Document:

EXHIBIT (4)(C)

 EXHIBIT (4)(c) 

FORM OF POLICY RIDER (RETIREMENT INCOME CHOICE) 

			
	

		Home Office located at:
		[4 Manhattanville Road, Purchase, New York 10577]
		Adm. Office located at:
		[4333 Edgewood Road N.E. Cedar Rapids, Iowa 52499]
	A Stock Company (Hereafter called the Company, we, our or us)		[(319) 398-8511]

 GUARANTEED LIFETIME WITHDRAWAL BENEFIT RIDER 

This rider is issued as a part of the policy (contract) to which it is attached. 

All provisions of the policy that do not conflict with this rider apply to this rider. In the event of any conflict between the provisions of this rider and
the provisions of the policy, the provisions of this rider shall prevail over the provisions of the policy. 
 Rider Data
Specification 
  

											
	Policy Number:				 		12345		 		

	Rider Date:				 		09/01/2007		 	
	Growth Rate Percentage:						5.00%			
	Initial Rider Fee Percentage:				 		0.60%		 	
	Annuitant:						John Doe		 	
	Annuitant’s Issue Age/Sex:				 		65 / Male		 	

 ARTICLE I 
 You
may cancel this rider before midnight of the thirtieth day after you received it and no rider fees will be assessed. 
 This benefit provides a
minimum withdrawal benefit that guarantees, upon election, a series of withdrawals from the policy equal to the Withdrawal Percentage shown in Article II applied to the benefit base. The benefit base is established for the sole purpose of
determining the minimum withdrawal benefit and is not used in calculating the cash surrender value or other guaranteed benefits. 
 This rider will
terminate upon the annuitant’s death, if you surrender your policy, elect to upgrade (as described in Article III of this rider), or elect to receive annuity payments under your policy. This rider will also terminate if the policy to which this
rider is attached is assigned or if the owner is changed without our approval. You can terminate this rider within [30] days after the [fifth] rider anniversary and every [fifth] rider anniversary thereafter. Termination of the rider will result in
the loss of all benefits provided by the rider. 
 If you elect this rider, 100% of your policy value must be in one or more of the designated funds (shown
on the application which is attached and made part of the policy). You can generally transfer between the designated funds as permitted under your policy; however, you cannot make transfers as provided for in the policy to a non-designated fund
while this rider is in force. If you wish to make a transfer to a non-designated fund, this rider must be terminated, as described above, prior to making the transfer. 

A rider fee will be deducted on each rider anniversary and upon rider termination as described below. 

DEFINITIONS: 
 Terms used that are not defined in this
rider shall have the same meaning as those in your policy. 
 Designated Funds 

Investment options authorized for use with this rider and identified by us as designated funds. 

  

					
	RGMB 27 0108 (IS) (NY)		(1)		(Income - Single)

 ARTICLE I CONTINUED 

Excess Withdrawal 
 The excess of a gross partial
withdrawal over the rider withdrawal amount remaining prior to the withdrawal, if any. 
 Gross Partial Withdrawal 

The amount which will be deducted from your policy value as a result of each partial withdrawal. 

Rider Anniversary 
 The anniversary of the rider date.

 Rider Fee 
 The rider fee is the rider fee percentage
multiplied by the withdrawal base at the time the fee is deducted. This amount will change if the withdrawal base changes. The rider fee percentage will not change during the first five rider years, and will only change thereafter due to an
automatic step-up. You will be notified of any increase in the rider fee percentage. This fee will be deducted from each subaccount in proportion to the amount of policy value in that subaccount on each rider anniversary prior to any increase in the
withdrawal base. A portion of this fee will also be deducted when the rider is terminated based on the number of days that have elapsed since the previous rider anniversary. 

Rider Monthiversary 
 The same day of the month as the
rider date. For months not containing that day, we will use the first day of the following month. 
 Rider Withdrawal Amount 

The total amount that can be withdrawn from the policy each rider year without reducing the withdrawal base. This amount will change if the withdrawal base
changes. 
 Rider Year 
 Each twelve-month period
following the rider date. 
 Withdrawal Base 
 The
amount used to calculate the rider withdrawal amount and the rider fee. This amount cannot be taken as a lump sum. 
 ARTICLE II 

GUARANTEED LIFETIME WITHDRAWAL BENEFIT 
 Under this rider,
we guarantee that you can withdraw up to the rider withdrawal amount each rider year, regardless of the policy value, until the annuitant’s death. 

The withdrawal percentage is determined by the attained age (age at last birthday) of the annuitant at the time of the first withdrawal of any amount from the
policy value taken on or after the rider anniversary following the annuitant’s 59th birthday. Once the withdrawal percentage is established, it may only be changed by an upgrade and redetermined at that time. The withdrawal percentages are
shown in the table below. 
  

																											
	 Attained Age
	 	 Withdrawal

Percentage

		 		 				 		 		 		 		 		 		 		  		 		  	
		 	 	 	 	59	  	 	- 	 	 	 	69	 	 	 		 		 	 	  	5.0%	 	 	  	
		 		 				 		 		 		 		 		 		 		  		 	 	  	
		 		 	 	70	  	 	-	 		 	79	 	 	 		 		 		  	6.0%	 	 	  	
		 	 	 	 	80 +	 	 	 		 		 	 	  	7.0%	 	 	  	

 If the annuitant is not yet 59 on the rider date, the withdrawal percentage will be zero until the rider anniversary following
the annuitant’s 59th birthday. 
 Withdrawals will reduce the policy value of the policy to which this rider is attached. If the policy value equals
zero, you cannot make subsequent premium payments and all other policy features, benefits and guarantees are no longer available. Withdrawals guaranteed by this rider can be continued by selecting an amount and frequency in accordance with the
policy provisions to which this rider attaches. Once the payment amount and frequency are established, they cannot be changed and no additional withdrawals will be allowed. 

  

					
	RGMB 27 0108 (IS) (NY)	  	(2)	  	(Income - Single)

 ARTICLE II CONTINUED 

We guarantee that you may withdraw up to the rider withdrawal amount each year regardless of the policy value until the annuitant’s death. Any amount you
withdraw in excess of the rider withdrawal amount may impact the withdrawal base on a greater than dollar-for-dollar basis. 
 Example

 Assume you are the owner and annuitant and make a single premium payment of $100,000 when you are 60 years old. Assume you do not make
any withdrawals or additional premium payments. Assume that after ten rider years, your policy value has declined to $50,000 solely because of negative investment performance. Assuming a withdrawal percentage of 6%, you could still withdraw up to
$9773 each rider year for the rest of your life (assuming that you do not withdraw more than $9773 in any one rider year). 
 Please see the Appendix
attached to this rider which illustrates the withdrawal benefit. 
 The Guaranteed Lifetime Withdrawal Benefit can only be taken as a withdrawal benefit and
it does not increase the policy value. 
 ISSUE AGE AND SURVIVAL 

The benefits under this rider depend on the annuitant being alive at the time of withdrawal and the amount of the benefit depends on the issue age of the
annuitant. Proof of survival and the issue age may be required by the Company. 
 If the annuitant’s age has been misstated, this rider’s fees and
benefits will be adjusted to the amounts which would have been calculated for the correct age. However, if this rider would not have been issued had the age not been misstated, the rider is treated as if it never existed. If withdrawals under the
provisions of the rider have already commenced and the misstatement caused the rider withdrawal amount to be overstated, any withdrawal in excess of the correct rider withdrawal amount will be considered an excess withdrawal and will impact the
withdrawal base and rider withdrawal amount. If overpayments occurred when the sum of the accumulated values in all the designated funds was zero, the amount of that overpayment will be deducted from one or more future payments until this amount is
paid in full. 
 RIDER WITHDRAWAL AMOUNT 
 The rider
withdrawal amount will be equal to the greater of 1) and 2), where: 
  

	1)	is the withdrawal percentage multiplied by the withdrawal base; 

  

	2)	is an amount equal to the minimum required distribution amount. Prior to the 1st rider anniversary, this amount is based on the initial policy value on the rider date. After this time, the minimum required distribution
is calculated based on the rules established by the IRS. The minimum required distribution may only be used if all of the following are true: 

  

	 	A)	the policy to which this rider is attached is a tax-qualified policy for which IRS minimum required distributions are required, 

  

	 	B)	the minimum required distributions do not start prior to the annuitant’s attained age 70 1/2, 

  

	 	C)	the minimum required distributions are based on either the Uniform Lifetime table or the Joint Life and Last Survivor Expectancy table, 

 

	 	D)	the minimum required distributions are based on age of the living annuitant. The minimum required distributions can not be based on the age of someone who is deceased, 

 

	 	E)	the minimum required distributions are based only on the policy to which this rider is attached, and 

  

	 	F)	the minimum required distributions are only for the current rider year. Amounts carried over from past rider years are not considered. 

If any of the above are not true, then 2) is equal to zero and it is not available as a rider withdrawal amount. An amount in addition to the amount described
in 2) above, may need to be taken to satisfy minimum required distributions, in certain situations. Such additional withdrawal amount will be considered an excess withdrawal. 

If you withdraw less than the rider withdrawal amount in a rider year, the unused portion cannot be carried over to the next rider year. 

 

  

					
	RGMB 27 0108 (IS) (NY)		(3)		(Income - Single)

 ARTICLE II CONTINUED 

WITHDRAWAL BASE 
 The withdrawal base is used to calculate
the rider withdrawal amount. On the rider date, the initial withdrawal base is equal to the policy value (less any premium enhancements if the rider is added in the first policy year). During any rider year, the withdrawal base is increased by
subsequent premium payments (less any premium enhancements), and is reduced for excess withdrawals. 
 On each rider anniversary, the withdrawal base will
be set to the greatest of: 
  

	 	1)	The current withdrawal base; 

  

	 	2)	The policy value on the rider anniversary; 

  

	 	3)	The highest policy value on a rider [monthiversary;] or 

  

	 	4)	The current withdrawal base immediately prior to anniversary processing increased by the growth rate percentage. 

Item 3) above will be zero if there have been any excess withdrawals in the current rider year. Item 4) above will be zero after the [10th] rider
anniversary or if there have been any withdrawals in the current rider year. 
 AUTOMATIC STEP-UP FEATURE 

The rider receives an automatic step-up on the rider anniversary if the withdrawal base is set equal to the policy value or the highest policy value on a rider
[monthiversary.] This feature does not require the termination of the existing rider. This rider will continue with the same rider date and features. The rider fee percentage may be changed due to an automatic step-up, but there will be no increase
in the rider fee percentage during the first [five] rider years. Following the [fifth] rider anniversary, the rider fee percentage may be increased due to an automatic step-up, but will not increase more than [0.75%] from the initial rider fee
percentage shown on page 1. 
 You have the right to reject an automatic step-up within [30] days following a rider anniversary, if the rider fee percentage
increases. If you reject an automatic step-up, you must notify us in a manner which is acceptable to us. Changes as a result of the automatic step-up feature will be reversed. And any increase in the rider fee percentage will also be reversed. 

WITHDRAWAL BASE ADJUSTMENTS 
 Gross partial withdrawals,
taken in a rider year, less than or equal to the rider withdrawal amount will not reduce the withdrawal base. Excess withdrawals will reduce the withdrawal base by the withdrawal base adjustment. The withdrawal base adjustment is the greater of 1)
and 2), where: 
  

	1)	is the excess withdrawal amount; and 

  

	2)	is the result of (A multiplied by B), divided by C, where: 

  

	 	A)	is the excess withdrawal; 

  

	 	B)	is the withdrawal base prior to the excess withdrawal amount; and 

  

	 	C)	is the policy value after the rider withdrawal amount has been withdrawn, but prior to the withdrawal of the excess withdrawal amount. 

  

					
	RGMB 27 0108 (IS) (NY)		(4)		(Income - Single)

 ARTICLE III 

CONTINUATION 
 In the case of spousal joint owners where
one spouse is the annuitant, if the spouse who is not the annuitant dies and the surviving spouse is the sole beneficiary, the surviving spouse may elect to continue the policy and rider. In the case of spousal joint owners where one spouse is the
annuitant, if the spouse who is the annuitant dies, this rider will terminate. 
 In the case of non-spousal joint owners where an owner who is not the
annuitant dies, the surviving owner (who is also the sole designated beneficiary) may elect to receive lifetime income payments under this rider instead of receiving any benefits applicable to the policy. The lifetime income payments must begin no
later than 1 year after the owner’s death and will be equal to the rider withdrawal amount divided by the number of payments made per year. Once the payments begin, no additional premium payments will be accepted and no additional withdrawals
will be paid. 
 ANNUITIZATION 
 On the maximum annuity
commencement date, you will have the option to receive lifetime income payments that are no less than your rider withdrawal amount each year. This option will also guarantee that the sum of all income payments received over time will equal or exceed
the policy value on the maximum annuity commencement date. If the annuitant should die before the sum of all income payments received equals or exceeds the policy value on the maximum annuity commencement date, the annuitant’s beneficiary will
receive a final payment equal to the difference. 
 RIDER UPGRADE 

You may elect, in writing, to upgrade the withdrawal base to the policy value within [30] days after the [fifth] rider anniversary and every [fifth] rider
anniversary thereafter, subject to the issue age restrictions on the new rider. If an upgrade is elected, this rider will terminate and a new rider with the same features will be issued with a new rider date. The new rider will have its own rider
fee percentage which may be higher than this rider’s rider fee percentage. Other riders with different features may be chosen, if available by the Company. 

At the time of upgrade, the rider withdrawal amount will be recalculated based on the new withdrawal base. 

The new rider date will be the date the Company receives all information necessary, in a written form acceptable to the Company, to process the upgrade. 

 

			
	Signed for us at our home office.
	

		

  

					
	RGMB 27 0108 (IS) (NY)		(5)		(Income - Single)

 APPENDIX 

EXAMPLE OF EFFECT OF WITHDRAWALS ON RIDER BENEFITS 
 The
following examples illustrate the effect of withdrawals on Rider benefits. A withdrawal greater than the rider withdrawal amount is assumed at the end of year 1. A withdrawal equal to the rider withdrawal amount is assumed at the end of year 2.

 The Withdrawal Base on the rider date is $100,000. For this example, hypothetical policy values prior to each annual withdrawal are assumed to be
$94,000 at the end of rider year 1, and $90,000 at the end of rider year 2. Assume the rider is added to the policy on 12/1/2007 and the age of the annuitant is 65 years old. Since the annuitant is age 66 when they take their first withdrawal, their
withdrawal percentage is assumed to be 5.0% in this example. 
 The effects on the withdrawal percentage, and on the Guaranteed Lifetime Withdrawal
Benefit are shown in succession in this example. 
 ADJUSTED PARTIAL WITHDRAWAL CALCULATIONS FOR GUARANTEED LIFETIME WITHDRAWAL BENEFITS: 

Withdrawal Base. Gross partial withdrawals up to the rider withdrawal amount will not reduce the withdrawal base. Gross partial withdrawals in excess of
the rider withdrawal amount will reduce the withdrawal base pro rata. The amount of the reduction due to the excess withdrawal is equal to the greater of: 
  

	 	1).	The excess gross partial withdrawal amount; and 

  

	 	2).	The result of (A / B) * C, where: 

  

	 	A	is the excess gross partial withdrawal (the amount in excess of the rider withdrawal amount remaining prior to the withdrawal); 

  

	 	B	is the policy value after the rider withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

  

	 	C	is the withdrawal base prior to the withdrawal of the excess amount. 

 When a withdrawal is taken, two parts of
the guaranteed lifetime withdrawal benefit can be affected: 
  

	 	1.	Withdrawal base (“WB”) 

  

	 	2.	Rider withdrawal amount (“RWA”) 

 Effects on WB and RWA: 

Year 1: 
 WB = $100,000 

5% Withdrawal (WD) would be $5,000 (5% of WB $100,000) 

Assumed WD = $7,000 

Excess withdrawal (“EWD”) = $2,000 ($7,000 - $5,000) 

Assumed Policy Value (PV) = $94,000 
  

  

					
	RGMB 27 0108 (IS) (NY)		(A-1)		

 Withdrawal Base after WD: 

Step One. The withdrawal base is only reduced by amount of the excess or the pro rata amount if greater. 

Step Two. Calculate how much the withdrawal base is effected by the excess withdrawal. 

 

	 	1.	The formula is (EWD / (PV- 5% WD)) * WB before any adjustments 

  

	 	2.	($2,000 / ($94,000 - $5,000)) * $100,000 = $2,247.19 

 Step Three. Which is larger, the actual $2,000
excess withdrawal or the $2,247.19 pro rata amount? 
 $2,247.19 pro rata amount 

Step Four. What is the new withdrawal base upon which the rider withdrawal amount is based? 

$100,000 - $2,247.19 = $97,752.81 
 Result. The
new withdrawal base is $97,752.81. 
 Rider Withdrawal Amount after WD: 

Because the withdrawal base was adjusted (due to excess withdrawal), we have to calculate a new rider withdrawal amount based on 5% for the guarantee that will
be available starting in the second rider year. 
 Step One. What is the rider withdrawal amount for rider year 2? 

$97,752.81 (the adjusted withdrawal base) * 5% = $4,887.64 

Result. Beginning in rider year 2, the maximum you can take out in a rider year is $4,887.64 annually without causing an excess withdrawal for the guarantee
and further reduction of the withdrawal base. 
 Year 2: 

WB = $97,752.81 
 5% WD would be
$4,887.64 (5% of WB $97,752.81) 
 Assumed WD = $4,887.64 

Excess withdrawal (“EWD”) = none 

Assumed PV = $90,000 
 Since no portion of the
total withdrawal exceeded the rider withdrawal amount, then the withdrawal base will stay at $97,752.81. 
  

  

					
	RGMB 27 0108 (IS) (NY)		(A-2)		

			
	

		Home Office located at:
		[4 Manhattanville Road, Purchase, New York 10577]
		Adm. Office located at:
		[4333 Edgewood Road N.E. Cedar Rapids, Iowa 52499]
	A Stock Company (Hereafter called the Company, we, our or us)		[(319) 398-8511]

 GUARANTEED LIFETIME WITHDRAWAL BENEFIT 

AND DEATH BENEFIT RIDER 
 This rider is
issued as a part of the policy (contract) to which it is attached. 
 All provisions of the policy that do not conflict with this rider apply to this rider.
In the event of any conflict between the provisions of this rider and the provisions of the policy, the provisions of this rider shall prevail over the provisions of the policy. 

Rider Data Specification 
  

											
	Policy Number:				 		12345		 		

	Rider Date:				 		09/01/2007		 	
	Growth Rate Percentage:						5.00%			
	Initial Rider Fee Percentage:				 		0.85%		 	
	Annuitant:						John Doe		 	
	Annuitant’s Issue Age/Sex:				 		65 / Male		 	

 ARTICLE I 
 You
may cancel this rider before midnight of the thirtieth day after you received it and no rider fees will be assessed. 
 This benefit provides a
minimum withdrawal benefit that guarantees, upon election, a series of withdrawals from the policy equal to the Withdrawal Percentage shown in Article II applied to the benefit base. The benefit base is established for the sole purpose of
determining the minimum withdrawal benefit and is not used in calculating the cash surrender value or other guaranteed benefits. 
 This rider will
terminate upon the annuitant’s death, if you surrender your policy, elect to upgrade (as described in Article III of this rider), or elect to receive annuity payments under your policy. This rider will also terminate if the policy to which this
rider is attached is assigned or if the owner is changed without our approval. You can terminate this rider within [30] days after the [fifth] rider anniversary and every [fifth] rider anniversary thereafter. Termination of the rider will result in
the loss of all benefits provided by the rider. 
 If you elect this rider, 100% of your policy value must be in one or more of the designated funds (shown
on the application which is attached and made part of the policy). You can generally transfer between the designated funds as permitted under your policy; however, you cannot make transfers as provided for in the policy to a non-designated fund
while this rider is in force. If you wish to make a transfer to a non-designated fund, this rider must be terminated, as described above, prior to making the transfer. 

A rider fee will be deducted on each rider anniversary and upon rider termination as described below. 

DEFINITIONS: 
 Terms used that are not defined in this
rider shall have the same meaning as those in your policy. 
 Designated Funds 

Investment options authorized for use with this rider and identified by us as designated funds. 

  

					
	RGMB 27 0108 (AS) (NY)		(1)		(Income/Death-Single)

 ARTICLE I CONTINUED 

Excess Withdrawal 
 The excess of a gross partial
withdrawal over the rider withdrawal amount remaining prior to the withdrawal, if any. 
 Gross Partial Withdrawal 

The amount which will be deducted from your policy value as a result of each partial withdrawal. 

Rider Anniversary 
 The anniversary of the rider date.

 Rider Fee 
 The rider fee is the rider fee percentage
multiplied by the withdrawal base at the time the fee is deducted. This amount will change if the withdrawal base changes. The rider fee percentage will not change during the first five rider years, and will only change thereafter due to an
automatic step-up. You will be notified of any increase in the rider fee percentage. This fee will be deducted from each subaccount in proportion to the amount of policy value in that subaccount on each rider anniversary prior to any increase in the
withdrawal base. A portion of this fee will also be deducted when the rider is terminated based on the number of days that have elapsed since the previous rider anniversary. 

Rider Monthiversary 
 The same day of the month as the
rider date. For months not containing that day, we will use the first day of the following month. 
 Rider Withdrawal Amount 

The total amount that can be withdrawn from the policy each rider year without reducing the withdrawal base. This amount will change if the withdrawal base
changes. 
 Rider Year 
 Each twelve-month period
following the rider date. 
 Withdrawal Base 
 The
amount used to calculate the rider withdrawal amount and the rider fee. This amount cannot be taken as a lump sum. 
 ARTICLE II 

GUARANTEED LIFETIME WITHDRAWAL BENEFIT 
 Under this rider,
we guarantee that you can withdraw up to the rider withdrawal amount each rider year, regardless of the policy value, until the annuitant’s death. 

The withdrawal percentage is determined by the attained age (age at last birthday) of the annuitant at the time of the first withdrawal of any amount from the
policy value taken on or after the rider anniversary following the annuitant’s 59th birthday. Once the withdrawal percentage is established, it may only be changed by an upgrade and redetermined at that time. The withdrawal percentages are
shown in the table below. 
  

																											
	 Attained Age
	 	 Withdrawal

Percentage

		 		 				 		 		 		 		 		 		 		  		 		  	
		 	 	 	 	59	  	 	- 	 	 	 	69	 	 	 		 		 	 	  	5.0%	 	 	  	
		 		 				 		 		 		 		 		 		 		  		 	 	  	
		 		 	 	70	  	 	-	 		 	79	 	 	 		 		 		  	6.0%	 	 	  	
		 	 	 	 	80 +	 	 	 		 		 	 	  	7.0%	 	 	  	

 If the annuitant is not yet 59 on the rider date, the withdrawal percentage will be zero until the rider anniversary following
the annuitant’s 59th birthday. 
 Withdrawals will reduce the policy value of the policy to which this rider is attached. If the policy value equals
zero, you cannot make subsequent premium payments and all other policy features, benefits and guarantees are no longer available. Withdrawals guaranteed by this rider can be continued by selecting an amount and frequency in accordance with the
policy provisions to which this rider attaches. Once the payment amount and frequency are established, they cannot be changed and no additional withdrawals will be allowed. 

  

					
	RGMB 27 0108 (AS) (NY)	  	(2)	  	(Income/Death-Single)

 ARTICLE II CONTINUED 

We guarantee that you may withdraw up to the rider withdrawal amount each year regardless of the policy value until the annuitant’s death. Any amount you
withdraw in excess of the rider withdrawal amount may impact the withdrawal base on a greater than dollar-for-dollar basis. 
 Example

 Assume you are the owner and annuitant and make a single premium payment of $100,000 when you are 60 years old. Assume you do not make
any withdrawals or additional premium payments. Assume that after ten rider years, your policy value has declined to $50,000 solely because of negative investment performance. Assuming a withdrawal percentage of 6%, you could still withdraw up to
$9773 each rider year for the rest of your life (assuming that you do not withdraw more than $9773 in any one rider year). 
 Please see the Appendix
attached to this rider which illustrates the withdrawal benefit. 
 The Guaranteed Lifetime Withdrawal Benefit can only be taken as a withdrawal benefit and
it does not increase the policy value. 
 ISSUE AGE AND SURVIVAL 

The benefits under this rider depend on the annuitant being alive at the time of withdrawal and the amount of the benefit depends on the issue age of the
annuitant. Proof of survival and the issue age may be required by the Company. 
 If the annuitant’s age has been misstated, this rider’s fees and
benefits will be adjusted to the amounts which would have been calculated for the correct age. However, if this rider would not have been issued had the age not been misstated, the rider is treated as if it never existed. If withdrawals under the
provisions of the rider have already commenced and the misstatement caused the rider withdrawal amount to be overstated, any withdrawal in excess of the correct rider withdrawal amount will be considered an excess withdrawal and will impact the
withdrawal base and rider withdrawal amount. If overpayments occurred when the sum of the accumulated values in all the designated funds was zero, the amount of that overpayment will be deducted from one or more future payments until this amount is
paid in full. 
 RIDER WITHDRAWAL AMOUNT 
 The rider
withdrawal amount will be equal to the greater of 1) and 2), where: 
  

	1)	is the withdrawal percentage multiplied by the withdrawal base; 

  

	2)	is an amount equal to the minimum required distribution amount. Prior to the 1st rider anniversary, this amount is based on the initial policy value on the rider date. After this time, the minimum required distribution
is calculated based on the rules established by the IRS. The minimum required distribution may only be used if all of the following are true: 

  

	 	A)	the policy to which this rider is attached is a tax-qualified policy for which IRS minimum required distributions are required, 

  

	 	B)	the minimum required distributions do not start prior to the annuitant’s attained age 70 1/2, 

  

	 	C)	the minimum required distributions are based on either the Uniform Lifetime table or the Joint Life and Last Survivor Expectancy table, 

 

	 	D)	the minimum required distributions are based on age of the living annuitant. The minimum required distributions can not be based on the age of someone who is deceased, 

 

	 	E)	the minimum required distributions are based only on the policy to which this rider is attached, and 

  

	 	F)	the minimum required distributions are only for the current rider year. Amounts carried over from past rider years are not considered. 

If any of the above are not true, then 2) is equal to zero and it is not available as a rider withdrawal amount. An amount in addition to the amount described
in 2) above, may need to be taken to satisfy minimum required distributions, in certain situations. Such additional withdrawal amount will be considered an excess withdrawal. 

If you withdraw less than the rider withdrawal amount in a rider year, the unused portion cannot be carried over to the next rider year. 

 

  

					
	RGMB 27 0108 (AS) (NY)		(3)		(Income/Death-Single)

 ARTICLE II CONTINUED 

WITHDRAWAL BASE 
 The withdrawal base is used to calculate
the rider withdrawal amount. On the rider date, the initial withdrawal base is equal to the policy value (less any premium enhancements if the rider is added in the first policy year). During any rider year, the withdrawal base is increased by
subsequent premium payments (less any premium enhancements), and is reduced for excess withdrawals. 
 On each rider anniversary, the withdrawal base will
be set to the greatest of: 
  

	 	1)	The current withdrawal base; 

  

	 	2)	The policy value on the rider anniversary; 

  

	 	3)	The highest policy value on a rider [monthiversary;] or 

  

	 	4)	The current withdrawal base immediately prior to anniversary processing increased by the growth rate percentage. 

Item 3) above will be zero if there have been any excess withdrawals in the current rider year. Item 4) above will be zero after the [10th] rider
anniversary or if there have been any withdrawals in the current rider year. 
 AUTOMATIC STEP-UP FEATURE 

The rider receives an automatic step-up on the rider anniversary if the withdrawal base is set equal to the policy value or the highest policy value on a rider
[monthiversary.] This feature does not require the termination of the existing rider. This rider will continue with the same rider date and features. The rider fee percentage may be changed due to an automatic step-up, but there will be no increase
in the rider fee percentage during the first [five] rider years. Following the [fifth] rider anniversary, the rider fee percentage may be increased due to an automatic step-up, but will not increase more than [0.75%] from the initial rider fee
percentage shown on page 1. 
 You have the right to reject an automatic step-up within [30] days following a rider anniversary, if the rider fee percentage
increases. If you reject an automatic step-up, you must notify us in a manner which is acceptable to us. Changes as a result of the automatic step-up feature will be reversed. And any increase in the rider fee percentage will also be reversed. 

WITHDRAWAL BASE ADJUSTMENTS 
 Gross partial withdrawals,
taken in a rider year, less than or equal to the rider withdrawal amount will not reduce the withdrawal base. Excess withdrawals will reduce the withdrawal base by the withdrawal base adjustment. The withdrawal base adjustment is the greater of 1)
and 2), where: 
  

	1)	is the excess withdrawal amount; and 

  

	2)	is the result of (A multiplied by B), divided by C, where: 

  

	 	A)	is the excess withdrawal; 

  

	 	B)	is the withdrawal base prior to the excess withdrawal amount; and 

  

	 	C)	is the policy value after the rider withdrawal amount has been withdrawn, but prior to the withdrawal of the excess withdrawal amount. 

 

  

					
	RGMB 27 0108 (AS) (NY)		(4)		(Income/Death-Single)

 ARTICLE II CONTINUED 

RIDER DEATH BENEFIT 
 Upon the annuitant’s death, we
will pay an additional death benefit amount equal to the excess, if any, of the rider death benefit over the greater of the base policy death benefit and this rider will then terminate. The rider death benefit on the rider date is equal to the
policy value (less any premium enhancements, if the rider is added in the first policy year). The rider death benefit after the rider date is equal to the rider death benefit on the rider date plus any premiums (not including premium enhancements,
if any) added after the rider date less any rider death benefit adjustments. 
 The rider death benefit does not reset due to the automatic step-up. 

RIDER DEATH BENEFIT ADJUSTMENTS 
 Cumulative gross partial
withdrawals, taken in a rider year, up to the rider withdrawal amount will reduce the rider death benefit by the same amount (dollar for dollar). Excess withdrawals will reduce the rider death benefit by the greater of: 

 

	1)	the excess withdrawal amount; and 

  

	2)	the result of (A divided by B), multiplied by C, where: 

  

	 	A)	is the excess withdrawal; 

  

	 	B)	is the policy value after the rider withdrawal amount has been withdrawn, but prior to the excess withdrawal; and 

  

	 	C)	is the rider death benefit after the rider withdrawal amount has been withdrawn, but prior to the excess withdrawal. 

ARTICLE III 
 CONTINUATION 

In the case of spousal joint owners where one spouse is the annuitant, if the spouse who is not the annuitant dies and the surviving spouse is the sole
beneficiary, the surviving spouse may elect to continue the policy and rider. In the case of spousal joint owners where one spouse is the annuitant, if the spouse who is the annuitant dies, this rider will terminate. No additional death benefit will
be paid under this rider at this time. 
 In the case of non-spousal joint owners where an owner who is not the annuitant dies, the surviving owner (who is
also the sole designated beneficiary) may elect to receive lifetime income payments under this rider instead of receiving any benefits applicable to the policy. The lifetime income payments must begin no later than 1 year after the owner’s
death and will be equal to the rider withdrawal amount divided by the number of payments made per year. Once the payments begin, no additional premium payments will be accepted and no additional withdrawals will be paid. If these payments are
elected but the annuitant dies before the rider death benefit equals zero, the annuitant’s beneficiary will receive a death benefit equal to the rider death benefit. 

ANNUITIZATION 
 On the maximum annuity commencement date,
you will have the option to receive lifetime income payments that are no less than your rider withdrawal amount each year. This option will also guarantee that the sum of all income payments received over time will equal or exceed the greater of the
policy value or the rider death benefit on the maximum annuity commencement date. If the annuitant should die before the sum of all income payments received equals or exceeds the greater of the policy value or the rider death benefit on the maximum
annuity commencement date, the annuitant’s beneficiary will receive a final payment equal to the difference. 
  

  

					
	RGMB 27 0108 (AS) (NY)		(5)		(Income/Death-Single)

 ARTICLE III CONTINUED 

RIDER UPGRADE 
 You may elect, in writing, to upgrade the
withdrawal base to the policy value within [30] days after the [fifth] rider anniversary and every [fifth] rider anniversary thereafter, subject to the issue age restrictions on the new rider. If an upgrade is elected, this rider will terminate and
a new rider with the same features will be issued with a new rider date. The new rider will have its own rider fee percentage which may be higher than this rider’s rider fee percentage. Other riders with different features may be chosen, if
available by the Company. 
 At the time of upgrade, the rider death benefit will also be upgraded to the policy value and the rider withdrawal amount will
be recalculated based on the new withdrawal base. 
 The new rider date will be the date the Company receives all information necessary, in a written form
acceptable to the Company, to process the upgrade. 
 Signed for us at our home office. 

 

			
	

		

  

  

					
	RGMB 27 0108 (AS) (NY)		(6)		(Income/Death-Single)

 APPENDIX 

EXAMPLE OF EFFECT OF WITHDRAWALS ON RIDER BENEFITS 
 The
following examples illustrate the effect of withdrawals on Rider benefits. A withdrawal greater than the rider withdrawal amount is assumed at the end of year 1. A withdrawal equal to the rider withdrawal amount is assumed at the end of year 2.

 The Withdrawal Base and Rider Death Benefit on the rider date are $100,000. For this example, hypothetical policy values prior to each annual
withdrawal are assumed to be $94,000 at the end of rider year 1, and $90,000 at the end of rider year 2. Assume the rider is added to the policy on 12/1/2007 and the age of the annuitant is 65 years old. Since the annuitant is age 66 when they take
their first withdrawal, their withdrawal percentage is assumed to be 5.0% in this example. 
 The effects on the withdrawal percentage, and on the
Guaranteed Lifetime Withdrawal Benefit are shown in succession in this example. 
 ADJUSTED PARTIAL WITHDRAWAL CALCULATIONS FOR GUARANTEED LIFETIME
WITHDRAWAL BENEFITS: 
 Withdrawal Base. Gross partial withdrawals up to the rider withdrawal amount will not reduce the withdrawal base. Gross
partial withdrawals in excess of the rider withdrawal amount will reduce the withdrawal base pro rata. The amount of the reduction due to the excess withdrawal is equal to the greater of: 

 

	 	1).	The excess gross partial withdrawal amount; and 

  

	 	2).	The result of (A / B) * C, where: 

  

	 	A	is the excess gross partial withdrawal (the amount in excess of the rider withdrawal amount remaining prior to the withdrawal); 

  

	 	B	is the policy value after the rider withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

  

	 	C	is the withdrawal base prior to the withdrawal of the excess amount. 

 Rider Death Benefit 

Gross partial withdrawals, up to the rider withdrawal amount will reduce the rider death benefit by the same amount (dollar-for-dollar). Gross partial
withdrawals in excess of the rider withdrawal amount will reduce the rider death benefit pro rata. The amount of the reduction due to excess withdrawal is equal to the greater of: 

 

	1)	is the excess withdrawal amount; and 

  

	2)	is the result of (A / B) * C, where: 

  

	 	A)	is the excess gross partial withdrawal (the amount in excess of the rider withdrawal amount remaining prior to the withdrawal); 

  

	 	B)	is the policy value after the rider withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

  

	 	C)	is the rider death benefit after the rider withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount. 

When a withdrawal is taken, three parts of the guaranteed lifetime withdrawal benefit can be affected: 

 

	 	1.	Rider Death Benefit (RDB) 

  

	 	2.	Withdrawal base (WB) 

  

	 	3.	Rider withdrawal amount (RWA) 

  

					
	RGMB 27 0108 (AS) (NY)		(A-1)		

 Effects on RDB, WB and RWA: 

Year 1: 
 WB = $100,000 

RDB = $100,000 
 5% Withdrawal
(WD) would be $5,000 (5% of WB $100,000) 
 Assumed WD = $7,000 

Excess withdrawal (“EWD”) = $2,000 ($7,000 - $5,000) 

Assumed Policy Value (PV) = $94,000 
 Rider
Death Benefit amount after WD: 
  

			
	Step One.		Is any portion of the total withdrawal greater than the rider withdrawal amount?
		
			Yes. $7,000 - $5,000 = $2,000 (the excess withdrawal amount)
		
	Step Two.		How much of the rider death benefit is effected by the excess withdrawal?
		
			1. Formula for pro rata amount is: (EWD / (PV - 5% WD)) * (RDB - 5% WD)
		
			2. ($2,000 / ($94,000 - $5,000)) * ($100,000 - $5,000) = $2,134.83
		
	Step Three.		Which is larger, the actual $2,000 excess withdrawal or the $2,134.83 pro rata amount?
		
			$2,134.83 pro rata amount
		
	Step Four.		What is the rider death benefit after the withdrawal has been taken?
		
			1. Total to deduct from the rider death benefit is $5,000 (RWA) + $2,134.83 (pro rata excess) = $7,134.83
		
			2. $100,000 - $7,134.83 = $92,865.17

 Withdrawal Base after WD: 

Step One. The withdrawal base is only reduced by amount of the excess or the pro rata amount if greater. 

Step Two. Calculate how much the withdrawal base is effected by the excess withdrawal. 

1. The formula is (EWD / (PV - 5% WD)) * WB before any adjustments 

2. ($2,000 / ($94,000 - $5,000)) * $100,000 = $2,247.19 

Step Three. Which is larger, the actual $2,000 excess withdrawal or the $2,247.19 pro rata amount? 

$2,247.19 pro rata amount 
 Step Four. What is
the new withdrawal base upon which the rider withdrawal amount is based? 
 $100,000 - $2,247.19 = $97,752.81 

Result. The new withdrawal base is $97,752.81. 
 Rider
Withdrawal Amount after WD: 
 Because the withdrawal base was adjusted (due to excess withdrawal), we have to calculate a new rider withdrawal amount
based on 5% for the guarantee that will be available starting in the second rider year. 
 Step One. What is the rider withdrawal amount for rider year 2?

 $97,752.81 (the adjusted withdrawal base) * 5% = $4,887.64 

Result. Beginning in rider year 2, the maximum you can take out in a rider year is $4,887.64 annually without causing an excess withdrawal for the guarantee
and further reduction of the withdrawal base. 
  

  

					
	RGMB 27 0108 (AS) (NY)		(A-2)		

 Year 2: 

WB = $97,752.81 
 RDB = $92,865.17

 5% WD would be $4,887.64 (5% of WB $97,752.81) 

Assumed WD = $4,887.64 
 Excess
withdrawal (“EWD”) = none 
 Assumed PV = $90,000 

Step One. Is any portion of the total withdrawal greater than the rider withdrawal amount? 

No. 
 Step Two. What is the rider death benefit
after the withdrawal has been taken? 
 1. Total to deduct from the rider death benefit is $4,887.64 (there is no excess to deduct). 

2. $92,865.17 - $4,887.64 = $87,977.53 
 First
day of Rider Year 3: 
 Assume the Death occurs for the policy. Also assume that the Policy Value on the date of death is $70,000, and the base policy
death benefit is $75,000. The additional death benefit for the rider would be equal to the excess of the RDB over the base policy death proceeds. 

($87,977.53 - $75,000.00) = $12,977.53 
  

  

					
	RGMB 27 0108 (AS) (NY)		(A-3)EXHIBIT (4)(D)

 EXHIBIT (4)(d) 

FORM OF POLICY RIDER (GPS) 

											
	

						Home Office located at:				
		 		 		4 Manhattanville Road, Purchase, New York 10577 Adm. Office located at:		 		
		 				4333 Edgewood Road N.E. Cedar Rapids, Iowa 52499				
	A Stock Company (Hereafter called the Company, we, our or us)	 	 	 	 	  	(319) 398-8511	  	 	  	

 LIVING BENEFITS RIDER 

This rider is issued as a part of the policy (contract) to which it is attached. Policy refers to the individual policy if the rider is attached to an
individual annuity or the group certificate if the rider is attached to a group annuity. 
 Rider Data Specification 

 

											
			 		 				 		
	 Policy Number:
		 				07 - 12345				
	 Rider Date:
		 				07-01-2003				
	 “Principal Back” Withdrawal Percentage:
		 				7.00%				
	 “For Life” Withdrawal Percentage:*
		 				5.00%				
	 Rider Fee Percentage:
		 				0.75%				
	 Guaranteed Future Value Date:
		 				07-01-2013				
			 		 				 		

  

	*	Percentage will be zero until the Rider Anniversary that occurs after the Annuitant’s 59th birthday. 

  

 
 ARTICLE I 

The Guaranteed Living Benefits rider provides You with a Guaranteed Minimum Withdrawal Benefit and a Guaranteed Minimum Accumulation Benefit prior to the
Annuity Commencement Date of the policy to which the rider is attached. The Guaranteed Minimum Withdrawal Benefit consists of two withdrawal guarantees as described in Article IV. Only one of the withdrawal guarantees may be exercised at one time,
however You may switch back and forth between the two options at any time as described in Article IV. This rider permits You to invest in variable investment options while still having the Policy Value and liquidity protected to the extent provided
by the rider. 
 You do not have any protection under the Guaranteed Minimum Accumulation Benefit unless You hold the rider until the Guaranteed Future
Value Date. If You think that You may terminate the policy or elect to start receiving annuity payments before the Guaranteed Future Value Date, You should consider whether electing the rider is in Your best interests. 

Beginning on the Rider Date shown above, you can withdraw an amount up to the “Principal Back” Withdrawal Percentage, shown above, of the Total
Withdrawal Base each year until Your “Principal Back” Minimum Remaining Withdrawal Amount reaches zero; or 
 Beginning on the Rider Anniversary
following the Annuitant’s 59th birthday, You can withdraw an amount equal to the “For Life” Withdrawal Percentage shown above, of the Total Withdrawal Base each Rider Year until the later of the Annuitant’s death or until Your
“For Life” Minimum Remaining Withdrawal Amount reaches zero. 
 You can terminate this rider any time after the fifth Rider Anniversary. This
rider will also terminate if You surrender Your policy or on the Annuity Commencement Date. However, You should consider the availability of any rider guarantees prior to surrendering Your policy. 

A Rider Fee will be deducted on each Rider Anniversary and upon rider termination as described below. 

DEFINITIONS: 
 Terms used that are not defined in this
rider shall have the same meaning as those in Your policy. 
 Gross Partial Withdrawal 

The amount which will be deducted from Your Policy Value as a result of each Partial Withdrawal. 

Investment Options 
 One or more Subaccounts of the
Separate Account available under Your policy which we designate. 
 Portfolio Allocation Method Investment Options 

One or more Fixed Account options, Guaranteed Period options, or Separate Account options that we will use to provide rider guarantees. 

Rider Anniversary 
 The anniversary of the Rider Date.

  
 RGMB  3  0803

 ARTICLE I (continued) 

Rider Fee 
 The Rider Fee is the Rider Fee Percentage
referenced above, multiplied by the Total Withdrawal Base at the time the fee is deducted. For purposes of calculating this fee, we will use the Total Withdrawal Base for the “Principal Back” withdrawal guarantee. This fee will be deducted
from the Separate Account only on each Rider Anniversary. A portion of this fee will also be deducted when the rider is terminated based on the number of months that have elapsed since it was last deducted. 

Rider Year 
 Each twelve-month period following the Rider
Date. 
 Total Withdrawal Base 
 The amount as defined
in Article IV of this rider. 
 Valuation Period 
 The
period of time from one determination of the value of a Subaccount to the next. Such determinations are made when the value of the assets and liabilities of each Subaccount is calculated. This is generally the close of business on each day on which
the New York Stock Exchange is open. 
 ARTICLE II 

When this rider is attached to Your policy, we require the Portfolio Allocation Method to be used. Under the Portfolio Allocation Method we compare Your Policy
Value to the rider guarantees once per Valuation Period. 
 Generally, transfers to the Portfolio Allocation Method Investment Options first occur when the
Policy Value drops by a cumulative amount of 3% to 5% over any period of time, although we may make transfers to the Portfolio Allocation Method Investment Options when the Policy Value drops by less than 3%. If the Policy Value continues to fall,
more transfers to the Portfolio Allocation Method Investment Options will occur. When a transfer occurs, the transferred Policy Value is allocated to the Portfolio Allocation Method Investment Option(s) we deem appropriate. The Portfolio Allocation
Method Investment Options will generally be one or more of the Guaranteed Period Options of the Fixed Account or variable subaccounts which invest in fixed income instruments or which have conservative to moderate investment objectives. The Policy
Value allocated to the Portfolio Allocation Method Investment Options will remain there until the performance of Your chosen Investment Options recovers sufficiently to enable us to transfer amounts back to Your Investment Options while maintaining
the guarantees under the rider. This generally occurs when the Policy Value increases by 5% to 10% in relation to the rider guarantees, although we may require a larger increase before transferring amounts back to Your Investment Options. 

The Portfolio Allocation Method is designed to help reduce portfolio risk associated with negative performance. Using the Portfolio Allocation Method, we will
transfer amounts from Your Investment Options to the Portfolio Allocation Method Investment Options to the extent we deem, in our sole discretion, necessary to help manage portfolio risk and support the guarantees under the rider. You should not
view the rider nor the Portfolio Allocation Method as “market timing” or other type of investment program designed to enhance Your Policy Value. Choosing this rider may result in a lower Policy Value in certain situations. If Policy Value
is transferred from Your Investment Options to the Portfolio Allocation Method Investment Options, less of your Policy Value may be available to participate in any future positive investment performance of Your Investment Options. This may
potentially provide a lower Policy Value than what may have resulted without the rider. 
 Transfers out of Your Investment Options to the Portfolio
Allocation Method Investment Options will be pro rata. Likewise, transfers from the Portfolio Allocation Method Investment Options into Your Investment Options will be pro rata. 

Since the Portfolio Allocation Method is designed to manage portfolio risk, the Policy Value of the Portfolio Allocation Method Investment Options should not
fall as dramatically during market downturns, but it also may not allow the Policy Value in the Portfolio Allocation Method Investment Options to move back into the Separate Account as quickly as You may desire during market upturns. 

You cannot allocate premiums or transfers to the Portfolio Allocation Method Investment Options. 

Transfers pursuant to this Article will not be subject to any transfer fees and do not count against the number of free transfers allowed under Your policy.

 The details of the Portfolio Allocation Method formula have been filed with the Superintendent of the New York Insurance Department. We may change the
Portfolio Allocation Method Program, on a prospective basis only. 

  
 RGMB  3  0803 (2)

 ARTICLE III 

GUARANTEED MINIMUM ACCUMULATION BENEFIT 
 We guarantee that
Your Policy Value will be at least as great as the Guaranteed Future Value on the Guaranteed Future Value Date shown on page one of this rider. 
 On the
Guaranteed Future Value Date, if Your Policy Value is less than the Guaranteed Future Value, we will add the difference to Your Policy Value pro rata (based on the current proportion of the Investment Options in relation to the then-current Policy
Value) at the end of the next Valuation Period. This addition will not be considered premium. We will provide no benefit under the Guaranteed Minimum Accumulation Benefit after the Guaranteed Future Value Date. 

Guaranteed Future Value 
 The Guaranteed Future Value on
the Rider Date is equal to Your Policy Value (less any applicable premium enhancements if this rider is added in the first Policy Year). The Guaranteed Future Value after the Rider Date and before the Guaranteed Future Value Date, is equal to the
Guaranteed Future Value on the Rider Date, plus a percentage of premiums added after the Rider Date as shown in the table below, (not including premium enhancements, if any) less any adjustments for withdrawals described below. 

 

					
	 	  	Percent of Subsequent
Premiums added to
Guaranteed Future Value	 
	 1
	  	 	100	% 
	 2
	  	 	90	% 
	 3
	  	 	80	% 
	 4
	  	 	70	% 
	 5
	  	 	60	% 
	 6
	  	 	50	% 
	 7
	  	 	50	% 
	 8
	  	 	50	% 
	 9
	  	 	50	% 
	 10
	  	 	0	% 

 The Guaranteed Future Value after the Guaranteed Future Value Date is zero. 

Guaranteed Minimum Accumulation Benefit Adjustments 

Gross Partial Withdrawals will reduce the Guaranteed Future Value pro rata as shown in the formula below. The amount of the reduction is equal to the greater
of: 

	1)	the Gross Partial Withdrawal amount; and 

	2)	the result of (A divided by B), multiplied by C, where: 

  

	 	A	is the amount of Gross Partial Withdrawal; 

  

	 	B	is the Policy Value immediately prior to the Gross Partial Withdrawal; and 

  

	 	C	is the Guaranteed Future Value immediately prior to the Gross Partial Withdrawal. 

 ARTICLE IV

 GUARANTEED MINIMUM WITHDRAWAL BENEFIT 
 We
guarantee that You may take a specified annual withdrawal amount regardless of the Policy Value under the Guaranteed Minimum Withdrawal Benefit. You are not required to select only one withdrawal guarantee. You may select one withdrawal guarantee
and then switch to the other one at any time, and switch back if You choose. The amount You withdraw may impact the Guaranteed Annual Withdrawal Amount, Total Withdrawal Base, and Minimum Remaining Withdrawal Amount under each guarantee and such
impact may be on a greater than dollar-for-dollar basis. Please see the Appendix attached to this rider which illustrates these withdrawal benefits. The two withdrawal guarantees under this rider are: 

“Principal Back” Withdrawal Guarantee 

You can withdraw up to the Maximum Annual Withdrawal Amount each Rider Year until the Minimum Remaining Withdrawal Amount is zero. 

Example (Based on a 7% “Principal Back” withdrawal percentage) 

Assume You make a single premium payment of $100,000 and that You do not make any withdrawals or additional premium payments. Assume that after
five Rider Years, Your Policy Value has declined to $50,000 solely because of negative investment performance. You could still withdraw up to $7,000 each Rider Year for the next fourteen years and $2,000 in the next year so you would get back your
full $100,000 (assuming that You do not withdraw more that $7,000 in any one Rider Year). 

  
 RGMB  3  0803 (3)

 ARTICLE IV CONTINUED 

“For Life” Withdrawal Guarantee 

Starting with the Rider Anniversary following the Annuitant’s 59th birthday, You can withdraw up to the Maximum Annual Withdrawal Amount
each Rider Year until the later of: 
  

	 	(i)	the Annuitant’s death, or 

  

	 	(ii)	the Minimum Remaining Withdrawal Amount is zero. 

 Example (Based on a 5% “For
Life” withdrawal percentage) 
 Assume You are the owner and annuitant and make a single premium payment of $100,000 when You are 55
years old. Assume You do not make any withdrawals or additional premium payments. Assume that after five Rider Years, your Policy Value has declined to $50,000 solely because of negative investment performance. You could still withdraw up to $5,000
each Rider Year for the rest of your life (assuming that You do not withdraw more that $5,000 in any one Rider Year). 
 We will calculate a Maximum Annual
Withdrawal Amount, Minimum Remaining Withdrawal Amount, and Total Withdrawal Base as described below, for each of the two withdrawal guarantees we provide and the amounts may differ. 

Withdrawals will reduce the Policy Value. Once the Policy Value equals zero, You cannot make subsequent premium payments and all other policy features,
benefits and guarantees are terminated except those provided by this rider. Withdrawals guaranteed by this rider can be continued by selecting an amount and frequency of payment in a manner acceptable to Us. The amount selected by You can be taken
as monthly, quarterly, semi-annual or annual withdrawals. Once the payment amount and frequency are established, they cannot be changed. 
 The Guaranteed
Minimum Withdrawal Benefit can only be taken as a withdrawal benefit and it does not increase the Policy Value. 
 Maximum Annual Withdrawal Amount

 The Maximum Annual Withdrawal Amount that can be withdrawn each Rider Year without reducing the guaranteed amounts under this rider is equal to the
sum of the Total Withdrawal Base on the most recent Rider Anniversary plus any premiums added after that Rider Anniversary (not including premium enhancements, if any), multiplied by the withdrawal percentage shown on page one of this rider. 

Minimum Remaining Withdrawal Amount 
 The Minimum
Remaining Withdrawal Amount is the total minimum dollar amount of guaranteed withdrawals You have remaining. The Minimum Remaining Withdrawal Amount on the Rider Date is equal to the Policy Value (less any applicable premium enhancements, if the
rider is added in the first Policy Year). After the Rider Date, the Minimum Remaining Withdrawal Amount is equal to the Minimum Remaining Withdrawal Amount on the Rider Date, plus any premiums added after the Rider Date (not including premium
enhancements, if any), less any adjustments for withdrawals described below. 
 Minimum Remaining Withdrawal Amount Adjustments 

Gross Partial Withdrawals up to the Maximum Annual Withdrawal Amount will reduce the Minimum Remaining Withdrawal Amount by the same amount (dollar for
dollar). Gross Partial Withdrawals in excess of the Maximum Annual Withdrawal Amount will reduce the Minimum Remaining Withdrawal Amount pro rata as shown in the formula below. The amount of the reduction is equal to the greater of: 

 

	 	1)	the excess Gross Partial Withdrawal amount; and 

  

	 	2)	the result of (A divided by B), multiplied by C, where: 

  

	 	A	is the excess Gross Partial Withdrawal (the amount in excess of the Maximum Annual Withdrawal Amount remaining, which is the Maximum Annual Withdrawal Amount at the beginning of the Rider Year reduced by any Gross
Partial Withdrawals taken during that Rider Year, prior to the withdrawal); 

  

	 	B	is the Policy Value after the Maximum Annual Withdrawal Amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

 

	 	C	is the Minimum Remaining Withdrawal Amount after the Maximum Annual Withdrawal Amount has been withdrawn, but prior to the withdrawal of the excess amount. 

Total Withdrawal Base 
 The Total Withdrawal Base on the
Rider Date is equal to the Policy Value (less any applicable premium enhancements, if the rider is added within the first Policy Year). After the Rider Date, the Total Withdrawal Base is equal to the Total Withdrawal Base on the Rider Date, plus the
full amount of any premiums added after the Rider Date (not including premium enhancements, if any), less any adjustments for withdrawals described below. 

  
 RGMB  3  0803 (4)

 ARTICLE IV (continued) 

Total Withdrawal Base Adjustments 
 Gross Partial
Withdrawals up to the Maximum Annual Withdrawal Amount will not reduce the Total Withdrawal Base. Gross Partial Withdrawals in excess of the Maximum Annual Withdrawal Amount will reduce the Total Withdrawal Base pro rata as shown in the formula
below. The amount of the reduction is equal to the greater of: 
  

	 	1)	the excess Gross Partial Withdrawal amount; and 

  

	 	2)	the result of (A divided by B), multiplied by C, where: 

  

	 	A	is the excess Gross Partial Withdrawal (the amount in excess of the Maximum Annual Withdrawal Amount remaining, which is the Maximum Annual Withdrawal Amount at the beginning of the Rider Year reduced by any Gross
Partial Withdrawals taken during that Rider Year, prior to the withdrawal); 

  

	 	B	is the Policy Value after the Maximum Annual Withdrawal Amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

 

	 	C	is the Total Withdrawal Base prior to the withdrawal of the excess amount. 

 Please see the Appendix attached
to this rider which illustrates the withdrawal benefits. 
 Signed for us at our home office. 

 

			
	

		

  
 RGMB  3  0803 (5)

 APPENDIX 

EXAMPLE OF EFFECT OF WITHDRAWALS ON RIDER BENEFITS 
 The
following examples illustrate the effect of withdrawals on Rider benefits. A withdrawal equal to the guaranteed annual withdrawal amount for the Principal Back Withdrawal Guarantee is assumed at the end of year 1. A withdrawal equal to the
guaranteed annual withdrawal amount for the For Life Withdrawal Guarantee is assumed at the end of year 2. A withdrawal equal to the guaranteed annual withdrawal amount for the Principal Back Withdrawal Guarantee is assumed at the end of year 3.

 The initial Total Withdrawal Base and Minimum Remaining Withdrawal Amount are both $100,000. For this example, hypothetical policy values prior to
each annual withdrawal are assumed to be $90,000 at the end of year 1, $95,000 at the end of year 2 and $85,000 at the end of year 3. 
 The effects
on the 5% For Life Withdrawal Guarantee, the 7% Principal Back Withdrawal Guarantee and on the Guaranteed Minimum Accumulation Benefit, the guaranteed benefits provided by this Rider, are shown in succession in this example. In particular, the first
example shows the effect of 7% Principal Back Withdrawal on the guaranteed amounts provided by the 5% For Life Withdrawal. 
 ADJUSTED PARTIAL
WITHDRAWAL CALCULATIONS FOR GUARANTEED MINIMUM WITHDRAWAL BENEFITS: 
 Total Withdrawal Base. Gross partial withdrawals up to the guaranteed
annual withdrawal amount will not reduce the total withdrawal base. Gross partial withdrawals in excess of the guaranteed annual withdrawal amount will reduce the total withdrawal base pro rata. The amount of the reduction due to the excess
withdrawal is equal to the greater of: 
  

	 	1).	The excess gross partial withdrawal amount; and 

  

	 	2).	The result of (A / B) * C, where: 

  

	 	A	is the excess gross partial withdrawal (the amount in excess of the guaranteed annual withdrawal amount remaining prior to the withdrawal); 

 

	 	B	is the policy value after the guaranteed annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

 

	 	C	is the total withdrawal base prior to the withdrawal of the excess amount. 

 Minimum Remaining Withdrawal
Amount. Gross partial withdrawals up to the guaranteed annual withdrawal amount will reduce the minimum remaining withdrawal amount by the same amount (dollar-for-dollar). Gross partial withdrawals in excess of the guaranteed annual withdrawal
amount will reduce the minimum remaining withdrawal amount pro rata. The amount of the reduction due to the excess withdrawal is equal to the greater of: 
  

	 	1).	The excess gross partial withdrawal amount; and 

  

	 	2).	The result of (A / B) * C, where: 

  

	 	A	is the excess gross partial withdrawal (the amount in excess of the guaranteed annual withdrawal amount remaining prior to the withdrawal); 

 

	 	B	is the policy value after the guaranteed annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

 

	 	C	is the minimum remaining withdrawal amount after the guaranteed annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount. 

When a withdrawal is taken, three parts of the guaranteed minimum withdrawal benefit can be effected: 

 

	 	1.	Minimum remaining withdrawal amount (“MRWA”) 

  

	 	2.	Total withdrawal base (“TWB”) 

  

	 	3.	Guaranteed annual withdrawal amount (“GAWA”) 

 Effects on 5% “For Life” MRWA, TWB, and
GAWA: 
 Year 1: 
 TWB = $100,000

 MRWA = $100,000 
 5%
Withdrawal (WD) would be $5,000 (5% of TWB $100,000) 

  

RGMB  3  0803(A-1) 

 Assumed WD = $7,000 

Excess withdrawal (“EWD”) = $2,000 ($7,000 – $5,000) 

Assumed Policy Value (PV) = $90,000 

“For Life” minimum remaining withdrawal amount after WD: 

Step One. Is any portion of the total withdrawal greater than the guaranteed annual withdrawal amount? 

Yes. $7,000 – $5,000 = $2,000 (the excess withdrawal amount) 

Step Two. How much of the minimum remaining withdrawal amount is effected by the excess withdrawal? 

 

	 	1.	Formula for pro rata amount is (EWD / (PV – 5% WD)) * (MRWA – 5% WD) 

  

	 	2.	($2,000 / ($90,000 – $5,000)) * ($100,000 – $5,000) = $2,235.29 

 Step Three. Which is larger, the
actual $2,000 excess withdrawal or the $2,235.29 pro rata amount? 
 $2,235.29 pro rata amount 

Step Four. What is the minimum remaining withdrawal amount after the withdrawal has been taken? 

 

	 	1.	Total to deduct from the minimum remaining withdrawal amount is $5,000 (GAWA) + $2,235.29 (pro rata excess) = $7,235.29 

  

	 	2.	$100,000 – $7,235.29 = $92,764.71 

 “For Life” total withdrawal base after WD: 

Step One. The total withdrawal base is only reduced by amount of the excess or the pro rata amount if greater. 

Step Two. Calculate how much the total withdrawal base is effected by the excess withdrawal. 

 

	 	1.	The formula is (EWD / (PV – 5% WD)) * TWB before any adjustments 

  

	 	2.	($2,000 / ($90,000 – $5,000)) * $100,000 = $2,352.94 

 Step Three. Which is larger, the actual
$2,000 excess withdrawal or the $2,352.94 pro rata amount? 
 $2,352.94 pro rata amount 

Step Four. What is the new total withdrawal base upon which the guaranteed annual withdrawal amount is based? 

$100,000 – $2,352.94 = $97,647.06 
 Result.
The new “For Life” total withdrawal base is $97,647.06. 
 “For Life” guaranteed annual withdrawal amount after WD: 

Because the “For Life” total withdrawal base was adjusted (due to excess withdrawal), we have to calculate a new guaranteed annual withdrawal amount
for the 5% “For Life” guarantee that will be available starting in the second rider year. 
 Step One. What is the “For Life” guaranteed
annual withdrawal amount for year 2? 
 $97,647.06 (the adjusted total withdrawal base) * 5% = $4,882.35 

  

RGMB  3  0803(A-2) 

 Result Beginning in rider year 2, the maximum you can take out in a rider year is $4,882.35 annually without
causing an excess withdrawal for the “For Life” guarantee and further reduction of the “For Life” total withdrawal base. 
 Year 2:

 TWB = $97,647.06 
 MRWA
= $92,764.71 
 5% WD would be $4,882.35 (5% of TWB $97,647.06) 

Assumed WD = $4,882.35 
 Excess
withdrawal (“EWD”) = none 
 Assumed PV = $95,000 

Step One. Is any portion of the total withdrawal greater than the guaranteed annual withdrawal amount? 

No. 
 Step Two. What is the minimum remaining
withdrawal amount after the withdrawal has been taken? 
  

	 	1.	Total to deduct from the minimum remaining withdrawal amount is $4,882.35 (there is no excess to deduct). 

  

	 	2.	$92,764.71 – $4,882.35 = $87,882.36 

 Year 3: 

TWB = $97,647.06 
 MRWA =
$87,882.36 
 5% WD would be $4,882.35 (5% of TWB $97,647.06) 

Assumed WD = $7,000 
 Excess
withdrawal (“EWD”) = $2,117.65 ($7,000 – $4,882.35) 
 Assumed PV = $85,000 

“For Life” minimum remaining withdrawal amount after WD: 

Step One. Is any portion of the total withdrawal greater than the guaranteed annual withdrawal amount? 

Yes. $7,000 – $4,882.35 = $2,117.65 (the excess withdrawal amount) 

Step Two. How much of the minimum remaining withdrawal amount is effected by the excess withdrawal? 

 

	 	1.	Formula for pro rata amount is: (EWD / (PV - 5% WO)) * (MRWA - 5% WD) 

  

	 	2.	$2,117.65 / ($85,000 – $4,882.35)) * ($87,882.36 – $4,882.35) = $2,193.84 

 Step Three. Which
is larger, the actual $2,117.65 excess withdrawal or the $2,193.84 pro rata amount? 
 $2,193.84 pro rata amount 

Step Four. What is the minimum remaining withdrawal amount after the withdrawal has been taken? 

 

	 	1.	Total to deduct from the minimum remaining withdrawal amount is $4,882.35 (GAWA) + $2,193.84 (pro rata excess) = $7,076.19 

  

	 	2.	$87,882.36 – $7,076.19 = $80,806.17 

  

RGMB  3  0803(A-3) 

 “For Life” total withdrawal base after WD: 

Step One. The total withdrawal base is only reduced by amount of the excess or the pro rata amount if greater. 

Step Two. Calculate how much the total withdrawal base is effected by the excess withdrawal. 

 

	 	1.	The formula is (EWD / (PV – 5% WD)) * TWB before any adjustments 

  

	 	2.	($2,117.65 / ($85,000 – $4,882.35)) * $97,647.06 = $2,580.98 

 Step Three. Which is larger, the
actual $2,117.65 excess withdrawal or the $2,580.98 pro rata amount? 
 $2,580.98 pro rata amount 

Step Four. What is the new total withdrawal base upon which the guaranteed annual withdrawal amount is based? 

$97,647.06 – $2,580.98 = $96,066.08 

Result. The new “For Life” total withdrawal base is $96,066.08. 

“For Life” guaranteed annual withdrawal amount after WD: 

Because the “For Life” total withdrawal base was adjusted (due to excess withdrawal) we have to calculate a new guaranteed annual withdrawal amount
for the 5% “For Life” guarantee that will be available starting in the fourth rider year. 
 Step One. What is the “For Life” guaranteed
annual withdrawal amount for rider year 4? 
 $96,066.08 (the adjusted total withdrawal base) * 5% = $4,803.30 

Result. Beginning in rider year 4, the maximum you can take out in a rider year is $4,803.30 annually without causing an excess withdrawal for the “For
Life” guarantee and further reduction of the “For Life” total withdrawal base. 
 Effects on 7% “Principal Back” TWB, MRWA, and
GAWA: 
 Year 1: 
 TWB = $l00,000

 MRWA = $100,000 
 7% WD would
be $7,000 (7% of TWB $100,000) 
 Assumed WD = $7,000 

Excess withdrawal (“EWD”) = none 

Assumed PV = $90,000 
 Step One. Is any portion
of the total withdrawal greater than the guaranteed annual withdrawal amount? 
 No. There is no excess withdrawal under the “Principal
Back” guarantee if no more than $7,000 is withdrawn. 
 Step Two. What is the minimum remaining withdrawal amount after the withdrawal has been taken?

  

	 	1.	Total to deduct from the minimum remaining withdrawal amount is $7,000 (there is no excess to deduct). 

  

	 	2.	$100,000 – $7,000 = $93,000 

  

RGMB  3  0803(A-4) 

 Year 2: 

TWB = $100,000 
 MRWA = $93,000

 7% WD would be $7,000 (7% of TWB $100,000) 

Assumed WD = $4,882.35 
 Excess
withdrawal (“EWD”) = none 
 Assumed PV = $95,000 

Step One. Is any portion of the total withdrawal greater than the guaranteed annual withdrawal amount? 

No. There is no excess withdrawal under the “Principal Back” guarantee if no more than $7,000 is withdrawn. 

Step Two. What is the minimum remaining withdrawal amount after the withdrawal has been taken? 

 

	 	1.	Total to deduct from the minimum remaining withdrawal amount is $5,000 (there is no excess to deduct) 

  

	 	2.	$93,000 – $4,882.35 = $88,117.65 

 Year 3: 

TWB = $100,000 
 MRWA = $88,117.65

 7% WD would be $7,000 (7% of TWB $100,000) 

Assumed WD = 7% = $7,000 

Excess withdrawal (“EWD”) = none 

Assumed PV = $85,000 
 Step One. Is any portion
of the total withdrawal greater than the guaranteed annual withdrawal amount? 
 No. There is no excess withdrawal under the “Principal
Back” guarantee if no more than $7,000 is withdrawn. 
 Step Two. What is the minimum remaining withdrawal amount after the withdrawal has been taken?

  

	 	1.	Total to deduct from the minimum remaining withdrawal amount is $7,000 (there is no excess to deduct) 

  

	 	2.	$88,117.65 – $7,000 = $81,117.65 

 Guaranteed Minimum Accumulation Benefit Adjusted Partial
Surrenders 
 Gross partial withdrawals will reduce the guaranteed future value pro rata. The amount of the reduction is equal to the greater of: 

 

	 	1.)	The gross partial withdrawal amount; and 

  

	 	2.)	The result of (A / B) * C, where: 

  

	 	A	is the amount of the gross partial withdrawal; 

  

	 	B	is the policy value immediately prior to the gross partial withdrawal; and 

  

	 	C	is the guaranteed future value immediately prior to the gross partial withdrawal. 

 The following demonstrates,
on a purely hypothetical basis, the effects of the partial withdrawals under the Guaranteed minimum accumulation benefit. 

  

RGMB  3  0803(A-5) 

 Effects on Guaranteed Future Value of Guaranteed Minimum Accumulation Benefit: 

Year 1: 
 Assumed Policy value prior to
withdrawal (“PV”) = $90,000 
 Guaranteed future value prior to withdrawal (“GFV”) = $100,000 

Assumed Withdrawal amount (“WD”) = $7,000 

Step One. What is the pro rata value of the amount withdrawn? 
  

	 	1.	Formula is (WD / PV) * GFV = pro rata amount 

  

	 	2.	($7,000 / $90,000) * $100,000 = $7,777.78 

 Step Two. Which is larger, the $7,000 withdrawal or the
$7,777.78 pro rata amount? 
 $7, 777.78 pro rata amount 

Step Three. After the withdrawal is take, what will be the new guaranteed future value? 

$100,000 – $7,777.78 = $92,222.22 

Result. If no more withdrawals were taken, the guaranteed future value on the 10th rider anniversary
would be $92,222.22. 
 Year 2: 

Assumed Policy value prior to withdrawal (“PV”) = $95,000 

Guaranteed future value prior to withdrawal (“GFV”) = $92,222.22 

Assumed Withdrawal amount (“WD”) = $4,882.35 

Step One. What is the pro rata value of the amount withdrawn? 
  

	 	1.	Formula is (WD / PV) * GFV = pro rata amount 

  

	 	2.	($4,882.35 / $95,000) * $92,222.22 = $4,739.59 

 Step Two. Which is larger, the $4,882.35 withdrawal or
the $4,739.59 pro rata amount? 
 $4,882.35 withdrawal 

Step Three. After the withdrawal is taken, what will be the new guaranteed future value? 

$92,222.22 – $4,882.35 = $87,339.87 

Result. If no more withdrawals were taken, the guaranteed future value on the 10th rider anniversary
would be $87,339.87. 
 Year 3: 

Assumed Policy value prior to withdrawal (“PV”) = $85,000 

Guaranteed future value prior to withdrawal (“GFV”) = $87,339.87 

Assumed Withdrawal amount (“WD”) = $7,000 

Step One. What is the pro rata value of the amount withdrawn? 
  

	 	1.	Formula is (WD / PV) * GFV = pro rata amount 

  

	 	2.	($7,000 / $85,000) * $87,339.87 = $7,192.70 

 Step Two. Which is larger, the $7,000 withdrawal or the
$7,192.70 pro rata amount? 
 $7,192.70 pro rata amount 

Step Three. After the withdrawal is taken, what will be the new guaranteed future value? 

$87,339.87 – $7,192.70 = $80,147.17 

Result. If no more withdrawals were taken, the guaranteed future value on the 10th rider anniversary
would be $80,147.17. 

  

RGMB  3  0803(A-6)

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