Document:

Exhibit 4.2

 Exhibit 4.2 
 GROUP GUARANTEED INCOME 
 ANNUITY CERTIFICATE 
 Please read this Certificate carefully. This Certificate is a legal annuity and a summary of rights and obligations between the Certificate Owner (“you”
or “your”) and Genworth Life and Annuity Insurance Company (the “Company”, “we”, “us” or “our”). We agree to make income payments to you or your named Beneficiaries, subject to Certificate
provisions. 
 THIS CERTIFICATE HAS NO CASH VALUE AND NO SURRENDER VALUE. 
 Right to Cancel 
 IMPORTANT. YOU HAVE PURCHASED A FIXED ANNUITY CERTIFICATE. CAREFULLY REVIEW IT FOR LIMITATIONS.
THIS CERTIFICATE HAS NO CASH VALUE. WITHIN 30 DAYS AFTER ITS DELIVERY, YOU MAY RETURN THIS CERTIFICATE TO THE INSURANCE COMPANY OR AGENT WHO SOLD YOU THIS CERTIFICATE. YOU HAVE PAID A FEE FOR THIS CERTIFICATE. ANY FEE RECEIVED BY THE COMPANY WILL BE
RETURNED TO THE CERTIFICATE OWNER. THE COMPANY DOES NOT CONTROL YOUR INVESTMENT ACCOUNT ASSOCIATED WITH THIS CERTIFICATE AND WILL MAKE NO REFUND OF ANY KIND WITH RESPECT TO THE INVESTMENTS IN YOUR ACCOUNT. 
 For Genworth Life and Annuity Insurance Company, 
  

			
	 /s/ PAMELA S. SCHUTZ
	 	 /s/ THOMAS E. DUFFY

	PAMELA S. SCHUTZ	 	THOMAS E. DUFFY
	PRESIDENT	 	SECRETARY

 GENWORTH LIFE AND ANNUITY 
 INSURANCE COMPANY 
 GROUP GUARANTEED INCOME ANNUITY CERTIFICATE

 ALLOCATED FIXED ANNUITY 
 NONPARTICIPATING STOCK COMPANY 
 CUSTOMER SERVICE TELEPHONE [(866) 360-4015] 
 HOME OFFICE: 
 [6610 WEST BROAD
STREET, RICHMOND, VIRGINIA 23230] 
 ADMINISTRATIVE OFFICE: 
 [PO BOX 27601, RICHMOND, VIRGINIA 23286-8786] 
  

			
	P7170 5/07 VA	  	

			
	Data Pages	  	
		
	Contract Number:	  	[000000000]
		
	Contract Owner:	  	[AssetMark, Investment Services, Inc.]
		
	Certificate Number:	  	[999999999]
		
	Certificate Owner(s):	  	[John Doe]
		
	Certificate Date:	  	[May 15, 2007]
		
	Issued In:	  	[California]
		
	Income Plan(s):	  	[Life of Participant(s) with return of Premium]
		
	 Participant:
         Date of Birth:
	  	 [John Doe]
         [June 1, 1952]

		
	 Joint Participant:
         Date of Birth:
	  	 [Jane Doe]
         [July 19, 1954]

		
	Asset Allocation Model(s):	  	[AssetMark Portfolio Allocations, Profile 3 or Profile 4]
		
	Withdrawal Age:	  	[60]
		
	[Joint Participant’s Limitations:]	  	[Spousal only, subject to state law.]
		
	Account Limit at issue for Non-qualified Accounts:	  	[$2,000,000]
		
	 Account Limit for
 Qualified
Accounts:
	  	[Subject to Code limitations]
		
	Minimum Account Value:	  	[ETF                   $100,000]
		  	[Mutual Fund   $50,000]
		
	Initial Withdrawal Guarantee:	  	[$1,250]
		
	Notice Period:	  	[30 business days]
		
	Maximum Issue Age:	  	[84]
		
	Maximum Annuity Age:	  	[100]

 IF YOU HAVE A QUESTION, WOULD LIKE TO OBTAIN INFORMATION ABOUT YOUR CERTIFICATE, OR IF YOU NEED ASSISTANCE
RESOLVING A COMPLAINT, PLEASE CONTACT YOUR REPRESENTATIVE OR CALL OUR ADMINISTRATIVE OFFICE TOLL FREE AT [(866) 360-4015]. 
  

			
	P7170 5/07 VA	  	

			
	Data Pages	  	
		
	Contract Number:	  	[000000000]
		
	Certificate Number:	  	[999999999]
		
	Contract Suspension Events:	  	[None]
		
	Suspension Cure Period:	  	[90 business days]
		
	Contract Termination Events:	  	[No additional events listed.]
		
	Termination Cure Period:	  	[180 business days]
		
	Asset Charge:	  	For Single Participant Certificates with Profile 3 - [0.75%] Annually on Account Value of each Certificate.
		  	For Joint Participant Certificates with Profile 3 - [0.90%] Annually on Account Value of each Certificate.
		
		  	For Single Participant Certificates with Profile 4 - [0.85%] Annually on Account Value of each Certificate.
		  	For Joint Participant Certificates with Profile 4 - [1.00%] Annually on Account Value of each Certificate.
		
	Addition Exceptions:	  	[Transfers among investment options within the Account, investment returns, dividends, interest, expense reimbursements.]
		
	Withdrawal Exceptions:	  	[Transfers among investment options within the Account; in a given Withdrawal Year, 2.00% of Account Value collected by the Contract Owner for advisory, administrative, custodial and other
services.]

			
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	Data Pages	  	
		
	Certificate Number:	  	[99999999]

 [Withdrawal Guarantee Factors 
  

											
	 Attained Age
	 	 Annual Factor
	 	 Attained Age
	 	 Annual Factor
	 	 Attained Age
	 	 Annual Factor

	 [60 & under
	 	0.05]	 	[70	 	0.05]	 	[80	 	0.05]
	 [61
	 	0.05]	 	[71	 	0.05]	 	[81	 	0.05]
	 [62
	 	0.05]	 	[72	 	0.05]	 	[82	 	0.05]
	 [63
	 	0.05]	 	[73	 	0.05]	 	[83	 	0.05]
	 [64
	 	0.05]	 	[74	 	0.05]	 	[84	 	0.05]
	 [65
	 	0.05]	 	[75	 	0.05]	 	[85	 	0.05]
	 [66
	 	0.05]	 	[76	 	0.05]	 	[86	 	0.05]
	 [67
	 	0.05]	 	[77	 	0.05]	 	[87	 	0.05]
	 [68
	 	0.05]	 	[78	 	0.05]	 	[88	 	0.05]
	 [69
	 	0.05]	 	[79	 	0.05]	 	[89	 	0.05]
		 		 		 		 	[90 & older	 	0.05]

 ] 

			
	P7170 5/07 VA	  	

 TABLE OF CONTENTS 
  

					
	 ARTICLE
	  	 	  	PAGE
		  	Data Pages.	  	3
	I.	  	Definitions	  	4
	II.	  	General Features	  	6
	III.	  	Funding Phase - Certificate Date	  	8
	IV.	  	Funding Phase – Changes In Withdrawal Guarantee	  	9
	V.	  	Funding Phase – Death Provisions	  	10
	VI	  	Payout Phase - Income Provisions	  	11
	VII.	  	General Provisions	  	13
	VIII.	  	Charges	  	17
			
		  	Copies of any riders and endorsements follow page 17.	  	

 ARTICLE I – DEFINITIONS 
  

	1.1	Account – The investment vehicle provided by the Contract Owner to hold the assets in your investment portfolio and covered under this Certificate. The Certificate is
not a contract. The Account is managed according to the asset allocation model(s) shown on the Data Pages. 

  

	1.2	Account Limit – The maximum Account Value allowed at the time of any Addition without the approval of our Administrative Office. The initial value is shown on the Data
Pages. 

  

	1.3	Account Value – The value of the assets in the Account, as determined by the Contract Owner as of the close of business on a Valuation Day. For purposes of this
Certificate once the Account Value is determined on a Valuation Day, it does not change until the next Valuation Day. 

  

	1.4	Addition – Amounts contributed into the Account by you after the Certificate Date. 

  

	1.5	Administrative Office – Our Administrative Office that is located at the address shown on the Certificate cover page. 

  

	1.6	Alternate Payee – Your named Alternate Payee. 

  

	1.7	Annuity Date – The date on which the Premium is received. 

  

	1.8	Annuity Exercise Date – The earliest of the following three dates: (i) the date the Account Value is less than the Withdrawal Guarantee; (ii) the date the
Account Value is less than the minimum Account Value as shown on the Data Pages; and (iii) the date the younger of the Participant or any Joint Participant reaches the maximum annuity age as shown on the Data Pages, less the number of days in
the Notice Period. 

  

	1.9	Annuity Year – The first Annuity Year is the period of time between the Annuity Date and the first Birthday following the Annuity Date. Subsequent Annuity Years are the
one-year periods beginning on each Birthday. 

  

			
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	1.10	Attained Age – On any date, age on the last Birthday. 

  

	1.11	Base Income – The base annual payment under the Base Income provision paid by us to you. 

  

	1.12	Base Income Factor – A factor from the tables shown under the Base Income provision used in the calculation of the Base Income. 

  

	1.13	Beneficiary – The person or entity entitled to receive any Base Income or Guaranteed Income payments remaining upon the death of the Participant or Joint Participant as
shown on the Certificate Data Pages. Any remaining income payments will be paid in accordance with the terms of the Certificate. 

  

	1.14	Birthday – The end of day each year on the anniversary of the date of birth of the Participant or the younger Joint Participant. 

  

	1.15	Certificate – A no cash value certificate issued to you pursuant to the terms of the Contract. The Certificate describes the Withdrawal Guarantee as well as your rights
and obligations with respect to the Guaranteed Income to be paid following the Latest Annuity Date. The Certificate also describes your rights and obligations with respect to the Base Income provision. 

  

	1.16	Certificate Date – The Valuation Day as of which a Certificate becomes effective as shown on the Certificate Data Pages. 

  

	1.17	Certificate Owner(s) – The person(s) or entity named on the Certificate Data Pages. “You” or “your” refers to the Certificate Owner.

  

	1.18	Code – The Internal Revenue Code of 1986, as amended. 

  

	1.19	Company – Genworth Life and Annuity Insurance Company (also referred to as “we”, “us” or “our”). 

  

	1.20	Contract – The group guaranteed income annuity contract named on the Certificate Data Pages with any attached application, riders and endorsements .

  

	1.21	Contract Owner – The named Contract Owner as shown on the Data Pages. The Contract Owner may exercise all of the rights and privileges under the Contract. All ownership
rights with respect to this Certificate shall belong to you, or the annuity Beneficiary as may be designated under the terms of this Certificate or determined through the operation of law. 

  

	1.22	Early Withdrawal – Any Withdrawal before the withdrawal age as shown on the Data Pages. 

  

	1.23	Excess Withdrawal – After the withdrawal age as shown on the Data Pages, the portion of all Withdrawals during a Withdrawal Year that is in excess of the Withdrawal
Guarantee. 

  

			
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	1.24	Guaranteed Income – The guaranteed annual payment as determined by the last recorded Withdrawal Guarantee payable to you under the Guaranteed Income provision.

  

	1.25	Income Plan – An Income Plan made available to you as shown on the Data Pages. 

  

	1.26	Joint Participant – If named on the Data Pages, the person whose age, together with the Participant’s age, determines the Base Income annual payment factor under
this Certificate. 

  

	1.27	Latest Annuity Date – The Annuity Exercise Date plus the Notice Period. 

  

	1.28	Notice Period – The period as shown on the Data Pages. 

  

	1.29	Participant – The person whose age is used to determine the Withdrawal Guarantee Factor and the Base Income annual payment factor under this Certificate.

  

	1.30	Premium – The amount on the Annuity Date applied as payment for either the Base Income or the Guaranteed Income. 

  

	1.31	Qualified Account – An Account listed under the Qualified Accounts provision receiving favorable tax treatment under the Code. 

  

	1.32	Valuation Day – Each day on which the New York Stock Exchange is open for regular trading, except for days that the Account’s corresponding portfolio does not value
its shares. 

  

	1.33	Withdrawal – Any disbursement from the Account other than Withdrawal Exceptions. 

  

	1.34	Withdrawal Exceptions – Disbursements shown on the Data Pages that will not be treated as Withdrawals. 

  

	1.35	Withdrawal Exercise Date – The date when the Participant or the younger Joint Participant reaches the withdrawal age as shown on the Data Pages.

  

	1.36	Withdrawal Guarantee – After the withdrawal age as shown on the Data Pages, the maximum amount you may withdraw from your Account Value in a Withdrawal Year without
reducing the Guaranteed Income. 

  

	1.37	Withdrawal Guarantee Factor – A factor used in the calculation of the Withdrawal Guarantee as shown on the tables located on the Data Pages. 

  

	1.38	Withdrawal Year – After the Participant or younger Joint Participant reaches the withdrawal age as shown on the Data Pages, it is the period between two Birthdays.

 ARTICLE II – GENERAL FEATURES 
  

	2.1	The terms of this Certificate provide for a guaranteed income over the life of the Participant(s) based on your Account Value provided all conditions specified in this
Certificate are met. The Contract Owner maintains the Account on your behalf. We do not manage the Account. Should your Account Value drop below the Withdrawal 

  

			
	P7170 5/07 VA	  	6

 Guarantee or the minimum Account Value as shown on the Data Pages, and provided all other contractual
terms are satisfied, we guarantee to make payments in the form of Guaranteed Income equal to your Withdrawal Guarantee. A Base Income is also available. Payments will be made in accordance with the Income Plan shown on the Data Pages. 
  

	2.2	Certain persons or entities have important roles in this Certificate. 

  

	2.2.1	The Contract Owner is shown on the Data Pages. The Contract Owner is the entity that is responsible for managing the asset allocation model(s) and administering the
Account on your behalf. This responsibility includes obtaining your income election, if any, by the maximum annuity age as shown on the Data Pages. The Contract Owner is responsible for delivering to us your fees assessed under this Certificate, as
well as any Premium. 

  

	2.2.2	The Certificate Owner(s) is you, the person or entity named on the Data Pages who owns the assets of the Account and may surrender this Certificate. All ownership
rights with respect to this Certificate shall belong to you, or your named Beneficiary as may be designated under the terms of this Certificate or determined through the operation of law. If the Certificate Owner(s) is an individual, he or she must
be a named Participant on the Certificate Date. The individual(s) you designated as a named Participant(s) is shown on the Data Pages. 

  

	2.2.3	The Participant or Joint Participant is the person(s) named on the Certificate Data Pages whose age is used in determining the Guaranteed Income. Neither the
Participant nor Joint Participant can be changed once named. Except as provided in this Certificate for Qualified Accounts, any limitations on Joint Participants are shown on the Data Pages. 

  

	2.2.4	During the payout phase, upon the death of the last surviving Participant, the Beneficiary receives any remaining income. 

  

	2.2.5	If a trust is named as the Certificate Owner(s) or Beneficiary and subsequently exercises ownership rights or claims benefits, we have no obligation to verify that a
trust is valid and in effect. We will have no obligation to verify that the trustee is acting within the scope of his or her authority. Payment of any benefits to the trustee or trust will release us from all obligations under this Certificate to
the extent of the payment. When we make a payment, we will have no obligation to ensure that such payment is applied according to the terms of the trust agreement. 

  

	2.3	The Withdrawal Guarantee is established on the Certificate Date and is adjusted according to the terms of this Certificate. At all times the Account Value must be allocated
to one or more asset allocation model(s) as shown on the Data Pages. The Contract Owner has determined the asset allocation model(s) permitted. You are required to conduct all trading activity for your Account through a broker-dealer or registered
investment adviser approved by the Contract Owner. An allocation of the Account by you inconsistent with the asset allocation model(s) shown on the Data Pages will result in suspension and may result in the termination as described in the General
Provisions section under Suspension and Termination. 

  

			
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	2.4	Withdrawals covered by the Withdrawal Guarantee may begin on or after the younger of the Participant or any Joint Participant reaches the withdrawal age as shown on the Data
Pages. The Withdrawal Guarantee may be reduced if any Withdrawals are taken prior to that date. The Withdrawal Guarantee may be reduced on or after the Withdrawal Exercise Date if any Withdrawals in a Withdrawal Year exceed the Withdrawal Guarantee.

  

	2.5	You will be charged an asset charge as stated in the Data Pages. Failure to pay the asset charge will be deemed an election to terminate the Certificate. You may elect to
terminate the Certificate at any time without additional charge. If the Participant(s) die(s) prior to the Annuity Date, the Certificate terminates unless otherwise stipulated in this Certificate. 

  

	2.6	Funding Phase. The funding phase starts on the Certificate Date. During the funding phase you may contribute to the Account to accumulate assets for retirement or other
purposes. The Contract Owner is responsible for managing the Account. The Account must be managed using the asset allocation model(s) shown in the Data Pages. You may take Withdrawals from the Account at any time as permitted by the Contract Owner.
However, Withdrawals before the Participant or any younger Joint Participant reaches the withdrawal age as shown on the Data Pages, will reduce the Withdrawal Guarantee. On or after the withdrawal age as shown on the Data Pages, Withdrawals within
Certificate limitations will not reduce the Withdrawal Guarantee. 

  

	2.7	Payout Phase. The payout phase begins as of the Annuity Date. You will authorize transfer of the Account Value to us and we will begin making annuity payments. We will
continue to make payments while any Participant is living. There are two annuity provisions. Guaranteed Income and Base Income. Only one provision may be elected. Guaranteed Income starts if the Account Value falls below the minimum Account Value as
shown on the Data Pages or the Withdrawal Guarantee, or if the younger of the Participant or any Joint Participant reaches the maximum annuity age shown on the Data Pages. You have the right at any time to elect a Base Income level by transferring
the Account Value to us. 

 ARTICLE III – FUNDING PHASE – CERTIFICATE DATE 
  

	3.1	Initial Withdrawal Guarantee 

  

	3.1.1	On the Certificate Date, the initial Withdrawal Guarantee is established. The initial Withdrawal Guarantee is equal to (a) multiplied by (b), where: 

 

	 	(a)	is the Account Value on the Certificate Date subject to the Account Limit; and 

  

	 	(b)	is the Withdrawal Guarantee Factor for the Attained Age. 

  

	3.1.2	Requests to issue Certificates greater than the Account Limit are subject to approval by our Administrative Office, as are requests to issue additional Certificates to
current Certificate Owners. We are not required to approve such requests. 

  

	3.1.3	Additions to a Certificate Owner’s Account which currently exceeds the Account Limit or will cause the Account Limit to be exceeded are subject to approval by our
Administrative Office. We are not required to approve such requests. Until approval is granted, the Certificate will be suspended as described in the General Provisions section. 

  

			
	P7170 5/07 VA	  	8

	3.2	Changes in the Withdrawal Guarantee Factor 

  

	 3.2.1
	 We reserve the right to change the Withdrawal Guarantee Factors as of January 1st of each calendar year. If we make a change, we will send you and the Contract Owners written notice of such change at least [30] days before the change becomes effective. 

  

	3.3	Changes to the Account Limit 

  

	3.3.1	We reserve the right to increase the Account Limit for Certificates already issued. 

 ARTICLE IV - FUNDING PHASE - CHANGES IN WITHDRAWAL GUARANTEE 
  

	4.1	Increases to the Withdrawal Guarantee on the Birthday 

  

	4.1.1	On each Birthday, the Withdrawal Guarantee may increase. The new Withdrawal Guarantee is equal to the greater of the Withdrawal Guarantee on the prior Valuation Day, and
(a) multiplied by (b), where: 

  

	 	(a)	is the Account Value, on the Birthday; and 

  

	 	(b)	is the current Withdrawal Guarantee Factor for the Attained Age. 

  

	4.2	Decreases in Withdrawal Guarantee 

  

	4.2.1	Withdrawals from the Account that reduce the Withdrawal Guarantee are: (a) Early Withdrawals; and (b) Excess Withdrawals. 

  

	4.3	Early Withdrawals 

  

	4.3.1	Any Withdrawals prior to the Participant or the younger Joint Participant reaching the withdrawal age as shown on the Data Pages, are Early Withdrawals. Early Withdrawals
will reduce your Withdrawal Guarantee. 

  

	4.3.2	The adjusted Withdrawal Guarantee, after an Early Withdrawal, is the lesser of (a) and (b), where: 

  

	 	(a)	is the Withdrawal Guarantee on the Valuation Day prior to the Withdrawal; and 

  

	 	(b)	is equal to (i) multiplied by (ii), where: 

  

	 	(i)	is the Account Value, subject to the Account Limit; 

  

	 	(ii)	is the Withdrawal Guarantee Factor for the Attained Age. 

  

	4.3.3	In the event of an Early Withdrawal, we will restore the Withdrawal Guarantee if, within 30 days the Certificate Owner both: (i) makes Additions equal to or greater than
the Early Withdrawal amount and (ii) requests a restoration of the Withdrawal Guarantee. The Contract Owner may make this request on the Certificate Owner’s behalf. 

  

			
	P7170 5/07 VA	  	9

	4.4	Excess Withdrawals 

  

	4.4.1	You will have an Excess Withdrawal by Withdrawing more than the Withdrawal Guarantee in a given Withdrawal Year. Excess Withdrawals reduce your Withdrawal Guarantee.

  

	4.4.2	For any Withdrawal after the withdrawal age as shown on the Data Pages, the Excess Withdrawal amount is equal to the greater of zero and the remainder of (a) minus
(b) minus (c), where: 

  

	 	(a)	is the Withdrawal plus all previous Withdrawals during the Withdrawal Year; 

  

	 	(b)	is the Withdrawal Guarantee; and 

  

	 	(c)	is the previous Excess Withdrawals during the Withdrawal Year. 

  

	4.4.3	The adjusted Withdrawal Guarantee, after an Excess Withdrawal is made, is the lesser of 

  

	 	(a)	and (b), where: (a) is the Withdrawal Guarantee on the Valuation Day, prior to the Withdrawal; and 

  

	 	(b)	is equal to (i) multiplied by (ii), where: 

	 	(i)	is the Account Value, subject to the Account Limit; and 

  

	 	(ii)	is the Withdrawal Guarantee Factor for the Attained Age. 

  

	4.4.4	In the event of an Excess Withdrawal, we will restore the Withdrawal Guarantee if, within 30 days the Certificate Owner both: (i) makes Additions equal to or greater
than the Excess Withdrawal amount; and (ii) requests a restoration of the Withdrawal Guarantee. The Contract Owner may make this request on the Certificate Owner’s behalf. 

  

	4.5	Closing the Account 

  

	4.5.1	The Withdrawal Guarantee is reduced to zero when you close your Account. No additional charges will be assessed. 

  

	4.6	Withdrawal Guarantee During the First Withdrawal Year 

  

	4.6.1	If, on the Certificate Date the Participant or younger Joint Participant is older than the withdrawal age as shown on the Data Pages, any Withdrawal taken in the first
Withdrawal Year will cause the Withdrawal Guarantee to be adjusted prorata for the number of days between the Certificate Date and the next Birthday. In this case, the adjusted prorata Withdrawal Guarantee during the first Withdrawal Year is
(a) multiplied by (b) divided by (c), where: 

  

	 	(a)	is the unadjusted Withdrawal Guarantee; 

  

	 	(b)	is the number of days between the Certificate Date and the next Birthday; and 

  

	 	(c)	is 365. 

  

	4.6.2	Withdrawals during the first Withdrawal Year that do not exceed the adjusted prorata Withdrawal Guarantee do not change the Withdrawal Guarantee for future Withdrawal Years.

 ARTICLE V - FUNDING PHASE – DEATH PROVISIONS 
  

	5.1	If a Certificate Owner dies and the sole remaining Certificate Owner is the surviving spouse of the deceased Certificate Owner, the surviving spouse will remain as the sole
Certificate Owner. The Certificate will not automatically terminate. If the Certificate Owner dies and the sole Certificate Owner is not the surviving spouse, the Certificate will terminate. 

  

			
	P7170 5/07 VA	  	10

	5.2	If a Participant dies and there is a Joint Participant who is the surviving spouse of the deceased Participant, the surviving Joint Participant will be deemed to be the
Beneficiary of the Certificate. 

  

	5.3	If the sole Certificate Owner with respect to the Account, other than a Qualified Account, dies, the Certificate will terminate upon that death if: (a) there is no Joint
Participant; or (b) the Joint Participant is not the Certificate Owner’s surviving spouse. 

  

	5.3.1	If the Certificate does not terminate, the surviving spouse will become the Certificate Owner. 

  

	5.4	If the Certificate Owner with respect to the Account, other than a Qualified Account, is not a natural person, and the Participant dies or a Joint Participant dies, the
Certificate will terminate upon that death. 

 ARTICLE VI - PAYOUT PHASE - INCOME PROVISIONS 
  

	6.1	There are two income provisions, Guaranteed Income and Base Income. You may elect the Guaranteed Income only on or after the Annuity Exercise Date. Under the Guaranteed
Income provision income payments are based on the Withdrawal Guarantee. You may instead elect the Base Income at any time prior to the maximum annuity age as shown on the Data Pages. The Base Income provision will have income payments based on the
Account Value and the appropriate annual payment factor table below. An election must be made by the maximum annuity age shown on the Data Pages. We will begin income payments within thirty days of the Annuity Date. 

  

	6.2	Guaranteed Income 

  

	6.2.1	Guaranteed Income is available on the Latest Annuity Date. We will provide written notice to you on the Annuity Exercise Date. The notice will inform you that, as of the
Latest Annuity Date, if you elect Guaranteed Income, you will authorize the Contract Owner to transfer the Account Value to us. We will make Guaranteed Income payments in accordance with the Income Plan shown on the Data Pages.

  

	6.2.2	The Premium for Guaranteed Income is the Account Value on the Latest Annuity Date. 

  

	6.2.3	Guaranteed Income in the first Annuity Year is adjusted for Withdrawals taken since the last Birthday. Guaranteed Income during the first Annuity Year is the greater of zero
and (a) minus (b), where: 

  

	 	(a)	is the Withdrawal Guarantee on the Latest Annuity Date; 

  

	 	(b)	is any Withdrawal(s) made since the last Birthday. 

  

	6.2.4	The Guaranteed Income after the first Annuity Year is equal to the Withdrawal Guarantee on the Latest Annuity Date. 

  

	6.2.5	Payments will be made annually on the Birthday according to the Income Plan shown on the Data Pages. Other modes of payment may be made available. However, if any

  

			
	P7170 5/07 VA	  	11

	  	payment made more frequently than annually would be less than $100, we reserve the right to reduce the frequency of payments to an interval that would result in each payment being
at least $100. 

  

	6.2.6	If you notify us in writing of your intent to cancel the guarantee within the Notice Period this Certificate will terminate. If the Contract Owner fails to deliver the
Premium, the Guaranteed Income payments may be delayed until Premium is delivered to us. 

  

	6.2.7	On the Latest Annuity Date, if the Base Income is greater than the Withdrawal Guarantee, the Guaranteed Income will be increased to equal the Base Income.

  

	6.3	Base Income 

  

	6.3.1	You may elect Base Income payments at any time prior to the maximum annuity age as shown on the Data Pages. Base Income payments may be less than the last recorded Withdrawal
Guarantee. We will make Base Income payments in accordance with the Income Plan shown on the Data Pages. The Premium for the Base Income is equal to the Account Value on the Annuity Date. Once the Premium is paid to us, the Withdrawal Guarantee will
be reduced to zero. 

  

	6.3.2	The annual payment under the Base Income provision is equal to (a) multiplied by (b) divided by (c), where: 

  

	 	(a)	is the annual payment rate per $1,000, shown below using the Attained Age(s) of the Participant(s) on the Annuity Date; 

  

	 	(b)	is the Premium; and 

  

	 	(c)	is $1,000. 

  

	6.3.3	The annual payment rate is based on the [Annuity 2000 Mortality Table], using an interest rate of [1.0%]. 

 Base Income Factors 
  

	6.3.1	Single Participant Accounts 

 Annual payment factors
for each $1,000 of Premium 
  

			
	 Participant Age
	  	Factor
	 60
	  	37.01
	 65
	  	41.47
	 70
	  	47.07
	 75
	  	54.16
	 80
	  	63.16
	 85
	  	74.42
	 90
	  	88.62
	 95
	  	107.53
	 100
	  	136.90

 Values for ages not shown will be furnished upon request. 
  

			
	P7170 5/07 VA	  	12

	6.3.2	Joint Participant Accounts 

 Annual payment factors
for each $1,000 of Premium 
  

																			
	 Participant
 Age
	 	Joint Participant Age
	 	60	 	65	 	70	 	75	 	80	 	85	 	90	 	95	 	100
	60	 	34.23	 	35.78	 	36.70	 	37.07	 	37.13	 	37.10	 	37.06	 	37.04	 	37.03
	65	 	35.78	 	38.30	 	40.19	 	41.24	 	41.62	 	41.64	 	41.58	 	41.54	 	41.51
	70	 	36.70	 	40.19	 	43.41	 	45.75	 	46.95	 	47.31	 	47.28	 	47.20	 	47.15
	75	 	37.07	 	41.24	 	45.75	 	49.91	 	52.83	 	54.21	 	54.53	 	54.44	 	54.32
	80	 	37.13	 	41.62	 	46.95	 	52.83	 	58.17	 	61.83	 	63.48	 	63.74	 	63.53
	85	 	37.10	 	41.64	 	47.31	 	54.21	 	61.83	 	68.65	 	73.27	 	75.30	 	75.33
	90	 	37.06	 	41.58	 	47.28	 	54.53	 	63.48	 	73.27	 	82.06	 	88.04	 	90.33
	95	 	37.04	 	41.54	 	47.20	 	54.44	 	63.74	 	75.30	 	88.04	 	100.16	 	108.21
	100	 	37.03	 	41.51	 	47.15	 	54.32	 	63.53	 	75.33	 	90.33	 	108.21	 	127.64

 Values for ages not shown will be furnished upon request. 
  

	6.4	Continuation of Income Payments 

  

	6.4.1	Upon the death of a Participant we will continue to make income payments for the life of the surviving Participant, if any. Income payments will be made at least as rapidly
as under the method of distribution in effect before the Participant’s death. 

  

	6.4.2	If the last surviving Participant dies after the Annuity Date, your designated Beneficiary will receive any remaining income payments. The income payment will be payable on
the Birthday. Income payments will be made at least as rapidly as under the method of distribution in effect before the last Participant’s death. If there is no surviving Beneficiary upon the death of all the Participant(s), the estate of the
last surviving Certificate Owner will be the Beneficiary. If the Certificate Owner is not an individual, the Certificate Owner will be the Beneficiary. 

  

	6.5	Required Minimum Distributions 

  

	6.5.1	In a calendar year during the funding phase, if you are required to take minimum distributions under the Code you will not be considered to have made Excess Withdrawals
unless the Withdrawals for the calendar year exceed both the Withdrawal Guarantee and the required minimum distribution under the Code. Calculations will be based solely on the distributions required for the one Account associated with this
Certificate. 

 ARTICLE VII - GENERAL PROVISIONS 
  

	7.1	Assignment 

  

	7.1.1	You may assign some or all of your rights under the Certificate only during the payout phase. If the Account is a Qualified Account you may assign rights under this
Certificate only to the extent permitted under Section 401(g) of the Code. Your rights and the rights 

  

			
	P7170 5/07 VA	  	13

	  	of a Beneficiary may be affected by an assignment. A request for an assignment must be in writing and sent to our Administrative Office. Once our Administrative Office approves and
records the assignment, it will become effective as of the date the written notice was signed. 

  

	7.1.2	We are not responsible for the validity or tax consequences of any assignment. We are not liable to the assignee for any payment or settlement made under this Certificate
before the assignment is recorded. Assignments will not be approved and recorded until our Administrative Office receives sufficient direction from you and the assignee regarding the proper allocation of Certificate rights. 

 

	7.2	Right to Refuse Additions 

  

	7.2.1	We reserve the right to refuse to accept Additions to the Account Value for the purpose of computing both the Withdrawal Guarantee and asset charges upon written notice to
both the Contract Owner and the Certificate Owners. 

  

	7.3	Suspension 

  

	7.3.1	If the Contract is closed to new certificate owners, this action would not adversely affect your rights under this Certificate. 

  

	7.3.2	Other rights under the Certificate may be restricted due to a Contract suspension which includes your Certificate. Contract suspension will not change or suspend the
calculation of your benefits or charges. We reserve the right to suspend your Certificate as part of a Contract suspension if any of the following events occur: 

  

	 	(a)	the Contract Owner’s non-compliance with any provision of the Contract; 

  

	 	(b)	non-compliance with the asset allocation model agreement by or on behalf of the Contract Owner; or 

  

	 	(c)	the Contract Owner’s violation of any rights or obligations imposed by law as determined by governing regulatory and judicial bodies. 

  

	7.3.3	We will provide you with written notice if the Contract has been suspended. The notice will indicate the reason for the suspension, any restrictions on your rights under the
Certificate, and the date the suspension began. 

  

	7.3.4	Once a Contract suspension has occurred you will have the right to preserve the Withdrawal Guarantee by transferring your Account Value to a third party account insured by us
or to an annuity contract we, or one of our affiliates, offer. The Contract Owner has agreed not to charge any fees for the transfer. The Withdrawal Guarantee transferred shall be equal to the Withdrawal Guarantee on the Valuation Day of the
transfer. 

  

	7.4	Termination 

  

	7.4.1	This Certificate will not terminate if the Contract is terminated during the payout phase. During the termination cure period, as shown on the Data Pages, you will have the
right to preserve the Withdrawal Guarantee, during the funding phase, by transferring your Account Value to a third party account insured by us or to an annuity contract we offer. The Contract Owner agreed not to charge any fees for such transfer.
The Withdrawal Guarantee transferred shall be equal to the Withdrawal Guarantee on the Valuation Day of the transfer. Failure to preserve your Withdrawal Guarantee through an acceptable transfer will terminate your Certificate.

  

			
	P7170 5/07 VA	  	14

	7.4.2	We reserve the right to terminate the Contract if any of the following events occur: 

  

	 	(a)	the Contract Owner discontinues administration of the Contract without arranging for a successor to take over its responsibilities that is acceptable to us;

  

	 	(b)	the Contract Owner fails to cure the cause of a Contract suspension within the suspension cure period as shown on the Data Pages; or 

  

	 	(c)	there is a violation of any material rights or obligations imposed by law as determined by governing regulatory and/or judicial bodies. 

  

	7.4.3	We will provide you with written notice that a Contract termination event has occurred. The notice will state the reason(s) for the termination and that we intend to
terminate the Contract at the end of the Contract termination cure period as shown on the Data Pages. The termination will not take effect if the Contract Owner cures the cause. We will work with the Contract Owner to attempt to effect a mutually
acceptable cure. 

  

	7.4.4	Once during the duration of your Certificate, if the Contract Owner notifies us that you transferred your Account Value to an allocation model offered by the Contract Owner,
but not listed on the Data Pages, you will not have your Certificate terminated, but instead suspended. We will notify you that the suspension has occurred and that it will last until the end of the suspension cure period shown on the Data Pages.
During the suspension cure period, you may cure the suspension by transferring your Account Value to an allocation model shown on the Data Pages. Following such a transfer, the Withdrawal Guarantee will be recalculated on the Valuation Day following
the suspension cure period using the Account Value multiplied by the current Withdrawal Guarantee Factor for the Attained Age. This calculation will occur as of the Valuation Day following the end of the suspension cure period regardless of which
day during the cure period you transfer your assets into an allowable allocation model. If you fail to transfer your Account Value to an allowable allocation model listed on the Data Pages by the end of the suspension cure period, your Certificate
will terminate. 

  

	7.4.5	If an Addition is made to your Account when your Account exceeds the Account Limit, or if an Addition causes your Account to exceed the Account Limit, your Certificate will
be suspended. During the suspension cure period, in the case of an Account which was already over the Account Limit, you may cure the suspension by withdrawing the entire Addition. In the case of an Addition which caused the Account to exceed the
Account Limit, you may cure the suspension by withdrawing the portion of the Account Value exceeding the Account Limit. In neither case will there be an Early or Excess Withdrawal. If the suspension cure period ends without such corrective action,
your Certificate will remain suspended until the amount needed to cure the suspension is withdrawn from the Account. In this case, Early Withdrawals and Excess Withdrawals apply. Until the suspension is lifted, asset charges will apply to the
greater of the Account Limit and the Account Value prior to the Addition. 

  

	7.4.6	Your Certificate will terminate if any of the following events occur: 

  

	 	(a)	A second occurrence of you transferring your Account Value to an allocation model not shown on the Data Pages; 

  

	 	(b)	failure to pay the asset charge. 

  

			
	P7170 5/07 VA	  	15

	7.5	Income Tax Qualification 

  

	7.5.1	This Certificate is intended to qualify for tax treatment as an annuity contract under Section 72 of the Code. With respect to an Account other than a Qualified Account, if a
Certificate Owner dies during the funding phase and the surviving spouse does not become the sole Certificate Owner, the Certificate will immediately terminate. Death of the Participant or Joint Participant will terminate the Certificate if the
Certificate Owner is a non-natural person. This will satisfy the requirement in Section 72(s)(1)(B) of the Code that the entire interest of such holder in the contract be distributed within 5 years after death. If a Certificate Owner dies
during the payout phase, Section 72(s) is satisfied by the Continuation of Income Payments provision and the Death Provisions included in the Certificate. The Certificate provisions will be interpreted to preserve the intended tax
treatment. We reserve the right to amend this Certificate as needed to maintain its tax status under the Code. We will send you a copy of any amendment. 

  

	7.5.2	If the Account is a Qualified Account per the Qualified Accounts provision, this Certificate is intended to qualify for tax treatment under Section 401(g) of the
Code. 

  

	7.6	Qualified Accounts 

  

	7.6.1	If the Account is a Qualified Account maintained pursuant to an eligible retirement plan defined in Code section 402(c)(8)(B), a plan under Code section 457(b) or other plans
subject to Section 401(g), only a single person or entity may be named as Certificate Owner. For a Qualified Account, the Participant will be the individual for whose benefit the Account is maintained under the plan or arrangement. The Joint
Participant, if any, of a Qualified Account must be the Participant’s spouse. If the Participant dies during the funding phase and the sole beneficiary of the Account is not the Joint Participant, the Certificate will terminate upon the
Participant’s date of death. A former spouse may be a Joint Participant when required by a Qualified Domestic Relations Order, as defined in Code section 414(p). 

  

	7.6.2	For any Qualified Account, the Certificate may not be sold, assigned, discounted or pledged to any person other than us. It cannot be used as collateral for a loan. It cannot
be used as security for the performance of an obligation. It cannot be alienated for any other purpose. 

  

	7.7	Misstatement of Age or Account Value 

  

	7.7.1	If any Participant or Joint Participant’s age or Birthday is misstated, any Certificate benefits will be re-determined using the correct age(s). If any overpayments have
been made, future payments will be adjusted. Any underpayments will be paid in full. 

  

	7.7.2	If your Account Value is misstated, any Certificate benefits will be re-determined using the correct timing and value. If any overpayments of charges have been collected, the
overpayment will be paid in full. Any underpayments will be collected in full from you. 

  

	7.8	Nonparticipating 

  

	7.8.1	This Certificate is nonparticipating. It does not share in our profits or surplus. No dividends are payable. 

  

			
	P7170 5/07 VA	  	16

	7.9	Premium Tax 

  

	7.9.1	Premium tax rates and rules vary by state and may change. We reserve the right to deduct any such tax either from fees or Premium when received. 

  

	7.10	Written Notice 

  

	7.10.1	All written notices, including proof of death and any required forms, must be sent to our Administrative Office in a form satisfactory to us. All notices must include your
name and the Participant and any Joint Participant and the Certificate number. We will not be responsible for any actions taken prior to our receipt of a valid change request. We will send correspondence relating to your Certificate to your last
known address. 

  

	7.11	Evidence of Death, Age, Marital Status or Survival 

  

	7.11.1	We will require, to be received in our Administrative Office and in a form satisfactory to us with respect to any person, due proof of death, age, marital status or survival
and any other required forms before we act on Certificate provisions that require such documentation. 

  

	7.12	Entire Contract 

  

	  	This Certificate describes the Certificate Owners rights under the Contract. The Contract is a legal contract between the named Contract Owner, us and the named Certificate Owners
and no one else. This Contract is the entire contract. An agent cannot change this Contract. Any change to the Contract must be in writing and approved by us. Only an authorized officer of the Company can give our approval. This Contract will be
construed according to the laws of the jurisdiction in which it is issued, as shown on the Data Pages. 

 ARTICLE VIII -
CHARGES 
  

	8.1	Asset Charge 

  

	8.1.1	The Contract Owner will calculate, collect and remit to us an asset charge as shown on the Data Pages. Your Account may be assessed for these charges. 

  

	8.2	Change in Charges 

  

	8.2.1	We reserve the right to change the asset charge as shown on the Data Pages. We will send you advance written notice of such change at least [30] days before the change becomes
effective. Charges will be assessed on the weighted average of the Account Value at the old rate and the Addition at the new rate from the point of the Addition forward. 

  

			
	P7170 5/07 VA	  	17

 GROUP GUARANTEED INCOME 
 ANNUITY CERTIFICATE 
  

 GENWORTH LIFE AND ANNUITY 
 INSURANCE
COMPANY 

 GROUP GUARANTEED INCOME 
 ANNUITY CERTIFICATE 
 Please read this Certificate carefully. This Certificate is a legal
annuity and a summary of rights and obligations between the Certificate Owner (“you” or “your”) and Genworth Life and Annuity Insurance Company (the “Company”, “we”, “us” or “our”). We
agree to make income payments to you or your named Beneficiaries, subject to Certificate provisions. 
 THIS CERTIFICATE HAS NO CASH VALUE AND NO
SURRENDER VALUE. 
 Right to Cancel 
 IMPORTANT.
YOU HAVE PURCHASED A FIXED ANNUITY CERTIFICATE. CAREFULLY REVIEW IT FOR LIMITATIONS. THIS CERTIFICATE HAS NO CASH VALUE. WITHIN 30 DAYS AFTER ITS DELIVERY, YOU MAY RETURN THIS CERTIFICATE TO THE INSURANCE COMPANY OR AGENT WHO SOLD YOU THIS
CERTIFICATE. YOU HAVE PAID A FEE FOR THIS CERTIFICATE. ANY FEE RECEIVED BY THE COMPANY WILL BE RETURNED TO THE CERTIFICATE OWNER. THE COMPANY DOES NOT CONTROL YOUR INVESTMENT ACCOUNT ASSOCIATED WITH THIS CERTIFICATE AND WILL MAKE NO REFUND OF ANY
KIND WITH RESPECT TO THE INVESTMENTS IN YOUR ACCOUNT. 
 For Genworth Life and Annuity Insurance Company, 
  

			
	 /s/ PAMELA S. SCHUTZ
	 	 /s/ THOMAS E. DUFFY

	PAMELA S. SCHUTZ	 	THOMAS E. DUFFY
	PRESIDENT	 	SECRETARY

 GENWORTH LIFE AND ANNUITY 
 INSURANCE COMPANY 
 GROUP GUARANTEED INCOME ANNUITY CERTIFICATE

 ALLOCATED FIXED ANNUITY 
 NONPARTICIPATING STOCK COMPANY 
 CUSTOMER SERVICE TELEPHONE [(866) 360-4015] 
 HOME OFFICE: 
 [6610 WEST BROAD
STREET, RICHMOND, VIRGINIA 23230] 
 ADMINISTRATIVE OFFICE: 
 [PO BOX 27601, RICHMOND, VIRGINIA 23286-8786] 

			
	  
 P7170 5/07
	  	

			
	Data Pages	  	
		
	Contract Number:	  	[000000000]
		
	Contract Owner:	  	[AssetMark, Investment Services, Inc.]
		
	Certificate Number:	  	[999999999]
		
	Certificate Owner(s):	  	[John Doe]
		
	Certificate Date:	  	[May 15, 2007]
		
	Issued In:	  	[California]
		
	Income Plan(s):	  	[Life of Participant(s) with return of Premium]
		
	 Participant:
         Date of Birth:
	  	 [John Doe]
         [June 1, 1952]

		
	 Joint Participant:
         Date of Birth:
	  	 [Jane Doe]
         [July 19, 1954]

		
	Asset Allocation Model(s):	  	[AssetMark Portfolio Allocations, Profile 3 or Profile 4]
		
	Withdrawal Age:	  	[60]
		
	[Joint Participant’s Limitations:]	  	[Spousal only, subject to state law.]
		
	Account Limit at issue for Non-qualified Accounts:	  	[$2,000,000]
		
	Account Limit for Qualified Accounts:	  	[Subject to Code limitations]
		
	Minimum Account Value:	  	 [ETF                 $100,000]
 [Mutual Fund   $50,000]

		
	Initial Withdrawal Guarantee:	  	[$1,250]
		
	Notice Period:	  	[30 business days]
		
	Maximum Issue Age:	  	[84]
		
	Maximum Annuity Age:	  	[100]

 IF YOU HAVE A QUESTION, WOULD LIKE TO OBTAIN INFORMATION ABOUT YOUR CERTIFICATE, OR IF YOU NEED ASSISTANCE
RESOLVING A COMPLAINT, PLEASE CONTACT YOUR REPRESENTATIVE OR CALL OUR ADMINISTRATIVE OFFICE TOLL FREE AT [(866) 360-4015]. 

			
	  
 P7170 5/07
	  	

			
	Data Pages	  	
		
	Contract Number:	  	[000000000]
		
	Certificate Number:	  	[999999999]
		
	Contract Suspension Events:	  	[None]
		
	Suspension Cure Period:	  	[90 business days]
		
	Contract Termination Events:	  	[No additional events listed.]
		
	Termination Cure Period:	  	[180 business days]
		
	Asset Charge:	  	For Single Participant Certificates with Profile 3 - [0.75%] Annually on Account Value of each Certificate. For Joint Participant Certificates with Profile 3 - [0.90%] Annually on Account Value
of each Certificate.
		
		  	For Single Participant Certificates with Profile 4 - [0.85%] Annually on Account Value of each Certificate. For Joint Participant Certificates with Profile 4 - [1.00%] Annually on Account Value
of each Certificate.
		
	Addition Exceptions:	  	[Transfers among investment options within the Account, investment returns, dividends, interest, expense reimbursements.]
		
	Withdrawal Exceptions:	  	[Transfers among investment options within the Account; in a given Withdrawal Year, 2.00% of Account Value collected by the Contract Owner for advisory, administrative, custodial and other
services.]

			
	  
 P7170 5/07
	  	

			
	Data Pages	  	
		
	Certificate Number:	  	[99999999]

 [Withdrawal Guarantee Factors 
  

											
	 Attained Age
	 	 Annual Factor
	 	 Attained Age
	 	 Annual Factor
	 	 Attained Age
	 	 Annual Factor

	 [60 & under
	 	0.05]	 	[70	 	0.05]	 	[80	 	0.05]
	 [61
	 	0.05]	 	[71	 	0.05]	 	[81	 	0.05]
	 [62
	 	0.05]	 	[72	 	0.05]	 	[82	 	0.05]
	 [63
	 	0.05]	 	[73	 	0.05]	 	[83	 	0.05]
	 [64
	 	0.05]	 	[74	 	0.05]	 	[84	 	0.05]
	 [65
	 	0.05]	 	[75	 	0.05]	 	[85	 	0.05]
	 [66
	 	0.05]	 	[76	 	0.05]	 	[86	 	0.05]
	 [67
	 	0.05]	 	[77	 	0.05]	 	[87	 	0.05]
	 [68
	 	0.05]	 	[78	 	0.05]	 	[88	 	0.05]
	 [69
	 	0.05]	 	[79	 	0.05]	 	[89	 	0.05]
		 		 		 		 	[90 & older	 	0.05]
	 ]
	 		 		 		 		 	

			
	  
 P7170 5/07
	  	

 TABLE OF CONTENTS 
  

					
	 ARTICLE
	  	 	  	PAGE
		  	Data Pages.	  	3
	 I.
	  	Definitions	  	4
	 II.
	  	General Features	  	6
	 III.
	  	Funding Phase - Certificate Date	  	8
	 IV.
	  	Funding Phase – Changes In Withdrawal Guarantee	  	9
	 V.
	  	Funding Phase – Death Provisions	  	10
	 VI
	  	Payout Phase - Income Provisions	  	11
	 VII.
	  	General Provisions	  	13
	 VIII.
	  	Charges	  	17
			
		  	Copies of any riders and endorsements follow page 17.	  	

 ARTICLE I – DEFINITIONS 
  

	1.1	Account – The investment vehicle provided by the Contract Owner to hold the assets in your investment portfolio and covered under this Certificate. The Certificate is
not a contract. The Account is managed according to the asset allocation model(s) shown on the Data Pages. 

  

	1.2	Account Limit – The maximum Account Value allowed at the time of any Addition without the approval of our Administrative Office. The initial value is shown on the Data
Pages. 

  

	1.3	Account Value – The value of the assets in the Account, as determined by the Contract Owner as of the close of business on a Valuation Day. For purposes of this
Certificate once the Account Value is determined on a Valuation Day, it does not change until the next Valuation Day. 

  

	1.4	Addition – Amounts contributed into the Account by you after the Certificate Date. 

  

	1.5	Administrative Office – Our Administrative Office that is located at the address shown on the Certificate cover page. 

  

	1.6	Alternate Payee – Your named Alternate Payee. 

  

	1.7	Annuity Date – The date on which the Premium is received. 

  

	1.8	Annuity Exercise Date – The earliest of the following three dates: (i) the date the Account Value is less than the Withdrawal Guarantee; (ii) the date the
Account Value is less than the minimum Account Value as shown on the Data Pages; and (iii) the date the younger of the Participant or any Joint Participant reaches the maximum annuity age as shown on the Data Pages, less the number of days in
the Notice Period. 

  

	1.9	Annuity Year – The first Annuity Year is the period of time between the Annuity Date and the first Birthday following the Annuity Date. Subsequent Annuity Years are the
one-year periods beginning on each Birthday. 

			
	  
 P7170 5/07
	  	  
 4

	1.10	Attained Age – On any date, age on the last Birthday. 

  

	1.11	Base Income – The base annual payment under the Base Income provision paid by us to you. 

  

	1.12	Base Income Factor – A factor from the tables shown under the Base Income provision used in the calculation of the Base Income. 

  

	1.13	Beneficiary – The person or entity entitled to receive any Base Income or Guaranteed Income payments remaining upon the death of the Participant or Joint Participant as
shown on the Certificate Data Pages. Any remaining income payments will be paid in accordance with the terms of the Certificate. 

  

	1.14	Birthday – The end of day each year on the anniversary of the date of birth of the Participant or the younger Joint Participant. 

  

	1.15	Certificate – A no cash value certificate issued to you pursuant to the terms of the Contract. The Certificate describes the Withdrawal Guarantee as well as your rights
and obligations with respect to the Guaranteed Income to be paid following the Latest Annuity Date. The Certificate also describes your rights and obligations with respect to the Base Income provision. 

  

	1.16	Certificate Date – The Valuation Day as of which a Certificate becomes effective as shown on the Certificate Data Pages. 

  

	1.17	Certificate Owner(s) – The person(s) or entity named on the Certificate Data Pages. “You” or “your” refers to the Certificate Owner.

  

	1.18	Code – The Internal Revenue Code of 1986, as amended. 

  

	1.19	Company – Genworth Life and Annuity Insurance Company (also referred to as “we”, “us” or “our”). 

  

	1.20	Contract – The group guaranteed income annuity contract named on the Certificate Data Pages with any attached riders, endorsements and Certificate forms.

  

	1.21	Contract Owner – The named Contract Owner as shown on the Data Pages. The Contract Owner may exercise all of the rights and privileges under the Contract. All ownership
rights with respect to this Certificate shall belong to you, or the annuity Beneficiary as may be designated under the terms of this Certificate or determined through the operation of law. 

  

	1.22	Early Withdrawal – Any Withdrawal before the withdrawal age as shown on the Data Pages. 

  

	1.23	Excess Withdrawal – After the withdrawal age as shown on the Data Pages, the portion of all Withdrawals during a Withdrawal Year that is in excess of the Withdrawal
Guarantee. 

			
	  
 P7170 5/07
	  	  
 5

	1.24	Guaranteed Income – The guaranteed annual payment as determined by the last recorded Withdrawal Guarantee payable to you under the Guaranteed Income provision.

  

	1.25	Income Plan – An Income Plan made available to you as shown on the Data Pages. 

  

	1.26	Joint Participant – If named on the Data Pages, the person whose age, together with the Participant’s age, determines the Base Income annual payment factor under
this Certificate. 

  

	1.27	Latest Annuity Date – The Annuity Exercise Date plus the Notice Period. 

  

	1.28	Notice Period – The period as shown on the Data Pages. 

  

	1.29	Participant – The person whose age is used to determine the Withdrawal Guarantee Factor and the Base Income annual payment factor under this Certificate.

  

	1.30	Premium – The amount on the Annuity Date applied as payment for either the Base Income or the Guaranteed Income. 

  

	1.31	Qualified Account – An Account listed under the Qualified Accounts provision receiving favorable tax treatment under the Code. 

  

	1.32	Valuation Day – Each day on which the New York Stock Exchange is open for regular trading, except for days that the Account’s corresponding portfolio does not value
its shares. 

  

	1.33	Withdrawal – Any disbursement from the Account other than Withdrawal Exceptions. 

  

	1.34	Withdrawal Exceptions – Disbursements shown on the Data Pages that will not be treated as Withdrawals. 

  

	1.35	Withdrawal Exercise Date – The date when the Participant or the younger Joint Participant reaches the withdrawal age as shown on the Data Pages.

  

	1.36	Withdrawal Guarantee – After the withdrawal age as shown on the Data Pages, the maximum amount you may withdraw from your Account Value in a Withdrawal Year without
reducing the Guaranteed Income. 

  

	1.37	Withdrawal Guarantee Factor – A factor used in the calculation of the Withdrawal Guarantee as shown on the tables located on the Data Pages. 

  

	1.38	Withdrawal Year – After the Participant or younger Joint Participant reaches the withdrawal age as shown on the Data Pages, it is the period between two Birthdays.

 ARTICLE II – GENERAL FEATURES 
  

	2.1	 The terms of this Certificate provide for a guaranteed income over the life of the Participant(s) based on your Account Value provided all conditions
specified in this Certificate are met. The Contract Owner maintains the Account on your behalf. We do not manage the Account. Should your Account Value drop below the Withdrawal 

			
	  
 P7170 5/07
	  	  
 6

	 	 
Guarantee or the minimum Account Value as shown on the Data Pages, and provided all other contractual terms are satisfied, we guarantee to make payments in
the form of Guaranteed Income equal to your Withdrawal Guarantee. A Base Income is also available. Payments will be made in accordance with the Income Plan shown on the Data Pages. 

  

	2.2	Certain persons or entities have important roles in this Certificate. 

  

	2.2.1	The Contract Owner is shown on the Data Pages. The Contract Owner is the entity that is responsible for managing the asset allocation model(s) and administering the
Account on your behalf. This responsibility includes obtaining your income election, if any, by the maximum annuity age as shown on the Data Pages. The Contract Owner is responsible for delivering to us your fees assessed under this Certificate, as
well as any Premium. 

  

	2.2.2	The Certificate Owner(s) is you, the person or entity named on the Data Pages who owns the assets of the Account and may surrender this Certificate. All ownership
rights with respect to this Certificate shall belong to you, or your named Beneficiary as may be designated under the terms of this Certificate or determined through the operation of law. If the Certificate Owner(s) is an individual, he or she must
be a named Participant on the Certificate Date. The individual(s) you designated as a named Participant(s) is shown on the Data Pages. 

  

	2.2.3	The Participant or Joint Participant is the person(s) named on the Certificate Data Pages whose age is used in determining the Guaranteed Income. Neither the
Participant nor Joint Participant can be changed once named. Except as provided in this Certificate for Qualified Accounts, any limitations on Joint Participants are shown on the Data Pages. 

  

	2.2.4	During the payout phase, upon the death of the last surviving Participant, the Beneficiary receives any remaining income. 

  

	2.2.5	If a trust is named as the Certificate Owner(s) or Beneficiary and subsequently exercises ownership rights or claims benefits, we have no obligation to verify that a
trust is valid and in effect. We will have no obligation to verify that the trustee is acting within the scope of his or her authority. Payment of any benefits to the trustee or trust will release us from all obligations under this Certificate to
the extent of the payment. When we make a payment, we will have no obligation to ensure that such payment is applied according to the terms of the trust agreement. 

  

	2.3	The Withdrawal Guarantee is established on the Certificate Date and is adjusted according to the terms of this Certificate. At all times the Account Value must be allocated
to one or more asset allocation model(s) as shown on the Data Pages. The Contract Owner has determined the asset allocation model(s) permitted. You are required to conduct all trading activity for your Account through a broker-dealer or registered
investment adviser approved by the Contract Owner. An allocation of the Account by you inconsistent with the asset allocation model(s) shown on the Data Pages will result in suspension and may result in the termination as described in the General
Provisions section under Suspension and Termination. 

			
	  
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	2.4	Withdrawals covered by the Withdrawal Guarantee may begin on or after the younger of the Participant or any Joint Participant reaches the withdrawal age as shown on the Data
Pages. The Withdrawal Guarantee may be reduced if any Withdrawals are taken prior to that date. The Withdrawal Guarantee may be reduced on or after the Withdrawal Exercise Date if any Withdrawals in a Withdrawal Year exceed the Withdrawal Guarantee.

  

	2.5	You will be charged an asset charge as stated in the Data Pages. Failure to pay the asset charge will be deemed an election to terminate the Certificate. You may elect to
terminate the Certificate at any time without additional charge. If the Participant(s) die(s) prior to the Annuity Date, the Certificate terminates unless otherwise stipulated in this Certificate. 

  

	2.6	Funding Phase. The funding phase starts on the Certificate Date. During the funding phase you may contribute to the Account to accumulate assets for retirement or other
purposes. The Contract Owner is responsible for managing the Account. The Account must be managed using the asset allocation model(s) shown in the Data Pages. You may take Withdrawals from the Account at any time as permitted by the Contract Owner.
However, Withdrawals before the Participant or any younger Joint Participant reaches the withdrawal age as shown on the Data Pages, will reduce the Withdrawal Guarantee. On or after the withdrawal age as shown on the Data Pages, Withdrawals within
Certificate limitations will not reduce the Withdrawal Guarantee. 

  

	2.7	Payout Phase. The payout phase begins as of the Annuity Date. You will authorize transfer of the Account Value to us and we will begin making annuity payments. We will
continue to make payments while any Participant is living. There are two annuity provisions. Guaranteed Income and Base Income. Only one provision may be elected. Guaranteed Income starts if the Account Value falls below the minimum Account Value as
shown on the Data Pages or the Withdrawal Guarantee, or if the younger of the Participant or any Joint Participant reaches the maximum annuity age shown on the Data Pages. You have the right at any time to elect a Base Income level by transferring
the Account Value to us. 

 ARTICLE III – FUNDING PHASE – CERTIFICATE DATE 
  

	3.1	Initial Withdrawal Guarantee 

  

	3.1.1	On the Certificate Date, the initial Withdrawal Guarantee is established. The initial Withdrawal Guarantee is equal to (a) multiplied by (b), where: (a) is the Account
Value on the Certificate Date subject to the Account Limit; and (b) is the Withdrawal Guarantee Factor for the Attained Age. 

  

	3.1.2	Requests to issue Certificates greater than the Account Limit are subject to approval by our Administrative Office, as are requests to issue additional Certificates to
current Certificate Owners. We are not required to approve such requests. 

  

	3.1.3	Additions to a Certificate Owner’s Account which currently exceeds the Account Limit or will cause the Account Limit to be exceeded are subject to approval by our
Administrative Office. We are not required to approve such requests. Until approval is granted, the Certificate will be suspended as described in the General Provisions section. 

			
	  
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	3.2	Changes in the Withdrawal Guarantee Factor 

  

	 3.2.1
	 We reserve the right to change the Withdrawal Guarantee Factors as of January 1st of each calendar year. If we make a change, we will send you and the Contract Owners written notice of such change at least [30] days before the change becomes effective. 

  

	3.3	Changes to the Account Limit 

  

	3.3.1	We reserve the right to increase the Account Limit for Certificates already issued. 

 ARTICLE IV – FUNDING PHASE – CHANGES IN WITHDRAWAL GUARANTEE 
  

	4.1	Increases to the Withdrawal Guarantee on the Birthday 

  

	4.1.1	On each Birthday, the Withdrawal Guarantee may increase. The new Withdrawal Guarantee is equal to the greater of the Withdrawal Guarantee on the prior Valuation Day, and
(a) multiplied by (b), where: 

  

	 	(a)	is the Account Value, on the Birthday; and 

  

	 	(b)	is the current Withdrawal Guarantee Factor for the Attained Age. 

  

	4.2	Decreases in Withdrawal Guarantee 

  

	4.2.1	Withdrawals from the Account that reduce the Withdrawal Guarantee are: 

  

	 	(a)	Early Withdrawals; and 

  

	 	(b)	Excess Withdrawals. 

  

	4.3	Early Withdrawals 

  

	4.3.1	Any Withdrawals prior to the Participant or the younger Joint Participant reaching the withdrawal age as shown on the Data Pages, are Early Withdrawals. Early Withdrawals
will reduce your Withdrawal Guarantee. 

  

	4.3.2	The adjusted Withdrawal Guarantee, after an Early Withdrawal, is the lesser of (a) and (b), where: 

  

	 	(a)	is the Withdrawal Guarantee on the Valuation Day prior to the Withdrawal; and 

  

	 	(b)	is equal to (i) multiplied by (ii), where: 

  

	 	(i)	is the Account Value, subject to the Account Limit; 

  

	 	(ii)	is the Withdrawal Guarantee Factor for the Attained Age. 

  

	4.3.3	In the event of an Early Withdrawal, we will restore the Withdrawal Guarantee if, within 30 days the Certificate Owner both: (i) makes Additions equal to or greater than
the Early Withdrawal amount and (ii) requests a restoration of the Withdrawal Guarantee. The Contract Owner may make this request on the Certificate Owner’s behalf. 

			
	  
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	4.4	Excess Withdrawals 

  

	4.4.1	You will have an Excess Withdrawal by Withdrawing more than the Withdrawal Guarantee in a given Withdrawal Year. Excess Withdrawals reduce your Withdrawal Guarantee.

  

	4.4.2	For any Withdrawal after the withdrawal age as shown on the Data Pages, the Excess Withdrawal amount is equal to the greater of zero and the remainder of (a) minus
(b) minus (c), where: 

  

	 	(a)	is the Withdrawal plus all previous Withdrawals during the Withdrawal Year; 

  

	 	(b)	is the Withdrawal Guarantee; and 

  

	 	(c)	is the previous Excess Withdrawals during the Withdrawal Year. 

  

	4.4.3	The adjusted Withdrawal Guarantee, after an Excess Withdrawal is made, is the lesser of (a) and (b), where: 

  

	 	(a)	is the Withdrawal Guarantee on the Valuation Day, prior to the Withdrawal; and 

  

	 	(b)	is equal to (i) multiplied by (ii), where: 

  

	 	(i)	is the Account Value, subject to the Account Limit; and 

  

	 	(ii)	is the Withdrawal Guarantee Factor for the Attained Age. 

  

	4.4.4	In the event of an Excess Withdrawal, we will restore the Withdrawal Guarantee if, within 30 days the Certificate Owner both: (i) makes Additions equal to or greater
than the Excess Withdrawal amount; and (ii) requests a restoration of the Withdrawal Guarantee. The Contract Owner may make this request on the Certificate Owner’s behalf. 

  

	4.5	Closing the Account 

  

	4.5.1	The Withdrawal Guarantee is reduced to zero when you close your Account. No additional charges will be assessed. 

  

	4.6	Withdrawal Guarantee During the First Withdrawal Year 

  

	4.6.1	If, on the Certificate Date the Participant or younger Joint Participant is older than the withdrawal age as shown on the Data Pages, any Withdrawal taken in the first
Withdrawal Year will cause the Withdrawal Guarantee to be adjusted prorata for the number of days between the Certificate Date and the next Birthday. In this case, the adjusted prorata Withdrawal Guarantee during the first Withdrawal Year is
(a) multiplied by (b) divided by (c), where: 

  

	 	(a)	is the unadjusted Withdrawal Guarantee; 

  

	 	(b)	is the number of days between the Certificate Date and the next Birthday; and 

  

	 	(c)	is 365. 

  

	4.6.2	Withdrawals during the first Withdrawal Year that do not exceed the adjusted prorata Withdrawal Guarantee do not change the Withdrawal Guarantee for future Withdrawal Years.

 ARTICLE V - FUNDING PHASE – DEATH PROVISIONS 
  

	5.1	If a Certificate Owner dies and the sole remaining Certificate Owner is the surviving spouse of the deceased Certificate Owner, the surviving spouse will remain as the sole
Certificate Owner. The Certificate will not automatically terminate. If the Certificate Owner dies and the sole Certificate Owner is not the surviving spouse, the Certificate will terminate. 

			
	  
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 10

	5.2	If a Participant dies and there is a Joint Participant who is the surviving spouse of the deceased Participant, the surviving Joint Participant will be deemed to be the
Beneficiary of the Certificate. 

  

	5.3	If the sole Certificate Owner with respect to the Account, other than a Qualified Account, dies, the Certificate will terminate upon that death if: (a) there is no Joint
Participant; or (b) the Joint Participant is not the Certificate Owner’s surviving spouse. 

  

	5.3.1	If the Certificate does not terminate, the surviving spouse will become the Certificate Owner. 

  

	5.4	If the Certificate Owner with respect to the Account, other than a Qualified Account, is not a natural person, and the Participant dies or a Joint Participant dies, the
Certificate will terminate upon that death. 

 ARTICLE VI - PAYOUT PHASE - INCOME PROVISIONS 
  

	6.1	There are two income provisions, Guaranteed Income and Base Income. You may elect the Guaranteed Income only on or after the Annuity Exercise Date. Under the Guaranteed
Income provision income payments are based on the Withdrawal Guarantee. You may instead elect the Base Income at any time prior to the maximum annuity age as shown on the Data Pages. The Base Income provision will have income payments based on the
Account Value and the appropriate annual payment factor table below. An election must be made by the maximum annuity age shown on the Data Pages. We will begin income payments within thirty days of the Annuity Date. 

  

	6.2	Guaranteed Income 

  

	6.2.1	Guaranteed Income is available on the Latest Annuity Date. We will provide written notice to you on the Annuity Exercise Date. The notice will inform you that, as of the
Latest Annuity Date, if you elect Guaranteed Income, you will authorize the Contract Owner to transfer the Account Value to us. We will make Guaranteed Income payments in accordance with the Income Plan shown on the Data Pages.

  

	6.2.2	The Premium for Guaranteed Income is the Account Value on the Latest Annuity Date. 

  

	6.2.3	Guaranteed Income in the first Annuity Year is adjusted for Withdrawals taken since the last Birthday. Guaranteed Income during the first Annuity Year is the greater of zero
and (a) minus (b), where: 

  

	 	(a)	is the Withdrawal Guarantee on the Latest Annuity Date; 

  

	 	(b)	is any Withdrawal(s) made since the last Birthday. 

  

	6.2.4	The Guaranteed Income after the first Annuity Year is equal to the Withdrawal Guarantee on the Latest Annuity Date. 

			
	  
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	6.2.5	Payments will be made annually on the Birthday according to the Income Plan shown on the Data Pages. Other modes of payment may be made available. However, if any payment
made more frequently than annually would be less than $100, we reserve the right to reduce the frequency of payments to an interval that would result in each payment being at least $100. 

  

	6.2.6	If you notify us in writing of your intent to cancel the guarantee within the Notice Period this Certificate will terminate. If the Contract Owner fails to deliver the
Premium, the Guaranteed Income payments may be delayed until Premium is delivered to us. 

  

	6.2.7	On the Latest Annuity Date, if the Base Income is greater than the Withdrawal Guarantee, the Guaranteed Income will be increased to equal the Base Income.

  

	6.3	Base Income 

  

	6.3.1	You may elect Base Income payments at any time prior to the maximum annuity age as shown on the Data Pages. Base Income payments may be less than the last recorded Withdrawal
Guarantee. We will make Base Income payments in accordance with the Income Plan shown on the Data Pages. The Premium for the Base Income is equal to the Account Value on the Annuity Date. Once the Premium is paid to us, the Withdrawal Guarantee will
be reduced to zero. 

  

	6.3.2	The annual payment under the Base Income provision is equal to (a) multiplied by (b) divided by (c), where: (a) is the annual payment rate per $1,000, shown
below using the Attained Age(s) of the Participant(s) on the Annuity Date; (b) is the Premium; and (c) is $1,000. 

  

	6.3.3	The annual payment rate is based on the [Annuity 2000 Mortality Table], using an interest rate of [1.0%]. 

 Base Income Factors 
  

	6.3.1	Single Participant Accounts 

 Annual payment factors
for each $1,000 of Premium 
  

			
	 Participant Age
	  	Factor
	 60
	  	37.01
	 65
	  	41.47
	 70
	  	47.07
	 75
	  	54.16
	 80
	  	63.16
	 85
	  	74.42
	 90
	  	88.62
	 95
	  	107.53
	 100
	  	136.90

 Values for ages not shown will be furnished upon request. 

			
	  
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	6.3.2	Joint Participant Accounts 

 Annual payment factors
for each $1,000 of Premium 
  

																			
	 Participant
 Age
	 	Joint Participant Age
	 	60	 	65	 	70	 	75	 	80	 	85	 	90	 	95	 	100
	60	 	34.23	 	35.78	 	36.70	 	37.07	 	37.13	 	37.10	 	37.06	 	37.04	 	37.03
	65	 	35.78	 	38.30	 	40.19	 	41.24	 	41.62	 	41.64	 	41.58	 	41.54	 	41.51
	70	 	36.70	 	40.19	 	43.41	 	45.75	 	46.95	 	47.31	 	47.28	 	47.20	 	47.15
	75	 	37.07	 	41.24	 	45.75	 	49.91	 	52.83	 	54.21	 	54.53	 	54.44	 	54.32
	80	 	37.13	 	41.62	 	46.95	 	52.83	 	58.17	 	61.83	 	63.48	 	63.74	 	63.53
	85	 	37.10	 	41.64	 	47.31	 	54.21	 	61.83	 	68.65	 	73.27	 	75.30	 	75.33
	90	 	37.06	 	41.58	 	47.28	 	54.53	 	63.48	 	73.27	 	82.06	 	88.04	 	90.33
	95	 	37.04	 	41.54	 	47.20	 	54.44	 	63.74	 	75.30	 	88.04	 	100.16	 	108.21
	100	 	37.03	 	41.51	 	47.15	 	54.32	 	63.53	 	75.33	 	90.33	 	108.21	 	127.64

 Values for ages not shown will be furnished upon request. 
  

	6.4	Continuation of Income Payments 

  

	6.4.1	Upon the death of a Participant we will continue to make income payments for the life of the surviving Participant, if any. Income payments will be made at least as rapidly
as under the method of distribution in effect before the Participant’s death. 

  

	6.4.2	If the last surviving Participant dies after the Annuity Date, your designated Beneficiary will receive any remaining income payments. The income payment will be payable on
the Birthday. Income payments will be made at least as rapidly as under the method of distribution in effect before the last Participant’s death. If there is no surviving Beneficiary upon the death of all the Participant(s), the estate of the
last surviving Certificate Owner will be the Beneficiary. If the Certificate Owner is not an individual, the Certificate Owner will be the Beneficiary. 

  

	6.5	Required Minimum Distributions 

  

	6.5.1	In a calendar year during the funding phase, if you are required to take minimum distributions under the Code you will not be considered to have made Excess Withdrawals
unless the Withdrawals for the calendar year exceed both the Withdrawal Guarantee and the required minimum distribution under the Code. Calculations will be based solely on the distributions required for the one Account associated with this
Certificate. 

 ARTICLE VII - GENERAL PROVISIONS 
  

	7.1	Assignment 

  

	7.1.1	 You may assign some or all of your rights under the Certificate only during the payout phase. If the Account is a Qualified Account you may assign rights
under this Certificate only to the extent permitted under Section 401(g) of the Code. Your rights and the rights of a Beneficiary may be affected by an assignment. A request for an assignment must be in writing and sent to our Administrative
Office. Once our Administrative Office approves and records the assignment, it will become effective as of the date the written notice was signed. 

			
	  
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	7.1.2	We are not responsible for the validity or tax consequences of any assignment. We are not liable to the assignee for any payment or settlement made under this Certificate
before the assignment is recorded. Assignments will not be approved and recorded until our Administrative Office receives sufficient direction from you and the assignee regarding the proper allocation of Certificate rights. 

 

	7.2	Right to Refuse Additions 

  

	7.2.1	We reserve the right to refuse to accept Additions to the Account Value for the purpose of computing both the Withdrawal Guarantee and asset charges upon written
notice to both the Contract Owner and the Certificate Owners. 

  

	7.3	Suspension 

  

	7.3.1	If the Contract is closed to new certificate owners, this action would not adversely affect your rights under this Certificate. 

  

	7.3.2	Other rights under the Certificate may be restricted due to a Contract suspension which includes your Certificate. Contract suspension will not change or suspend the
calculation of your benefits or charges. We reserve the right to suspend your Certificate as part of a Contract suspension if any of the following events occur: 

  

	 	(a)	the Contract Owner’s non-compliance with any provision of the Contract; 

  

	 	(b)	non-compliance with the asset allocation model agreement by or on behalf of the Contract Owner; or 

  

	 	(c)	the Contract Owner’s violation of any rights or obligations imposed by law as determined by governing regulatory and judicial bodies. 

  

	7.3.3	We will provide you with written notice if the Contract has been suspended. The notice will indicate the reason for the suspension, any restrictions on your rights under the
Certificate, and the date the suspension began. 

  

	7.3.4	Once a Contract suspension has occurred you will have the right to preserve the Withdrawal Guarantee by transferring your Account Value to a third party account insured by us
or to an annuity contract we, or one of our affiliates, offer. The Contract Owner has agreed not to charge any fees for the transfer. The Withdrawal Guarantee transferred shall be equal to the Withdrawal Guarantee on the Valuation Day of the
transfer. 

  

	7.4	Termination 

  

	7.4.1	This Certificate will not terminate if the Contract is terminated during the payout phase. During the termination cure period, as shown on the Data Pages, you will have the
right to preserve the Withdrawal Guarantee, during the funding phase, by transferring your Account Value to a third party account insured by us or to an annuity contract we offer. The Contract Owner agreed not to charge any fees for such transfer.
The Withdrawal Guarantee transferred shall be equal to the Withdrawal Guarantee on the Valuation Day of the transfer. Failure to preserve your Withdrawal Guarantee through an acceptable transfer will terminate your Certificate.

  

			
	  
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	7.4.2	We reserve the right to terminate the Contract if any of the following events occur: 

  

	 	(a)	the Contract Owner discontinues administration of the Contract without arranging for a successor to take over its responsibilities that is acceptable to us;

  

	 	(b)	the Contract Owner fails to cure the cause of a Contract suspension within the suspension cure period as shown on the Data Pages; or 

  

	 	(c)	there is a violation of any material rights or obligations imposed by law as determined by governing regulatory and/or judicial bodies. 

  

	7.4.3	We will provide you with written notice that a Contract termination event has occurred. The notice will state the reason(s) for the termination and that we intend to
terminate the Contract at the end of the Contract termination cure period as shown on the Data Pages. The termination will not take effect if the Contract Owner cures the cause. We will work with the Contract Owner to attempt to effect a mutually
acceptable cure. 

  

	7.4.4	Once during the duration of your Certificate, if the Contract Owner notifies us that you transferred your Account Value to an allocation model offered by the Contract Owner,
but not listed on the Data Pages, you will not have your Certificate terminated, but instead suspended. We will notify you that the suspension has occurred and that it will last until the end of the suspension cure period shown on the Data Pages.
During the suspension cure period, you may cure the suspension by transferring your Account Value to an allocation model shown on the Data Pages. Following such a transfer, the Withdrawal Guarantee will be recalculated on the Valuation Day following
the suspension cure period using the Account Value multiplied by the current Withdrawal Guarantee Factor for the Attained Age. This calculation will occur as of the Valuation Day following the end of the suspension cure period regardless of which
day during the cure period you transfer your assets into an allowable allocation model. If you fail to transfer your Account Value to an allowable allocation model listed on the Data Pages by the end of the suspension cure period, your Certificate
will terminate. 

  

	7.4.5	If an Addition is made to your Account when your Account exceeds the Account Limit, or if an Addition causes your Account to exceed the Account Limit, your Certificate will
be suspended. During the suspension cure period, in the case of an Account which was already over the Account Limit, you may cure the suspension by withdrawing the entire Addition. In the case of an Addition which caused the Account to exceed the
Account Limit, you may cure the suspension by withdrawing the portion of the Account Value exceeding the Account Limit. In neither case will there be an Early or Excess Withdrawal. If the suspension cure period ends without such corrective action,
your Certificate will remain suspended until the amount needed to cure the suspension is withdrawn from the Account. In this case, Early Withdrawals and Excess Withdrawals apply. Until the suspension is lifted, asset charges will apply to the
greater of the Account Limit and the Account Value prior to the Addition. 

  

	7.4.6	Your Certificate will terminate if any of the following events occur: 

  

	 	(a)	A second occurrence of you transferring your Account Value to an allocation model not shown on the Data Pages; 

  

	 	(b)	failure to pay the asset charge. 

  

			
	  
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	7.5	Income Tax Qualification 

  

	7.5.1	This Certificate is intended to qualify for tax treatment as an annuity contract under Section 72 of the Code. With respect to an Account other than a Qualified Account, if a
Certificate Owner dies during the funding phase and the surviving spouse does not become the sole Certificate Owner, the Certificate will immediately terminate. Death of the Participant or Joint Participant will terminate the Certificate if the
Certificate Owner is a non-natural person. This will satisfy the requirement in Section 72(s)(1)(B) of the Code that the entire interest of such holder in the contract be distributed within 5 years after death. If a Certificate Owner dies
during the payout phase, Section 72(s) is satisfied by the Continuation of Income Payments provision and the Death Provisions included in the Certificate. The Certificate provisions will be interpreted to preserve the intended tax
treatment. We reserve the right to amend this Certificate as needed to maintain its tax status under the Code. We will send you a copy of any amendment. 

  

	7.5.2	If the Account is a Qualified Account per the Qualified Accounts provision, this Certificate is intended to qualify for tax treatment under Section 401(g) of the
Code. 

  

	7.6	Qualified Accounts 

  

	7.6.1	If the Account is a Qualified Account maintained pursuant to an eligible retirement plan defined in Code section 402(c)(8)(B), a plan under Code section 457(b) or other plans
subject to Section 401(g), only a single person or entity may be named as Certificate Owner. For a Qualified Account, the Participant will be the individual for whose benefit the Account is maintained under the plan or arrangement. The Joint
Participant, if any, of a Qualified Account must be the Participant’s spouse. If the Participant dies during the funding phase and the sole beneficiary of the Account is not the Joint Participant, the Certificate will terminate upon the
Participant’s date of death. A former spouse may be a Joint Participant when required by a Qualified Domestic Relations Order, as defined in Code section 414(p). 

  

	7.6.2	For any Qualified Account, the Certificate may not be sold, assigned, discounted or pledged to any person other than us. It cannot be used as collateral for a loan. It cannot
be used as security for the performance of an obligation. It cannot be alienated for any other purpose. 

  

	7.7	Misstatement of Age or Account Value 

  

	7.7.1	If any Participant or Joint Participant’s age or Birthday is misstated, any Certificate benefits will be re-determined using the correct age(s). If any overpayments have
been made, future payments will be adjusted. Any underpayments will be paid in full. 

  

	7.7.2	If your Account Value is misstated, any Certificate benefits will be re-determined using the correct timing and value. If any overpayments of charges have been collected, the
overpayment will be paid in full. Any underpayments will be collected in full from you. 

  

	7.8	Nonparticipating 

  

	7.8.1	This Certificate is nonparticipating. It does not share in our profits or surplus. No dividends are payable. 

  

			
	  
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	7.9	Premium Tax 

  

	7.9.1	Premium tax rates and rules vary by state and may change. We reserve the right to deduct any such tax either from fees or Premium when received. 

  

	7.10	Written Notice 

  

	7.10.1	All written notices, including proof of death and any required forms, must be sent to our Administrative Office in a form satisfactory to us. All notices must include your
name and the Participant and any Joint Participant and the Certificate number. We will not be responsible for any actions taken prior to our receipt of a valid change request. We will send correspondence relating to your Certificate to your last
known address. 

  

	7.11	Evidence of Death, Age, Marital Status or Survival 

  

	7.11.1	We will require, to be received in our Administrative Office and in a form satisfactory to us with respect to any person, due proof of death, age, marital status or survival
and any other required forms before we act on Certificate provisions that require such documentation. 

 ARTICLE VIII -
CHARGES 
  

	8.1	Asset Charge 

  

	8.1.1	The Contract Owner will calculate, collect and remit to us an asset charge as shown on the Data Pages. Your Account may be assessed for these charges. 

  

	8.2	Change in Charges 

  

	8.2.1	We reserve the right to change the asset charge as shown on the Data Pages. We will send you advance written notice of such change at least [30] days before the change becomes
effective. Charges will be assessed on the weighted average of the Account Value at the old rate and the Addition at the new rate from the point of the Addition forward. 

  

			
	  
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 GROUP GUARANTEED INCOME 
 ANNUITY CERTIFICATE 
  

 GENWORTH LIFE AND ANNUITY 
 INSURANCE
COMPANYExhibit 4.3

 Exhibit 4.3 
  

					
	 

	 	 LifeHarborSM series, AssetMark
guaranteed income annuity participation form
 from Genworth Life and Annuity Insurance
Company

		
	 Genworth Life & Annuity
 6610 West Broad Street

 Richmond, VA 23230
 Tel: 866 447.2530
	 	 Page 1 of 4
  
 Use this form to request participation in the LifeHarbor series, AssetMark guaranteed income annuity.

									
		  		 		  	Investment account number	  	  

					
		  		 		  	Investment strategy name/number	  	  

					
		  		 		  	APL ID number Internal use only	  	  

									
	
	Certificate owner information

																							
		 		 	¡  Individual	 		  	¡  Joint	 		  	¡  Trust or custodial account	  		  		  		  		  	

													
							
		 	Certificate owner/trust name    Last, First, M.I.	 		  	Birth/trust date	 		  	 ¡  Male
 ¡  Female
 ¡  Entity
	 	
		 	 •   
	 	 	  	 •   
	 	 	  	 	 	 
		 	Address	 		  		 		  		 	
							
		 	 •   
	 	 	  	 	 	 	  	 	 	 
		 	City	 		  	State	 		  	Zip	 	
							
		 	 •   
	 	 	  	 •   
	 	 	  	 •   
	 	 
		 	Country of citizenship    If non-U.S. citizen	 		  	Social Security/Tax ID Number	 	
					
		 	 •   
	 	 	  	 •   
	 	 
							
	 If the certificate owner is a natural person, only his or
her spouse can be the joint
 certificate owner.
	 	Joint spousal owner name    Last, First, M.I.	 		  		 		  	 ¡  Male
 ¡  Female
	 	
	 	 •   
	 	 	  	 	 	 	  	 	 	 
	 	Address	 		  	Birth date	 		  		 	
							
		 	 •   
	 	 	  	 •   
	 	 	  	 	 	 
		 	City	 		  	State	 		  	Zip	 	
							
		 	 •   
	 	 	  	 •   
	 	 	  	 •   
	 	 
		 	Country of citizenship    If non-U.S. citizen	 		  	Social Security Number	 		  		 	
							
		 	 •   
	 	 	  	 •   
	 	 	  	 	 	 

													
				
	Participant information	 	 	  	 	 	 
	 The participant is the person
 on
whose life expectancy the
 guaranteed income payments
 are based.

	 	 If the owner type indicated above is individual, you may name the owner’s spouse as the joint participant. Individual owners
are automatically the participant.
 If the owner type indicated above is joint, do not complete this section. Joint owners are automatically the
participant and joint participant.
 If the owner type indicated above is a trust, you must name a participant below. You may name the spouse of the
participant as the joint participant.

							
		 	Participant	 		  		 		  		 	
							
		 	Participant name Last, First, M.I.	 		  		 		  	 ¡  Male
 ¡  Female
	 	
		 	 •   
	 	 	  	 	 	 	  	 	 	 
		 	Social Security Number	 		  	Birth date	 		  		 	
							
		 	 •   
	 	 	  	 •   
	 	 	  	 	 	 
		 	Country of citizenship    If non-U.S. citizen	 		  		 		  		 	
							
		 	 •   
	 	 	  	 	 	 	  	 	 	 
						
		 	Joint participant May only be spouse of participant	  		 		  		 	
							
		 	Joint participant name    Last, First, M.I.	 		  		 		  	 ¡  Male
 ¡  Female
	 	
		 	 •   
	 	 	  	 	 	 	  	 	 	 
		 	Social Security Number	 		  	Birth date	 		  		 	
							
		 	 •   
	 	 	  	 •   
	 	 	  	 	 	 
		 	Country of citizenship    If non-U.S. citizen	 		  		 		  		 	
							
		 	 •   
	 	 	  	 	 	 	  	 	 	 

  

													
		 	 LifeHarborSM series, AssetMark
guaranteed income annuity participation form
  
 Page 2 of
4
	 	

	
	
	Investment account

													
		 	 Type of funds    Select one
  
 Qualified funds
  
 ¡  Inherited IRA                ¡
  Traditional IRA                ¡  Rollover IRA                  ¡  Roth IRA
  
 ¡  Non-qualified funds
	 	
							
	Beneficiary information	 	 	 	 	  	 	 	 	  	 	 	 
	 You must name at least
 one beneficiary.

  
 If this is a joint account,
 you may not name the joint
 owner as beneficiary.
  
 Additional beneficiary
 designations may be made
 on a separate sheet of paper
 signed by the owner(s).
  
 If no allocation percentage

 is indicated, we will assume
 equal distribution
among
 all beneficiaries.
  
 If an allocation is made, but
 is less than 100%, we will
 make the distribution as
 indicated and will assume
 equal distribution for any
 remaining amount among
 all beneficiaries.
	 	Beneficiary name    Last, First, M.I.	 		  	Birth date	 		  	 ¡  Male
 ¡  Female
 ¡  Entity
	 	
	 	 •   
	 	 	  	 •   
	 	 	  	 	 	 
	 	Address	 		  		 		  		 	
	 	 •   
	 	 	  	 	 	 	  	 	 	 
	 	City	 		  	State	 		  	Zip	 	
	 	 •   
	 	 	  	 •   
	 	 	  	 •   
	 	 
	 	Social Security Number	 		  	Percentage of death benefit	 	
	 	 •   
	 	 	  	%	 	 
	 	Relationship to participant	 		  		 	
	 	 •   
	 	 	  	 	 	 
	 	Beneficiary name    Last, First, M.I.	 		  	Birth date	 		  	 ¡  Male
 ¡  Female
 ¡  Entity
	 	
	 	 •   
	 	 	  	 •   
	 	 	  	 	 	 
	 	Address	 		  		 		  		 	
	 	 •   
	 	 	  	 	 	 	  	 	 	 
	 	City	 		  	State	 		  	Zip	 	
	 	 •   
	 	 	  	 •   
	 	 	  	 •   
	 	 
	 	Social Security Number	 		  	Percentage of death benefit	 	
	 	 •   
	 	 	  	%	 	 	  	 	 	 
	 	Relationship to participant	 		  		 	
	 	 •   
	 	 	  	 	 	 
					
	State disclosure	 	 	 	 	  	 	 	 
		 	RESIDENTS OF ALL STATES EXCEPT CALIFORNIA, PLEASE NOTE: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit, or knowingly presents
false information in an application for insurance may be guilty of a crime and may be subject to fines and confinement in prison.
		
	 	 	 CALIFORNIA RESIDENTS PLEASE NOTE: For your protection, California law requires the
following to appear on this form. Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance may be guilty of a crime and may be subject to
fines and confinement in prison.
  

	 California residents
 age 65 and
older
  
 Please initial, indicating you
 have read each statement that
 applies to you.

	 	 The certificate will provide for a period of no less than 30 days after delivery during which
you may return it for a refund of any asset changes collected. Submit your request to: Genworth Life and Annuity Insurance Company, P.O. Box 40012, Lynchburg, VA 24506.
  

X                Owner(s) initials Advisement of consequences
in the sale or liquidation of assets:
 I have been advised that the sale or liquidation of any stock, bond, IRA, certificate of deposit, mutual fund,
annuity or other asset used to fund the purchase of a life or annuity product may involve tax consequences, early withdrawal penalties, or other costs or penalties associated with the sale or liquidation of the asset. I have also been advised by the
agent to obtain the advice of independent legal or financial counsel before selling any assets and before purchasing the life or annuity product.

		
		 	X                Owner(s) initials
Medi-Cal notice: If I am purchasing a financial product on the basis of its treatment under the Medi-Cal program, I have been advised that I do not have to use up all of my savings before applying for Medi-Cal and that under certain
conditions I am allowed to keep specific amounts as monthly income.
		
	 42523 12/19/07
  
	 	 X                Owner(s) initials
At home pre-solicitation notice:
 The sale of these financial products was not conducted in my home. Or ...
 X                Owner(s) initials The sale of these financial
products was conducted in my home and I received, in writing, no less than 24 hours prior to the agent’s visit, or if I have an existing insurance relationship with the agent and requested the meeting the same day, just prior to the meeting, a
notice informing me of the pertinent details surrounding the products I was going to be presented, my rights to have others present at the presentation, my right to contact the Department of Insurance for information or to file a complaint, and the
names, title and insurance license information of all individuals coming to my home.

					
		 	LifeHarborSM series, AssetMark guaranteed income annuity participation
form
		 	Page 3 of 4	 	
		
	Signature section	 	
	 Certificate owner signature

		
		 	I hereby request a guaranteed income annuity certificate under the contract issued by Genworth Life & Annuity to AssetMark Investment Services, Inc. I understand that upon
acceptance of this participation form by Genworth Life & Annuity, I will be bound by the provisions and entitled to the benefits of the certificate. I represent to the best of my knowledge that all statements set forth in this form are full,
complete, and true as written and are correctly recorded. I have received and read the applicable product prospectus. I have read and understand the state disclosures on page 2. I have been advised to consult with a tax professional concerning
the taxation of any annuity payments that I may receive under the certificate.
		
		 	By signing this participation form, I acknowledge that:
		
		 	 •   I have discussed this product with my investment professional and/or tax adviser and believe the
selections meet my insurance needs, financial objectives and risk tolerance.

		
		 	 •   I have received and read the applicable product prospectus, which describes the LifeHarbor Guaranteed
Income Annuity, and the available Asset Allocation Models, and AssetMark’s advisory brochures, which provide additional important information about AssetMark, it’s services and role.

		
		 	 •   I will attempt to remain a client of an investment adviser of my choosing during the life of this
investment. I understand that if I no longer have an investment adviser (such as might happen, for example, if I terminate my adviser or if my adviser retires and a new adviser does not take over that business), my account will be frozen so that no
changes to the Asset Allocation Models, (including changes to investment options and allocations), will be implemented for my account until I again have an investment adviser. I also understand that by not implementing those recommended changes to
the Asset Allocation Models, my account may experience lower performance or higher risk compared to what would have otherwise been the case. For that reason, I realize that hiring a new adviser as soon as possible would be in my best
interest.

		
		 	 •   I may utilize investment tools made available by AssetMark for selecting an Asset Allocation Model. I
understand that it is my decision, in consultation with my investment professional, to select a Model. I understand that AssetMark Investment Services, Inc (AssetMark) serves as my investment adviser for the sole purpose of providing the Asset
Allocation Models, and does not provide me with any investment advice with respect to the selection of any Model.

		
		 	 •   I understand that there is a risk of loss of my investment from market declines regardless of the Asset
Allocation Model used in the Asset Allocation Program.

		
		 	 •   I understand that the Asset Allocation Models will be analyzed from time to time and, as a result,
investment options may be added or deleted from a Model, and/or the weightings of the investment options may change. These investment options may be different from those available now and in the future. I have read the prospectus and understand that
the Asset Allocation Models may be updated from time to time. I understand that AssetMark will follow instructions from my investment adviser with respect to any changes to my account, and will assume my consent to any changes if I or my investment
adviser do not object after prior notice of a change from AssetMark.

		
		 	 •   I understand that I will receive transaction confirmations of any Asset Allocation Model
updates.

		
		 	 •   I understand that I may transfer from an Asset Allocation Model at any time, however, doing so may cause
the forfeiture of benefits available under the LifeHarbor Guaranteed Income Annuity.

			
	Your signature indicates you have read and understand all sections of this form. If you are a Trustee, Attorney-in-Fact, Guardian, Conservator or other Fiduciary, you must sign in
your capacity (e.g. Jane Smith, Trustee) and attach relevant legal documentation.	 	Certificate owner signature	 	Date
	 	X	 	 •   

	 	Capacity If applicable	 	Name of state where signed
	 	 •   
	 	 •   

	 		 	
	 	Joint certificate owner signature	 	Date
	 	X	 	 •   

	 	Capacity If applicable	 	
	 	 •   
	 	 

					
		 	LifeHarborSM series, AssetMark guaranteed income annuity participation
form
		 	Page 4 of 4
	
	 Representative signature

		
		 	By signing, I certify that the above signature(s) are genuine and that all information contained in this election form is true to the best of my knowledge and
belief.
			
		 	Broker/dealer name	 	
			
		 	 •   
	 	 
		 	Representative name Last, First, M.I. Please print	 	Licensing number Required in FL
			
		 	 •   
	 	 •   

		 	Social Security Number	 	Telephone number
			
		 	 •   
	 	 •   

		 	Representative signature	 	Date
			
		 	X	 	 •   

  

					
	 Mailing instructions Please return all pages

			
		 	For accounts held at Pershing	 	For accounts held at Genworth
		 	Advisor Solutions, Fiserv ISS	 	Financial Trust Company:
		 	or Fidelity:	 	Genworth Financial Trust Company
		 	AssetMark Investment Services, Inc.	 	P.O. Box 80007
		 	Account Operations - Box 250	 	Phoenix, AZ 85060
		 	2300 Contra Costa Blvd.	 	Tel: 800 664.5345
		 	Pleasant Hill, CA 94523	 	Fax: 602 277.0202
		 	Tel: 800 664.5354	 	
		 	Fax: 925 521.1050

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