Document:

November 3, 2014 S8 Exhibit 10.23

Exhibit 10.23

 

 

 

 

8X8, INC.

                  AMENDED AND RESTATED 2013 NEW EMPLOYEE INDUCEMENT INCENTIVE PLAN

 

 

Amended as of October 22, 2013

 

8X8, INC.

NEW EMPLOYEE INDUCEMENT INCENTIVE PLAN

	Purposes

1.1   General Purpose.  The Company, by means of the Plan, seeks to retain the services of
persons not previously an employee or director of the Company, or following a bona fide period of non-employment, as an
inducement material to the individual's entering into employment with the Company within the meaning of Rule 5635(c)(4) of the
Nasdaq Listing Rules, and to provide incentives for such persons to exert maximum efforts for the success of the Company and its
Affiliates.

1.2   Available Awards.  The purpose of the Plan is to provide a means by which eligible recipients of
Awards may be given an opportunity to benefit from increases in value of the Common Stock through the granting of the following Stock
Awards: Options, Restricted Stock, Restricted Stock Units, Stock Appreciation Rights, Performance Units and Stock
Grants.

	Definitions 
As used in this Plan, the following terms shall have the following meanings:

2.1   Accelerate, Accelerated, and Acceleration means: (a)
when used with respect to a Stock Right, that as of the time of reference the Stock Right will become exercisable with respect to some
or all of the shares of Stock for which it was not then otherwise exercisable by its terms; (b) when used with respect to Restricted Stock
or Restricted Stock Units, that the Risk of Forfeiture otherwise applicable to the Stock or Units shall expire with respect to some or all of
the shares of Restricted Stock or Units then still otherwise subject to the Risk of Forfeiture; and (c) when used with respect to
Performance Units, that the applicable Performance Goals or other business objectives shall be deemed to have been met as to some
or all of the Units.  

2.2   Affiliate means any corporation, partnership, limited liability company, business trust, or
other entity controlling, controlled by or under common control with the Company.

2.3   Award means any grant or sale pursuant to the Plan of Options, Stock Appreciation Rights,
Performance Units, Restricted Stock, Restricted Stock Units or Stock Grants.

2.4   Award Agreement means an agreement between the Company and the recipient of an
Award, or other notice of grant of an Award, setting forth the terms and conditions of the Award.

2.5   Board means the Company's Board of Directors.

2.6   Code means the Internal Revenue Code of 1986, as amended from time to time, or any
successor statute thereto, and any regulations issued from time to time thereunder.

2.7   Committee means the Compensation Committee of the Board, which in general is
responsible for the administration of the Plan, as provided in Section 4 of the Plan.  For any period during which no such
committee is in existence, "Committee" shall mean the Independent Board, and all authority and responsibility assigned to
the Committee under the Plan shall be exercised, if at all, by the Independent Board.

2.8   Company means 8x8, Inc., a corporation organized under the laws of the State of
Delaware.

2.9   Corporate Transaction means any (1) merger or consolidation of the Company with or into
another entity as a result of which the Stock of the Company is converted into or exchanged for the right to receive cash, securities or
other property or is cancelled, (2) sale or exchange of all of the Stock of the Company for cash, securities or other property, (3) sale,
transfer, or other disposition of all or substantially all of the Company's assets to one or more other persons in a single transaction or
series of related transactions or (4) liquidation or dissolution of the Company; except, in the case of clauses (1) and (2), for a
transaction the principal purpose of which is to change the state in which the Company is incorporated.

2.10   Effective Date means the date on which this Plan has been approved by the Board,
including the Independent Board.

2.11   Exchange Act means the Securities Exchange Act of 1934, as amended.

2.12   Grant Date means the date as of which an Option is granted, as determined under
Section 6.1(a).

2.13   Independent Board means a majority of the independent directors on the Board.
"Independent director" has the meaning given under Rule 5605(a)(2) of the Nasdaq Listing
Rules.

2.14   Market Value means the value of a share of Stock on a particular date determined by such
methods or procedures as may be established by the Committee.  Unless otherwise determined by the Committee, the Market Value of
Stock as of any date is: (a) the closing price for the Stock as reported on the NASDAQ Global Market (or on any other national
securities exchange on which the Stock is then listed) for that date or, if no closing price is reported for that date, the closing price on
the next preceding date for which a closing price was reported; or (b) if the Stock is not traded on a national securities exchange but is
traded over-the-counter, the closing or last price of the Stock on the composite tape or other comparable reporting system on that date
or, if such date is not a trading day, the last market trading day prior to such date.

2.15   Option means an option to purchase shares of Stock.

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2.16   Optionee means a Participant to whom an Option shall have been granted under the
Plan.

2.17   Participant means any holder of an outstanding Award under the Plan.

2.18   Performance Criteria means the criteria that the Committee selects for purposes of
establishing the Performance Goal or Performance Goals for a Participant for a Performance Period. The Performance Criteria used to
establish Performance Goals are limited to: (i) cash flow (before or after dividends), (ii) earnings per share (including, without limitation,
earnings before interest, taxes, depreciation and amortization), (iii) stock price, (iv) return on equity, (v) stockholder return or total
stockholder return, (vi) return on capital (including, without limitation, return on total capital or return on invested capital), (vii) return on
investment, (viii) return on assets or net assets, (ix) market capitalization, (x) economic value added, (xi) debt leverage (debt to capital),
(xii) revenue, (xiii) sales or net sales, (xiv) backlog, (xv) income, pre-tax income or net income, (xvi) operating income or pre-tax profit,
(xvii) operating profit, net operating profit or economic profit, (xviii) gross margin, operating margin or profit margin, (xix) return on
operating revenue or return on operating assets, (xx) cash from operations, (xxi) operating ratio, (xxii) operating revenue, (xxiii) market
share improvement, (xxiv) general and administrative expenses and (xxv) customer service.

2.19   Performance Goals means, for a Performance Period, the written goal or goals established
by the Committee for the Performance Period based upon one or more of the Performance Criteria.  The Performance Goals may be
expressed in terms of overall Company performance or the performance of a division, business unit, subsidiary, or an individual, either
individually, alternatively or in any combination, applied to either the Company as a whole or to a business unit or Affiliate, either
individually, alternatively or in any combination, and measured either quarterly, annually or cumulatively over a period of years, on an
absolute basis or relative to a pre-established target, to previous years' results or to a designated comparison group, in each case as
specified by the Committee. The Committee will objectively define the manner of calculating the Performance Goal or Goals it selects to
use for such Performance Period for such Participant, including whether or to what extent there shall not be taken into account any of
the following events that occurs during a performance period: (i) asset write-downs, (ii) litigation, claims, judgments or settlements, (iii)
the effect of changes in tax law, accounting principles or other such laws or provisions affecting reported results, (iv) accruals for
reorganization and restructuring programs and (v) any extraordinary, unusual, non-recurring or non-comparable items (A) as described
in Accounting Standard Codification Section 225-20 (or its successor provisions), (B) as described in management's discussion and
analysis of financial condition and results of operations appearing in the Company's annual report to stockholders for the applicable
year, or (C) publicly announced by the Company in a press release or conference call relating to the Company's results of operations or
financial condition for a completed quarterly or annual fiscal period.

2.20   Performance Period means the one or more periods, which may be of varying and
overlapping durations, selected by the Committee, over which the attainment of one or more Performance Goals or other business
objectives will be measured for purposes of determining a Participant's right to, and the payment of, a Performance Unit.

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2.21   Performance Unit means a right granted to a Participant under Section 6.5, to
receive cash, Stock or other Awards, the payment of which is contingent on achieving Performance Goals or other business objectives
established by the Committee.

2.22   Plan means this Amended and Restated 2013 New Employee Inducement Incentive Plan of the Company, as
amended from time to time, and including any attachments or addenda hereto.

2.23   Restricted Stock means a grant or sale of shares of Stock to a Participant subject to a Risk
of Forfeiture.

2.24   Restricted Stock Units means rights to receive shares of Stock at the close of a Restriction
Period, subject to a Risk of Forfeiture.

2.25   Restriction Period means the period of time, established by the Committee in connection
with an Award of Restricted Stock or Restricted Stock Units, during which the shares of Restricted Stock or Restricted Stock Units are
subject to a Risk of Forfeiture described in the applicable Award Agreement.

2.26   Risk of Forfeiture means a limitation on the right of the Participant to retain Restricted
Stock or Restricted Stock Units, including a right in the Company to reacquire shares of Restricted Stock at less than their then Market
Value, arising because of the occurrence or non-occurrence of specified events or conditions.

2.27   Securities Act means the Securities Act of 1933, as amended.

2.28   SEC means the Securities and Exchange Commission.

2.29   Stock means common stock, par value $0.001 per share, of the Company, and
such other securities as may be substituted for Stock pursuant to Section 7.

2.30   Stock Appreciation Right means a right to receive any excess in the Market Value of
shares of Stock (except as otherwise provided in Section 6.2(c)) over a specified exercise price.

2.31   Stock Grant means the grant of shares of Stock not subject to restrictions or other forfeiture
conditions.

2.32   Stock Right means an Award in the form of an Option or a Stock Appreciation
Right.

2.33   Stockholders' Agreement means any agreement by and among the holders of at least a
majority of the outstanding voting securities of the Company and setting forth, among other provisions, restrictions upon the transfer of
shares of Stock or on the exercise of rights appurtenant thereto (including, but not limited to, voting rights).

	Shares Subject to the Plan; Term of the Plan

3.1   Number of Shares.  Subject to Section 7.1, the aggregate number of shares of Stock that
have been reserved for issuance pursuant to this Plan is two million two hundred thousand (2,200,000) shares, and at no time shall the number of shares of Stock issued pursuant to or subject to

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outstanding Awards granted under the Plan exceed such number. For purposes of
applying the foregoing limitation, settlement of any Award shall not count against the foregoing limitations except to the extent settled in
the form of Stock and, without limiting the generality of the foregoing:

	if any Option or Stock-settled Stock Appreciation Right expires, terminates, or is cancelled for any
reason without having been exercised in full, or if any other Award is forfeited by the recipient or repurchased at less than its Market
Value as a means of effecting a forfeiture, the shares of Stock not purchased by the Optionee or which are forfeited by the recipient or
repurchased shall again be available for Awards to be granted under the Plan;

	if any Option is exercised by delivering previously owned shares of Stock in payment of the exercise
price therefor, only the net number of shares, that is, the number of shares of Stock issued minus the number received by the Company
in payment of the exercise price, shall be considered to have been issued pursuant to an Award granted under the Plan; and

	any shares of Stock either tendered or withheld in satisfaction of tax withholding obligations of the
Company or an Affiliate shall again be available for issuance under the Plan.

Shares of Stock issued pursuant to the Plan may be either authorized but unissued shares or shares held by
the Company in its treasury. 

3.2   Term.  Unless the Plan shall have been earlier terminated by the Board, Awards may be granted
under this Plan at any time in the period commencing on the Effective Date of approval of the Plan by the Board and ending
immediately prior to the tenth (10th) anniversary thereof.  Awards granted pursuant to the Plan within that period shall not expire solely
by reason of the termination of the Plan.

	Administration
In all events the Plan shall be administered by the Independent Board or Committee in compliance with
Rule 5635(c)(4) (and any successor thereto) of the Listing Rules of the NASDAQ Stock Market LLC ("Nasdaq").  The grant
of any Award under the Plan must be approved by a majority of the members of the Board (each of whom is an "independent
director" as defined in the Nasdaq Listing Rules) or by the Company's independent compensation committee (as intended under
the Nasdaq Listing Rules).  The Plan shall be administered by the Committee, provided, however, that at any time and on any
one or more occasions the Independent Board may itself exercise any of the powers and responsibilities assigned the Committee under
the Plan and when so acting shall have the benefit of all of the provisions of the Plan pertaining to the Committee's exercise of its
authorities hereunder.  Subject to the provisions of the Plan, the Committee shall have complete authority, in its discretion, to make or
to select the manner of making all determinations with respect to each Award to be granted by the Company under the Plan, including
the new employee to receive the Award and the form of Award.  All Awards of Stock or which otherwise entitle the Award recipient to
acquire any shares of Stock shall be made from the authorized but unissued shares of Stock of the Company. The Committee, or the Independent Board, shall

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determine in its sole discretion how many shares of Stock to issue under this Plan in the aggregate.  In
making its determinations, the Committee may take into account the nature of the services to be rendered by the new employees, their
potential contributions to the success of the Company and its Affiliates, and such other factors as the Committee in its discretion shall
deem relevant.  Subject to the provisions of the Plan, the Committee shall also have complete authority to:  (a) interpret the Plan, to
prescribe, amend and rescind rules and regulations relating to it; (b) approve one or more forms of Award Agreement; (c) determine the
initial terms and provisions of the respective Award Agreements (which need not be identical), including, without limitation, as
applicable, (i) the exercise price of the Award, (ii) the method of payment for shares of Stock purchased upon the exercise of the
Award, (iii) the timing, terms and conditions of the exercisability of the Award or the vesting of any shares acquired upon the exercise
thereof, (iv) the time of the expiration of the Award, (v) the effect of the Participant's termination of employment or other association with
the Company on any of the foregoing, and (vi) all other terms, conditions and restrictions applicable to the Award or such shares not
inconsistent with the terms of the Plan; (d) amend, modify, extend, cancel or renew any Award or to waive any restrictions or conditions
applicable to any Award or any shares acquired upon the exercise thereof; (e) accelerate, continue, extend or defer the exercisability of
any Award or the vesting of any shares acquired upon the exercise thereof, including with respect to the period following a Participant's
termination of employment or other association with the Company; (f) correct any defect, supply any omission or reconcile any
inconsistency in the Plan or any Award Agreement and to make all other determinations and take such other actions with respect to the
Plan or any Award as the Committee may deem advisable to the extent not inconsistent with the provisions of the Plan or applicable
law; and (g) make all other determinations necessary or advisable for the administration of the Plan.  The Committee's determinations
made in good faith on matters referred to in the Plan shall be final, binding and conclusive on all persons having or claiming any interest
under the Plan or an Award made pursuant hereto.

	Authorization of Grants

5.1   Eligibility.  Persons eligible for Awards shall consist of employees whose potential
contribution, in the judgment of the Committee, will benefit the future success of the Company and/or an Affiliate.  Offers of Awards may
be made prior to the commencement of employment with the Company or an Affiliate, but Awards may be granted only effective on or
after the commencement of such employment to persons not previously an employee or director of the Company, or following a
bona fide period of non-employment, as an inducement material to the individual's entering into employment with the Company
within the meaning of Rule 5635(c)(4) of the Nasdaq Listing Rules (or applicable replacement rules or regulations).  In addition,
notwithstanding any other provision of the Plan to the contrary, all Awards must be granted either by the Independent Board or the
Committee.

5.2   General Terms of Awards.  Each grant of an Award shall be subject to all applicable terms and
conditions of the Plan (including but not limited to any specific terms and conditions applicable to that type of Award set out in the
following Section), and such other terms and conditions, not inconsistent with the terms of the Plan, as the Committee may prescribe.
No prospective Participant shall have any rights with respect to an Award, unless and until such Participant has executed an Award
agreement evidencing the Award, delivered a fully executed copy thereof to the Company, and otherwise complied with the applicable
terms and conditions of such Award.

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5.3   Effect of Termination of Employment, Disability or Death. 

	Termination of Employment, Etc.  Unless the Committee shall provide otherwise with respect to
any Award, if the Participant's employment or other association with the Company and its Affiliates ends for any reason other than by
total disability or death, including because of an Affiliate ceasing to be an Affiliate, (a) any outstanding Stock Right of the Participant
shall cease to be exercisable in any respect not later than three months following that event and, for the period it remains exercisable
following that event, shall be exercisable only to the extent exercisable at the date of that event, and (b) any other outstanding Award of
the Participant shall be forfeited or otherwise subject to return to or repurchase by the Company on the terms specified in the applicable
Award Agreement.  Cessation of the performance of services in one capacity, for example, as an employee, shall not result in
termination of an Award while the Participant continues to perform services in another capacity, for example as a director. Military or
sick leave or other bona fide leave shall not be deemed a termination of employment or other association, provided that it does
not exceed the longer of three months or the period during which the absent Participant's reemployment rights, if any, are guaranteed
by statute or by contract.  To the extent consistent with applicable law, the Committee may provide that Awards continue to vest for
some or all of the period of any such leave, or that their vesting shall be tolled during any such leave and only recommence upon the
Participant's return from leave, if ever.

	Disability of Participant.  If a Participant's employment or other association with the Company and
its Affiliates ends due to disability (as defined in Section 22(e)(3) of the Code), any outstanding Stock Right may be exercised at any
time within six months following the date of termination of service, but only to the extent of the accrued right to exercise at the time of
termination of service, subject to the condition that no Stock Right shall be exercised after its expiration in accordance with its
terms.

	Death of Participant.  In the event of the death during the Option period, or period during which the
Stock Appreciation Right may be exercised, of a Participant who is at the time of his or her death an employee, director or consultant
and whose services had not ceased or been terminated (as determined with regard to the second sentence of Section 5.3(a)) as such
from the Grant Date until the date of death, the Stock Right of the Participant may be exercised at any time within six months following
the date of death by such Participant's estate or by a person who acquired the right to exercise the Stock Right by bequest, inheritance
or otherwise as a result of the Participant's death, but only to the extent of the accrued right to exercise at the time of death, subject to
the condition that no Stock Right shall be exercised after its expiration in accordance with its terms.

5.4   Transferability of Awards.  Except as otherwise provided in this Section 5.4, Awards shall not be
transferable, and no Award or interest therein may be sold, transferred, pledged, assigned, or otherwise alienated or hypothecated,
other than by will or by the laws of descent and distribution.  All of a Participant's rights in any Award may be exercised during the life of
the Participant only by the Participant or the Participant's legal representative.  However, the Committee may, at or after the grant of an
Award of an Option or shares of Restricted Stock, provide that such Award may be transferred by the recipient to

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a family member; provided, however, that any such transfer is without payment of any consideration whatsoever and that no transfer shall
be valid unless first approved by the Committee, acting in its sole discretion.  For this purpose, "family
member" means any child, stepchild, grandchild, parent, grandparent, stepparent, spouse, former spouse, sibling, niece,
nephew, mother-in-law, father-in-law, son-in-law, daughter-in-law, brother-in-law, or sister-in-law, including adoptive relationships, any
person sharing the employee's household (other than a tenant or employee), a trust in which the foregoing persons have more than 50
percent of the beneficial interests, a foundation in which the foregoing persons (or the Participant) control the management of assets,
and any other entity in which these persons (or the Participant) own more than 50 percent of the voting interests.  The events of
termination of service of Section 5.3 hereof or in the Award Agreement shall continue to be applied with respect to the original
Participant, following which the Awards shall be exercisable by the transferee only to the extent, and for the periods specified in the
Award Agreement or Section 5.3, as applicable.

	Specific Terms of Awards

6.1   Options.

	Date of Grant.  The granting of an Option shall take place at the time that legally effective action to
grant the award is taken by the Committee or the Independent Board.

	Exercise Price.  The price at which shares of Stock may be acquired under each Option shall be
the Market Value of Stock on the Grant Date, except as provided otherwise by the Committee upon the grant of the Option.

	Option Period.  No Option may be exercised on or after the tenth anniversary of the Grant Date,
except as provided otherwise by the Committee upon the grant of the Option.

	Exercisability.  An Option may be immediately exercisable or become exercisable in such
installments, cumulative or non-cumulative, as the Committee may determine.  In the case of an Option not otherwise immediately
exercisable in full, the Committee may Accelerate such Option in whole or in part at any time.

	Method of Exercise.  An Option may be exercised by the Optionee giving written notice, in the
manner provided in Section 14, specifying the number of shares of Stock with respect to which the Option is then being exercised.  The
notice shall be accompanied by payment in the form of cash or check payable to the order of the Company in an amount equal to the
exercise price of the shares of Stock to be purchased or, subject in each instance to the Committee's approval, acting in its sole
discretion, and to such conditions, if any, as the Committee may deem necessary to avoid adverse accounting effects to the
Company,

	by delivery to the Company of shares of Stock having a Market Value equal to the exercise price of the
shares to be purchased, or 

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	by surrender of the Option as to all or part of the shares of Stock for which the Option is then exercisable in
exchange for shares of Stock having an aggregate Market Value equal to the difference between (1) the aggregate Market Value of the
surrendered portion of the Option, and (2) the aggregate exercise price under the Option for the surrendered portion of the Option, or

	unless prohibited by applicable law, by delivery to the Company of the Optionee's executed promissory
note in the principal amount equal to the exercise price of the shares of Stock to be purchased and otherwise in such form as the
Committee shall have approved, or 

	by delivery of any other lawful means of consideration which the Committee may approve.

If the Stock is traded on an established market, payment of any exercise price may also be made through and
under the terms and conditions of any formal cashless exercise program authorized by the Company entailing the sale of the Stock
subject to an Option in a brokered transaction (other than to the Company).  Receipt by the Company of such notice and payment in
any authorized or combination of authorized means shall constitute the exercise of the Option.  Within 30 days thereafter but subject to
the remaining provisions of the Plan, the Company shall deliver or cause to be delivered to the Optionee or his agent a certificate or
certificates or book-entry authorization and instruction to the Company's transfer agent and registrar for the number of shares then
being purchased.  Such shares of Stock shall be fully paid and nonassessable.  In its reasonable discretion, the Committee may
suspend or halt Option exercises for such length of time as the Committee deems reasonably necessary under circumstances in which
such suspension or halt is considered to be in the best interests of the Company.

6.2   Stock Appreciation Rights.

	Tandem or Stand-Alone.  Stock Appreciation Rights may be granted in tandem with an Option (at
or after the award of the Option), or alone and unrelated to an Option.  Stock Appreciation Rights in tandem with an Option shall
terminate to the extent that the related Option is exercised, and the related Option shall terminate to the extent that the tandem Stock
Appreciation Rights are exercised.

	Exercise Price.  Stock Appreciation Rights shall have an exercise price of not less than the Market
Value of the Stock on the date of award, or in the case of Stock Appreciation Rights in tandem with Options, the exercise price of the
related Option.

	Other Terms.  Except as the Committee may deem inappropriate or inapplicable in the
circumstances, Stock Appreciation Rights shall be subject to terms and conditions substantially similar to those applicable to an Option.
In addition, a Stock Appreciation Right related to an Option which can only be exercised during limited periods following a Corporate
Transaction may entitle the Participant to receive an amount based upon the highest price paid or offered for Stock in any transaction
relating to the Corporate Transaction or paid during the 30-day period immediately preceding the occurrence of the Corporate
Transaction in any transaction reported in the stock market in which the Stock is normally traded.

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6.3   Restricted Stock.

	Purchase Price.  Shares of Restricted Stock shall be issued under the Plan for such consideration,
in cash, other property or services, or any combination thereof, as is determined by the Committee.

	Issuance of Certificates.  Each Participant receiving a Restricted Stock Award, subject to
subsection (c) below, shall be issued a stock certificate in respect of such shares of Restricted Stock, or if issued in uncertificated form,
shall be registered in the name of the Participant on the books of the Company's transfer agent and registrar.  Such certificate or
uncertificated shares shall be registered in the name of such Participant, and, if applicable, the certificate or the books of the
Company's transfer agent and registrar shall bear an appropriate legend referring to the terms, conditions, and restrictions applicable to
such Award substantially in the following form: 

The shares evidenced by this certificate are subject to the terms and conditions of the 8x8, Inc. Amended and Restated 2013 New
Employee Inducement Incentive Plan and an Award Agreement entered into by the registered owner and 8x8, Inc., copies of which will
be furnished by the Company to the holder of the shares evidenced by this certificate upon written request and without charge. 

	Escrow of Shares.  The Committee may require that the stock certificates evidencing shares of
Restricted Stock be held in custody by a designated escrow agent (which may but need not be the Company) until the restrictions
thereon shall have lapsed, and that the Participant deliver a stock power, endorsed in blank, relating to the Stock covered by such
Award.

	Restrictions and Restriction Period.  During the Restriction Period applicable to shares of
Restricted Stock, such shares shall be subject to limitations on transferability and a Risk of Forfeiture arising on the basis of such
conditions related to the performance of services, Company or Affiliate performance or otherwise as the Committee may determine and
provide for in the applicable Award Agreement.  Any such Risk of Forfeiture may be waived or terminated, or the Restriction Period
shortened, at any time by the Committee on such basis as it deems appropriate. 

	Rights Pending Lapse of Risk of Forfeiture or Forfeiture of Award.  Except as otherwise provided
in the Plan or the applicable Award Agreement, at all times prior to lapse of any Risk of Forfeiture applicable to, or forfeiture of, an
Award of Restricted Stock, the Participant shall have all of the rights of a stockholder of the Company, including the right to vote, and
the right to receive any dividends with respect to, the shares of Restricted Stock (but any dividends or other distributions payable in
shares of Stock or other securities of the Company shall constitute additional Restricted Stock, subject to the same Risk of Forfeiture as
the shares of Restricted Stock in respect of which such shares of Stock or other securities are paid).  The Committee, as determined at
the time of Award, may permit or require the payment of cash dividends to be deferred and, if the Committee so determines, reinvested
in additional Restricted Stock to the extent shares of Stock are available under Section 3.1.

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	Lapse of Restrictions.  If and when the Restriction Period expires without a prior forfeiture of the
Restricted Stock, the certificates for such shares shall be delivered to the Participant promptly if not theretofore so
delivered.

6.4   Restricted Stock Units.

	Character.  Each Restricted Stock Unit shall entitle the recipient to a share of Stock at a close of
such Restriction Period as the Committee may establish and subject to a Risk of Forfeiture arising on the basis of such conditions
relating to the performance of services, Company or Affiliate performance or otherwise as the Committee may determine and provide
for in the applicable Award Agreement.  Any such Risk of Forfeiture may be waived or terminated, or the Restriction Period shortened,
at any time by the Committee on such basis as it deems appropriate.

	Form and Timing of Payment.  Payment of earned Restricted Stock Units shall be made in a
single lump sum following the close of the applicable Restriction Period unless the applicable Award Agreement provides for a later
settlement date in compliance with Section 409A of the Code.  At the discretion of the Committee, Participants may be entitled to
receive payments equivalent to any dividends declared with respect to Stock referenced in grants of Restricted Stock Units but only
following the close of the applicable Restriction Period and then only if the underlying Stock shall have been earned.  Unless the
Committee shall provide otherwise, any such dividend equivalents shall be paid, if at all, without interest or other
earnings.

6.5   Performance Units.

	Character.  Each Performance Unit shall entitle the recipient to the value of a specified number of
shares of Stock, over the initial value for such number of shares, if any, established by the Committee at the time of grant, at the close
of a specified Performance Period to the extent specified business objectives, including, but not limited to, Performance Goals, shall
have been achieved.

	Earning of Performance Units. The Committee shall set Performance Goals or other business
objectives in its discretion which, depending on the extent to which they are met within the applicable Performance Period, will
determine the number and value of Performance Units that will be paid out to the Participant.  After the applicable Performance Period
has ended, the holder of Performance Units shall be entitled to receive payout on the number and value of Performance Units earned
by the Participant over the Performance Period, to be determined as a function of the extent to which the corresponding Performance
Goals or other business objectives have been achieved.

	Form and Timing of Payment.  Payment of earned Performance Units shall be made in a single
lump sum following the close of the applicable Performance Period.  At the discretion of the Committee, Participants may be entitled to
receive any dividends declared with respect to Stock which have been earned in connection with grants of Performance Units which
have been earned, but not yet distributed to Participants.  Subject to compliance with Section 409A of the Code, the Committee may
permit or, if it so provides at grant require, a Participant to defer such Participant's receipt of the payment of cash or the delivery of
Stock that would otherwise be due to such Participant by virtue of the

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satisfaction of any requirements or goals with respect to Performance Units.  If any such deferral election is required or permitted, the Committee shall establish rules and procedures for such
payment deferrals.

6.6   Stock Grants. Stock Grants shall be awarded solely in recognition of expected contributions to the
success of the Company or its Affiliates, as an inducement to employment, and in such other limited circumstances as the Committee
deems appropriate.  Stock Grants shall be made without forfeiture conditions of any kind.

6.7   Awards to Participants Outside the United States.  The Committee may modify the terms of any
Award under the Plan, granted to a Participant who is, at the time of grant or during the term of the Award, resident or primarily
employed outside of the United States in any manner deemed by the Committee to be necessary or appropriate in order that the Award
shall conform to laws, regulations, and customs of the country in which the Participant is then resident or primarily employed, or so that
the value and other benefits of the Award to the Participant, as affected by foreign tax laws and other restrictions applicable as a result
of the Participant's residence or employment abroad, shall be comparable to the value of such an Award to a Participant who is resident
or primarily employed in the United States.  The Committee may establish supplements to, or amendments, restatements, or alternative
versions of, the Plan for the purpose of granting and administrating any such modified Award.  No such modification, supplement,
amendment, restatement or alternative version may increase the share limit of Section 3.1.

	Adjustment Provisions

7.1   Adjustment for Corporate Actions. All of the share numbers set forth in the Plan reflect the
capital structure of the Company as of the Effective Date.  If subsequent to the Effective Date the outstanding shares of Stock (or any
other securities covered by the Plan by reason of the prior application of this Section) are increased, decreased, or exchanged for a
different number or kind of shares or other securities, or if additional shares or new or different shares or other securities are distributed
with respect to shares of Stock, as a result of a reorganization, recapitalization, reclassification, stock dividend, stock split, reverse
stock split, or other similar distribution with respect to such shares of Stock, an appropriate and proportionate adjustment will be made
in (i) the maximum numbers and kinds of shares provided in Section 3.1, (ii) the numbers and kinds of shares or other securities subject
to the then outstanding Awards, (iii) the exercise price for each share or other unit of any other securities subject to then outstanding
Stock Rights (without change in the aggregate exercise price as to which such Rights remain exercisable), and (iv) the repurchase price
of each share of Restricted Stock then subject to a Risk of Forfeiture in the form of a Company repurchase right.

7.2   Adjustment of Awards Upon the Occurrence of Certain Unusual or Nonrecurring Events.  In the
event of any corporate action not specifically covered by the preceding Section, including, but not limited to, an extraordinary cash
distribution on Stock, a corporate separation or other reorganization or liquidation, the Committee may make such adjustment of
outstanding Awards and their terms, if any, as it, in its sole discretion, may deem equitable and appropriate in the circumstances.  The
Committee also may make adjustments in the terms and conditions of, and the criteria included in, Awards in recognition of unusual or nonrecurring events (including, without limitation, the events

                                                   12

described in this Section) affecting the Company or the financial
statements of the Company or of changes in applicable laws, regulations, or accounting principles, whenever the Committee
determines that such adjustments are appropriate in order to prevent dilution or enlargement of the benefits or potential benefits
intended to be made available under the Plan.

7.3   Related Matters.  Any adjustment in Awards made pursuant to Section 7.1 or 7.2  shall be
determined and made, if at all, by the Committee, acting in its sole discretion, and shall include any correlative modification of terms,
including of Stock Right exercise prices, rates of vesting or exercisability, Risks of Forfeiture, applicable repurchase prices for
Restricted Stock, and Performance Goals and other business objectives which the Committee may deem necessary or appropriate so
as to ensure the rights of the Participants in their respective Awards are not substantially diminished nor enlarged as a result of the
adjustment and corporate action other than as expressly contemplated in this Section 7.  The Committee, in its discretion, may
determine that no fraction of a share of Stock shall be purchasable or deliverable upon exercise, and in that event if any adjustment
hereunder of the number of shares of Stock covered by an Award would cause such number to include a fraction of a share of Stock,
such number of shares of Stock shall be adjusted to the nearest smaller whole number of shares.  No adjustment of an Option exercise
price per share pursuant to Sections 7.1 or 7.2 shall result in an exercise price which is less than the par value of the Stock. 

7.4   Corporate Transactions.

	Treatment of Awards in a Corporate Transaction.  In a Corporate Transaction, the Committee, in
its sole and absolute discretion, may take any one or more of the following actions as to all or any (or any portion of) outstanding
Awards.

	Assumption and Substitution.  Provide that such Awards shall be assumed, or substantially
equivalent rights shall be provided in substitution therefor, by the acquiring or succeeding entity (or an affiliate thereof), and that any
repurchase or other rights of the Company under each such Award shall inure to the benefit of such acquiring or succeeding entity (or
affiliate thereof).

	Termination, Forfeiture and Reacquisition.  Upon written notice to the holders, provide
that:

	any unexercised Stock Rights shall terminate immediately prior to the consummation of the Corporate
Transaction unless exercised within a specified period following the date of such notice and that any Stock Rights not then exercisable
will expire automatically upon consummation of the Corporate Transaction;

	any Restricted Stock Units shall terminate and be forfeited immediately prior to the consummation of
the Corporate Transaction to the extent they are then subject to a Risk of Forfeiture; and/or

                                                   13

	any shares of Restricted Stock shall automatically be reacquired by the Corporation upon
consummation of the Corporate Transaction at a price per share equal to the lesser of the Market Value of the Restricted Stock and the
purchase price paid by the Participant.

	Acceleration of Vesting.  Provide that:

	 any and all Stock Rights not already exercisable in full shall Accelerate with respect to all or a portion
of the shares for which such Stock Rights are not then exercisable prior to or upon the consummation of the Corporate Transaction;
and/or

	any Risk of Forfeiture applicable to Restricted Stock and Restricted Stock Units which is not based on
achievement of Performance Goals or other business objectives shall lapse upon consummation of the Corporate Transaction with
respect to all or a portion of the Restricted Stock and Restricted Stock Units then subject to such Risk of Forfeiture.

	Achievement of Performance Goals.  Provide that all outstanding Awards of Restricted Stock and
Restricted Stock Units conditioned on the achievement of Performance Goals or other business objectives and the target payout
opportunities attainable under outstanding Performance Units shall be deemed to have been satisfied as of the effective date of the
Corporate Transaction as to (i) none of, (ii) all of or (iii) a pro rata number of shares based on the assumed achievement of all relevant
Performance Goals or other business objectives and the length of time within the Restriction Period or Performance Period which has
elapsed prior to the Corporate Transaction.  All such Awards of Performance Units and Restricted Stock Units shall be paid to the
extent earned to Participants in accordance with their terms within 30 days following the effective date of the Corporate
Transaction.

	Cash Payments to Holders of Stock Rights.  Provide for cash payments, net of applicable tax
withholdings, to be made to holders of Stock Rights equal to the excess, if any, of (A) the acquisition price times the number of shares
of Stock subject to a Stock Right (to the extent the exercise price does not exceed the acquisition price) over (B) the aggregate exercise
price for all such shares of Stock subject to the Stock Right, in exchange for the termination of such Stock Right; provided, that if the
acquisition price does not exceed the exercise price of any such Stock Right, the Committee may cancel that Stock Right without the
payment of any consideration therefor prior to or upon the Corporate Transaction.  For this purpose, "acquisition price"
means the amount of cash, and market value of any other consideration, received in payment for a share of Stock surrendered in a
Corporate Transaction. 

	Conversion of Stock Rights Upon Liquidation or Dissolution.  Provide that, in connection with a

                                                   14

shall convert into the right to receive liquidation proceeds net of the exercise liquidation or dissolution of the Company, Stock Rights
price thereof and any applicable tax withholdings.

	Any combination of the foregoing.

None of the foregoing shall apply, however, (i) in the case of any Award pursuant to an Award Agreement
requiring other or additional terms upon a Corporate Transaction (or similar event), or (ii) if specifically prohibited under applicable laws,
or by the rules and regulations of any governing governmental agencies or national securities exchanges on which the Stock is listed.

	Assumption and Substitution of Awards.  For purposes of Section 7.4(a)(i) above, an Award
shall be considered assumed, or a substantially equivalent award shall be considered to have been provided in substitution therefor, if
following consummation of the Corporate Transaction the Award is assumed and/or exchanged or replaced with another award issued
by the acquiring or succeeding entity (or an affiliate thereof) that confers the right to purchase or receive the value of, for each share of
Stock subject to the Award immediately prior to the consummation of the Corporate Transaction, the consideration (whether cash,
securities or other property) received as a result of the Corporate Transaction by holders of Stock for each share of Stock held
immediately prior to the consummation of the Corporate Transaction (and if holders were offered a choice of consideration, the type of
consideration chosen by the holders of a majority of the outstanding shares of Stock); provided, however, that if the consideration
received as a result of the Corporate Transaction is not solely common stock (or its equivalent) of the acquiring or succeeding entity (or
an affiliate thereof), the Committee may provide for the consideration to be received upon the exercise of Award to consist of or be
based on solely common stock (or its equivalent) of the acquiring or succeeding entity (or an affiliate thereof) equivalent in value to the
per share consideration received by holders of outstanding shares of Stock as a result of the Corporate Transaction.

	Related Matters. In taking any of the actions permitted under this Section 7.4, the Committee
shall not be obligated to treat all Awards, all Awards held by a Participant, or all Awards of the same type, identically. Any
determinations required to carry out the foregoing provisions of this Section 7.4, including, but not limited to, the market value of other
consideration received by holders of Stock in a Corporate Transaction and whether substantially equivalent awards have been
substituted, shall be made by the Committee acting in its sole and absolute discretion.  In connection with any action or actions taken
by the Committee in respect of Awards and in connection with a Transaction, the Committee may require such acknowledgements of
satisfaction and releases from Participants as it may determine. 

	Settlement of Awards

8.1   In General.  Awards of Restricted Stock shall be settled in accordance with their terms.  All
other Awards may be settled in cash, Stock, or other Awards, or a combination thereof, as determined by the Committee at or after
grant and subject to any contrary Award Agreement.  The Committee may not require settlement of any Award in Stock pursuant to the
immediately preceding sentence to the extent issuance of such Stock would be prohibited or unreasonably delayed by reason of any
other provision of the Plan.

                                                   15

8.2   Violation of Law.  Notwithstanding any other provision of the Plan or the relevant Award
Agreement, if, at any time, in the reasonable opinion of the Company, the issuance of shares of Stock covered by an Award may
constitute a violation of law, then the Company may delay such issuance and the delivery of a certificate for such shares until
(i) approval shall have been obtained from such governmental agencies, other than the Securities and Exchange Commission, as
may be required under any applicable law, rule, or regulation and (ii) in the case where such issuance would constitute a violation
of a law administered by or a regulation of the Securities and Exchange Commission, one of the following conditions shall have been
satisfied:

	the shares are at the time of the issue of such shares effectively registered under the Securities Act;
or

	the Company shall have determined, on such basis as it deems appropriate (including an opinion of
counsel in form and substance satisfactory to the Company) that the sale, transfer, assignment, pledge, encumbrance or other
disposition of such shares or such beneficial interest, as the case may be, does not require registration under the Securities Act or any
applicable State securities laws.

The Company shall make all reasonable efforts to bring about the occurrence of said events

8.3   Corporate Restrictions on Rights in Stock. Any Stock to be issued pursuant to Awards granted
under the Plan shall be subject to all restrictions upon the transfer thereof which may be now or hereafter imposed by the charter,
certificate or articles, or by laws, of the Company.  Whenever Stock is to be issued pursuant to an Award, if the Committee so directs at
or after grant, the Company shall be under no obligation to issue such shares until such time, if ever, as the recipient of the Award (and
any person who exercises any Option, in whole or in part), shall have become a party to and bound by the Stockholders' Agreement, if
any.  In the event of any conflict between the provisions of this Plan and the provisions of the Stockholders' Agreement, the provisions
of the Stockholders' Agreement shall control, but insofar as possible the provisions of the Plan and such Agreement shall be construed
so as to give full force and effect to all such provisions.

8.4   Investment Representations.  The Company shall be under no obligation to issue any shares
covered by any Award unless the shares to be issued pursuant to Awards granted under the Plan have been effectively registered
under the Securities Act, or the Participant shall have made such written representations to the Company (upon which the Company
believes it may reasonably rely) as the Company may deem necessary or appropriate for purposes of confirming that the issuance of
such shares will be exempt from the registration requirements of the Securities Act and any applicable state securities laws and
otherwise in compliance with all applicable laws, rules and regulations, including but not limited to that the Participant is acquiring the
shares for his or her own account for the purpose of investment and not with a view to, or for sale in connection with, the distribution of
any such shares.

8.5   Registration.  If the Company shall deem it necessary or desirable to register under the Securities
Act or other applicable statutes any shares of Stock issued or to be issued pursuant to Awards granted under the Plan, or to qualify any
such shares of Stock for exemption from the Securities Act or other applicable statutes, then the Company shall take

                                                   16

such action at its own expense.  The Company may require from each recipient of an Award, or each holder of shares of Stock acquired pursuant to the
Plan, such information in writing for use in any registration statement, prospectus, preliminary prospectus or offering circular as is
reasonably necessary for that purpose and may require reasonable indemnity to the Company and its officers and directors from that
holder against all losses, claims, damage and liabilities arising from use of the information so furnished and caused by any untrue
statement of any material fact therein or caused by the omission to state a material fact required to be stated therein or necessary to
make the statements therein not misleading in the light of the circumstances under which they were made.  In addition, the Company
may require of any such person that he or she agree that, without the prior written consent of the Company or the managing underwriter
in any public offering of shares of Stock, he or she will not sell, make any short sale of, loan, grant any option for the purchase of,
pledge or otherwise encumber, or otherwise dispose of, any shares of Stock during the period not to exceed 180 days commencing on
the effective date of the registration statement relating to the underwritten public offering of securities. Without limiting the generality of
the foregoing provisions of this Section 8.5, if in connection with any underwritten public offering of securities of the Company the
managing underwriter of such offering requires that the Company's directors and officers enter into a lock-up agreement containing
provisions that are more restrictive than the provisions set forth in the preceding sentence, then (a) each holder of shares of Stock
acquired pursuant to the Plan (regardless of whether such person has complied or complies with the provisions of clause (b) below)
shall be bound by, and shall be deemed to have agreed to, the same lock-up terms as those to which the Company's directors and
officers are required to adhere; and (b) at the request of the Company or such managing underwriter, each such person shall execute
and deliver a lock-up agreement in form and substance equivalent to that which is required to be executed by the Company's directors
and officers.

8.6   Placement of Legends; Stop Orders; etc.  Each share of Stock to be issued pursuant to Awards
granted under the Plan may bear a reference to the investment representations made in accordance with Section 8.4 in addition
to any other applicable restrictions under the Plan, the terms of the Award and, if applicable, to the fact that no registration statement
has been filed with the Securities and Exchange Commission in respect to such shares of Stock.  All certificates for shares of Stock or
other securities delivered under the Plan shall be subject to such stop transfer orders and other restrictions as the Committee may
deem advisable under the rules, regulations, and other requirements of any stock exchange upon which the Stock is then listed, and
any applicable federal or state securities law, and the Committee may cause a legend or legends to be put on any such certificates to
make appropriate reference to such restrictions.

8.7   Tax Withholding. Whenever shares of Stock are issued or to be issued pursuant to Awards
granted under the Plan, the Company shall have the right to require the recipient to remit to the Company an amount sufficient to satisfy
federal, state, local or other withholding tax requirements if, when, and to the extent required by law (whether so required to secure for
the Company an otherwise available tax deduction or otherwise) prior to the delivery of any certificate or certificates for such shares.
The obligations of the Company under the Plan shall be conditional on satisfaction of all such withholding obligations and the Company
shall, to the extent permitted by law, have the right to deduct any such taxes from any payment of any kind otherwise due to the
recipient of an Award.  However, in such cases Participants may elect, subject to the approval of the Committee, acting in its sole discretion,

                                                   17

to satisfy an applicable withholding requirement, in whole or in part, by having the Company withhold shares to satisfy their
tax obligations.  Participants may only elect to have shares withheld having a Market Value on the date the tax is to be determined
equal to the minimum statutory total tax which could be imposed on the transaction.  All elections shall be irrevocable, made in writing,
signed by the Participant, and shall be subject to any restrictions or limitations that the Committee deems appropriate.

8.8   Company Charter and By-Laws; Other Company Policies.  This Plan and all Awards granted
under the Plan (including the exercise, settlement or exchange of an Award) are subject to and must comply with the certificate of
incorporation and by-laws of the Company, as they may be amended from time to time, and all other Company policies duly adopted by
the Board, the Committee or any other committee of the Board as in effect from time to time regarding the acquisition, ownership or
sale of Stock by employees and other service providers, including, without limitation, policies intended to limit the potential for insider
trading and to avoid or recover compensation payable or paid on the basis of inaccurate financial results or statements, employee
conduct, and other similar events.

	Reservation of Stock
The Company shall at all times during the term of the Plan and any outstanding Awards granted hereunder
reserve or otherwise keep available such number of shares of Stock as will be sufficient to satisfy the requirements of the Plan (if then
in effect) and the Awards and shall pay all fees and expenses necessarily incurred by the Company in connection therewith.

	Limitation of Rights in Stock; No Special Service Rights
A Participant shall not be deemed for any purpose to be a stockholder of the Company with respect to any
of the shares of Stock subject to an Award, unless and until a certificate shall have been issued therefor and delivered to the Participant
or his agent, or if uncertificated shares are to be issued, until such shares have been registered in the name of the Participant on the
books of the transfer agent and registrar of the Stock.  Any Stock to be issued pursuant to Awards granted under the Plan shall be
subject to all restrictions upon the transfer thereof which may be now or hereafter imposed by the certificate of incorporation and the
bylaws of the Company.  Nothing contained in the Plan or in any Award Agreement shall confer upon any recipient of an Award any
right with respect to the continuation of his or her employment or other association with the Company (or any Affiliate), or interfere in
any way with the right of the Company (or any Affiliate), subject to the terms of any separate employment or consulting agreement or
provision of law or certificate of incorporation or by laws to the contrary, at any time to terminate such employment or consulting
agreement or to increase or decrease, or otherwise adjust, the other terms and conditions of the recipient's employment or other
association with the Company and its Affiliates.

	Unfunded Status of Plan
The Plan is intended to constitute an "unfunded" plan for incentive compensation, and the Plan
is not intended to constitute a plan subject to the provisions of the Employee Retirement Income Security Act of 1974, as amended.
With respect to any payments not yet made to a Participant by the Company, nothing contained herein shall give any such

                                                   18

Participant any rights that are greater than those of a general creditor of the Company.  In its sole discretion, the Committee may authorize the
creation of trusts or other arrangements to meet the obligations created under the Plan to deliver Stock or payments with respect to
Options, Stock Appreciation Rights and other Awards hereunder, provided, however, that the existence of such trusts or other
arrangements is consistent with the unfunded status of the Plan.

	Nonexclusivity of the Plan
Neither the adoption of the Plan by the Board nor any action taken in connection with the adoption or
operation of the Plan shall be construed as creating any limitations on the power of the Board to adopt such other incentive
arrangements as it may deem desirable, including without limitation, the granting of stock options and restricted stock other than under
the Plan, and such arrangements may be either applicable generally or only in specific cases.

	Termination and Amendment of the Plan
The Independent Board may at any time terminate the Plan or make such modifications of the Plan as it
shall deem advisable.  Unless the Independent Board otherwise expressly provides, no amendment of the Plan shall affect the terms of
any Award outstanding on the date of such amendment.  In any case, no termination or amendment of the Plan may, without the
consent of any recipient of an Award granted hereunder, adversely affect the rights of the recipient under such Award.

The Committee may amend the terms of any Award theretofore granted, prospectively or retroactively, provided
that the Award as amended is consistent with the terms of the Plan, but no such amendment shall impair the rights of the recipient of
such Award without his or her consent.

	Notices and Other Communications
Any notice, demand, request or other communication hereunder to any party shall be deemed to be
sufficient if contained in a written instrument delivered in person or duly sent by first class registered, certified or overnight mail, postage
prepaid, or telecopied with a confirmation copy by regular, certified or overnight mail, addressed or telecopied, as the case may be, (i) if
to the recipient of an Award, at his or her residence address last filed with the Company and (ii) if to the Company, at its principal place
of business, addressed to the attention of its Chief Financial Officer, or to such other address or telecopier number, as the case may be,
as the addressee may have designated by notice to the addressor.  All such notices, requests, demands and other communications
shall be deemed to have been received: (i) in the case of personal delivery, on the date of such delivery; (ii) in the case of mailing,
when received by the addressee; and (iii) in the case of facsimile transmission, when confirmed by facsimile machine report.

	No Guarantee of Tax Consequences
Neither the Company nor any Affiliate, nor any director, officer, agent, representative or employee of either,
guarantees to the Participant or any other person any particular tax

                                                   19

consequences as a result of the grant of, exercise of rights under,
or payment in respect of an Award, including, but not limited to, that the provisions and penalties of Section 409A of the Code,
pertaining to non-qualified plans of deferred compensation, will or will not apply.

	Administrative Provisions
Nothing contained in the Plan shall require the issuance or delivery of certificates for any period during
which the Company has elected to maintain or caused to be maintained the evidence of ownership of its shares of Stock, either
generally or in the case of Stock acquired pursuant to Awards, by book entry, and all references herein to such actions or to certificates
shall be interpreted accordingly in light of the systems maintained for that purpose.  Furthermore, any reference herein to actions to be
taken or notices (including of grants of Awards) to be provided in writing or pursuant to specific procedures may be satisfied by means
of and pursuant to any electronic or automated voice response systems the Company may elect to establish for such purposes, either
by itself or through the services of a third party, for the period such systems are in effect.

	Governing Law

It is intended that all Awards shall be granted and maintained on a basis which ensures they are exempt
from, or otherwise compliant with, the requirements of Section 409A of the Code and the Plan shall be governed, interpreted and
enforced consistent with such intent.  Neither the Committee nor the Company, nor any of its Affiliates or its or their officers, employees,
agents, or representatives, shall have any liability or responsibility for any adverse federal, state or local tax consequences and penalty
taxes which may result the grant or settlement of any Award on a basis contrary to the provisions of Section 409A of the Code or
comparable provisions of any applicable state or local income tax laws.  The Plan and all Award Agreements and actions taken
thereunder otherwise shall be governed, interpreted and enforced in accordance with the laws of the state of California, without regard
to the conflict of laws principles thereof.

 

                                                     20exv4wa

EXHIBIT
(4)(a)

The United States Life Insurance Company in the City of New York

A STOCK COMPANY            NEW YORK, NEW YORK

CONTRACT NUMBER       [P9999999999]

OWNER                               [JOHN DOE]

THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (“We”, “Us”, the “Company”,
or “US Life”) agrees to provide benefits to the Owner in accordance with the provisions set forth
in this Contract and in consideration of the Application and Purchase Payments We receive.

The value of amounts allocated to the Separate Account during the accumulation and annuity periods is not guaranteed, and will increase or decrease in value based upon the investment experience of
the Variable Portfolios You choose.

The Separate Account Charge is charged against the assets of the Separate Account. This charge includes fees for mortality and expense risk and the distribution expense. On an annualized basis
the charge equals 1.25%. These charges are assessed, on a simple interest basis, as a percentage
of the average daily ending value of the assets attributable to the Accumulation Units of the
Variable Portfolios to which your Contract Value is allocated. The daily charge is
1/365th of the annualized charge. Thus, the smallest annual effective rate of the
investment return that would have to be earned on assets of the Separate Account so that the dollar
amount of variable annuity payments will not decrease is 4.80%, compounded daily. The Contract’s
assumed rate of return is based on compound interest.

The Fixed Account Options, Dollar Cost Averaging (DCA) Fixed Account Option(s) or one or more fixed account Guarantee Periods may not be available on the Contract Date. Please check with Your
registered representative for availability of these options as well as the Contract Data Page,
which lists available options.

This Contract may include one or more endorsement(s) or rider(s) as part of the Entire Contract containing definitions and additional terms affecting how this Contract may work. You should
carefully read the Entire Contract.

RIGHT TO EXAMINE — If, within 10 days of receipt of this Contract (60 days if the Contract replaced any other life insurance or annuity contract(s)) You are not satisfied with it, You may return this
Contract to Our Annuity Service Center or to the agent through whom the Contract was purchased.
The Company will refund the Purchase Payment or the Contract Value, whichever is greater, computed
as of the business day during which we receive the Contract. Upon such refund, the Contract shall
be void.

For Individual Retirement Annuities, or if a refund of the Purchase Payment(s) is required, We
reserve the right to allocate Your Purchase Payment(s) to the Cash Management Portfolio until the
end of the Right To Examine period.

With 30 days advance notice, we may cease offering Fixed Account Guarantee Period Options and/or
Dollar Cost Averaging Fixed Account Options if market conditions are such that we are not able to
credit the Minimum Guarantee Rate shown on the Contract Data Page.

Signed at the Home Office on the Contract Date.

THIS IS A LEGAL DOCUMENT. READ IT CAREFULLY.

For Inquiries Call: [1-800-445-7862]

[www.aig.com/annuities]

FLEXIBLE PAYMENT FIXED AND VARIABLE DEFERRED ANNUITY CONTRACT

Nonparticipating

	 	 	 

	US-802 (5/14)

	1	 

 

 

TABLE OF CONTENTS

	 	 	 	 	 

	Contract Data Page
	 	Page 3-4
	 
	 	 	 	 
	Definitions
	 	Page 5
	 
	 	 	 	 
	Purchase Payment Provisions
	 	Page 8
	 
	 	 	 	 
	Accumulation Provisions
	 	Page 9
	 
	 	 	 	 
	Charges and Deductions
	 	Page 10
	 
	 	 	 	 
	Transfer Provisions
	 	Page 11
	 
	 	 	 	 
	Withdrawal Provisions
	 	Page 11
	 
	 	 	 	 
	Death Benefit Provisions
	 	Page 13
	 
	 	 	 	 
	Annuity Provisions
	 	Page 14
	 
	 	 	 	 
	General Provisions
	 	Page 16
	 
	 	 	 	 
	Annuity Income Payment Options
	 	Page 19
	 
	 	 	 	 
	Fixed Annuity Income Payment Options Table
	 	Page 20
	 
	 	 	 	 
	Variable Annuity Income Payment Options Table
	 	Page 23

	 	 	 

	US-802 (5/14)

	2	 

 

 

CONTRACT DATA PAGE

Contract Number: [P9999999999]                   Contract Date: [May 2, 2011]

	 	 	 	 	 

	Owner: [JOHN DOE]

	 	Date of Birth: [March 1, 1976]
	 	Age at Issue: [35]
	 
	 	 	 	 
	[Owner: [JANE DOE]

	 	Date of Birth: [June 10, 1976]
	 	Age at Issue: [34]]
	 
	 	 	 	 
	Annuitant: [JOHN DOE]

	 	Date of Birth: [March 1, 1976]
	 	Age at Issue: [35]
	 
	 	 	 	 
	[Annuitant: [JANE DOE]

	 	Date of Birth: [June 10, 1976]
	 	Age at Issue: [34]]

Beneficiary: As named by You

Initial Purchase Payment: [$25,000.00]

Maximum Purchase Payment Without Our Approval: $1,000,000

Purchase Payment Age Limit: Prior to the 86th birthday

Minimum Subsequent Purchase Payment: $500

Fixed
Account Options – Minimum Guarantee Rate:
[1.0%]

With 30 days advance notice, we may cease offering the Fixed
Account Options, Fixed Account
Guarantee Period Options and/or Dollar Cost Averaging Fixed Account
Options if market conditions
are such that we are not able to credit the Minimum Guarantee Rate Shown on this page.

Fixed Account Options: [1 Year Fixed, 6 Month DCA Fixed, 1 Year DCA Fixed]

Minimum Partial Withdrawal Amount: $1,000

Maximum Penalty-Free Withdrawal Percentage: 10%

Minimum Systematic Withdrawal Amount: $100

Minimum Amount Remaining After a Partial Withdrawal: $2,500

Withdrawal Charge Schedule:

	 	 	 	 	 	 
	 
	 	Number of Full Years Elapsed	 	 	Withdrawal Charge as a	 
	 	Between Purchase Payment Contribution	 	 	Percentage of Withdrawn	 
	 	And Date of Withdrawal	 	 	Purchase Payment	 
	 	0
	 	 	7%	 
	 	1
	 	 	7%	 
	 	2
	 	 	6%	 
	 	3
	 	 	6%	 
	 	4
	 	 	5%	 
	 	5
	 	 	0%	 
	 

See Page [11] for Withdrawal Provisions.

	 	 	 

	US-802 (5/14)

	3	 

 

 

CONTRACT DATA PAGE (Cont’d.)

Minimum Transfer Amount: $100

Separate Account Charge (including guaranteed death benefit risk charge of 0.10%): 1.10%

Annual Contract Maintenance Fee: $50

Transfer Fee: $25

Earliest Annuity Date After the Contract Date: Two years

Latest Annuity Date: 1st day of the month following Your 95th Birthday

Separate Account: FS VARIABLE SEPARATE ACCOUNT

	 	 	 

	US-802 (5/14)

	4	 

 

 

DEFINITIONS

Defined in this section are some of the words and phrases used in this Contract. These terms are
capitalized when used in the Contract with the meaning set forth below.

ACCUMULATION UNIT

An Accumulation Unit is a unit of measure used to compute the Contract Value in a Variable
Portfolio before the Annuity Date.

AGE

The Age of a person is the attained age as a person’s last birthday. Unless otherwise defined in
an endorsement or rider to this Contract, in the case of Joint Owners/Annuitants, the age of the
older person will be used to determine any age-driven benefit.

ANNUITANT

The Annuitant is the natural person(s) (collectively, “Joint Annuitants”) whose life/lives are used
to determine the Annuity Income Payments under the Contract. If the Contract is in force and the
Annuitant is alive on the date Annuity Income Payments begin, We will begin Annuity Income Payments
to the Payee. This Contract cannot have Joint Annuitants if it is issued in connection with a
tax-qualified retirement plan.

ANNUITIZATION

Annuitization is a series of periodic Annuity Income Payments. If you select Variable
Annuitization, these periodic Annuity Income Payments vary in amount according to investment
experience of one or more Variable Portfolios, as selected by You and such payments are made from
the Company’s Separate Account. If You select Fixed Annuitization, these periodic Annuity Income
Payments do not vary with investment experience and such payments are made from the Company’s
general asset account.

ANNUITY DATE

The Annuity Date is the date on which Annuity Income Payments to the Payee begin. This date cannot
be later than the Latest Annuity Date.

ANNUITY SERVICE CENTER

The Annuity Service Center is the address shown on Page 1 of this Contract where all Purchase
Payments and requests regarding this Contract are to be sent.

ANNUITY UNIT

An Annuity Unit is a unit of measure determined on or after the Annuity Date and is used to compute
Annuity Income Payments from the Variable Portfolio(s) if Variable Annuitization is selected.

BENEFICIARY

The Beneficiary is selected by You in Writing and will receive the Death Benefit under this
Contract upon Your death.

BUSINESS DAY

Business Day is any day that We are open and the New York Stock Exchange (“NYSE”) is open for
trading and generally ends at 4:00 p.m. Eastern Time. The Business Day is the day in which all
financial transactions and requests are deemed to occur when received by Us.

CONTINUATION DATE

The Continuation Date is the date on which We receive, at Our Annuity Service Center: (a) the
Spousal Beneficiary’s Written request to continue the Contract in a form satisfactory to Us; and
(b) Due Proof of 

	 	 	 

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Death of the Owner. If We receive (a) and (b) on different dates, the
Continuation Date will be the later date.

CONTRACT ANNIVERSARY

The date that occurs on the same month and date as the Contract Date for each Contract Year. The
first Contract Anniversary is one (1) year after the Contract Date on the same month and date of
the following Contract Year.

CONTRACT DATE

The Contract Date is the date Your Contract is issued, as shown on the Contract Data Page. It is
the date from which Contract Years and Contract Anniversaries are measured.

CONTRACT VALUE

The Contract Value is the sum of: (1) Your share of the Variable Portfolios’ Accumulation Unit
Values; and (2) the value of amounts if any, allocated to any available Fixed Account Option(s).

CONTRACT YEAR

The one (1) year period starting from the Contract Date in one (1) calendar year and ending on the
date preceding the Contract Anniversary in the following calendar year, and every year thereafter.

DOLLAR COST AVERAGING (DCA)

Dollar Cost Averaging is an optional program under which You authorize the systematic transfer of
specified amounts or percentages from any Variable Portfolio(s) or any available Fixed Account
Option into any Variable Portfolio(s) other than the source account.

FIXED ACCOUNT OPTION(S)

The Fixed Account Option(s) are investment options, if available under this Contract, that become
part of the Company’s general asset account and are credited with a fixed rate of interest declared
by the Company. The general asset account contains all the assets of the Company except for the
Separate Account and other segregated asset accounts. The amount You have in any Fixed Account
Option at a given time is a result of Purchase Payment(s) You have allocated to it or any part of
Your Contract Value You have transferred to it.

GUARANTEE PERIOD

The Guarantee Period is the period for which a set rate of interest is credited to amounts
allocated to any available Fixed Account Option(s). We determine in Our sole discretion the
periods, if any, that will be offered.

IRC

IRC refers to the Internal Revenue Code of 1986, as amended, or as it may be amended or superseded.

JOINT OWNER

A Joint Owner is any person named as Joint Owner on the Application for a non-qualified contract
and listed on the Contract Data Page, unless subsequently changed. The Joint Owner, if any,
possesses an undivided interest in this Contract in conjunction with the Owner. All references
within this Contract to Owner will also apply to the Joint Owner.

LATEST ANNUITY DATE

The Latest Annuity Date is the first day of the month following the 95th Birthday of the
Owner, shown on the Contract Data Page. If the Contract is owned by Joint Owners, the Latest
Annuity Date is based on the older Owner’s date of birth. If the Owner is a non-natural person,
the Latest Annuity Date is the first day of the month following the 95th Birthday of the
Annuitant. If the Contract is owned by a non-natural person and has 

	 	 	 

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Joint Annuitants, the Latest
Annuity Date is based on the older Annuitant’s date of birth. The Latest Annuity Date is the date
upon which Annuity Income Payments must begin or the Contract must be surrendered.

OWNER

The Owner is the natural person or entity named in the Contract who is entitled to exercise all
rights and privileges of ownership under the Contract. Owner means both Joint Owners, if
applicable. If there are Joint Owners, the authorizations of both Joint Owners are required In
Writing for all Contract changes and the exercise of any other rights of ownership.

PAYEE

The person receiving Annuity Income Payments under this Contract.

PURCHASE PAYMENTS

Purchase Payment(s) are payment(s) in U.S. currency made by or on behalf of the Owner to the
Company to purchase the Contract.

REQUIRED DOCUMENTATION

Required Documentation must be received by Us at Our Annuity Service Center and is: (a) Due Proof
of Death of the Owner before the Annuity Date; (b) an election form specifying the Annuity Income
Payment options; and (c) any other documentation We may require.

SEPARATE ACCOUNT

The Separate Account is a segregated asset account named on the Contract Data Page. The Separate
Account consists of Variable Portfolios, each investing in shares of the Underlying Fund(s). The
assets of the Separate Account are not commingled with the general assets and liabilities of the
Company. Income, gains and losses, whether or not realized, from assets allocated to the Separate
Accounts shall be credited to or charged against the applicable Separate Account without regard to
other income, gains, or losses of the Company. We will maintain Separate Account assets with a
value at least equal to the amounts accumulated in accordance with the applicable agreements with
respect to this Separate Account, and also the reserves for variable annuities in the course of
payment. The portion of the assets of the Separate Account not exceeding the reserves and other
contract liabilities shall not be chargeable with liabilities arising out of any other business of
Ours. The value of amounts allocated to the Variable Portfolios of the Separate Account is not
guaranteed.

SPOUSAL BENEFICIARY

The Spousal Beneficiary is the surviving spouse of the original deceased Owner. The Spousal
Beneficiary is designated as the primary Beneficiary at the time of the Owner’s death and may
continue the Contract as the Owner on the Continuation Date.

SUBSEQUENT PURCHASE PAYMENTS

Subsequent Purchase Payments are Purchase Payments made after the initial Purchase Payment.

UNDERLYING FUND

The Underlying Fund is the underlying investment portfolios in which the Variable Portfolio(s)
invest.

VARIABLE PORTFOLIO

A Variable Portfolio is one or more divisions of the Separate Account which provides for the
variable investment options available under this Contract. Each Variable Portfolio has its own
investment objective and is invested in the Underlying Fund(s). A Variable Portfolio is not
chargeable with liabilities arising out of any other Variable Portfolio.

	 	 	 

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WE, OUR, US, THE COMPANY

We, Our, Us, The Company refers to The United States Life Insurance Company in the City of New
York.

WITHDRAWAL(S)

Withdrawals are any amount(s) withdrawn by the Owner from the Contract Value, including any charges
that include but are not limited to Withdrawal Charges, applicable to each such Withdrawal.

WRITTEN, IN WRITING

Written or In Writing refers to a written request or notice in acceptable form and content to Us,
which is signed and dated and is received at Our Annuity Service Center.

YOU, YOUR

You, Your refers to the Owner.

PURCHASE PAYMENT PROVISIONS

PURCHASE PAYMENTS

Purchase Payments are flexible. This means that, subject to Company disclosed restrictions, You
may change the amounts, frequency and/or timing of Purchase Payments. Purchase Payments can be
made at any time after the Contract Date, but must be received at Our Annuity Service Center before
the Purchase Payment Age Limit, as shown on the Contract Data Page. With instructions from You,
Purchase Payments will be allocated to the Variable Portfolio(s) and/or Fixed Account Option(s), if
available. We reserve the right, upon advance notice to You, to: 1) limit the maximum amount of
Purchase Payments; and 2) discontinue acceptance of any subsequent Purchase Payment(s).

DOLLAR COST AVERAGING (DCA) FIXED ACCOUNT OPTION(S)

Any portion of a Purchase Payment allocated to the DCA Fixed Account Option(s), if available, must
be transferred to the Variable Portfolio(s) within the specified DCA Fixed Account Option period.
Upon termination of the DCA program, any amounts remaining in the DCA Fixed Account Option(s) will
be transferred to the DCA target allocation(s) for the program being terminated. We reserve the
right to impose a maximum contribution level on Purchase Payments allocated to a DCA Fixed Account
Option(s) and/or change the terms and conditions of the DCA program at any time. We reserve the
right to cease offering DCA Fixed Account Option(s). Upon annuitization, any amounts remaining in
the DCA Fixed Account Option(s) will be applied to a Fixed Annuitization. The unit values credited
and applied to Your Contract are determined on each date of transfer. The minimum contribution
amount that may be allocated to the DCA Fixed Account Option(s) is $600 for the 6 month DCA and
$1,200 for the 1 year DCA.

CHANGES TO VARIABLE PORTFOLIO OFFERINGS

If the shares of an Underlying Fund should no longer be available for investment by the Separate
Account, then We may substitute shares of another Underlying Fund, for shares already purchased, or
to be purchased in the future. At any given time, some Variable Portfolios may not be available
for receipt of Purchase Payment(s) or transfer(s). Substitutions may be necessary and will be
carried out in accordance with any applicable state and/or federal laws or regulations.

MINIMUM CONTRACT VALUE

If Your Contract Value falls below the Minimum Amount Remaining After Any Partial Withdrawal, as
shown on the Contract Data Page, as a result of taking partial Withdrawals, subject to applicable
state and federal laws, rules and regulations, We may treat Your partial Withdrawal request as a
request for a total Withdrawal and terminate Your Contract.

	 	 	 

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ACCUMULATION PROVISIONS

Your Contract provides for an accumulation phase and an income phase. During the accumulation
phase, Your Purchase Payment(s) received prior to the annuity date are allocated among any
available Fixed Account Option(s) and/or one or more of the Variable Portfolio(s) in Your Contract.
During the income phase, payments under an Annuity Payment Option selected by You are made to You
or Your designated Payee.

SEPARATE ACCOUNT ACCUMULATION VALUE

The Separate Account Accumulation Value under the Contract is the sum of the Accumulation Unit
Values held in the Variable Portfolios for You. The Company does not hold itself out to be a
trustee of the Separate Account.

NUMBER OF ACCUMULATION UNITS

Your Contract is credited with Accumulation Units of the Separate Account when amounts are
allocated to the Variable Portfolio(s). For that portion of each Purchase Payment and/or transfer
amount allocated to a Variable Portfolio, the number of Accumulation Units credited is equal to:

The sum of each Purchase Payment and/or transfer amount allocated to the Variable Portfolio
reduced by any applicable premium taxes:

Divided by

The Accumulation Unit Value for that Variable Portfolio for the Business Day in which the
Purchase Payment or transfer amount is allocated to the Variable Portfolio.

The number of Accumulation Units will be reduced for Withdrawals, Annuitizations, amounts
transferred out of a Variable Portfolio, the Contract Maintenance Fee, if applicable, and
applicable charges for any elected features as set forth in endorsements or riders to this
Contract. Any reduction to the Contract Value will be made as of the Business Day in which We
receive all requirements In Writing for the transaction, as appropriate.

ACCUMULATION UNIT VALUE (AUV)

The AUV of a Variable Portfolio for Business Day is determined as follows:

	 	1.	 	We calculate the Net Investment Rate by dividing (a) by (b) minus (c) where:

	 	(a)	 	is the Variable Portfolio’s income and capital gains and losses (whether
realized or unrealized) on the current Business Day;
	 
	 	(b)	 	is the value of the Variable Portfolio for the immediately preceding Business;
and
	 
	 	(c)	 	is the daily Separate Account charge.

	 	2.	 	We calculate the AUV by multiplying (d) by [1+(e)] where:

	 	(d)	 	is the AUV of the immediately preceding Business Day; and
	 
	 	(e)	 	is the Net Investment Rate of the current Business Day.

FIXED ACCOUNT ACCUMULATION VALUE

The Fixed Account Accumulation Value, if any, is the sum of all amounts allocated or transferred to
the Fixed Account Option(s), if available, reduced by any applicable premium taxes, plus all
interest credited to the Fixed Account Option(s) during the period that You have Contract Value
allocated to the Fixed Account

	 	 	 

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Option(s). This amount will be adjusted for Withdrawals,
Annuitizations, transfers, the Contract Maintenance Fee, if applicable and allowed by Your state,
and applicable charges for any elected features as set forth in endorsements/riders to this
Contract. The Fixed Account Accumulation Value will not be less than the minimum values required
by law in the state where this Contract is issued.

FIXED ACCOUNT GUARANTEE PERIOD OPTIONS AND INTEREST CREDITING

The portion of Your Contract Value within the Fixed Account Option(s), if any, is credited with
interest at rates guaranteed by Us for the Guarantee Period(s) selected. Interest is credited on a
daily basis at the then applicable effective interest rate for the applicable Guarantee Period.
You may select from one or more Guarantee Periods which We may offer at any particular time. We
reserve the right at any time to add or discontinue Guarantee Periods. A written notification will
be provided to the Owner at least 30 days prior to the discontinuation of a Guarantee Period. If
You have allocated any part of Your initial Purchase Payment to a Guarantee Period, the percentage
allocated, as well as the duration of the Guarantee Period, is shown on the Application or
administrative election form as completed by You.

The interest rate applicable to the allocation of a Purchase Payment or transfer of Contract Value
to a Fixed Account Option is the rate in effect for the applicable Guarantee Period at the time of
the allocation or transfer. If You have allocated or transferred amounts at different times to any
available Fixed Account Option(s), each allocation or transfer may have a unique effective interest
rate associated with that amount. We guarantee that the effective annual rate of interest for any
available Fixed Account Option(s), including any of the available Guaranteed Periods, will not be
less than the Minimum Guarantee Rate as mandated by Your state, and shown on the Contract Data
Page.

CHARGES AND DEDUCTIONS

We will deduct the following charges from the Contract:

CONTRACT MAINTENANCE FEE

The charge, as shown on the Contract Data Page, if applicable, will be deducted on each Contract
Anniversary on or prior to the Annuity Date. It will also be deducted when the Contract Value is
withdrawn in full if the Withdrawal is not on the Contract Anniversary. We reserve the right to
waive the fee for Contract Values of $75,000.00 and up.

WITHDRAWAL CHARGE

The charge, as shown on the Contract Data Page, if any, may be deducted upon Withdrawal of any
portion of the Contract Value that is not considered a Penalty-Free Withdrawal. See WITHDRAWAL
PROVISIONS below.

SEPARATE ACCOUNT CHARGE

This charge, as shown on the Contract Data Page, on an annualized basis equals a percentage of the
average daily ending value of the assets attributable to the Accumulation Units of the Variable
Portfolio(s) to which all or part of the Contract Value is allocated. This charge compensates Us
for the mortality and expense risk and the costs of contract distribution assumed by Us. We
subtract this charge daily from the Separate Account.

TRANSFER FEE

We permit 15 free transfers between Variable Portfolios and/or available Fixed Account Option(s)
each Contract Year. We may charge You a fee, as shown on the Contract Data Page, for each
additional transfer in that Contract Year, except for transfers made as part of an automated
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TRANSFER PROVISIONS

Subject to applicable restrictions, You may transfer all or part of Your Contract Value amongst the
Variable Portfolios and/or available Fixed Account Option(s) (unless otherwise noted). The minimum
amount that can be transferred is subject to the Minimum Transfer Amount, as shown on the Contract
Data page. The amount that can remain in a Variable Portfolio and/or available Fixed Account
Option is subject to Company limits. We reserve the right to restrict Your transfer privileges.

Due to the risks that frequent transfers impose upon Owners and other investors in Variable
Portfolio(s) and/or Underlying Funds, We or the manager of an Underlying Fund may limit transfer
and impose other requirements to minimize these risks, including but not limited to, requiring a
minimum amount that can be transferred, and an amount that can remain in a Variable Portfolio
and/or available Fixed Account Option after a transfer.

TRANSFERS BEFORE THE ANNUITY DATE

Before the Annuity Date, transfers are subject to certain restrictions as indicated above and on
the Contract Data Page. You may transfer all or a portion of Your Contract Value from one Variable
Portfolio to another Variable Portfolio(s) or any available Fixed Account Option(s) other than the
DCA Fixed Account Option(s). You may also transfer all or a portion of Your Contract Value from
any available Fixed Account Option(s) to the Variable Portfolio(s) and/or any available Fixed
Account Option(s) other than the DCA Fixed Account Option(s) of the Contract. A transfer to a
Variable Portfolio will result in the redemption of Accumulation Units in a Variable Portfolio and
the purchase of Accumulation Units in the other Variable Portfolio. Transfers will be effective at
the end of the Business Day on which We receive Your completed Written transfer request.

Unless You instruct Us to make a transfer, Your allocation to any available Fixed Account Option(s)
and Variable Portfolio(s) will remain unchanged, subject to the terms of the Contract. We reserve
the right to terminate Your ability to transfer to any discontinued Fixed Account Option(s) and/or
Variable Portfolio(s). A written notification will be provided to You at Your last known address
prior to any such termination of Your ability to transfer.

TRANSFERS AFTER THE ANNUITY DATE

On and after the Annuity Date, transfers into and out of any available Fixed Account Option(s) are
not allowed. You may transfer all or a portion of Your Annuity Units from one Variable Portfolio
to another Variable Portfolio(s). A transfer will result in the redemption of Annuity Units in a
Variable Portfolio and the purchase of Annuity Units in the other Variable Portfolio. Transfers
will be effective on the last Business Day of the month on which We receive Your Written request
for the transfer.

WITHDRAWAL PROVISIONS

On or before the Annuity Date and while You are living, You may withdraw all (“total Withdrawal”)
or part of Your Contract Value under this Contract by informing Us In Writing. The Minimum Partial
Withdrawal Amount is shown on the Contract Data Page.

Unless You tell Us otherwise in writing, Withdrawals will be deducted from the Contract Value in
proportion to their allocation among any available Fixed Account Option(s) and the Variable
Portfolio(s). Withdrawals will be based on values for the Business Day on which the Written
request for Withdrawal is received by Us. Payment of the total Withdrawal will terminate this
Contract and We will have no further 

	 	 	 

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obligations under the Contract. Unless the SUSPENSION OF
PAYMENTS or DEFERMENT OF PAYMENTS provisions are in effect, payment of Withdrawals will be made
within seven calendar days.

WITHDRAWAL CHARGE

Withdrawals of all or a portion of the Contract Value may be subject to a Withdrawal Charge, as
shown on the Contract Data Page. The Withdrawal Charge percentage applied to any Withdrawal will
depend on how long the Purchase Payment to which the Withdrawal is attributed has been in the
Contract. No Withdrawal Charge is deducted on an amount which is considered a Penalty-Free
Withdrawal or a Purchase Payment no longer subject to a Withdrawal Charge.

For the purpose of determining the Withdrawal Charge applicable to a partial Withdrawal, the
Withdrawal will be attributed to amounts in the following order: (1) any remaining Penalty-Free
Withdrawal amount (except in the case of a total Withdrawal); (2) Purchase Payments not yet
withdrawn and no longer subject to Withdrawal Charges; (3) Purchase Payments not yet withdrawn and
still subject to Withdrawal Charges; and (4) any remaining Contract Value. A Purchase Payment, or
portion thereof, is considered withdrawn when the Withdrawal incurs a Withdrawal Charge, and is
assumed to be withdrawn on a first-in-first-out (FIFO) basis. The Withdrawal Charge will be
assessed against the Variable Portfolio(s) and the available Fixed Account Option(s) in the same
proportion that the remaining Contract Value is allocated unless You request that the Withdrawal
come from a particular Variable Portfolio or available Fixed Account Option.

PENALTY-FREE WITHDRAWALS

On any day in a Contract Year before the Annuity Date, You may make a partial Withdrawal of up to
the Penalty-Free Withdrawal amount as of that day without incurring a Withdrawal Charge. The
Maximum Penalty-Free Withdrawal Percentage is shown on the Contract Data Page.

Each Contract Year, the Penalty-Free Withdrawal amount is calculated as the Maximum Penalty-Free
Withdrawal Percentage multiplied by the remaining Purchase Payments not yet withdrawn and still
subject to Withdrawal Charges.

Although amounts withdrawn as Penalty-Free Withdrawals reduce the Contract Value, they do not
reduce the remaining Purchase Payments for purposes of calculating future Penalty-Free Withdrawal
amounts and Withdrawal Charges. Partial Withdrawals in a Contract Year that are in excess of the
Penalty-Free Withdrawal amount incur a Withdrawal Charge applicable to the remaining Purchase
Payments and reduce those Purchase Payments on a first-in-first-out (FIFO) basis.

If You choose to take less than the Penalty-Free Withdrawal amount during a Contract Year, You may
not carry over the unused Penalty-Free Withdrawal amount in any subsequent Contract Years. If Your
Contract Value is subject to Withdrawal Charges, a Penalty-Free Withdrawal is not available to You
if You take a full Withdrawal.

SYSTEMATIC WITHDRAWAL PROGRAM

Prior to the Annuity Date, You may elect to participate in a Systematic Withdrawal Program by
informing Us at Our Annuity Service Center. The Systematic Withdrawal Program allows You to make
automatic Withdrawals from Your Contract monthly, quarterly, semiannually or annually. The Minimum
Systematic Withdrawal Amount is shown on the Contract Data Page. Any amount withdrawn through the
Systematic Withdrawal Program may be subject to a Withdrawal Charge as discussed in the WITHDRAWAL
CHARGE and PENALTY-FREE WITHDRAWALS provisions. You may terminate Your participation in the
Systematic Withdrawal Program at any time by sending Us a Written request.

	 	 	 

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DEATH BENEFIT PROVISIONS

Notwithstanding any provision of this Contract to the contrary, all payments of benefits under this
Contract will be made in a manner that satisfies the requirements of IRC Section 72(s), as amended
from time to time. If the Contract is owned by a trust or other non-natural person, We will treat
the death of any Annuitant as the death of the “Primary Annuitant” and as the death of any Owner.

DUE PROOF OF DEATH

Due Proof of Death means any Written proof, which may include but is not limited to:

	 	1.	 	a certified copy of a death certificate; or
	 
	 	2.	 	a certified copy of a decree of a court of competent jurisdiction as to the
finding of death; or
	 
	 	3.	 	a written statement by a medical doctor who attended the deceased Owner at the
time of death.

DEATH OF OWNER BEFORE THE ANNUITY DATE

Upon Your death, We will pay a Death Benefit to the Beneficiary upon Our receiving all Required
Documentation. Unless You have previously designated a payment option on behalf of the Beneficiary,
the Beneficiary must select one of the following options:

	 	1.	 	Immediately collect the Death Benefit in a lump sum payment. If a lump
sum payment is elected, payment will be in accordance with any applicable laws and
regulations governing payments on death; or

	 
	 	2.	 	Collect the Death Benefit in the form of one of the Annuity Income
Payment Options. If an Annuity Income Payment Option is desired, an option must be
elected within 60 days of Our receipt of all Required Documentation. The Annuity
Income Payments must be over the life of the Beneficiary or over a period not
extending beyond the life expectancy of the Beneficiary. Consistent with applicable
tax rules, payments under this option generally must begin within one year after the
Owner’s death, otherwise, the Death Benefit will be paid in accordance with option 1
above; or

	 
	 	3.	 	If eligible and You are the Spousal Beneficiary, You may continue the
Contract (“Continuing Spouse”). If this option is elected, no Death Benefit is paid
out to the Continuing Spouse on the Continuation Date; or

	 
	 	4.	 	A payment option that is mutually
agreeable between You and Us.

The entire interest in the Contract will be distributed within the five year period specified under
applicable laws and regulations, commencing with the date of death of the Owner unless option 2 or
3 was selected under DEATH OF OWNER BEFORE THE ANNUITY DATE.

Upon the Continuing Spouse’s death, the entire interest of the Contract must be distributed
immediately under option 1, 2 or 4 as provided under DEATH OF OWNER BEFORE THE ANNUITY DATE.

AMOUNT OF DEATH BENEFIT

The amount of the Death Benefit is the Contract Value on the Business Day during which We receive
all Required Documentation.

SPOUSAL BENEFICIARY CONTINUATION

If the Spousal Beneficiary continues the Contract on the Continuation Date (“Continuing Spouse”),
the amount continued is the Death Benefit, which is the Contract Value on the Business Day during
which We receive all Required Documentation.

	 	 	 

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DEATH OF OWNER OR ANNUITANT ON OR AFTER THE ANNUITY DATE

If any Owner or Annuitant dies on or after the Annuity Date and before the entire interest in the
Contract has been distributed, We will continue to make payments of any remaining portion of the
Annuity Income Payment(s) to the Beneficiary under the existing Annuity Income Payments, if a
specified term was elected, upon Our receipt of all Required Documentation. For further
information pertaining to death of the Annuitant, see ANNUITY INCOME PAYMENT OPTIONS.

BENEFICIARY

The Beneficiary is selected by the Owner. While the Owner is living and before the Annuity Date,
the Owner may change the Beneficiary by written notice. A change in Beneficiary will take effect
on the date We receive the Written notice. If two or more persons are named as Beneficiaries under
the Contract, those surviving the Owner will share equally unless otherwise specified by the Owner
and each must elect to receive their respective portions of the Death Benefit according to the
options listed under DEATH OF OWNER BEFORE THE ANNUITY DATE. Joint Owners, if applicable, shall be
each other’s primary Beneficiary. Joint Annuitants, if any, when the Owner is a non-natural
person, shall be each other’s primary Beneficiary. Any other Beneficiary designation will be
treated as a contingent Beneficiary.

If the Annuitant survives the Owner, and there are no surviving Beneficiaries, the Annuitant will
be deemed the Beneficiary. Joint Annuitants, if any, when the Owner is a trust or other non-natural
person, shall be each other’s primary Beneficiary. Any other Beneficiary designation will be
treated as a contingent Beneficiary.

If the Owner is also the Annuitant and there are no surviving Beneficiaries, upon Our receipt of
all Required Documentation, We will pay the Death Benefit to the estate of the Owner in accordance
with option 1, under DEATH OF OWNER BEFORE THE ANNUITY DATE.

ANNUITY PROVISIONS

ANNUITY DATE

You may specify an Annuity Date. You may change the Annuity Date at any time, at least thirty (30)
days prior to the Annuity Date, by Written notice. The Annuity Date must always be the first day
of the calendar month. The Earliest Annuity Date After the Contract Date is shown on the Contract
Date Page. The Annuity Date must not be beyond the Latest Annuity Date shown on the Contract Data
Page. If no Annuity Date is specified by You, the Annuity Date will be the Latest Annuity Date.

PAYMENTS TO OWNER

Unless You request otherwise, We will make Annuity Income Payments to You. If You want the Annuity
Income Payments under an Annuity Payment Option select by You to be made to some other Payee, We
will make such Annuity Income Payments subject to receipt of a Written no later than thirty (30)
days before the due date of the first Annuity Income Payment or subsequent Annuity Income Payment.

Any such request is subject to the rights of any assignee. No Annuity Income Payments available to
or being paid to the Payee while the Annuitant is alive can be transferred, commuted, anticipated
or encumbered.

BETTERMENT OF RATES

The amount of the Owner’s initial monthly payment will be at least equal to the monthly payment
produced by the application of an amount equal to the Contract Value of this Contract to purchase
any single consideration immediate annuity contract offered by the Company at the same time to the
same class of annuitants. We are not currently offering any single premium immediate annuity
contracts.

FIXED ANNUITIZATION

If a Fixed Annuitization has been elected, the proceeds payable under this Contract less any
applicable premium taxes, shall be applied to the payment of the fixed Annuity Income Payment
option elected at rates 

	 	 	 

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which are at least equal to the annuity rates based upon the applicable
tables in the Contract. Upon Annuitization, any amounts remaining in the DCA Fixed Account
Option(s), if applicable, will be applied to a Fixed Annuitization. The unit values credited and
applied to Your Contract are determined on each date of transfer.

AMOUNT OF FIXED ANNUITY INCOME PAYMENTS

The amount of each fixed Annuity Income Payment will be determined by applying the portion of the
Contract Value allocated by You for Fixed Annuitization on the Annuity Date, less any applicable
premium taxes, to the annuity factor applicable to the fixed Annuity Income Payment option chosen.
In no event will the Fixed Annuitization be changed once it begins.

AMOUNT OF VARIABLE ANNUITY INCOME PAYMENTS

	(a)	 	FIRST VARIABLE ANNUITY INCOME PAYMENT: The dollar amount of the first Variable Annuitization
payment will be determined by applying the portion of the Contract Value allocated to the
Variable Portfolio(s) on the Annuity Date, less any applicable premium taxes, to the annuity
factor applicable to the variable Annuity Income Payment option chosen. If the Contract Value
is allocated to more than one Variable Portfolio, the value of Your allocation in each
Variable Portfolio is applied separately to the variable Annuity Income Payment option factor
to determine the amount of the first Annuity Income Payment attributable to each Variable
Portfolio.

	 
	(b)	 	NUMBER OF VARIABLE ANNUITY UNITS: The number of Annuity Units for each applicable Variable
Portfolio is the amount of the first Annuity Income Payment attributable to that Variable
Portfolio divided by the value of the applicable Annuity Unit for that Variable Portfolio as
of the Annuity Date. The number of Annuity Units will not change as a result of investment
experience.

	 
	(c)	 	VALUE OF EACH VARIABLE ANNUITY UNIT: The value of an Annuity Unit may increase or decrease
from one month to the next. For any month, the value of an Annuity Unit of a particular
Variable Portfolio is the value of that Annuity Unit as of the last Business Day of the
preceding month, multiplied by the Net Investment Factor for that Variable Portfolio for the
last Business Day of the current month.

The Net Investment Factor for any Variable Portfolio for a certain month is determined by dividing
(1) by (2) and multiplying by (3) where:

	 	(1)	 	is the Accumulation Unit Value of the Variable Portfolio
determined as of the last Business Day at the end of that month,
and

	 
	 	(2)	 	is the Accumulation Unit Value of the Variable Portfolio
determined as of the last Business Day at the end of the preceding
month, and

	 
	 	(3)	 	is a monthly discount factor of an assumed annualized
investment rate of 3.50%.

	(d)	 	SUBSEQUENT VARIABLE ANNUITY INCOME PAYMENTS: After the first Variable Annuitization payment,
subsequent Variable Annuitization payments will vary in amount according to the investment
performance of the applicable Variable Portfolio(s) in which You are invested. The amount may
change from month to month. The amount of each subsequent payment for each Variable Portfolio
is (1) multiplied by (2) where:

	 	(1)	 	is the number of Annuity Units for each Variable Portfolio
as determined for the first Annuity Income Payment

	 	 	 

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	 	(2)	 	is the value of an Annuity Unit for that Variable Portfolio
determined as of the last Business Day at the end of the month immediately
preceding the month in which the Annuity Income Payment is due.

We guarantee that the amount of each Variable Annuitization payments will not be affected by
variations in expenses or mortality experience.

GENERAL PROVISIONS

ENTIRE CONTRACT

The Entire Contract between You and Us consists of this Contract, the Application for this Contract
and any attached endorsement(s) and/or rider(s). Any change must be In Writing and approved by Us.
Only Our President, Secretary, or one of Our Vice-Presidents can give Our approval. All
statements made by the applicant for the issuance of this Contract shall, in absence of fraud, be
deemed representations and not warranties.

CHANGE OF ANNUITANT

If the Owner is an individual, the Owner may change the Annuitant(s) at any time prior to the
Annuity Date, subject to Our approval. To request such a change, the Owner must send a request In
Writing at least thirty (30) days before the Annuity Date. If the Owner is a trust or non-natural
person, the Owner may not change the Annuitant. Any change of the Annuitant may have income tax
consequences.

DEATH OF ANNUITANT

If the Owner is an individual, the Owner and Annuitant are different persons, and the Annuitant
dies before the Annuity Date, the Owner becomes the Annuitant until the Owner elects a new
Annuitant. If there are Joint Annuitants, upon the death of any Annuitant prior to the Annuity
Date, the Owner may elect a new Joint Annuitant, subject to Our approval. However, if the Owner is
a trust or other non-natural person, We will treat the death of any Annuitant as the death of the
“Primary Annuitant” as defined in the IRC, and as the death of the Owner, as explained in the DEATH
PROVISIONS.

MISSTATEMENT OF AGE OR SEX

You must, upon Our request, provide proof of the Annuitant’s birth date and sex. If the Age or sex
of any Annuitant is misstated, We will adjust future Annuity Income Payments. The amount remaining
to be paid will be the amount that should have been paid with the correct information. We will
credit or charge the amount of any underpayment or overpayment against the next succeeding Annuity
Income Payment(s), if any remain. We reserve the right to collect any overpayment directly from
the Payee.

With respect to Contract issue Age and other age driven features in the Contract, should We
discover a misstatement of Age such that You would not otherwise qualify for an Age-driven benefit,
We may fully pursue Our remedies including possible revocation of any Age driven benefits. A
written notification will be provided to the Owner at least ten (10) days prior to the revocation
of the Contract.

PROOF OF AGE, SEX, OR SURVIVAL

We may require satisfactory proof of correct Age or sex at any time. If any payment under this
Contract depends on the Annuitant being alive, We may reasonably require satisfactory proof of
survival.

DEFERMENT OF PAYMENTS

We may defer making payments, subject to state requirements, from the available Fixed Account
Option(s) for up to six (6) months. Interest, subject to state requirements, will be credited
during the deferral period.

SUSPENSION OF PAYMENTS

We may suspend or postpone any payments from the Variable Portfolios if any of the following occur:

	 	 	 

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	16	 

 

 

	(a)	 	the NYSE is closed (other than customary
weekend and holiday closings);

	 
	(b)	 	trading on the NYSE is restricted;

	 
	(c)	 	an emergency exists such that it is not reasonably practical to dispose of securities in the
Variable Portfolios or to determine the value of its assets;

	 
	(d)	 	the United States Securities and Exchange Commission, by order, so permits for the protection
of Owners; or

	 
	(e)	 	We are on notice that this Contract is the subject of a court proceeding, an arbitration, a
regulatory matter or other legal action.

Conditions in (b) and (c) will be decided by or in accordance with rules of the United States
Securities and Exchange Commission.

CONFORMITY WITH STATE LAWS

The provisions of this Contract will be interpreted by the laws of the State of New York, the state
in which this Contract is delivered. Any provision which, on the Contract Date, is in conflict
with the law of such state is amended to conform to the minimum requirements of such law. The
paid-up annuity benefits, cash surrender benefits, and death benefits provided under this Contract
are not less than those required by the state where the contract was issued.

CHANGES IN LAW

If the laws governing this Contract or the taxation of benefits under the Contract change, We will
amend this Contract, subject to New York State Department of Financial Services approval, to comply
with any changes.

ASSIGNMENT / CHANGE OF OWNER

Unless restricted by federal tax law, this Contract can be assigned before the Annuity Date, but We
will not be bound by an assignment or change of Owner unless the request for assignment is In
Writing and is recorded. Your rights and those of any other person referred to in this Contract
will be subject to the assignment. Certain assignments may be taxable. We do not assume any
responsibility for the validity or tax consequences of any assignment. The assignment, unless
otherwise specified by You, will take effect on the date that You signed the notice of assignment,
subject to any payments made or actions taken by Us prior to Us receiving such assignment In
Writing. We reserve the right to not recognize assignments or change of Owner if it changes the
risk profile of the Owner of the Contract as determined in Our sole discretion.

INSURABLE INTEREST

Evidence must exist that the Owner(s), Annuitant(s) or Beneficiary(ies) will suffer a financial
loss at the death of the life that triggers the Death Benefit. Generally, We consider an interest
insurable if a familial relationship and/or economic interest exists. A familial relationship
generally includes those persons related by blood or by law. An economic interest exists when the
Owner has a lawful and substantial economic interest in having the life, health or bodily safety of
the insured life preserved.

CLAIMS OF CREDITORS

To the extent permitted by law, no right or proceeds payable under this Contract will be subject to
claims of creditors or legal process.

PREMIUM TAXES OR OTHER TAXES

We may deduct from Your Contract Value any premium tax or other taxes payable to a state or other
government entity, if applicable. Should We advance any amount so due, We are not waiving any
right to collect such amount at a later date. We will deduct any withholding taxes required by
applicable law.

	 	 	 

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WRITTEN NOTICE

Any notice We send to You will be sent to Your address shown in the Application unless You request
otherwise.

PERIODIC REPORTS

At least once during each Contract Year, We will send You a statement of the account activity of
the Contract. The statement will include all transactions which have occurred during the
accounting period shown on the statement.

INCONTESTABILITY

This Contract will be incontestable after it has been in force for a period of two years from the
Contract Date during the lifetime of any Owner who is required to provide Us with information
concerning their such Owner’s identity. Accurate statements as to any Owner’s identity are
required as a condition of issuing this Contract. The Incontestability of this Contract applies to
any statements any Owner makes, except as otherwise stated in the Misstatement of Age or Sex
Provision.

NONPARTICIPATING

This Contract does not share in Our surplus.

WAIVER

Our waiver of any of the terms and conditions under this Contract will not be deemed to constitute
waiver of the right to enforce strict compliance.

	 	 	 

	US-802 (5/14)

	18	 

 

 

ANNUITY INCOME PAYMENT OPTIONS

During the Annuitant’s life, upon Written election, the Contract Value may be applied to provide
one of the following Annuity Income Payment options or any Annuity Income Payment option that is
mutually agreeable. Prior to the Annuity Date but not before the Earliest Annuity Date After the
Contract Date shown on the Contract Data Page, You can choose one of the options described below.
If no option has been selected by the Annuity Date, You will automatically receive option 4, below,
with 120 monthly payments guaranteed; for Joint Owners, You will automatically receive Option 3,
below, with 120 monthly payments guaranteed.

OPTIONS 1 & 1v - LIFE ANNUITY, LIFETIME PAYMENTS GUARANTEED

Payments payable to a Payee during the lifetime of the Annuitant. No further annuity income
payments are payable after the death of the Annuitant.

OPTIONS 2 & 2v - JOINT AND SURVIVOR LIFE ANNUITY

Payments payable to the Payee during the lifetime of the Annuitant and during the lifetime of a
designated second person. No further Annuity Income Payments are payable after the deaths of both
the Annuitant and the designated second person.

OPTIONS 3 & 3v - JOINT AND SURVIVOR LIFE ANNUITY - WITH 120 OR 240 MONTHLY PAYMENTS GUARANTEED

Payments payable to the Payee during the lifetime of the Annuitant and during the lifetime of a
designated second person. If, at the death of the survivor, Annuity Income Payments have been made
for less than 120 or 240 monthly periods, the remaining guaranteed Annuity Income Payments will be
continued to the Beneficiary. If, at the death of the survivor, Annuity Income Payments have been
made for at least 120 or 240 monthly periods, as selected at the time of annuitization, no further
annuity income payments will be made.

OPTIONS 4 & 4v - LIFE ANNUITY WITH - 120 OR 240 MONTHLY PAYMENTS GUARANTEED

Payments payable to the Payee during the lifetime of the Annuitant. If, at the death of the
Annuitant, Annuity Income Payments have been made for less than the 120 or 240 monthly periods, as
selected at the time of Annuitization, the remaining guaranteed annuity income payments will be
continued to the Beneficiary. If, at death of the Annuitant, Annuity Income Payments have been
made for at least 120 or 240 monthly periods, no further payments will be made.

OPTIONS 5 & 5v - FIXED PAYMENTS FOR A SPECIFIED PERIOD CERTAIN

Payments payable to the Payee for any specified period of time for five (5) years or more, but not
exceeding thirty (30) years, as selected at the time of Annuitization. The selection must be made
for full twelve month periods. In the event of death of the Annuitant during the specified period
of time, any remaining Annuity Income Payments will be continued to the Beneficiary. If the
Annuitant dies after the end of the specific period of time, no further Annuity Income Payments
will be made. If Variable Annuity Income Payments are elected under this Annuity Income Payment
Option, any remaining guaranteed Variable Annuity Income Payments may be redeemed for a discounted
value determined by Us.

	 	 	 

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	19	 

 

 

FIXED ANNUITY INCOME PAYMENT OPTIONS TABLE

BASIS OF COMPUTATION

The actuarial basis for the Table of Annuity Rates is the Annuity 2000 Mortality Table with a
guaranteed interest rate of 1.50%, with quinquennial age setbacks. In order to determine the
applicable factors at the time of Annuitization, the Annuitant’s age will be set back by one year
for every five year period after the Contract Date. The Fixed Annuity Income Payment Options Table
does not include any applicable premium tax.

OPTIONS
1 & 4 - TABLE OF MONTHLY INSTALLMENTS PER $1,000.

(Monthly installments for ages and gender combinations
not shown will be furnished upon 
request.)

	 	 	 	 	 	 	 	 	 	 	 
	 	 	Option 1	 	Option 4	Option 4
	 	 	 	 	 	 	Life Annuity	Life Annuity
	Age of	 	 	 	(w/120 payments	(w/240 payments
	Annuitant	 	Life Annuity	 	guaranteed)	guaranteed)
	 	 	 	 	 	 	 	 	 	 	 
	 	 	Male	 	Female	 	Male	 	Female	Male	Female
	55
	 	3.68
	 	3.38
	 	3.64
	 	3.35 	3.48	3.27
	56
	 	3.77
	 	3.46
	 	3.73
	 	3.43	3.55	3.34
	57
	 	3.87
	 	3.54
	 	3.82
	 	3.51 	3.62	3.40
	58
	 	3.98
	 	3.63
	 	3.92
	 	3.60	3.69	3.47
	59
	 	4.09
	 	3.73
	 	4.02
	 	3.69	3.76	3.54
	60
	 	4.21
	 	3.83
	 	4.13
	 	3.78	3.83	3.62
	61
	 	4.34
	 	3.93
	 	4.24
	 	3.89	3.90	3.69
	62
	 	4.47
	 	4.05
	 	4.36
	 	3.99	3.97	3.77
	63
	 	4.62
	 	4.17
	 	4.49
	 	4.10	4.04	3.84
	64
	 	4.77
	 	4.30
	 	4.62
	 	4.22	4.10	3.92
	65
	 	4.93
	 	4.44
	 	4.76
	 	4.35	4.17	4.00
	66
	 	5.11
	 	4.58
	 	4.90
	 	4.48	4.24	4.07
	67
	 	5.30
	 	4.74
	 	5.05
	 	4.62	4.30	4.15
	68
	 	5.49
	 	4.91
	 	5.20
	 	4.76	4.36	4.22
	69
	 	5.71
	 	5.09
	 	5.36
	 	4.92	4.41	4.29
	70
	 	5.93
	 	5.29
	 	5.53
	 	5.08	4.47	4.36
	71
	 	6.17
	 	5.50
	 	5.70
	 	5.25	4.51	4.42
	72
	 	6.43
	 	5.73
	 	5.87
	 	5.43	4.56	4.48
	73
	 	6.70
	 	5.98
	 	6.05
	 	5.62	4.60	4.53
	74
	 	6.99
	 	6.24
	 	6.23
	 	5.81	4.63	4.58
	75
	 	7.31
	 	6.53
	 	6.41
	 	6.01	4.67	4.62
	76
	 	7.64
	 	6.84
	 	6.59
	 	6.21	4.69	4.65
	77
	 	8.00
	 	7.18
	 	6.78
	 	6.41	4.72	4.69
	78
	 	8.38
	 	7.55
	 	6.96
	 	6.62	4.74	4.71
	79
	 	8.79
	 	7.94
	 	7.13
	 	6.83	4.75	4.74
	80
	 	9.23
	 	8.37
	 	7.31
	 	7.03	4.77	4.75
	81
	 	9.70
	 	8.84
	 	7.47
	 	7.23	4.78	4.77
	82
	 	10.20
	 	9.34
	 	7.63
	 	7.42	4.79	4.78
	83
	 	10.73
	 	9.88
	 	7.78
	 	7.60	4.80	4.79
	84
	 	11.30
	 	10.47
	 	7.93
	 	7.77	4.80	4.80
	85
	 	11.90
	 	11.10
	 	8.06
	 	7.93	4.81	4.80

	 	 	 

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OPTION
2 - TABLE OF MONTHLY INSTALLMENTS PER $1,000.

(Monthly installments for ages and gender combinations not shown
will be furnished upon 
request.)

Joint & 100% Survivor Life Annuity

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Age of	 	 
	Male	 	 
	Annuitant	 	Age of Female Annuitant
	 
	 	55
	 	60
	 	65
	 	70
	 	75
	 	80
	 	85
	55
	 	3.01
	 	3.18
	 	3.33
	 	3.45
	 	3.54
	 	3.60
	 	3.64
	60
	 	3.12
	 	3.36
	 	3.59
	 	3.78
	 	3.94
	 	4.05
	 	4.12
	65
	 	3.21
	 	3.51
	 	3.83
	 	4.13
	 	4.40
	 	4.61
	 	4.75
	70
	 	3.27
	 	3.63
	 	4.03
	 	4.46
	 	4.89
	 	5.26
	 	5.53
	75
	 	3.32
	 	3.70
	 	4.18
	 	4.74
	 	5.35
	 	5.95
	 	6.45
	80
	 	3.34
	 	3.76
	 	4.29
	 	4.95
	 	5.75
	 	6.62
	 	7.45
	85
	 	3.36
	 	3.79
	 	4.35
	 	5.09
	 	6.05
	 	7.20
	 	8.44

OPTION
3 - TABLE OF MONTHLY INSTALLMENTS PER $1,000.

(Monthly installments for ages and gender combinations not shown will be furnished upon 
request)

Joint & 100% Survivor Life Annuity (w/120 payments guaranteed)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Age of	 	 
	Male	 	 
	Annuitant	 	Age of Female Annuitant
	 
	 	55
	 	60
	 	65
	 	70
	 	75
	 	80
	 	85
	55
	 	3.01
	 	3.18
	 	3.33
	 	3.45
	 	3.53
	 	3.59
	 	3.62
	60
	 	3.12
	 	3.36
	 	3.58
	 	3.78
	 	3.93
	 	4.03
	 	4.09
	65
	 	3.21
	 	3.51
	 	3.82
	 	4.12
	 	4.38
	 	4.56
	 	4.67
	70
	 	3.27
	 	3.62
	 	4.02
	 	4.44
	 	4.84
	 	5.16
	 	5.36
	75
	 	3.31
	 	3.70
	 	4.16
	 	4.70
	 	5.26
	 	5.76
	 	6.11
	80
	 	3.33
	 	3.74
	 	4.25
	 	4.88
	 	5.59
	 	6.28
	 	6.80
	85
	 	3.35
	 	3.77
	 	4.31
	 	4.99
	 	5.81
	 	6.66
	 	7.35

OPTION
3 - TABLE OF MONTHLY INSTALLMENTS PER $1,000.

(Monthly installments for ages and gender combinations not shown will be furnished upon 
request)

Joint & 100% Survivor Life Annuity (w/240 payments guaranteed)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Age of	 	 
	Male	 	 
	Annuitant	 	Age of Female Annuitant
	 
	 	55
	 	60
	 	65
	 	70
	 	75
	 	80
	 	85
	55
	 	3.00
	 	3.16
	 	3.30
	 	3.39
	 	3.45
	 	3.47
	 	3.48
	60
	 	3.11
	 	3.33
	 	3.53
	 	3.68
	 	3.77
	 	3.81
	 	3.82
	65
	 	3.18
	 	3.46
	 	3.72
	 	3.94
	 	4.08
	 	4.15
	 	4.17
	70
	 	3.23
	 	3.54
	 	3.86
	 	4.14
	 	4.33
	 	4.43
	 	4.46
	75
	 	3.26
	 	3.59
	 	3.94
	 	4.27
	 	4.50
	 	4.62
	 	4.66
	80
	 	3.27
	 	3.61
	 	3.98
	 	4.33
	 	4.58
	 	4.71
	 	4.76
	85
	 	3.27
	 	3.62
	 	3.99
	 	4.35
	 	4.61
	 	4.75
	 	4.80

	 	 	 

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	21	 

 

 

OPTION
5 - TABLE OF MONTHLY INSTALLMENTS PER $1,000.

Fixed Payment for Specified Period

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Number	 	Monthly	 	Number	 	Monthly	 	Number	 	Monthly	 	Number	 	Monthly
	of Years	 	Payment	 	of Years	 	Payment	 	of Years	 	Payment	 	of Years	 	Payment
	 
	 	 
	 	 
	 	 
	 	 
	 	 
	 	 
	 	 
	 
	 	 	 	10
	 	8.96
	 	17
	 	5.55
	 	24
	 	4.13
	 
	 	 	 	11
	 	8.21
	 	18
	 	5.27
	 	25
	 	3.99
	5
	 	17.28
	 	12
	 	7.58
	 	19
	 	5.03
	 	26
	 	3.86
	6
	 	14.51
	 	13
	 	7.05
	 	20
	 	4.81
	 	27
	 	3.75
	7
	 	12.53
	 	14
	 	6.59
	 	21
	 	4.62
	 	28
	 	3.64
	8
	 	11.04
	 	15
	 	6.20
	 	22
	 	4.44
	 	29
	 	3.54
	9
	 	9.89
	 	16
	 	5.85
	 	23
	 	4.28
	 	30
	 	3.44

	 	 	 

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VARIABLE ANNUITY INCOME PAYMENT OPTIONS TABLE

BASIS OF COMPUTATION

The actuarial basis for the Table of Annuity Rates is the Annuity 2000 Mortality Table with an
effective annual Assumed Investment Rate of 3.50%, with quinquennial age setbacks. For every five
years that the Contract has been in effect at the time of annuitization, the Annuitant’s age will
be set back by one year to determine the applicable factors. The Variable Annuity Income Payment
Options Table does not include any applicable premium tax.

OPTIONS
1v& 4v - TABLE OF INITIAL MONTHLY INSTALLMENT PER $1,000

(Monthly installments for ages
and gender combinations not shown will be furnished upon 
request.)

	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	Option 1v	 	Option 4v	 	Option 4v
	 	 	 	 	 	 	Life Annuity	 	Life Annuity
	Age of 	 	 	 	 	 	(w/120 payments	 	(w/240 payments
	Annuitant	 	Life Annuity	 	guaranteed)	 	guaranteed)
	 
	 	 	Male	 	Female	 	Male	 	Female	 	Male	 	Female
	55
	 	4.80
	 	4.48
	 	4.74
	 	4.45
	 	4.54
	 	4.34
	56
	 	4.89
	 	4.56
	 	4.82
	 	4.52
	 	4.60
	 	4.40
	57
	 	4.99
	 	4.64
	 	4.91
	 	4.60
	 	4.67
	 	4.46
	58
	 	5.09
	 	4.73
	 	5.01
	 	4.68
	 	4.73
	 	4.53
	59
	 	5.21
	 	4.82
	 	5.11
	 	4.77
	 	4.79
	 	4.59
	60
	 	5.33
	 	4.92
	 	5.21
	 	4.86
	 	4.86
	 	4.66
	61
	 	5.45
	 	5.03
	 	5.32
	 	4.96
	 	4.92
	 	4.73
	62
	 	5.59
	 	5.14
	 	5.44
	 	5.06
	 	4.98
	 	4.80
	63
	 	5.73
	 	5.26
	 	5.56
	 	5.17
	 	5.05
	 	4.87
	64
	 	5.89
	 	5.39
	 	5.69
	 	5.29
	 	5.11
	 	4.94
	65
	 	6.06
	 	5.53
	 	5.83
	 	5.41
	 	5.17
	 	5.01
	66
	 	6.24
	 	5.68
	 	5.97
	 	5.54
	 	5.23
	 	5.08
	67
	 	6.43
	 	5.84
	 	6.11
	 	5.67
	 	5.29
	 	5.14
	68
	 	6.63
	 	6.01
	 	6.26
	 	5.82
	 	5.34
	 	5.21
	69
	 	6.84
	 	6.19
	 	6.42
	 	5.97
	 	5.39
	 	5.28
	70
	 	7.07
	 	6.39
	 	6.57
	 	6.12
	 	5.44
	 	5.34
	71
	 	7.32
	 	6.60
	 	6.74
	 	6.29
	 	5.48
	 	5.39
	72
	 	7.58
	 	6.84
	 	6.91
	 	6.46
	 	5.52
	 	5.45
	73
	 	7.86
	 	7.09
	 	7.08
	 	6.64
	 	5.56
	 	5.49
	74
	 	8.16
	 	7.36
	 	7.25
	 	6.83
	 	5.59
	 	5.54
	75
	 	8.47
	 	7.65
	 	7.42
	 	7.02
	 	5.62
	 	5.57
	76
	 	8.82
	 	7.97
	 	7.59
	 	7.22
	 	5.64
	 	5.61
	77
	 	9.18
	 	8.31
	 	7.77
	 	7.41
	 	5.67
	 	5.64
	78
	 	9.57
	 	8.69
	 	7.94
	 	7.61
	 	5.68
	 	5.66
	79
	 	9.99
	 	9.09
	 	8.11
	 	7.81
	 	5.70
	 	5.68
	80
	 	10.43
	 	9.53
	 	8.27
	 	8.00
	 	5.71
	 	5.70
	81
	 	10.91
	 	10.00
	 	8.43
	 	8.19
	 	5.72
	 	5.71
	82
	 	11.42
	 	10.51
	 	8.58
	 	8.38
	 	5.73
	 	5.72
	83
	 	11.96
	 	11.07
	 	8.72
	 	8.55
	 	5.74
	 	5.73
	84
	 	12.53
	 	11.67
	 	8.85
	 	8.71
	 	5.74
	 	5.74
	85
	 	13.15
	 	12.31
	 	8.98
	 	8.86
	 	5.75
	 	5.74

	 	 	 

	US-802 (5/14)

	23	 

 

 

OPTION
2v - TABLE OF INITIAL MONTHLY INSTALLMENT PER $1,000.

(Monthly installments for ages and gender combinations not shown
will be furnished upon
 request.)

Joint & 100% Survivor Life Annuity

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Age of	 	 
	Male	 	 
	Annuitant	 	Age of Female Annuitant
	 
	 	55
	 	60
	 	65
	 	70
	 	75
	 	80
	 	85
	55
	 	4.09
	 	4.25
	 	4.40
	 	4.52
	 	4.62
	 	4.69
	 	4.74
	60
	 	4.20
	 	4.42
	 	4.64
	 	4.84
	 	5.00
	 	5.13
	 	5.21
	65
	 	4.29
	 	4.56
	 	4.87
	 	5.17
	 	5.45
	 	5.67
	 	5.83
	70
	 	4.35
	 	4.68
	 	5.07
	 	5.49
	 	5.92
	 	6.30
	 	6.60
	75
	 	4.40
	 	4.77
	 	5.23
	 	5.78
	 	6.38
	 	6.99
	 	7.50
	80
	 	4.43
	 	4.83
	 	5.34
	 	6.00
	 	6.79
	 	7.66
	 	8.50
	85
	 	4.45
	 	4.87
	 	5.42
	 	6.15
	 	7.10
	 	8.25
	 	9.49

OPTION
3v -  TABLE OF INITIAL MONTHLY INSTALLMENT PER $1,000.

(Monthly installments for ages and gender combinations not shown will
be furnished upon 
request)

Joint and 100% Survivor Life Annuity (w/120 payments guaranteed)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Age of	 	 
	Male	 	 
	Annuitant	 	Age of Female Annuitant
	 
	 	55
	 	60
	 	65
	 	70
	 	75
	 	80
	 	85
	55
	 	4.08
	 	4.25
	 	4.40
	 	4.52
	 	4.61
	 	4.68
	 	4.71
	60
	 	4.19
	 	4.41
	 	4.63
	 	4.83
	 	4.99
	 	5.10
	 	5.16
	65
	 	4.28
	 	4.56
	 	4.86
	 	5.15
	 	5.41
	 	5.61
	 	5.73
	70
	 	4.35
	 	4.68
	 	5.05
	 	5.46
	 	5.86
	 	6.18
	 	6.40
	75
	 	4.39
	 	4.76
	 	5.20
	 	5.72
	 	6.27
	 	6.76
	 	7.11
	80
	 	4.42
	 	4.81
	 	5.30
	 	5.91
	 	6.60
	 	7.26
	 	7.77
	85
	 	4.44
	 	4.84
	 	5.36
	 	6.03
	 	6.82
	 	7.63
	 	8.29

OPTION
3v - TABLE OF INITIAL MONTHLY INSTALLMENT PER $1,000.

(Monthly installments for ages and gender combinations not shown will
be furnished upon 
request)

Joint and 100% Survivor Life Annuity (w/240 payments guaranteed)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Age of	 	 
	Male	 	 
	Annuitant	 	Age of Female Annuitant
	 
	 	55
	 	60
	 	65
	 	70
	 	75
	 	80
	 	85
	55
	 	4.07
	 	4.22
	 	4.36
	 	4.45
	 	4.51
	 	4.53
	 	4.54
	60
	 	4.17
	 	4.38
	 	4.56
	 	4.71
	 	4.80
	 	4.84
	 	4.85
	65
	 	4.25
	 	4.50
	 	4.74
	 	4.95
	 	5.08
	 	5.14
	 	5.17
	70
	 	4.30
	 	4.58
	 	4.88
	 	5.14
	 	5.31
	 	5.40
	 	5.43
	75
	 	4.32
	 	4.63
	 	4.96
	 	5.25
	 	5.46
	 	5.57
	 	5.61
	80
	 	4.34
	 	4.65
	 	4.99
	 	5.31
	 	5.54
	 	5.66
	 	5.70
	85
	 	4.34
	 	4.66
	 	5.00
	 	5.33
	 	5.57
	 	5.69
	 	5.74

	 	 	 

	US-802 (5/14)

	24	 

 

 

OPTION
5v - TABLE OF INITIAL MONTHLY INSTALLMENT PER $1,000.

Payments for a Specified Period

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Number	 	Monthly	 	Number	 	Monthly	 	Number	 	Monthly	 	Number	 	Monthly
	of Years	 	Payment	 	of Years	 	Payment	 	of Years	 	Payment	 	of Years	 	Payment
	 
	 	 
	 	 
	 	 
	 	 
	 	 
	 	 
	 	 
	 
	 	 	 	10
	 	8.96
	 	17
	 	5.55
	 	24
	 	4.13
	 
	 	 	 	11
	 	8.21
	 	18
	 	5.27
	 	25
	 	3.99
	5
	 	17.28
	 	12
	 	7.58
	 	19
	 	5.03
	 	26
	 	3.86
	6
	 	14.51
	 	13
	 	7.05
	 	20
	 	4.81
	 	27
	 	3.75
	7
	 	12.53
	 	14
	 	6.59
	 	21
	 	4.62
	 	28
	 	3.64
	8
	 	11.04
	 	15
	 	6.20
	 	22
	 	4.44
	 	29
	 	3.54
	9
	 	9.89
	 	16
	 	5.85
	 	23
	 	4.28
	 	30
	 	3.44

	 	 	 

	US-802 (5/14)

	25	 

 

 

The United States Life Insurance Company in the City of New York

A STOCK COMPANY            NEW YORK, NEW YORK

FLEXIBLE PAYMENT FIXED AND VARIABLE DEFERRED ANNUITY CONTRACT

Nonparticipating

Copyright
© 2014 American International Group, Inc. All rights reserved.

	 	 	 

	US-802 (5/14)

	26

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00236-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00236-of-00352.parquet"}]]