Document:

p-rilaxschxdcd10x21

P-RILA-SCH-DCD(10/21)       ANNUITY SCHEDULE PAGE      ANNUITY NUMBER: [001-00001] ISSUE DATE:  [March 1, 2013]    TYPE OF BUSINESS:  [Non-Qualified]    OWNER:  [John Doe DCD FBO Jack Doe]            DATE OF BIRTH:     SEX:      KEY LIFE:  [Jack Doe]     DATE OF BIRTH:  [October 21,1975] SEX:  [Male]      ALLOCATION OF INITIAL PUCHASE PAYMENT    PURCHASE PAYMENT:  [$100,000.00]    INDEX STRATEGY ALLOCATION PERCENTAGE(S):    [Point to Point with Cap Index Strategy   XX%     [Index Name] [Index Term]  [$XXXX.XX] [XX.XX% Buffer]      Tiered Participation Rate Index Strategy   XX%     [Index Name] [Index Term]  [$XXXX.XX] [XX.XX% Buffer]      Step Rate Plus Index Strategy   XX%     [Index Name] [Index Term]  [$XXXX.XX] [XX.XX% Buffer]]      VARIABLE SUB-ACCOUNT ALLOCATION PERCENTAGE:  [VA Fund 1]     XX%]  [VA Fund 2]     XX%]  [VA Fund 3]     XX%]  [VA Fund 4]     XX%]  [VA Fund 5]     XX%]     HOLDING ACCOUNT PERIOD: [30] Days from the Issue Date    PURCHASE PAYMENT AGE LIMITATION:  No Additional Purchase Payments accepted    MINIMUM ADDITIONAL PURCHASE PAYMENT:  Not applicable    MINIMUM ADDITIONAL PURCHASE PAYMENT UNDER AUTOMATIC PURCHASE PLANS:  Not applicable    WITHDRAWALS    MAXIMUM FREE WITHDRAWAL PERCENTAGE: [10%] of Purchase Payments    MINIMUM WITHDRAWAL AMOUNT:  [$100]    MINIMUM SURRENDER VALUE AFTER A PARTIAL WITHDRAWAL:  [$2,000]          

 

P-RILA-SCH-DCD(10/21) 2    ANNUITY SCHEDULE PAGE (continued)    ALLOCATION OF ACCOUNT VALUE    MINIMUM VARIABLE SUB-ACCOUNT AMOUNT:  [$20]    MINIMUM INDEX STRATEGY AMOUNT:  [$2,000]    CHARGES    INSURANCE CHARGE (ONLY APPLICABLE TO ACCOUNT VALUE ALLOCATED TO THE  VARIABLE SUB-ACCOUNT(S)):    MORTALITY AND EXPENSE RISK CHARGE:     For Purchase Payments less than [$1,000,000] the Insurance Charge is [X.XX%]     For Purchase Payments of [$1,000,000] or more the Insurance Charge is reduced to [X.XX%]    ADMINISTRATION CHARGE: [0.15%]    CONTINGENT DEFERRED SALES CHARGE: The Contingent Deferred Sales Charge for each Purchase  Payment is a percentage of the Purchase Payment being withdrawn that is in excess of the Free Withdrawal  amount.  The charge decreases as the Purchase Payment ages.  The aging of a Purchase Payment is  measured from the date it is allocated to your Annuity.The charge percentage is shown below.  The charge is  deducted from the Allocation Options in the same proportion as the withdrawal upon which it is assessed.    [Age of Purchase Payment Being Withdrawn    Year 0-1    Year 1-2    Year 2-3    Year 3-4    Year 4-5    Year 5-6    Year 6  or older    7% 7% 6% 5% 4% 3% 0.00]    ANNUITIZATION    LATEST AVAILABLE ANNUITY DATE:  Not applicable    EARLIEST AVAILABLE ANNUITY DATE:  Not applicable    MINIMUM ANNUITY PAYMENT:  Not applicable    MINIMUM SURRENDER VALUE AT ANNUITIZATION:  Not applicable    SEPARATE ACCOUNT(S):    VARIABLE SEPARATE ACCOUNT(S): [Pruco Life Flexible Premium Variable Annuity Account]    INDEX STRATEGIES SEPARATE ACCOUNT(S): [Pruco Life Insurance Company Index Strategies Separate  Account]      RIDERS AND ENDORSEMENTS MADE A PART OF THE ANNUITY ON THE ISSUE DATE:  [Medically Related Surrender Endorsement  Point to Point with Cap Index Strategy Endorsement  Tiered Participation Rate Index Strategy Endorsment  Step Rate Plus Index Strategy Endorsement]p-rilaxschxixdcd10x21

P-RILA-SCH-I-DCD(10/21)       ANNUITY SCHEDULE PAGE      ANNUITY NUMBER: [001-00001] ISSUE DATE:  [March 1, 2013]    TYPE OF BUSINESS:  [Non-Qualified]    OWNER:  [John Doe DCD FBO Jack Doe]            DATE OF BIRTH:     SEX:      KEY LIFE:  [Jack Doe]     DATE OF BIRTH:  [October 21,1975] SEX:  [Male]      ALLOCATION OF INITIAL PUCHASE PAYMENT    PURCHASE PAYMENT:  [$100,000.00]    INDEX STRATEGY ALLOCATION PERCENTAGE(S):    [Point to Point with Cap Index Strategy   XX%     [Index Name] [Index Term]  [$XXXX.XX] [XX.XX% Buffer]      Tiered Participation Rate Index Strategy   XX%     [Index Name] [Index Term]  [$XXXX.XX] [XX.XX% Buffer]      Step Rate Plus Index Strategy   XX%     [Index Name] [Index Term]  [$XXXX.XX] [XX.XX% Buffer]]      VARIABLE SUB-ACCOUNT ALLOCATION PERCENTAGE:  [VA Fund 1]     XX%]  [VA Fund 2]     XX%]  [VA Fund 3]     XX%]  [VA Fund 4]     XX%]  [VA Fund 5]     XX%]    HOLDING ACCOUNT PERIOD: [30] Days from the Issue Date    PURCHASE PAYMENT AGE LIMITATION:  No Additional Purchase Payments accepted    MINIMUM ADDITIONAL PURCHASE PAYMENT:  Not applicable    MINIMUM ADDITIONAL PURCHASE PAYMENT UNDER AUTOMATIC PURCHASE PLANS:  Not applicable    WITHDRAWALS    MINIMUM WITHDRAWAL AMOUNT:  [$100]    MINIMUM SURRENDER VALUE AFTER A PARTIAL WITHDRAWAL:  [$2,000]    ALLOCATION OF ACCOUNT VALUE    MINIMUM VARIABLE SUB-ACCOUNT AMOUNT:  [$20]    MINIMUM INDEX STRATEGY AMOUNT:  [$2,000]  

 

P-RILA-SCH-I-DCD(10/21) 2    ANNUITY SCHEDULE PAGE (continued)    CHARGES    INSURANCE CHARGE (ONLY APPLICABLE TO ACCOUNT VALUE ALLOCATED TO THE  VARIABLE SUB-ACCOUNT(S)):    MORTALITY AND EXPENSE RISK CHARGE:     For Purchase Payments less than [$1,000,000] the Insurance Charge is [X.XX%]     For Purchase Payments of [$1,000,000] or more the Insurance Charge is reduced to [X.XX%]    ADMINISTRATION CHARGE: [0.15%]    CONTINGENT DEFERRED SALES CHARGE: NONE    ADVISORY FEES: We treat Advisory Fee payments as an expense of the Annuity and not a taxable distribution  if (1) your Annuity is being used in conjunction with a “qualified” retirement plan (plans meeting the requirements  of Sections 401, 403 or 408 of the Code) or (2) your non-qualified Annuity satisfies the requirements of Private  Letter Ruling 201945005 (“PLR”) issued by the IRS to PALAC. In accordance with the PLR, Advisory Fee  payments from your non-qualified Annuity are treated as an expense as long as your investment adviser attests  to Prudential that the PLR requirements have been met, including that the advisory fees will not exceed [1.50]%  of the Annuity’s Account Value in a calendar year. In relation to the Death Benefit, we will treat any Advisory  Fees that are deducted as withdrawals that reduce the Death Benefit.     ANNUITIZATION    LATEST AVAILABLE ANNUITY DATE:  Not applicable    EARLIEST AVAILABLE ANNUITY DATE:  Not applicable    MINIMUM ANNUITY PAYMENT:  Not applicable    MINIMUM SURRENDER VALUE AT ANNUITIZATION:  Not applicable    SEPARATE ACCOUNT(S):    VARIABLE SEPARATE ACCOUNT(S): [Pruco Life Flexible Premium Variable Annuity Account]    INDEX STRATEGIES SEPARATE ACCOUNT(S): [Pruco Life Insurance Company Index Strategies Separate  Account]    RIDERS AND ENDORSEMENTS MADE A PART OF THE ANNUITY ON THE ISSUE DATE:  [Point to Point with Cap Index Strategy Endorsement  Tiered Participation Rate Index Strategy Endorsment  Step Rate Plus Index Strategy Endorsement]p-ridxrilaxrop10x21

P-RID-RILA-ROP(10/21) 1  PRUCO LIFE INSURANCE COMPANY, PHOENIX, ARIZONA      RETURN OF PURCHASE PAYMENTS DEATH BENEFIT RIDER    ANNUITY NUMBER: [001-00001]    EFFECTIVE DATE: [Contract Issue Date]    This Rider is made part of your Annuity.  For purposes of this Rider, certain provisions of your Annuity are  amended as described below.  If the terms of your Annuity and those of this Rider conflict, the provisions  of this Rider shall control.  Should this Rider terminate, any amended or replaced Annuity provisions  based on this Rider’s terms will revert to the provisions in the Annuity, except as may be provided below.    This Rider will terminate upon assignment or a change in ownership of your Annuity unless the  new assignee or Owner meets the qualifications specified in the Termination provision. This Rider  may not be re-elected after it terminates. The benefit provided pursuant to the terms of this Rider is a  “Return of Purchase Payments Death Benefit."  This Rider should be read in conjunction with any other  Rider or Endorsement made a part of your Annuity.     Charge for this Rider: [None]    Definitions:      Purchase Payment(s) :  A cash consideration in the currency of the United States of America given to us  in exchange for the rights, privileges and benefits outlined in this Annuity reduced for any applicable fees,  charges or Tax Charges.    Withdrawals:  Withdrawals of any type (including Partial Withdrawals) before the application of any  Contingent Deferred Sales Charge or other charge applicable upon a Withdrawal.    Death Benefit: If we receive Due Proof of Death within a period of [1 year], beginning on the decedent’s  date of death, the Death Benefit of the Annuity equals the greater of (a) and (b), where:    (a) is the “Return of Purchase Payments Amount” described below; and    (b) is the Account Value as described in the “Death Benefit” section of the Annuity.    If we do not receive Due Proof of Death within a period of [1 year], beginning on the decedent’s date of  death, the Death Benefit of the Annuity equals (b) above.  We reserve the right to waive or extend, on a  non-discriminatory basis, our right to enforce the Due Proof of Death period.  This right will only apply for  purposes of determining the amount payable as a Death Benefit, and in no way restricts when a claim  may be filed.    Return of Purchase Payments Amount:  Initially, this is an amount equal to the initial Purchase  Payment on the Effective Date of this Rider.  Thereafter, on each Valuation Day, up to and including the  date we receive Due Proof of Death, the Return of Purchase Payments Amount is increased by the  amount of any additional Purchase Payments allocated to the Annuity on that day and reduced for any  Withdrawal(s) by the ratio of the Withdrawal amount to the Account Value immediately prior to the  Withdrawal.     Other Death Benefit Provisions:  The provisions applicable to the Death Benefit described in your  Annuity regarding eligibility, limits of applicability, methods of payment to Beneficiaries or any other  provision regarding the Death Benefit, other than the method of calculation of the Death Benefit, continue  to apply unless specifically indicated otherwise in this Rider.    Spousal Continuation:  If the Annuity is eligible for Spousal Continuation and Spousal Continuation  occurs, upon Spousal Continuation the Account Value is increased, if necessary, to equal the greater of  the (1) Return of  Purchase Payments Amount and (2) the Death Benefit described in the Annuity. Any  increase to the Account Value resulting from such adjustment will be allocated to the Variable Sub- Accounts pro-rata or to the Holding Account if there is no Account Value in the Variable Sub-Accounts.   

 

P-RID-RILA-ROP(10/21) 2  The spouse who continues the Annuity may transfer available Account Value to any of the Variable Sub- Accounts at any time or to a new Index Strategy on the next Index Anniversary Date.   Following Spousal Continuation, any subsequent Death Benefit will be equal to the Account Value,  including any increase described above.    Termination of this Rider and its Benefits:  Benefits pursuant to this Rider will terminate upon the first  to occur of the following events:    1) the date the Annuity’s Death Benefit is determined, unless the Annuity is eligible for Spousal  Continuation and Spousal Continuation is elected;    2) we process a request to change the Owner(s) (or Annuitant if entity owned) more than 60 days  after the Effective Date, resulting in a change in the person(s) upon whose death a Death Benefit  is determined, other than when the Annuity is jointly owned and one of the Owners remains the  Owner;    3) we process an assignment of the Annuity to which this Rider is made a part;    4) if there is then any Account Value on the Annuity Date, or if earlier, the date we transfer all  Account Value in order to begin annuity payments;    5) the date we receive your request for full surrender;     6) if your Account Value reduces to zero;        PRUCO LIFE INSURANCE COMPANY                  [ ]   Secretary

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