Document:

Exhibit
4.8

 

PRE-FUNDED
COMMON STOCK PURCHASE WARRANT

CEA
INDUSTRIES INC.

 

	Warrant
    Shares: _______	 
	 	Issue
    Date: ___, 2022

 

THIS
PRE-FUNDED COMMON STOCK PURCHASE WARRANT (the “Warrant”) certifies that, for value received, _____________ or its
assigns (the “Holder”) is entitled, upon the terms and subject to the limitations on exercise and the conditions hereinafter
set forth, at any time on or after the Issue Date and until this Warrant is exercised in full (the “Termination Date”)
but not thereafter, to subscribe for and purchase from CEA Industries Inc., a Nevada corporation (the “Company”),
up to ______ shares of Common Stock (as subject to adjustment hereunder, the “Warrant Shares”). The purchase price
of one share of Common Stock under this Warrant shall be equal to the Exercise Price, as defined in Section 2(b).

 

Section
1. Definitions. In addition to the terms defined elsewhere in this Warrant, the following terms have the meanings indicated
in this Section 1:

 

“Affiliate”
means any Person that, directly or indirectly through one or more intermediaries, controls or is controlled by or is under common control
with a Person, as such terms are used in and construed under Rule 405 under the Securities Act.

 

“Commission”
means the United States Securities and Exchange Commission.

 

“Common
Stock” means the common stock of the Company, par value $.00001 per share, and any other class of securities into which such
securities may hereafter be reclassified or changed.

 

“Common
Stock Equivalents” means any securities of the Company or the Subsidiaries which would entitle the holder thereof to acquire
at any time Common Stock, including, without limitation, any debt, preferred stock, right, option, warrant or other instrument that is
at any time convertible into or exercisable or exchangeable for, or otherwise entitles the holder thereof to receive, Common Stock.

 

“Exchange
Act” means the Securities Exchange Act of 1934, as amended, and the rules and regulations promulgated thereunder.

 

“Liens”
means a lien, charge pledge, security interest, encumbrance, right of first refusal, preemptive right or other restriction.

 

“Person”
means an individual or corporation, partnership, trust, incorporated or unincorporated association, joint venture, limited liability
company, joint stock company, government (or an agency or subdivision thereof) or other entity of any kind.

 

“Proceeding”
means an action, claim, suit, investigation or proceeding (including, without limitation, an informal investigation or partial proceeding,
such as a deposition), whether commenced or threatened.

 

“Registration
Statement” means the Company’s registration statement on Form S-1 (File No. 333-261648).

 

“Rule
144” means Rule 144 promulgated by the Commission pursuant to the Securities Act, as such Rule may be amended or interpreted
from time to time, or any similar rule or regulation hereafter adopted by the Commission having substantially the same purpose and effect
as such Rule.

 

    	 

     

    

 

“Securities
Act” means the Securities Act of 1933, as amended, and the rules and regulations promulgated thereunder.

 

“Trading
Day” means a day on which the Common Stock is traded on a Trading Market.

 

“Trading
Market” means any of the following markets or exchanges on which the Common Stock is listed or quoted for trading on the date
in question: the OTCQB, OTCQX or Pink Open Market operated by OTC Markets Group, the NYSE American, the Nasdaq Capital Market, the Nasdaq
Global Market, the Nasdaq Global Select Market, or the New York Stock Exchange (or any successors to any of the foregoing).

 

“Transfer
Agent” means Continental Stock Transfer & Trust Company, One State Street Plaza, 30th Floor, New York, New York, 10004,
telephone number of 212-509-4000, and any successor transfer agent of the Company.

 

“Warrants”
means this Warrant and other Pre-Funded Common Stock Purchase Warrants issued by the Company pursuant to the Registration Statement.

 

Section
2. Exercise.

 

a)
Exercise of the purchase rights represented by this Warrant may be made, in whole or in part, at any time or times on or after the Issue
Date and on or before the Termination Date by delivery to the Company of a duly executed facsimile copy (or e-mail attachment) of the
Notice of Exercise in the form annexed hereto (the “Notice of Exercise”). Within the earlier of (i) two (2) Trading
Days and (ii) the number of Trading Days comprising the Standard Settlement Period (as defined in Section 2(d)(i) herein) following the
date of exercise as aforesaid, the Holder shall deliver to the Company the aggregate Exercise Price for the Warrant Shares specified
in the applicable Notice of Exercise by wire transfer or cashier’s check drawn on a United States bank unless the cashless exercise
procedure specified in Section 2(c) below is specified in the applicable Notice of Exercise. No ink-original Notice of Exercise shall
be required, nor shall any medallion guarantee (or other type of guarantee or notarization) of any Notice of Exercise form be required.
Notwithstanding anything herein to the contrary, the Holder shall not be required to physically surrender this Warrant to the Company
until the Holder has purchased all of the Warrant Shares available hereunder and the Warrant has been exercised in full, in which case,
the Holder shall surrender this Warrant to the Company for cancellation within three (3) Trading Days of the date on which the final
Notice of Exercise is delivered to the Company. Partial exercises of this Warrant resulting in purchases of a portion of the total number
of Warrant Shares available hereunder shall have the effect of lowering the outstanding number of Warrant Shares purchasable hereunder
in an amount equal to the applicable number of Warrant Shares purchased. The Holder and the Company shall maintain records showing the
number of Warrant Shares purchased and the date of such purchases. The Company shall deliver any objection to any Notice of Exercise
within one (1) Trading Day of receipt of such notice. The Holder and any assignee, by acceptance of this Warrant, acknowledge and
agree that, by reason of the provisions of this paragraph, following the purchase of a portion of the Warrant Shares hereunder, the number
of Warrant Shares available for purchase hereunder at any given time may be less than the amount stated on the face hereof.

 

b)
Exercise Price. The aggregate exercise price of this Warrant, except for a nominal exercise price of $0.01 per Warrant Share,
was pre-funded to the Company on or prior to the Issue Date and, consequently, no additional consideration (other than the nominal exercise
price of $0.01 per Warrant Share) shall be required to be paid by the Holder to any Person to effect any exercise of this Warrant. The
Holder shall not be entitled to the return or refund of all, or any portion, of such pre-paid aggregate exercise price under any circumstance
or for any reason whatsoever, including in the event this Warrant shall not have been exercised prior to the Termination Date. The remaining
unpaid exercise price per share of Common Stock under this Warrant shall be $0.01, subject to adjustment hereunder (the “Exercise
Price”).

 

    	2

    	 

    

 

c)
Cashless Exercise. This Warrant may also be exercised, in whole or in part, at such time by means of a “cashless exercise”
in which the Holder shall be entitled to receive a number of Warrant Shares for the deemed surrender of the Warrant in whole or in part
equal to the quotient obtained by dividing [(A-B) (X)] by (A), where:

 

		(A)
    =	as
  applicable: (i) the Closing Sale Price of the Common Stock on the Trading Day immediately preceding the date of the applicable Notice
  of Exercise if such Notice of Exercise is (1) both executed and delivered pursuant to Section 2(a) hereof on a day that is not a Trading
  Day or (2) both executed and delivered pursuant to Section 2(a) hereof on a Trading Day prior to the opening of “regular trading
  hours” (as defined in Rule 600(b)(68) of Regulation NMS promulgated under the federal securities laws) on such Trading Day, (ii)
  at the option of the Holder, either (x) the VWAP on the Trading Day immediately preceding the date of the applicable Notice of Exercise
  or (y) the Bid Price of the Common Stock as of the time of the Holder’s execution of the applicable Notice of Exercise if such
  Notice of Exercise is executed during “regular trading hours” on a Trading Day and is delivered within two (2) hours thereafter
  pursuant to Section 2(a) hereof (including until two (2) hours after the close of “regular trading hours” on a Trading
  Day), or (iii) the Closing Sale Price of the Common Stock on the date of the applicable Notice of Exercise if the date of such Notice
  of Exercise is a Trading Day and such Notice of Exercise is both executed and delivered pursuant to Section 2(a) hereof after the close
  of “regular trading hours” on such Trading Day;

 

		(B)
    =	the
  Exercise Price of this Warrant, as adjusted hereunder; and

 

		(X)
    =	the
  number of Warrant Shares that would be issuable upon exercise of this Warrant in accordance with the terms of this Warrant if such
  exercise were by means of a cash exercise rather than a cashless exercise.

 

The
issue price for each such Warrant Share to be issued pursuant to the cashless exercise of a Warrant will be equal to (B), as defined
above, and the total issue price for the aggregate number of Warrant Shares issued pursuant to the cashless exercise of a Warrant will
be deemed paid and satisfied in full by the deemed surrender to the Company of the portion of such Warrant being exercised in accordance
with this Section 1(c). Notwithstanding anything herein to the contrary, the Company shall not be required to make any cash payments
or net cash settlement to the Holder in lieu of delivery of the Warrant Shares. If Warrant Shares are issued in such a cashless exercise,
the parties acknowledge and agree that in accordance with Section 3(a)(9) of the Securities Act, the Warrant Shares shall take on the
registered characteristics of the Warrants being exercised. The Company agrees not to take any position contrary to this Section 2(c).

 

“Bid
Price” means, for any security as of the particular time of determination, the bid price for such security on the Trading Market
as reported by Bloomberg as of such time of determination, or, if the Trading Market is not the principal securities exchange or trading
market for such security, the bid price of such security on the principal securities exchange or trading market where such security is
listed or traded as reported by Bloomberg as of such time of determination, or if the foregoing does not apply, the bid price of such
security in the over-the-counter market on the electronic bulletin board for such security as reported by Bloomberg as of such time of
determination, or, if no bid price is reported for such security by Bloomberg as of such time of determination, the average of the bid
prices of any market makers for such security as reported on the Pink Open Market as of such time of determination. If the Bid Price
cannot be calculated for a security as of the particular time of determination on any of the foregoing bases, the Bid Price of such security
as of such time of determination shall be the fair market value as mutually determined by the Company and the Holder. If the Company
and the Holder are unable to agree upon the fair market value of such security, then such fair market value shall be determined pursuant
to the provisions set forth in clause (d) of the definition of VWAP. All such determinations to be appropriately adjusted for any stock
dividend, share split, share consolidation, reclassification or other similar transaction during the applicable calculation period.

 

    	3

    	 

    

 

“Closing
Sale Price” means, for any security as of any date, the last closing trade price for such security on the Trading Market, as
reported by Bloomberg, or, if the Trading Market begins to operate on an extended hours basis and does not designate the closing trade
price, then the last trade price of such security prior to 4:00:00 p.m., New York time, as reported by Bloomberg, or, if the Trading
Market is not the principal securities exchange or trading market for such security, the last trade price of such security on the principal
securities exchange or trading market where such security is listed or traded as reported by Bloomberg, or if the foregoing do not apply,
the last trade price of such security in the over-the-counter market on the electronic bulletin board for such security as reported by
Bloomberg, or, if no last trade price is reported for such security by Bloomberg, the average of the ask prices of any market makers
for such security as reported on the in the OTC Link or on the Pink Open Market. If the Closing Sale Price cannot be calculated for a
security on a particular date on any of the foregoing bases, Closing Sale Price of such security on such date shall be the fair market
value as mutually determined by the Company and the Holder. If the Company and the Holder are unable to agree upon the fair market value
of such security, then such fair market value shall be determined pursuant to the provisions set forth in clause (d) of the definition
of VWAP. All such determinations to be appropriately adjusted for any stock dividend, share split, share consolidation, reclassification
or other similar transaction during the applicable calculation period.

 

“VWAP”
means, for any date, the price determined by the first of the following clauses that applies: (a) if the Common Stock is then listed
or quoted for trading on a Trading Market other than the OTCQB, OTCQX or Pink Open Market operated by OTC Markets Group, the daily volume
weighted average price of the Common Stock for such date (or the nearest preceding date) on the Trading Market on which the Common Stock
is then listed or quoted as reported by Bloomberg L.P. (based on a Trading Day from 9:30 a.m. (New York City time) to 4:02 p.m. (New
York City time)), (b) if the Common Stock is then quoted for trading on the OTCQB or OTCQX operated by OTC Markets Group, the volume
weighted average price of the Common Stock for such date (or the nearest preceding date) on OTCQB or OTCQX as applicable, (c) if the
Common Stock is then quoted for trading on the Pink Open Market operated by OTC Markets Group (or a similar organization or agency succeeding
to its functions of reporting prices), the most recent bid price per share of Common Stock reported on the Pink Open Market, or (d) in
all other cases, the fair market value of a share of Common Stock as determined by an independent appraiser selected in good faith by
the holders of a majority in interest of the Warrants then outstanding and reasonably acceptable to the Company, the fees and expenses
of which shall be paid by the Company.

 

d)
Mechanics of Exercise.

 

i.
Delivery of Warrant Shares Upon Exercise. The Company shall cause the Warrant Shares purchased hereunder to be transmitted by
the Transfer Agent to the Holder by crediting the account of the Holder’s or its designee’s balance account with The Depository
Trust Company through its Deposit or Withdrawal at Custodian system (the “DWAC”) if the Company is then a participant
in such system and either (A) there is an effective registration statement permitting the issuance of the Warrant Shares to or resale
of the Warrant Shares by the Holder or (B) this Warrant is being exercised via cashless exercise, and otherwise by physical delivery
of a certificate, registered in the Company’s share register in the name of the Holder or its designee, for the number of Warrant
Shares to which the Holder is entitled pursuant to such exercise to the address specified by the Holder in the Notice of Exercise by
the date that is the earlier of (i) two (2) Trading Days and (ii) the number of Trading Days comprising the Standard Settlement Period
after the delivery to the Company of the Notice of Exercise (such date, the “Warrant Share Delivery Date”). Upon delivery
of the Notice of Exercise, the Holder shall be deemed for all corporate purposes to have become the Holder of record of the Warrant Shares
with respect to which this Warrant has been exercised, irrespective of the date of delivery of the Warrant Shares, provided that payment
of the aggregate Exercise Price (other than in the case of a cashless exercise) is received within the earlier of (i) two (2) Trading
Days and (ii) the number of Trading Days comprising the Standard Settlement Period following delivery of the Notice of Exercise. If the
Company fails for any reason to deliver to the Holder the Warrant Shares subject to a Notice of Exercise by the Warrant Share Delivery
Date, the Company shall pay to the Holder, in cash, as liquidated damages and not as a penalty, for each $1,000 of Warrant Shares subject
to such exercise (based on the VWAP of the Common Stock on the date of the applicable Notice of Exercise), $10 per Trading Day (increasing
to $20 per Trading Day on the fifth Trading Day after such liquidated damages begin to accrue) for each Trading Day after such Warrant
Share Delivery Date until such Warrant Shares are delivered to said Holder or the Holder rescinds such exercise. The Company agrees to
maintain a transfer agent that is a participant in the Fast Automated Securities Transfer or FAST program so long as this Warrant remains
outstanding and exercisable. As used herein, “Standard Settlement Period” means the standard settlement period, expressed
in a number of Trading Days, on the Company’s primary Trading Market with respect to the Common Stock as in effect on the date
of delivery of the Notice of Exercise. Notwithstanding the foregoing, with respect to any Notice(s) of Exercise delivered on or prior
to 12:00 p.m. (New York City time) on the Issue Date, which may be delivered at any time after the time of execution of the Underwriting
Agreement, dated February [•], 2022 between the Company and ThinkEquity LLC, the Company agrees to deliver the Warrant Shares subject
to such notice(s) by 4:00 p.m. (New York City time) on the Issue Date.

 

    	4

    	 

    

 

ii.
Delivery of New Warrants Upon Exercise. If this Warrant shall have been exercised in part, the Company shall, at the request of
a Holder and upon surrender of this Warrant certificate, at the time of delivery of the Warrant Shares, deliver to the Holder a new Warrant
evidencing the rights of the Holder to purchase the unpurchased Warrant Shares called for by this Warrant, which new Warrant shall in
all other respects be identical with this Warrant.

 

iii.
Rescission Rights. If the Company fails to cause the Transfer Agent to transmit to the Holder the Warrant Shares pursuant to Section
2(d)(i) by the Warrant Share Delivery Date, then the Holder will have the right to rescind such exercise.

 

iv.
Compensation for Buy-In on Failure to Timely Deliver Warrant Shares Upon Exercise. In addition to any other rights available to
the Holder, if the Company fails to cause the Transfer Agent to transmit to the Holder the Warrant Shares in accordance with the provisions
of Section 2(d)(i) above pursuant to an exercise on or before the Warrant Share Delivery Date, and if after such date the Holder is required
by its broker to purchase (in an open market transaction or otherwise) or the Holder’s brokerage firm otherwise purchases, share
of Common Stock to deliver in satisfaction of a sale by the Holder of the Warrant Shares which the Holder anticipated receiving upon
such exercise (a “Buy-In”), then the Company shall (A) pay in cash to the Holder the amount, if any, by which (x)
the Holder’s total purchase price (including brokerage commissions, if any) for the shares of Common Stock so purchased exceeds
(y) the amount obtained by multiplying (1) the number of Warrant Shares that the Company was required to deliver to the Holder in connection
with the exercise at issue by (2) the price at which the sell order giving rise to such purchase obligation was executed, and (B) at
the option of the Holder, either reinstate the portion of the Warrant and equivalent number of Warrant Shares for which such exercise
was not honored (in which case such exercise shall be deemed rescinded) or deliver to the Holder the number of Common Stock that would
have been issued had the Company timely complied with its exercise and delivery obligations hereunder. For example, if the Holder purchases
Common Stock having a total purchase price of $11,000 to cover a Buy-In with respect to an attempted exercise of Common Stock with an
aggregate sale price giving rise to such purchase obligation of $10,000, under clause (A) of the immediately preceding sentence the Company
shall be required to pay the Holder $1,000. The Holder shall provide the Company written notice indicating the amounts payable to the
Holder in respect of the Buy-In and, upon request of the Company, evidence of the amount of such loss. Nothing herein shall limit a Holder’s
right to pursue any other remedies available to it hereunder, at law or in equity including, without limitation, a decree of specific
performance and/or injunctive relief with respect to the Company’s failure to timely deliver Common Stock upon exercise of the
Warrant as required pursuant to the terms hereof.

 

    	5

    	 

    

 

v.
No Fractional Shares or Scrip. No fractional shares or scrip representing fractional shares shall be issued upon the exercise
of this Warrant. As to any fraction of a share which the Holder would otherwise be entitled to purchase upon such exercise, the Company
shall, at its election, either pay a cash adjustment in respect of such final fraction in an amount equal to such fraction multiplied
by the Exercise Price or round up to the next whole share.

 

vi.
Charges, Taxes and Expenses. Issuance of Warrant Shares shall be made without charge to the Holder for any issue or transfer tax
or other incidental expense in respect of the issuance of such Warrant Shares, all of which taxes and expenses shall be paid by the Company,
and such Warrant Shares shall be issued in the name of the Holder or in such name or names as may be directed by the Holder; provided,
however, that in the event that Warrant Shares are to be issued in a name other than the name of the Holder, this Warrant when
surrendered for exercise shall be accompanied by the Assignment Form attached hereto duly executed by the Holder and the Company may
require, as a condition thereto, the payment of a sum sufficient to reimburse it for any transfer tax incidental thereto. The Company
shall pay all Transfer Agent fees required for same-day processing of any Notice of Exercise and all fees to the Depository Trust Company
(or another established clearing corporation performing similar functions) required for same-day electronic delivery of the Warrant Shares.

 

vii.
Closing of Books. The Company shall not close its stockholder books or records in any manner which prevents the timely exercise
of this Warrant, pursuant to the terms hereof.

 

e)
Holder’s Exercise Limitations. The Company shall not effect any exercise of this Warrant, and a Holder shall not have the
right to exercise any portion of this Warrant, pursuant to Section 2 or otherwise, to the extent that after giving effect to such issuance
after exercise as set forth on the applicable Notice of Exercise, the Holder (together with the Holder’s Affiliates, and any other
Persons acting as a group together with the Holder or any of the Holder’s Affiliates (such Persons, “Attribution Parties”)),
would beneficially own in excess of the Beneficial Ownership Limitation (as defined below). For purposes of the foregoing sentence, the
number of shares of Common Stock beneficially owned by the Holder and its Affiliates and Attribution Parties shall include the number
of shares of Common Stock issuable upon exercise of this Warrant with respect to which such determination is being made, but shall exclude
the number of shares of Common Stock which would be issuable upon (i) exercise of the remaining, non-exercised portion of this Warrant
beneficially owned by the Holder or any of its Affiliates or Attribution Parties and (ii) exercise or conversion of the unexercised or
non-converted portion of any other securities of the Company (including, without limitation, any other Common Share Equivalents) subject
to a limitation on conversion or exercise analogous to the limitation contained herein beneficially owned by the Holder or any of its
Affiliates or Attribution Parties. Except as set forth in the preceding sentence, for purposes of this Section 2(e), beneficial ownership
shall be calculated in accordance with Section 13(d) of the Exchange Act and the rules and regulations promulgated thereunder, it being
acknowledged by the Holder that the Company is not representing to the Holder that such calculation is in compliance with Section 13(d)
of the Exchange Act and the Holder is solely responsible for any schedules required to be filed in accordance therewith. To the extent
that the limitation contained in this Section 2(e) applies, the determination of whether this Warrant is exercisable (in relation to
other securities owned by the Holder together with any Affiliates and Attribution Parties) and of which portion of this Warrant is exercisable
shall be in the sole discretion of the Holder, and the submission of a Notice of Exercise shall be deemed to be the Holder’s determination
of whether this Warrant is exercisable (in relation to other securities owned by the Holder together with any Affiliates and Attribution
Parties) and of which portion of this Warrant is exercisable, in each case subject to the Beneficial Ownership Limitation, and the Company
shall have no obligation to verify or confirm the accuracy of such determination. In addition, a determination as to any group status
as contemplated above shall be determined in accordance with Section 13(d) of the Exchange Act and the rules and regulations promulgated
thereunder. For purposes of this Section 2(e), in determining the number of outstanding shares of Common Stock, a Holder may rely on
the number of outstanding shares of Common Stock as reflected in (A) the Company’s most recent periodic or annual report filed
with the Commission, as the case may be, (B) a more recent public announcement by the Company or (C) a more recent written notice by
the Company or the Transfer Agent setting forth the number of shares of Common Stock outstanding. Upon the written or oral request of
a Holder, the Company shall within two Trading Days confirm orally and in writing to the Holder the number of shares of Common Stock
then outstanding. In any case, the number of outstanding shares of Common Stock shall be determined after giving effect to the conversion
or exercise of securities of the Company, including this Warrant, by the Holder or its Affiliates or Attribution Parties since the date
as of which such number of outstanding shares of Common Stock was reported. The “Beneficial Ownership Limitation”
shall be 4.99% (or, upon election by a Holder prior to the issuance of any Warrants, 9.99%) of the number of shares of Common Stock outstanding
immediately after giving effect to the issuance of Common Stock issuable upon exercise of this Warrant. The Holder, upon notice to the
Company, may increase or decrease the Beneficial Ownership Limitation provisions of this Section 2(e), provided that the Beneficial Ownership
Limitation in no event exceeds 9.99% of the number of shares of Common Stock outstanding immediately after giving effect to the issuance
of Common Stock upon exercise of this Warrant held by the Holder and the provisions of this Section 2(e) shall continue to apply. Any
increase in the Beneficial Ownership Limitation will not be effective until the 61st day after such notice is delivered to
the Company. The provisions of this paragraph shall be construed and implemented in a manner otherwise than in strict conformity with
the terms of this Section 2(e) to correct this paragraph (or any portion hereof) which may be defective or inconsistent with the intended
Beneficial Ownership Limitation herein contained or to make changes or supplements necessary or desirable to properly give effect to
such limitation. The limitations contained in this paragraph shall apply to a successor holder of this Warrant.

 

    	6

    	 

    

 

Section
3. Certain Adjustments.

 

a)
Stock Dividends and Splits. If the Company, at any time while this Warrant is outstanding: (i) pays a stock dividend or otherwise
makes a distribution or distributions on its Common Stock or any other equity or equity equivalent securities payable in Common Stock
(which, for avoidance of doubt, shall not include any Common Stock issued by the Company upon exercise of this Warrant), (ii) subdivides
outstanding Common Stock into a larger number of shares, (iii) combines (including by way of reverse share split or consolidation) outstanding
Common Stock into a smaller number of shares, or (iv) issues by reclassification of Common Stock any shares of the Company, then in each
case the Exercise Price shall be multiplied by a fraction of which the numerator shall be the number of Common Stock (excluding treasury
shares, if any) outstanding immediately before such event and of which the denominator shall be the number of shares of Common Stock
outstanding immediately after such event, and the number of shares issuable upon exercise of this Warrant shall be proportionately adjusted
such that the aggregate Exercise Price of this Warrant shall remain unchanged. Any adjustment made pursuant to this Section 3(a) shall
become effective immediately after the record date for the determination of stockholders entitled to receive such dividend or distribution
and shall become effective immediately after the effective date in the case of a subdivision, combination or re-classification.

 

b)
Subsequent Rights Offerings. In addition to any adjustments pursuant to Section 3(a) above, if at any time the Company grants,
issues or sells any Common Stock Equivalents or rights to purchase stock, warrants, securities or other property pro rata to the record
holders of shares of Common Stock (the “Purchase Rights”), then the Holder will be entitled to acquire, upon the terms
applicable to such Purchase Rights, the aggregate Purchase Rights which the Holder could have acquired if the Holder had held the number
of shares of Common Stock acquirable upon complete exercise of this Warrant (without regard to any limitations on exercise hereof, including
without limitation, the Beneficial Ownership Limitation) immediately before the date on which a record is taken for the grant, issuance
or sale of such Purchase Rights, or, if no such record is taken, the date as of which the record holders of shares of Common Stock are
to be determined for the grant, issue or sale of such Purchase Rights (provided, however, to the extent that the Holder’s right
to participate in any such Purchase Right would result in the Holder exceeding the Beneficial Ownership Limitation, then the Holder shall
not be entitled to participate in such Purchase Right to such extent (or beneficial ownership of such shares of Common Stock as a result
of such Purchase Right to such extent) and such Purchase Right to such extent shall be held in abeyance for the Holder until such time,
if ever, as its right thereto would not result in the Holder exceeding the Beneficial Ownership Limitation).

 

    	7

    	 

    

 

c)
Pro Rata Distributions. During such time as this Warrant is outstanding, if the Company shall declare or make any dividend or
other distribution of its assets (or rights to acquire its assets) to holders of shares of Common Stock, by way of return of capital
or otherwise (including, without limitation, any distribution of cash, stock or other securities, property or options by way of a dividend,
spin off, reclassification, corporate rearrangement, scheme of arrangement or other similar transaction) (a “Distribution”),
at any time after the issuance of this Warrant, then, in each such case, the Holder shall be entitled to participate in such Distribution
to the same extent that the Holder would have participated therein if the Holder had held the number of shares of Common Stock acquirable
upon complete exercise of this Warrant (without regard to any limitations on exercise hereof, including without limitation, the Beneficial
Ownership Limitation) immediately before the date of which a record is taken for such Distribution, or, if no such record is taken, the
date as of which the record holders of shares of Common Stock are to be determined for the participation in such Distribution (provided,
however, to the extent that the Holder’s right to participate in any such Distribution would result in the Holder exceeding
the Beneficial Ownership Limitation, then the Holder shall not be entitled to participate in such Distribution to such extent (or in
the beneficial ownership of any shares of Common Stock as a result of such Distribution to such extent) and the portion of such Distribution
shall be held in abeyance for the benefit of the Holder until such time, if ever, as its right thereto would not result in the Holder
exceeding the Beneficial Ownership Limitation).

 

d)
Fundamental Transaction. If, at any time while this Warrant is outstanding, (i) the Company, directly or indirectly, in one or
more related transactions effects any merger or amalgamation or consolidation of the Company with or into another Person, (ii) the Company,
directly or indirectly, effects any sale, lease, license, assignment, transfer, conveyance or other disposition of all or substantially
all of its assets in one or a series of related transactions, (iii) any, direct or indirect, purchase offer, tender offer or exchange
offer (whether by the Company or another Person) is completed pursuant to which holders of Common Stock are permitted to sell, tender
or exchange their shares for other securities, cash or property and has been accepted by the holders of 50% or more of the outstanding
Common Stock, (iv) the Company, directly or indirectly, in one or more related transactions effects any reclassification, reorganization
or recapitalization of the Common Stock or any compulsory share exchange pursuant to which the Common Stock is effectively converted
into or exchanged for other securities, cash or property, or (v) the Company, directly or indirectly, in one or more related transactions
consummates a share purchase agreement or other business combination (including, without limitation, a reorganization, recapitalization,
spin-off or scheme of arrangement) with another Person or group of Persons whereby such other Person or group acquires more than 50%
of the outstanding shares of Common Stock (not including any shares of Common Stock held by the other Person or other Persons making
or party to, or associated or affiliated with the other Persons making or party to, such share purchase agreement or other business combination)
(each a “Fundamental Transaction”), then, upon any subsequent exercise of this Warrant, the Holder shall have the
right to receive, for each Warrant Share that would have been issuable upon such exercise immediately prior to the occurrence of such
Fundamental Transaction, at the option of the Holder (without regard to any limitation in Section 2(e) on the exercise of this Warrant),
the number of shares of Common Stock of the successor or acquiring corporation or of the Company, if it is the surviving corporation
or is otherwise the continuing corporation, and any additional consideration (the “Alternate Consideration”) receivable
as a result of such Fundamental Transaction by a holder of the number of shares of Common Stock for which this Warrant is exercisable
immediately prior to such Fundamental Transaction (without regard to any limitation in Section 2(e) on the exercise of this Warrant).
For purposes of any such exercise, the determination of the Exercise Price shall be appropriately adjusted to apply to such Alternate
Consideration based on the amount of Alternate Consideration issuable in respect of one shares of Common Stock in such Fundamental Transaction,
and the Company shall apportion the Exercise Price among the Alternate Consideration in a reasonable manner reflecting the relative value
of any different components of the Alternate Consideration. If holders of Common Stock are given any choice as to the securities, cash
or property to be received in a Fundamental Transaction, then the Holder shall be given the same choice as to the Alternate Consideration
it receives upon any exercise of this Warrant following such Fundamental Transaction. The Company shall cause any successor entity in
a Fundamental Transaction in which the Company is not the survivor (the “Successor Entity”) to assume in writing all
of the obligations of the Company under this Warrant in accordance with the provisions of this Section 3(d) pursuant to written agreements
prior to such Fundamental Transaction and shall, at the option of the Holder, deliver to the Holder in exchange for this Warrant a security
of the Successor Entity evidenced by a written instrument substantially similar in form and substance to this Warrant which is exercisable
for a corresponding number of shares or other securities of such Successor Entity (or its parent entity) equivalent to the shares of
Common Stock acquirable and receivable upon exercise of this Warrant (without regard to any limitations on the exercise of this Warrant)
prior to such Fundamental Transaction, and with an exercise price which applies the exercise price hereunder to such shares of or other
securities (but taking into account the relative value of the shares of Common Stock pursuant to such Fundamental Transaction and the
value of such shares or securities, such number of shares or securities and such exercise price being for the purpose of protecting the
economic value of this Warrant immediately prior to the consummation of such Fundamental Transaction). Upon the occurrence of any such
Fundamental Transaction, the Successor Entity shall succeed to, and be substituted for (so that from and after the date of such Fundamental
Transaction, the provisions of this Warrant referring to the “Company” shall refer instead to the Successor Entity), and
may exercise every right and power of the Company and shall assume all of the obligations of the Company under this Warrant with the
same effect as if such Successor Entity had been named as the Company herein.

 

    	8

    	 

    

 

e)
Calculations. All calculations under this Section 3 shall be made to the nearest cent or the nearest 1/100th of a share, as the
case may be. For purposes of this Section 3, the number of shares of Common Stock deemed to be issued and outstanding as of a given date
shall be the sum of the number of shares of Common Stock (excluding treasury shares, if any) issued and outstanding.

 

f)
Notice to Holder.

 

i.
Adjustment to Exercise Price. Whenever the Exercise Price is adjusted pursuant to any provision of this Section 3, the Company
shall promptly deliver to the Holder by facsimile or email a notice setting forth the Exercise Price after such adjustment and any resulting
adjustment to the number of Warrant Shares and setting forth a brief statement of the facts requiring such adjustment.

 

ii.
Notice to Allow Exercise by Holder. If (A) the Company shall declare a dividend (or any other distribution in whatever form) on
the Common Stock, (B) the Company shall declare a special nonrecurring cash dividend on or a redemption of the Common Stock, (C) the
Company shall authorize the granting to all holders of the Common Stock rights or warrants to subscribe for or purchase any shares of
the Company or of any rights, (D) the approval of any stockholders of the Company shall be required in connection with any reclassification
of the Common Stock, any consolidation or merger, amalgamation or arrangement to which the Company is a party, any sale or transfer of
all or substantially all of the assets of the Company, or any compulsory share exchange whereby the Common Stock is converted into other
securities, cash or property, or (E) the Company shall authorize the voluntary or involuntary dissolution, liquidation or winding up
of the affairs of the Company, then, in each case, the Company shall cause to be delivered by facsimile or email to the Holder at its
last facsimile number or email address as it shall appear upon the Warrant Register of the Company, at least 20 calendar days prior to
the applicable record or effective date hereinafter specified, a notice stating (x) the date on which a record is to be taken for the
purpose of such dividend, distribution, redemption, rights or warrants, or if a record is not to be taken, the date as of which the holders
of the Common Stock of record to be entitled to such dividend, distributions, redemption, rights or warrants are to be determined or
(y) the date on which such reclassification, consolidation, merger, amalgamation, arrangement, sale, transfer or share exchange is expected
to become effective or close, and the date as of which it is expected that holders of the Common Stock of record shall be entitled to
exchange their shares of Common Stock for securities, cash or other property deliverable upon such reclassification, consolidation, merger,
amalgamation, arrangement sale, transfer or share exchange; provided that the failure to deliver such notice or any defect therein or
in the delivery thereof shall not affect the validity of the corporate action required to be specified in such notice. To the extent
that any notice provided in this Warrant constitutes, or contains, material, non-public information regarding the Company or any of its
subsidiaries (the “Subsidiaries”), the Company shall simultaneously file such notice with the Commission pursuant
to a Current Report on Form 8-K. The Holder shall remain entitled to exercise this Warrant during the period commencing on the date of
such notice to the effective date of the event triggering such notice except as may otherwise be expressly set forth herein.

 

    	9

    	 

    

 

Section
4. Transfer of Warrant.

 

a)
Transferability. This Warrant and all rights hereunder are transferable, in whole or in part, upon surrender of this Warrant at
the principal office of the Company or its designated agent, together with a written assignment of this Warrant substantially in the
form attached hereto duly executed by the Holder or its agent or attorney and funds sufficient to pay any transfer taxes payable upon
the making of such transfer. Upon such surrender and, if required, such payment, the Company shall execute and deliver a new Warrant
or Warrants in the name of the assignee or assignees, as applicable, and in the denomination or denominations specified in such instrument
of assignment, and shall issue to the assignor a new Warrant evidencing the portion of this Warrant not so assigned, and this Warrant
shall promptly be cancelled. Notwithstanding anything herein to the contrary, the Holder shall not be required to physically surrender
this Warrant to the Company unless the Holder has assigned this Warrant in full, in which case, the Holder shall surrender this Warrant
to the Company within three (3) Trading Days of the date on which the Holder delivers an assignment form to the Company assigning this
Warrant in full. This Warrant, if properly assigned in accordance herewith, may be exercised by a new holder for the purchase of Warrant
Shares without having a new Warrant issued.

 

b)
New Warrants. This Warrant may be divided or combined with other Warrants upon presentation hereof at the aforesaid office of
the Company, together with a written notice specifying the names and denominations in which new Warrants are to be issued, signed by
the Holder or its agent or attorney. Subject to compliance with Section 4(a), as to any transfer which may be involved in such division
or combination, the Company shall execute and deliver a new Warrant or Warrants in exchange for the Warrant or Warrants to be divided
or combined in accordance with such notice. All Warrants issued on transfers or exchanges shall be dated the original Issue Date of this
Warrant and shall be identical with this Warrant except as to the number of Warrant Shares issuable pursuant thereto.

 

c)
Warrant Register. The Company shall register this Warrant, upon records to be maintained by the Company for that purpose (the
“Warrant Register”), in the name of the record Holder hereof from time to time. The Company may deem and treat the
registered Holder of this Warrant as the absolute owner hereof for the purpose of any exercise hereof or any distribution to the Holder,
and for all other purposes, absent actual notice to the contrary.

 

Section
5. Miscellaneous.

 

a)
No Rights as Stockholder Until Exercise. This Warrant does not entitle the Holder to any voting rights, dividends or other rights
as a stockholder of the Company prior to the exercise hereof as set forth in Section 2(d)(i), except as expressly set forth in Section
3. Without limiting any rights of a Holder to receive Warrant Shares on a “cashless exercise”
pursuant to Section 2(c) or to receive cash payments pursuant to Section 2(d)(i) and Section 2(d)(iv) herein, in no event, including
if the Company is for any reason unable to issue and deliver Warrant Shares upon exercise of this Warrant as required pursuant to the
terms thereof, shall the Company be required to net cash settle an exercise of this Warrant.

 

b)
Loss, Theft, Destruction or Mutilation of Warrant. The Company covenants that upon receipt by the Company of evidence reasonably
satisfactory to it of the loss, theft, destruction or mutilation of this Warrant or any stock certificate relating to the Warrant Shares,
and in case of loss, theft or destruction, of indemnity or security reasonably satisfactory to it (which shall in no event include the
posting of any bond), and upon surrender and cancellation of such Warrant or stock certificate, if mutilated, the Company shall make
and deliver a new Warrant or stock certificate of like tenor and dated as of such cancellation, in lieu of such Warrant or stock certificate.

 

    	10

    	 

    

 

c)
Saturdays, Sundays, Holidays, etc. If the last or appointed day for the taking of any action or the expiration of any right required
or granted herein shall not be a Trading Day, then, such action may be taken or such right may be exercised on the next succeeding Trading
Day.

 

d)
Authorized Shares.

 

The
Company covenants that, during the period the Warrant is outstanding, it will reserve from its authorized and unissued Common Stock a
sufficient number of shares to provide for the issuance of the Warrant Shares upon the exercise of any purchase rights under this Warrant.
The Company further covenants that its issuance of this Warrant shall constitute full authority to its officers who are charged with
the duty of issuing the necessary Warrant Shares upon the exercise of the purchase rights under this Warrant. The Company shall take
all such reasonable action as may be necessary to assure that such Warrant Shares may be issued as provided herein without violation
of any applicable law or regulation, or of any requirements of the Trading Market upon which the Common Stock may be listed or quoted
for trading. The Company covenants that all Warrant Shares which may be issued upon the exercise of the purchase rights represented by
this Warrant will, upon exercise of the purchase rights represented by this Warrant and payment for such Warrant Shares in accordance
herewith, be duly authorized, validly issued, fully paid and non-assessable and free from all taxes, liens and charges created by the
Company in respect of the issue thereof (other than taxes in respect of any transfer occurring contemporaneously with such issue).

 

Except
and to the extent as waived or consented to by the Holder, the Company shall not by any action, including, without limitation, amending
its certificate of incorporation or through any reorganization, transfer of assets, consolidation, merger, amalgamation, arrangement
dissolution, issue or sale of securities or any other voluntary action, avoid or seek to avoid the observance or performance of any of
the terms of this Warrant, but will at all times in good faith assist in the carrying out of all such terms and in the taking of all
such actions as may be necessary or appropriate to protect the rights of Holder as set forth in this Warrant against impairment. Without
limiting the generality of the foregoing, the Company shall (i) not increase the par value of any Warrant Shares above the amount payable
therefor upon such exercise immediately prior to such increase in par value, (ii) take all such action as may be necessary or appropriate
in order that the Company may validly and legally issue fully paid and non-assessable Warrant Shares upon the exercise of this Warrant
and (iii) use commercially reasonable efforts to obtain all such authorizations, exemptions or consents from any public regulatory body
having jurisdiction thereof, as may be, necessary to enable the Company to perform its obligations under this Warrant.

 

Before
taking any action which would result in an adjustment in the number of Warrant Shares for which this Warrant is exercisable or in the
Exercise Price, the Company shall obtain all such authorizations or exemptions thereof, or consents thereto, as may be necessary from
any public regulatory body or bodies having jurisdiction thereof.

 

e)
Governing Law. All questions concerning the construction, validity, enforcement and interpretation of this Warrant shall be governed
by and construed and enforced in accordance with the internal laws of the State of New York, without regard to the principles of conflict
of laws thereof. Each party agrees that all legal Proceedings concerning the interpretation, enforcement and defense of this Warrant
shall be commenced in the state and federal courts sitting in the City of New York, Borough of Manhattan (the “New York Courts”).
Each party hereto hereby irrevocably submits to the exclusive jurisdiction of the New York Courts for the adjudication of any dispute
hereunder or in connection herewith or with any transaction contemplated hereby or discussed herein (including with respect to the enforcement
of any provision hereunder), and hereby irrevocably waives, and agrees not to assert in any suit, action or Proceeding, any claim that
it is not personally subject to the jurisdiction of such New York Courts, or such New York Courts are improper or inconvenient venue
for such Proceeding. If any party shall commence an action or Proceeding to enforce any provisions of this Warrant, then the prevailing
party in such action or Proceeding shall be reimbursed by the other party for its attorneys’ fees and other costs and expenses
incurred in the investigation, preparation and prosecution of such action or Proceeding.

 

    	11

    	 

    

 

f)
Restrictions. The Holder acknowledges that the Warrant Shares acquired upon the exercise of this Warrant, if not registered, and
the Holder does not utilize cashless exercise, will have restrictions upon resale imposed by state and federal securities laws.

 

g)
Nonwaiver and Expenses. No course of dealing or any delay or failure to exercise any right hereunder on the part of Holder shall
operate as a waiver of such right or otherwise prejudice the Holder’s rights, powers or remedies. Without limiting any other provision
of this Warrant, if the Company willfully and knowingly fails to comply with any provision of this Warrant, which results in any material
damages to the Holder, the Company shall pay to the Holder such amounts as shall be sufficient to cover any costs and expenses including,
but not limited to, reasonable attorneys’ fees, including those of appellate Proceedings, incurred by the Holder in collecting
any amounts due pursuant hereto or in otherwise enforcing any of its rights, powers or remedies hereunder.

 

h)
Notices. Any and all notices or other communications or deliveries to be provided by the Holders hereunder including, without
limitation, any Notice of Exercise, shall be in writing and delivered personally, by facsimile or by e-mail, or sent by a nationally
recognized overnight courier service, addressed to the Company, at 385 South Pierce Avenue, Suite C, Louisville, Colorado 80027, Attention:
CFO, facsimile number: [ ], email address: [ ], or such other facsimile number, email address or address as the Company may specify for
such purposes by notice to the Holders. Any and all notices or other communications or deliveries to be provided by the Company hereunder
shall be in writing and delivered personally, by facsimile, email or sent by a nationally recognized overnight courier service addressed
to each Holder at the facsimile number, email address or address of such Holder appearing on the books of the Company. Any notice or
other communication or deliveries hereunder shall be deemed given and effective on the earliest of (i) the time of transmission, if such
notice or communication is delivered via facsimile at the facsimile number or e-mail at the e-mail address set forth in this Section
prior to 5:30 p.m. (New York City time) on any date, (ii) the next Trading Day after the date of transmission, if such notice or communication
is delivered via facsimile at the facsimile number or e-mail at the e-mail address set forth in this Section on a day that is not a Trading
Day or later than 5:30 p.m. (New York City time) on any Trading Day, (iii) the second Trading Day following the date of mailing, if sent
by U.S. nationally recognized overnight courier service, or (iv) upon actual receipt by the party to whom such notice is required to
be given.

 

i)
Limitation of Liability. No provision hereof, in the absence of any affirmative action by the Holder to exercise this Warrant
to purchase Warrant Shares, and no enumeration herein of the rights or privileges of the Holder, shall give rise to any liability of
the Holder for the purchase price of any Common Stock or as a stockholder of the Company, whether such liability is asserted by the Company
or by creditors of the Company.

 

j)
Remedies. The Holder, in addition to being entitled to exercise all rights granted by law, including recovery of damages, will
be entitled to specific performance of its rights under this Warrant. The Company agrees that monetary damages would not be adequate
compensation for any loss incurred by reason of a breach by it of the provisions of this Warrant and hereby agrees to waive and not to
assert the defense in any action for specific performance that a remedy at law would be adequate.

 

k)
Successors and Assigns. Subject to applicable securities laws, this Warrant and the rights and obligations evidenced hereby shall
inure to the benefit of and be binding upon the successors and permitted assigns of the Company and the successors and permitted assigns
of Holder. The provisions of this Warrant are intended to be for the benefit of any Holder from time to time of this Warrant and shall
be enforceable by the Holder or holder of Warrant Shares.

 

l)
Amendment. This Warrant may be modified or amended or the provisions hereof waived with the written consent of the Company, on
the one hand, and the Holder on the other hand.

 

m)
Severability. Wherever possible, each provision of this Warrant shall be interpreted in such manner as to be effective and valid
under applicable law, but if any provision of this Warrant shall be prohibited by or invalid under applicable law, such provision shall
be ineffective to the extent of such prohibition or invalidity, without invalidating the remainder of such provisions or the remaining
provisions of this Warrant.

 

n)
No Expense Reimbursement. The Holder shall no way be required the pay, or to reimburse the Company for, any fees or expenses of
the Company’s transfer agent in connection with the issuance or holding or sale of the Common Stock, Warrant and/or Warrant Shares.
The Company shall solely be responsible for any and all such fees and expenses.

 

o)
Headings. The headings used in this Warrant are for the convenience of reference only and shall not, for any purpose, be deemed
a part of this Warrant.

 

********************

 

(Signature
Page Follows)

 

    	12

    	 

    

 

IN
WITNESS WHEREOF, the Company has caused this Warrant to be executed by its officer thereunto duly authorized as of the date first above
indicated.

 

	 	CEA
    INDUSTRIES INC.
	 	 	 
	 	By:	             
	 	Name:	
	 	Title:	

 

    	 

     

    

 

NOTICE
OF EXERCISE

 

	To:	CEA
    INDUSTRIES INC.

 

(1)
The undersigned hereby elects to purchase ________ Warrant Shares of the Company pursuant to the terms of the attached Warrant (only
if exercised in full), and tenders herewith payment of the exercise price in full, together with all applicable transfer taxes, if any.

 

(2)
Payment shall take the form of (check applicable box):

 

☐
in lawful money of the United States; or

 

☐
the cancellation of such number of Warrant Shares as is necessary, in accordance with the formula set forth
in subsection 2(c), to exercise this Warrant with respect to the maximum number of Warrant Shares purchasable pursuant to the cashless
exercise procedure set forth in subsection 2(c).

 

(3)
Please issue said Warrant Shares in the name of the undersigned or in such other name as is specified below:

 

	 	 	 

 

The
Warrant Shares shall be delivered to the following DWAC Account Number:

 

	 	 	 
	 	 	 
	 	 	 
	 	 	 
	 	 	 

 

[SIGNATURE
OF HOLDER]

 

	Name
    of Investing Entity:	 

 

	Signature
    of Authorized Signatory of Investing Entity:	   

 

	Name
    of Authorized Signatory:	 

 

	Title
    of Authorized Signatory:	 

 

	Date:	 

 

    	 

     

    

 

ASSIGNMENT
FORM

 

(To
assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.)

 

FOR
VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to

 

	Name:	 	 	 
	 	 	(Please
    Print)	 
	 	 	 	 
	Address:	 	 	 
	 	 	(Please
    Print)	 
	 	 	 	 
	Phone
    Number:	 	 	 
	 	 	 	 
	Email
    Address:	 	 	 
	 	 	 	 
	Dated:
    _____________________ __, ______	 	 	 
	 	 	 	 
	Holder’s
    Signature:	       	 	 	 
	 	 	 	 	 
	Holder’s
    Address:p-cda_ind11x21final

  P-CDA/IND(11/21)                                                      1      Pruco Life Insurance Company    Principal Office:       Service Office Address:  [One Corporate Drive       [P.O. Box 7960  Shelton, CT 06484]       Philadelphia, PA 19176               Toll Free: 1-888-PRU-2888           Website:www.prudential.com]          Please read this annuity contract (“Contract”) carefully; it is a legal contract between you and Pruco Life  Insurance Company (”Prudential”). This Contract is issued to the Contract Owner(s) named in the  Contract Schedule when all requirements are received in Good Order.  Subject to the terms and  conditions of this Contract, Pruco Life Insurance Company will pay the benefits described in this Contract.   This Contract takes effect on the Contract Date shown in the Contract Schedule.      RIGHT TO CANCEL:  On written request, we will provide, within a reasonable time, reasonable factual  information regarding the benefits and provisions of the Contract to you. If for any reason you are not  satisfied with the Contract, you may cancel this Contract for a refund by notification to us in Good Order  or by returning the Contract to our Service Office or to the representative who sold it to you within but no  later than 30 days after you receive it (or such longer period as required by law). The Contract can be  mailed or delivered either to us, at our Service Office, or to the representative who sold it to you. Return  of this Contract by mail is effective upon being postmarked, properly addressed and postage prepaid.    The amount of the refund will equal any Contract Fees paid as of the Valuation Day we receive the  returned Contract at our Service Office or the cancellation request in Good Order.    Signed for Pruco Life Insurance Company:                                                 [                 ] [                               ]  Secretary  President                            INDIVIDUAL CONTINGENT DEFERRED ANNUITY. NONPARTICIPATING.  THIS CONTRACT HAS NO CASH VALUE, NO DEATH BENEFIT AND NO SURRENDER VALUE.          

 

  P-CDA/IND(11/21)                                                      2          TABLE OF CONTENTS      CONTRACT SCHEDULE  ....................................................................................... 3    DEFINITIONS .......................................................................................................... 6    GENERAL FEATURES ........................................................................................... 8    CONTRACT DESIGNATIONS ................................................................................. 8    PRE-INCOME STAGE ............................................................................................. 9    INCOME STAGE ..................................................................................................... 10    INSURED INCOME STAGE AND PORTABILITY OPTIONS ................................. 12    ANNUITIZATION ..................................................................................................... 12    CONTRACT FEES ................................................................................................... 14    GENERAL PROVISIONS ........................................................................................ 22    TAX PROVISIONS ................................................................................................... 17    TERMINATION OF CONTRACT................................................................18                                                            

 

  P-CDA/IND(11/21)                                                      3      CONTRACT SCHEDULE      ACCOUNT REFERENCE NUMBER: [1234567-0005]    CONTRACT NUMBER: [1234-456-789]   CONTRACT DATE: [July 1, 2021]    CONTRACT OWNER(S):          [John Doe        SEX: Male DATE OF BIRTH: January 1, 1948    Mary Doe     SEX: Female DATE OF BIRTH: January 15, 1948]    ANNUITANT:  [John Doe        SEX: Male DATE OF BIRTH: January 1, 1948    CO-ANNUITANT:  Mary Doe     SEX: Female DATE OF BIRTH: January 15, 1948]    INITIAL ACCOUNT VALUE CONTRIBUTION: [$25,000.00]    MAXIMUM ACCOUNT VALUE CONTRIBUTION LIMIT:  [$5,000,000]. Higher Account Value Contributions are  subject to our approval.    MINIMUM ANNUITY PAYMENT: [$100]    MINIMUM ACCOUNT VALUE: [$0.00]    MINIMUM INCOME PAYMENT: [$100]    CONTRACT FEE: [1.00]% annualized as a percentage of the Account Value.  [A Contract Fee is calculated  [quarterly] in the amount of [0.25]% of the Account Value on the Contract date and then each successive three  month anniversary of the Contract Date.]    MAXIMUM CONTRACT FEE: [1.50%] annualized as a percentage of the Account Value.    EARLIEST CONTRACT FEE CHANGE DATE: [The Valuation Day coinciding with or next following the [3rd]   anniversary of the Contract Date]     INITIAL INCOME PERCENTAGE:   Age on Contract Date Single Income Option Percentages Joint Income Option Percentages  [45-49 2.85% 2.50%  50-54 3.00% 2.65%  55-59 3.30% 2.95%  60-64 3.65% 3.30%  65-69 4.10% 3.75%  70-74 4.65% 4.30%  75-79 5.30% 4.95%  80-84 6.10% 5.75%  85+ 6.10 5.75]    MINIMUM INITIAL INCOME PERCENTAGE FOR ADDITIONAL ACCOUNT VALUE CONTRIBUTIONS: [1%]            

 

  P-CDA/IND(11/21)                                                    4    CONTRACT SCHEDULE (continued)    INCOME DEFERRAL RATE:  Age on Contract Date Anniversary Income Deferral Rate Percentage                  [45-49 0.05%  50-54 0.10%  55-59 0.10%  60-64 0.15%  65-69 0.20%  70-74 0.25%  75-79 0.35%  80-84 0.40%  85+ 0.40%]    ANNUITY TABLES FOR ANNUITY PAYMENTS  The rates in Tables 1 and 2 below are applied upon the Annuitization to compute the minimum amount of the  Annuity Payment for the payout options described below. Table 1 is used to compute the minimum Annuity  Payment under Option 1 (Payments for Life with a Fixed Period Certain of 120 Months). Table 2 is used to  compute the minimum initial Annuity Payment under Option 2 (Joint and Last Survivor).    BASIS OF COMPUTATION FOR ANNUITY OPTIONS: We use an annualized interest rate of [0.25]%. The  adjusted age is the Annuitant’s age as of the Annuitant’s last birthday prior to the date on which the first payment  is due, adjusted as shown in the “Translation of Adjusted Age” table below. The actuarial basis of the Annuity  Options is the Annuity 2000 valuation mortality table, with four-year age setback and projected mortality  improvement factors (modified Scale G) projected from the age at annuitization to the age at which the  probability of survival is needed in the calculation of the Annuity Payment.    AMOUNT OF MONTHLY PAYMENT FOR EACH $1,000 APPLIED    [ANNUITY OPTION 1 Table – Payments for Life with 120 Months Period Certain  Adjusted   Age Male Female  Adjusted   Age Male Female  Adjusted   Age Male Female  41 1.76 1.62 61 2.90 2.60 81 5.83 5.39  42 1.79 1.65 62 2.99 2.68 82 6.03 5.61  43 1.83 1.68 63 3.09 2.76 83 6.22 5.83  44 1.87 1.72 64 3.19 2.85 84 6.41 6.05  45 1.91 1.75 65 3.30 2.94 85 6.60 6.27  46 1.96 1.79 66 3.41 3.04 86 6.78 6.48  47 2.00 1.83 67 3.53 3.15 87 6.96 6.69  48 2.05 1.87 68 3.65 3.26 88 7.12 6.89  49 2.10 1.91 69 3.78 3.37 89 7.28 7.08  50 2.15 1.95 70 3.92 3.50 90 7.43 7.25  51 2.20 2.00 71 4.07 3.63 91 7.56 7.41  52 2.26 2.05 72 4.22 3.77 92 7.69 7.56  53 2.32 2.10 73 4.38 3.91 93 7.80 7.69  54 2.38 2.15 74 4.54 4.07 94 7.91 7.81  55 2.44 2.20 75 4.71 4.23 95 8.00 7.92]  56 2.51 2.26 76 4.89 4.40        57 2.58 2.32 77 5.07 4.59        58 2.65 2.39 78 5.25 4.78        59 2.73 2.45 79 5.44 4.97        60 2.81 2.53 80 5.64 5.18                                                                                                    

 

  P-CDA/IND(11/21)                                                    5      CONTRACT SCHEDULE (continued)        [ANNUITY OPTION 2 Table - Joint and Last Survivor  Male  Adjusted  Age  Female Adjusted Age  45 50 55 60 65 70 75 80 85 90 95  45 [1.59 1.68 1.75 1.80 1.84 1.87   1.89 1.90   1.91   1.91 1.91  50 1.64 1.76 1.86 1.95 2.02 2.07 2.11 2.13 2.14 2.15 2.15  55 1.68 1.82 1.96 2.09 2.21 2.30 2.36 2.40 2.43 2.44 2.45  60 1.71 1.87 2.05 2.22 2.39 2.54 2.65 2.73 2.78 2.81 2.82  65 1.73 1.90 2.11 2.33 2.56 2.79 2.98 3.13 3.23 3.29 3.32  70 1.74 1.92 2.15 2.41 2.70 3.02 3.32 3.58 3.78 3.90 3.97  75 1.74 1.94 2.17 2.46 2.81 3.21 3.64 4.06 4.42 4.68 4.84  80 1.75 1.95 2.19 2.50 2.88 3.35 3.91 4.52 5.12 5.60 5.94  85 1.75 1.95 2.20 2.51 2.92 3.44 4.10 4.91 5.79 6.62 7.26  90 1.75 1.95 2.20 2.53 2.94 3.49 4.23 5.19 6.36 7.62 8.73  95 1.75 1.95 2.21 2.53 2.96 3.52 4.30 5.37 6.78 8.47 10.15]        Translation of Adjusted Age  Calendar Year in   Which First Payment   Is Due  Adjusted Age Calendar Year in   Which First Payment   Is Due  Adjusted Age  2020 through 2029 Actual Age minus 1 2070 through 2079 Actual Age minus 6  2030 through 2039 Actual Age minus 2 2080 through 2089 Actual Age minus 7  2040 through 2049 Actual Age minus 3 2090 through 2099 Actual Age minus 8  2050 through 2059 Actual Age minus 4 2100 through 2109 Actual Age minus 9]  2060 through 2069 Actual Age minus 5                                          

 

  P-CDA/IND(11/21)                                                    6      DEFINITIONS      Account: Your account, or portion thereof, at your Financial Firm for which the coverage under this Contract is in  relation to and is shown as ‘Account Reference Number’ in the Contract Schedule.     Account Owner(s):  The natural person(s) or entity who has all rights to the Account.      Account Value: The value of the assets in your Account as of the close of business on a Valuation Day.  For the  purposes of this Contract, once the Account Value has been determined on a Valuation Day, it does not change  until the close of business on the next Valuation Day.      Additional Account Value Contribution:  Amounts contributed to the Account by you, or on your behalf, after  the Initial Account Value Contribution shown in the Contract Schedule, as permitted under this Contract, and  acknowledged by us.    Advisory Fees: The amount your Financial Firm deducts from your Account periodically for the investment  advisory services provided in relation to the Account.       Annuitant(s):  The natural person(s) named in the Contract Schedule whose life expectancy(ies) is the basis for  Insured Income Payments and Annuity Payments under this Contract.  Unless we are instructed otherwise, the  Contract Owner is the Annuitant or, if more than one Contract Owner, the first named Contract Owner as shown  in the Contract Schedule will be the Annuitant and the other Contract Owner will be the Co-Annuitant.  The  Annuitant and Co-Annuitant are collectively referred to herein as the Annuitants.  The ages of the Annuitant(s)  are the basis for determining the Annual Income Amount, Income Payment amount and Annuity Payment  amount.     If the Contract Owner is an entity that we allow, the Annuitant(s) is a natural person who has a beneficial interest  in the Account and the Entity and is named by the Contract Owner at issuance of the Contract.    Annuity Date:  The date on which the Account is permanently converted into Annuity Payments or Insured  Income Payments.  Annuity Payments cannot begin earlier than the first anniversary of the Contract Date except  as described in the Annuitization section of this Contract.    Annuity Payments:  Payments we make to the Annuitant(s), designated payee, or the Beneficiary(ies) on or  after the Annuity Date as described in the Annuitization section of this Contract.     Beneficiary(ies): The natural person(s) or entity named as beneficiary on or after the Annuity Date. The  Beneficiary is entitled to receive any remaining Period Certain Annuity Payments, if applicable, at the death of  the Annuitant(s). Prior to the Annuity Date, this Contract has no value payable upon the death of a Contract  Owner or Annuitant(s).     Code or Internal Revenue Code:  The Internal Revenue Code of 1986, as amended from time to time, and the  regulations promulgated thereunder.    Company: Pruco Life Insurance Company (also referred to as “Prudential”, “we”, “us” or “our”).    Contract Date:  This is the Valuation Day we receive all information we need in Good Order to issue the  Contract and this Contract becomes effective.  The Contract Date is shown in the Contract Schedule.    Contract Fee:  The amounts paid to the Company by you, or the Financial Firm on your behalf, to maintain this  Contract.    Contract Owner(s):  The natural persons or entity to whom a Contract is issued (also referred to as “you” or  “your,” where applicable).  All ownership rights with respect to any issued Contract belong to the Contract  Owner(s), or as determined through the operation of applicable law.  The Contract Owner(s) is named in the  Contract Schedule.    

 

  P-CDA/IND(11/21)                                                    7    Contract Year:   The first Contract Year begins on the Contract Date and continues through and includes the  day immediately preceding the first anniversary of the Contract Date.  Subsequent Contract Years begin on the  anniversary of the Contract Date and continue through and include the day immediately preceding the next  anniversary of the Contract Date.  For tax qualified contracts, when the Income Stage begins, the next Contract  Year begins on the first Valuation Day of the calendar year. Each subsequent Contract Year will then correspond  with the calendar year.    Contingent Deferred Annuity:  This Contract is an annuity contract that establishes Pruco’s obligation to make  periodic payments for the annuitant’s lifetime, or other stated period, at the time Eligible Account Assets, which  are not owned or held by Pruco, are depleted to the Minimum Account Value due to contractually permitted  withdrawals, market performance, fees and/or other charges.    Custodial IRA Account:  A custodial or trust account which holds IRA or Roth IRA retirement assets pursuant  to the provisions of Sections 408(a) and 408A of the Internal Revenue Code.    Due Proof of Death:  Due Proof of Death is satisfied when we receive all of the following in Good Order:  a  death certificate or legal documentation and all representations required or mandated by applicable law or  regulation in relation to a continuation of the Contract, Insured Income Payments or Annuity Payments after  death.     Eligible Account Assets: An investment that we designate as eligible for coverage under this Contract. After  the Contract is issued, we may designate additional investments as Eligible Account Assets. Once we designate  an investment as an Eligible Account Asset, we, at any time in the future, may determine that such investment is  no longer an Eligible Account Asset.    Excess Withdrawal: All or any portion of an Income Withdrawal that exceeds the Annual Income Amount for  that particular Contract Year and any Unused Annual Income Amount.  If the Required Minimum Distribution  amount in any Contract Year is greater than the Annual Income Amount plus any Unused Annual Income  Amount, then only the amount of Income Withdrawals you make that exceed the Required Minimum Distribution  amount calculated by us, if any, will be treated as Excess Withdrawal.     Financial Firm: The entity you choose to hold your Account and approved by us.    Good Order:  Good Order is a state or condition determined to be reasonably necessary for the accurate  execution of the intended transaction or direction, including: a) being received at our Service Office in a manner  that is sufficiently complete and clear that we do not need to exercise any discretion; b) complies with all relevant  laws and regulations; c) on specific forms, or by other means we then permit (such as via telephone or electronic  transmission); and/or d) with any signatures and dates as we may require.  We will notify the Financial Firm or  you when Good Order conditions have not been met.    Income Withdrawal:  Any Withdrawal taken from the Account that is not designated by you as a Non-Income  Withdrawal.  Once you have taken your first Income Withdrawal from the Account, or notified us in Good Order  to begin the Income Stage, all further Withdrawals will be deemed to be Income Withdrawals.    Initial Account Value Contribution:  The initial amount contributed to the Account by you, or on your behalf,  shown in the Contract Schedule and acknowledged by us.    Insured Income Payment:  Payments we make after the Annuity Date as described in the ‘Insured Income  Stage and Portability Options’ section of this Contract.    Maximum Contract Limits:  The amount that the Initial Account Value Contribution, plus all Additional Account  Value Contributions, may not exceed. The Maximum Contract Limit is shown in the Contract Schedule.  For any  intended Additional Account Value Contribution that would result in an amount exceeding the Maximum Contract  Limit, only the portion that would not exceed the Maximum Contract Limit will be treated as an Additional  Account Value Contribution under this Contract.    Minimum Account Value: The minimum balance the Financial Firm requires to maintain your Account with the  Financial Firm.      

 

  P-CDA/IND(11/21)                                                    8    Non-Income Withdrawal:  Any amount taken from the Account prior to the Income Stage, or notification to us in  Good Order to begin the Income Stage, and designated as such by you.  Once you take a Withdrawal that you  have not designated as a Non-Income Withdrawal, all future Withdrawals will be deemed Income Withdrawals.       Qualified Account:  An Account maintained pursuant to an eligible retirement plan as defined in Code Section  402(c)(8)(B), other than a custodial account described in Code Section 403(b)(7).    Service Office/ Service Office Address:  Certain requests must be sent directly to us at the location shown on  the cover page of the Contract in Good Order regarding this Contract or Contract Fees, if applicable.  We refer to  this as our “Service Office.”  The Service Office Address may be changed at any time.  We will notify you and the  Firm in advance of any change in address.      Valuation Day:  Every day the New York Stock Exchange is open for regular trading or any other day that the  Securities and Exchange Commission requires mutual funds, exchange traded funds or unit investment trusts  registered under the Investment Company Act of 1940 to be valued.    we, us, our: Pruco Life Insurance Company    Withdrawal/Withdrawn:  Any amount taken from the Account.    you, your:  The Contract Owner(s) shown in the Contract Schedule.    GENERAL FEATURES    This Contract provides the following options, when all specified conditions are met:    Insured Income Payments:  Distribution of an Annual Income Amount over the lifetime of the Annuitant or over  the joint lifetimes of the Annuitants when one of the following events occurs and you exercise your option to  receive, or continue receiving, the Annual Income Amount under this Contract: a) your Account Value is reduced  to zero as long as the Income Withdrawals in that Contract Year are less than or equal to the Annual Income  Amount plus any Unused Annual Income Amount or reduced to below the Minimum Account Value b) you  terminate your Account with the Financial Firm or c) after notification to you, the Financial Firm is no longer  approved to hold your Account.  You must meet the eligibility requirements within this Contract to receive Insured  Income Payments (see the “Insured Income Payment Stage” section of this Contract for more information  regarding this feature).  Once Insured Income Payments have begun no further Income Withdrawals may be  taken.    Annuity Payments:  The option to convert your Account Value into a stream of Annuity Payments guaranteed  for life with a period certain or for joint lives with no period certain, depending on the option you choose.  If you  elect this feature, your Account Value will be transferred to us from your Account.  See the “Annuitization”  section of this Contract for more information regarding this feature.    CONTRACT DESIGNATIONS    For Income Withdrawals to begin on a single income basis:    • If one Contract Owner is named, the Contract Owner and the Annuitant must be the same.  The Contract  Owner must be an Account Owner.  Upon Due Proof of Death of the Contract Owner, this Contract will  terminate.     • If two Contract Owners are named, they must be spouses and the Annuitant must be one of the Contract  Owners and the Account Owner.  No additional Contract Owners may be named.  While both Contract  Owners are alive, the Contract ownership rights will be vested equally in both Contract Owners.  If the  Contract Owner who is also the Annuitant dies first, this Contract will terminate upon Due Proof of Death.   Unless otherwise instructed, if the Contract Owner who is not the Annuitant dies first, and is still the  spouse of the surviving Contract Owner at the time of death, this Contract will continue.      

 

  P-CDA/IND(11/21)                                                    9    • If the Contract Owner is an entity that we permit, the Annuitant must be named and have a beneficial  interest in the entity.  The entity must be the Account Owner.  Upon receipt of Due Proof of Death of the  death of the Annuitant, this Contract will terminate.     For Income Withdrawals to begin on a joint income basis:    • If one Contract Owner is named, the Contract Owner will be the Annuitant, unless the Contract Owner is  an entity, in which case an Annuitant must be named and have a beneficial interest in the entity.  The  Contract Owner must be an Account Owner.  A Co-Annuitant must be designated and be the spouse of  the Annuitant.  If the Co-Annuitant survives the Contract Owner (or the Annuitant if the Contract is  owned by an entity), then, upon the receipt of Due Proof of Death of the Contract Owner (or the  Annuitant if the Contract is owned by an entity), the Co-Annuitant will become the Contract Owner and  Annuitant (if the contract is owned by an entity, the Co Annuitant would become the Annuitant but not  the Contract Owner).  The Co-Annuitant must be or become the Account Owner (if the Contract Owner  is an entity, the entity must remain the Account Owner) and be the spouse of the deceased Contract  Owner and/or Annuitant at the time of death, subject to the Tax Provisions section of this Contract;  otherwise this Contract will terminate.    • If two Contract Owners are named, the first named Contract Owner as shown in the Contract Schedule  will be the Annuitant and the other Contract Owner will be the Co-Annuitant, unless we are instructed  otherwise.  At least one of the Contract Owners must also be an Account Owner.  The Contract Owners  must be spouses and each must have the option of continuing the Account upon the first Contract  Owner’s death.  Upon the receipt of Due Proof of Death of a Contract Owner, this Contract will continue  if the Contract Owners were spouses at the time of death and the surviving spouse is or becomes the  Account Onwer.  The Account and the Annual Income Amount will continue to be based on the  applicable Joint Income Option Percentage(s); no additional Contract Owners or Annuitants may be  named and this Contract will terminate upon the death of the last surviving Contract Owner.    A Co-Annuitant may be named or changed at any time prior to the start of Income Withdrawals, subject to our  acceptance. The Annuitant cannot be changed except in the event of divorce as described in the circumstances  below.  Upon receipt of notice of the divorce, and any other documentation we require, in Good Order at our  Service Office:      • When no Co-Annuitant is named at the time of the divorce: If the divorce occurs prior to the Income  Stage and results in the removal of the Annuitant from this Contract (as Annuitant and/or Contract  Owner) or as an Account Owner and the former spouse is named as an Account Owner, the Contract  Owner and the Annuitant, the Contract will continue, unless we are instructed otherwise. If this Contract  is continued, the Annual Income Amount will be determined using the applicable Joint Income Option  Percentage(s) and Income Deferral Rate based on the younger of the new Annuitant and the Annuitant  on the Contract Date.  A new Co-Annuitant may not be named if divorce occurs during the Income  Stage, and results in the removal of the Annuitant from this Contract (as Annuitant and/or Contract  Owner) or as an Account Owner this Contract will terminate.    • When a Co-Annuitant is named: If the divorce results in the removal of one of the Annuitants from this  Contract (as Annuitant and/or Contract Owner) or as an Account Owner and the remaining Annuitant is  named as an Account Owner, the Contract Owner and Annuitant, the Contract will continue, unless we  are instructed otherwise.  If this occurs prior to the Income Stage, the Annual Income Amount will be  determined using the applicable Joint Income Option Percentage(s) and Income Deferral Rate under this  Contract as of the divorce.  If divorce occurs in the Income Stage, the divorce will not result in a new  Annual Income Amount and we will only make Insured Income Payments as described below in the  Insured Income Payments section until the death of the resulting Annuitant.  A new Co-Annuitant may  not be named.    PRE-INCOME STAGE    Pre-Income Stage: The period of time before the Income Stage.    Income Base: On each Valuation Day during the Pre-Income Stage, the Income Base will equal the Account  Value.  Withdrawals of any type, including any Required Minimum Distribution, Advisory Fees and Contract Fees  

 

  P-CDA/IND(11/21)                                                    10    paid from the Account, will reduce the Account Value and, as a result, will reduce the Income Base. The Income  Base during the Pre-Income Stage is only used to quote the Annual Income Amount for the Income Stage and  does not reflect any cash value in this Contract.    Income Percentage: The Income Percentage is the rate we apply to the Income Base to determine the Annual  Income Amount.  The Initial Income Percentages are shown in the Contract Schedule.    The Initial Income Percentage applicable to your Initial Account Value Contribution is based on the age of the  Annuitant, or the younger of the Annuitants, on the Contract Date. During the Pre-Income Stage, the Income  Percentage will equal the Initial Income Percentage applicable to the Initial Account Value Contribution  unless/until one of the following occurs as discussed further below:    • The Income Percentage is increased by the Income Deferral Rate; or  • You make an Additional Account Value Contribution.    You may change the Co-Annuitant in the Pre-Income Stage, subject to the requirements set forth in the Contract  Designations sections of this Contract.  If the Co-Annuitant has been added, changed, or removed, we  recalculate the Annual Income Amount using the applicable Income Percentage(s) and Income Deferral Rate as  described herein based on the age of the named Annuitant or younger of the Annutants on the Contract Date  and in the Additional Account Value Contributions section below based on the age of the named Annuitant or  younger of the Annuitants as of the effective date of each such addition, change, or removal.    Income Deferral Rate:  The Income Deferral Rate, expressed in the Contract Schedule as an annualized  percentage, is applied on each Valuation Day to the Income Percentage during the Pre-Income Stage.  The Income  Deferral Rate is based on the attained age of the Annuitant, or the younger of the Annuitants, on the Contract Date  and each Contract Date anniversary thereafter and is shown in the Contract Schedule.     Impact of Additional Account Value Contribution(s):  You may make Additional Account Value Contributions,  subject to the “Additional Account Value Contribution(s) Limitation” section.  For each Additional Account Value  Contribution, the Income Base is increased by the dollar amount of the Additional Account Value Contribution on  the Valuation Day on which the Additional Account Value Contribution is acknowledged by the Company.      When Additional Account Value Contributions are applied to the Account, the Income Percentage will be  recalculated. The recalculated Income Percentage is determined by using a weighted average.  The components  of the weighted average are:     A) The Income Base immediately before an Additional Account Value Contribution is effective.  B) The Income Percentage (including any accrued Income Deferral Rate) immediately before the Additional  Account Value Contribution is effective.  C) The amount of the Additional Account Value Contribution.  D) The then current Initial income percentage delared for new sales of the Contract or, if no longer offering  for new sales, the current declared income percentage for Additional Account Value Contributions, based  on the attained age of the Annuitant or younger of the Annuitants.  The income percentage used will not  be less than the Minimum Income Percentage shown in the Contract Schedule.    The formula for the new weighted Income Percentage = ((A x B) + (C x D)) / (A + C)    This new weighted Income Percentage accumulates according to the applicable Income Deferral Rate shown in  the Contract Schedule.    Annual Income Amount: An amount that, if Income Withdrawals were to begin on the Valuation Day quoted,  could be Withdrawn from the Account during a Contract Year without being considered an Excess Withdrawal. We  will quote this amount upon request. The quoted Annual Income Amount is determined by multiplying the Income  Base as of the prior Valuation Day by the Income Percentage, including any accrued Income Deferral Rate on the  date of the quote.          

 

  P-CDA/IND(11/21)                                                    11      INCOME STAGE    Income Stage: The time period beginning on the Valuation Day next following the earlier of the first Income  Withdrawal or notification by you, received by us in Good Order, to begin the Income Stage and ending on the  Annuity Date or termination of the Contract.  You may not change the Annuitants during the Income Stage.    Annual Income Amount: The amount that can be Withdrawn from your Account during a Contract Year,  excluding any Unused Annual Income Amount, without being considered an Excess Withdrawal.      The Annual Income Amount is calculated on the Valuation Day the Contract goes into the Income Stage and on  the first Valuation Day of each Contract Year thereafter by multiplying the Income Percentage by the Income  Base as of that Valuation Day (prior to the Income Base being adjusted for any Additional Account Value  Contributions or Excess Withdrawals on that date).  Fees do not reduce the Annual Income Amount available for  withdrawal for the Contract Year in which the fee is deducted from the Account.    You may make Additional Account Value Contributions, subject to the “Additional Account Value Contribution(s)  Limitation” section.  For each Additional Account Value Contribution, the Income Base is increased by the dollar  amount of the Additional Account Value Contribution on the Valuation Day on which the Additional Account Value  Contribution is acknowledged by the Company.       When Additional Account Value Contributions are applied to the Account, the Income Percentage will be  recalculated to determine a weighted Income Percentage. The recalculated Income Percentage is determined by  using a weighted average.  The components of the weighted average are:      A) The Income Base immediately before an Additional Account Value Contribution is effective.  B) The Income Percentage immediately before the Additional Account Value Contribution is  effective.  C) The amount of the Additional Account Value Contribution.  D) The then current initial income percentage declared for new sales of this Contract or, if no longer  offering new sales, the current declared income percentage for Additional Account Value  Contributions, based on the attained age of the Annuitant or younger of the Annuitants.  The  income percentage used will not be less than the Minimum Income Percentage shown in the  Contract Schedule.     The formula for the new weighted Income Percentage = ((A x B) + (C x D)) / (A + C)     The remaining Annual Income Amount for the Contract Year in which the additional Account Value Contribution  is made is also increased by an amount equal to the new weighted Income Percentage applied to the Additional  Account Value Contribution.    The Annual Income Amount is also adjusted if you opt out of a Contract Fee increase, as described under  “CONTRACT FEES.”      Income Base: During the Income Stage, the Income Base is used to calculate the Annual Income Amount only  and does not reflect any available cash value in this Contract.  The Income Base will change as follows:    • On each Valuation Day, the Income Base will change by the same percentage as the change in your  Account Value from the preceding Valuation Day, excluding the changes due to Additional Account Value  Contributions and Withdrawals on the current Valuation Day, referred to as the net performance  adjustment. Any fees that reduce your Account Value will impact the net performance adjustment.     • Excess Withdrawals proportionally reduce the Income Base by the ratio of the Excess Withdrawal amount  to the Account Value immediately prior to the Excess Withdrawal.  Any fees or charges related to the  Withdrawal deducted from the Account are included in the total amount of the Excess Withdrawal by  which the Income Base will be reduced.      

 

  P-CDA/IND(11/21)                                                    12    • Additional Account Value Contributions may be made, subject to the “Additional Account Value  Contributions Limitation” section.  For each Additional Account Value Contribution, the Income Base is   increased by the dollar amount of the Additional Account Value Contribution.     Income Percentage:  The rate applied to the Income Base to determine the Annual Income Amount.  The  Income Percentage in the Income Stage is equal to the Income Percentage at the end of the Pre-Income Stage  unless you made Additional Account Value Contributions as described herein.  The Income Deferral Rate no  longer accrues in the Income Stage.    Impact of Income Withdrawals on the Income Base and Annual Income Amount:  Income Withdrawals less  than or equal to the Annual Income Amount and any Unused Annual Income Amount do not reduce the Income  Base.  Income Withdrawals reduce the Annual Income Amount or Unused Annual Income Amount by the  amount of the Income Withdrawal.     Unused Annual Income Amount: Any portion of the Annual Income Amount not withdrawn in a Contract Year  will be carried over to allow for Income Withdrawals above the Annual Income Amount in future Contract Years  until the Annuity Date. Any Unused Annual Income Amount for a Contract Year will fluctuate in value based on  the change in Income Base from the prior Contract anniversary excluding any increase to the Income Base from  Additional Account Value Contributions.  Fees do not reduce the Unused Annual Income Amount available for  Withdrawal for the Contract Year in which the fee is deducted from the Account.    In any Contract Year where Unused Annual Income Amount is available, Income Withdrawals will be taken first  from the current Contract Year’s Annual Income Amount and then from any Unused Annual Income Amount  unless you request otherwise.      INSURED INCOME STAGE AND PORTABILITY OPTIONS    Insured Income Stage: The time period beginning on the Annuity Date and ending upon termination of the  Contract.  Once the Insured Income Stage begins there is no longer an Account Value.     The Insured Income Stage will begin when one of the following events occurs:     a) your Account Value is reduced to zero, assuming no Excess Withdrawals have been taken  during that Contract Year,or reduced to below the Minimum Account Value. You can elect to  continue receiving your Annual Income Amount and we subsequently will make Insured Income  Payments until the death of the Annuitant or, if a Co-Annuitant is named on this Contract at the  time this event occurs, until the deaths of both Annuitants. In the Contract Year in which this  event occurs, the only Insured Income Payment due, if any, equals the Annual Income Amount  not yet Withdrawn in that Contract Year plus any Unused Annual Income Amount. If the event  occurred as a result of the Account Value being reduced to the Minimum Account Value, any  remaining Account Value, less any Annual Income Amount not yet Withdrawn in that Contract  year, plus any Unused Annual Income Amount must be received by us to commence Insured  Income Payments.    In subsequent Contract Years, the Insured Income Payment equals the Annual Income Amount  as of the date of the event, adjusted for any Additional Account Value Contraibutions and/or  Excess Withdrawals that occurring in the Contract year in which the event occurred.  Unless you  instruct otherwise, Insured Income Payments will be paid to you in equal monthly payments  beginning on the 1st day of the month on or immediately following the date that your Insured  Income Payments are set to begin.    b) you terminate your Account with the Financial Firm or the Financial Firm no longer has an  agreement with us to service this Contract (and you do not move your Account to a Financial  Firm that has an agreement with us to service this Contract) and you exercise your option to  receive, or continue receiving, the Annual Income Amount as of the date the event occurs, by  transferring any remaining Account Value to us.  You may exercise this option while this  Contract is in effect, prior to the event described in (a) above.  You may request that we make  Insured Income Payments each year equal to the Annual Income Amount on the date of the  event, adjusted for any Additional Account Value Contributions and/or Excess Withdrawals that  

 

  P-CDA/IND(11/21)                                                    13    occurred in the Contract Year in which the event occurred, excluding any Unused Annual  Income Amount. Insured Income Payments will be paid to you, at the frequency you select  beginning on the next Valuation Day. We will continue to make such payments until the later of  the death of the Annuitant or, if a Co-Annuitant is named on this Contract at the time this event  occurs, deaths of both Annuitants.  In the Contract Year in which the event occurs, the only  payment due equals the Annual Income Amount not yet Withdrawn in that Contract Year, if any,  and any Unused Annual Income Amount, if any.        The amount of the Insured Income Payments will not change after payments have begun. Any Unused  Annual Income Amount can no longer be carried over to the next Contract Year and will not be applied in  determining the amount of the Insured Income Payment.    We must receive your request at our Service Office in Good Order.  Once we receive your election to commence  Insured Income Payments, the election is irrevocable.    If the total Insured Income Payment due each Contract Year is less than the Minimum Income Payment amount  shown in the Contract Schedule, we may change the frequency of Insured Income Payment, however, Insured  Income Payments will still be made at least annually.     Insured Income Payments available on the Annuity Date will not be less than those provided by the application of  an equivalent amount to the purchase of a single premium immediate annuity contract offered by us on the  Annuity Date to the same Annuitant or Annuitants class for the same life only payment option, if available.    We may offer other Insured Income Payment options. Any such additional options will be offered to all contract  purchasers in the same class of annuitants, in a non-discriminatory manner. You will be notified of any such  options available to you.    ANNUITIZATION    On or after the earliest Annuity Date, and if Insured Income Payments have not become payable, you may elect  to apply your entire remaining Account Value, less any remaining Annual Income Amount for that Contract Year  and Unused Annual Income Amount you choose to withdraw, to an Annuity Payment Option described below.     Annuity Payment Options:  The basis of computation for each Annuity Payment Option is shown in the  Contract Schedule.     Option 1: Fixed Payments for Single Life with a Fixed Period Certain: We will pay equal periodic  payments for the longer of the Annuitant’s remaining lifetime or a fixed period of time (the “Period Certain”). If  the Annuitant dies after all Annuity Payments have been made for the Period Certain, Annuity Payments shall  end with the last scheduled Annuity Payment due before the Annuitant’s death.  If the Annuitant dies before  all Annuity Payments have been made for the Period Certain, Annuity Payments will continue for the  remainder of the Period Certain term to the Beneficiary(ies) designated by the Contract Owner.    Option 2: Joint Lives and Last Survivor: We will pay equal periodic payments for the joint remaining  lifetimes of the Annuitants. Annuity Payments end with the last scheduled Annuity Payment due before the  last surviving Annuitant’s death. A Beneficiary may not be named under this option.    We must receive your request at our Service Office in Good Order. Once we receive your election to commence  Annuity Payments, we will only make Annuity Payments under the specific Annuity Payout Option elected, and the  Annuity Payment option cannot be changed. We may limit the length of any Annuity Payout Option including, any  period certain, to conform to applicable tax rules.    Annuity Payments available on the Annuity Date will not be less than those provided by the application of an  equivalent amount to the purchase of a single premium immediate annuity contract offered by us on the Annuity  Date to the same Annuitant or Annuitants class for the same payment option.    We may offer other Annuity Payout Options.  Any such additional options will be offered to all contract  purchasers in the same class of Annuitants, in a non-discriminatory manner. You will be notified of any such  options available to you.  

 

  P-CDA/IND(11/21)                                                    14      CONTRACT FEES    The Contract Fee for this Contract is equal to a percentage of the Account Value, as shown in the Contract  Schedule and any rider or endorsements elected with the Contract.  We will notify you and/or the Firm of the fee  amount and due date.  This fee must be remitted to us by you or the Firm on your behalf by the due date. The  Financial Firm may withdraw the Contract Fee from the Account, or the fee may be collected through some other  option made available by either the Financial Firm or Us.     We may change the Contract Fee for this Contract at any time on or after the Earliest Contract Fee Change  Date. Any increased Contract Fee will not exceed the Maximum Contract Fee for the Contract. The Earliest  Contract Fee Change Date and the Maximum Contract Fee for the Contract are shown in the Contract Schedule.     You will be notified in writing at least 60 days in advance of an increase in the Contract Fee for the Contract. You  will have the option of refusing the Contract Fee increase. If you refuse the Contract Fee increase, the Contract  Fee will continue at the present rate while this Contract is in effect. However, your Income Percentage will be  subject to a one time and permanent reduction of 5% of the Income Percentage on the next anniversary of the  Contract Date.     If you wish to opt out of the Contract Fee increase, we must receive your direction at our Service Office in Good  order; otherwise the Contract Fee increase will become effective. You may request the estimated dollar amount  of the 5% Income Percentage reduction prior to opting out. If you opt out during the Income Stage, you will  receive confirmation of the new Annual Income Amount.    The Contract Fee ceases upon the earlier of (i) the termination of the Contract or (ii) the Annuity Date. In the  event this Contract terminates for any reason other than death, a final pro-rated Contract Fee is due to us upon  termination.    GENERAL PROVISIONS    Additional Account Value Contribution(s) Limitation:  Amounts contributed to the Account by you, or on your  behalf are subject to review by us on a non-disciminatory basis before being considered Additional Account  Value Contributions under this Contract.  Circumstances where amounts contributed to your Account may not be  considered Additional Account Value Contributions include, but are not limited to, the following:     • if we determine that, as a result of the timing and amounts of your Additional Account Value  Contributions and Withdrawals, the Annual Income Amount is being increased in an unintended fashion.   Among the factors we will use in making a determination as to whether an action is designed to increase  the Annual Income Amount in an unintended fashion is the relative size of Additional Account Value  Contribution(s); or  • Additional Account Value Contributions made on or after the Annuity Date to the Account; or  • the oldest Owner(s) reaches age [85]; or  • if we are not then offering this Contract for new issues; or  • if we are offering a modified version of this Contract for new issues.     Assignment:  You may not assign the Contract or any rights under the Contract.    Claims of Creditors:  To the extent permitted by law, no payment or value payable under the terms of this  Contract is subject to the claims of your creditors, or those of any other Contract Owner, Annuitant, Co-Annuitant  or Beneficiary.    Currency:  All Contract Fees and other monies payable to us must be in the lawful currency of the United States  of America.    Deferral of Transactions:  We may defer any Income Payment or Annuity Payment for a period not to exceed  the lesser of 6 months or the period permitted by applicable law.  Where required, we will make written request  to, and obtain prior written approval from, the state insurance commissioner.  If we elect to postpone payments  for 30 days or more, we will pay interest as required by applicable law.    

 

  P-CDA/IND(11/21)                                                    15    Elections, Designations, Changes and Requests:  All elections, designations, changes and requests that we  require must be received by us in Good Order and are effective only after they have been acknowledged by us,  subject to any transactions made by us before receipt of such notices.    Eligible Account Assets:  This Contract will have Eligible Account Assets that your Account must be allocated  to at all times prior to the Annuity Date.  We may terminate this Contract on a non-discriminatory basis if you or  your Financial Firm invests any portion of your Account outside of the Eligible Account Assets or if any Eligible  Account Asset becomes a non Eligible Account Asset.     Entire Contract:  This Contract, including the Contract Schedule, any riders, endorsements, schedule  supplements, and amendments that are made part of this Annuity, are the entire contract. This Contract may be  changed or modified only in a writing signed by our President, a Vice President, or Secretary. We are not bound  by any promises or representations made by, or to, any other person.    Evidence of Survival or Marital Status: Before we make an Income Payment or Annuity Payment, we have the  right to require proof of continued life or marital status and any other documentation we need to make such  payment. We can require this proof for any person whose life or death determines whether or to whom we must  make the Income payment or Annuity Payment.    Financial Firm:  We rely on the Financial Firm to maintain your Account, and to do so in accordance with  Eligible Account Assets.   We also rely on the Financial Firm to provide us with information about your Account that we need to administer  your Contract. We may terminate this Contract as of the date the Financial Firm fails to provide timely and  accurate information about your Account or properly assess and forward the Contract Fee in  accordance with the agreement between the Financial Firm and Us.    If you transfer your Account to a Financial Firm with which we have an agreement to service this Contract, you  may request to continue this Contract in relation to the Account at the new Financial Firm. We must receive your  request in Good Order on or before the date you close your Account at your Financial Firm.     Facility of Payment: We reserve the right, in settlement of full liability, to make Insured Income Payments or  Annuity Payments to a guardian, relative, or other person deemed eligible by us if a person(s) to whom we are  making Income, Insured Income or Annuity Payments is deemed to be legally incompetent, as permitted by law.    Incontestability:  We will not contest this Contract.  All statements in the Contract Owner’s application are  representations, not warranties.    Misstatement of Age or Sex:  If there has been a misstatement of the age and/or sex of any person upon  whose life any amounts we are obligated to determine in order to make any payment, including Insured Income  Payments or Annuity Payments, we will adjust such amounts to conform to that for the correct age and/or sex.   As to Annuity Payments and Insured Income Payments: (a) any underpayments by us will be remedied on the  next payment following the correction with interest at a rate not less than that required by applicable law but not  exceeding 6%; and (b) any overpayments by us will be charged against future amounts payable by us under  your Contract. If there has been a misstatement of the age and/or sex of a person(s) upon whose life the Insured  Income Payments or Annuity Payments under this Contract are based, we will make adjustments to any  availability and any benefits payable under this Contract to conform to the facts.    Non-Participation:  This Contract does not share in our profits or surplus earnings.  No dividends are payable.    Premium Tax:  Premium tax rates and rules vary by state and may change.  We reserve the right to deduct any  such tax from Annuity Payments or Insured Income Payments.     Recovery of Excess Payments:  We may recover from you or your estate any Insured Income Payments or  Annuity Payments made after the death of the Annuitant or the last of the Annuitants that would have otherwise  resulted in the termination of this Contract.    Reports to you:  Each contract year after the first, you will receive a report at least once annually.    

 

  P-CDA/IND(11/21)                                                    16    Reserved Rights: In addition to rights specifically reserved elsewhere in this Contract, we reserve the right to  perform any or all of the following: (a) make changes required by any change in the federal securities laws,  including the Securities Act of 1933, the Securities Exchange Act of 1934, the Investment Company Act of 1940,  or any changes to the Securities and Exchange Commission’s interpretation thereof; (b) make changes that are  necessary to maintain the tax status of your Contract, any rider, amendment or endorsement attached hereto or  any charge or distribution from your Contract under the Internal Revenue Code; and (c) make any changes  required by federal or state laws with respect to annuity contracts. We reserve the right to modify this Contract  without receiving your prior consent, except as may be required by any applicable law, if we are required to  make changes necessary to comply with state regulatory requirements, Internal Revenue Service ("IRS")  requirements or other federal requirements.     Required Minimum Distributions:  Applicable to IRAs and other qualified contracts, unless designated as a  Non-Income Withdrawal, a Required Minimum Distribution is considered an Income Withdrawal under this  Contract.  The following rules apply to determine if any portion of a Required Minimum Distribution amount will  be treated as an Excess Withdrawal.      For purposes of these provisions, Required Minimum Distributions are determined based on the value of the  Account (including this Contract), and do not include the value of any other annuities, savings or investments  subject to the Required Minimum Distribution rules.      In general, Income Withdrawals made from the Account to meet the Required Minimum Distribution provisions of  the Code will not be treated as an Excess Withdrawal.      If, in any Contract Year, your Required Minimum Distribution amount is less than the Annual Income Amount  plus Unused Annual Income Amount, any Income Withdrawals in excess of the Annual Income Amount plus  Unused Annual Income Amount will be treated as an Excess Withdrawal.    In any Contract Year that the Required Minimum Distribution equal to an amount we would calculate for this  Contract is greater than the Annual Income Amount plus Unused Annual Income Amount, only the amount of  Income Withdrawals you make that exceed the Required Minimum Distribution amount calculated by us will be  treated as an Excess Withdrawal.      In any year in which the requirement to take Required Minimum Distributions is suspended by law, we reserve  the right, regardless of any position taken on this issue in a prior year, to treat any amount that would have been  considered as a Required Minimum Distribution, if not for the suspension, as eligible for treatment under this  provision.    Tax Reporting and Withholding:  We will comply with all applicable federal and state tax reporting and  withholding laws and regulations with respect to Insured Income Payments and Annuity Payments payable under  this Contract.  We will not provide tax reporting or withholding with respect to custodial held Contracts.    Written Notice:  All elections, designations, changes and written notices, including proof of death and any  required forms, must be sent to us in a form or format satisfactory to us.  In lieu of a written communication, we  may agree in advance to communication regarding a specific matter by telephone or by some other form of  electronic transmission in a manner we accept.  All notices must include the Contract Owner’s(s’) name and  Contract Number.  We will not be responsible for any actions taken before we receive a valid change request.   Correspondence from us relating to your Contract will be sent to your last known address.    Any notice we are required to provide to you, in accordance with the terms of this Contract, will be in writing  unless we mutually agree to the use of another medium or format, e.g., electronic, etc.    TAX PROVISIONS     Income Tax Qualification:  The Contract is intended to qualify for tax treatment as an annuity contract under  Section 72 of the Code.  The Contract provisions will be interpreted to preserve the intended tax treatment.  This  “Tax Provisions” section contains references to terms which, if not defined in the “Definitions” section or  elsewhere in this Contract, have the meaning provided in the applicable section of the Code.  Such references  are subject to change from time to time, in accordance with changes in the Code, and will be administered to  comply with such change.  

 

  P-CDA/IND(11/21)                                                    17      We reserve the right to amend the Contract as needed to maintain its tax status under the Code.  We will send  you copies of any amendment.  Please contact the Financial Firm that manages your Account if you have  questions regarding the tax status of your Account.    Accounts other than Qualified Accounts:  With respect to an Account other than a Qualified Account, the  Contract provisions regarding distributions after death, if any, are intended to comply with Section 72(s) of the  Code.  To ensure compliance, however, all distributions from a Contract that is not held in connection with a  Qualified Account will be made in accordance with the following requirements, unless the terms of the Contract  otherwise require amounts to be paid sooner:    1. If any Contract Owner of this Contract dies on or after the annuity starting date (within the meaning of  Code Section 72) and before the entire interest in this Contract has been distributed, the remaining  portion of such interest will be distributed at least as rapidly as under the method of distribution being  used as of the date of death.  a. If any Contract Owner of this Contract dies before the annuity starting date (within the  meaning of Code Section 72), the Contract will terminate, except if the designated  beneficiary (within the meaning of Code Section 72) of the Contract is the Owner’s  spouse, this paragraph 1(a) shall be applied by treating such spouse as the holder of  the Contract.   2. If the Contract Owner of the Contract is not an individual, the Annuitant shall be treated as the  Contract Owner.  In addition, a change of the Annuitant will be treated as the death of a Contract  Owner. For these purposes, the Annuitant is the individual, the events in the life of whom are of  primary importance in affecting the timing or amount of the payout under the Contract.      Qualified Accounts:  If the Account is a Qualified Account, only the Qualified Account may be named as  Contract Owner and Beneficiary. For a Qualified Account, the Annuitant will be the individual for whose benefit  the Account is maintained under the plan or arrangement.    TERMINATION OF CONTRACT    You may terminate this Contract at any time prior to the Annuity Date.  Termination will occur upon receipt of  your notification of termination in Good Order. We reserve the right to terminate this Contract on a non- discriminatory basis upon the first of the following events to occur:    1. on the death of a Contract Owner unless this Contract is continued as described in the “Contract  Designations” section; or    2. on the date of death of the Annuitant if Income Withdrawals have not begun and a surviving  spouse does not remain or become an owner of the Account and/or continue this Contract as  described in the “Contract Designations” section; or    3. on the date of death of the Annuitant, or on the date of death of the last surviving Annuitant if a  Co-Annuitant is named, if Income Withdrawals or Insured Income Payments have begun; or    4. if the Contract is owned by a non-natural person and the Annuitant is changed, section 72(s) of  the Code treats the change as the death of the Annuitant unless there is a Co-Annuitant and the  change results in the Co-Annuitant becoming the Annuitant as described in the “Contract  Designations” section; or     5. if the Account Owner changes to someone other than one of the Annuitants; or    6. if the Annuitant(s) dies prior to the end of the Period Certain term under Option 1 as described in  the “Annuitization” section, then this Contract will terminate upon the final Period Certain Annuity  Payment; or    

 

  P-CDA/IND(11/21)                                                    18    7. upon the date of death of the Annuitant or last surviving Annuitant if Annuity Payments are being  made under Option 2 in the “Annuitization” section; or    8. as of the date both the Account Value and the Income Base is $0; or    9. upon violation of the Contract provisions, including (a) a violation of the Eligible Account Assets and b)  failure to provide timely information about the Account necessary to properly administer this Contract; or    10. the date the Contract Fee is due and Contract Fees are outstanding; or    11. upon liquidation of the Account, unless the Account Value is re-established within an Account at  a Financial Firm where this Contract is available or your Account Value has been transferred to  us to begin Annuity Payments or Insured Income Payments.      If this Contract is terminated, you will receive written notification of the termination. Termination of the  Contract is irrevocable.                                                                                            

 

  P-CDA/IND(11/21)                                                    19            INDIVIDUAL CONTINGENT DEFERRED ANNUITY. NONPARTICIPATING.  THIS CONTRACT HAS NO CASH VALUE, NO DEATH BENEFIT AND NO SURRENDER VALUE.

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00339-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00339-of-00352.parquet"}]]