Exhibit h.55
FORM OF
AMENDMENT TO PARTICIPATION AGREEMENT
AMONG
ING PARTNERS, INC.
ING LIFE INSURANCE AND ANNUITY COMPANY
ING FINANCIAL ADVISERS, LLC
AND
ING USA ANNUITY AND LIFE INSURANCE COMPANY
(FORMERLY, GOLDEN AMERICAN LIFE INSURANCE COMPANY)
This Amendment is dated as of day of , 2004 by and between ING Partners,
Inc. (the "Fund"), ING Life Insurance and Annuity Company (the "Adviser"), ING
Financial Advisers, LLC (the "Distributor") and ING USA Annuity and Life
Insurance Company (formerly, Golden American Life Insurance Company) (the
"Company") (collectively, the "Parties").
WHEREAS, the Parties entered into a Participation Agreement on July 13,
2001 (the "Agreement") and subsequently amended the Agreement on September 1,
2001 and May 1, 2003;
WHEREAS, the Parties desire to further amend said Agreement in the manner
hereinafter set forth;
NOW THEREFORE, the parties hereby amend the Agreement in the following
form:
1. By replacing the existing Schedule B with the Schedule B attached
hereto.
2. All of the other provisions contained in the Agreement shall remain in
full force and effect.
IN WITNESS WHEREOF, the parties hereto have caused this instrument to be
executed by their duly authorized signatories as of the date and year first
above written.
ING PARTNERS, INC. ING LIFE INSURANCE AND ANNUITY COMPANY
By: By:
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Name: Name:
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Title: Title:
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ING FINANCIAL ADVISERS, LLC ING USA ANNUITY AND LIFE INSURANCE COMPANY
By: By:
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Name: Name:
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Title: Title:
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FORM OF
SCHEDULE B
ING PARTNERS, INC.
DESIGNATED PORTFOLIOS
ING Aeltus Enhanced Index Portfolio - Initial, Adviser and Service Class
ING ▇▇▇▇▇ Growth Portfolio - Initial, Adviser and Service Class
ING ▇▇▇▇▇ Aggressive Growth Portfolio - Initial, Adviser and Service Class
ING ▇▇▇▇▇ Capital Appreciation Portfolio - Initial, Adviser and Service Class
ING American Century Small Cap Value Portfolio - Initial, Adviser and Service Class
ING Baron Small Cap Growth Portfolio - Initial, Adviser and Service Class
ING Fidelity(R) VIP Contrafund(R) Portfolio** - Initial, Adviser and Service Class
ING Fidelity(R) VIP Growth Portfolio - Initial, Adviser and Service Class
ING Fidelity(R) VIP Value Strategies Portfolio - Initial, Adviser and Service Class
ING Fidelity(R) VIP Equity-Income Portfolio - Initial, Adviser and Service Class
ING Fidelity(R) VIP Mid Cap Portfolio - Initial, Adviser and Service Class
ING ▇▇▇▇▇▇▇ ▇▇▇▇▇(R) Capital Growth Portfolio* - Initial, Adviser and Service Class
ING ▇▇▇▇▇▇▇ Sachs(R) Core Equity Portfolio* - Initial, Adviser and Service Class
ING JPMorgan ▇▇▇▇▇▇▇ International Portfolio - Initial, Adviser and Service Class
ING JPMorgan Mid Cap Value Portfolio - Initial, Adviser and Service Class
ING MFS Capital Opportunities Portfolio - Initial, Adviser and Service Class
ING MFS Global Growth Portfolio - Initial, Adviser and Service Class
ING MFS Research Equity Portfolio - Initial, Adviser and Service Class
ING OpCap Balanced Value Portfolio - Initial, Adviser and Service Class
ING PIMCO Total Return Portfolio - Initial, Adviser and Service Class
ING Salomon Brothers Aggressive Growth Portfolio - Initial, Adviser and Service Class
ING Salomon Brothers Investors Value Portfolio - Initial, Adviser and Service Class
ING Salomon Brothers Fundamental Value Portfolio - Initial, Adviser and Service Class
ING ▇. ▇▇▇▇ Price Growth Equity Portfolio - Initial, Adviser and Service Class
ING UBS Tactical Asset Allocation Portfolio - Initial, Adviser and Service Class
ING ▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇ Portfolio - Initial, Adviser and Service Class
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*▇▇▇▇▇▇▇ Sachs(R) is a registered service ▇▇▇▇ of ▇▇▇▇▇▇▇, ▇▇▇▇▇ & Co., and it
is used by agreement with ▇▇▇▇▇▇▇, Sachs & Co.
**Fidelity(R) and Contrafund(R) are registered trademarks of FMR Corp.