Document:

Subordinated Promissory Note (Dairy Farmers of America, Inc.)

 Exhibit 10.4 
  
 THIS NOTE WAS ORIGINALLY ISSUED ON DECEMBER 21, 2004, AND HAS NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS
AMENDED, OR ANY COMPARABLE STATE SECURITIES LAW. NEITHER THIS NOTE NOR ANY PORTION HEREOF OR INTEREST HEREIN MAY BE SOLD, ASSIGNED, TRANSFERRED, PLEDGED OR OTHERWISE DISPOSED OF UNLESS THE SAME IS REGISTERED UNDER SAID ACT AND APPLICABLE STATE
SECURITIES LAWS OR UNLESS AN EXEMPTION FROM SUCH REGISTRATION IS AVAILABLE. 
  
 PAYMENT WITH RESPECT TO THIS NOTE IS SUBJECT TO CERTAIN SUBORDINATION PROVISIONS SET FORTH IN SECTION 3 HEREIN. 
  
 EAGLE FAMILY FOODS, INC. 
 SUBORDINATED PROMISSORY NOTE 
  

			
	December 21, 2004	 	$12,000,000

  
 Eagle Family Foods,
Inc., a Delaware corporation (the “Company”), hereby promises to pay to Dairy Farmers of America, Inc., a Kansas marketing cooperative association (together with its successors and Permitted Assigns, the “Holder”),
the aggregate principal amount of $12,000,000 (as the same may be adjusted in accordance with the provisions hereof), together with interest thereon calculated from the date hereof in accordance with the provisions of this Subordinated Promissory
Note (this “Note”). 
  
 1. Interest.
Interest shall accrue on a daily basis at a rate equal to 90-Day LIBOR as published in The Wall Street Journal from time to time plus two percent (2%) per annum (or, if less, at the highest rate then permitted under applicable law)
(calculated on the basis of a 360 day year) on the unpaid principal amount outstanding from time to time. To the extent not prohibited by the terms of Section 3 hereof, interest shall be due and payable in arrears in cash by the Company to the
Holder under this Note on the last business day of each calendar quarter, beginning March 31 2005 (each such business day, a “Payment Date”). If interest is not paid on a Payment Date because such payment is prohibited by the
provisions of Section 3 hereof, interest will accrue on a daily basis and compound on a quarterly basis and, to the extent that any accrued or compounded interest has not theretofore been paid, such accrued and compounded interest shall be paid as
soon as permitted in accordance with Section 3 hereof. Any interest (including accrued interest and compounded interest) which has not theretofore been paid shall be paid in full on the date on which the final principal payment on this Note is made.

  
 2. Principal. 
  
 (a) Generally. The outstanding principal amount and
all accrued but unpaid interest shall be paid in full on the first to occur of (i) November 1, 2007, (ii) a Sale of the Company or (iii) a Recapitalization. 
  
 (b) Optional Prepayment. Subject to Section 3 hereof, the Company shall be entitled to prepay all or any portion of the outstanding
principal amount of this Note without premium or penalty at any time. Upon any such optional prepayment, the Company shall pay all accrued and unpaid interest on the principal amount so prepaid. 
  
 3. Subordination; Restrictions on Payment. 

 (a) Notwithstanding anything in this Note to the contrary, the obligations of the Company
on or in respect of this Note (including, without limitation, the principal, interest, fees and charges on this Note) shall be subordinate and junior in right of payment, to the extent and in the manner hereinafter set forth, to all Superior Debt.

  
 (b) Anything in this Note to the contrary
notwithstanding, after (i) notice (such notice, the “Payment Default Blockage Notice”) from any holder of Superior Debt has been received by the Holder that any payment of the principal of or interest, fees or other amounts on any
Superior Debt has not been paid when due, whether at stated maturity, by mandatory prepayment, by acceleration or otherwise (each, a “Payment Default”) and remains unpaid or (ii) notice from the Designated Holder has been received
by the Holder that an event of default under any Superior Debt Agreement other than as described in clause (b)(i) above has occurred and is continuing (such notice, the “Ordinary Default Blockage Notice” and together with the
Payment Default Blockage Notice, the “Blockage Notices”), the Company shall not make, nor shall the Holder accept, any payments (whether in cash, securities or other property but excluding any amounts which are setoff pursuant to
the provisions of this Note against the outstanding principal amount and accrued but unpaid interest on this Note) of principal, interest or other amounts due or past due (other than reasonable fees and expenses in connection with amendments,
waivers and forbearances) until, in the case of clause (b)(i) above, the Payment Default no longer exists and in the case of clause (b)(ii), the earlier of (x) the cessation of such event of default or (y) 180 days after the receipt of the
applicable Ordinary Default Blockage Notice by the Holder. The Holder shall immediately deliver any Blockage Notice that it receives to the Company. The Holder shall not be required to honor more than four (4) Ordinary Default Blockage Notices, and
no Ordinary Default Blockage Notice shall be effective unless 270 days have passed since the last notice for an Ordinary Default. 
  
 (c) Any amendment or modification of the terms of Sections 1, 2 or 3 of this Note shall not be effective unless each holder or transferee
of Superior Debt (or the Designated Holder on behalf of such holder as provided in the applicable Superior Debt Documents) so consents in writing. 
  
 (d) If, notwithstanding the provisions of Section 3 of this Note, any payment or distribution of any character (whether in cash,
securities or other property but excluding any amounts which are setoff pursuant to the provisions of this Note against the outstanding principal amount and accrued but unpaid interest on this Note) or any security shall be received by the Holder in
contravention of this Section 3 and before all the Superior Debt (other than contingent indemnity obligations) shall have been paid in full in cash, such payment, distribution or security shall be held in trust for the benefit of, and shall be
immediately paid over or delivered or transferred to, the Designated Holder for application first for the payment in full of the obligations under the Senior Credit Agreement and thereafter according to the priorities of other Superior Debt and
ratably among the holders of such other class of Superior Debt. Any such payments received by the holder of this Note and delivered to the holders of the Superior Debt shall be deemed not to be a payment on this Note for any reason whatsoever and
the indebtedness under this Note shall remain as if such erroneous payment had never been paid by the Company or received by the Holder. In the event of the failure of Holder to endorse or assign any such payment, distribution or security, each
holder of any Superior Debt is hereby irrevocably authorized to endorse or assign the same. 
  
 (e) No present or future holder of Superior Debt shall be prejudiced in its right to enforce the provisions of Section 3 of this Note by
any act or failure to act on the part of the Company. 
  

 2 

 (f) From and after the date of the receipt of any Blockage Notice by the Holder pursuant
to the terms of this Section 3 (each of the events giving rise to the Blockage Notice or such Event of Default, a “Blockage Event”), the Holder shall not take or continue any action, or exercise or continue to exercise any rights,
remedies or powers under the terms of this Note, or exercise or continue to exercise any other right or remedy at law or equity that the Holder might otherwise possess, to collect any amount due and payable in respect of this Note, including,
without limitation, the acceleration of this Note, the commencement of any foreclosure on any lien or security interest, the filing of any petition in bankruptcy or the taking advantage of any other insolvency law of any jurisdiction (and shall
discontinue and cease any such actions including if this Note has already been accelerated, the Holder will, immediately upon becoming aware of the occurrence of such Blockage Event, rescind such acceleration), until: 
  

	 	(i)	the Superior Debt (other than contingent indemnity obligations) shall have been fully and finally paid (in cash) and all lending commitments under the Senior Credit Agreement shall
have terminated; 

  

	 	(ii)	the occurrence of an Insolvency Event; 

  

	 	(iii)	the written consent of the applicable requisite holders of Superior Debt terminating the Blockage Notice; 

  

	 	(iv)	the Event of Default giving rise to the Blockage Notice shall have been cured or waived; or 

  

	 	(v)	a period of 180 days commencing on the date of the Ordinary Default Blockage Notice, if applicable, shall have elapsed. 

  
 Notwithstanding the foregoing or any permissible action
taken by the Holder, the Holder shall not be entitled to receive any payment in contravention of the other provisions of this Section 3 before all Superior Debt (other than contingent indemnity obligations) shall have been paid in full in cash and
all lending commitments under the Senior Credit Agreement shall have terminated, but shall be entitled to (a) file proofs of claim and other similar actions (provided, however, that if the Holder has not filed a proof claim within five (5) days of
the bar for such filing, the holders of the Superior Debt may file such proof of claim), (b) vote its claims with respect to the obligations under this Note in any bankruptcy proceeding as long as the rights of any holder of Superior Debt are not
adversely affected and (c) retain distribution of securities that are subordinated on substantially the same terms hereof. 
  
 (g) If any payment or distribution to which Holder would otherwise have been entitled but for the provisions of this Section 3 shall have
been applied, pursuant to the provisions of this Section 3, to the payment of Superior Debt, then and in such case and to such extent, the Holder following payment in full in cash of the Superior Debt (other than contingent indemnity obligations)
and the termination of all lending commitments under the Senior Credit Agreement shall be entitled to receive any and all further payments or distributions applicable to Superior Debt, and following payment in full in cash of the Superior Debt
(other than contingent indemnity obligations), shall be subrogated to the rights of the holders of the Superior Debt to receive distributions applicable to the Superior Debt, in each case until this Note shall have been paid in full in cash or such
other consideration acceptable to the Holder in its sole discretion. If the Holder has been subrogated to the rights of the holders of Superior Debt due to the operation of this Section 3(j), the Company agrees to take all such reasonable actions as
are requested by the 
  

 3 

 Holder in order to cause the Holder to obtain payments from the Company with respect to such subrogation
rights as soon as possible. 
  
 (h) The
provisions of this Section 3 are solely for the purpose of defining the relative rights of the holders of Superior Debt, on the one hand, and the Holder on the other, against the Company and its assets, and nothing herein is intended to or shall
impair, as between the Company and the Holder, the obligations of this Company under this Note, to pay to the Holder the principal and interest on this Note as and when they become due and payable in accordance with their terms, or is intended to or
will affect the relative rights of the Holder and creditors of the Company other than the holders of the Superior Debt, nor, except as provided in this Section 3, will anything herein or therein prevent the Holder from exercising all remedies
otherwise permitted under this Note subject to the rights, if any, under this Section 3 of the holders of Superior Debt in respect of cash, property or securities of the Company received upon the exercise of any such remedy and subject to this
Section 3. The provisions of this Section 3 are for the benefit of the holders of Superior Debt, and may be enforced by, the Designated Holder. 
  
 (i) This Note is on a parity with the Company’s 8 3/4% Senior Subordinated Notes due 2008. 
  
 4. [Reserved.] 
  
 5. Events of Default. 
  
 (a) Definition. For purposes of this Note, an “Event of Default” shall be deemed to have occurred if: 

 

	 	(i)	the Company fails to pay when due and payable (whether at maturity or otherwise) the principal payment on this Note, together with accrued and unpaid interest thereof, within five
(5) business days after the due date thereof; 

  

	 	(ii)	the Company breaches any term of this Note and fails to remedy the same within thirty (30) days following receipt of notice of such breach from the Holder or an event of default
shall have occurred under the Investor Note; 

  

	 	(iii)	an Insolvency Event occurs; or 

  

	 	(iv)	the Superior Debt has become due and payable in full by acceleration prior to maturity. 

  
 The foregoing shall constitute Events of Default whatever the reason or cause for any such Event of Default and whether it
is voluntary or involuntary or is effected by operation of law or pursuant to any judgment, decree or order of any court or any order, rule or regulation of any administrative or governmental body. 
  
 (b) Consequences of Events of Default. Subject to
Section 3: 
  

	 	(i)	If any Event of Default of the type described in Section 5(a)(i), Section 5(a)(ii) or Section 5(a)(iv) has occurred and is continuing, the Holder may declare all or any portion of
the outstanding principal amount of this 

  

 4 

 Note (together with all accrued interest thereon and all other amounts due and payable with respect
thereto) to be immediately due and payable and may demand immediate payment of all or any portion of the outstanding principal amount of this Note (together with all such other amounts then due and payable). If the Holder demands immediate payment
of all or any portion of this Note, the Company shall immediately pay to the Holder all amounts due and payable with respect to this Note. 
  

	 	(ii)	If an Event of Default of the type described in Section 5(a)(iii) has occurred, the aggregate principal amount of this Note (together with all accrued interest thereon and all other
amounts due and payable with respect thereto) shall become immediately due and payable without any action on the part of the Holder, and the Company shall immediately pay to the Holder all amounts due and payable with respect to this Note.

  

	 	(iii)	The Holder shall also have any other rights which it may have pursuant to applicable law. 

  

	 	(iv)	The Company hereby waives diligence, presentment, protest and demand and notice of protest and demand, dishonor and nonpayment of this Note, and expressly agrees that this Note, or
any payment thereunder, may be extended from time to time and that the Holder may accept security for this Note or release security for this Note, all without in any way affecting the liability of the Company hereunder. 

  
 6. Covenants. 
  
 (a) As long as any amount of principal or accrued interest
is owed under this Note, the Company shall deliver to Holder (i) a quarterly, unaudited consolidated balance sheet of the Company and its subsidiaries and related statements of income and cash flows for the period then ending no later than sixty
(60) days following the end of each fiscal quarter starting with the fiscal quarter ending on April 2, 2005, in each case prepared in conformity with U.S. generally accepted accounting principles (subject to the absence of footnote disclosures and
year-end adjustments) and (ii) an annual, audited consolidated balance sheet of the Company and its Subsidiaries and related statements of financial income and cash flows for the period then ending no later than one hundred twenty (120) days
following the end of each fiscal year starting with the fiscal year ending on July 2, 2005; provided that the Company shall not have any obligation under this Section 6(a) during any period in which the Company is subject to Section 13 or
15(d) of the Securities Exchange Act of 1934, as amended. 
  
 (b) Upon prior written notice to the Company, the Company shall permit Holder, at Holder’s sole cost and expense, to have access to its employees and those of its Subsidiaries at reasonable times and places
during regular business hours. The Company shall have the right to designate a representative to accompany any representative of Holder during any such meeting, and the Company shall have the right to have its representative present during any
discussions by the Holder with any employee of Company or its Subsidiaries. 
  
 (c) The Company shall not, and shall not permit any of its Subsidiaries to, declare, redeem or make any distribution or payment or other distribution of cash on account of any equity interest in such Person, except
(i) that the foregoing shall not restrict the ability of any Subsidiary 
  

 5 

 of the Company to make any payment or distribution, or take any of the actions, referred to in Section
4.05 of the Indenture, dated as of January 23, 1998 (the “Indenture”), between the Company and IBJ Schroder Bank & Trust Company, as trustee, and (ii) for any of the foregoing permitted pursuant to the terms of any Superior Debt
Agreement. 
  
 (d) The Company shall not, and
shall not permit any of its Subsidiaries to, make any payment with respect to any Other Debt, except (i) that the foregoing shall not restrict the ability of any Subsidiary of the Company to make any payment or distribution, or take any of the
actions, referred to in Section 4.05 of the Indenture and (ii) for any such payment permitted pursuant to the terms of any Superior Debt Agreement. 
  
 7. Amendment and Waiver. Except as otherwise expressly provided herein (including, without limitation, Section 3(c)), the provisions of this Note
may be amended only with the consent of the Company and the Holder, and the Company may take any action prohibited under this Note, or omit to perform any act required to be performed by it under this Note, only if the Company has obtained the
written consent of the Holder. 
  
 8. Costs of Collection.
Subject to Section 3, in the event any amount due and owing is not paid when due at any stated or accelerated maturity, the party owing such amount shall pay, in addition to such amount, all reasonable out-of-pocket costs of collection of the
collecting party, including the collecting party’s reasonable out-of-pocket attorneys’ fees. Subject to Section 3, during such time as an Event of Default under the terms and conditions of this Note shall be continuing, the Company shall
pay to the Holder all reasonable out-of-pocket costs and expenses incurred by the Holder in enforcing its rights under this Note as a result of such Event of Default. 
  
 9. Usury Savings Clause. The Company and the Holder intend to comply at all times with applicable usury laws. If at
any time such laws would render usurious any amounts due under this Note under applicable law, then it is the Company’s and the Holder’s express intention that the Company not be required to pay interest on this Note at a rate in excess of
the maximum lawful rate, that the provisions of this Section 9 shall control over all other provisions of this Note which may be in apparent conflict hereunder, that such excess amount shall be immediately credited to the principal balance of this
Note, and the provisions hereof shall immediately be reformed and the amounts thereafter decreased, so as to comply with the then applicable usury law, but so as to permit the recovery of the fullest amount otherwise due under this Note. 

 
 10. Definitions. For purposes of this Note, the following
capitalized terms have the following meaning: 
  
 “Affiliate” of any Person means a Person that directly or indirectly through one or more intermediaries controls, is controlled by, or is under common control with, the first Person. For purposes of this definition, the
term “control”, “controlled by” or “under common control with” means the power, direct or indirect, to direct or cause the direction of the management and policies of a Person, whether through the ownership of voting
securities, by contract, as trustee or executor, or otherwise. 
  
 “Designated Holder” means the “Administrative Agent” under the Senior Credit Agreement or any such Person designated by the lenders under the Senior Credit Agreement or, if no Senior Credit Agreement then exists
and all obligations thereunder have been paid in full in cash, by any such Person designated by the holders of Superior Debt. For the avoidance of doubt, the “Administrative Agent” under the Senior Credit Agreement shall act solely as an
agent of the “Lenders” under the Senior Credit Agreement and nothing contained in this Note (including, without limitation, its designation as “Designated Holder” hereunder), whether express or implied, is intended to or shall be
so construed as to 
  

 6 

 impose upon the Administrative Agent under the Senior Credit Agreement any obligation or duty towards, or relationship of
any agency or trust with or for, any other holder of Superior Debt, the Holder, the Company or any Guarantor. 
  
 “Insolvency Event” means the occurrence of any of the following: (i) the Company makes a general assignment for the benefit of creditors;
(ii) an order, judgment or decree is entered adjudicating the Company bankrupt or insolvent; (iii) any order for relief with respect to the Company is entered under the Federal Bankruptcy Code; (iv) the Company petitions or applies to any tribunal
for the appointment of a custodian, trustee, receiver or liquidator of the Company or of any substantial part of the assets of the Company, or commences any proceeding relating to the Company under any bankruptcy, reorganization, arrangement,
insolvency, readjustment of debt, dissolution or liquidation law of any jurisdiction; or (v) any such petition or application is filed, or any such proceeding is commenced, against the Company and not dismissed or stayed within 60 days. 

 
 “Other Debt” means all principal of, premium (if any),
interest (including, without limitation, interest accruing or that would have accrued but for the filing of a bankruptcy, reorganization or other insolvency proceeding whether or not such interest constitutes an allowable claim in such proceeding)
on, and any and all other fees, expense reimbursement obligations, and other amounts due pursuant to the terms of all agreements, documents and instruments providing for, creating, securing or evidencing or otherwise entered into in connection with
(i) indebtedness for borrowed money of the Company (including, without limitation, guarantees and other contingent obligations with respect to indebtedness for borrowed money of its Subsidiaries) of the type typically held by commercial banks,
investment banks, insurance companies and other recognized lending institutions, entities and funds, whether now outstanding or hereafter created, incurred, assumed or guaranteed which is not Superior Debt, (ii) obligations evidenced by bonds,
debentures, notes or similar instruments, or upon which interest payments are customarily made, of the type typically held by commercial banks, investment banks, insurance companies and other recognized lending institutions or entities, whether now
outstanding or hereafter created, incurred, assumed or guaranteed which is not Superior Debt (together with renewals, extensions, refundings, refinancings, deferrals, restructurings, amendments and modifications of the items described in (i) or (ii)
above). 
  
 “Permitted Assign” means (i) any
Affiliate of the Holder that has received an assignment of this Note with, as long as no Event of Default has occurred and is continuing, the consent of the Company (which consent shall not be unreasonably withheld, conditioned or delayed) and (ii)
any bank or financial institution as a pledgee that has received possession of this Note as security for the Holder’s indebtedness for borrowed money. 
  
 “Person” means an individual, a partnership, a corporation, a limited liability company, an association, a joint stock company, a trust,
a joint venture, an unincorporated organization and a governmental entity or any department, agency or political subdivision thereof. 
  
 “Recapitalization” means any recapitalization, redemption or refinancing by the Company or Milnot Company pursuant to which holders of
the Company’s equity securities receive a cash dividend, cash or publicly traded securities in cash in exchange for such equity securities. 
  
 “Sale of the Company” means any transaction or series of transactions pursuant to which any Person or group of related Persons acquire
directly or indirectly (i) equity securities of the Company or Milnot Company possessing the voting power under normal circumstances to elect a majority of the Company’s or Milnot Company’s board of directors, or (ii) all or substantially
all of the Company’s or Milnot Company’s assets determined on a consolidated basis (in either case, whether by merger, 
  

 7 

 consolidation, sale, issuance or transfer of the Company’s or Milnot Company’s equity securities or sale or
transfer of the Company’s or Milnot Company’s consolidated assets or otherwise). 
  
 “Senior Credit Agreement” means that certain Financing Agreement, dated as of March 23, 2004, by and among Eagle Family Foods Holdings, Inc., Eagle Family Foods, Inc., the financial institutions from
time to time party there to, Fortress Credit Opportunities, ILP, as collateral agent for the Lenders, and Congress Financial Corporation (Central), as administrative agent for the Lenders, as such Financing Agreement has been and may be amended,
restated, supplemented or otherwise modified from time to time in accordance with the terms thereof. 
  
 “Subsidiary” means, with respect to any Person, any corporation, limited liability company, partnership, association or other business
entity of which (i) if a corporation, a majority of the total voting power of shares of stock entitled (without regard to the occurrence of any contingency) to vote in the election of directors, managers or trustees thereof is at the time owned or
controlled, directly or indirectly, by that Person or one or more of the other Subsidiaries of that Person or a combination thereof, or (ii) if a limited liability company, partnership, association or other business entity, a majority of the
partnership or other similar ownership interest thereof is at the time owned or controlled, directly or indirectly, by that Person or one or more Subsidiaries of that Person or a combination thereof. For purposes hereof, a Person or Persons shall be
deemed to have a majority ownership interest in a limited liability company, partnership, association or other business entity if such Person or Persons shall be allocated a majority of limited liability company, partnership, association or other
business entity gains or losses or shall be or control any managing director or general partner of such limited liability company, partnership, association or other business entity. 
  
 “Superior Debt” means any and all obligations of the Company and its Subsidiaries arising under the Senior
Credit Agreement and each document related thereto or executed in connection therewith together with amendments and modifications thereof and including in all events any extensions, refinancings or restructurings thereof. 
  
 “Superior Debt Agreements” shall mean the Senior Credit
Agreement and each document related thereto or executed in connection therewith. 
  
 11. Cancellation. Immediately after all principal and accrued interest at any time owed on this Note has been indefeasibly paid in full, this Note shall be automatically canceled and the Holder shall
immediately surrender this Note to the Company for cancellation. After cancellation of this Note, this Note shall not be reissued. 
  
 12. Payments; Place of Payment. All payments to be made to the Holder shall be made in the lawful money of the United States of America in
immediately available funds. Payments of principal and interest shall be delivered to the Holder at the address of the Holder set forth on the Company’s records or at such other address as is specified by prior written notice by the Holder to
the Company. 
  
 13. Governing Law. All questions
concerning the construction, validity and interpretation of this Note will be governed by and construed in accordance with the laws of the State of New York, without giving effect to any choice of law or conflict of law provision or rule that would
cause the application of the laws of any jurisdiction other than the State of New York. 
  
 14. Business Days. If any payment is due, or any time period for giving notice or taking action expires, on a day which is a Saturday, Sunday or legal holiday in the State of New York or the State of Illinois,
the payment shall be due and payable on, and the time period shall automatically be 
  

 8 

 extended to, the next business day immediately following such Saturday, Sunday or legal holiday, and interest shall
continue to accrue at the required rate hereunder until any such payment is made. 
  
 15. [Reserved] 
  
 16.
Notices. All notices, demands or other communications to be given or delivered under or by reason of the provisions of this Note shall be in writing and shall be deemed to have been given (a) when delivered personally to the recipient, (b)
when sent to the recipient by telecopy (receipt electronically confirmed by sender’s telecopy machine) if during normal business hours of the recipient, otherwise on the next business day, (c) one business day after the date when sent to the
recipient by reputable express courier service (charges prepaid), or (d) seven business days after the date when mailed to the recipient by certified or registered mail, return receipt requested and postage prepaid. Such notices, demands and other
communications shall be sent to the Holder and to the Company at the addresses indicated below: 
  

			
	If to the Holder:	  	Dairy Farmers of America, Inc.
	 	  	10220 North Ambassador Drive
	 	  	Kansas City, MO 64153
	 	  	Attention: Gerald L. Bos
	 	  	Facsimile No.: 816-801-6451
		
	With a copy to:	  	Dairy Farmers of America, Inc.
	(which shall not	  	10220 North Ambassador Drive
	constitute notice)	  	Kansas City, MO 64153
	 	  	Attention: David Geisler
	 	  	Facsimile No.: 816-801-6441
		
	If to the Company:	  	Eagle Family Foods, Inc.
	 	  	735 Taylor Road, Suite 200
	 	  	Gahanna, OH 43230
	 	  	Attention: Craig Steinke
	 	  	Facsimile No.: (614) 501-4423
		
	With a copy to:	  	Willkie Farr & Gallagher LLP
	(which shall not constitute notice)	  	787 Seventh Avenue
	 	  	New York, NY 10019
	 	  	Attention: Steven J. Gartner, Esq.
	 	  	Facsimile No. (212) 728-9222

  
 or to such other address as either
party hereto may, from time to time, designate in writing delivered pursuant to the terms of this section. 
  
 * * * * * 
  

 9 

 IN WITNESS WHEREOF, the Company has executed and delivered this Secured Subordinated Promissory Note on
the date first above written. 
  

			
	EAGLE FAMILY FOODS, INC.
		
	By:	 	 /s/ Craig Steinke

	Name:	 	Craig Steinke
	Its:	 	President and CEO

  

			
	Acknowledged and agreed:
	
	DAIRY FARMERS OF AMERICA, INC.
		
	By:	 	 /s/ Gerald L. Bos

	Name:	 	Gerald L. Bos
	Its:	 	CFO

  

 10Exhibit 4.A

  
 EXHIBIT (4)(a)

  
 FORM OF POLICY 
  

			
	 

  
 A Stock Company (Hereafter
called the Company, we, our or us)
	 	 Home Office located at:
 [4
Manhattanville Road, Purchase, New York 10577
 Adm. Office located at:
 4333 Edgewood Road N.E. Cedar Rapids, Iowa 52499
 (319) 398-8511]

	 
	 
	 
	 

  
 POLICY NUMBER: [07
– 12345] 
  
 This is a legal contract between the Owner and
Transamerica Financial Life Insurance Company, a Stock Company (Hereafter called the Company, we, our or us.) The Company will provide annuities and other benefits as set out in this annuity contract, subject to its provisions. This annuity contract
is delivered in, and is governed by, the laws of the State of New York. 
  
 WE AGREE 
  

	 	•	To provide annuity payments as set forth in Section 10 of this policy, 

  

	 	•	Or to pay withdrawal benefits in accordance with Section 5 of this policy, 

  

	 	•	Or to pay death proceeds in accordance with Section 9 of this policy. 

  
 This contract permits the accumulation of funds on a tax-deferred basis and provides a periodic annuity payment for the life of the annuitant or for a certain period of
time, payments start on the annuity commencement date. 
  
 The smallest annual
rate of investment return that would have to be earned on the assets of the separate account so that the dollar amount of variable annuity payments will not decrease is 6.45% 
  
 Prior to the annuity commencement date, a daily charge corresponding to an annual charge of no more than 2.20% for the Return of Premium
death benefit option (2.60% for the Annual Step-Up death benefit option), is applied by the Company to the assets of the separate account. The corresponding annual charge after the annuity commencement date is no more than 1.45% regardless of death
benefit option elected prior to the annuity commencement date. The amounts applicable to this policy are shown on the Policy Data page. In addition, a maximum annual service charge of $30 is assessed (prior to the annuity commencement date only) on
each policy anniversary if either the sum of premium less withdrawals is less than $50,000 (or the policy value is less than $50,000) on the policy anniversary. 
  

See the “Service Charge” provision in Section 4 and the “Charges and Deductions” provision in Section 6 of this contract for more details. These
agreements are subject to the provisions of this contract. This contract is issued in consideration of the application and payment of the initial premium as provided. This contract may be applied for and issued to qualify as a tax-qualified annuity
under the applicable sections of the Internal Revenue Code. 
  
 20 DAY RIGHT TO CANCEL 
  
 You may cancel this contract by
delivering or mailing a written notice to us or your agent. You must return the contract before midnight of the twentieth day after the day you receive it. Notice given by mail and return of the contract by mail are effective upon being mailed,
properly addressed and postage prepaid. We will return the policy value, including any fees and charges, within 10 days after we receive notice of cancellation and the returned contract. 
  
 If this contract is a replacement of another contract, the Right to Cancel period is extended to 60 days and we will return the policy
value, including any fees and charges, for this contract within 10 days after we receive notice of cancellation and the returned contract. 
  
 The value of the subaccount(s) is based on the value of the separate account assets which are not guaranteed as to fixed dollar amounts and will increase or decrease in
value based on investment results. 
  
 Signed for us at our home
office. 
  

					
	 	 	 	 	 
			
	[/s/ Illegible]	 	 	 	[/s/ Illegible]
	SECRETARY	 	 	 	PRESIDENT

  
 This policy is a legal
contract between the policyowner and the Company. 
 READ YOUR POLICY CAREFULLY 
  
 Flexible Premium Deferred Variable Annuity 
 Income Payable At Annuity Commencement Date 
 Benefits Based On The Performance Of The Separate Account Are 
 Variable And Are Not Guaranteed As To Dollar Amount (See
Sections 5, 6, 9 and 10C) 
 Non-Participating 
 WE RESERVE THE RIGHT TO (I) REFUSE PREMIUM PAYMENTS TO THE FIXED ACCOUNT, 
 AND (II) PROHIBIT
TRANSFERS TO THE FIXED ACCOUNT, AFTER THE POLICY DATE 
  

			
	AV1178 101 194 904	  	 

  
 SECTION 6 - SEPARATE
ACCOUNT 
  
 SEPARATE ACCOUNT 
  
 We have established and will maintain one or more separate accounts, under the laws of the
state of New York. Any realized or unrealized income, net gains and losses from the assets of the separate account are credited to or charged against it without regard to our other income, gains, or losses. Assets are put in the separate account for
this policy, as well as for other variable annuity policies. Any separate account may invest assets in shares of one or more mutual fund portfolio, or in the case of a managed separate account, direct investments in stocks or other securities as
permitted by law. Fund shares refer to shares of underlying mutual funds or prorata ownership of the assets held in a subaccount of a managed separate account. Fund shares are purchased, redeemed, and valued on behalf of the separate account.

  
 The separate account is divided into subaccounts. Each subaccount invests
exclusively in shares of one of the portfolios of an underlying fund. We reserve the right to add or remove any subaccount of the separate account. 
  
 The separate account meets the definition of a “separate account’: under rule 0–1(e)(1) of the Investment Company Act of 1940 (the “1940 Act”).
The assets of the separate account are our property. These assets will equal or exceed the reserves and other contract liabilities of the separate account. These assets will not be chargeable with liabilities arising out of any other business we
conduct. We reserve the right, subject to regulations governing the separate account, to transfer assets of a subaccount, in excess of the reserves and other contract liabilities with respect to that subaccount, to another subaccount or to our
general account. 
  
 We will determine the fair market value of the assets of the
separate account in accordance with a method of valuation, which we establish in good faith. Valuation period means the period of time from one determination of the value of each subaccount to the next. Such determinations are made when the value of
the assets and liabilities of each subaccount is calculated. This is generally the close of business on each day on which the New York Stock Exchange is open. In order to determine the value of an asset on a day that is not a business day, the
Company will use the value of that asset as of the end of the next business day on which trading takes place. 
  
 The Company will determine the value of the reserves for assets in the separate account at the end of each business day. In order to determine the value of reserves for assets on a day that is not a business day, the
Company will use the value of that asset as of the end of the prior business day on which trading took place. 
  
 We also reserve the right to transfer assets of the separate account, which we determine to be associated with the class of policies to which this policy belongs, to another separate account. If this type of transfer
is made, the term “separate account”, as used in the policy, shall then mean the separate account to which the assets were transferred. 
  
 We also reserve the right, when permitted by law, to: 
  

	(a)	deregister the separate account under the Investment Company Act of 1940; 

  

	(b)	manage the separate account under the direction of a committee at any time; 

  

	(c)	restrict or eliminate any voting rights of policy owners or other persons who have voting rights as to the separate account; 

  

	(d)	combine the separate account with one or more other separate accounts; 

  

	(e)	create new separate accounts; 

  

	(f)	add new subaccounts to or remove existing subaccounts from the separate account, or combine subaccounts; and 

  

	(g)	add new underlying mutual funds, remove existing mutual funds, or substitute a new fund for an existing fund. 

  

			
	PB1935	  	Page 7

  
 SECTION 6 - CONTINUED

  
 The net asset value of a fund share is the per-share value calculated by
the mutual fund or, in the case of a managed separate account, by the Company. The net asset value is computed by adding the value of the subaccount’s investments, cash and other assets, subtracting its liabilities, and then dividing by the
number of shares outstanding. Net asset values of fund shares reflect investment advisory fees and other expenses incurred in managing a mutual fund or a managed separate account. 
  
 CHANGE IN INVESTMENT, OBJECTIVE OR POLICY OF A MUTUAL FUND 
  
 If required by law or regulation, an investment policy of the separate account will only be changed if approved by the appropriate insurance
official of the state of New York or deemed approved in accordance with such law or regulation. If so required, the process for obtaining such approval is filed with the insurance official of the state or district in which this policy is delivered.

  
 CHARGES AND DEDUCTIONS 
  
 The mortality and expense risk fee and the administrative charge are each deducted both
before and after the annuity commencement date to compensate for changes in mortality and expenses not anticipated by the mortality and administration charges guaranteed in the policy. The service charge is deducted prior to the annuity commencement
date only. 
  
 If the mortality and expense risk fee is more than sufficient, the
Company will retain the balance as profit or may reduce this fee in the future. 
  
 ACCUMULATION UNITS 
  
 The policy value in the separate account
before the annuity commencement date is represented by accumulation units. The dollar value of accumulation units for each subaccount will change from business day to business day reflecting the investment experience of the subaccount Accumulation
units shall be used to account for all amounts allocated to or withdrawn from a subaccount of the separate account as a result of premium payments, partial withdrawals, transfers, or fees and charges. 
  
 Transfers and premium payments allocated to the subaccounts will be applied to provide
accumulation units in those subaccounts. The number of accumulation units purchased in a subaccount will be determined by dividing the dollar amount allocated to or transferred to that subaccount, by the value of an accumulation unit for that
subaccount on the premium payment or transfer date. 
  
 The number of accumulation
units withdrawn or transferred from the subaccounts will be determined by dividing the dollar amount withdrawn or transferred by the value of an accumulation unit for that subaccount on the withdrawal or transfer date. 
  
 We set the initial accumulation unit value for each subaccount. Subsequent accumulation unit
values for each subaccount are determined by multiplying the accumulation unit value for the immediately preceding valuation period by the net investment factor of the subaccount for the current valuation period. 
  
 The net investment factor used to calculate the value of an accumulation unit in each
subaccount for the valuation period is determined by dividing (a) by (b) and subtracting (c) from the result, where: 
  

	(a)	is the result of: 

  

	 	(1)	the net asset value of a fund share held in that subaccount determined as of the end of the current valuation period; plus 

  

	 	(2)	the per share amount of any dividend or capital gain distributions made by the fund for shares held in that subaccount if the ex-dividend date occurs during the valuation period;
plus or minus 

  

	 	(3)	a per share credit or charge for any taxes reserved for, which we determine to have resulted from the investment operations of that subaccount. 

  

	(b)	is the net asset value of a fund share held in that subaccount determined as of the end of the immediately preceding valuation period. 

  

	(c)	is a factor representing the mortality and expense risk fee and administrative charge before the annuity commencement date. This factor is less than or equal to, on an annual basis,
the percentage shown on the Policy Data page of the daily net asset value of a fund share held in that subaccount. 

  
 Since the net investment factor may be greater or less than one, the accumulation unit value may increase or decrease. 
  

			
	V1761	  	Page 8

  
 SECTION 7 - FIXED ACCOUNT

  
 FIXED ACCOUNT 
  
 The fixed account is comprised of a one–year guaranteed period option and the dollar
cost averaging fixed account option that we may choose to offer. Premium payments applied to and any amounts transferred to the fixed account will reflect a fixed interest rate. The interest rates we set will be credited for increments of at least
one year measured from each premium payment or transfer date. These rates will never be less than the Fixed Account Guaranteed Minimum Effective Annual Interest Rate shown on Page 3. 
  
 We reserve the right, at our sole discretion, to prohibit premium payments and/or transfers allocated to any of the fixed account options
described in this section after the policy date. We will provide 30 days advance written notice of this decision. We will also provide timely written notification to you once any such prohibition of premium payments and/or transfers is no longer in
effect. 
  
 GUARANTEED PERIOD OPTION 
  
 We may offer a one–year Guaranteed Period Option in the fixed account, into which
premium payments may be paid or amounts transferred. The current interest rate we set for funds entering the one–year guaranteed period option is guaranteed until the end of that option’s guaranteed period. At that time, the premium
payment made or amount transferred into the guaranteed period option, less any withdrawals or transfers from that guaranteed period option, plus accrued interest, may be rolled into a new guaranteed period option or may be transferred to any
subaccount(s) within the separate account(s). 
  
 You may choose the investment
option(s) you want the funds transferred into by giving us a written notice within 30 days before the end of the expiring option’s guaranteed period. However, any available guaranteed period elected may not extend beyond the maximum annuity
commencement date defined in Section 11. In the absence of such election, the funds will be rolled into a new guaranteed period option which is the same as the expiring guaranteed period option unless that guaranteed period option is no longer
offered. In that case, the funds will be rolled into the next shorter guaranteed period option available, otherwise the next longer guaranteed period option available if we are allowing transfers into the guaranteed period options at that time. You
will be mailed a notice of completion of the rollover with the new interest rate applicable. The new guaranteed period option will be deemed as accepted if we do not receive a written rejection within 30 days from the postmark date of the completion
notice. If we are prohibiting transfers into new guaranteed period options, we will provide 30 days advance written notice of this decision. We will also provide timely written notification to you once any such prohibition of transfers is no longer
in effect. 
  
 When funds are withdrawn or transferred from a guaranteed period
option, the policy value associated with the oldest premium payment or transfer is considered to be withdrawn or transferred first. If the amount withdrawn or transferred exceeds the policy value associated with the oldest premium, the policy value
associated with the next oldest premium payment or transfer is considered to be withdrawn or transferred next, and so on until the policy value associated with the most recent premium payment or transfer is considered to be withdrawn or transferred.

  
 DOLLAR COST AVERAGING FIXED ACCOUNT OPTION 
  
 We may offer a dollar cost averaging fixed account option separate from the guaranteed
period options. This option will have a one–year interest rate guarantee. The current interest rate we set for the dollar cost averaging fixed account may differ from the rates credited on the one-year guaranteed period option in the fixed
account. In addition, the current interest rate we credit may vary on different portions of the dollar cost averaging fixed account. The credited interest rate will never be less than the Fixed Account Guaranteed Minimum Effective Annual Interest
Rate shown on Page 3. The dollar cost averaging fixed account option will only be available under a dollar cost averaging program as described in Section 8. 
  

			
	VB1761	  	Page 9

  
 SECTION 8 - TRANSFERS

  

	A.	TRANSFERS BEFORE THE ANNUITY COMMENCEMENT DATE 

  
 Prior to the annuity commencement date, you may transfer the policy values from one investment option to another by notifying us in a form and manner acceptable to us.
Transfers under this policy may be restricted if you elect a rider which contains restrictions on transfers. 
  
 Transfers of policy value from the separate account are subject to a minimum of $500 or the entire subaccount policy value, if less. However, if the remaining subaccount policy value is less than $500, we reserve the
right to include that amount as part of the transfer. 
  
 Transfers of interest
credited in the guaranteed period options to other Investment Options are allowed on a “First-In, First-Out” basis. Such transfers may be made monthly, quarterly, semi-annually, or annually. Each such transfer must be at least $50.

  
 You may choose the one-year guaranteed period option to transfer to or from,
however, any guaranteed period option elected may not extend beyond the maximum annuity commencement date defined in Section 11. 
  
 We reserve the right to limit transfers to no more than 12 in any one policy year. Any transfers in excess of 12 per policy year may be charged a $10 per transfer fee.
Transfers among multiple investment options will be treated as one transfer in determining the number of transfers that have occurred. We also reserve the right, at our sole discretion, to refuse transfers allocated to any of the fixed account
options. If we are prohibiting transfers to the fixed account, we will provide 30 days advance written notice of this decision. You must indicate which investment option(s) to transfer the funds to while such prohibition is in effect. We will also
provide timely written notification to you once any such prohibition of transfers is no longer in effect. 
  
 This policy was not designed for the use of programmed, large, frequent, or short-term transfers. Such transfers may be disruptive to the underlying fund portfolios, increase transaction costs, and cause adverse
effects for other policy owners and beneficiaries. If we determine you are engaged in such activities we will use a combination of the following measures in an attempt to deter those activities, without taking the same measures for all owners: (1)
monitor your trading activity; (2) advise you in writing of our policy against market timing and disruptive trading; (3) revoke expedited transfer privileges (we consider transfers by fax, overnight mail, or the Internet to be “expedited”
transfers); (4) require written transfer requests with an original signature conveyed only via U.S. Mail for all transfers; (5) restrict the transfer privileges of others acting on your behalf, including your registered representative or an asset
allocation or investment advisory service; (6) suspend or discontinue your transfer privileges; (7) impose holding period requirements; (8) limit the number, size, frequency, manner, or timing of transfers; (9) reject any premium payment or transfer
request; (10) implement, administer, and impose fees or restrictions, including redemption fees, imposed by an underlying fund portfolio; and (11) reverse potentially harmful transfers. For all of these purposes, we may aggregate two or more
policies that we believe are connected. We will also administer the policy to comply with state, federal and other regulatory requirements concerning transfers. 
  

DOLLAR COST AVERAGING OPTION 
  
 Prior to the annuity commencement date, you may instruct us to automatically transfer a specified amount from source accounts made available by us to any other
subaccount(s) of the separate account. The automatic transfers can occur monthly or quarterly. You may change the subaccounts to which these transfers are allocated as permitted by us from time to time. 
  
 Transfers will continue until the elected source account is depleted. The amount transferred
each time must be at least $500. All transfers from the source account will be the same amount as the initial transfer. Changes to the subaccounts to which these transfers are allocated are not restricted. Transfers must be scheduled for at least 6
months, but not more than 24 months or for at least 4 quarters, but not more than 8 quarters each time the dollar cost averaging program is started or restarted following termination of the program for any reason. 
  
 Dollar cost averaging results in the purchase of more accumulation units when the value of
the accumulation unit is low, and fewer accumulation units when the value of the accumulation unit is high. However, there is no guarantee that the dollar cost averaging program will result in higher policy values or will otherwise be successful.

  

			
	L1214	  	Page 10

  
 SECTION 8 - CONTINUED

  
 Dollar cost averaging may be discontinued before its scheduled completion
by sending written notice to us. If dollar cost averaging is discontinued prior to the end of the scheduled period, all remaining funds in the dollar cost averaging fixed account will be transferred at that time. Unless we are notified otherwise the
funds remaining in the dollar cost averaging fixed account will be transferred to the subaccounts in the percentages currently indicated. While dollar cost averaging is in effect, asset rebalancing is not available. 
  
 ASSET REBALANCING 
  
 Prior to the annuity commencement date, you may instruct us to automatically transfer amounts among the subaccounts of the separate account
on a regular basis to maintain a desired allocation of the policy value among the various subaccounts offered. Rebalancing will occur on a monthly, quarterly, semi-annual, or annual basis, beginning on a date selected by you. You must select the
percentage of the policy value desired in each of the various subaccounts offered (totaling 100%}. Any amounts in the fixed account are ignored for the purposes of asset rebalancing. Rebalancing can be started, stopped or changed at any time. Asset
rebalancing is not available while dollar cost averaging is in effect. Rebalancing will cease as soon as we receive a request for any other transfer. 
  

	B.	TRANSFERS AFTER THE ANNUITY COMMENCEMENT DATE 

  
 After the annuity commencement date, you may transfer the value of the variable annuity units from one subaccount to another within the separate account or to the fixed
account. If you want to transfer the value of the variable annuity units, you must provide a signed notice, containing the facts that we need. We reserve the right to limit transfers between the subaccounts or to the fixed accounts to once per
policy year. 
  
 The minimum amount which may be transferred is the lesser of $10
monthly income or the entire monthly income of the variable annuity units in the subaccount from which the transfer is being made. If the monthly income of the remaining units in a subaccount is less than $10, we have the right to include the value
of those variable annuity units as part of the transfer. 
  
 After the annuity
commencement date, no transfers may be made from the fixed account to any other investment options. 
  
 SECTION 9 - DEATH PROCEEDS 
  

	A.	DEATH PROCEEDS PRIOR TO ANNUITY COMMENCEMENT DATE 

  
 The amount of death proceeds will be the greater of the policy value or the guaranteed minimum death benefit plus any additional premium payments received, less any gross
partial withdrawals, from the date of death to the date of payment of death proceeds. 
  
 Until the death proceeds are paid, the policy value will remain in the subaccounts as previously specified by the owner or as reallocated pursuant to instructions received by us from all beneficiaries (due proof of death is required before
we will accept such instructions). Therefore, the policy value (and cash value} will fluctuate with the investment performance of the applicable subaccounts and accordingly, the amount of the death proceeds will also vary until the proceeds are
paid. 
  
 For purposes of this policy, proof of death means: 
  

	(a)	a certified copy of the death certificate; or 

  

	(b)	a certified copy of a decree of a court of competent jurisdiction as to a finding of death; and 

  

	(c)	any other proof or other documents required by us. 

  
 If you have not directed how death proceeds are to be paid by the date of death, the beneficiary may make such election within one year of the date we receive due proof
of the owner’s or annuitant’s death as described in Subsection C below. The beneficiary may elect to receive the death proceeds as a lump sum or in payments as described in Subsection C below. We will pay interest on death proceeds as
required by law. 
  
 We must distribute death proceeds or continue making payments
under an income option under this annuity policy as required in Internal Revenue Code Section 72(s). The requirements of Internal Revenue Code Section 72(s) will override any provision of this policy to the contrary. 
  

	B.	GUARANTEED MINIMUM DEATH BENEFIT 

  
 The amount of the guaranteed minimum death benefit (GMDB) is based on the guaranteed minimum death benefit option shown on the policy data page. You may not change the
guaranteed minimum death benefit option after we issue the policy. 
  

			
	LB1214	  	Page 11

  
 SECTION 9 - CONTINUED

  
 Annual Step-Up Death Benefit 
  
 This GMDB is equal to: 
  

	 	(1)	the largest policy value on the policy date or on any policy anniversary prior to the earlier of the date of death or the annuitant’s 81st birthday; plus 

  

	 	(2)	any premium payments subsequent to the date of the policy anniversary with the largest policy value; minus 

  

	 	(3)	any adjusted partial withdrawals (as described below), subsequent to the date of the policy anniversary with the largest policy value. 

  
 Return of Premium Death Benefit 
  
 This GMDB is equal to the total premiums paid for this policy, less any
adjusted partial withdrawals (as described below), as of the date of death. 
  
 Adjusted Partial Withdrawals – A partial withdrawal taken as provided in Section 5 will reduce the elected guaranteed minimum death benefit by an amount referred to as the “adjusted partial withdrawal”. The adjusted
partial withdrawal may be a different amount than the gross partial withdrawal described in Section 5. If at the time of the partial withdrawal, the policy value is greater than the GMDB, the adjusted partial withdrawal will equal the gross partial
withdrawal. 
  
 The adjusted partial withdrawal formula is APW = GPW times (DP/PV)
where: 
  

					
	 APW
	 	=	  	adjusted partial withdrawal
			
	 GPW
	 	=	  	gross partial withdrawal
			
	 DP
	 	=	  	death proceeds prior to the withdrawal (equal to the greater of PV and GMDB)
			
	 PV
	 	=	  	policy value prior to the withdrawal
			
	 GMDB
	 	=	  	guaranteed minimum death benefit prior to the withdrawal

  

	C.	DEATH PRIOR TO ANNUITY COMMENCEMENT DATE 

  
 Payment of death proceeds depends on the relationships between the owner, annuitant, and beneficiary as outlined below. 
  
 If there are surviving owners, the surviving owners automatically take the place of any
designated beneficiary or beneficiaries. 
  
 Where there are joint annuitants, the
death proceeds become payable only upon the death of the surviving annuitant subject to the distribution requirements under Subsection C.II. below. 
  

	I.	Annuitant Death 

  
 When we have due proof that the annuitant died before the annuity commencement date, the death proceeds are payable to the beneficiary. Interest upon the
death proceeds paid will be computed daily at the rate currently being credited to the fixed account from the date of death, in connection with the death claim of this policy to the date of payment and will be considered a part of the total sum
paid. If no beneficiary is designated and there is no surviving owner, the owner’s estate will become the beneficiary. 
  

	 	a)	When the beneficiary is the deceased annuitant’s surviving spouse. The beneficiary may elect to continue this policy as owner and annuitant rather
than receiving the death proceeds. If the policy is continued, an amount equal to the excess, if any, of the guaranteed minimum death benefit over the policy value will then be added to the policy value pro rata according to the amount of policy
value in each investment option at that time. This is a one-time only policy value adjustment applied at the time the policy is continued, and the guaranteed minimum death benefit previously selected will continue on as applicable.

  
 If the policy is continued, all current
surrender charges will be waived; however, any premium received after the deceased annuitant’s death will be subject to any applicable surrender charges. 
  

If the beneficiary elects to have the death proceeds paid rather than continue the policy, the death proceeds must be distributed pursuant to
subsections (b)(1) and (2) below. 
  

	 	b)	When the beneficiary is an individual who is not the deceased annuitant’s surviving spouse. The death proceeds must be distributed: 

  

	 	(1)	by the end of 5 years after the date of the deceased annuitant’s death; or 

  

	 	(2)	payments (either as annuity payments or partial withdrawals) must begin no later than one year after the deceased annuitant’s death and must be made for a period certain or for
this beneficiary’s lifetime, so long as any period certain does not exceed this beneficiary’s life expectancy (as defined by the Internal Revenue Code and regulations adopted under that Code). Election of this option must be made at least
60 days prior to the one year anniversary of the annuitant’s death. 

  

	 	c)	When the beneficiary is not a natural person. The death proceeds must be distributed within 5 years after the annuitant’s death. 

  

			
	D645	  	Page 12

  
 SECTION 9 - CONTINUED

  

	II.	Owner Death 

  
 At death of any owner, all current surrender charges will be waived, however, any premium received after the deceased owner’s death will be subject
to any applicable surrender charges. 
  
 If the deceased owner is
also the sole annuitant. Subsection C.I. “Annuitant Death” above applies. 
  
 If an owner or joint owner who is not the sole annuitant dies prior to the annuity commencement date and before the entire interest in the policy is distributed, the successor owner as defined below will become the
new owner, and no death proceeds are payable. The person or entity first listed below who is alive or in existence on the date of that death will become the successor owner: 
  

	 	a)	surviving owner; 

  

	 	b)	primary beneficiary; 

  

	 	c)	contingent beneficiary; or 

  

	 	d)	deceased owner’s estate. 

  
 The successor owner will need to take distributions according to a), b), or c) below: 
  

	 	a)	If the sole successor owner is the deceased owner’s spouse, we will continue this policy with the successor owner as the new owner, unless the deceased owner’s spouse
elects to take distribution as described in b)(1) or b)(2) below. 

  

	 	b)	If the successor owner is an individual who is not the deceased owner’s spouse, the adjusted policy value or the minimum required cash value, if greater, must be distributed:

  

	 	(1)	by the end of 5 years after the date of the deceased owner’s death; or 

  

	 	(2)	payments (either as annuity payments or partial withdrawals) must begin no later than one year after the deceased owner’s death and must be made for a period certain or for the
successor owner’s lifetime, so long as any period certain does not exceed the successor owner’s life expectancy (as defined by the Internal Revenue Code and regulations adopted under that Code). Election of this option must be made at
least 60 days prior to the one year anniversary of the deceased owner’s death. 

  

	 	c)	If the successor owner is not a natural person, the adjusted policy value or the minimum required cash value, if greater, must be distributed within 5 years after the owner’s
death. 

  

	D.	DEATH ON OR AFTER THE ANNUITY COMMENCEMENT DATE 

  
 The death proceeds on or after the annuity commencement date depend on the payment option selected, if any owner dies on or after the annuity commencement date, but
before the entire interest in the policy is distributed, the remaining portion of such interest in the policy will be distributed to the beneficiary at least as rapidly as under the method of distribution being used as of the date of that death.

  

	E.	AN OWNER IS NOT AN INDIVIDUAL 

  
 In the case of a non tax-qualified annuity, if any owner or beneficial owner is not an individual, then for purposes of Section 72(s) of the Internal Revenue Code’s
mandatory distribution provisions in subsection C or D above, (1) the primary annuitant will be treated as the owner of the policy, and (2) if there is any change in the primary annuitant, such a change will be treated as the death of the owner.

  

			
	DB645	  	Page 13

  
 SECTION 10 - INCOME
OPTIONS 
  

	A.	GENERAL PAYMENT PROVISIONS 

  
 Payment 
  
 If this policy is in force on the annuity commencement date, we will use the fixed account portion and/or the separate account portion of the policy value to make payments under an income option to the payee under
fixed income option 2 and/or variable income option 3-V, respectively, with 10 years certain, or if elected, under one or more of the other income options described in this section, or any other method of payment if we agree. However, the income
option elected must provide for lifetime income or income for a period of at least 60 months. You will become the annuitant at the annuity commencement date. Payments will be made at 1, 3, 6, or 12-month intervals. We reserve the right to change the
frequency of payments to avoid making payments of less than $20. 
  
 Before the
annuity commencement date, if the death proceeds become payable, or if you surrender this policy, we will pay any proceeds in one sum, or if elected, all or part of these proceeds may be applied to one or more of the income options described in this
section, or any other method of payment if we agree. 
  
 Betterment of Rates

  
 The amounts shown in the tables on page 18-19 are the guaranteed amounts.
Current amounts offered to individuals of the same class may be obtained from us. Fixed annuity payments at the time of their commencement will not be less than those which would be provided by the application of the policy value to purchase any
single consideration immediate annuity contract (as described in Section 4223 (a)(1)(E) of the New York Insurance Law) offered by the company at the time to the same class of annuitant. 
  
 Adjusted Age 
  
 Payments under fixed income options 2 and 4 and the first payment under variable income options 3-V and 5-V are determined based on the adjusted age of the annuitant. The
adjusted age is the annuitant’s actual age on the annuitant’s nearest birthday, at the annuity commencement date, adjusted as follows: 
  

			
	 Annuity
Commencement Date

	  	Adjusted Age

	 Before 2010
	  	Actual Age
	 2010 - 2019
	  	Actual Age minus 1
	 2020 - 2026
	  	Actual Age minus 2
	 2027 - 2033
	  	Actual Age minus 3
	 2034 - 2040
	  	Actual Age minus 4
	 After 2040
	  	Actual Age minus 5

  
 Election of Optional Method of
Payment 
  
 Before the annuity commencement date, you can elect or change an
income option. You may elect, in a notice in a form and manner acceptable to us, income options that may be either variable, fixed, or a combination of both. If you elect a combination, you must also tell us what part of the policy value on the
annuity commencement date are to be applied to provide each type of payment. (You must also specify which subaccounts.) The amount of a combined payment will be the sum of the variable and fixed payments. Payments under a variable income option will
reflect the investment performance of the selected subaccount(s) of the separate account. 
  
 Payee 
  
 Unless you specify otherwise,
the payee shall be the annuitant. 
  
 Proof of Age 
  
 We may require proof of the age of any person who elects income options 2, 3-V, 4 and 5-V of
this Section before we make the first payment. 
  
 Minimum Proceeds

  
 If the policy value on the annuity commencement date is less than $2,000,
we reserve the right to pay the policy value out as a lump sum instead of applying them to an income option. 
  
 Premium Tax 
  
 The Insurance laws of the
State of New York currently do not allow the imposition of premium taxes on the amount applied to a settlement option. Therefore, such deductions will not be made while the owner is a resident of the State of New York, unless subsequent changes in
New York’s insurance laws provide otherwise. However, if the owner becomes a non-resident of New York or if New York changes its insurance laws to allow the imposition of premium taxes on the amount applied to a settlement option, we will
deduct the applicable premium tax before applying the proceeds. 
  
 Supplementary Contract 
  
 Once proceeds become payable and an
income option has been selected, we will issue a supplementary contract to reflect the terms of the selected income option. The supplemental contract will name the payee(s) and will describe the payment schedule. 
  

			
	S1419	  	Page 14

  
 SECTION 10 - CONTINUED

  

	B.	FIXED INCOME OPTIONS 

  
 Commutation of Payments after the Annuity Commencement Date 
  
 For options 1, 2 and 3, if the present value is paid in a single sum, the interest rate used for commutation is the interest rate that equated the amount applied at annuitization to the present value of annuity
payments. For option 2(b), present values would be determined using only an interest rate component, but not using a mortality component. 
  
 Only the remaining guaranteed annuity payments may be commuted, payments beyond the certain period that are contingent on the life of the annuitant may not be commuted.

  
 Determination of Fixed Income Options 
  
 The fixed income option is determined by multiplying each $1,000 of policy proceeds
allocated to a fixed income option by the amounts shown on pages 18 and 19 for the option you select. Options 1 and 3 are based on a guaranteed interest rate of 1.5%. Options 2 and 4 are based on a guaranteed interest rate of 1.5% and the
“Annuity 2000” (male and female) mortality table projected for improvement using projection scale G (50% of the female scale G factors were used, while 100% of the male scale G factors were used). The rates were projected dynamically using
an assumed annuity commencement date of 2005. The “Annuity 2000” mortality rates are adjusted based on improvements in mortality since 2000 to more appropriately reflect increased longevity. This is accomplished using a set of improvement
factors referred to as projection scale G. 
  
 Fixed Income Option 1 - Income
for a Specified Period 
  
 We will make level payments only for the fixed
period you choose. In the event of the death of the person receiving payments prior to the end of the fixed period elected, payments will be continued to that person’s beneficiary or may be commuted and their present value may be paid in a
single sum. No funds will remain at the end. 
  
 Fixed Income Option 2 - Life
Income 
  
 You may choose between: 
  

	(a)	No Period Certain - We will make level payments only during the annuitant’s lifetime. 

  

	(b)	10 Years Certain - We will make level payments for the longer of the annuitant’s lifetime or ten years. In the event of the death of the person receiving payments prior
to the end of the fixed period elected, payments will be continued to that person’s beneficiary or may be commuted and their present value may be paid in a single sum. 

  

	(c)	Guaranteed Return of Policy Proceeds - We will make level payments for the longer of the annuitant’s lifetime or until the total dollar amount of payments equals the
amount applied to this option. 

  
 If a life only option is elected,
no further payments will be made in the event of the death of the person upon whose life the payments are based. 
  
 Fixed income option 2(a) is not available for annuitant adjusted age(s) greater than 85. 
  

			
	SB1419	  	Page 15

  
 SECTION 10 - CONTINUED

  
 Fixed Income Option 3 - Income of a Specified Amount 
  
 Payments are made for any specified amount until the amount applied to this option, with
interest, is exhausted. This will be a series of level payments followed by a smaller final payment. The period of time over which these payments will be made is the guaranteed period. The specified amount (i.e., level payment) determines the
guaranteed period and the smaller final payment, based on the guaranteed interest rate of 1.5%. The guaranteed period and the smaller final payment will be determined using current interest rates if they are greater than the guaranteed interest
rate. This option is similar to Option 1, except that the information cannot be included in a table (since the specified amount is not known in advance). In the event of the death of the person receiving payments prior to the time proceeds with
interest are exhausted, payments will be continued to that person’s beneficiary or may be commuted and their present value may be paid in a single sum. 
  
 Fixed Income Option 4 - Joint and Survivor Annuity 
  
 No Period Certain - We will make payments during the joint lifetime of the annuitant and a joint annuitant of your choosing. We will make payments as long as
either person is living. 
  
 Fixed income option 4 is not available for annuitant
adjusted age(s) greater than 85. 
  
 Current Income Options 
  
 The amounts shown in the tables on pages 18 and 19 are the guaranteed amounts. You may
obtain current amounts we offer to individuals of the same class, subject to availability as described under “Guaranteed Income Options” above. Any rates not shown in the tables contained in this annuity policy and which are available will
be provided by the Company upon request. 
  

	C.	VARIABLE INCOME OPTIONS 

  
 Variable Annuity Units 
  
 We will use the policy value you tell us to apply to a variable income option to purchase variable annuity units in your chosen subaccounts. The dollar value of variable annuity units in your chosen subaccounts will
increase or decrease reflecting the investment experience of your chosen subaccounts. The value of a variable annuity unit in a particular subaccount on any business day is equal to (a) multiplied by (b) multiplied by (c), where: 
  

	(a)	is the variable annuity unit value for that subaccount on the immediately preceding business day; 

  

	(b)	is the net investment factor for that subaccount for the valuation period; and 

  

	(c)	is the assumed investment return adjustment factor for the valuation period. 

  

The assumed investment return adjustment factor for the valuation period is the product of daily discount factors which reflect the effective annual assumed investment
return shown on page 20. 
  
 The net investment factor used to calculate the value
of a variable annuity unit in each subaccount for the valuation period is determined by dividing (a) by (b) and subtracting (c) from the result, where: 
  

	(a)	is the net result of: 

  

	 	(1)	the net asset value of a fund share held in that subaccount determined as of the end of the current valuation period; plus 

  

	 	(2)	the per share amount of any dividend or capital gain distributions made by the fund for shares held in that subaccount if the ex-dividend date occurs during the valuation period;
plus or minus 

  

	 	(3)	a per share credit or charge for any taxes reserved for, which we determine to have resulted from the investment operations of the subaccount. 

  

	(b)	is the net asset value of a fund share held in that subaccount determined as of the end of the immediately preceding valuation period. 

  

	(c)	is a factor representing the mortality and expense risk fee and administrative charge applicable after the annuity commencement date. This factor is less than or equal to, on an
annual basis, the percentage shown on the Policy Data page, of the daily net asset value of a fund share held in the separate account for that subaccount. 

  

			
	C995	  	Page 16

  
 SECTION 10 –
CONTINUED 
  
 Determination of the First Variable Payment 

 
 The amount of the first variable payment is determined by multiplying each $1,000 of
policy value allocated to a variable income option by the amounts shown on the variable income option table for the variable income option you select. The tables are based on the effective annual assumed investment return shown on page 20 and the
“Annuity 2000” (male, female, and unisex if required by law) mortality table projected for improvement using projection scale G (50% of the female scale G factors were used, while 100% of the male scale G factors were used). The rates were
projected dynamically using an assumed Annuity Commencement date of 2005. The “Annuity 2000” mortality rates are adjusted based on improvements in mortality since 2000 to more appropriately reflect increased longevity. This is accomplished
using a set of improvement factors referred to as projection scale G. 
  
 Variable Income Option 3-V - Life Income 
  
 You may choose
between: 
  

	(a)	No Period Certain – We will make payments during the lifetime of the annuitant. 

  

	(b)	10 Years Certain – We will make payments for the longer of the annuitant’s lifetime or ten years. In the event of the death of the person receiving payments prior
to the end of the guarantee period for which the election was made, payments will be continued to that person’s beneficiary or may be commuted and their present value may be paid in a single sum. For this option, present values would be
determined using only an interest rate component, but not using a mortality component. 

  
 Variable Income Option 3-V(a) is not available for adjusted age(s) greater than 85. 
  
 Variable Income Option 5-V - Joint and Survivor Annuity 
  
 No Period Certain – We will make payments as long as either the annuitant or the joint annuitant is living. 
  
 Variable income option 5-V is not available for annuitant adjusted age(s) greater than 85.

  
 Determination of Subsequent Variable Payments 
  
 The number of variable annuity units in each selected subaccount is determined by dividing
the first variable annuity payment allocated to the subaccount by the variable annuity unit value of that subaccount on the annuity commencement date. The amount of each variable annuity payment after the first payment will increase or decrease
according to the value of the variable annuity units which reflect the investment experience of the selected subaccounts. Each variable annuity payment after the first payment will be equal to the number of variable annuity units in the selected
subaccounts multiplied by the variable annuity unit value on the date the payment is made. 
  
 Once annuity payments begin, neither expenses actually incurred other than taxes on the investment return, nor mortality actually experienced by the Company, shall adversely affect the dollar amount of variable
annuity payments to any annuitant for whom such payments have commenced. 
  

			
	CB995	  	Page 17

  
 GUARANTEED FIXED INCOME
OPTIONS ** 
  
 The amounts shown in these tables are the
guaranteed monthly amounts for each 1,000 of the proceeds. 
 Higher current amounts may be available at the time of settlement. 
  

																							
	 Option 1

	  	Age*

	  	Option 2 (a)

	  	Option 2 (b)

	  	Option 2 (c)

	 Number
of
Years
Payable

	  	Amount of
Monthly
Installment

	  	  	 Monthly Installment
 For Life No Period
Certain

	  	Monthly Installment
For Life 10 Years
Certain

	  	Monthly Installment For
Life Guaranteed Return
of Policy Proceeds

	 	  	 	  	  	Male

	  	Female

	  	Male

	  	Female

	  	Male

	  	Female

	 	  	 	  	50	  	$	2.97	  	$	2.86	  	$	2.96	  	$	2.86	  	$	2.79	  	$	2.74
	 	  	 	  	51	  	 	3.04	  	 	2.92	  	 	3.02	  	 	2.91	  	 	2.84	  	 	2.79
	 	  	 	  	52	  	 	3.10	  	 	2.98	  	 	3.08	  	 	2.97	  	 	2.89	  	 	2.84
	 	  	 	  	53	  	 	3.18	  	 	3.05	  	 	3.15	  	 	3.03	  	 	2.94	  	 	2.89
	 5
	  	17.28	  	54	  	 	3.25	  	 	3.11	  	 	3.22	  	 	3.10	  	 	3.00	  	 	2.94
	 6
	  	14.51	  	55	  	 	3.33	  	 	3.18	  	 	3.30	  	 	3.17	  	 	3.06	  	 	3.00
	 7
	  	12.53	  	56	  	 	3.41	  	 	3.26	  	 	3.38	  	 	3.24	  	 	3.12	  	 	3.06
	 8
	  	11.04	  	57	  	 	3.50	  	 	3.34	  	 	3.46	  	 	3.32	  	 	3.18	  	 	3.12
	 9
	  	9.89	  	58	  	 	3.60	  	 	3.42	  	 	3.55	  	 	3.39	  	 	3.25	  	 	3.18
	 10
	  	8.96	  	59	  	 	3.69	  	 	3.51	  	 	3.65	  	 	3.48	  	 	3.32	  	 	3.25
	 11
	  	8.21	  	60	  	 	3.80	  	 	3.60	  	 	3.75	  	 	3.57	  	 	3.39	  	 	3.32
	 12
	  	7.58	  	61	  	 	3.91	  	 	3.70	  	 	3.85	  	 	3.66	  	 	3.46	  	 	3.39
	 13
	  	7.05	  	62	  	 	4.03	  	 	3.81	  	 	3.96	  	 	3.76	  	 	3.54	  	 	3.47
	 14
	  	6.59	  	63	  	 	4.16	  	 	3.92	  	 	4.07	  	 	3.87	  	 	3.63	  	 	3.55
	 15
	  	6.20	  	64	  	 	4.30	  	 	4.04	  	 	4.20	  	 	3.98	  	 	3.72	  	 	3.63
	 16
	  	5.85	  	65	  	 	4.45	  	 	4.16	  	 	4.32	  	 	4.09	  	 	3.81	  	 	3.72
	 17
	  	5.55	  	66	  	 	4.60	  	 	4.30	  	 	4.46	  	 	4.22	  	 	3.91	  	 	3.81
	 18
	  	5.27	  	67	  	 	4.77	  	 	4.45	  	 	4.60	  	 	4.35	  	 	4.01	  	 	3.91
	 19
	  	5.03	  	68	  	 	4.95	  	 	4.60	  	 	4.75	  	 	4.49	  	 	4.11	  	 	4.01
	 20
	  	4.81	  	69	  	 	5.14	  	 	4.77	  	 	4.90	  	 	4.64	  	 	4.23	  	 	4.12
	 	  	 	  	70	  	 	5.34	  	 	4.95	  	 	5.06	  	 	4.79	  	 	4.34	  	 	4.24
	 	  	 	  	71	  	 	5.56	  	 	5.15	  	 	5.22	  	 	4.95	  	 	4.47	  	 	4.36
	 	  	 	  	72	  	 	5.79	  	 	5.36	  	 	5.39	  	 	5.12	  	 	4.60	  	 	4.49
	 	  	 	  	73	  	 	6.03	  	 	5.59	  	 	5.56	  	 	5.30	  	 	4.73	  	 	4.62
	 	  	 	  	74	  	 	6.30	  	 	5.83	  	 	5.74	  	 	5.49	  	 	4.88	  	 	4.77
	 	  	 	  	75	  	 	6.58	  	 	6.10	  	 	5.93	  	 	5.68	  	 	5.03	  	 	4.92
	 	  	 	  	76	  	 	6.88	  	 	6.39	  	 	6.11	  	 	5.88	  	 	5.18	  	 	5.08
	 	  	 	  	77	  	 	7.20	  	 	6.70	  	 	6.30	  	 	6.09	  	 	5.35	  	 	5.25
	 	  	 	  	78	  	 	7.55	  	 	7.03	  	 	6.49	  	 	6.30	  	 	5.53	  	 	5.43
	 	  	 	  	79	  	 	7.92	  	 	7.40	  	 	6.68	  	 	6.51	  	 	5.71	  	 	5.61
	 	  	 	  	80	  	 	8.32	  	 	7.79	  	 	6.87	  	 	6.72	  	 	5.90	  	 	5.81
	 	  	 	  	81	  	 	8.75	  	 	8.22	  	 	7.06	  	 	6.93	  	 	6.11	  	 	6.02
	 	  	 	  	82	  	 	9.20	  	 	8.69	  	 	7.24	  	 	7.13	  	 	6.32	  	 	6.24
	 	  	 	  	83	  	 	9.69	  	 	9.19	  	 	7.41	  	 	7.33	  	 	6.55	  	 	6.48
	 	  	 	  	84	  	 	10.21	  	 	9.74	  	 	7.58	  	 	7.52	  	 	6.78	  	 	6.72
	 	  	 	  	85	  	 	10.77	  	 	10.33	  	 	7.74	  	 	7.69	  	 	7.03	  	 	6.98
	 	  	 	  	86	  	 	 	  	 	 	  	 	7.89	  	 	7.86	  	 	7.29	  	 	7.26
	 	  	 	  	87	  	 	 	  	 	 	  	 	8.03	  	 	8.01	  	 	7.57	  	 	7.54
	 	  	 	  	88	  	 	 	  	 	 	  	 	8.16	  	 	8.15	  	 	7.86	  	 	7.84
	 	  	 	  	89	  	 	 	  	 	 	  	 	8.28	  	 	8.27	  	 	8.17	  	 	8.15
	 	  	 	  	90	  	 	 	  	 	 	  	 	8.38	  	 	8.38	  	 	8.49	  	 	8.48
	 	  	 	  	91	  	 	 	  	 	 	  	 	8.48	  	 	8.48	  	 	8.83	  	 	8.82
	 	  	 	  	92	  	 	 	  	 	 	  	 	8.57	  	 	8.57	  	 	9.19	  	 	9.18
	 	  	 	  	93	  	 	 	  	 	 	  	 	8.65	  	 	8.64	  	 	9.58	  	 	9.56
	 	  	 	  	94	  	 	 	  	 	 	  	 	8.72	  	 	8.71	  	 	10.00	  	 	9.97
	 	  	 	  	95	  	 	 	  	 	 	  	 	8.78	  	 	8.77	  	 	10.45	  	 	10.40
	 	  	 	  	96	  	 	 	  	 	 	  	 	8.83	  	 	8.82	  	 	10.94	  	 	10.87
	 	  	 	  	97	  	 	 	  	 	 	  	 	8.87	  	 	8.86	  	 	11.48	  	 	11.38
	 	  	 	  	98	  	 	 	  	 	 	  	 	8.90	  	 	8.90	  	 	12.07	  	 	11.95

  

	*	Adjusted age as defined in Section 10.A. 

  

	**	The guaranteed fixed income amounts are based on a guaranteed annual effective interest rate of 1.5%. 

  
 Dollar amounts of monthly, quarterly, semi-annual and annual installments not shown in the above tables will be calculated on the same basis
as those shown and may be obtained from the Company (if the option is available based on adjusted age as described in Section 10). 
  
 If any life income settlement option with a period certain provides for installment payments of the same amount at some ages for different periods certain, the Company
will deem the election to have been made for the longest period certain which could have been elected for such age and amount. 
  

			
	T1148	  	Page 18

  
 Fixed Income Option 4

  
 Monthly Installment For Joint and Full Survivor 

 

																						
	 Adjusted Age
 of
 Male
Annuitant*

	  	Adjusted Age of Female Annuitant*

	  	15 Years
Less Than
Male

	  	12 Years
Less Than
Male

	  	9 Years
Less Than
Male

	  	6 Years
Less Than
Male

	  	3 Years
Less Than
Male

	  	Same As
Male

	  	3 Years
More Than
Male

	 50
	  	$	2.20	  	$	2.27	  	$	2.34	  	$	2.41	  	$	2.48	  	$	2.55	  	$	2.62
	 55
	  	 	2.35	  	 	2.44	  	 	2.52	  	 	2.61	  	 	2.71	  	 	2.80	  	 	2.88
	 60
	  	 	2.54	  	 	2.64	  	 	2.76	  	 	2.88	  	 	2.99	  	 	3.11	  	 	3.23
	 65
	  	 	2.77	  	 	2.91	  	 	3.06	  	 	3.22	  	 	3.38	  	 	3.54	  	 	3.69
	 70
	  	 	3.08	  	 	3.26	  	 	3.46	  	 	3.67	  	 	3.89	  	 	4.11	  	 	4.33
	 75
	  	 	3.47	  	 	3.72	  	 	3.99	  	 	4.29	  	 	4.60	  	 	4.93	  	 	5.24
	 80
	  	 	4.01	  	 	4.35	  	 	4.74	  	 	5.17	  	 	5.62	  	 	6.08	  	 	6.53
	 85
	  	 	4.75	  	 	5.25	  	 	5.81	  	 	6.44	  	 	7.09	  	 	7.75	  	 	8.36

  

	*	Adjusted age as defined in Section 10.A. 

  
 Dollar amounts of monthly, quarterly, semi-annual, and annual installments not shown in the above tables will be calculated on the same basis as those shown and may be
obtained from the Company (if the option is available based on adjusted age as described in Section 10). 
  
 If any life income settlement option with a period certain provides for installment payments of the same amount at some ages for different periods certain, the Company will deem the election to have been made for the
longest period certain which could have been elected for such age and amount. 
  

			
	TB1148	  	Page 19

  
 VARIABLE INCOME OPTIONS

 BASED ON ASSUMED INVESTMENT RETURN ** 
  
 The amounts shown in these tables are the initial payment amounts based on a 5.0% assumed 
 investment return for each $1,000 of the proceeds. 
  

													
	 	  	Option 3-V (a)

	  	Option 3-V (b)

	 	  	 Monthly Installment for Life
 No Period Certain

	  	 Monthly Installment for Life
 10 Years Certain

	 Age*

	  	Male

	  	Female

	  	Male

	  	Female

	 50
	  	$	5.07	  	$	4.93	  	$	5.04	  	$	4.92
	 51
	  	 	5.13	  	 	4.99	  	 	5.09	  	 	4.96
	 52
	  	 	5.19	  	 	5.04	  	 	5.15	  	 	5.01
	 53
	  	 	5.26	  	 	5.10	  	 	5.21	  	 	5.07
	 54
	  	 	5.33	  	 	5.16	  	 	5.27	  	 	5.12
	 55
	  	 	5.40	  	 	5.22	  	 	5.34	  	 	5.18
	 56
	  	 	5.48	  	 	5.29	  	 	5.41	  	 	5.25
	 57
	  	 	5.57	  	 	5.36	  	 	5.49	  	 	5.32
	 58
	  	 	5.66	  	 	5.44	  	 	5.57	  	 	5.39
	 59
	  	 	5.75	  	 	5.52	  	 	5.66	  	 	5.47
	 60
	  	 	5.85	  	 	5.61	  	 	5.75	  	 	5.55
	 61
	  	 	5.97	  	 	5.70	  	 	5.85	  	 	5.63
	 62
	  	 	6.09	  	 	5.81	  	 	5.95	  	 	5.72
	 63
	  	 	6.21	  	 	5.91	  	 	6.06	  	 	5.82
	 64
	  	 	6.35	  	 	6.03	  	 	6.17	  	 	5.92
	 65
	  	 	6.50	  	 	6.16	  	 	6.29	  	 	6.03
	 66
	  	 	6.66	  	 	6.29	  	 	6.42	  	 	6.15
	 67
	  	 	6.83	  	 	6.43	  	 	6.55	  	 	6.27
	 68
	  	 	7.01	  	 	6.59	  	 	6.69	  	 	6.40
	 69
	  	 	7.21	  	 	6.76	  	 	6.83	  	 	6.54
	 70
	  	 	7.41	  	 	6.94	  	 	6.98	  	 	6.69
	 71
	  	 	7.63	  	 	7.14	  	 	7.13	  	 	6.84
	 72
	  	 	7.87	  	 	7.35	  	 	7.28	  	 	7.00
	 73
	  	 	8.12	  	 	7.58	  	 	7.45	  	 	7.17
	 74
	  	 	8.39	  	 	7.83	  	 	7.61	  	 	7.34
	 75
	  	 	8.68	  	 	8.11	  	 	7.78	  	 	7.52
	 76
	  	 	8.99	  	 	8.40	  	 	7.95	  	 	7.71
	 77
	  	 	9.32	  	 	8.72	  	 	8.12	  	 	7.90
	 78
	  	 	9.68	  	 	9.07	  	 	8.29	  	 	8.09
	 79
	  	 	10.06	  	 	9.45	  	 	8.47	  	 	8.29
	 80
	  	 	10.47	  	 	9.85	  	 	8.64	  	 	8.48
	 81
	  	 	10.91	  	 	10.30	  	 	8.80	  	 	8.67
	 82
	  	 	11.38	  	 	10.78	  	 	8.97	  	 	8.86
	 83
	  	 	11.88	  	 	11.30	  	 	9.12	  	 	9.04
	 84
	  	 	12.42	  	 	11.87	  	 	9.27	  	 	9.21
	 85
	  	 	12.99	  	 	12.48	  	 	9.41	  	 	9.37
	 86
	  	 	 	  	 	 	  	 	9.54	  	 	9.51
	 87
	  	 	 	  	 	 	  	 	9.67	  	 	9.65
	 88
	  	 	 	  	 	 	  	 	9.78	  	 	9.77
	 89
	  	 	 	  	 	 	  	 	9.89	  	 	9.88
	 90
	  	 	 	  	 	 	  	 	9.98	  	 	9.98
	 91
	  	 	 	  	 	 	  	 	10.07	  	 	10.07
	 92
	  	 	 	  	 	 	  	 	10.15	  	 	10.15
	 93
	  	 	 	  	 	 	  	 	10.22	  	 	10.22
	 94
	  	 	 	  	 	 	  	 	10.28	  	 	10.28
	 95
	  	 	 	  	 	 	  	 	10.34	  	 	10.28
	 96
	  	 	 	  	 	 	  	 	10.38	  	 	10.38
	 97
	  	 	 	  	 	 	  	 	10.42	  	 	10.42
	 98
	  	 	 	  	 	 	  	 	10.45	  	 	10.45

  

	*	Adjusted age as defined in Section 10.A. 

  

	**	The discount factor per day which corresponds to the assumed investment return of 5.0% is 99986634. 

  
 Dollar amounts of monthly, quarterly, semi-annual, and annual installments not shown in the above tables will be calculated on the same
basis as those shown and may be obtained from the Company (if the option is available based on adjusted age as described in Section 10). 
  
 If any life income settlement option with a period certain provides for installment payments of the same amount at some ages for different periods certain, the Company
will deem the election to have been made for the longest period certain which could have been elected for such age and amount. 
  

			
	H1513	  	Page 20

  
 Variable Income Option 5-V

  
 Monthly Installment For Joint and Full Survivor 

 

																						
	 Adjusted Age
 of
 Male
 Annuitant*

	  	Adjusted Age of Female Annuitant*

	  	 15 Years
 Less Than
Male

	  	 12 Years
 Less Than
Male

	  	 9 Years
 Less Than
Male

	  	 6 Years
 Less Than
Male

	  	 3 Years
 Less Than
Male

	  	Same As
Male

	  	 3 Years
 More Than
Male

	 50
	  	$	4.37	  	$	4.42	  	$	4.46	  	$	4.51	  	$	4.56	  	$	4.62	  	$	4.67
	 55
	  	 	4.48	  	 	4.54	  	 	4.60	  	 	4.67	  	 	4.74	  	 	4.81	  	 	4.88
	 60
	  	 	4.62	  	 	4.70	  	 	4.79	  	 	4.88	  	 	4.98	  	 	5.08	  	 	5.18
	 65
	  	 	4.81	  	 	4.92	  	 	5.04	  	 	5.17	  	 	5.31	  	 	5.46	  	 	5.61
	 70
	  	 	5.07	  	 	5.23	  	 	5.40	  	 	5.59	  	 	5.79	  	 	6.00	  	 	6.22
	 75
	  	 	5.43	  	 	5.65	  	 	5.90	  	 	6.18	  	 	6.48	  	 	6.79	  	 	7.11
	 80
	  	 	5.94	  	 	6.26	  	 	6.63	  	 	7.04	  	 	7.49	  	 	7.95	  	 	8.40
	 85
	  	 	6.67	  	 	7.15	  	 	7.70	  	 	8.31	  	 	8.97	  	 	9.63	  	 	10.26

  

	*	Adjusted age as defined in Section 10.A. 

  
 Dollar amounts of monthly, quarterly, semi-annual, and annual installments not shown in the above tables will be calculated on the same basis as those shown and may be
obtained from the Company (if the option is available based on adjusted age as described in Section 10). 
  
 If any life income settlement option with a period certain provides for installment payments of the same amount at some ages for different periods certain, the Company will deem the election to have been made for the
longest period certain which could have been elected for such age and amount. 
  

			
	J1513	  	Page 21

  
 SECTION 11 - GENERAL
PROVISIONS 
  
 THE CONTRACT 
  
 The entire contract consists of this policy, the Policy Data page, endorsements, and riders,
if any, and the application signed by you, a copy of which is attached hereto. No insertion in or other alteration of any written application can be made by any person other than you without your written consent, except that insertions may be made
by us for administrative purposes only in such manner as to indicate clearly that the insertions are not to be ascribed to you. All statements in the application made by or under the authority of the applicant are representations and not warranties.
Nothing is incorporated by reference, unless a copy is endorsed upon or attached to the policy. Nothing in the policy or any attached endorsements or riders thereto invalidates or impairs any right granted to the owner by New York law. 

 
 MODIFICATION OF POLICY 
  
 No change in this policy is valid unless made in writing by us and approved by one of our
authorized officers. No agent or registered representative has authority to change or waive any provision of your policy. 
  
 TAX QUALIFICATION 
  
 This policy is intended to qualify as an annuity contract for federal income tax purposes. The provisions of this policy are to be interpreted to maintain such qualification, notwithstanding any other provisions to
the contrary. To maintain such tax qualification, we reserve the right to amend this policy to reflect any clarifications that may be needed or are appropriate to maintain such tax qualification or to conform this policy to any applicable changes in
the tax qualification requirements. Any such amendment will be filed with and approved by the New York Department of Insurance prior to use. We will send you a copy in the event of any such amendment. If you refuse such an amendment it must be by
giving us written notice, and your refusal may result in adverse tax consequences. 
  
 NON-PARTICIPATING 
  
 This policy will not share in our profits
or surplus. 
  
 AGE OR SEX CORRECTIONS 
  
 If the age or sex of the annuitant has been misstated, the benefits will be those, which the
premiums paid, would have purchased for the correct age and sex. Any underpayment made by us will be paid with the next payment. Any overpayment made by us will be deducted from future payments. Any underpayment or overpayment, will include interest
at 5% per year, from the date of the incorrect payment to the date of the adjustment. 
  
 INCONTESTABILITY 
  
 This policy shall be incontestable from the
policy date. 
  
 EVIDENCE OF SURVIVAL 
  
 We have the right to require evidence satisfactory to us that a person was alive if a
payment is based on that person being alive. No payment will be made until we receive the evidence of continued survival. 
  
 SETTLEMENT 
  
 Any payment by us under this policy is payable at our administrative office. 
  
 RIGHTS OF OWNER 
  
 Prior to the annuity
commencement date, the owner may, while the annuitant is living: 
  

	 	1.	Assign this policy. 

  

	 	2.	Surrender the policy to us. 

  

	 	3.	Amend or modify the policy with our consent. 

  

	 	4.	Name a payee to receive the payments. 

  

	 	5.	Exercise, receive, and enjoy every other right and benefit contained in the policy. 

  
 The use of these rights may be subject to the consent of any assignee, irrevocable beneficiary, and of the spouse in a community or marital
property state. 
  
 CHANGE OF OWNERSHIP 
  
 As permitted by law, you can change the owner of this policy by notifying us in writing in a
form and manner acceptable to us. When a change takes effect, all rights of ownership in this policy will pass to the new owner. 
  
 A change of owner will not be effective until it is received by us. After it has been so received, the change will take effect as of the date you signed the notice.
However, if the annuitant dies before the notice has been so received, it will not be effective as to those proceeds we have paid before the change was received by us. 
  
 We may require that the change be endorsed in the policy. Changing the owner does not change the beneficiary or the annuitant. 

 
 A change of ownership may result in adverse tax consequences. 
  
 ANNUITY COMMENCEMENT DATE 
  
 The annuity commencement date is the date annuity payments begin. In no event can this date
be later than the last day of the month following the month in which the annuitant attains age 90, or 10 years from the policy date, if later. You may change the annuity commencement date at any time before the annuity commencement date by giving us
30 days’ written notice. However, the revised annuity commencement date may not be earlier than the first day of the calendar month coinciding with or next following the first policy anniversary. 
  

			
	R449	  	Page 22

  
 SECTION 11 - CONTINUED

  
 ASSIGNMENT 
  

	(a)	In the case of a non tax-qualified annuity, this Policy may be assigned. The assignment must be in writing and filed with us. 

  

	(b)	We assume no responsibility for the validity of any assignment. Any claim made under an assignment shall be subject to proof of interest and the extent of the assignment.

  

	(c)	This policy may be applied for and issued to qualify as a tax-qualified annuity under certain sections of the Internal Revenue Code. Ownership of this policy is then restricted so
that it will comply with provisions of the Internal Revenue Code. 

  
 Assignment of this policy may result in adverse tax consequences. 
  
 BENEFICIARY 
  
 Death proceeds, when payable in accordance with
Section 9, are payable to the designated beneficiary or beneficiaries. However, if there is a surviving owner(s), the surviving owner(s) automatically takes the place of any beneficiary designation. Prior to the annuitant’s death, you may name
or change a beneficiary, without the beneficiary’s consent (unless irrevocably designated or required by law) at any time by notifying us in writing in a form and manner acceptable to us. The change will take effect upon the date you sign it,
whether or not you are living when we receive it. The notice must have been postmarked (or show other evidence of delivery that is acceptable to us) on or before the date of the annuitant’s death. Your most recent change of beneficiary notice
will replace any prior beneficiary designations in their entirety. No change will apply to any payment we made before the written notice was received. If an irrevocable beneficiary dies, you may designate a new beneficiary. 
  
 You may direct the manner of payment of death proceeds pursuant to the terms of this policy,
subject to applicable law. In the absence of such direction, the beneficiary may elect the manner of payment or make an election of any option. 
  
 Only those beneficiaries living or in existence at the time of the annuitant’s death will be eligible to receive a share of the death proceeds. If both primary and
contingent beneficiaries have been named, payment will be made to the named primary beneficiaries living or in existence at the time the death proceeds become payable. Payment will be made to the named contingent beneficiaries only if all primary
beneficiaries have died before the death proceeds become payable. 
  
 If death
proceeds are payable to more than one beneficiary and you failed to specify their interest, they will share equally. If any beneficiary is alive at the time the death proceeds become payable, but dies before receiving their payment, their share will
be paid to their estate. 
  
 PROTECTION OF PROCEEDS 
  
 Unless you so direct by filing written notice with us, no beneficiary may assign any
payments under this policy before the payments are due. To the extent permitted by law, no payments under this policy will be subject to the claims of creditors of any beneficiary. 
  
 DEFERMENT 
  
 We will pay any partial withdrawals or surrender proceeds from the separate account within 7 days after all requirements have been met. However, it may happen that the
New York Stock Exchange is closed for trading (other than the usual weekend or holiday closings), or the Securities and Exchange Commission restricts trading or determines that an emergency exists. If so, it may not be practical for us to determine
the investment experience of the separate account. In that case, we may defer transfers among the subaccounts and to the fixed account, and determination or payment of partial withdrawals or surrender proceeds. 
  
 When permitted by law, we may defer paying any partial withdrawals or surrender proceeds from
the fixed account for up to 6 months from the date we receive your request. If the annuitant dies after the request is made, but before the request is processed, the request will be processed before the death proceeds are determined. The interest
rate will be the effective annual interest rate currently being credited to the fixed account. 
  
 REPORTS TO OWNER 
  
 We will give you an
annual report at least once each policy year. This report will show the number and value of the accumulation units held in each of the subaccounts as well as the value of the fixed account. It will also show the death benefit, cash value; surrender
charges and the method for determining the cash value. The report will be sent to you at the most current address we have recorded for you. 
  

			
	RB449	  	Page 23

			
	 

  
 A Stock Company (Hereafter
called the Company, we, our or us)
	 	 Home Office located at:
 4 Manhattanville Road, Purchase, New York 10577
 [Adm. Office located at:
 4333 Edgewood Road N.E. Cedar Rapids, Iowa 52499
 (319) 398-8511]

	 

  
 INDEX 
  

			
	 	 	Page

	 Accumulation Units
	 	8
	 Adjusted Age
	 	14
	 Age or Sex Corrections
	 	22
	 Annuity Commencement Date
	 	22
	 Assignment
	 	23
	 Beneficiary
	 	23
	 Betterment of Rates
	 	14
	 Cash Value
	 	5
	 Commutation of Payments after the Annuity Commencement Date
	 	15
	 Contract
	 	22
	 Death Proceeds
	 	11
	 Definitions
	 	2
	 Dollar Cost Averaging Option
	 	10
	 Evidence of Survival
	 	22
	 Fixed Account
	 	9
	 Guaranteed Minimum Death Benefit
	 	11
	 Guaranteed Return of Fixed Account Premium Payments
	 	6
	 Income Options
	 	15
	 Income Option Tables
	 	18
	 Incontestability
	 	22
	 Modification of Policy
	 	22
	 Non-participating
	 	22
	 Partial Withdrawals
	 	5
	 Payee
	 	14
	 Payment of Premiums
	 	4
	 Policy Data Page
	 	3
	 Policy Value
	 	5
	 Proof of Age
	 	14
	 Protection of Proceeds
	 	23
	 Right to Cancel
	 	1
	 Rights of Owner
	 	22
	 Separate Account
	 	7
	 Service Charge
	 	5
	 Settlement
	 	22
	 Surrender Charges
	 	6
	 Transfers
	 	10

  
 Flexible Premium
Deferred Variable Annuity 
 Income Payable At Annuity Commencement Date 
 Benefits Based On The Performance Of The Separate Account 
 Are Variable And
Are Not Guaranteed As To Dollar Amount (See Sections 5, 6, 9 and 10C) 
 Non-Participating 
 WE RESERVE THE RIGHT TO (I) REFUSE PREMIUM PAYMENTS TO THE FIXED ACCOUNT, 
 AND (II) PROHIBIT TRANSFERS TO THE FIXED ACCOUNT, AFTER THE POLICY DATE 
  

			
	Y1231	  	 

			
	 

  
 A Stock Company (Hereafter
called the Company, we, our or us)
	 	 Home Office located at:
 4 Manhattanville Road, Purchase, New York 10577
 [Adm. Office located at:
 4333 Edgewood Road N.E. Cedar Rapids, Iowa 52499
 (319) 398-8511]

	 

  
 UNISEX AMENDATORY
ENDORSEMENT 
  
 The Policy to which this Endorsement is attached is amended to
replace the Age or Sex Corrections provision in Section 11, the Guaranteed Income Options provision in Section 10 and the Tables in Section 10 (Guaranteed Fixed Income Options and Variable Income Options) with the following language: 
  
 Age Corrections 
  
 If the age of the Annuitant has been misstated, the benefits will be those, which the premiums paid, would have purchased for the correct
age. 
  
 Any underpayment made by us will be paid with the next payment. Any
overpayment made by us will be deducted from future payments. Any underpayment or overpayment will include interest at 5% per year, from the date of the wrong payment to the date of the adjustment. 
  
 Determination of Fixed Income Options 
  
 The fixed income option is determined by multiplying each $1,000 of policy proceeds
allocated to a fixed income option by the amounts shown on pages 18 and 19 for the option you select. Options 1 and 3 are based on a guaranteed interest rate of 1.5%. Options 2 and 4 are based on a guaranteed interest rate of 1.5% and the
“Annuity 2000” (30% male, 70% female) mortality table projected for improvement using projection scale G (50% of the female scale G factors were used, while 100% of the male scale G factors were used). The rates were projected dynamically
using an assumed annuity commencement date of 2005. The “Annuity 2000” mortality rates are adjusted based on improvements in mortality since 2000 to more appropriately reflect increased longevity. This is accomplished using a set of
improvement factors referred to as projection scale G. 
  

			
	AE 1234 1004	  	 

  
 GUARANTEED FIXED INCOME
OPTIONS** 
  
 The amounts shown in these tables are the
guaranteed monthly amounts for each $1,000 of 
 the proceeds. Higher current amounts may be available at the time of settlement. 

 

											
	 Option 1

	  	 	  	 Option 2 (a)

	  	 Option 2 (b)

	  	 Option 2 (c)

	 Number
 of Years

 Payable

	  	 Amount of
Monthly
Installment

	  	 	  	 Monthly Installment For Life
No Period Certain

	  	 Monthly Installment For
Life
10 Years Certain

	  	 Monthly Installment For
Life Guaranteed Return Of
Proceeds

	 	  	 	  	 Age*

	  	 Unisex

	  	 Unisex

	  	 Unisex

	 	  	 	  	50	  	  2.90	  	2.89	  	  2.76
	 	  	 	  	51	  	  2.96	  	2.94	  	  2.80
	 	  	 	  	52	  	  3.02	  	3.01	  	  2.85
	 	  	 	  	53	  	  3.09	  	3.07	  	  2.90
	 5
	  	17.28	  	54	  	  3.15	  	3.14	  	  2.96
	 6
	  	14.51	  	55	  	  3.23	  	3.21	  	  3.02
	 7
	  	12.53	  	56	  	  3.30	  	3.28	  	  3.07
	 8
	  	11.04	  	57	  	  3.39	  	3.36	  	  3.14
	 9
	  	  9.89	  	58	  	  3.47	  	3.44	  	  3.20
	 10
	  	  8.96	  	59	  	  3.56	  	3.53	  	  3.27
	 11
	  	  8.21	  	60	  	  3.66	  	3.62	  	  3.34
	 12
	  	  7.58	  	61	  	  3.76	  	3.72	  	  3.41
	 13
	  	  7.05	  	62	  	  3.87	  	3.82	  	  3.49
	 14
	  	  6.59	  	63	  	  3.99	  	3.93	  	  3.57
	 15
	  	  6.20	  	64	  	  4.12	  	4.04	  	  3.66
	 16
	  	  5.85	  	65	  	  4.25	  	4.16	  	  3.75
	 17
	  	  5.55	  	66	  	  4.39	  	4.29	  	  3.84
	 18
	  	  5.27	  	67	  	  4.54	  	4.42	  	  3.94
	 19
	  	  5.03	  	68	  	  4.71	  	4.57	  	  4.04
	 20
	  	  4.81	  	69	  	  4.88	  	4.71	  	  4.15
	 	  	 	  	70	  	  5.07	  	4.87	  	  4.27
	 	  	 	  	71	  	  5.27	  	5.03	  	  4.39
	 	  	 	  	72	  	  5.49	  	5.20	  	  4.52
	 	  	 	  	73	  	  5.72	  	5.38	  	  4.66
	 	  	 	  	74	  	  5.97	  	5.57	  	  4.80
	 	  	 	  	75	  	  6.24	  	5.76	  	  4.95
	 	  	 	  	76	  	  6.53	  	5.95	  	  5.11
	 	  	 	  	77	  	  6.85	  	6.15	  	  5.28
	 	  	 	  	78	  	  7.19	  	6.36	  	  5.46
	 	  	 	  	79	  	  7.55	  	6.56	  	  5.64
	 	  	 	  	80	  	  7.95	  	6.77	  	  5.84
	 	  	 	  	81	  	  8.38	  	6.97	  	  6.05
	 	  	 	  	82	  	  8.84	  	7.16	  	  6.27
	 	  	 	  	83	  	  9.34	  	7.36	  	  6.50
	 	  	 	  	84	  	  9.88	  	7.54	  	  6.74
	 	  	 	  	85	  	10.46	  	7.71	  	  7.00
	 	  	 	  	86	  	 	  	7.87	  	  7.27
	 	  	 	  	87	  	 	  	8.01	  	  7.55
	 	  	 	  	88	  	 	  	8.15	  	  7.85
	 	  	 	  	89	  	 	  	8.27	  	  8.16
	 	  	 	  	90	  	 	  	8.38	  	  8.48
	 	  	 	  	91	  	 	  	8.48	  	  8.83
	 	  	 	  	92	  	 	  	8.57	  	  9.19
	 	  	 	  	93	  	 	  	8.65	  	  9.57
	 	  	 	  	94	  	 	  	8.71	  	  9.98
	 	  	 	  	95	  	 	  	8.77	  	10.42
	 	  	 	  	96	  	 	  	8.82	  	10.89
	 	  	 	  	97	  	 	  	8.86	  	11.41
	 	  	 	  	98	  	 	  	8.90	  	11.99

  

	*	Adjusted age as defined in Section 10.A. 

  

	**	The guaranteed income amounts are based on a guaranteed interest rate of 1.5%. 

  

Dollar amounts of monthly, quarterly, semi-annual, and annual installments not shown in the above tables will be calculated on the same basis as those shown and may be
obtained from the Company (if the option is available based on adjusted age as described in Section 10). 
  
 If any life income settlement option with a period certain provides for installment payments of the same amount at some ages for different periods certain, the Company will deem the election to have been made for the
longest period certain which could have been elected for such age and amount. 
  

			
	AE 1234 1004 (2)	  	 

  
 Fixed Income Option 4

  
 Monthly Installment For Unisex Joint and Full Survivor

  

																						
	 Adjusted
 Age of
First
Annuitant*

	  	Adjusted Age of Joint Annuitant*

	  	15 Years
Less Than
First

	  	12 Years
Less Than
First

	  	9 Years
Less Than
First

	  	6 Years
Less Than
First

	  	3 Years
Less Than
First

	  	Same As
First

	  	3 Years
More Than
First

	 50
	  	$	2.20	  	$	2.27	  	$	2.34	  	$	2.41	  	$	2.48	  	$	2.55	  	$	2.61
	 55
	  	 	2.36	  	 	2.44	  	 	2.53	  	 	2.62	  	 	2.70	  	 	2.79	  	 	2.87
	 60
	  	 	2.55	  	 	2.65	  	 	2.76	  	 	2.88	  	 	2.99	  	 	3.10	  	 	3.20
	 65
	  	 	2.79	  	 	2.92	  	 	3.07	  	 	3.22	  	 	3.37	  	 	3.52	  	 	3.66
	 70
	  	 	3.10	  	 	3.28	  	 	3.47	  	 	3.67	  	 	3.88	  	 	4.09	  	 	4.28
	 75
	  	 	3.50	  	 	3.75	  	 	4.02	  	 	4.30	  	 	4.60	  	 	4.89	  	 	5.16
	 80
	  	 	4.06	  	 	4.40	  	 	4.78	  	 	5.19	  	 	5.62	  	 	6.04	  	 	6.44
	 85
	  	 	4.83	  	 	5.32	  	 	5.87	  	 	6.47	  	 	7.10	  	 	7.71	  	 	8.28

  

	*	Adjusted age as defined in Section 10.A. 

  
 Dollar amounts of monthly, quarterly, semi-annual and annual installments not shown in the above tables will be calculated on the same basis as those shown and may be
obtained from the Company (if the option is available based on adjusted age as described in Section 10). 
  
 If any life income settlement option with a period certain provides for installment payments of the same amount at some ages for different periods certain, the Company will deem the election to have been made for the
longest period certain which could have been elected for such age and amount. 
  

			
	AE 1234 1004 (3)	  	 

  
 VARIABLE INCOME OPTIONS

 BASED ON ASSUMED INVESTMENT RETURN** 
  
 The amounts shown in these tables are the initial payment amount based on a 5.0% 
 assumed investment return for each $1,000 of the proceeds. 
  

					
	 	  	Option 3-V(a)

	  	Option 3-V(b)

	 	  	Monthly Installment For Life
No Period Certain

	  	Monthly Installment For
Life
10 Years Certain

	 Age*

	  	Unisex

	  	Unisex

	 50
	  	$  4.98  	  	$  4.95  
	 51
	  	  5.03	  	  5.00
	 52
	  	  5.08	  	  5.05
	 53
	  	  5.14	  	  5.11
	 54
	  	  5.21	  	  5.17
	 55
	  	  5.27	  	  5.23
	 56
	  	  5.35	  	  5.30
	 57
	  	  5.42	  	  5.37
	 58
	  	  5.50	  	  5.44
	 59
	  	  5.59	  	  5.52
	 60
	  	  5.68	  	  5.61
	 61
	  	  5.78	  	  5.70
	 62
	  	  5.89	  	  5.79
	 63
	  	  6.00	  	  5.89
	 64
	  	  6.13	  	  6.00
	 65
	  	  6.26	  	  6.11
	 66
	  	  6.40	  	  6.23
	 67
	  	  6.55	  	  6.36
	 68
	  	  6.71	  	  6.49
	 69
	  	  6.89	  	  6.63
	 70
	  	  7.08	  	  6.77
	 71
	  	  7.28	  	  6.93
	 72
	  	  7.50	  	  7.09
	 73
	  	  7.74	  	  7.25
	 74
	  	  8.00	  	  7.42
	 75
	  	  8.28	  	  7.60
	 76
	  	  8.58	  	  7.78
	 77
	  	  8.90	  	  7.97
	 78
	  	  9.25	  	  8.16
	 79
	  	  9.63	  	  8.34
	 80
	  	10.04	  	  8.53
	 81
	  	10.48	  	  8.71
	 82
	  	10.96	  	  8.89
	 83
	  	11.47	  	  9.06
	 84
	  	12.03	  	  9.23
	 85
	  	12.63	  	  9.38
	 86
	  	 	  	  9.52
	 87
	  	 	  	  9.65
	 88
	  	 	  	  9.77
	 89
	  	 	  	  9.88
	 90
	  	 	  	  9.98
	 91
	  	 	  	10.07
	 92
	  	 	  	10.15
	 93
	  	 	  	10.22
	 94
	  	 	  	10.28
	 95
	  	 	  	10.28
	 96
	  	 	  	10.38
	 97
	  	 	  	10.42
	 98
	  	 	  	10.45

  

	*	Adjusted age as defined in the Section 10.A. 

  

	**	The discount factor per day which corresponds to the assumed return of 5.0% is .99986634. 

  
 Dollar amounts of monthly, quarterly, semi-annual, and annual installments not shown in the above tables will be calculated on the same
basis as those shown and may be obtained from the Company (if the option is available based on adjusted age as described in Section 10). 
  
 If any life income settlement option with a period certain provides for installment payments of the same amount at some ages for different periods certain, the Company
will deem the election to have been made for the longest period certain which could have been elected for such age and amount. 
  

			
	AE 1234 1004 (4)	  	 

  
 Variable Income Option 5-V

  
 Monthly Installment For Unisex Joint and Full Survivor

  

																						
	 Adjusted Age
of
First
Annuitant*

	  	Adjusted Age of Joint Annuitant*

	  	15 Years
Less Than
First

	  	12 Years
Less Than
First

	  	9 Years
Less Than
First

	  	6 Years
Less Than
First

	  	3 Years
Less Than
First

	  	Same As
First

	  	3 Years
More Than
First

	 50
	  	$	4.38	  	$	4.42	  	$	4.47	  	$	4.51	  	$	4.56	  	$	4.61	  	$	4.66
	 55
	  	 	4.48	  	 	4.54	  	 	4.60	  	 	4.67	  	 	4.73	  	 	4.80	  	 	4.87
	 60
	  	 	4.63	  	 	4.70	  	 	4.79	  	 	4.88	  	 	4.97	  	 	5.07	  	 	5.16
	 65
	  	 	4.82	  	 	4.93	  	 	5.05	  	 	5.17	  	 	5.30	  	 	5.44	  	 	5.57
	 70
	  	 	5.09	  	 	5.24	  	 	5.41	  	 	5.59	  	 	5.78	  	 	5.97	  	 	6.16
	 75
	  	 	5.46	  	 	5.68	  	 	5.93	  	 	6.19	  	 	6.47	  	 	6.75	  	 	7.03
	 80
	  	 	5.99	  	 	6.31	  	 	6.67	  	 	7.07	  	 	7.48	  	 	7.90	  	 	8.30
	 85
	  	 	6.75	  	 	7.23	  	 	7.76	  	 	8.35	  	 	8.97	  	 	9.59	  	 	10.17

  

	*	Adjusted age as defined in Section 10.A 

  
 Dollar amounts of monthly, quarterly, semi-annual, and annual installments not shown in the above tables will be calculated on the same basis as those shown and may be
obtained from the Company (if the option is available based on adjusted age as described in Section 10). 
  
 If any life income settlement option with a period certain provides for installment payments of the same amount at some ages for different periods certain, the Company will deem the election to have been made for the
longest period certain which could have been elected for such age and amount. 
  
 Signed for us at our home office. 
  

					
			
	[/s/ Illegible]	 	 	 	[/s/ Illegible]
	SECRETARY	 	 	 	PRESIDENT

  

			
	AE 1234 1004 (5)

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00076-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00076-of-00352.parquet"}]]