Document:

exhibit101_09302014.htm

Exhibit 10.1

 

Borrowing Base Redetermination

 

This Borrowing Base Redetermination (this “Redetermination”) dated as of September 30, 2014, is by and among Northern Oil and Gas, Inc., a Minnesota corporation (the “Borrower”), Royal Bank of Canada (the “Administrative Agent”), and the Lenders party hereto.

 

R e c i t a l s

WHEREAS, the Borrower, the Administrative Agent and the other Lenders party thereto entered into that certain Third Amended and Restated Credit Agreement, dated as of February 28, 2012 (as previously amended by the First Amendment dated as of June 29, 2012, the Second Amendment dated as of September 28, 2012, the Third Amendment dated as of March 28, 2013, and the Fourth Amendment dated as of September 30, 2013 and as the same may be further amended, modified, supplemented or restated from time to time, the “Credit Agreement”); and

WHEREAS, the Administrative Agent and the Lenders are willing to redetermine the Borrowing Base as provided herein.

NOW, THEREFORE, in consideration of the premises and the mutual covenants herein contained, for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereto agree as follows:

Section 1.                      Defined Terms.  Each capitalized term which is defined in the Credit Agreement, but which is not defined in this Redetermination, shall have the meaning ascribed such term in the Credit Agreement.  Unless otherwise indicated, all references to sections and articles in this Redetermination refer to sections and articles of the Credit Agreement.

Section 2.                      Borrowing Base Redetermination.  Effective as of the Redetermination Effective Date (as defined below), notwithstanding the requirements of Section 2.07 of the Credit Agreement, the amount of the Borrowing Base is hereby increased from $500,000,000.00 to $550,000,000.00, subject to further adjustments from time to time after the Redetermination Effective Date pursuant to Section 2.07, Section 8.13(c) or Section 9.12(d) of the Credit Agreement.  The increase of the Borrowing Base pursuant to this Section 2 shall constitute the October 1st, 2014 Scheduled Redetermination.

Section 3.                      Conditions Precedent.  This Redetermination shall become effective on the date when each of the following conditions are satisfied or waived in accordance with Section 12.02 of the Credit Agreement (such date, the “Redetermination Effective Date”):

 

3.1           The Administrative Agent shall have received from each Lender and the Borrower counterparts (in such number as may be requested by the Administrative Agent) of this Redetermination signed on behalf of such Persons.

 

 

  

  

 

3.2           No Default shall have occurred and be continuing as of the Redetermination Effective Date.

 

3.3           The Administrative Agent and the Lenders shall have received all fees and other amounts due and payable on or prior to the Redetermination Effective Date, including, without limitation, all fees set forth in the Fee Letter referred to in Section 3.4 hereof.

 

3.4           The Borrower shall have accepted, in writing, and complied with the terms and conditions, of a fee letter dated the date hereof from the Administrative Agent to Borrower (the “Fee Letter”) pursuant to which the Borrower agrees to pay, or cause to be paid, to the Administrative Agent, for the account of the Lenders, certain fees and expenses in connection with the increase of the Borrowing Base.

 

3.5           The Administrative Agent shall have received such other documents as the Administrative Agent or its counsel may reasonably require.

 

The Administrative Agent is hereby authorized and directed to declare this Redetermination to be effective (and the Redetermination Effective Date shall occur) when it has received documents confirming or certifying, to the satisfaction of the Administrative Agent, compliance with the conditions set forth in this Section 3 or the waiver of such conditions as permitted in Section 12.02 of the Credit Agreement.  Such declaration shall be final, conclusive and binding upon all parties to the Credit Agreement for all purposes.

 

Section 4.                      Miscellaneous.

 

4.1           Confirmation.  The provisions of the Credit Agreement shall remain in full force and effect following the Redetermination Effective Date.

 

4.2           Ratification and Affirmation; Representations and Warranties.  Each Obligor hereby (a) acknowledges the terms of this Redetermination; (b) ratifies and affirms its obligations under, and acknowledges its continued liability under, each Loan Document to which it is a party and agrees that each Loan Document to which it is a party remains in full force and effect as expressly amended hereby; and (c) represents and warrants to the Lenders that as of the date hereof, after giving effect to the terms of this Redetermination:  (i) each of the representations and warranties made by the Borrower under the Credit Agreement and each other Loan Document is true and correct on and as of the actual date of execution of this Redetermination by the Borrower, as if made on and as of such date, except for any representations and warranties made as of a specified date, which are true and correct as of such specified date, (ii) no Default or Event of Default has occurred and is continuing and (iii) no event or events have occurred which individually or in the aggregate could reasonably be expected to have a Material Adverse Effect.

 

Borrowing Base Redetermination

Page 2 

  

  

 

 

4.3           Counterparts.  This Redetermination may be executed by one or more of the parties hereto in any number of separate counterparts, and all of such counterparts taken together shall be deemed to constitute one and the same instrument.  Delivery of an executed counterpart of a signature page of this Redetermination by telecopy, facsimile or other similar electronic means shall be effective as delivery of a manually executed counterpart of this Redetermination.

 

4.4           No Oral Agreement.  This Redetermination, the Credit Agreement and the other Loan Documents executed in connection herewith and therewith represent the final agreement between the parties and may not be contradicted by evidence of prior, contemporaneous, or unwritten oral agreements of the parties.  There are no subsequent oral agreements between the parties.

 

4.5           GOVERNING LAW.  THIS REDETERMINATION SHALL BE GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW YORK.

 

4.6           Successors and Assigns.  This Redetermination shall be binding upon and inure to the benefit of the parties hereto and their respective successors and assigns.

 

[Signature Pages Follow]

 

 

 

Borrowing Base Redetermination

Page 3 

  

  

  

 

IN WITNESS WHEREOF, the parties hereto have caused this Redetermination to be duly executed by their respective authorized officers as of the date first written above.

 

NORTHERN OIL AND GAS, INC., as the Borrower

 

By:           /s/  Thomas Stoelk                                                                                           

Name:            Thomas Stoelk

Title:              CFO

Signature Page

Borrowing Base Redetermination

 

  

  

  

 

 

ROYAL BANK OF CANADA, as Administrative Agent

By:           /s/ Rodica Dutka         

Name:           Rodica Dutka

Title:             Authorized Signatory

ROYAL BANK OF CANADA, as a Lender

By:           /s/ Don J. McKinnerney          

Name:           Don J. McKinnerney

Title:             Authorized Signatory

SUNTRUST BANK, as a Lender

By:           /s/  Shannon Juhan         

Name:            Shannon Juhan

Title:              Vice President

BMO HARRIS FINANCING, INC., as a Lender

By:           /s/ Melissa Guzmann        

Name:           Melissa Guzmann

Title:             Vice President

KEYBANK NATIONAL ASSOCIATION, as a Lender

By:           /s/  John Dravenstott          

Name:            John Dravenstott

Title:              Vice President

U.S. BANK NATIONAL ASSOCIATION, as a Lender

By:           /s/  Daniel K. Hansen        

Name:            Daniel K. Hansen

Title:              Vice President

 

Signature Page

Borrowing Base Redetermination

 

  

  

  

 

 

SANTANDER BANK, N.A., as a Lender

By:           /s/  Aidan Lanigan        

Name:            Aidan Lanigan

Title:              SVP

 

By:           /s/  Gilbert Torres             

Name:            Gilbert Torres               

Title:              SVP      

 

CAPITAL ONE, NATIONAL ASSOCIATION, as a Lender

By:           /s/  Victor Ponce de León      

Name:            Victor Ponce de León

Title:              Vice President

BOKF, NA dba BANK OF OKLAHOMA, as a Lender

By:           /s/  Parker Heikes                 

Name:            Parker Heikes

Title:              Vice President

BRANCH BANKING & TRUST COMPANY, as a Lender

By:           /s/  James Giordano              

Name:            James Giordano

Title:              Vice President

CADENCE BANK, N.A., as a Lender

By:           /s/  Eric Broussard                

Name:            Eric Broussard

Title:              Executive Director

Signature Page

Borrowing Base Redetermination

  

  

  

THE BANK OF NOVA SCOTIA, as a Lender

By:           /s/  Alan Dawson        

Name:            Alan Dawson

Title:              Director

ING CAPITAL LLC, as a Lender

By:           /s/  Josh Strong         

Name:            Josh Strong

Title:              Director    

By:           /s/  Charles Hall                

Name:            Charles Hall               

Title:              Managing Director   

 

FIFTH THIRD BANK, as a Lender

By:           /s/  Justin B. Crawford            

Name:            Justin B. Crawford  

Title:              Director

Signature Page

Borrowing Base RedeterminationExhibit (4)(j)

 EXHIBIT (4)(j) 

INCOME SELECT FOR LIFE RIDER 

											
	WESTERN RESERVE LIFE	  		 		 	Home Office: Columbus, Ohio	 		 	
	ASSURANCE CO. OF OHIO	  		 		 	Administrative Office:	 		 	
	A Stock Company	  	 	 	 	 	P.O. Box 9051	 		 	 
	(Hereafter called the Company, We, Our or Us)	  	 	 		 	Clearwater, Florida 33758 - 9051	 		 	 
		  	 	 	 	 	(800) 851 - 9777	 		 	 

 GUARANTEED MINIMUM WITHDRAWAL BENEFIT 

This rider is issued as a part of the policy (contract) to which it is attached. 

Rider Data Specification 
  

											
	Policy Number:	  		 	 	 	12345	 	 	  	
	Rider Date:	  		 		 	01/03/2006	 	 	  	
	Rider Fee Percentage:	  		 		 	0.55%	 	 	  	
	Annuitant:	  		 		 	John Doe	 	 	  	
		  		 		 		 	 	  	
	Annuitant’s Issue Age/Sex:	  		 	 	 	35 / Male	 	 	  	

  
  

ARTICLE I 
 This rider is not available for an
existing qualified policy which has been continued by a surviving spouse or beneficiary as the new owner. This rider will terminate upon the annuitant’s death, if you surrender your policy, elect to upgrade (as described in Article III of this
rider), or elect to receive annuity payments under your policy. This rider will also terminate if the policy to which this rider is attached is assigned or if the owner is changed without our approval. You can terminate this rider within [30 days]
after the [first] rider anniversary and [30 days] after each rider anniversary thereafter. Termination of the rider will result in the loss of all benefits provided by the rider. 

If you elect this rider, [100%] of your policy value must be in one or more of the designated funds. You can generally transfer between the designated funds
as permitted under your policy; however, you cannot make transfers as provided for in the policy to a non-designated fund while this rider is in force. If you wish to make a transfer to a non-designated fund, this rider must be terminated, as
described above, prior to making the transfer. 
 A rider fee will be deducted on each rider anniversary and upon rider termination as described below. 

DEFINITIONS: 
 Terms used that are not defined in this
rider shall have the same meaning as those in your policy. 
 Gross Partial Withdrawal 

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

Rider Anniversary 
 The anniversary of the rider date.

 Rider Fee 
 The rider fee is the rider fee percentage
referenced above, multiplied by the total withdrawal base at the time the fee is deducted. This fee will be deducted from each investment option in proportion to the amount of policy value in that investment option on each rider anniversary. A
portion of this fee will also be deducted when the rider is terminated based on the number of days that have elapsed since it was last deducted. 
 Rider
Year 
 Each twelve-month period following the rider date. 

  

					
	RGMB 19 0106	  	(1)	  	(Income-Single)

 ARTICLE II 

FOR LIFE GUARANTEED MINIMUM WITHDRAWAL BENEFIT 
 Under this
rider, we guarantee that you can withdraw up to the maximum annual withdrawal amount each year, regardless of the policy value, until the annuitant’s death. 

The “For Life” Withdrawal Percentage is determined by the attained age of the annuitant at the time of the first withdrawal of any amount from the
policy value taken on or after January 1st following the annuitant’s [59th] birthday: 
  

																	
	 	 	 Attained Age at

    First Withdrawal    

 
	 	 	 	 “For Life” Withdrawal

          Percentage          

 
	 	 
		 	 	 	 59 - 64
	 	 	 		 	 	  	4.5%	 	 	 	
		 		 	 65 - 69
	 	 	 		 		  	5.0%	 	 	 	
		 		 	 70 - 74
	 	 	 		 		  	5.5%	 	 	 	
		 		 	 75 - 79
	 	 	 		 		  	6.0%	 	 	 	
		 		 	 80 - 84
	 	 	 		 		  	6.5%	 	 	 	
		 		 	 85 - 89
	 	 	 		 		  	7.0%	 	 	 	
		 		 	 90 - 94
	 	 	 		 		  	7.5%	 	 	 	
		 	 	 	 95 +
	 	 	 		 	 	  	8.0%	 	 	 	

 If the annuitant is not yet [59] on the rider date, then this percentage will be zero until the January 1st following the
annuitant’s [59th] birthday. 
 Withdrawals will reduce the policy value of the policy to which this rider is attached. If the policy value equals
zero, you cannot make subsequent premium payments and all other policy features, benefits and guarantees are no longer available. Withdrawals guaranteed by this rider can be continued by selecting an amount and frequency of payment in a manner
acceptable to us. Once the payment amount and frequency are established, they cannot be changed and no additional withdrawals will be paid. 
 Maximum
Annual Withdrawal Amount 
 On the rider date the maximum annual withdrawal amount will be equal to the greater of 1 and 2, where: 

 

	1)	is A multiplied by B multiplied by C where: 

  

	 	A)	is the total withdrawal base on the rider date, 

  

	 	B)	is the “For Life” withdrawal percentage as determined and shown above. If the annuitant is not yet [59] on the rider date, this percentage will be equal to 0%, and 

 

	 	C)	is equal to the number of days between the rider date and January 1st of the next calendar year, divided by the number of days in the current calendar year. 

 

	2)	is an amount equal to the minimum required distribution amount (based on the premium paid to the policy to which this rider is attached) for the current calendar year using the annuitant’s age only if all of the
following are true: 

  

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

  

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

  

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

 

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

 

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

  

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

If any of the above are not true, then 2) is equal to zero and it is not available as a maximum annual withdrawal amount. An amount in addition
to the amount described in 2 above, may need to be taken to satisfy minimum required distributions, in certain situations. Such additional withdrawal amount will be considered an excess gross partial withdrawal (as described under “Total
Withdrawal Base Adjustments” below). 

  

					
	RGMB 19 0106	  	(2)	  	(Income-Single)

 ARTICLE II CONTINUED 

On January 1st of each subsequent calendar year following the rider date, the maximum annual withdrawal amount will be reset equal to the greater of 1 and
2, where: 
  

	1)	is A multiplied by B where: 

  

	 	A)	is the total withdrawal base as of this date, and 

  

	 	B)	is the “For Life” withdrawal percentage as determined and shown above. If the annuitant is not yet [59] on January 1st of the current calendar year, this percentage will be equal to 0%. 

 

	2)	is an amount equal to the minimum required distribution amount for this policy for the current calendar year using the annuitant’s age only if all of the following are true: 

 

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

  

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

  

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

 

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

 

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

  

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

If any of the above are not true, then 2) is equal to zero and the minimum required distribution is not available as a maximum annual
withdrawal amount. An amount in addition to the amount described in 2 above, may need to be taken to satisfy minimum required distributions. Such additional withdrawal amount will be considered an excess gross partial withdrawal (as described under
“Total Withdrawal Base Adjustments” below). 
 Total Withdrawal Base 

The total withdrawal base on the rider date is equal to the policy value (less any premium enhancements, if the rider is added in the first policy year). After
the rider date, the total withdrawal base is equal to the total withdrawal base on the rider date, plus the full amount of any premiums added after the rider date, less any adjustments for withdrawals described below. 

Total Withdrawal Base Adjustments 
 Gross partial
withdrawals up to the maximum annual withdrawal amount will not reduce the total withdrawal base. Gross partial withdrawals in excess of the maximum annual withdrawal amount will reduce the total withdrawal base by the greater of 1 and 2, where:

  

	1)	is the excess gross partial withdrawal amount; and 

  

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

  

	 	A)	is the excess gross partial withdrawal (the amount in excess of the maximum annual withdrawal amount remaining prior to the withdrawal); 

 

	 	B)	is the policy value after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

 

	 	C)	is the total withdrawal base prior to the withdrawal of the excess amount. 

  

					
	RGMB 19 0106	  	(3)	  	(Income-Single)

 ARTICLE III 

CONTINUATION 
 In the case of spousal joint owners where
one spouse is the annuitant, if the spouse who is not the annuitant dies and the surviving spouse is the sole beneficiary, the surviving spouse may elect to continue the policy and rider. 

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

RIDER UPGRADE 
 You may elect, in writing, to upgrade the
total withdrawal base to the policy value within [30 days] after the [first] rider anniversary and [30 days] after each rider anniversary thereafter, subject to the age restrictions on the new rider. If an upgrade is elected, this rider will
terminate and a new rider with the same features will be issued with a new rider date. The new rider will have its own Rider Fee Percentage which may be higher than this rider’s Rider Fee Percentage. 

At the time of upgrade, the maximum annual withdrawal amount will be recalculated based on the new total withdrawal base. 

The new rider effective date will be the date the Company receives all information necessary, in a written form acceptable to the Company, to process the
upgrade. 
 Signed for us at our home office. 
  

															
		 	 	 	

	 	 	 		 	 	 	

	 	 
		 		 		 		 		 		 		 	
		 		 	SECRETARY	 		 		 		 	PRESIDENT	 	

  

					
	RGMB 19 0106	  	(4)	  	(Income-Single)

											
	WESTERN RESERVE LIFE	  		 		 	Home Office: Columbus, Ohio	 		 	
	ASSURANCE CO. OF OHIO	  		 		 	Administrative Office:	 		 	
	A Stock Company	  	 	 	 	 	P.O. Box 9051	 		 	 
	(Hereafter called the Company, We, Our or Us)	  	 	 		 	Clearwater, Florida 33758 - 9051	 		 	 
		  	 	 	 	 	(800) 851 - 9777	 		 	 

 GUARANTEED MINIMUM WITHDRAWAL BENEFIT AND DEATH BENEFIT RIDER 

This rider is issued as a part of the policy (contract) to which it is attached. 

Rider Data Specification 
  

											
	Policy Number:	  		 	 	 	12345	 	 	  	
	Rider Date:	  		 		 	01/03/2006	 	 	  	
	Rider Fee Percentage:	  		 		 	0.85%	 	 	  	
	Annuitant:	  		 		 	John Doe	 	 	  	
			 		 	
	Annuitant’s Issue Age/Sex:	  		 	 	 	35 / Male	 	 	  	

  
  

ARTICLE I 
 This rider is not available for an
existing qualified policy which has been continued by a surviving spouse or beneficiary as the new owner. This rider will terminate upon the annuitant’s death, if you surrender your policy, elect to upgrade (as described in Article III of this
rider), or elect to receive annuity payments under your policy. This rider will also terminate if the policy to which this rider is attached is assigned or if the owner is changed without our approval. You can terminate this rider within [30 days]
after the [first] rider anniversary and [30 days] after each rider anniversary thereafter. Termination of the rider will result in the loss of all benefits provided by the rider. 

If you elect this rider, [100%] of your policy value must be in one or more of the designated funds. You can generally transfer between the designated funds
as permitted under your policy; however, you cannot make transfers as provided for in the policy to a non-designated fund while this rider is in force. If you wish to make a transfer to a non-designated fund, this rider must be terminated, as
described above, prior to making the transfer. 
 A rider fee will be deducted on each rider anniversary and upon rider termination as described below. 

DEFINITIONS: 
 Terms used that are not defined in this
rider shall have the same meaning as those in your policy. 
 Gross Partial Withdrawal 

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

Rider Anniversary 
 The anniversary of the rider date.

 Rider Fee 
 The rider fee is the rider fee percentage
referenced above, multiplied by the total withdrawal base at the time the fee is deducted. This fee will be deducted from each investment option in proportion to the amount of policy value in that investment option on each rider anniversary. A
portion of this fee will also be deducted when the rider is terminated based on the number of days that have elapsed since it was last deducted. 
 Rider
Year 
 Each twelve-month period following the rider date. 

  

					
	RGMB 19 0106	  	(1)	  	(Income/Death-Single)

 ARTICLE II 

FOR LIFE GUARANTEED MINIMUM WITHDRAWAL BENEFIT 
 Under this
rider, we guarantee that you can withdraw up to the maximum annual withdrawal amount each year, regardless of the policy value, until the annuitant’s death. 

The “For Life” Withdrawal Percentage is determined by the attained age of the annuitant at the time of the first withdrawal of any amount from the
policy value taken on or after January 1st following the annuitant’s [59th] birthday: 
  

																	
	 	 	 Attained Age at

    First Withdrawal    

 
	 	 	 	 “For Life” Withdrawal

          Percentage          

 
	 	 
		 	 	 	 59 - 64
	 	 	 		 	 	  	4.5%	 	 	 	
		 		 	 65 - 69
	 	 	 		 		  	5.0%	 	 	 	
		 		 	 70 - 74
	 	 	 		 		  	5.5%	 	 	 	
		 		 	 75 - 79
	 	 	 		 		  	6.0%	 	 	 	
		 		 	 80 - 84
	 	 	 		 		  	6.5%	 	 	 	
		 		 	 85 - 89
	 	 	 		 		  	7.0%	 	 	 	
		 		 	 90 - 94
	 	 	 		 		  	7.5%	 	 	 	
		 	 	 	 95 +
	 	 	 		 	 	  	8.0%	 	 	 	

 If the annuitant is not yet [59] on the rider date, then this percentage will be zero until the January 1st following the
annuitant’s [59th] birthday. 
 Withdrawals will reduce the policy value of the policy to which this rider is attached. If the policy value equals
zero, you cannot make subsequent premium payments and all other policy features, benefits and guarantees are no longer available. Withdrawals guaranteed by this rider can be continued by selecting an amount and frequency of payment in a manner
acceptable to us. Once the payment amount and frequency are established, they cannot be changed and no additional withdrawals will be paid. 
 Maximum
Annual Withdrawal Amount 
 On the rider date the maximum annual withdrawal amount will be equal to the greater of 1 and 2, where: 

 

	1)	is A multiplied by B multiplied by C where: 

  

	 	A)	is the total withdrawal base on the rider date, 

  

	 	B)	is the “For Life” withdrawal percentage as determined and shown above. If the annuitant is not yet [59] on the rider date, this percentage will be equal to 0%, and 

 

	 	C)	is equal to the number of days between the rider date and January 1st of the next calendar year, divided by the number of days in the current calendar year. 

 

	2)	is an amount equal to the minimum required distribution amount (based on the premium paid to the policy to which this rider is attached) for the current calendar year using the annuitant’s age only if all of the
following are true: 

  

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

  

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

  

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

 

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

 

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

  

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

If any of the above are not true, then 2) is equal to zero and it is not available as a maximum annual withdrawal amount. An amount in addition
to the amount described in 2 above, may need to be taken to satisfy minimum required distributions, in certain situations. Such additional withdrawal amount will be considered an excess gross partial withdrawal (as described under “Total
Withdrawal Base Adjustments” below). 

  

					
	RGMB 19 0106	  	(2)	  	(Income/Death-Single)

 ARTICLE II CONTINUED 

On January 1st of each subsequent calendar year following the rider date, the maximum annual withdrawal amount will be reset equal to the greater of 1 and
2, where: 
  

	1)	is A multiplied by B where: 

  

	 	A)	is the total withdrawal base as of this date, and 

  

	 	B)	is the “For Life” withdrawal percentage as determined and shown above. If the annuitant is not yet [59] on January 1st of the current calendar year, this percentage will be equal to 0%. 

 

	2)	is an amount equal to the minimum required distribution amount for this policy for the current calendar year using the annuitant’s age only if all of the following are true: 

 

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

  

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

  

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

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

 

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

  

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

If any of the above are not true, then 2) is equal to zero and the minimum required distribution is not available as a maximum annual
withdrawal amount. An amount in addition to the amount described in 2 above, may need to be taken to satisfy minimum required distributions. Such additional withdrawal amount will be considered an excess gross partial withdrawal (as described under
“Total Withdrawal Base Adjustments” below). 
 Minimum Remaining Withdrawal Amount 

The minimum remaining withdrawal amount is the total minimum dollar amount of guaranteed withdrawals you have remaining, provided withdrawals do not exceed the
maximum annual withdrawal amount each rider year. The minimum remaining withdrawal amount on the rider date is equal to the policy value (less premium enhancements, if the rider is added in the first policy year). The minimum remaining withdrawal
amount after the rider date is equal to the minimum remaining withdrawal amount on the rider date plus any premiums added after the rider date (not including premium enhancements, if any) less any adjustments for withdrawals (as described under
“Minimum Withdrawal Amount Adjustments” below). 
 Minimum Remaining Withdrawal Amount Adjustments 

Gross partial withdrawals up to the maximum annual withdrawal amount will reduce the minimum remaining withdrawal amount by the same amount (dollar for
dollar). Gross partial withdrawals in excess of the maximum annual withdrawal amount will reduce the minimum remaining withdrawal amount by the greater of: 
  

	1)	the excess gross partial withdrawal amount; and 

  

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

  

	 	A)	is the excess gross partial withdrawal (the amount in excess of the maximum annual withdrawal amount remaining prior to the withdrawal); 

 

	 	B)	is the policy value after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

 

	 	C)	is the minimum remaining withdrawal amount after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount. 

Total Withdrawal Base 
 The total withdrawal base on the
rider date is equal to the policy value (less any premium enhancements, if the rider is added in the first policy year). After the rider date, the total withdrawal base is equal to the total withdrawal base on the rider date, plus the full amount of
any premiums added after the rider date, less any adjustments for withdrawals described below. 

  

					
	RGMB 19 0106	  	(3)	  	(Income/Death-Single)

 ARTICLE II CONTINUED 

Total Withdrawal Base Adjustments 
 Gross partial
withdrawals up to the maximum annual withdrawal amount will not reduce the total withdrawal base. Gross partial withdrawals in excess of the maximum annual withdrawal amount will reduce the total withdrawal base by the greater of 1 and 2, where:

  

	1)	is the excess gross partial withdrawal amount; and 

  

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

  

	 	A)	is the excess gross partial withdrawal (the amount in excess of the maximum annual withdrawal amount remaining prior to the withdrawal); 

 

	 	B)	is the policy value after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

 

	 	C)	is the total withdrawal base prior to the withdrawal of the excess amount. 

 Death Benefit 

Upon the death of the annuitant, we will pay an additional death benefit amount equal to the excess, if any, of the minimum remaining withdrawal amount over
the base policy death benefit and this rider will then terminate. 
 ARTICLE III 

CONTINUATION 
 In the case of spousal joint owners where
one spouse is the annuitant, if the spouse who is not the annuitant dies and the surviving spouse is the sole beneficiary, the surviving spouse may elect to continue the policy and rider. No additional death benefit will be paid under this rider at
this time. 
 In the case of non-spousal joint owners where an owner who is not the annuitant dies, the surviving owner (who is also the sole designated
beneficiary) may elect to receive lifetime income payments under this rider instead of receiving any benefits applicable to the policy. The lifetime income payments must begin no later than 1 year after the owner’s death and will be equal to
the maximum annual withdrawal amount divided by the number of payments made per year. Once the payments begin, no additional premium payments will be accepted and no additional withdrawals will be paid. If these payments are elected but the
annuitant dies before the minimum remaining withdrawal amount equals zero, the annuitant’s beneficiary will receive a death benefit equal to the minimum remaining withdrawal amount. 

RIDER UPGRADE 
 You may elect, in writing, to upgrade the
total withdrawal base to the policy value within [30 days] after the [first] rider anniversary and [30 days] after each rider anniversary thereafter, subject to the age restrictions on the new rider. If an upgrade is elected, this rider will
terminate and a new rider with the same features will be issued with a new rider date. The new rider will have its own Rider Fee Percentage which may be higher than this rider’s Rider Fee Percentage. 

At the time of upgrade, the minimum remaining withdrawal amount will also be upgraded to the policy value and the maximum annual withdrawal amount will be
recalculated based on the new total withdrawal base. 
 The new rider effective date will be the date the Company receives all information necessary, in a
written form acceptable to the Company, to process the upgrade. 
 Signed for us at our home office. 

 

															
		 	 	 	

	 	 	 		 	 	 	

	 	 
		 		 		 		 		 		 		 	
		 		 	SECRETARY	 		 		 		 	PRESIDENT	 	

  

					
	RGMB 19 0106	  	(4)	  	(Income/Death-Single)

											
	WESTERN RESERVE LIFE	  		 		 	Home Office: Columbus, Ohio	 		 	
	ASSURANCE CO. OF OHIO	  		 		 	Administrative Office:	 		 	
	A Stock Company	  	 	 	 	 	P.O. Box 9051	 		 	 
	(Hereafter called the Company, We, Our or Us)	  	 	 		 	Clearwater, Florida 33758 - 9051	 		 	 
		  	 	 	 	 	(800) 851 - 9777	 		 	 

 GUARANTEED MINIMUM WITHDRAWAL BENEFIT PLUS GROWTH 

This rider is issued as a part of the policy (contract) to which it is attached. 

Rider Data Specification 
  

											
	Policy Number:	  		 	 	 	12345	 	 	  	
	Rider Date:	  		 		 	01/03/2006	 	 	  	
	Growth Rate Percentage:	  		 		 	5.00%	 	 	  	
	Rider Fee Percentage:	  		 		 	0.75%	 	 	  	
	Annuitant:	  		 		 	John Doe	 	 	  	
		  		 		 		 	 	  	
	Annuitant’s Issue Age/Sex:	  		 	 	 	35 / Male	 	 	  	

  
  

ARTICLE I 
 This rider is not available for an existing
qualified policy which has been continued by a surviving spouse or beneficiary as the new owner. This rider will terminate upon the annuitant’s death, if you surrender your policy, elect to upgrade (as described in Article III of this rider),
or elect to receive annuity payments under your policy. This rider will also terminate if the policy to which this rider is attached is assigned or if the owner is changed without our approval. You can terminate this rider within [30 days] after the
[first] rider anniversary and [30 day] after each rider anniversary thereafter. Termination of the rider will result in the loss of all benefits provided by the rider. 

If you elect this rider, [100%] of your policy value must be in one or more of the designated funds. You can generally transfer between the designated funds
as permitted under your policy; however, you cannot make transfers as provided for in the policy to a non-designated fund while this rider is in force. If you wish to make a transfer to a non-designated fund, this rider must be terminated, as
described above, prior to making the transfer. 
 A rider fee will be deducted on each rider anniversary and upon rider termination as described below. 

DEFINITIONS: 
 Terms used that are not defined in this
rider shall have the same meaning as those in your policy. 
 Gross Partial Withdrawal 

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

Rider Anniversary 
 The anniversary of the rider date.

 Rider Fee 
 The rider fee is the rider fee percentage
referenced above, multiplied by the total withdrawal base at the time the fee is deducted. This fee will be deducted from each investment option in proportion to the amount of policy value in that investment option on each rider anniversary. A
portion of this fee will also be deducted when the rider is terminated based on the number of days that have elapsed since it was last deducted. 
 Rider
Year 
 Each twelve-month period following the rider date. 

  

					
	RGMB 19 0106	  	(1)	  	(Income/Growth-Single)

 ARTICLE II 

GROWTH BENEFIT AND GROWTH PERIOD 
 The total withdrawal
base will accumulate using the growth rate percentage as described in this Article. The growth period is the period of time from the rider date until the earlier of the first withdrawal of any amount from the policy value or the [10th] rider
anniversary. The growth rate percentage applies only to the total withdrawal base. 
 FOR LIFE GUARANTEED MINIMUM WITHDRAWAL BENEFIT 

Under this rider, we guarantee that you can withdraw up to the maximum annual withdrawal amount each year, regardless of the policy value, until the
annuitant’s death. 
 The “For Life” Withdrawal Percentage is determined by the attained age of the annuitant at the time of the first
withdrawal of any amount from the policy value taken on or after January 1st following the annuitant’s [59th] birthday: 
  

																	
	 	 	 Attained Age at

    First Withdrawal    

 
	 	 	 	 “For Life” Withdrawal

          Percentage          

 
	 	 
		 	 	 	 59 - 64
	 	 	 		 	 	  	4.5%	 	 	 	
		 		 	 65 - 69
	 	 	 		 		  	5.0%	 	 	 	
		 		 	 70 - 74
	 	 	 		 		  	5.5%	 	 	 	
		 		 	 75 - 79
	 	 	 		 		  	6.0%	 	 	 	
		 		 	 80 - 84
	 	 	 		 		  	6.5%	 	 	 	
		 		 	 85 - 89
	 	 	 		 		  	7.0%	 	 	 	
		 		 	 90 - 94
	 	 	 		 		  	7.5%	 	 	 	
		 	 	 	 95 +
	 	 	 		 	 	  	8.0%	 	 	 	

 If the annuitant is not yet [59] on the rider date, then this percentage will be zero until the January 1st following the
annuitant’s [59th] birthday. 
 Withdrawals will reduce the policy value of the policy to which this rider is attached. If the policy value equals
zero, you cannot make subsequent premium payments and all other policy features, benefits and guarantees are no longer available. Withdrawals guaranteed by this rider can be continued by selecting an amount and frequency of payment in a manner
acceptable to us. Once the payment amount and frequency are established, they cannot be changed and no additional withdrawals will be paid. 
 Maximum
Annual Withdrawal Amount 
 On the rider date the maximum annual withdrawal amount will be equal to the greater of I and 2, where: 

 

	1)	is A multiplied by B multiplied by C where: 

  

	 	A)	is the total withdrawal base on the rider date, 

  

	 	B)	is the “For Life” withdrawal percentage as determined and shown above. If the annuitant is not yet [59] on the rider date, this percentage will be equal to 0%, and 

 

	 	C)	is equal to the number of days between the rider date and January 1st of the next calendar year, divided by the number of days in the current calendar year. 

 

	2)	is an amount equal to the minimum required distribution amount (based on the premium paid to the policy to which this rider is attached) for the current calendar year using the annuitant’s age only if all of the
following are true: 

  

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

  

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

  

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

 

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

 

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

  

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

  

					
	RGMB 19 0106	  	(2)	  	(Income/Growth-Single)

 ARTICLE II CONTINUED 

If any of the above are not true, then 2) is equal to zero and it is not available as a maximum annual withdrawal amount. An amount in addition
to the amount described in 2 above, may need to be taken to satisfy minimum required distributions, in certain situations. Such additional withdrawal amount will be considered an excess gross partial withdrawal (as described under “Total
Withdrawal Base Adjustments” below). 
 On January 1st of each subsequent calendar year following the rider date, the maximum annual withdrawal
amount will be reset equal to the greater of 1 and 2, where: 
  

	1)	is A multiplied by B where: 

  

	 	A)	is the total withdrawal base as of this date, and 

  

	 	B)	is the “For Life” withdrawal percentage as determined and shown above. If the annuitant is not yet [59] on January 1st of the current calendar year, this percentage will be equal to 0%. 

 

	2)	is an amount equal to the minimum required distribution amount for this policy for the current calendar year using the annuitant’s age only if all of the following are true: 

 

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

  

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

  

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

 

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

 

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

  

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

If any of the above are not true, then 2) is equal to zero and the minimum required distribution is not available as a maximum annual
withdrawal amount. An amount in addition to the amount described in 2 above, may need to be taken to satisfy minimum required distributions. Such additional withdrawal amount will be considered an excess gross partial withdrawal (as described under
“Total Withdrawal Base Adjustments” below). 
 Total Withdrawal Base 

The total withdrawal base on the rider date is equal to the policy value (less any premium enhancements, if the rider is added in the first policy year). 

The total withdrawal base during the growth period (as described in Growth Benefit and Growth Period” above) is equal to: 

 

	 	A)	the total withdrawal base on the rider date, plus 

  

	 	B)	any premiums added during the growth period, 

  

	 	C)	all of which are accumulated daily to the end of the growth period at an annual effective rate equal to the growth rate percentage shown on page 1. 

The total withdrawal base after the growth period is equal to: 
  

	 	A)	the total withdrawal base at the end of the growth period, plus 

  

	 	B)	any premiums added after the growth period, less 

  

	 	C)	any adjustments for withdrawals (as described under “Total Withdrawal Base Adjustments” below) including the withdrawal at the end of the growth period, if any. 

The growth period stops upon or at the earlier of the first withdrawal of any amount from the policy value or the [10th] rider anniversary. 

Total Withdrawal Base Adjustments 
 Gross partial
withdrawals up to the maximum annual withdrawal amount will not reduce the total withdrawal base. Gross partial withdrawals in excess of the maximum annual withdrawal amount will reduce the total withdrawal base by the greater of 1 and 2, where:

  

					
	RGMB 19 0106	  	(3)	  	(Income/Growth-Single)

 ARTICLE II CONTINUED 
  

	1)	is the excess gross partial withdrawal amount; and 

  

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

  

	 	A)	is the excess gross partial withdrawal (the amount in excess of the maximum annual withdrawal amount remaining prior to the withdrawal); 

 

	 	B)	is the policy value after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

 

	 	C)	is the total withdrawal base prior to the withdrawal of the excess amount. 

 ARTICLE III 

CONTINUATION 
 In the case of spousal joint owners where
one spouse is the annuitant, if the spouse who is not the annuitant dies and the surviving spouse is the sole beneficiary, the surviving spouse may elect to continue the policy and rider. 

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

RIDER UPGRADE 
 You may elect, in writing, to upgrade the
total withdrawal base to the policy value within [30 days] after the [first] rider anniversary and [30 days] after each rider anniversary thereafter, subject to the age restrictions on the new rider. If an upgrade is elected, this rider will
terminate and a new rider with the same features will be issued with a new rider date. The new rider will have its own Growth Rate Percentage which may be lower than this rider’s Growth Rate Percentage. The new rider will have its own Rider Fee
Percentage which may be higher than this rider’s Rider Fee Percentage. 
 At the time of upgrade, the maximum annual withdrawal amount will be
recalculated based on the new total withdrawal base. 
 The new rider effective date will be the date the Company receives all information necessary, in a
written form acceptable to the Company, to process the upgrade. 
 Signed for us at our home office. 

 

															
		 	 	 	

	 	 	 		 	 	 	

	 	 
		 		 		 		 		 		 		 	
		 		 	SECRETARY	 		 		 		 	PRESIDENT	 	

  

					
	RGMB 19 0106	  	(4)	  	(Income/Growth-Single)

											
	WESTERN RESERVE LIFE	  		 		 	Home Office: Columbus, Ohio	 		 	
	ASSURANCE CO. OF OHIO	  		 		 	Administrative Office:	 		 	
	A Stock Company	  	 	 	 	 	P.O. Box 9051	 		 	 
	(Hereafter called the Company, We, Our or Us)	  	 	 		 	Clearwater, Florida 33758 - 9051	 		 	 
		  	 	 	 	 	(800) 851 - 9777	 		 	 

 GUARANTEED MINIMUM WITHDRAWAL BENEFIT PLUS GROWTH AND DEATH BENEFIT RIDER 

This rider is issued as a part of the policy (contract) to which it is attached. 

Rider Data Specification 
  

											
	Policy Number:	  		 	 	 	12345	 	 	  	
	Rider Date:	  		 		 	01/03/2006	 	 	  	
	Growth Rate Percentage:	  		 		 	5.00%	 	 	  	
	Rider Fee Percentage:	  		 		 	1.05%	 	 	  	
	Annuitant:	  		 		 	John Doe	 	 	  	
		  		 		 		 	 	  	
	Annuitant’s Issue Age/Sex:	  		 	 	 	35 / Male	 	 	  	

  
  

ARTICLE I 
 This rider is not available for an
existing qualified policy which has been continued by a surviving spouse or beneficiary as the new owner. This rider will terminate upon the annuitant’s death, if you surrender your policy, elect to upgrade (as described in Article III of this
rider), or elect to receive annuity payments under your policy. This rider will also terminate if the policy to which this rider is attached is assigned or if the owner is changed without our approval. You can terminate this rider within [30 days]
after the [first] rider anniversary and [30 days] after each rider anniversary thereafter. Termination of the rider will resulting the loss of all benefits provided by the rider. 

If you elect this rider, [100%] of your policy value must be in one or more of the designated funds. You can generally transfer between the designated funds
as permitted under your policy; however, you cannot make transfers as provided for in the policy to a non-designated fund while this rider is in force. If you wish to make a transfer to a non-designated fund, this rider must be terminated, as
described above, prior to making the transfer. 
 A rider fee will be deducted on each rider anniversary and upon rider termination as described below. 

DEFINITIONS: 
 Terms used that are not defined in this
rider shall have the same meaning as those in your policy. 
 Gross Partial Withdrawal 

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

Rider Anniversary 
 The anniversary of the rider date.

 Rider Fee 
 The rider fee is the rider fee percentage
referenced above, multiplied by the total withdrawal base at the time the fee is deducted. This fee will be deducted from each investment option in proportion to the amount of policy value in that investment option on each rider anniversary. A
portion of this fee will also be deducted when the rider is terminated based on the number of days that have elapsed since it was last deducted. 
 Rider
Year 
 Each twelve-month period following the rider date. 

  

					
	RGMB 19 0106	  	(1)	  	(Income/Growth/Death-Single)

 ARTICLE II 

GROWTH BENEFIT AND GROWTH PERIOD 
 The total withdrawal
base will accumulate using the growth rate percentage as described in this Article. The growth period is the period of time from the rider date until the earlier of the first withdrawal of any amount from the policy value or the [10th] rider
anniversary. The growth rate percentage applies only to the total withdrawal base. 
 FOR LIFE GUARANTEED MINIMUM WITHDRAWAL BENEFIT 

Under this rider, we guarantee that you can withdraw up to the maximum annual withdrawal amount each year, regardless of the policy value, until the
annuitant’s death. 
 The “For Life” Withdrawal Percentage is determined by the attained age of the annuitant at the time of the first
withdrawal of any amount from the policy value taken on or after January 1st following the annuitant’s [59th] birthday: 
  

																	
	 	 	 Attained Age at

    First Withdrawal    

 
	 	 	 	 “For Life” Withdrawal

          Percentage          

 
	 	 
		 	 	 	 59 - 64
	 	 	 		 	 	  	4.5%	 	 	 	
		 		 	 65 - 69
	 	 	 		 		  	5.0%	 	 	 	
		 		 	 70 - 74
	 	 	 		 		  	5.5%	 	 	 	
		 		 	 75 - 79
	 	 	 		 		  	6.0%	 	 	 	
		 		 	 80 - 84
	 	 	 		 		  	6.5%	 	 	 	
		 		 	 85 - 89
	 	 	 		 		  	7.0%	 	 	 	
		 		 	 90 - 94
	 	 	 		 		  	7.5%	 	 	 	
		 	 	 	 95 +
	 	 	 		 	 	  	8.0%	 	 	 	

 If the annuitant is not yet [59] on the rider date, then this percentage will be zero until the January 1st following the
annuitant’s [59th] birthday. 
 Withdrawals will reduce the policy value of the policy to which this rider is attached. If the policy value equals
zero, you cannot make subsequent premium payments and all other policy features, benefits and guarantees are no longer available. Withdrawals guaranteed by this rider can be continued by selecting an amount and frequency of payment in a manner
acceptable to us. Once the payment amount and frequency are established, they cannot be changed and no additional withdrawals will be paid. 
 Maximum
Annual Withdrawal Amount 
 On the rider date the maximum annual withdrawal amount will be equal to the greater of 1 and 2, where: 

 

	1)	is A multiplied by B multiplied by C where: 

  

	 	A)	is the total withdrawal base on the rider date, 

  

	 	B)	is the “For Life” withdrawal percentage as determined and shown above. If the annuitant is not yet [59] on the rider date, this percentage will be equal to 0%, and 

 

	 	C)	is equal to the number of days between the rider date and January 1st of the next calendar year, divided by the number of days in the current calendar year. 

 

	2)	is an amount equal to the minimum required distribution amount (based on the premium paid to the policy to which this rider is attached) for the current calendar year using the annuitant’s age only if all of the
following are true: 

  

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

  

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

  

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

 

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

 

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

  

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

  

					
	RGMB 19 0106	  	(2)	  	(Income/Growth/Death-Single)

 ARTICLE II CONTINUED 

If any of the above are not true, then 2) is equal to zero and it is not available as a maximum annual withdrawal amount. An amount in addition
to the amount described in 2 above, may need to be taken to satisfy minimum required distributions, in certain situations. Such additional withdrawal amount will be considered an excess gross partial withdrawal (as described under “Total
Withdrawal Base Adjustments” below). 
 On January 1st of each subsequent calendar year following the rider date, the maximum annual withdrawal
amount will be reset equal to the greater of 1 and 2, where: 
  

	1)	is A multiplied by B where: 

  

	 	A)	is the total withdrawal base as of this date, and 

  

	 	B)	is the “For Life” withdrawal percentage as determined and shown above. If the annuitant is not yet [59] on January 1st of the current calendar year, this percentage will be equal to 0%. 

 

	2)	is an amount equal to the minimum required distribution amount for this policy for the current calendar year using the annuitant’s age only if all of the following are true: 

 

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

  

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

  

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

 

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

 

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

  

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

If any of the above are not true, then 2) is equal to zero and the minimum required distribution is not available as a maximum annual
withdrawal amount. An amount in addition to the amount described in 2 above, may need to be taken to satisfy minimum required distributions. Such additional withdrawal amount will be considered an excess gross partial withdrawal (as described under
“Total Withdrawal Base Adjustments” below). 
 Minimum Remaining Withdrawal Amount 

The minimum remaining withdrawal amount is the total minimum dollar amount of guaranteed withdrawals you have remaining, provided withdrawals do not exceed the
maximum annual withdrawal amount each rider year. The minimum remaining withdrawal amount on the rider date is equal to the policy value (less premium enhancements, if the rider is added in the first policy year). The minimum remaining withdrawal
amount after the rider date is equal to the minimum remaining withdrawal amount on the rider date plus any premiums added after the rider date (not including premium enhancements, if any) less any adjustments for withdrawals (as described under
“Minimum Withdrawal Amount Adjustments” below). 
 Minimum Remaining Withdrawal Amount Adjustments 

Gross partial withdrawals up to the maximum annual withdrawal amount will reduce the minimum remaining withdrawal amount by the same amount (dollar for
dollar). Gross partial withdrawals in excess of the maximum annual withdrawal amount will reduce the minimum remaining withdrawal amount by the greater of: 
  

	1)	the excess gross partial withdrawal amount; and 

  

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

  

	 	A)	is the excess gross partial withdrawal (the amount in excess of the maximum annual withdrawal amount remaining prior to the withdrawal); 

 

	 	B)	is the policy value after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

 

	 	C)	is the minimum remaining withdrawal amount after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount. 

  

					
	RGMB 19 0106	  	(3)	  	(Income/Growth/Death-Single)

 ARTICLE II CONTINUED 

Total Withdrawal Base 
 The total withdrawal base on the
rider date is equal to the policy value (less any premium enhancements, if the rider is added in the first policy year). 
 The total withdrawal base during
the growth period (as described in “Growth Benefit and Growth Period” above) is equal to: 
  

	 	A)	the total withdrawal base on the rider date; plus 

  

	 	B)	any premiums added during the growth period; 

  

	 	C)	all of which are accumulated daily to the end of the growth period at an annual effective rate equal to the growth rate percentage shown on page 1. 

The total withdrawal base after the growth period is equal to: 
  

	 	A)	the total withdrawal base at the end of the growth period, plus 

  

	 	B)	any premiums added after the growth period; less 

  

	 	C)	any adjustments for withdrawals (as described under “Total Withdrawal Base Adjustments” below) including the withdrawal at the end of the growth period, if any. 

The Growth Period stops upon or at the earlier of the first withdrawal of any amount from the policy value or the [10th] rider anniversary. 

Total Withdrawal Base Adjustments 
 Gross partial
withdrawals up to the maximum annual withdrawal amount will not reduce the total withdrawal base. Gross partial withdrawals in excess of the maximum annual withdrawal amount will reduce the total withdrawal base by the greater of 1 and 2, where:

  

	1)	is the excess gross partial withdrawal amount; and 

  

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

  

	 	A)	is the excess gross partial withdrawal (the amount in excess of the maximum annual withdrawal amount remaining prior to the withdrawal); 

 

	 	B)	is the policy value after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

 

	 	C)	is the total withdrawal base prior to the withdrawal of the excess amount. 

 Death Benefit 

Upon the death of the annuitant, we will pay an additional death benefit amount equal to the excess, if any, of the minimum remaining withdrawal amount over
the base policy death benefit and this rider will then terminate. 
 ARTICLE III 

CONTINUATION 
 In the case of spousal joint owners where
one spouse is the annuitant, if the spouse who is not the annuitant dies and the surviving spouse is the sole beneficiary, the surviving spouse may elect to continue the policy and rider. No additional death benefit will be paid under this rider at
this time. 
 In the case of non-spousal joint owners where an owner who is not the annuitant dies, the surviving owner (who is also the sole designated
beneficiary) may elect to receive lifetime income payments under this rider instead of receiving any benefits applicable to the policy. The lifetime income payments must begin no later than 1 year after the owner’s death and will be equal to
the maximum annual withdrawal amount divided by the number of payments made per year. Once the payments begin, no additional premium payments will be accepted and no additional withdrawals will be paid. If these payments are elected but the
annuitant dies before the minimum remaining withdrawal amount equals zero, the annuitant’s beneficiary will receive a death benefit equal to the minimum remaining withdrawal amount. 

  

					
	RGMB 19 0106	  	(4)	  	(Income/Growth/Death-Single)

 ARTICLE III CONTINUED 

RIDER UPGRADE 
 You may elect, in writing, to upgrade the
total withdrawal base to the policy value within [30 days] after the [first] rider anniversary and [30 days] after each rider anniversary thereafter, subject to the age restrictions on the new rider. If an upgrade is elected, this rider will
terminate and a new rider with the same features will be issued with a new rider date. The new rider will have its own Growth Rate Percentage which may be lower than this rider’s Growth Rate Percentage. The new rider will have its own Rider Fee
Percentage which may be higher than this rider’s Rider Fee Percentage. 
 At the time of upgrade, the minimum remaining withdrawal amount will also be
upgraded to the policy value and the maximum annual withdrawal amount will be recalculated based on the new total withdrawal base. 
 The new rider
effective date will be the date the Company receives all information necessary, in a written form acceptable to the Company, to process the upgrade. 

Signed for us at our home office. 
  

															
		 	 	 	

	 	 	 		 	 	 	

	 	 
		 		 		 		 		 		 		 	
		 		 	SECRETARY	 		 		 		 	PRESIDENT	 	

  

					
	RGMB 19 0106	  	(5)	  	(Income/Growth/Death-Single)

											
	WESTERN RESERVE LIFE	  		 		 	Home Office: Columbus, Ohio	 		 	
	ASSURANCE CO. OF OHIO	  		 		 	Administrative Office:	 		 	
	A Stock Company	  	 	 	 	 	P.O. Box 9051	 		 	 
	(Hereafter called the Company, We, Our or Us)	  	 	 		 	Clearwater, Florida 33758 - 9051	 		 	 
		  	 	 	 	 	(800) 851 - 9777	 		 	 

 GUARANTEED MINIMUM WITHDRAWAL BENEFIT 

This rider is issued as a part of the policy (contract) to which it is attached. 

Rider Data Specification 
  

											
	 Policy Number:
	  		 	 	 	12345	 	 	  	
	 Rider Date:
	  		 		 	01/03/2006	 	 	  	
	 Rider Fee Percentage:
	  		 		 	0.80%	 	 	  	
	 Annuitant:
	  		 		 	John Doe	 	 	  	
		  		 		 		 	 	  	
	 Annuitant’s Issue Age/Sex:
	  		 		 	35 / Male	 	 	  	
	 Annuitant’s Spouse:
	  		 		 	Jane Doe	 	 	  	
	 Annuitant’s Spouse’s Issue Age/Sex:
	  		 	 	 	35 / Female	 	 	  	

  
  

ARTICLE I 
 This rider is not available for an
existing qualified policy which has been continued by a surviving spouse or beneficiary as the new owner. This rider will terminate upon the later of the annuitant’s or annuitant’s spouse’s (as of the rider date) death, if you
surrender your policy, elect to upgrade (as described in Article III of this rider), or elect to receive annuity payments under your policy. This rider will also terminate if the policy to which this rider is attached is assigned or if the owner is
changed without our approval. You can terminate this rider within [30 days] after the [first] rider anniversary and [30 days] after each rider anniversary thereafter. Termination of the rider will result in the loss of all benefits provided by the
rider. 
 If you elect this rider, [100%] of your policy value must be in one or more of the designated funds. You can generally transfer between the
designated funds as permitted under your policy; however, you cannot make transfers as provided for in the policy to a non-designated fund while this rider is in force. If you wish to make a transfer to a non-designated fund, this rider must be
terminated, as described above, prior to making the transfer. 
 The annuitant’s spouse as of the rider date is hereafter referred to as the
annuitant’s spouse. As it pertains to the benefits of this rider, the annuitant’s spouse can not be changed. The annuitant’s spouse must be the sole primary beneficiary and/or a joint owner. The only living owners allowed on the
contract to which this rider is attached are the annuitant and the annuitant’s spouse. 
 A rider fee will be deducted on each rider anniversary and
upon rider termination as described below. 

  

					
	RGMB 19 0106	  	(1)	  	(Income-Joint)

 ARTICLE I CONTINUED 

 

 DEFINITIONS: 

Terms used that are not defined in this rider shall have the same meaning as those in your policy. 

Gross Partial Withdrawal 
 The amount which will be
deducted from your policy value as a result of each partial withdrawal. 
 Rider Anniversary 

The anniversary of the rider date. 
 Rider Fee 

The rider fee is the rider fee percentage referenced above, multiplied by the total withdrawal base at the time the fee is deducted. This fee will be deducted
from each investment option in proportion to the amount of policy value in that investment option on each rider anniversary. A portion of this fee will also be deducted when the rider is terminated based on the number of days that have elapsed since
it was last deducted. 
 Rider Year 
 Each twelve-month
period following the rider date. 
 ARTICLE II 

FOR LIFE GUARANTEED MINIMUM WITHDRAWAL BENEFIT 
 Under this
rider, we guarantee that you can withdraw up to the maximum annual withdrawal amount each year, regardless of the policy value, until the later of the annuitant’s or the annuitant’s spouse’s death. 

The “For Life” Withdrawal Percentage is determined by the attained age of the younger of the living spouses at the time of the first withdrawal of
any amount from the policy value taken on or after January 1st following the younger of the living spouse’s [59th] birthday: 
  

																	
	 	 	 Attained Age at

    First Withdrawal    

 
	 	 	 	 “For Life” Withdrawal

          Percentage          

 
	 	 
		 	 	 	 59 - 64
	 	 	 		 	 	  	4.5%	 	 	 	
		 		 	 65 - 69
	 	 	 		 		  	5.0%	 	 	 	
		 		 	 70 - 74
	 	 	 		 		  	5.5%	 	 	 	
		 		 	 75 - 79
	 	 	 		 		  	6.0%	 	 	 	
		 		 	 80 - 84
	 	 	 		 		  	6.5%	 	 	 	
		 		 	 85 - 89
	 	 	 		 		  	7.0%	 	 	 	
		 		 	 90 - 94
	 	 	 		 		  	7.5%	 	 	 	
		 	 	 	 95 +
	 	 	 		 	 	  	8.0%	 	 	 	

 If the younger of the annuitant and the annuitant’s spouse is not yet [59] on the rider date, then this percentage will
be zero until the January 1st following the younger of the living spouse’s [59th] birthday. 
 Withdrawals will reduce the policy value of the
policy to which this rider is attached. If the policy value equals zero, you cannot make subsequent premium payments and all other policy features, benefits and guarantees are no longer available. Withdrawals guaranteed by this rider can be
continued by selecting an amount and frequency of payment in a manner acceptable to us. Once the payment amount and frequency are established, they cannot be changed and no additional withdrawals will be paid. 

Maximum Annual Withdrawal Amount 
 On the rider date the
maximum annual withdrawal amount will be equal to the greater of 1 and 2, where: 
  

	1)	is A multiplied by B multiplied by C where: 

  

	 	A)	is the total withdrawal base on the rider date, 

  

	 	B)	is the “For Life” withdrawal percentage as determined and shown above. If the younger of the annuitant or the annuitant’s spouse is not yet [59] on the rider date, this percentage will be equal to 0%, and

  

	 	C)	is equal to the number of days between the rider date and January 1st of the next calendar year, divided by the number of days in the current calendar year. 

  

					
	RGMB 19 0106	  	(2)	  	(Income-Joint)

 ARTICLE II CONTINUED 

 

	2)	is an amount equal to the minimum required distribution amount (based on the premium paid to the policy to which this rider is attached) for the current calendar year using the annuitant’s age only if all of the
following are true: 

  

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

  

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

  

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

 

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

  

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

  

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

If any of the above are not true, then 2) is equal to zero and it is not available as a maximum annual withdrawal amount. An amount in addition
to the amount described in 2 above, may need to be taken to satisfy minimum required distributions, in certain situations. Such additional withdrawal amount will be considered an excess gross partial withdrawal (as described under “Total
Withdrawal Base Adjustments” below). 
 On January 1st of each subsequent calendar year following the rider date, the maximum annual withdrawal
amount will be reset equal to the greater of 1 and 2, where: 
  

	1)	is A multiplied by B where: 

  

	 	A)	is the total withdrawal base as of this date, and 

  

	 	B)	is the “For Life” withdrawal percentage as determined and shown above. If the younger of the annuitant or the annuitant’s spouse is not yet [59] on January 1st of the current calendar year, this
percentage will be equal to 0%. 

  

	2)	is an amount equal to the minimum required distribution amount for this policy for the current calendar year using the annuitant’s age only if all of the following are true: 

 

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

  

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

  

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

 

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

  

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

  

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

If any of the above are not true, then 2) is equal to zero and the minimum required distribution is not available as a maximum annual withdrawal amount. An
amount in addition to the amount described in 2 above, may need to be taken to satisfy minimum required distributions. Such additional withdrawal amount will be considered an excess gross partial withdrawal (as described under “Total Withdrawal
Base Adjustments” below). 
 Total Withdrawal Base 

The total withdrawal base on the rider date is equal to the policy value (less any premium enhancements, if the rider is added in the first policy year). After
the rider date, the total withdrawal base is equal to the total withdrawal base on the rider date, plus the full amount of any premiums added after the rider date, less any adjustments for withdrawals described below. 

Total Withdrawal Base Adjustments 
 Gross partial
withdrawals up to the maximum annual withdrawal amount will not reduce the total withdrawal base. Gross partial withdrawals in excess of the maximum annual withdrawal amount will reduce the total withdrawal base by the greater of 1 and 2, where:

  

					
	RGMB 19 0106	  	(3)	  	(Income-Joint)

 ARTICLE II CONTINUED 

 

	1)	is the excess gross partial withdrawal amount; and 

  

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

  

	 	A)	is the excess gross partial withdrawal (the amount in excess of the maximum annual withdrawal amount remaining prior to the withdrawal); 

 

	 	B)	is the policy value after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

 

	 	C)	is the total withdrawal base prior to the withdrawal of the excess amount. 

 ARTICLE III 

CONTINUATION 
 In the case of spousal joint owners where
one spouse is the annuitant, if the spouse who is not the annuitant dies and the surviving spouse is the sole beneficiary, the surviving spouse may elect to continue the policy and rider. 

RIDER UPGRADE 
 You may elect, in writing, to upgrade the
total withdrawal base to the policy value within [30 days] after the [first] rider anniversary and [30 days] after each rider anniversary thereafter, subject to the age restrictions on the new rider. If an upgrade is elected, this rider will
terminate and a new rider with the same features will be issued with a new rider date. The new rider will have its own Rider Fee Percentage which may be higher than this rider’s Rider Fee Percentage. 

At the time of upgrade, the maximum annual withdrawal amount will be recalculated based on the new total withdrawal base. 

The new rider effective date will be the date the Company receives all information necessary, in a written form acceptable to the Company, to process the
upgrade. 
 Signed for us at our home office. 
  

															
		 	 	 	

	 	 	 		 	 	 	

	 	 
		 		 		 		 		 		 		 	
		 		 	SECRETARY	 		 		 		 	PRESIDENT	 	

  

					
	RGMB 19 0106	  	(4)	  	(Income-Joint)

											
	WESTERN RESERVE LIFE	  		 		 	Home Office: Columbus, Ohio	 		 	
	ASSURANCE CO. OF OHIO	  		 		 	Administrative Office:	 		 	
	A Stock Company	  	 	 	 	 	P.O. Box 9051	 		 	 
	(Hereafter called the Company, We, Our or Us)	  	 	 		 	Clearwater, Florida 33758 - 9051	 		 	 
		  	 	 	 	 	(800) 851 - 9777	 		 	 

 GUARANTEED MINIMUM WITHDRAWAL BENEFIT AND DEATH BENEFIT RIDER 

This rider is issued as a part of the policy (contract) to which it is attached. 

Rider Data Specification 
  

											
	 Policy Number:
	  		 	 	 	12345	 	 	  	
	 Rider Date:
	  		 		 	01/03/2006	 	 	  	
	 Rider Fee Percentage:
	  		 		 	1.05%	 	 	  	
	 Annuitant:
	  		 		 	John Doe	 	 	  	
		  		 		 		 	 	  	
	 Annuitant’s Issue Age/Sex:
	  		 		 	35 / Male	 	 	  	
	 Annuitant’s Spouse:
	  		 		 	Jane Doe	 	 	  	
	 Annuitant’s Spouse’s Issue Age/Sex:
	  		 	 	 	35 / Female	 	 	  	

  
  

ARTICLE I 
 This rider is not available for an
existing qualified policy which has been continued by a surviving spouse or beneficiary as the new owner. This rider will terminate upon the later of the annuitant’s or the annuitant’s spouse’s (as of the rider date) death, if you
surrender your policy, elect to upgrade (as described in Article III of this rider), or elect to receive annuity payments under your policy. This rider will also terminate if the policy to which this rider is attached is assigned or if the owner is
changed without our approval. You can terminate this rider within [30 days] after the [first] rider anniversary and [30 days] after each rider anniversary thereafter. Termination of the rider will result in the loss of all benefits provided by the
rider. 
 If you elect this rider, [100%] of your policy value must be in one or more of the designated funds. You can generally transfer between the
designated funds as permitted under your policy; however, you cannot make transfers as provided for in the policy to a non-designated fund while this rider is in force. If you wish to make a transfer to a non-designated fund, this rider must be
terminated, as described above, prior to making the transfer. 
 The annuitant’s spouse as of the rider date is hereafter referred to as the
annuitant’s spouse. As it pertains to the benefits of this rider, the annuitant’s spouse can not be changed. The annuitant’s spouse must be the sole primary beneficiary and/or a joint owner. The only living owners allowed on the
contract to which this rider is attached are the annuitant and the annuitant’s spouse. 
 A rider fee will be deducted on each rider anniversary and
upon rider termination as described below. 

  

					
	RGMB 19 0106	  	(1)	  	(Income/Death-Joint)

 ARTICLE I CONTINUED 

 

 DEFINITIONS: 

Terms used that are not defined in this rider shall have the same meaning as those in your policy. 

Gross Partial Withdrawal 
 The amount which will be
deducted from your policy value as a result of each partial withdrawal. 
 Rider Anniversary 

The anniversary of the rider date. 
 Rider Fee 

The rider fee is the rider fee percentage referenced above, multiplied by the total withdrawal base at the time the fee is deducted. This fee will be deducted
from each investment option in proportion to the amount of policy value in that investment option on each rider anniversary. A portion of this fee will also be deducted when the rider is terminated based on the number of days that have elapsed since
it was last deducted. 
 Rider Year 
 Each twelve-month
period following the rider date. 
 ARTICLE II 

FOR LIFE GUARANTEED MINIMUM WITHDRAWAL BENEFIT 
 Under this
rider, we guarantee that you can withdraw up to the maximum annual withdrawal amount each year, regardless of the policy value, until the annuitant’s or the annuitant’s spouse’s death, whichever is later. 

The “For Life” Withdrawal Percentage is determined by the attained age of the younger of the living spouses at the time of the first withdrawal of
any amount from the policy value taken on or after January 1st following the younger of the living spouse’s [59th] birthday. 
  

																	
	 	 	 Attained Age at

    First Withdrawal    

 
	 	 	 	 “For Life” Withdrawal

          Percentage          

 
	 	 
		 	 	 	 59 - 64
	 	 	 		 	 	  	4.5%	 	 	 	
		 		 	 65 - 69
	 	 	 		 		  	5.0%	 	 	 	
		 		 	 70 - 74
	 	 	 		 		  	5.5%	 	 	 	
		 		 	 75 - 79
	 	 	 		 		  	6.0%	 	 	 	
		 		 	 80 - 84
	 	 	 		 		  	6.5%	 	 	 	
		 		 	 85 - 89
	 	 	 		 		  	7.0%	 	 	 	
		 		 	 90 - 94
	 	 	 		 		  	7.5%	 	 	 	
		 	 	 	 95 +
	 	 	 		 	 	  	8.0%	 	 	 	

 If the younger of the annuitant and the annuitant’s spouse is not yet [59] on the rider date, then this percentage will
be zero until the January 1st following the younger of the living spouse’s [59th] birthday. 
 Withdrawals will reduce the policy value of the
policy to which this rider is attached. If the policy value equals zero, you cannot make subsequent premium payments and all other policy features, benefits and guarantees are no longer available. Withdrawals guaranteed by this rider can be
continued by selecting an amount and frequency of payment in a manner acceptable to us. Once the payment amount and frequency are established, they cannot be changed and no additional withdrawals will be paid. 

Maximum Annual Withdrawal Amount 
 On the rider date the
maximum annual withdrawal amount will be equal to the greater of 1 and 2, where: 
  

	1)	A multiplied by B multiplied by C where: 

  

	 	A)	is the total withdrawal base on the rider date, 

  

	 	B)	is the “For Life” withdrawal percentage as determined and shown above. If the younger of the annuitant or the annuitant’s spouse is not yet [59] on the rider date, this percentage will be equal to 0%, and

  

	 	C)	is equal to the number of days between the rider date and January 1st of the next calendar year, divided by the number of days in the current calendar year. 

  

					
	RGMB 19 0106	  	(2)	  	(Income/Death-Joint)

 ARTICLE II CONTINUED 

 

	2)	is an amount equal to the minimum required distribution amount (based on the premium paid to the policy to which this rider is attached) for the current calendar year using the annuitant’s age only if all of the
following are true: 

  

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

  

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

  

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

 

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

  

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

  

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

If any of the above are not true, then 2) is equal to zero and it is not available as a maximum annual withdrawal amount. An amount in addition
to the amount described in 2 above, may need to be taken to satisfy minimum required distributions, in certain situations. Such additional withdrawal amount will be considered an excess gross partial withdrawal (as described under “Total
Withdrawal Base Adjustments” below). 
 On January 1st of each subsequent calendar year following the rider date, the maximum annual withdrawal
amount will be reset equal to the greater of 1 and 2 where: 
  

	1)	is A multiplied by B where: 

  

	 	A)	is the total withdrawal base as of this date, and 

  

	 	B)	is the “For Life” withdrawal percentage as determined and shown above. If the younger of the annuitant or the annuitant’s spouse is not yet [59] on January 1st of the current calendar year, this
percentage will be equal to 0%. 

  

	2)	is an amount equal to the minimum required distribution amount for this policy for the current calendar year using the annuitant’s age only if all of the following are true: 

 

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

  

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

  

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

 

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

  

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

  

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

If any of the above are not true, then 2) is equal to zero and the minimum required distribution is not available as a maximum annual
withdrawal amount. An amount in addition to the amount described in 2 above, may need to be taken to satisfy minimum required distributions. Such additional withdrawal amount will be considered an excess gross partial withdrawal (as described under
“Total Withdrawal Base Adjustments” below). 
 Minimum Remaining Withdrawal Amount 

The minimum remaining withdrawal amount is the total minimum dollar amount of guaranteed withdrawals you have remaining, provided withdrawals do not exceed the
maximum annual withdrawal amount each rider year. The minimum remaining withdrawal amount on the rider date is equal to the policy value (less premium enhancements, if the rider is added in the first policy year). The minimum remaining withdrawal
amount after the rider date is equal to the minimum remaining withdrawal amount on the rider date plus any premiums added after the rider date (not including premium enhancements, if any) less any adjustments for withdrawals (as described under
“Minimum Withdrawal Amount Adjustments”). 

  

					
	RGMB 19 0106	  	(3)	  	(Income/Death-Joint)

 ARTICLE II CONTINUED 

 

 Minimum Remaining Withdrawal Amount Adjustments 

Gross partial withdrawals up to the maximum annual withdrawal amount will reduce the minimum remaining withdrawal amount by the same amount (dollar for
dollar). Gross partial withdrawals in excess of the maximum annual withdrawal amount will reduce the minimum remaining withdrawal amount by the greater of: 
  

	1)	the excess gross partial withdrawal amount; and 

  

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

  

	 	A)	is the excess gross partial withdrawal (the amount in excess of the maximum annual withdrawal amount remaining prior to the withdrawal); 

 

	 	B)	is the policy value after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

 

	 	C)	is the minimum remaining withdrawal amount after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount. 

Total Withdrawal Base 
 The total withdrawal base on the
rider date is equal to the policy value (less any premium enhancements, if the rider is added in the first policy year). After the rider date, the total withdrawal base is equal to the total withdrawal base on the rider date, plus the full amount of
any premiums added after the rider date, less any adjustments for withdrawals described below. 
 Total Withdrawal Base Adjustments 

Gross partial withdrawals up to the maximum annual withdrawal amount will not reduce the total withdrawal base. Gross partial withdrawals in excess of the
maximum annual withdrawal amount will reduce the total withdrawal base by the greater of: 
  

	1)	the excess gross partial withdrawal amount; and 

  

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

  

	 	A)	is the excess gross partial withdrawal (the amount in excess of the maximum annual withdrawal amount remaining prior to the withdrawal); 

 

	 	B)	is the policy value after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

 

	 	C)	is the total withdrawal base prior to the withdrawal of the excess amount. 

 Death Benefit 

Upon the later of the annuitant or the annuitant’s spouse’s death, we will pay an additional death benefit amount equal to the excess, if any, of the
minimum remaining withdrawal amount over the base policy death benefit and this rider will then terminate. 
 ARTICLE III 

CONTINUATION 
 In the case of spousal joint owners where
one spouse is the annuitant, if the spouse who is not the annuitant dies and the surviving spouse is the sole beneficiary, the surviving spouse may elect to continue the policy and rider. No additional death benefit will be paid under this rider at
this time. 

  

					
	RGMB 19 0106	  	(4)	  	(Income/Death-Joint)

 ARTICLE III CONTINUED 

 

 RIDER UPGRADE 

You may elect, in writing, to upgrade the total withdrawal base to the policy value within [30 days] after the [first] rider anniversary and [30 days] after
each rider anniversary thereafter, subject to the age restrictions on the new rider. If an upgrade is elected, this rider will terminate and a new rider with the same features will be issued with a new rider date. The new rider will have its own
Rider Fee Percentage which may be higher than this rider’s Rider Fee Percentage. 
 At the time of upgrade, the minimum remaining withdrawal amount
will also be upgraded to the policy value and the maximum annual withdrawal amount will be recalculated based on the new total withdrawal base. 
 The new
rider effective date will be the date the Company receives all information necessary, in a written form acceptable to the Company, to process the upgrade. 

Signed for us at our home office. 
  

															
		 	 	 	

	 	 	 		 	 	 	

	 	 
		 		 		 		 		 		 		 	
		 		 	SECRETARY	 		 		 		 	PRESIDENT	 	

  

					
	RGMB 19 0106	  	(5)	  	(Income/Death-Joint)

											
	WESTERN RESERVE LIFE	  		 		 	Home Office: Columbus, Ohio	 		 	
	ASSURANCE CO. OF OHIO	  		 		 	Administrative Office:	 		 	
	A Stock Company	  	 	 	 	 	P.O. Box 9051	 		 	 
	(Hereafter called the Company, We, Our or Us)	  	 	 		 	Clearwater, Florida 33758 - 9051	 		 	 
		  	 	 	 	 	(800) 851 - 9777	 		 	 

 GUARANTEED MINIMUM WITHDRAWAL BENEFIT PLUS GROWTH 

This rider is issued as a part of the policy (contract) to which it is attached. 

Rider Data Specification 
  

											
	 Policy Number:
	  		 	 	 	12345	 	 	  	
	 Rider Date:
	  		 		 	01/03/2006	 	 	  	
	 Growth Rate Percentage:
	  		 		 	5.00%	 	 	  	
	 Rider Fee Percentage:
	  		 		 	1.25%	 	 	  	
	 Annuitant:
	  		 		 	John Doe	 	 	  	
		  		 		 		 	 	  	
	 Annuitant’s Issue Age/Sex:
	  		 		 	35 / Male	 	 	  	
	 Annuitant’s Spouse:
	  		 		 	Jane Doe	 	 	  	
	 Annuitant’s Spouse’s Issue Age/Sex:
	  		 	 	 	35 / Female	 	 	  	

  
  

ARTICLE I 
 This rider is not available for an
existing qualified policy which has been continued by a surviving spouse or beneficiary as the new owner. This rider will terminate upon the later of the annuitant’s or annuitant’s spouse’s (as of the rider date) death, if you
surrender your policy, elect to upgrade (as described in Article III of this rider), or elect to receive annuity payments under your policy. This rider will also terminate if the policy to which this rider is attached is assigned or if the owner is
changed without our approval. You can terminate this rider within [30 days] after the [first] rider anniversary and [30 days] after each rider anniversary thereafter. Termination of the rider will result in the loss of all benefits provided by the
rider. 
 If you elect this rider, [100%] of your policy value must be in one or more of the designated funds. You can generally transfer between the
designated funds as permitted under your policy; however, you cannot make transfers as provided for in the policy to a non-designated fund while this rider is in force. If you wish to make a transfer to a non-designated fund, this rider must be
terminated, as described above, prior to making the transfer. 
 The annuitant’s spouse as of the rider date is hereafter referred to as the
annuitant’s spouse. As it pertains to the benefits of this rider, the annuitant’s spouse can not be changed. The annuitant’s spouse must be the sole primary beneficiary and/or a joint owner. The only living owners allowed on the
contract to which this rider is attached are the annuitant and the annuitant’s spouse. 
 A rider fee will be deducted on each rider anniversary and
upon rider termination as described below. 

  

					
	RGMB 19 0106	  	(1)	  	(Income/Growth-Joint)

 ARTICLE I CONTINUED 

 

 DEFINITIONS: 

Terms used that are not defined in this rider shall have the same meaning as those in your policy. 

Gross Partial Withdrawal 
 The amount which will be
deducted from your policy value as a result of each partial withdrawal. 
 Rider Anniversary 

The anniversary of the rider date. 
 Rider Fee 

The rider fee is the rider fee percentage referenced above, multiplied by the total withdrawal base at the time the fee is deducted. This fee will be deducted
from each investment option in proportion to the amount of policy value in that investment option on each rider anniversary. A portion of this fee will also be deducted when the rider is terminated based on the number of days that have elapsed since
it was last deducted. 
 Rider Year 
 Each twelve-month
period following the rider date. 
 ARTICLE II 

GROWTH BENEFIT AND GROWTH PERIOD 
 The total withdrawal
base will accumulate using the growth rate percentage as described in this Article. The growth period is the period of time from the rider date until the earlier of the first withdrawal of any amount from the policy value or the [10th] rider
anniversary. The growth rate percentage applies only to the total withdrawal base. 
 FOR LIFE GUARANTEED MINIMUM WITHDRAWAL BENEFIT 

Under this rider, we guarantee that you can withdraw up to the maximum annual withdrawal amount each year, regardless of the policy value, until the
annuitant’s or the annuitant’s spouse’s death, whichever is later. 
 The “For Life” Withdrawal Percentage is determined by the
attained age of the younger of the living spouses at the time of the first withdrawal of any amount from the policy value taken on or after January 1st following the younger of the living spouse’s [59th] birthday: 

 

																	
	 	 	 Attained Age at

    First Withdrawal    

 
	 	 	 	 “For Life” Withdrawal

          Percentage          

 
	 	 
		 	 	 	 59 - 64
	 	 	 		 	 	  	4.5%	 	 	 	
		 		 	 65 - 69
	 	 	 		 		  	5.0%	 	 	 	
		 		 	 70 - 74
	 	 	 		 		  	5.5%	 	 	 	
		 		 	 75 - 79
	 	 	 		 		  	6.0%	 	 	 	
		 		 	 80 - 84
	 	 	 		 		  	6.5%	 	 	 	
		 		 	 85 - 89
	 	 	 		 		  	7.0%	 	 	 	
		 		 	 90 - 94
	 	 	 		 		  	7.5%	 	 	 	
		 	 	 	 95 +
	 	 	 		 	 	  	8.0%	 	 	 	

 If the younger of the annuitant and the annuitant’s spouse is not yet [59] on the rider date, then this percentage will
be zero until the January 1st following the younger of the living spouse’s [59th] birthday. 
 Withdrawals will reduce the policy value of the
policy to which this rider is attached. Once the policy value equals zero, you cannot make subsequent premium payments and all other policy features, benefits and guarantees are no longer available. Withdrawals guaranteed by this rider can be
continued by selecting an amount and frequency of payment in a manner acceptable to us. Once the payment amount and frequency are established, they cannot be changed and no additional withdrawals will be paid. 

  

					
	RGMB 19 0106	  	(2)	  	(Income/Growth-Joint)

 ARTICLE II CONTINUED 

 

 Maximum Annual Withdrawal Amount 

On the rider date the maximum annual withdrawal amount will be equal to the greater of 1 and 2, where: 

 

	1)	is A multiplied by B multiplied by C where: 

  

	 	A)	is the total withdrawal base on the rider date, 

  

	 	B)	is the “For Life” withdrawal percentage as determined and shown above. If the younger of the annuitant or the annuitant’s spouse is not yet [59] on the rider date, this percentage will be equal to 0%, and

  

	 	C)	is equal to the number of days between the rider date and January 1st of the next calendar year, divided by the number of days in the current calendar year. 

 

	2)	is an amount equal to the minimum required distribution amount (based on the premium paid to the policy to which this rider is attached) for the current calendar year using the annuitant’s age only if all of the
following are true: 

  

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

  

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

  

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

 

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

  

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

  

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

If any of the above are not true, then 2) is equal to zero and it is not available as a maximum annual withdrawal amount. An amount in addition
to the amount described in 2 above, may need to be taken to satisfy minimum required distributions, in certain situations. Such additional withdrawal amount will be considered an excess gross partial withdrawal (as described under “Total
Withdrawal Base Adjustments” below). 
 On January 1st of each subsequent calendar year following the rider date, the maximum annual withdrawal
amount will be reset equal to the greater of 1 and 2, where: 
  

	1)	is A multiplied by B where: 

  

	 	A)	is the total withdrawal base as of this date, and 

  

	 	B)	is the “For Life” withdrawal percentage as determined and shown above. If the younger of the annuitant or the annuitant’s spouse is not yet [59] on January 1st of the current calendar year, this
percentage will be equal to 0%. 

  

	2)	is an amount equal to the minimum required distribution amount for this policy for the current calendar year using the annuitant’s age only if all of the following are true: 

 

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

  

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

  

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

 

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

  

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

  

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

If any of the above are not true, then 2) is equal to zero and the minimum required distribution is not available as a maximum annual
withdrawal amount. An amount in addition to the amount described in 2 above, may need to be taken to satisfy minimum required distributions. Such additional withdrawal amount will be considered an excess gross partial withdrawal (as described under
“Total Withdrawal Base Adjustments” below). 

  

					
	RGMB 19 0106	  	(3)	  	(Income/Growth-Joint)

 ARTICLE II CONTINUED 

 

 Total Withdrawal Base 

The total withdrawal base on the rider date is equal to the policy value (less any premium enhancements, if the rider is added in the first policy year). 

The total withdrawal base during the growth period (as described in “Growth Benefit and Growth Period” above) is equal to: 

 

	 	A)	the total withdrawal base on the rider date, plus 

  

	 	B)	any premiums added during the growth period, 

  

	 	C)	all of which are accumulated daily to the end of the growth period at an annual effective rate equal to the growth rate percentage shown on page 1. 

The total withdrawal base after the growth period is equal to: 
  

	 	A)	the total withdrawal base at the end of the growth period, plus 

  

	 	B)	any premiums added after the growth period, less 

  

	 	C)	any adjustments for withdrawals (as described under “Total Withdrawal Base Adjustments” below) including the withdrawal at the end of the growth period, if any. 

The growth period slops upon or at the earlier of the first withdrawal of any amount from the policy value or the [10th] rider anniversary. 

Total Withdrawal Base Adjustments 
 Gross partial
withdrawals up to the maximum annual withdrawal amount will not reduce the total withdrawal base. Gross partial withdrawals in excess of the maximum annual withdrawal amount will reduce the total withdrawal base by the greater of 1 and 2, where:

  

	1)	is the excess gross partial withdrawal amount; and 

  

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

  

	 	A)	is the excess gross partial withdrawal (the amount in excess of the maximum annual withdrawal amount remaining prior to the withdrawal); 

 

	 	B)	is the policy value after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

 

	 	C)	is the total withdrawal base prior to the withdrawal of the excess amount. 

 ARTICLE III 

CONTINUATION 
 In the case of spousal joint owners where
one spouse is the annuitant, if the spouse who is not the annuitant dies and the surviving spouse is the sole beneficiary, the surviving spouse may elect to continue the policy and rider. 

  

					
	RGMB 19 0106	  	(4)	  	(Income/Growth-Joint)

 ARTICLE III CONTINUED 

 

 RIDER UPGRADE 

You may elect, in writing, to upgrade the total withdrawal base to the policy value within [30 days] after the [first] rider anniversary and [30 days] after
each rider anniversary thereafter, subject to the age restrictions on the new rider. If an upgrade is elected, this rider will terminate and a new rider with the same features will be issued with a new rider date. The new rider will have its own
Growth Rate Percentage which may be lower than this rider’s Growth Rate Percentage. The new rider will have its own Rider Fee Percentage which may be higher than this rider’s Rider Fee Percentage. 

At the time of upgrade, the maximum annual withdrawal amount will be recalculated based on the new total withdrawal base. 

The new rider effective date will be the date the Company receives all information necessary, in a written form acceptable to the Company, to process the
upgrade. 
 Signed for us at our home office. 
  

															
		 	 	 	

	 	 	 		 	 	 	

	 	 
		 		 		 		 		 		 		 	
		 		 	SECRETARY	 		 		 		 	PRESIDENT	 	

  

					
	RGMB 19 0106	  	(5)	  	(Income/Growth-Joint)

											
	WESTERN RESERVE LIFE	  		 		 	Home Office: Columbus, Ohio	 		 	
	ASSURANCE CO. OF OHIO	  		 		 	Administrative Office:	 		 	
	A Stock Company	  	 	 	 	 	P.O. Box 9051	 		 	 
	(Hereafter called the Company, We, Our or Us)	  	 	 		 	Clearwater, Florida 33758 - 9051	 		 	 
		  	 	 	 	 	(800) 851 - 9777	 		 	 

 GUARANTEED MINIMUM WITHDRAWAL BENEFIT PLUS GROWTH AND DEATH BENEFIT RIDER 

This rider is issued as a part of the policy (contract) to which it is attached. 

Rider Data Specification 
  

											
	 Policy Number:
	  		 	 	 	12345	 	 	  	
	 Rider Date:
	  		 		 	01/03/2006	 	 	  	
	 Growth Rate Percentage:
	  		 		 	5.00%	 	 	  	
	 Rider Fee Percentage:
	  		 		 	1.40%	 	 	  	
	 Annuitant:
	  		 		 	John Doe	 	 	  	
		  		 		 		 	 	  	
	 Annuitant’s Issue Age/Sex:
	  		 		 	35 / Male	 	 	  	
	 Annuitant’s Spouse:
	  		 		 	Jane Doe	 	 	  	
	 Annuitant’s Spouse’s Issue Age/Sex:
	  		 	 	 	35 /  Female	 	 	  	

  
  

ARTICLE I 
 This rider is not available for an
existing qualified policy which has been continued by a surviving spouse or beneficiary as the new owner. This rider will terminate upon the later of the annuitant’s or annuitant’s spouse’s (as of the rider date) death, if you
surrender your policy, elect to upgrade (as described in Article III of this rider), or elect to receive annuity payments under your policy. This rider will also terminate if the policy to which this rider is attached is assigned or if the owner is
changed without our approval. You can terminate this rider within [30 days] after the [first] rider anniversary and [30 days] after each rider anniversary thereafter. Termination of the rider will result in the loss of all benefits provided by the
rider. 
 If you elect this rider, 100% of your policy value must be in one or more of the designated funds. You can generally transfer between the
designated funds as permitted under your policy; however, you cannot make transfers as provided for in the policy to a non-designated fund while this rider is in force. If you wish to make a transfer to a non-designated fund, this rider must be
terminated, as described above, prior to making the transfer. 
 The annuitant’s spouse as of the rider date is hereafter referred to as the
annuitant’s spouse. As it pertains to the benefits of this rider, the annuitant’s spouse cannot be changed. The annuitant’s spouse must be the sole primary beneficiary and/or a joint owner. The only living owners allowed on the
contract to which this rider is attached are the annuitant and the annuitant’s spouse. 
 A rider fee will be deducted on each rider anniversary and
upon rider termination as described below. 

  

					
	RGMB 19 0106	  	(1)	  	(Income/Growth/Death-Joint)

 ARTICLE I CONTINUED 

 

 DEFINITIONS: 

Terms used that are not defined in this rider shall have the same meaning as those in your policy. 

Gross Partial Withdrawal 
 The amount which will be
deducted from your policy value as a result of each partial withdrawal. 
 Rider Anniversary 

The anniversary of the rider date. 
 Rider Fee 

The rider fee is the rider fee percentage referenced above, multiplied by the total withdrawal base at the time the fee is deducted. This fee will be deducted
from each investment option in proportion to the amount of policy value in that investment option on each rider anniversary. A portion of this fee will also be deducted when the rider is terminated based on the number of days that have elapsed since
it was last deducted. 
 Rider Year 
 Each twelve-month
period following the rider date. 
 ARTICLE II 

GROWTH BENEFIT AND GROWTH PERIOD 
 The total withdrawal
base will accumulate using the growth rate percentage as described in this Article. The growth period is the period of time from the rider date until the earlier of the first withdrawal of any amount from the policy value or the 10th rider
anniversary. The growth rate percentage applies only to the total withdrawal base. 
 FOR LIFE GUARANTEED MINIMUM WITHDRAWAL BENEFIT 

Under this rider, we guarantee that you can withdraw up to the maximum annual withdrawal amount each year, regardless of the policy value, until the
annuitant’s or the annuitant’s spouse’s death, whichever is later. 
 The “For Life” Withdrawal Percentage is determined by the
attained age of the younger of the living spouses at the time of the first withdrawal of any amount from the policy value taken on or after January 1st following the younger of the living spouse’s 59th birthday: 

 

																	
	 	 	 Attained Age at

    First Withdrawal    

 
	 	 	 	 “For Life” Withdrawal

          Percentage          

 
	 	 
		 	 	 	 59 - 64
	 	 	 		 	 	  	4.5%	 	 	 	
		 		 	 65 - 69
	 	 	 		 		  	5.0%	 	 	 	
		 		 	 70 - 74
	 	 	 		 		  	5.5%	 	 	 	
		 		 	 75 - 79
	 	 	 		 		  	6.0%	 	 	 	
		 		 	 80 - 84
	 	 	 		 		  	6.5%	 	 	 	
		 		 	 85 - 89
	 	 	 		 		  	7.0%	 	 	 	
		 		 	 90 - 94
	 	 	 		 		  	7.5%	 	 	 	
		 	 	 	 95 +
	 	 	 		 	 	  	8.0%	 	 	 	

 If the younger of the annuitant and the annuitant’s spouse is not yet [59] on the rider date, then this percentage will
be zero until the January 1st following the younger of the living spouse’s [59th] birthday. 
 Withdrawals will reduce the policy value of the
policy to which this rider is attached. If the policy value equals zero, you cannot make subsequent premium payments and all other policy features, benefits and guarantees are no longer available. Withdrawals guaranteed by this rider can be
continued by selecting an amount and frequency of payment in a manner acceptable to us. Once the payment amount and frequency are established, they cannot be changed and no additional withdrawals will be paid. 

Maximum Annual Withdrawal Amount 
 On the rider date the
maximum annual withdrawal amount will be equal to the greater of 1 and 2, where: 
  

	1)	is A multiplied by B multiplied by C where: 

  

	 	A)	is the total withdrawal base on the rider date, 

  

	 	B)	is the “For Life” withdrawal percentage as determined and shown above. If the younger of the annuitant or the annuitant’s spouse is not yet [59] on the rider date, this percentage will be equal to 0%, and

  

	 	C)	is equal to the number of days between the rider date and January 1st of the next calendar year, divided by the number of days in the current calendar year. 

  

					
	RGMB 19 0106	  	(2)	  	(Income/Growth/Death-Joint)

 ARTICLE II CONTINUED 

 

	2)	is an amount equal to the minimum required distribution amount (based on the premium paid to the policy to which this rider is attached) for the current calendar year using the annuitant’s age only if all of the
following are true: 

  

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

  

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

  

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

 

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

  

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

  

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

If any of the above are not true, then 2) is equal to zero and it is not available as a maximum annual withdrawal amount. An amount in addition
to the amount described in 2 above, may need to be taken to satisfy minimum required distributions, in certain situations. Such additional withdrawal amount will be considered an excess gross partial withdrawal (as described under “Total
Withdrawal Base Adjustments” below). 
 On January 1st of each subsequent calendar year following the rider date, the maximum annual withdrawal
amount will be reset equal to the greater of 1 and 2 where: 
  

	1)	is A multiplied by B where: 

  

	 	A)	is the total withdrawal base as of this date, and 

  

	 	B)	is the “For Life” withdrawal percentage as determined and shown above. If the younger of the annuitant or the annuitant’s spouse is not yet [59] on January 1st of the current calendar year, this
percentage will be equal to 0%. 

  

	2)	is an amount equal to the minimum required distribution amount for this policy for the current calendar year using the annuitant’s age only if all of the following are true: 

 

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

  

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

  

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

 

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

  

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

  

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

If any of the above are not true, then 2) is equal to zero and the minimum required distribution is not available as a maximum annual
withdrawal amount. An amount in addition to the amount described in 2 above, may need to be taken to satisfy minimum required distributions. Such additional withdrawal amount will be considered an excess gross partial withdrawal (as described under
“Total Withdrawal Base Adjustments” below). 
 Minimum Remaining Withdrawal Amount 

The minimum remaining withdrawal amount is the total minimum dollar amount of guaranteed withdrawals you have remaining, provided withdrawals do not exceed the
maximum annual withdrawal amount each rider year. The minimum remaining withdrawal amount on the rider date is equal to the policy value (less premium enhancements, if the rider is added in the first policy year). The minimum remaining withdrawal
amount after the rider date is equal to the minimum remaining withdrawal amount on the rider date plus any premiums added after the rider date (not including premium enhancements, if any) less any adjustments for withdrawals (as described under
“Minimum Withdrawal Amount Adjustments” below). 

  

					
	RGMB 19 0106	  	(3)	  	(Income/Growth/Death-Joint)

 ARTICLE II CONTINUED 

 

 Minimum Remaining Withdrawal Amount Adjustments 

Gross partial withdrawals up to the maximum annual withdrawal amount will reduce the minimum remaining withdrawal amount by the same amount (dollar for
dollar). Gross partial withdrawals in excess of the maximum annual withdrawal amount will reduce the minimum remaining withdrawal amount by the greater of: 
  

	1)	the excess gross partial withdrawal amount; and 

  

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

  

	 	A)	is the excess gross partial withdrawal (the amount in excess of the maximum annual withdrawal amount remaining prior to the withdrawal); 

 

	 	B)	is the policy value after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

 

	 	C)	is the minimum remaining withdrawal amount after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount. 

Total Withdrawal Base 
 The total withdrawal base on the
rider date is equal to the policy value (less any premium enhancements, if the rider is added in the first policy year). 
 The total withdrawal base during
the growth period (as described in “Growth Benefit and Growth Period” above) is equal to: 
  

	 	A)	the total withdrawal base on the rider date; plus 

  

	 	B)	any premiums added during the growth period, 

  

	 	C)	all of which are accumulated daily to the end of the growth period at an annual effective rate equal to the growth rate percentage shown on page 1. 

The total withdrawal base after the growth period is equal to: 
  

	 	A)	the total withdrawal base at the end of the growth period, plus 

  

	 	B)	any premiums added after the growth period; less 

  

	 	C)	any adjustments for withdrawals (as described under “Total Withdrawal Base Adjustments” below) including the withdrawal at the end of the growth period, if any. 

The growth period stops upon or at the earlier of the first withdrawal of any amount from the policy value or the [10th] rider anniversary. 

Total Withdrawal Base Adjustments 
 Gross partial
withdrawals up to the maximum annual withdrawal amount will not reduce the total withdrawal base. Gross partial withdrawals in excess of the maximum annual withdrawal amount will reduce the total withdrawal base by the greater of 1 and 2, where:

  

	1)	is the excess gross partial withdrawal amount; and 

  

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

  

	 	A)	is the excess gross partial withdrawal (the amount in excess of the maximum annual withdrawal amount remaining prior to the withdrawal); 

 

	 	B)	is the policy value after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

 

	 	C)	is the total withdrawal base prior to the withdrawal of the excess amount. 

 Death Benefit 

Upon the later of the annuitant or the annuitant’s spouse’s death, we will pay an additional death benefit amount equal to the excess, if any, of the
minimum remaining withdrawal amount over the base policy death benefit and this rider will then terminate. 

  

					
	RGMB 19 0106	  	(4)	  	(Income/Growth/Death-Joint)

 ARTICLE III 

CONTINUATION 
 In the case of spousal joint owners where
one spouse is the annuitant, if the spouse who is not the annuitant dies and the surviving spouse is the sole beneficiary, the surviving spouse may elect to continue the policy and rider. No additional death benefit will be paid under this rider at
this time. 
 RIDER UPGRADE 
 You may elect, in writing,
to upgrade the total withdrawal base to the policy value within [30 days] after the [first] rider anniversary and [30 days] after each rider anniversary thereafter, subject to the age restrictions on the new rider. If an upgrade is elected, this
rider will terminate and a new rider with the same features will be issued with a new rider date. The new rider will have its own Growth Rate Percentage which may be lower than this rider’s Growth Rate Percentage. The new rider will have its
own Rider Fee Percentage which may be higher than this rider’s Rider Fee Percentage. 
 At the time of upgrade, the minimum remaining withdrawal amount
will also be upgraded to the policy value and the maximum annual withdrawal amount will be recalculated based on the new total withdrawal base. 
 The new
rider effective date will be the date the Company receives all information necessary, in a written form acceptable to the Company, to process the upgrade. 

Signed for us at our home office. 
  

															
		 	 	 	

	 	 	 		 	 	 	

	 	 
		 		 		 		 		 		 		 	
		 		 	SECRETARY	 		 		 		 	PRESIDENT	 	

  

					
	RGMB 19 0106	  	(5)	  	(Income/Growth/Death-Joint)

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