Document:

EXHIBIT (4)(f)

 CONTRACT DATA PAGE 

 

			
	Contract Number:  [P9999999999]	  	Contract Date:  [May 2, 2014]

  

					
	Owner:  [JOHN DOE]	  	[Date of Birth:  [March 1, 1976]	  	Age at Issue:  [38]]
			
	[Owner:  [JANE DOE]	  	Date of Birth:  [June 10, 1976]	  	Age at Issue:  [37]]
			
	Annuitant:  [JOHN DOE]	  	Date of Birth:  [March 1, 1976]	  	Age at Issue:  [38]
			
	[Annuitant:  [JANE DOE]	  	Date of Birth:  [June 10, 1976]	  	Age at Issue:  [37]]

 Beneficiary: As named by You 

Initial Purchase Payment: [$25,000.00] 
 Maximum
Purchase Payment Without Our Approval:  [$1,000,000] 
 Purchase Payment Age Limit:  [Prior to the 86th birthday] 
 Minimum Subsequent Purchase Payment: [$500] 

Fixed Account Option(s) Minimum Guaranteed Interest Rate:  [1.0% - 3.0%] 

Minimum Partial Withdrawal Amount:  [$1,000] 

Maximum Penalty-Free Withdrawal Percentage:  [10%] 

Minimum Systematic Withdrawal Amount:  [$100] 

Minimum Amount Remaining After Any Partial Withdrawal:  [$2,500] 

Withdrawal Charge Schedule: 
  

 
 See Page [11] for Withdrawal Provisions. 

  

			
	AG-803-PPS4 (7/13)	  	3

 CONTRACT DATA PAGE (Cont’d.) 

[Premium Tax: None] 
 Minimum Transfer
Amount:  [$100] 
 Separate Account Charge  [(including guaranteed death benefit risk charge of [0.10%])]: 

 
 

 
 Annual Contract Maintenance Fee:  [$50] 

Transfer Fee:  [$25] 
 Earliest Annuity Date
After the Contract Date:  [Two years] 
 Latest Annuity Date:  [1st day
of the month following Your 95th Birthday] 
 Separate Account:  [Variable Separate
Account] 
  
 

 

  

			
	AG-803-PPS4 (7/13)	  	4EXHIBIT (4)(g)

 CONTRACT DATA PAGE 

 

			
	Contract Number:  [P9999999999]	  	Contract Date:  [May 2, 2014]

  

					
	Owner:  [JOHN DOE]	  	[Date of Birth:  [March 1, 1976]	  	Age at Issue:  [38]]
			
	[Owner:  [JANE DOE]	  	Date of Birth:  [June 10, 1976]	  	Age at Issue:  [37]]
			
	Annuitant:  [JOHN DOE]	  	Date of Birth:  [March 1, 1976]	  	Age at Issue:  [38]
			
	[Annuitant:  [JANE DOE]	  	Date of Birth:  [June 10, 1976]	  	Age at Issue:  [37]]

 Beneficiary: As named by You 

Initial Purchase Payment:  [$25,000.00] 

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

Purchase Payment Age Limit:  [Prior to the 86th birthday] 

Minimum Subsequent Purchase Payment:  [$500] 

Fixed Account Option(s) Minimum Guaranteed Interest Rate:  [1.0% - 3.0%] 

Minimum Partial Withdrawal Amount:  [$1,000] 

Maximum Penalty-Free Withdrawal Percentage:  [10%] 

Minimum Systematic Withdrawal Amount:  [$100] 

Minimum Amount Remaining After Any Partial Withdrawal:  [$2,500] 

Withdrawal Charge Schedule: 
  

 
 See Page [11] for Withdrawal Provisions. 
  

  

			
	AG-803-PPS7 (7/13)	  	3

 CONTRACT DATA PAGE (Cont’d.) 

[Premium Tax:  None] 
 Minimum Transfer
Amount:  [$100] 
 Separate Account Charge [(including guaranteed death benefit risk charge of  [0.10%])]: [1.15%]

 Annual Contract Maintenance Fee:  [$50] 

Transfer Fee:  [$25] 
 Earliest Annuity Date
After the Contract Date:  [Two years] 
 Latest Annuity Date:  [1st day
of the month following Your 95th Birthday] 
 Separate Account:  [Variable Separate
Account] 
  
 

 

  

			
	AG-803-PPS7 (7/13)	  	4EXHIBIT (4)(q)

 AMERICAN GENERAL LIFE INSURANCE COMPANY 

RETURN OF PURCHASE PAYMENT 

OPTIONAL DEATH BENEFIT ENDORSEMENT 
 This
Endorsement is a part of the Contract to which it is attached. Should any provision in this Endorsement conflict with the Contract, the provisions of this Endorsement will prevail. 

Capitalized terms within this Endorsement that are not defined in this Endorsement are defined or otherwise described in the Contract to which this
Endorsement is attached, including any endorsements or other riders attached to such Contract. 
 This Endorsement replaces the “AMOUNT OF DEATH
BENEFIT” and “SPOUSAL BENEFICIARY CONTINUATION” provisions under the “DEATH PROVISIONS” section in the Contract. 

TABLE OF CONTENTS 
  

					
	 Definitions
	  	 	Page1	  
	 Endorsement Data Page
	  	 	Page1	  
	 Amount of Death Benefit
	  	 	Page2	  
	 Spousal Beneficiary Continuation
	  	 	Page2	  

 DEFINITIONS 

For the purposes of this Endorsement, the following Definitions apply: 

MAXIMUM ANNUAL WITHDRAWAL AMOUNT 
 Maximum Annual
Withdrawal Amount refers to guaranteed Withdrawals applicable only if You have elected an optional guaranteed living benefit or guaranteed minimum withdrawal benefit and have not terminated the benefit under this Contract. 

NET PURCHASE PAYMENT(S) 
 Net Purchase Payment(s) are the
sum of all Purchase Payment(s), reduced for each Withdrawal in the same proportion that the Contract Value is reduced by each such Withdrawal. 

WITHDRAWAL ADJUSTMENTS 
 Withdrawal Adjustments refer to
the term used to calculate how the amount of the Death Benefit will be adjusted for Withdrawals depending on the amount of the Withdrawal and whether a guaranteed living benefit or guaranteed minimum withdrawal benefit is elected and has not been
terminated. 
 ENDORSEMENT DATA PAGE 
  

			
	 [OPTIONAL RETURN OF PURCHASE

PAYMENT DEATH BENEFIT CHARGE:
	  	Annual fee of [0.25%] of the average daily ending value of the assets attributable to the Accumulation Units of the Variable Portfolio(s) to which Your Contract is allocated. We deduct this charge daily. This charge is in
addition to other charges, fees and expenses described in Your Contract].

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

  

					
	AGE-8022 (7/13)	  	1	  	

 AMOUNT OF DEATH BENEFIT 

Upon Your death, We will pay a Death Benefit to the Beneficiary upon Our receiving all Required 

Documentation. The Death Benefit calculation is different depending on whether a guaranteed living benefit or 

guaranteed minimum withdrawal benefit has been elected and if the benefit has been terminated. 

If You did not elect a guaranteed living benefit or guaranteed minimum withdrawal benefit, We will calculate the Death Benefit as the greater of: 

 

	 	1.	The Contract Value on the Business Day during which We receive all Required Documentation; or 

  

	 	2.	Net Purchase Payment(s) received prior to the Owner’s [86th] birthday. 

If You elected a guaranteed living benefit or guaranteed minimum withdrawal benefit, We will calculate the Death Benefit as the greater of: 

 

	 	1.	The Contract Value on the Business Day during which We receive all Required Documentation; or 

  

	 	2.	Purchase Payment(s) received prior to the Owner’s [86th] birthday reduced by (a) or (b) as follows: 

 

	 	(a)	any Withdrawal Adjustments if the benefit has not been terminated; or 

  

	 	(b)	any Withdrawal Adjustments prior to the date the benefit is terminated, and reduced proportionately by any Withdrawals on and after the date the benefit is terminated. 

Spousal Beneficiary Continuation 
 If the Spousal
Beneficiary continues the Contract on the Continuation Date, the amount continued is calculated on the Business Day during which We receive all Required Documentation. The Death Benefit calculation is different depending on whether a guaranteed
living benefit or a guaranteed minimum withdrawal benefit has been elected and if the benefit has been terminated. 
 If the Spousal Beneficiary was Age [85
or younger] on the Continuation Date, and if the Owner did not elect a guaranteed living benefit or a guaranteed minimum withdrawal benefit, We will calculate the Death Benefit as the greater of: 

 

	 	1.	The Contract Value on the Business Day during which We receive all Required Documentation; or 

  

	 	2.	The Contract Value on the Continuation Date, plus Purchase Payment(s) received since the Continuation Date and prior to the Spousal Beneficiary’s [86th]
birthday, and reduced proportionately by any Withdrawals after the Continuation Date. 

 If the Spousal Beneficiary was Age [85 or younger] on
the Continuation Date, and if the Owner elected a guaranteed living benefit or guaranteed minimum withdrawal benefit, We will calculate the Death Benefit as the greater of: 
  

	 	1.	The Contract Value on the Business Day during which We receive all Required Documentation; or 

  

	 	2.	The Contract Value on the Continuation Date, plus Purchase Payment(s) received since the Continuation Date and prior to the Spousal Beneficiary’s [86th]
birthday, and reduced by (a) or (b): 

  

	 	(a)	any Withdrawal Adjustments after the Continuation Date if the benefit has not been terminated; or 

  

					
	AGE-8022 (7/13)	  	2	  	

	 	(b)	any Withdrawal Adjustments after the Continuation Date and prior to the date the benefit is terminated, and reduced proportionately by any Withdrawals after the Continuation Date and on and after the date the benefit is
terminated. 

 If the Spousal Beneficiary was Age [86 or older] on the Continuation Date, the amount of the Death Benefit is the Contract
Value on the Business Day during which We receive all Required Documentation. 
 Withdrawal Adjustments 

If a guaranteed living benefit or guaranteed minimum withdrawal benefit is elected and the benefit has not been terminated, the amount of the Death Benefit
will be adjusted for Withdrawals as follows: 
  

	 	a.	If the current Contract Year’s cumulative Withdrawals, including the current Withdrawal, are taken prior to Your [81st] birthday and are less than or equal to
the Maximum Annual Withdrawal Amount, the amount of adjustment will be the amount of each Withdrawal; or 

  

	 	b.	If the current Contract Year’s cumulative Withdrawals, including the current Withdrawal, are taken on and/or after Your [81st] birthday and/or are in excess of
the Maximum Annual Withdrawal Amount, the amount of adjustment is equal to the proportion that the amount of each Withdrawal in excess of the Maximum Annual Withdrawal Amount reduces the Contract Value. 

Signed for the Company to be effective on the Contract Date. 
  

 

  

					
	AGE-8022 (7/13)	  	3EXHIBIT (4)(r)

 AMERICAN GENERAL LIFE INSURANCE COMPANY 

MAXIMUM ANNIVERSARY VALUE 

OPTIONAL DEATH BENEFIT ENDORSEMENT 
 This
Endorsement is a part of the Contract to which it is attached. Should any provision in this Endorsement conflict with the Contract, the provisions of this Endorsement will prevail. 

Capitalized terms within this Endorsement that are not defined in this Endorsement are defined or otherwise described in the Contract to which this
Endorsement is attached, including any endorsements or other riders attached to such Contract. 
 This Endorsement replaces the “AMOUNT OF DEATH
BENEFIT” and “SPOUSAL BENEFICIARY CONTINUATION” provisions under the “DEATH PROVISIONS” section in the Contract. 

TABLE OF CONTENTS 
  

			
	 Definitions
	  	Page 1
	 Endorsement Data Page
	  	Page 1
	 Amount of Maximum Anniversary Value Death Benefit
	  	Page 2
	 Spousal Beneficiary Continuation
	  	Page 3
	 Withdrawal Adjustments
	  	Page 4

 DEFINITIONS 

For purposes of this Endorsement, the following Definitions apply: 

MAXIMUM ANNUAL WITHDRAWAL AMOUNT 
 Maximum Annual
Withdrawal Amount refers to guaranteed Withdrawals applicable only if You have elected an optional guaranteed living benefit or guaranteed minimum withdrawal benefit and have not terminated the benefit under this Contract. 

NET PURCHASE PAYMENT(S) 
 Net Purchase Payment(s) are the
sum of all Purchase Payment(s), reduced for each Withdrawal in the same proportion that the Contract Value is reduced by each such Withdrawal. 

WITHDRAWAL ADJUSTMENTS 
 Withdrawal Adjustments is the
term used to calculate how the amount of the Death Benefit will be adjusted for Withdrawals depending on the amount of the Withdrawal and whether a guaranteed living benefit or guaranteed minimum withdrawal benefit is elected and has not been
terminated. 
 ENDORSEMENT DATA PAGE 
  

			
	 MAXIMUM ANNIVERSARY VALUE

OPTIONAL DEATH BENEFIT CHARGE:
	  	Annual fee of [0.25%] of the average daily ending value of the assets attributable to the Accumulation Units of the Variable Portfolio(s) to which Your Contract is allocated. We deduct this charge daily. This charge is in
addition to other charges, fees and expenses described in Your Contract.

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

AMOUNT OF MAXIMUM ANNIVERSARY VALUE DEATH BENEFIT 

  

					
	AGE-8023 (7/13)	  	1	  	

 Upon Your death, We will pay a Death Benefit to the Beneficiary upon Our receipt of all Required Documentation.
The Death Benefit calculation is different depending on whether a guaranteed living benefit or guaranteed minimum withdrawal benefit has been elected and if the benefit has been terminated. 

If You were Age [80 or younger] on the Contract Date, and did not elect a guaranteed living benefit or guaranteed minimum withdrawal benefit, upon Our receipt
of all Required Documentation, We will calculate the Death Benefit as the greatest of: 
  

	 	1.	The Contract Value on the Business Day during which We receive all Required Documentation; or 

  

	 	2.	Net Purchase Payment(s) received prior to the Owner’s [86th] birthday; or 

 

	 	3.	The Maximum Anniversary Value that is equal to the greatest anniversary value determined prior to the earlier of: 

  

	 	a)	Your [83rd] birthday; or 

  

	 	b)	Your date of death; 

 plus Purchase Payment(s) received since that Contract anniversary, but
prior to Your [86th] birthday, and this sum is reduced proportionately for any Withdrawals since that Contract anniversary. 

If You were Age [80 or younger] on the Contract Date and elected a guaranteed living benefit or guaranteed minimum withdrawal benefit, We will calculate the
Death Benefit as the greatest of: 
  

	 	1.	The Contract Value on the Business Day during which We receive all Required Documentation; or 

  

	 	2.	Purchase Payment(s) received prior to Your [86th] birthday reduced by a) or b) as follows: 

 

	 	a)	any Withdrawal Adjustments if the benefit has not been terminated; 

  

	 	b)	any Withdrawal Adjustments prior to the date the benefit is terminated, and reduced proportionately for any Withdrawals on and after the date the benefit is terminated; or 

 

	 	3.	The Maximum Anniversary Value that is equal to the greatest anniversary value determined prior to the earlier of: 

  

	 	i)	Your [83rd] birthday; or 

  

	 	ii)	Your date of death; 

 plus Purchase Payment(s) received since that Contract anniversary, but
prior to 
 Your [86th] birthday, and this sum is reduced by a) or b) as follows: 

 

	 	a)	any Withdrawal Adjustments if the benefit has not been terminated; 

  

					
	AGE-8023 (7/13)	  	2	  	

	 	b)	any Withdrawal Adjustments prior to the date the benefit is terminated, and reduced proportionately for any Withdrawals on and after the date the benefit is terminated. 

Spousal Beneficiary Continuation 
 If the Spousal
Beneficiary continues the Contract on the Continuation Date, the amount continued is calculated on the Business Day during which We receive all Required Documentation. The Death Benefit calculation is different depending on whether a guaranteed
living benefit or guaranteed minimum withdrawal benefit has been elected and if the benefit has been terminated. 
 If the Spousal Beneficiary was Age [80
or younger] on the Continuation Date, and if the Owner did not elect a guaranteed living benefit or guaranteed minimum withdrawal benefit, We will calculate the Death Benefit as the greatest of: 

 

	 	1.	The Contract Value on the Business Day during which We receive all Required Documentation; or 

  

	 	2.	The Contract Value on the Continuation Date, plus Purchase Payment(s) received after the Continuation Date and prior to the Spousal Beneficiary’s [86th] birthday
and this sum is reduced proportionately for any Withdrawals after the Continuation Date; or 

  

	 	3.	The Maximum Anniversary Value after the Continuation Date that is equal to the greatest anniversary value determined prior to the earlier of: 

 

	 	a)	The Spousal Beneficiary’s [83rd] birthday; or 

	 	b)	The Spousal Beneficiary’s date of death; 

 plus Purchase Payment(s) received after the
Continuation Date and since that Contract anniversary, and prior to the Spousal Beneficiary’s [86th] birthday and this sum is reduced proportionately for any Withdrawals since that Contract
anniversary. 
 If the Spousal Beneficiary was Age [80 or younger] on the Continuation Date, and if the Owner elected a guaranteed living
benefit or guaranteed minimum withdrawal benefit, We will calculate the Death Benefit as the greatest of: 
  

	 	1.	The Contract Value on the Business Day during which We receive all Required Documentation; or 

  

	 	2.	The Contract Value on the Continuation Date, plus Purchase Payment(s) received after the Continuation Date and prior to the Spousal Beneficiary’s [86th] birthday
and this sum is reduced by a) or b) as follows: 

  

	 	a)	any Withdrawal Adjustments if the benefit has not been terminated; 

	 	b)	any Withdrawal Adjustments prior to the date the benefit is terminated, and reduced proportionately for any Withdrawals on and after the date the benefit is terminated; or 

 

	 	3.	The Maximum Anniversary Value after the Continuation Date that is equal to the greatest anniversary value determined prior to the earlier of: 

 

	 	i)	the Spousal Beneficiary’s [83rd] birthday; or 

	 	ii)	the Spousal Beneficiary’s date of death; 

  

					
	AGE-8023 (7/13)	  	3	  	

 plus Purchase Payment(s) received after the Continuation Date and since that Contract
anniversary, and prior to the Spousal Beneficiary’s [86th] birthday and this sum is reduced by a) or b) as follows: 
  

	 	a)	any Withdrawal Adjustments since that anniversary if the benefit has not been terminated; 

	 	b)	any Withdrawal Adjustments since that anniversary but prior to the date the benefit is terminated, and reduced proportionately for any Withdrawals since that anniversary that occur on and after the date the benefit is
terminated. 

 If the Spousal Beneficiary was at least Age [81 but younger than Age 86] on the Continuation Date, and if the
Owner did not elect a guaranteed living benefit or guaranteed minimum withdrawal benefit, We will calculate the Death Benefit as the greater of: 
  

	 	1.	The Contract Value on the Business Day during which We receive all Required Documentation; or 

  

	 	2.	The Contract Value on the Continuation Date, plus Purchase Payment(s) received after the Continuation Date, and prior to the Spousal Beneficiary’s 86th birthday,
and this sum is reduced proportionately for any Withdrawals after the Continuation Date. 

 If the Spousal Beneficiary was at
least Age [81 but younger than Age 86] on the Continuation Date, and if the Owner elected a guaranteed living benefit or guaranteed minimum withdrawal benefit, We will calculate the Death Benefit as the greater of: 

 

	 	1.	The Contract Value on the Business Day during which We receive all Required Documentation; or 

  

	 	2.	The Contract Value on the Continuation Date, plus Purchase Payment(s) received after the Continuation Date and prior to the Spousal Beneficiary’s 86th birthday
and this sum is reduced by (a) or (b) as follows: 

	 	a)	any Withdrawal Adjustments after the Continuation Date if the benefit has not been terminated; or 

	 	b)	any Withdrawal Adjustments after the Continuation Date and prior to the date the benefit is terminated, and reduced proportionately for any Withdrawals after the Continuation Date that occur on and after the date the
benefit is terminated. 

 If the Spousal Beneficiary was Age [86 or older] on the Continuation Date, the amount of the Death
Benefit is the Contract Value on the Business Day during which We receive all Required Documentation. 
 Withdrawal Adjustments 

If a guaranteed living benefit or guaranteed minimum withdrawal benefit is elected and the benefit has not been terminated, the amount of the
Death Benefit will be adjusted for Withdrawals as follows: 
  

	 	1.	If the current Contract Year’s cumulative Withdrawals, including the current Withdrawal, are taken prior to Your [81st] birthday and are less than or equal to
the Maximum Annual Withdrawal Amount, the amount of adjustment will be the amount of each Withdrawal; or 

  

	 	2.	If the current Contract Year’s cumulative Withdrawals, including the current Withdrawal, are taken on and/or after Your [81st] birthday and/or are in excess of
the Maximum Annual Withdrawal Amount, the amount of adjustment is equal to 

  

					
	AGE-8023 (7/13)	  	4	  	

 the proportion that the amount of each Withdrawal in excess of the Maximum 

Annual Withdrawal Amount reduces the Contract Value. 

Signed for the Company to be effective on the Contract Date. 
  

 

  

					
	AGE-8023 (7/13)	  	5

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