YOU HAVE THE RIGHT TO RETURN THIS CONTRACT Clause Samples

YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within days after you receive it by returning it to our administrative office, or to the agent who sold it to you, with a written request for cancellation. If you return it by mail, effective date of the cancellation will be determined by the postmark date on the properly addressed and postage-paid return package. We will promptly return the Contract Value plus any amounts deducted from the Purchase Payments or the Contract Value. The amount returned may be more or less than your Purchase Payments. Home and Administrative Office: PROTECTIVE LIFE AND ANNUITY INSURANCE COMPANY ▇▇▇.▇▇▇▇▇▇▇▇▇▇.▇▇▇ SCHEDULE A DEFINITIONS 2 PARTIES TO THE CONTRACT 3 Company 3 Owner 3 Change of Owner 3 Beneficiary 3 Change of Beneficiary 3 Annuitant 3 Change of Annuitant 4 Payee 4 GENERAL PROVISIONS 4 Entire Contract 4 Modification of the Contract 4 Non-Participating 4 Incontestability 4 Application of Law 4 Form Approval 4 Assignment 4 Protection of Proceeds 5 Minimum Values 5 Reports 5 Error in Age or Gender 5 Settlement 5 Receipt of Payment 5 Premium Tax 5 Written Notice 5 PURCHASE PAYMENTS 6 Purchase Payments 6 Allocation of Purchase Payments 6 VARIABLE ACCOUNT 6 General Description 6 Sub-Accounts of the Variable Account 6 Variable Account Value 7 Accumulation Unit Values 7 Net Investment Factor 8 TRANSFERS 8 Transfers 8 Limitation on Frequent Transfers 8 Dollar Cost Averaging 8 SURRENDERS AND WITHDRAWALS 9 Surrenders 9 Withdrawals 9 Surrender Value 9 Suspension or Delay in Payment of Surrender or Withdrawal 9 DEATH BENEFIT 9 Death of an Owner 9 Death of the Annuitant 9 Death Benefit 9 Payment of the Death Benefit 10 Suspension or Delay in Payment of Death Benefit 10 ANNUITY INCOME PAYMENTS 10 Annuity Date 10 Annuity Income Payments 10 Fixed Income Payments 10 Variable Income Payments 11 Annuity Unit Values 11 Selection of Annuity Option 11 Annuity Options 12 Minimum Amounts 12 Guaranteed Purchase Rates 12 FIXED ANNUITY TABLES 13 VARIABLE ANNUITY TABLES 13
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YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within ten (10) days after you receive it by returning the Contract to our Administrative Office or to the Agent who sold it to you with a written request for cancellation. Return of this Contract by mail is effective on being post-marked and properly addressed with postage paid. We will promptly return the Contract Value plus any amount deducted from the Purchase Payments or the Contract Value. This may be more or less than the Purchase Payments. If this Contract replaced a life insurance policy or another annuity contract, you may cancel this Contract within sixty (60) days after you receive it. { P. O. Box 10648 { AFVA-000000001 } { May 1, 2008 } { ▇▇▇▇ ▇. ▇▇▇ } { March 30, 1953 } { ▇▇▇▇ ▇. ▇▇▇ } { April 15, 1958 } { ▇▇▇▇ ▇. ▇▇▇ } { March 30, 1953 } As contained in our records { March 30, 2048 } INITIAL PURCHASE PAYMENT: { $100,000.00 } LATEST AGE FOR PURCHASE PAYMENTS: { 85 } MINIMUM GUARANTEED INTEREST RATE FOR THE GUARANTEED ACCOUNT: { 3.00% } DCA FIXED ACCOUNT 1 - { 4.00% } DCA FIXED ACCOUNT 2 - { 3.50% } { 1.40% } per annum. { 0.15% } per annum. { Return of Purchase Payments } { CoverPay® - A Benefit Based Fee } { CONTRACT MAINTENANCE FEE: $30 The contract maintenance fee is deducted prior to the Annuity Commencement Date on each Contract Anniversary, and on any day that the Contract is surrendered other than the Contract Anniversary. The contract maintenance fee will be deducted from the Allocation Options in the same proportion as their values are to the Contract Value. The contract maintenance fee will be waived by the Company in the event the Contract Value or the aggregate Purchase Payments reduced by surrenders equals or exceeds $50,000 on the date the contract maintenance fee is to be deducted. } { TRANSFER FEE $25 per transfer in excess of 12 transfers in any Contract Year. } DCA Fixed Account 1 DCA Fixed Account 2 VIP Contrafund® Service Class 2 VIP Equity-Income Service Class 2 VIP Growth Service Class 2 VIP Index 500 Service Class 2 VIP Investment Grade Bond Service Class 2 VIP Mid Cap Service Class 2 ▇▇▇▇▇▇▇▇ Flex Cap Growth Class 2 Franklin Income Class 2 Franklin Rising Dividends Class 2 Franklin Small-Mid Cap Growth Class 2 Franklin U. S. Government Class 2 Mutual Shares Class 2 ▇▇▇▇▇▇▇▇▇ Foreign Class 2 ▇▇▇▇▇▇▇▇▇ Global Income Securities Class 2 ▇▇▇▇▇▇▇▇▇ Growth Class 2 Capital Growth Growth and Income Strategic International Equity Structured Small Cap Equity Structured U. S. Equity America’s Value Bond...
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YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within days after you receive it by returning it to our administrative office, or to the agent who sold it to you, with a written request for cancellation. If you return it by mail, effective date of the cancellation will be determined by the postmark date on the properly addressed and postage-paid return package. We will promptly return the Contract Value plus any amounts deducted from the Purchase Payments or the Contract Value. The amount returned may be more or less than your Purchase Payments. P. O. Box 1928, Birmingham, Alabama 35282-8238 (▇▇▇) ▇▇▇-▇▇▇▇ SCHEDULE ......................................................... A VARIABLE ACCOUNT ........................................ 5 General Description....................................... 5 DEFINITIONS ...................................................... 1 Sub-Accounts of the Variable Account .......... 5 Variable Account Value ................................. 6 PARTIES TO THE CONTRACT .......................... 2 Accumulation Unit Values.............................. 6 Company ....................................................... 2 Net Investment Factor ................................... 7 Owner ............................................................ 2 Change of Owner .......................................... 2 TRANSFERS ....................................................... 7 Beneficiary..................................................... 2 Transfers ....................................................... 7 Change of Beneficiary ................................... 2 Limitation on Frequent Transfers .................. 7 Annuitant ....................................................... 2 Dollar Cost Averaging.................................... 7 Change of Annuitant...................................... 3 Payee ............................................................ 3 SURRENDERS AND WITHDRAWALS............... 8 Surrenders ..................................................... 8 GENERAL PROVISIONS .................................... 3 Withdrawals ................................................... 8 Entire Contract .............................................. 3 Surrender Value ............................................ 8
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YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within twenty days after you receive it by returning the Contract to our Home Office or to our Agent, with a written request for cancellation. The Contract will be as though it had never been issued. We will promptly return any Annuity Deposit made. Sub-Account # Period Interest Rate Deposit Rate Separate Account
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YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within ten (10) days after you receive it by returning the Contract to our Administrative Office or to the Agent who sold it to you with a written request for cancellation. Return of this Contract by mail is effective on being post-marked and properly addressed with postage paid. We will promptly return the Contract Value plus any amount deducted from the Purchase Payments or the Contract Value. This may be more or less than the Purchase Payments. If this Contract replaced a life insurance policy or another annuity contract, you may cancel this Contract within sixty (60) days after you receive it. { ▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇ { ▇▇▇▇▇▇▇ ▇. ▇▇▇▇ { P. O. Box 10648 { AFVA-000000001 } { May 1, 2008 } { ▇▇▇▇ ▇. ▇▇▇ } { March 30, 1953 }
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