"DRAFT"
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▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇
▇▇▇▇▇▇▇ ▇▇▇▇▇, ▇▇ ▇▇▇▇▇
▇▇▇▇ INDIVIDUAL RETIREMENT RIDER
This rider is part of the Contract to which it is attached by Pacific Life &
Annuity Company ("PL&A").
The Contract under which it has been issued is hereby modified as specified
below in order to qualify as a ▇▇▇▇ Individual Retirement Annuity (▇▇▇▇ ▇▇▇)
under section 408A of the Internal Revenue Code of 1986 (the "Code") as amended.
DEFINITIONS
ANNUITANT - is an individual named as a measuring life for periodic annuity
payments under this Contract.
ANNUITY START DATE - is the date you choose to have PL&A begin periodic annuity
payments to the Annuitant.
CONTINGENT ANNUITANT - is an individual who is designated as a successor when
the Annuitant dies. Absent a contrary indication by the Owner at such time, any
individual Owner shall be a Contingent Annuitant.
DESIGNATED BENEFICIARY - is an individual designated as a beneficiary by the
Owner.
YOU - is the Owner of the Contract.
In order to ensure treatment of the Contract as a ▇▇▇▇ ▇▇▇ the provisions of
this rider will control if in conflict with those of the Contract.
Notwithstanding any provisions in the contract to the contrary:
1. The Annuitant will at all times be the Owner of the Contract. Such Owner's
rights under the Contract shall be nonforfeitable and for the exclusive
benefit of such Owner and his or her beneficiaries.
2. No benefits under the Contract may be transferred, sold, assigned, or
pledged as collateral for a loan, or as security for the performance of an
obligation, or for any other purpose, to any person; except that the
Contract may be transferred to a former or separated spouse of the Owner
under a qualified domestic relations order. In the event of such a
transfer, the transferee shall for all purposes be treated as the Owner
under this Contract.
3. (a) MAXIMUM PERMISSIBLE AMOUNT. Except in the case of a qualified rollover
contribution or a recharacterization (as defined in 3(e) below), no
contribution will be accepted unless it is in cash and the total of such
contributions to all the individual Owner's ▇▇▇▇ IRAs for a taxable year
does not exceed the lesser of $2,000, or such Owner's compensation
[Pub 590 p.37]. This contribution is referred to as a "regular
contribution." A "qualified rollover contribution" is a rollover
contribution that meets the requirements of section 408(d)(3) of the Code,
except that the one-rollover-per-year rule of section 408(d)(3)(B) does
not apply if the rollover contribution is from an IRA other than a
▇▇▇▇ ▇▇▇ (a "nonRoth IRA"). Contributions may be limited under 3(b)
through (d) below.
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(b) REGULAR CONTRIBUTION LIMIT. If (i) and/or (ii) below apply, the maximum
regular contribution that can be made to all the Owner's ▇▇▇▇ IRAs for a
taxable year is the smaller of the amounts determined under (i) or (ii)
below.
(i) The maximum regular contribution is phased out ratably between
certain levels of modified adjusted gross income ("modified AGI,"
defined in (f) below) in accordance with the following table:
Full Phase-out No
Filing Status Contribution Range Contribution
----------------------------------------------------------------------------------------------------
Modified AGI
----------------------------------------------------------
Single or Head $95,000 or less Between $95,000 $110,000
Of Household and $110,000 or more
Joint Return $150,000 or less Between $150,000 $160,000
Or Qualifying and $160,000 or more
Widow(er)
Married- $0 Between $0 $10,000
Separate Return and $10,000 or more
If the Owner's modified AGI for a taxable year is in the phase-out range, the
maximum regular contribution determined under this table for that taxable year
is rounded up to the next multiple of $10 and is not reduced below $200. The
preceding limits may change as indexed for inflation or amended by tax law.
(ii) If the Owner makes regular contributions to both ▇▇▇▇ and
nonRoth IRAs for a taxable year, the maximum regular
contribution that can be made to all the Owner's ▇▇▇▇ IRAs
for that taxable year is reduced by the regular
contributions made to the Owner's nonRoth IRAs for the
taxable year.
(c) QUALIFIED ROLLOVER CONTRIBUTION LIMIT. A rollover from a nonRoth IRA
cannot be made to this IRA if, for the year the amount is distributed
from the nonRoth IRA, (i) the Owner is married and files a separate
return, (ii) the Owner is not married and has modified AGI in excess
of $100,000 or (iii) the Owner is married and together the Owner and
the Owner's spouse have modified AGI in excess of $100,000. For
purposes of the preceding sentence, a husband and wife are not treated
as married for a taxable year if they have lived apart at all times
during that taxable year and file separate returns for the taxable
year.
(d) SIMPLE IRA LIMITS. No contributions to this ▇▇▇▇ ▇▇▇ Contract will be
accepted under a SIMPLE IRA Plan established by any employer pursuant
to Code section 408(p). Also, no transfer or rollover of funds to this
▇▇▇▇ ▇▇▇ Contract and attributable to contributions made by a
particular employer under its SIMPLE IRA Plan will be accepted from a
SIMPLE IRA Plan prior to the expiration of the 2-year period beginning
on the date the Owner first participated in that employer's SIMPLE IRA
Plan.
(e) RECHARACTERIZATION. A regular contribution to a nonRoth IRA may be
recharacterized pursuant to the rules in section 1.408A-5 of the
regulations as regular contribution to this ▇▇▇▇ ▇▇▇, subject to the
limits in (b) above.
(f) MODIFIED AGI. For purposed of (b) and (c) above, an Owner's modified
AGI for a taxable year is defined in Code section 408A(c)(3)(C)(i) and
does not include any amount included in adjusted gross income as a
result of a rollover from a nonRoth IRA (a "conversion").
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4. Additional Purchase Payments (or premium payments) under the Contract must
be at least equal to the minimum amount stated in the Purchase Payments (or
Premiums) provision of the Contract.
5. Any Purchase Payments (or premiums) refund declared by PL&A other than
refunds attributable to excess contributions will be applied toward the
purchase of additional benefits before the close of the calendar year
following the refund.
6. (a) Upon the death of the Owner, distribution of the Owner's entire
interest in this Contract shall be completed by December 31 of
the calendar year containing the fifth anniversary of the Owner's
death except to the extent that an election is made to receive
distribution in accordance with (i) or (ii) below:
(i) If the Owner's interest is payable to a designated beneficiary,
then the entire interest of the Owner may be distributed over the
life, or over a period certain not greater than the life
expectancy of the designated beneficiary, commencing on or before
December 31 of the calendar year immediately following the
calendar year in which the Owner died.
(ii) If the designated beneficiary is the Owner's surviving spouse,
the date distributions are required to begin in accordance with
(i) above shall not be earlier than the later of (A) December 31
of the calendar year immediately following the calendar year in
which the Owner died or the date on which the Owner would have
attained age 70 1/2.
(b) If the designated beneficiary is the Owner's surviving spouse, such spouse
may elect to treat the contract as his or her own ▇▇▇▇ ▇▇▇. This election
will be deemed to have been made if such surviving spouse makes regular
contributions to the contract, makes a rollover to or from such contract,
or fails to take distributions under (a) above.
(c) Payments required under (a)(i) or (a)(ii) above must be made at intervals
of no longer than 1 year and must be either nonincreasing or increasing as
provided in Q&A F-3 of section 1.401(a)(9)-1 of the proposed regulations.
(d) Life expectancy is computed by use of the expected return multiples in
Table V of section 1.72-9 of the Income Tax Regulations. If the designated
beneficiary is the Owner's surviving spouse, then, unless otherwise elected
by such surviving spouse by the time distributions are required to begin,
such surviving spouse's life expectancy shall be recalculated annually.
Such election shall be irrevocable by such surviving spouse and shall apply
to all subsequent years. In the case of any other designated beneficiary,
life expectancies shall be calculated using the attained age of such
beneficiary during the calendar year in which distributions are required to
begin pursuant to (a)(i) or (a)(ii) above, and payments for any subsequent
calendar year shall be calculated based on such life expectancy reduced by
one for each calendar year which has elapsed since the calendar year life
expectancy was first calculated.
7. PL&A shall furnish annual calendar year reports concerning the status of
the Contract.
8. The Contract as amended by this rider is intended to qualify as a ▇▇▇▇ ▇▇▇
contract for federal income tax purposes. To that end, the provisions of
this rider and the Contract (including any other rider or endorsement) are
to be interpreted to ensure or maintain such tax qualification,
notwithstanding any other provision to the contrary. PL&A reserves the
right to amend this rider to comply with future changes in the Code, any
regulations or
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rulings issued thereunder and to reflect any clarifications that may be
needed or are appropriate to maintain such tax qualification without
consent (except for the states of Michigan, Pennsylvania, South Carolina
and Washington, where affirmative consent is required). PL&A shall provide
the Owner with a copy of any such amendment.
SIGNED FOR PACIFIC LIFE & ANNUITY COMPANY,
/s/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇, /s/ ▇▇▇▇▇▇ ▇. ▇▇▇▇▇
President and Chief Executive Officer Secretary
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