relation to the total assets of a Fund. If there is a
                        pattern of transfers that coincides with a market timing
                        strategy and/or that is disruptive to the Funds, the
                        Company reserves the right to refuse transfers or to
                        take other action (including, but not limited to,
                        limiting additional payments) to limit the use of such
                        activities.

                        WITHDRAWAL AND SURRENDER

                        Prior to the Annuity Date, the Owner may, by Request,
                        withdraw a part of the Surrender Value or surrender the
                        contract for its Surrender Value.

                        Any withdrawal must be at least the Minimum Withdrawal
                        Amount (see Specifications page). The Request must
                        indicate the dollar amount to be withdrawn and the
                        accounts from which it is to be withdrawn. A withdrawal
                        from a Guarantee Period Account will be subject to a
                        Market Value Adjustment.

                        When surrendered, this contract terminates and the
                        Company has no further liability under it. The Surrender
                        Value will be based on the Accumulated Value on the
                        Effective Valuation Date less any surrender charge,
                        Contract fee and Market Value Adjustment, if applicable.

Form A3037-02NY                       16                                   NYLS1
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                        Amounts taken from the Variable Account will be paid
                        within 7 days of the date a Request is received. The
                        Company reserves the right to defer surrenders and
                        withdrawals of amounts in the Variable Account for up to
                        six months during any period when (1) trading on the New
                        York Stock Exchange is closed for other than weekends
                        and holidays; (2) the Securities and Exchange Commission
                        by order has permitted such a suspension; or (3) an
                        emergency exists as determined by the Securities and
                        Exchange Commission such that disposal of portfolio
                        securities or valuation of assets of the Separate
                        Account is not reasonably practicable.

                        Amounts taken from the Fixed Account or the Guarantee
                        Period Accounts will normally be paid within 7 days of
                        the date a Request is received. The Company may defer
                        payment for up to six months from the date a Request is
                        received. If deferred for 10 days or more, the amount
                        payable will be credited interest at the rate(s) then
                        being credited by the Company. However, no interest will
                        be paid if it is less than $25 or if the delay is
                        pursuant to State insurance law.

Withdrawal Without      Prior to the Annuity Date, in each calendar year, by
Surrender Charge        Request, the Owner may take withdrawals up to the
                        Withdrawal Without Surrender Charge Amount (see
                        Specifications page) as of the Effective Valuation Date.

                        The Withdrawal Without Surrender Charge will first be
                        deducted from cumulative earnings. To the extent that it
                        exceeds cumulative earnings, the excess will be
                        considered withdrawn on a last-in, first-out basis from
                        Payments not previously withdrawn.

Withdrawal With         Any amounts withdrawn or surrendered in excess of the
Surrender Charge        Withdrawal Without Surrender Charge amount may be
                        subject to a surrender charge.

                        These amounts will be taken on a first-in, first-out
                        basis from Payments not previously considered withdrawn.
                        The Company will compute applicable charges using the
                        Surrender Charge Table (see Specifications page).

Waiver of Surrender     The surrender charge will be waived if an Owner, or the
Charge                  Annuitant if the Owner is a non-natural person , is
                        "physically disabled" after the issue date and after
                        being named Owner or Annuitant and before attaining age
                        65. The Company may require proof of continuing
                        disability, and reserves the right to obtain an
                        examination by a licensed "physician" of its choice and
                        at its expense.

                        "Physically disabled" means the Owner or Annuitant has
                        been unable to engage in an occupation for remuneration
                        or profit for a period of at least 12 consecutive months
                        as a result of disease or bodily injury. "Physician"
                        means a person other than the Owner, the Annuitant or a
                        member of one of their families who is State licensed to
                        give medical care or treatment and is acting within the
                        scope of that license.

                        No additional Payments are permitted after this
                        provision becomes effective.

Market Value            A transfer, withdrawal or surrender from a Guarantee
Adjustment              Period Account after the expiration of its Guarantee
                        Period will not be subject to a Market Value Adjustment.
                        A Market Value Adjustment will apply to all other
                        transfers, withdrawals, or surrenders from a Guarantee
                        Period Account on the date of the transaction. Amounts
                        in a Guarantee Period Account that are applied under an
                        Annuity Option are treated as withdrawals and a Market
                        Value Adjustment may apply. The Market Value Adjustment
                        will be determined

Form A3037-02NY                       17                                   NYLS1
<Page>
                        by multiplying the amount taken from each Guarantee
                        Period Account by the market value factor. The market
                        value factor for each Guarantee Period Account is equal
                        to:

                                    [(1 + i)/(1 + j)](n/365) - 1

                        where:

                                i - is the Guaranteed Interest Rate expressed as
                                a decimal being credited to the current
                                Guarantee Period;

                                j - is the new Guaranteed Interest Rate,
                                expressed as a decimal, for a Guarantee Period
                                with a duration equal to the number of years
                                remaining in the current Guarantee Period,
                                rounded to the next nearest number of whole
                                years. If this rate is not available, then the
                                Company will employ a method based on the U.S.
                                Industrial BBB Bond Indices published in
                                Standard and Poor's Credit Week. These indices
                                are contained in a table titled "Treasury and
                                Corporate Bond Yields". j will be equal to the
                                index (at the time of the calculation of the
                                Market Value Adjustment) at a duration equal to
                                the number of years remaining in the initial
                                Guarantee Period, rounded to the nearest number
                                of whole years. If a duration is not available
                                in the table, an index will be calculated by
                                linearly interpolating between the next highest
                                and next lowest index in the table less 2.55%.

                                n - is the number of days remaining from the
                                Effective Valuation Date to the end of the
                                current Guarantee Period.

                        If the Guaranteed Interest Rate being credited is lower
                        than the new Guaranteed Interest Rate, the Market Value
                        Adjustment will decrease the Guarantee Period Account
                        value (negative Market Value Adjustment). Similarly, if
                        the Guaranteed Interest Rate being credited is higher
                        than the new Guaranteed Interest Rate, the Market Value
                        Adjustment will increase the Guarantee Period Account
                        value (positive Market Value Adjustment). A positive or
                        negative Market Value Adjustment will never result in a
                        change to the Guarantee Period Account Value more than
                        the interest earned in excess of the Guarantee Period
                        Account Minimum Interest Rate (see Specifications page)
                        compounded daily from the beginning of the current
                        Guarantee Period Account.

                        This calculation creates a ceiling (capped) and a floor
                        (uncapped) that limits the impact a Market Value
                        Adjustment will have when money is withdrawn,
                        transferred or surrendered prior to the expiration of
                        the Guarantee Period. Examples of this are as follows:

                                The market value factor is:
                                [(1+i)/(1+j)](n/365)-1

                        A detailed description of this information has been
                        filed with the Superintendent.

                        DEATH BENEFIT

                        At the death of an Owner prior to the Annuity Date, the
                        Company will pay to the Beneficiary a Death Benefit upon
                        receipt at the Principal Office of Proof of Death. If
                        the Owner is a non-natural person, prior to the Annuity
                        Date, a Death Benefit is paid on the death of an
                        Annuitant, upon receipt at the Principal Office of Proof
                        of Death.

Form A3037-02NY                       18                                   NYLS1
<Page>

Death Benefit           The Death Benefit will be the greater of:

                            (a) the Accumulated Value on the Effective Valuation
                                Date, increased by any positive Market Value
                                Adjustment; or

                            (b) the sum of the gross payments made under this
                                contract prior to the date of death,
                                proportionately reduced to reflect all partial
                                withdrawals.

                                For each withdrawal, the proportionate reduction
                                is calculated by multiplying the Death Benefit
                                under (b) above, immediately prior to the
                                withdrawal, by the following:

                                         Amount of the withdrawal
                         -----------------------------------------------------
                         Accumulated Value immediately prior to the withdrawal

                        For example assume:

                        - the amount of the withdrawal is $5,000
                        - the Accumulated Value immediately prior to the
                          withdrawal is $100,000
                        - the death benefit under (b) above, before the
                          withdrawal deduction, is $110,000.

                           Amount of the withdrawal       $5,000
                        -----------------------------     --------
                        Accumulated Value immediately  =  $100,000  =  5%
                           prior to the withdrawal

                        Therefore, the death benefit under (b)
                        above, after the withdrawal deduction, is
                        reduced by 5%. Thus, it would be equal to
                        $110,000 times .95 = $104,500.

Payment of the Death    Unless the Owner has specified otherwise, the Death
Benefit                 Benefit will be paid to the Beneficiary within 7 days of
                        the Effective Valuation Date. If deferred for more than
                        7 days after the Effective Valuation Date, the amount
                        payable will be credited interest at the rate(s) then
                        being credited by the Company. No surrender charge will
                        apply when the Death Benefit is paid. Alternatively, the
                        Beneficiary may, by a Request in writing, elect to:

                            (a) defer distribution of the Death Benefit for a
                                period no more than 5 years from the date of
                                death; or

                            (b) receive distributions over his/her life
                                expectancy (or over a period not extending
                                beyond such life expectancy). Distributions must
                                begin within one year from the date of death.

                        If distribution of the Death Benefit is deferred under
                        (a) or (b), any value in the Guarantee Period Accounts
                        will be transferred to the money market Sub-Account. The
                        excess, if any, of the Death Benefit over the
                        Accumulated Value will also be transferred to the money
                        market Sub-Account. The Beneficiary may, by Request,
                        effect transfers and withdrawals, but may not make
                        additional Payments. If there are multiple
                        Beneficiaries, the consent of all is required.

                        If the sole Beneficiary is the deceased Owner's spouse,
                        the Beneficiary may, by a Request in writing, continue
                        the contract and become the new Owner and Annuitant
                        subject to the following:

                            (a) any value in the Guarantee Period Accounts will
                                be transferred to the money market Sub-Account;

Form A3037-02NY                       12                                   NYLS1
<Page>

                            (b) the excess, if any, of the Death Benefit over
                                the contract's Accumulated Value will be also
                                transferred to the money market Sub-Account;

                            (c) additional Payments may be made; and

                            (d) any subsequent spouse of the new Owner, if named
                                as the Beneficiary, may not continue the
                                contract.

Form A3037-02NY                       20                                   NYLS1
<Page>
                                THE PAYOUT PHASE

                        ANNUITY BENEFIT

Annuity Options         Annuity Options are available on a fixed, variable or
                        combination fixed and variable basis. The Annuity
                        Options described below or any alternative option
                        offered by the Company may be chosen. If no option is
                        chosen, monthly benefit payments will be made under the
                        Life Annuity with 10 Years Period Certain option.

                        Fixed annuity options are funded through the General
                        Account. Variable annuity options may be funded through
                        one or more of the Sub-Accounts. Not all Sub-Accounts
                        may be made available.

Selection of Annuity    The Owner must select an Annuity Benefit Payment Option
Benefit Payments        prior to or after the issue date but before the Annuity
                        Date. Annuity benefit payments will be paid monthly or
                        at any other frequency currently offered by the Company.
                        If the first payment would be less than the Minimum
                        Annuity Benefit Payment (see Specifications page), a
                        single payment will be made instead. If a life annuity
                        option has been elected, satisfactory proof of the date
                        of birth of the Annuitant must be received at the
                        Principal Office before any payment is made. Also, if a
                        life annuity option has been elected, from time to time,
                        the Company may require satisfactory proof that the
                        Annuitant is alive. The annuity benefit payments
                        provided under this contract are not less than those
                        required by the State.

Selection or Change     The Owner must select an Annuity Date when selecting an
Of Annuity Date         Annuity Benefit Payment Option. Prior to such
                        Annuity Date, the Owner may change the Annuity Date
                        by Request. The Request must be received at the
                        Principal Office at least one month before the new
                        Annuity Date. To the extent permitted by applicable
                        laws, rules and regulations governing variable
                        annuities, the new Annuity Date must be no later than
                        the Maximum Alternative Annuity Date shown on the
                        Specifications page, which can be no later than the
                        later of the oldest Owner's age ninety or ten years
                        after the Issue Date.

Annuity Benefit Payment In the case of a variable annuity option, the Owner must
Change Frequency        select an Annuity Benefit Payment Change Frequency. This
                        is the frequency of change in the dollar value of the
                        variable annuity benefit payments. For example, if an
                        annual Annuity Benefit Payment Change Frequency is
                        chosen, the dollar value of variable annuity benefit
                        payments will remain constant within each one-year
                        period. The Owner must also select the date of the first
                        change. The date of first change must be within one
                        Change Frequency of the Annuity Date.

Assumed Investment      In the case of a variable annuity option, the Assumed
Return                  Investment Return ("AIR") is a rate used to determine
                        the initial variable annuity benefit payment and how the
                        payment will change over time in response to the
                        performance of the selected Sub-Accounts. If the actual
                        performance of any selected Sub-Account (as measured by
                        the Net Investment Factor) is equal to the AIR, the
                        annuity benefit payment attributable to that Sub-Account
                        will be constant. If the actual performance is greater
                        than the AIR, the annuity benefit payment will increase.
                        If the actual performance is less than the AIR, the
                        annuity benefit payment will decrease.

Annuity Value           The Annuity Value will be the Accumulated Value, after
                        application of any Market Value Adjustment. The Annuity
                        Value applied under a variable Annuity

Form A3037-02NY                       21                                   NYLS1
<Page>

                        Option is based on the Accumulation Unit Value on a
                        Valuation Date, uniformly applied, before the Annuity
                        Date.

                        The amount of the first annuity benefit payment under
                        all available options except period certain options will
                        depend on the age and/or sex of the Annuitant on the
                        Annuity Date and the Annuity Value applied. Period
                        certain options are based only on the duration of
                        payments and the Annuity Value.

                        The annuity benefit payments under the contract will be
                        equal to or greater than the annuity benefit payments
                        under a single premium immediate annuity issued by the
                        Company at the time to the same class of annuitants
                        where the initial payment is equal to the greater of:

                            (a) the Surrender Value of the contract; or

                            (b) 95% of the Accumulated Value of the contract.

                        In addition, the fixed annuity benefit payments will be
                        equal to or greater than the annuity benefit payments
                        produced when the Accumulated Value is applied to the
                        guaranteed rates.

Annuity Unit Values     A Sub-Account Annuity Unit Value on any Valuation Date
                        is equal to its value on the preceding Valuation Date
                        multiplied by the product of:

                            (a) a discount factor equivalent to the Assumed
                                Investment Return, calculated on a daily basis;
                                and

                            (b) the Net Investment Factor of the Sub-Account
                                funding the annuity benefit payments for the
                                applicable Valuation Period.

                        The value of an Annuity Unit as of any date other than a
                        Valuation Date is equal to its value as of the preceding
                        Valuation Date.

                        Each variable annuity benefit payment is equal to the
                        number of Annuity Units multiplied by the applicable
                        value of an Annuity Unit, except that under a Joint and
                        Survivor Option, after the first death, the number of
                        units in each payment is equal to the total number of
                        units multiplied by the Survivor Annuity Benefit
                        Percentage.

                        Variable annuity benefit payments will increase or
                        decrease with the value of the Annuity Units as of the
                        date of the first payment of each Annuity Benefit
                        Payment Change Frequency. The Company guarantees that
                        the amount of each variable annuity benefit payment will
                        not be affected by changes in mortality and expense
                        experience.

Number of Annuity Units For each Sub-Account the number of Annuity Units
                        determining the benefit payable is equal to the amount
                        of the first annuity benefit payment divided by the
                        value of the Annuity Unit as of the Valuation Date used
                        to calculate the amount of the first payment. Once
                        annuity benefit payments begin, the number of Annuity
                        Units will not change unless a split, a withdrawal or a
                        transfer is made.

Payment of Annuity      Annuity Benefit Payments are paid to the Owner. By
Benefit Payments        Request in writing, the Owner may direct that payments
                        are made to another person, persons or entity. If an
                        Owner, who is not also an Annuitant, dies on or after
                        the Annuity Date, the following occurs:

Form A3037-02NY                       22                                   NYLS1
<Page>

                            (a) If the deceased Owner was the sole Owner, then
                                the remaining annuity benefit payments will be
                                payable to the Beneficiary in accordance with
                                the terms of the Annuity Option selected. Upon
                                the death of a sole Owner, the Beneficiary
                                becomes the Owner of the contract.

                            (b) If the contract has joint Owners, then the
                                remaining annuity benefit payments will be
                                payable to the surviving joint Owner in
                                accordance with the terms of the Annuity Option
                                selected. Upon the death of the surviving joint
                                Owner, the Beneficiary becomes the Owner of the
                                contract.

                        TRANSFER

                        After the Annuity Date and prior to the death of the
                        Annuitant, the Owner may transfer among Sub-accounts by
                        Request to the Principal Office.

                        Transfers may increase or decrease the number of Annuity
                        Units in each subsequent payment.

                        There is no charge for the first twelve transfers per
                        contract year. A transfer charge of up to $25 may be
                        imposed on each additional transfer.

                        The contract is not designed for use by individuals,
                        professional market timing organizations, or other
                        entities that do "market timing," programmed transfers,
                        frequent transfers, or transfers that are large in
                        relation to the total assets of a Fund. If there is a
                        pattern of transfers that coincides with a market timing
                        strategy and/or that is disruptive to the Funds, the
                        Company reserves the right to refuse transfers or to
                        take other action to limit the use of such activities.

                        WITHDRAWAL

                        Present Value Withdrawals may be made in accordance with
                        this provision after the Annuity Date and prior to the
                        death of the Annuitant. Withdrawals are available if one
                        of the following Annuity Options is selected:

                            (a) Period Certain Annuity or

                            (b) Life with Period Certain Annuity.

                        Over the life of the contract, the Owner may request
                        withdrawals that represent a percentage of the Present
                        Value of those remaining guaranteed annuity benefit
                        payments. "Guaranteed annuity benefit payments" refers
                        to the non-life contingent annuity benefit payments.
                        Each year a withdrawal is taken under this provision,
                        the Company records the percentage withdrawn. Each
                        withdrawal proportionately reduces future annuity
                        benefit payments. (See proportionate reduction
                        calculation below.) The total percentage withdrawn over
                        the life of the contract cannot exceed the Present Value
                        Withdrawal Amount (see Specifications page).

                        For the Life with Period Certain Annuity Option, only
                        one Request for a withdrawal may be made each calendar
                        year.

                        For fixed Annuity Options, each withdrawal
                        proportionately reduces the dollar amount of each future
                        guaranteed annuity benefit payment. The proportionate
                        reduction is

Form A3037-02NY                       23                                   NYLS1
<Page>
                        calculated by multiplying the dollar amount of each
                        future guaranteed annuity benefit payment by the
                        following:

                                      Amount of the withdrawal
                        -------------------------------------------------------
                        Present Value of all remaining fixed guaranteed annuity
                         benefit payments immediately prior to the withdrawal.

                        For variable Annuity Options, each withdrawal
                        proportionately reduces any remaining guaranteed
                        payments. The proportionate reduction is calculated by
                        multiplying the number of Annuity Units in each future
                        guaranteed annuity benefit payment by the following:

                                      Amount of the withdrawal
                          --------------------------------------------------
                          Present Value of all remaining variable guaranteed
                          annuity benefit payments immediately prior to the
                                             withdrawal.

                        If an Annuitant is still living after there are no
                        remaining guaranteed payments under a Life with Period
                        Certain Annuity Option:

                            (a) for variable Annuity Options, the number of
                                Annuity Units will increase to the number of
                                Annuity Units payable prior to any withdrawals,
                                adjusted for transfers.

                            (b) for fixed Annuity Options, the dollar amount of
                                the annuity benefit payments will increase to
                                the amount payable prior to any withdrawals,
                                adjusted for transfers.

                        Amounts withdrawn that were applied under a variable
                        Annuity Option will be paid within 7 days of the date a
                        Request is received. The Company reserves the right to
                        defer surrenders and withdrawals of amounts applied
                        under a variable Annuity Option for up to six months
                        during any period when (1) trading on the New York Stock
                        Exchange is closed for other than weekends and holidays;
                        (2) the Securities and Exchange Commission by order has
                        permitted such a suspension; or (3) an emergency exists
                        as determined by the Securities and Exchange Commission
                        such that disposal of portfolio securities or valuation
                        of assets of the Separate Account is not reasonably
                        practicable.

                        Amounts withdrawn that were applied under a fixed
                        Annuity Option will normally be paid within 7 days of
                        the date a Request is received. The Company may defer
                        payment for up to six months from the date a Request is
                        received. If deferred for 10 days or more, the amount
                        payable will be credited interest at the rate(s) then
                        being credited by the Company. However, no interest will
                        be paid if it is less than $25 or if the delay is
                        pursuant to State insurance law.

                        PRESENT VALUE OF ANNUITY BENEFIT PAYMENTS

                        For a variety of purposes, it is at times necessary to
                        determine the Present Value of either all future annuity
                        benefit payments or of future guaranteed annuity benefit
                        payments. Present Values are calculated based on the
                        Annuity 2000 Mortality Table, male or female rates as
                        appropriate, and the interest rate or AIR used to
                        determine the annuity benefit payments.

                        DEATH OF THE ANNUITANT

                        Unless otherwise indicated by the Owner, upon the death
                        of the Annuitant, the Present Value of the remaining
                        guaranteed annuity benefit payments may be paid to the
                        Owner.

Form A3037-02NY                       24                                   NYLS1
<Page>
                        ANNUITY BENEFIT PAYMENT OPTIONS

                        PERIOD CERTAIN ANNUITY:

                        Periodic annuity benefit payments for a chosen number of
                        years. The number of years selected may be from 10 to
                        30, or any other period currently made available by the
                        Company.

                        LIFE ANNUITY:

                            (a) Single Life - Periodic annuity benefit payments
                                during the Annuitant's life. The annuity benefit
                                payments do not continue after the death of the
                                Annuitant.

                            (b) Joint and Survivor - Periodic annuity benefit
                                payments during the joint lifetime of the Joint
                                Annuitants. For variable options, after the
                                first death, the number of units in each payment
                                during the lifetime of the survivor is equal to
                                the total number of units prior to such death
                                multiplied by the Survivor Annuity Benefit
                                Percentage. For fixed options, after the first
                                death, the dollar amount of each payment during
                                the lifetime of the survivor is equal to the
                                dollar value of each payment paid prior to such
                                death multiplied by the Survivor Annuity Benefit
                                Percentage.

                        LIFE ANNUITY GUARANTEE OPTIONS

                        If a life Annuity Option has been elected, the Owner may
                        also select one of the following guarantees:

                        PERIOD CERTAIN

                        Periodic guaranteed payments for a period of 10 to 30
                        years, or any other period currently made available by
                        the Company.

                        CASH BACK

                        Upon notification of the Annuitant's death, any excess
                        of the Annuity Value applied over the total amount of
                        the annuity benefit payments will be paid to the Owner
                        or Beneficiary, whichever is applicable.

                        ANNUITY OPTION RATE TABLES

                        The first variable annuity benefit payment will be based
                        on the greater of the guaranteed minimum Annuity Option
                        Rates shown in the tables on the following pages or the
                        Annuity Option Rates made available by the Company on
                        the rate basis available at the time the Annuity Option
                        is selected. The fixed annuity benefit payments will be
                        based on the greater of the guaranteed minimum Annuity
                        Option Rates shown in the tables on the following pages
                        or the Company's non-guaranteed current Annuity Option
                        Rates applicable to this class of contracts. The Company
                        guarantees that once an Annuity Option is selected, the
                        annuity benefit payments will not be affected by changes
                        in mortality and expense experience.

Form A3037-02NY                       25                                   NYLS1
<Page>
                              ANNUITY OPTION TABLES

                      FIRST MONTHLY ANNUITY BENEFIT PAYMENT
                    FOR EACH $1,000 OF ANNUITY VALUE APPLIED

<Table>
<Caption>
    AGE              LIFE ANNUITY WITH                       LIFE                           LIFE ANNUITY
  NEAREST         10 YEARS PERIOD CERTAIN                   ANNUITY                         WITH CASHBACK
  PAYMENT

               [MALE     FEMALE     [UNISEX      [MALE      FEMALE     [UNISEX      [MALE      FEMALE     [UNISEX

     <S>       <C>        <C>         <C>         <C>        <C>         <C>         <C>        <C>         <C>
     50        4.05       3.81        3.91        4.08       3.83        3.93        3.90       3.72        3.79

     51        4.11       3.87        3.97        4.15       3.89        3.99        3.96       3.77        3.85
     52        4.18       3.93        4.03        4.22       3.95        4.06        4.01       3.82        3.90
     53        4.25       3.99        4.10        4.30       4.01        4.13        4.07       3.88        3.96
     54        4.33       4.06        4.17        4.38       4.08        4.20        4.14       3.94        4.02
     55        4.41       4.13        4.24        4.46       4.15        4.28        4.20       3.99        4.07

     56        4.49       4.20        4.32        4.55       4.23        4.36        4.27       4.06        4.14
     57        4.58       4.28        4.40        4.65       4.31        4.45        4.34       4.12        4.21
     58        4.68       4.36        4.49        4.75       4.40        4.54        4.42       4.19        4.28
     59        4.78       4.45        4.58        4.86       4.49        4.64        4.50       4.26        4.36
     60        4.88       4.54        4.67        4.98       4.59        4.74        4.58       4.34        4.44

     61        4.99       4.63        4.77        5.10       4.69        4.85        4.67       4.42        4.52
     62        5.10       4.73        4.88        5.23       4.80        4.97        4.76       4.50        4.60
     63        5.23       4.84        4.99        5.37       4.92        5.10        4.85       4.59        4.69
     64        5.35       4.95        5.11        5.52       5.04        5.24        4.95       4.68        4.79
     65        5.48       5.07        5.24        5.69       5.18        5.38        5.06       4.78        4.89

     66        5.62       5.20        5.37        5.86       5.32        5.54        5.17       4.89        5.00
     67        5.77       5.33        5.51        6.04       5.47        5.70        5.28       4.99        5.11
     68        5.92       5.47        5.65        6.24       5.64        5.88        5.40       5.11        5.23
     69        6.07       5.62        5.80        6.45       5.82        6.07        5.52       5.23        5.35
     70        6.23       5.78        5.96        6.67       6.01        6.27        5.66       5.36        5.48

     71        6.39       5.94        6.12        6.90       6.21        6.49        5.79       5.49        5.61
     72        6.56       6.11        6.29        7.16       6.44        6.72        5.94       5.63        5.75
     73        6.73       6.29        6.47        7.43       6.68        6.98        6.09       5.78        5.90
     74        6.90       6.48        6.65        7.71       6.94        7.25        6.24       5.94        6.06
     75        7.08      6.67]       6.83]        8.02       7.22]      7.54]        6.41       6.11]      6.23]
</Table>

             These tables are based on an annual interest rate of 3%
                      and the Annuity 2000 Mortality Table

Form A3037-02NY                       26                                   NYLS1
<Page>
                        ANNUITY OPTION TABLES (CONTINUED)

                      FIRST MONTHLY ANNUITY BENEFIT PAYMENT
                    FOR EACH $1,000 OF ANNUITY VALUE APPLIED

                         JOINT AND SURVIVOR LIFE ANNUITY
                                    OLDER AGE

<Table>
<Caption>
                                    50      55       60       65       70       75      80
<S>        <C>                      <C>     <C>      <C>      <C>      <C>      <C>     <C>
Y          50                       3.53    3.61     3.68     3.73     3.76     3.79    3.80
O          55                               3.77     3.88     3.97     4.04     4.08    4.11
U          60                                        4.10     4.25     4.36     4.45    4.50
N          65                                                 4.55     4.74     4.90    5.01
G          70                                                          5.16     5.43    5.64
E          75                                                                   6.02    6.41
R          80                                                                           7.25
A
G
E
</Table>

                   JOINT AND TWO-THIRDS SURVIVOR LIFE ANNUITY
                                    OLDER AGE

<Table>
<Caption>
                                    50      55       60       65       70       75      80
<S>       <C>                       <C>     <C>      <C>      <C>      <C>      <C>     <C>
Y         50                        3.80    3.93     4.09     4.25     4.43     4.61    4.80
O         55                                4.11     4.29     4.49     4.70     4.91    5.13
U         60                                         4.53     4.77     5.02     5.29    5.55
N         65                                                  5.09     5.42     5.75    6.07
G         70                                                           5.88     6.31    6.75
E         75                                                                    6.99    7.59
R         80                                                                            8.58
A
G
E
</Table>

            These tables are based on an annual interest rate of 3 %
                      and the Annuity 2000 Mortality Table

Form A3037-02NY                       27                                   NYLS1
<Page>
                        ANNUITY OPTION TABLES (CONTINUED)

                      FIRST MONTHLY ANNUITY BENEFIT PAYMENT
                    FOR EACH $1,000 OF ANNUITY VALUE APPLIED

<Table>
<Caption>
                           NUMBER OF                 VARIABLE OR FIXED ANNUITY FOR A
                            YEARS                            CERTAIN PERIOD
<S>                          <C>                                 <C>
                             10                                  9.61

                             15                                  6.87

                             20                                  5.51

                             25                                  4.71

                             30                                  4.18
</Table>

             These tables are based on an annual interest rate of 3%
                      and the Annuity 2000 Mortality Table.

Form A3037-02NY                       28                                   NYLS1
<Page>
                               GENERAL PROVISIONS

Entire Contract                 The entire contract consists of this contract,
                                any application attached at issue, riders and
                                any endorsements. All statements made by the
                                Owner shall be deemed representations and not
                                warranties and no such statements shall be used
                                in any contest unless it is contained in a
                                written signed application. Nothing is
                                incorporated by reference, unless a copy is
                                endorsed upon or is attached to the contract. No
                                insertion in or other alteration of any written
                                application can be made by any person other than
                                the applicant without his/her written consent,
                                except that insertions may be made by the
                                Company for administrative purposes only in such
                                manner as to indicate clearly that the
                                insertions were not made by the applicant. This
                                contract is delivered in and governed by the
                                laws of the State.

                                Only the President or Secretary of the Company
                                may modify or waive any provisions of this
                                contract by written endorsement. Agents or
                                Brokers are not authorized to do so.

Misstatement of Age             If the age or sex of an individual is misstated,
or Sex                          the Company will adjust all benefits payable to
                                that which would be available at the correct age
                                or sex. Any underpayments already made by the
                                Company will be paid immediately. Any
                                overpayments will be deducted from future
                                annuity benefit payments. Any overpayments or
                                underpayments will be charged or credited with
                                interest as applicable at a rate of 6%.

Failure to Notify Company       Death After the Annuity Date and once notified
of Annuitant                    of the Annuitant's death, the Company reserves
                                the right to recover any overpaid annuity
                                benefit payments.

Incontestability                The Company cannot challenge the validity of
                                this contract after it has been in force for
                                more than two years from the date of issue.

Minimums                        All values and benefits available under this
                                contract equal or exceed those required by the
                                State in which the contract is delivered.

Annual Report                   The Company will furnish an annual report to the
                                Owner containing a statement of the number and
                                value of Accumulation Units credited to the
                                Sub-Accounts, the value of the Fixed Account and
                                the Guarantee Period Accounts, the amount of the
                                death benefit, the Surrender Value, the
                                withdrawal charge, the method used to derive any
                                Market Value Adjustment (if applicable) and any
                                other information required by applicable law,
                                rules and regulations.

Addition, Deletion, or          The Company reserves the right, subject to
Substitution of                 compliance with applicable law, to add to,
Investments                     delete from, or substitute for the shares of a
                                Fund that are held by the Sub-Accounts or that
                                the Sub-Accounts may purchase. The Company also
                                reserves the right to eliminate the shares of
                                any Fund no longer available for investment or
                                if the Company believes further investment in
                                the Fund is no longer appropriate for the
                                purposes of the Sub-Accounts.

                                The Company will not substitute shares
                                attributable to any interest in a Sub-Account
                                without notice to the Owner and prior approval
                                of the Securities and Exchange Commission as
                                required by the Investment Company Act of 1940.
                                This will not prevent the Variable Account from
                                purchasing other securities for other series or
                                classes of contracts, or from permitting a
                                conversion between series or classes of
                                contracts on the basis of requests made by
                                Owners.

Form A3037-02NY                       29                                   NYLS1
<Page>
                                The Company reserves the right, subject to
                                compliance with applicable laws, to establish
                                additional Separate Accounts, Guarantee Period
                                Accounts and Sub-Accounts and to make them
                                available to any class or series of contracts as
                                the Company considers appropriate. Each new
                                Separate Account or Sub-Account will invest in a
                                new investment company, or in shares of another
                                open-end investment company, or such other
                                investments as may be permitted under applicable
                                law. The Company also reserves the right to
                                eliminate or combine existing Sub-Accounts and
                                to transfer the assets of any Sub-Accounts to
                                any other Sub-Accounts. In the event of any
                                substitution or change, the Company may, by
                                appropriate notice, make such changes in this
                                and other contracts as may be necessary or
                                appropriate to reflect the substitution or
                                change. If the Company considers it to be in the
                                best interests of the owners, the Variable
                                Account or any Sub-Account may be operated as a
                                management company under the Investment Company
                                Act of 1940 or in any other form permitted by
                                law, or may be de-registered under the Act in
                                the event registration is no longer required, or
                                may be combined with other accounts of the
                                Company. No material changes in the investment
                                policy of a Variable Account or any Sub-Account
                                will be made without approval pursuant to the
                                applicable insurance laws of the State.

Changes in Law                  The Company reserves the right to make any
                                changes to provisions of the contract to comply
                                with, or give Owners the benefit of, any federal
                                or State statute, rule, or regulation.

Change of Name                  Subject to compliance with applicable law, the
                                Company reserves the right to change the names
                                of the Variable Account or the Sub-Accounts.

Federal Tax                     The Variable Account is not currently subject to
Considerations                  tax, but the Company reserves the right to
                                assess a charge for taxes if the Variable
                                Account becomes subject to tax, subject to prior
                                notification to the Superintendent of Insurance.

Splitting of Units              The Company reserves the right to split the
                                value of a unit, either to increase or decrease
                                the number of units. Any splitting of units will
                                have no material effect on the benefits,
                                provisions or investment return of this contract
                                or upon the Owner, the Annuitant, any
                                Beneficiary, or the Company.

                                Prior to the Annuity Date, the number of shares
                                is determined by dividing the dollar value of
                                the Sub-Account Accumulation Units by the net
                                asset value of one Fund share. After the Annuity
                                Date, the number of Fund shares is determined by
                                dividing the reserves held in each sub-account
                                to meet the annuity obligations by the net asset
                                value of one Fund share.

Insulation of Separate          The investment performance of Separate Account
Account                         assets is determined separately from the other
                                assets of the Company. The assets of a Separate
                                Account equal to the reserves and liabilities of
                                the contracts supported by the account will not
                                be charged with other income, gains or losses of
                                the Company or liabilities from any other
                                business that the Company may conduct.

Form A3037-02NY                       30                                   NYLS1
<Page>

   Flexible Payment Deferred Variable, Fixed and Market Value Adjusted Annuity
              Annuity Benefit Payments Payable on the Annuity Date
    Death Benefit Payable to Beneficiary if Owner Dies prior to Annuity Date
                                Non-Participating

Form A3037-02NY                       31                                   NYLS1<Page>
                FIRST ALLMERICA FINANCIAL LIFE INSURANCE COMPANY

                       ENHANCED DEATH BENEFIT "EDB" RIDER

OVERVIEW: This EDB Rider ("Rider") is an optional rider the Owner has selected.
It provides an Enhanced Death Benefit which provides an annual step-up.

APPLICABILITY: This Rider is made a part of the contract to which it is attached
and is effective on the issue date.

BENEFIT: The "Death Benefit" section of the "DEATH BENEFIT" provision is
replaced by the following:

I.   If an Owner, or an Annuitant if the Owner is a non-natural person, dies
     before the Annuity Date and before or on his/her 90th birthday, the Death
     Benefit will be the greatest of:

     (a)  the Accumulated Value on the date on which both the death certificate
          and all necessary claim paperwork, as determined by the Company, have
          been received at the Principal Office, increased for any positive
          Market Value Adjustment ("MVA"), if applicable;

     (b)  gross Payments proportionately reduced for withdrawals as they occur;
          and

     (c)  the highest Accumulated Value on any contract anniversary prior to the
          date of death, as determined after being increased for any positive
          MVA, if applicable, and subsequent Payments, and proportionately
          reduced for subsequent withdrawals.

II.  If an Owner, or an Annuitant if the Owner is a non-natural person, dies
     before the Annuity Date, but on or after his/her 90th birthday, the Death
     Benefit will be the greatest of:

     (a)  the Accumulated Value on the date on which both the death certificate
          and all necessary claim paperwork, as determined by the Company, have
          been received at the Principal Office, increased for any positive MVA,
          if applicable;

     (b)  gross Payments proportionately reduced for withdrawals as they occur;

     (c)  the highest Accumulated Value on any contract anniversary prior to the
          deceased's 90th birthday, as determined after being increased for any
          positive MVA, if applicable, and subsequent Payments, and
          proportionately reduced for subsequent withdrawals; and

     (d)  the Accumulated Value, increased for any positive MVA, if applicable,
          on the deceased's 90th birthday, increased for subsequent Payments,
          and proportionately reduced for subsequent withdrawals.

PROPORTIONATE REDUCTION: Sections I(b), I(c), II(b), II(c) and II(d) of the
"Benefit" provision are proportionately reduced by withdrawals. This
proportionate reduction is calculated by multiplying the Section I(b), I(c),
II(b), II(c) or II(d) value, whichever is applicable, determined immediately
prior to the withdrawal by the following:

                            Amount of the withdrawal
                    ----------------------------------------
                    Accumulated Value determined immediately
                             prior to the withdrawal

CHARGE FOR BENEFIT: While this Rider is in effect, the Company will assess a
daily charge. For amounts allocated to the variable Sub-Accounts, this charge is
equal to .25% on an annual basis of the daily value of the Sub-Account assets.
The charge only applies during the Accumulation phase.

FORM 3312-02NY                                                             NYLS4
<Page>
TERMINATION: This Rider will terminate on the earliest of the following:

     (a)  the Annuity Date;

     (b)  the date the Company determines a Death Benefit is payable and the
          contract is not continued under a spousal takeover; or

     (c)  surrender of the contract.

               Signed for the Company at Worcester, Massachusetts

   /s/ John F. O'Brien                            /s/ Charles F. Cronin
        President                                        Secretary

FORM 3312-02NY                         2                                   NYLS4

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