Exhibit 4(a)
First SunAmerica Life Insurance Company
A STOCK COMPANY NEW YORK, NEW YORK
CONTRACT NUMBER P9999999999
OWNER ▇▇▇▇ ▇▇▇
EXECUTIVE OFFICE ANNUITY SERVICE CENTER
▇▇▇ ▇▇▇▇▇ ▇▇▇., ▇▇▇ FLOOR ▇.▇. ▇▇▇ ▇▇▇▇▇
▇▇▇ ▇▇▇▇, ▇▇ ▇▇▇▇▇ ▇▇▇ ▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇-▇▇▇▇
FIRST SUNAMERICA LIFE INSURANCE COMPANY ("We", "Us", the "Company", or "First
SunAmerica") agrees to provide benefits to the Owner in accordance with the
provisions set forth in this Contract and in consideration of the Owner's
application and the Purchase Payment We receive.
The Separate Account Charge is charged against the assets of the Separate
Account. This charge includes fees for mortality and expense risk and the
distribution expense. On an annualized basis the charge equals 1.52% These
charges are assessed, on a simple interest basis, as a percentage of the average
daily ending value of the assets attributable to the Accumulation Units of the
Subaccounts to which Your Contract Value is allocated. The daily charge is
1/365th of the annualized charge. The variable annuity rate of return is based
on compound interest. Thus, the smallest annual effective rate of investment
return that would have to be earned on assets of the separate account so that
the dollar amount of variable annuity payments will not decrease is 5.09%,
compounded daily.
RIGHT TO EXAMINE - If, within 10 days of receipt of this Contract (60 days if
the Contract replaced any other life insurance or annuity contract(s)), You are
not satisfied with it, You may return the Contract to Our Annuity Service
Center, or the agent through whom the Contract was purchased. We will refund the
Contract Value computed as of the end of the business day we receive the
Contract in Our Annuity Service Center. Upon such refund, the Contract shall be
void.
For Individual Retirement Annuities, a refund of the Purchase Payment(s) may be
required. Therefore, We reserve the right to allocate Your Purchase Payment(s)
to the Cash Management Portfolio until the end of the Right To Examine period.
Thereafter, allocations will be made as shown on the Contract Purchase Payment
Allocation page.
THIS IS A LEGAL DOCUMENT. READ IT CAREFULLY.
/s/ ▇▇▇ ▇. ▇▇▇▇▇▇▇
---------------------------------
▇▇▇ ▇. ▇▇▇▇▇▇▇
President
INDIVIDUAL
VARIABLE ANNUITY CONTRACT
Nonparticipating
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TABLE OF CONTENTS
Contract Data Page ....................................... Page 3
Purchase Payment Allocation .............................. Page 4
Definitions .............................................. Page 5
General Provisions ....................................... Page 8
Purchase Payment Provisions .............................. Page 10
Accumulation Provisions .................................. Page 10
Charges and Deductions ................................... Page 11
Transfer Provision ....................................... Page 11
Withdrawal Provisions .................................... Page 12
Death Provisions ......................................... Page 13
Annuity Provisions ....................................... Page 15
Annuity Payment Options .................................. Page 17
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Contract Data Page
Contract Number: Annuity Service Center:
P9999999999 P. O. ▇▇▇ ▇▇▇▇▇
▇▇▇ ▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇-▇▇▇▇
Owner: Age at Issue:
▇▇▇▇ ▇▇▇ 35
Annuitant: Initial Purchase Payment:
▇▇▇▇ ▇▇▇ $10,000.00
Specified Annuity Date: Contract Date:
October 1, 2032 October 1, 2002
Latest Annuity Date: Minimum Guaranteed Rate for
October 1, 2062 Fixed Account Options -
3.00%
Separate Account Charge: Annual Contract Administration Charge:
1.52% $30.00
Beneficiary:
As named by You
Separate Account:
FS Variable Separate Account
Optional Elections Optional Election Charges:
Maximum Anniversary Value
Death Benefit: 0.20%
WITHDRAWAL CHARGE SCHEDULE
--------------------------
Number of full Years Elapsed Withdrawal Charge as a
Between Purchase Payment Contribution Percentage of Withdrawn
And Date of Withdrawal Purchase Payment
---------------------- --------------------
0 7%
1 6%
2 5%
3+ 0%
For Inquiries
[Call ▇-▇▇▇-▇▇▇-▇▇▇▇]
3
PURCHASE PAYMENT ALLOCATION
Subaccounts
_____% Growth-Income _____% Strategic Growth Portfolio _____% Alliance Growth
_____% Real Estate _____% Conservative Growth Portfolio _____% Global Equities
_____% Federated American Investors _____% Balanced Portfolio _____% Nations Capital Growth
_____% Telecom Utility _____% Conservative Balanced _____% Nations MidCap Growth
Portfolio
75% ▇▇▇▇▇▇▇ ▇▇▇▇▇ Research _____% Flexible Income Portfolio _____% Nations Small Company
-----
_____% ▇▇▇▇▇▇▇ Growth _____% Corporate Bond _____% Nations Value Fund
_____% MFS Massachusetts Investors Trust _____% Global Bond _____% Nations International Value
_____% International Diversified _____% Worldwide High Income _____% Nations ▇▇▇▇▇▇▇ 21st Century
Equities
_____% Emerging Markets _____% High-Yield Bond _____% Nations ▇▇▇▇▇▇▇ Focused
Equities
_____% International Growth & Income _____% Government and Quality Bond _____% MFS Growth & Income
_____% ▇▇▇▇▇▇ Growth: Voyager _____% Nations High Yield Bond _____% MFS Mid-Cap Growth
_____% Aggressive Growth _____% Focus Growth Portfolio _____% International Diversified
Equities
_____% Blue Chip Growth _____% Focus Growth & Income _____% Technology
Portfolio
_____% "Dogs" of Wall Street _____% Focus TechNet Portfolio _____% Nations Asset Allocation
_____% Growth Opportunities _____% Focus Value Portfolio _____% Asset Allocation
_____% Growth _____% Equity Income Fund _____% MFS Total Return
_____% Natural Resources _____% Growth & Income Fund _____% SunAmerica Balanced
_____% Large Cap Growth Portfolio _____% Growth Fund of the Northwest _____% Short Term Income Fund
_____% Large Cap Composite Portfolio _____% Growth Fund _____% Government Securities Fund
_____% Large Cap Value Portfolio _____% Mid Cap Stock Fund _____% Income Fund
_____% Mid Cap Growth Portfolio _____% Small Cap Stock Fund _____% Money Market Fund
_____% Mid Cap Value Portfolio _____% International Growth Fund _____% MFS Mid-Cap Growth
_____% Small Cap Portfolio _____% Alliance Growth _____% Technology
_____% International Equity Portfolio _____% Global Equities _____% Capital Appreciation
_____% Diversified Fixed Income _____% ▇▇▇▇▇ Venture Value _____% Moderate Growth Strategy
Portfolio
_____% Cash Management Portfolio _____% Nations ▇▇▇▇▇▇▇ Growth & _____% Balanced Growth Strategy
Income
_____% Growth Strategy _____% Nations ▇▇▇▇▇▇▇ International _____% Conservative Growth Strategy
_____% Small & Mid Cap Value Opportunities _____% Lord ▇▇▇▇▇▇ Series Fund
_____% Foreign Value
Fixed Account Options
---------------------
DCA Fixed Account Options Interest Rate
------------------------- -------------
0.00% 6-Month DCA Fixed 3.00%
0.00% 1-Year DCA Fixed
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DEFINITIONS
Defined in this section are some of the words and phrases used in this Contract.
These terms are capitalized when used in the Contract. Other capitalized terms
in the Contract refer to the captioned paragraph explaining that particular
concept in the Contract.
ACCUMULATION UNIT
A unit of measurement used to compute the Contract Value in a Subaccount prior
to the Annuity Date.
AGE
Age as of last birthday.
ANNUITANT
The natural person or persons (collectively, Joint Annuitants) whose life or
lives is/are used to determine the annuity benefits under the Contract. If the
Contract is in force and the Annuitant(s) is/are alive on the Annuity Date, We
will begin payments to the Payee. This Contract cannot have Joint Annuitants if
it is issued in connection with a tax-qualified retirement plan.
ANNUITY DATE
The date on which annuity payments ("income payments") to the Payee begin. This
date cannot be later than the Latest Annuity Date.
ANNUITY SERVICE CENTER
As specified on the Contract Data Page.
ANNUITY UNIT
A unit of measurement used to compute annuity payments from the Subaccounts.
BENEFICIARY
The Beneficiary is as named by You at issue, unless later changed by You in a
written request to Us at Our Annuity Service Center.
CONTRACT DATE
The date Your Contract is issued, as shown on the Contract Data Page. It is the
date from which Contract Years and anniversaries are measured.
CONTRACT VALUE
The sum of: (1) Your share of the Subaccounts Accumulation Unit values and (2)
the value of amounts allocated to the Fixed Account Options.
CONTRACT YEAR
One year starting from the Contract Date in one calendar year and ending on the
day preceding the anniversary of such date in the succeeding calendar years.
CONTINUATION DATE
The Date on which We receive, at Our Annuity Service Center: (a) the Spousal
Beneficiary's satisfactory written request to continue the Contract inforce, and
(b) Due Proof of Death of the Owner. If We receive (a) and (b) on different
dates, the Continuation Date will be the later date.
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CURRENT INTEREST RATE
The rate(s) of interest declared by Us applicable to allocations of Subsequent
Purchase Payments to the Fixed Account Options. The Current Interest Rate will
not be less than the Minimum Guaranteed Rate as shown on the Contract Data Page.
DOLLAR COST AVERAGING PROGRAM (DCA)
An optional program under which You authorize the automatic transfer of
specified amounts or percentages from the Fixed Account Option(s) or any
Subaccount(s) into any Subaccount(s) other than the source account. Any portion
of a Purchase Payment allocated to the DCA Fixed Account Option(s) must be
transferred out within the specified DCA Fixed Account Option Period (6 Contract
months or 1 Contract Year from the date each Purchase Payment is allocated to
the DCA Fixed Account Option), depending on which DCA Fixed Account Option is
selected. The unit values credited and applied to Your Contract are determined
on each date of transfer. Prior to the Annuity Date, You may transfer all or any
part of Your Contract Value from a DCA Fixed Account Option to any
Subaccount(s). Upon termination of the DCA program or annuitization any amounts
remaining in the DCA Fixed Account Option(s) will be transferred to the DCA
target allocation(s) for the program being terminated.
FIXED ACCOUNT OPTIONS
The DCA Fixed Account Options under this Contract that are credited with a fixed
rate of interest declared by the Company. . All amounts allocated to the DCA
Fixed Account Options become part of the Company's general asset account. The
general asset account contains all the assets of the Company except for the
Separate Account and other segregated asset accounts. The DCA Fixed Account
Options for this Contract are shown on page 4.
FIXED ANNUITY
A series of periodic annuity payments of predetermined amounts that do not vary
with investment experience. Such payments are made from the Company's general
asset account.
GUARANTEE PERIOD
The period for which either the Initial Interest Rate or the Current Interest
Rate is credited to amounts allocated to the Fixed Account Options.
INITIAL INTEREST RATE
The rate(s) of interest credited to any portion of the Initial Purchase Payment
allocated to the DCA Fixed Account Option(s) as described in the Accumulation
Provisions section. The Initial Interest Rate(s) for this Contract is/are listed
on page 4. The Initial Interest Rate may not be less than the Minimum Guaranteed
Rate as shown on the Contract Data Page.
IRC
The Internal Revenue Code of 1986, as amended, or as it may be amended or
superseded.
JOINT OWNER
If Joint Owners are named, each Joint Owner has an equal ownership interest in
the Contract unless We are advised otherwise in writing.
MINIMUM GUARANTEED RATE
The rate as shown on the Contract Data Page. The Initial Interest Rate and
Current Interest Rate will not be less than the Minimum Guaranteed Rate.
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NET PURCHASE PAYMENTS
The sum of all Purchase Payments, reduced proportionately on the date of each
partial withdrawal by the percentage at which the Contract Value is reduced by
each such withdrawal (including any charges applicable to the withdrawal).
NYSE
New York Stock Exchange.
OWNER
The person or entity named in the Contract who is entitled to exercise all
rights and privileges of ownership under the Contract. Owner means both Joint
Owners, if applicable.
PAYEE
The person receiving payment of annuity benefits under this Contract.
PURCHASE PAYMENTS
Payments in U.S. currency made by or on behalf of the Owner to the Company for
the Contract.
SEPARATE ACCOUNT
The segregated asset account named on the Contract Data Page. The Separate
Account consists of several Subaccounts, each investing in the shares of the
Underlying Fund(s) of the trust(s). The assets of the Separate Account are not
commingled with the general assets and liabilities of the Company. Each
Subaccount is not chargeable with liabilities arising out of any other
Subaccount. The value of amounts allocated to the Subaccounts of the Separate
Account is not guaranteed.
SPECIFIED ANNUITY DATE
The anticipated Annuity Date specified by You as shown on Contract Data Page.
This date may be changed by You in writing prior to the Annuity Date, but in no
event can it be later than the Latest Annuity Date. If this date is not
specified, it will be the Latest Annuity Date.
SPOUSAL BENEFICIARY
The deceased original Owner's surviving spouse who is designated as the primary
Beneficiary and may continue the Contract as the Owner on the Continuation Date.
SUBACCOUNT ("VARIABLE PORTFOLIO")
One or more divisions of the Separate Account, which provides for the variable
investment options available under this Contract. Each Subaccount has its own
investment objective and is invested in an Underlying Fund of the trusts. A
Subaccount is not chargeable with liabilities arising out of any other
Subaccount. The available Subaccounts are shown on page 4. Additional
Subaccounts may become available in the future.
SUBSEQUENT PURCHASE PAYMENTS
Purchase Payments made subsequent to the Initial Purchase Payment.
TOTAL INVESTED AMOUNT
The sum of all Purchase Payments less amounts previously withdrawn that incurred
a Withdrawal Charge, less Purchase Payments withdrawn that were no longer
subject to a Withdrawal Charge.
UNDERLYING FUND
The variable investment options that make up the trusts in which the
corresponding Subaccount(s) invest.
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VARIABLE ANNUITY
A series of periodic annuity payments which vary in amount according to the
investment experience of one or more Subaccount, as selected by You.
WE, OUR, US, THE COMPANY
First SunAmerica Life Insurance Company.
YOU, YOUR
The Owner.
GENERAL PROVISIONS
ENTIRE CONTRACT
The entire contract between You and Us consists of the Application Form as
completed by You at the time of purchase, this Contract and any attached
endorsement(s). An agent cannot change the terms or conditions of this Contract.
Any change must be in writing and approved by Us. Only Our President, Secretary,
or one of Our Vice-Presidents can give Our approval.
CHANGE OF ANNUITANT
If the Owner is an individual, the Owner may change the Annuitant at any time
prior to the Annuity Date. To make a change, the Owner must send a written
notice to Us at least 30 days before the Annuity Date. If the Owner is not an
individual, the Owner may not change the Annuitant.
DEATH OF ANNUITANT
If the Owner and Annuitant are different, and the Annuitant dies before the
Annuity Date, the Owner becomes the Annuitant until the Owner elects a new
Annuitant. If there are Joint Annuitants, upon the death of any Annuitant prior
to the Annuity Date, the Owner may elect a new Joint Annuitant. However, if the
Owner is a non-natural person, We will treat the death of any Annuitant as the
death of the "Primary Annuitant" and as the death of the Owner, see DEATH
PROVISIONS.
MISSTATEMENT OF AGE OR SEX
If the Age or sex of any Annuitant has been misstated, future annuity payments
will be adjusted using the correct Age and sex, according to Our rates in effect
on the date that annuity payments were determined. Any overpayment from the
Fixed Annuity Payment Options, plus interest at the rate of 4% per year, will be
deducted from the next payment(s) due. Any underpayment from the Fixed Annuity
Payment Options, plus interest at the rate of 4% per year, will be paid in full
with the next payment due. Any overpayment from the Subaccount(s) will be
deducted from the next payment(s) due. Any underpayment from the Subaccount(s)
will be paid in full with the next payment due.
PROOF OF AGE, SEX, OR SURVIVAL
The Company may require satisfactory proof of correct Age or sex at any time. If
any payment under this Contract depends on the Annuitant being alive, the
Company may require satisfactory proof of survival.
DEFERMENT OF PAYMENTS
We may defer making payments from the Fixed Account Options for up to six (6)
months. Interest, subject to state requirements, will be credited during the
deferral period.
SUSPENSION OF PAYMENTS
We may suspend or postpone any payments from the Subaccounts if any of the
following occur:
8
(a) the NYSE is closed;
(b) trading on the NYSE is restricted;
(c) an emergency exists such that it is not reasonably practical to dispose of
or determine the value of assets held in the Subaccount(s); or
(d) the Securities and Exchange Commission, by order, so permits for the
protection of Owners.
Conditions in (b) and (c) will be decided by or in accordance with rules of the
Securities and Exchange Commission.
CONFORMITY WITH STATE LAWS
The provisions of this Contract will be interpreted by the laws of the state in
which the Application Form was signed or such other state as is required by law.
Any provision which, on the Contract Date, is in conflict with the law of such
state is amended to conform to the minimum requirements of such law.
CHANGES IN LAW
If the laws governing this Contract or the taxation of benefits under the
Contract change, We reserve the right to amend this Contract, subject to New
York Department of Insurance approval, to comply with any change.
ASSIGNMENT
You may assign this Contract before the Annuity Date, but We will not be bound
by an assignment unless it is received by Us in writing. Your rights and those
of any other person referred to in this Contract will be subject to the
assignment. Certain assignments may be taxable. We do not assume any
responsibility for the validity or tax consequences of any assignment.
CLAIMS OF CREDITORS
To the extent permitted by law, no right or proceeds payable under this Contract
will be subject to claims of creditors or legal process.
PREMIUM TAXES AND OTHER TAXES
The Company may deduct from Your Contract Value any premium tax and/or other
taxes payable to a state or other government entity, if applicable. Should We
advance any amount so due, We are not waiving any right to collect such amount
at a later date. The Company will deduct any withholding taxes required by
applicable law.
WRITTEN NOTICE
Any notice We send to You will be sent to Your address shown in the Application
Form unless You request otherwise. Any written request or notice to Us must be
sent to Our Annuity Service Center, at the address specified on the Contract
Data Page.
PERIODIC REPORTS
During each Contract Year, We will send You quarterly statements of the account
activity of the Contract as well as confirmation reports after each financial
transaction. The statement will include all transactions which have occurred
during the quarterly accounting period shown on the statement.
INCONTESTABILITY
This Contract will be incontestable from the Contract Date.
NONPARTICIPATING
This Contract does not share in Our surplus.
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PURCHASE PAYMENT PROVISIONS
PURCHASE PAYMENTS
Purchase Payments are flexible. This means that, subject to Company declared
minimums and maximums, You may change the amounts, frequency and/or timing of
Purchase Payments. Purchase Payments will be allocated to the Fixed Account
Option(s) and/or one or more Subaccount(s) in accordance with instructions from
You. The minimum amount that may be allocated to the Fixed Account Option or a
Subaccount under this Contract is $100.
SUBSTITUTION OF INVESTMENT PORTFOLIO
If: (a) the shares of the Underlying Fund(s) in which the Subaccounts invest
should no longer be available for investment by the Separate Account; or (b) in
the judgment of the Board of Trustees further investment in the shares of a
Subaccount is no longer appropriate in view of the purpose of the Contract, then
We may substitute shares of another Underlying Fund for shares already
purchased, or to be purchased in the future by Purchase Payments under the
Contract. No substitution of securities may take place without prior approval of
the Securities and Exchange Commission and under such requirements as it may
impose.
ACCUMULATION PROVISIONS
SEPARATE ACCOUNT ACCUMULATION VALUE
The Separate Account Accumulation Value under the Contract shall be the sum of
the values of the Accumulation Units held in the Subaccounts for the Owner.
NUMBER OF ACCUMULATION UNITS
Your Contract is credited with Accumulation Units of the Separate Account when
amounts are allocated to the Subaccount(s). For that portion of each Purchase
Payment and/or transfer amount allocated to a Subaccount, the number of
Accumulation Units credited is equal to the sum of each Purchase Payment and/or
transfer amount allocated to that Subaccount reduced by premium taxes, if any:
Divided by
The Accumulation Unit value for that Subaccount for the NYSE business day in
which the Purchase Payment or transfer amount is allocated.
The number of Accumulation Units will be reduced for withdrawals of Contract
Value, annuitizations, amounts transferred out of a Subaccount, the Contract
Administration Charge and any optional charge(s) deducted . Reductions will be
made as of the end of the NYSE business day in which We receive all requirements
for the transaction, as appropriate.
ACCUMULATION UNIT VALUE (AUV)
The AUV of a Subaccount for any NYSE business day is calculated by subtracting
(2) from (1) and dividing the result by (3) where:
(1) is the total value at the end of the given NYSE business day of the assets
attributable to the Accumulation Units of the Subaccount minus the total
liabilities;
(2) is the cumulative unpaid charge for assumption of the Separate Account
Charge and any optional election charges deducted on a daily basis. (SEE
CHARGES AND DEDUCTIONS);
(3) is the number of Accumulation Units outstanding at the end of the given
NYSE business day.
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FIXED ACCOUNT ACCUMULATION VALUE
Under a Contract, the Fixed Account Accumulation Value shall be the sum of all
monies allocated to the DCA Fixed Account Option(s), reduced by any applicable
premium taxes, plus all interest credited on the DCA Fixed Account Option(s)
during the period that the Contract has been in effect. This amount shall be
adjusted for withdrawals (which includes any applicable charges associated with
such withdrawals), transfers, , the Contract Administration Charge and any
optional charges. .
FIXED ACCOUNT GUARANTEE PERIOD OPTIONS AND INTEREST CREDITING
Any amounts allocated to the DCA Fixed Account Options from the initial Purchase
Payment will earn interest at the Initial Interest Rate for the DCA Fixed
Account Option(s) selected for the duration of the Guarantee Period.
Subsequent Purchase Payments, if any, allocated to the DCA Fixed Account Options
will earn interest at the Current Interest Rate for the DCA Fixed Account
Option(s) selected for the duration of the Guarantee Period.
CHARGES AND DEDUCTIONS
We will deduct the following charges from the Contract:
CONTRACT ADMINISTRATION CHARGE
The charge specified on the Contract Data Page will be deducted on each Contract
anniversary that occurs on or prior to the Annuity Date. It will also be
deducted when the Contract Value is withdrawn in full if the withdrawal is not
on the Contract anniversary. We reserve the right to assess a charge on a class
basis which is less than the charge specified on the Contract Data Page. This
charge is not deducted when the Contract Value is greater than $50,000.
SEPARATE ACCOUNT CHARGE
This charge, as shown on the Contract Data Page, on an annualized basis equals a
percentage of the average daily ending value of the assets attributable to the
Accumulation Units of the Subaccount(s) to which the Contract is allocated. This
charge compensates Us for mortality and expense risks and distribution expenses
associated with the Contract. We subtract this charge daily. We reserve the
right to assess a charge on a class basis which is less than the charge
specified on the Contract Data Page.
TRANSFER PROVISIONS
Prior to the Annuity Date, You may transfer all or part of Your Contract Value
from any Subaccount to any of the Subaccounts . Transfer(s) into the Fixed
Account Options is/are not allowed. The minimum amount that can be transferred
is $100 and the minimum amount that can remain in a Subaccount is $100, or $0 in
the case of a full transfer. We reserve the right to charge a fee of $25.00 for
transfers if the number of transfers exceeds a limit of fifteen (15) in any
Contract Year. Transfers out of the DCA program is counted against the 15
allowable free transfers. Automatic asset rebalancing is not counted against the
15 allowable transfers.
TRANSFERS OF ACCUMULATION AND ANNUITY UNITS BETWEEN SUBACCOUNTS
Prior to and after the Annuity Date, You may transfer all or a portion of Your
Contract Value from one Subaccount to another Subaccount. Before the Annuity
Date, a transfer will result in the redemption of Accumulation Units in a
Subaccount and the purchase of Accumulation Units in the other Subaccount(s).
Transfers will be effected at the end of the NYSE business day in which We
receive Your completed request for the transfer. After the Annuity Date, a
transfer will result in the redemption of Annuity Units in a Subaccount and the
purchase of Annuity Units in the other Subaccount(s). Transfers will be effected
at the end of the NYSE business day on the first day of the month following
receipt of the transfer request.
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WITHDRAWAL PROVISIONS
On or before the Annuity Date and while the Owner is living, You may withdraw
all or part of Your Contract Value under this Contract by informing Us at Our
Annuity Service Center. For a full withdrawal, this Contract must be returned to
Our Annuity Service Center. The minimum partial withdrawal amount is $1,000 and
the minimum amount that must remain in the Contract after any partial withdrawal
is $500.
Without a written notice to the contrary, withdrawals will be deducted from the
Contract Value in proportion to their allocation among the Fixed Account Options
and the Subaccounts. Withdrawals will be based on values for the NYSE business
day in which the request for withdrawal and the Contract (in the case of a full
withdrawal), are received at the Annuity Service Center. Unless the SUSPENSION
OF PAYMENTS or DEFERMENT OF PAYMENTS sections are in effect, payment of
withdrawals will be made within seven calendar days.
WITHDRAWAL CHARGE
Withdrawals of all or a portion of the Contract Value may be subject to a
Withdrawal Charge as shown in the table below. This charge may be deducted upon
withdrawal of any portion of the Contract Value. The Withdrawal Charge
percentage applied to any withdrawal will depend on how long the Purchase
Payment to which the withdrawal is attributed has been in the Contract. No
Withdrawal Charge is made on an amount withdrawn which is considered to be a
withdrawal of penalty-free earnings.
For the purpose of determining the Withdrawal Charge on, a withdrawal will be
attributed to amounts in the following order: (1) penalty-free earnings in the
Contract; (2) Purchase Payments which are both no longer subject to the
Withdrawal Charge and are not yet withdrawn; (3) any remaining Penalty-Free
Withdrawal amount (except in the case of a full surrender); and (4) Purchase
Payments subject to a Withdrawal Charge. Purchase Payments, when withdrawn, are
assumed to be withdrawn on a first-in-first-out (FIFO) basis. You will not
receive the benefit of a Penalty-Free Withdrawal in a full surrender.
------------------------------------------------------------------------------
Number of full Years Elapsed Withdrawal Charge as a
Between Purchase Payment Contribution Percentage of Withdrawn
And Date of Withdrawal Purchase Payment
------------------------------------------------------------------------------
0 7%
------------------------------------------------------------------------------
1 6%
------------------------------------------------------------------------------
2 5%
------------------------------------------------------------------------------
3+ 0%
------------------------------------------------------------------------------
The Withdrawal Charge will be assessed against the Subaccounts and the Fixed
Account Options in the same proportion that the remaining Contract Value is
allocated unless You request that the withdrawal come from a particular Fixed
Account Option or Subaccount. After a Withdrawal is taken, the remaining
Contract Value must be sufficient to cover any Withdrawal Charge remaining upon
full surrender of the Contract.
PENALTY-FREE WITHDRAWALS
As of any day, You may make a withdrawal of up to the Penalty-Free Withdrawal
amount for that day without incurring a Withdrawal Charge. Any Penalty-Free
Withdrawal made in excess of penalty-free earnings in the Contract is considered
to be a withdrawal of future penalty-free earnings and is therefore not a
withdrawal of the Total Invested Amount. On any day, penalty-free earnings in
the Contract are calculated as the Contract Value at the end of that day less
the Total Invested Amount.
During the first Contract Year, the Penalty-Free Withdrawal amount is equal to
the penalty-free earnings in the Contract as of the date of withdrawal.
12
Alternatively, during the first Contract Year, You may make withdrawals of the
Penalty-Free Withdrawal amount through the Systematic Withdrawal Program. The
Penalty-Free Withdrawal amount as of any systematic withdrawal date is 10% of
the Total Invested Amount less any withdrawals already made during the Contract
Year.
After the first Contract Year, the maximum Penalty-Free Withdrawal amount as of
the date of the withdrawal is the greater of:
(a) penalty-free earnings in the Contract as of that date; or
(b) 10% of the Total Invested Amount on deposit for at least one year, less any
withdrawals already made during the year.
Although amounts withdrawn in accordance with the Penalty-Free Withdrawal
provision may reduce principal, they do not reduce the Total Invested Amount for
purposes of calculating the Withdrawal Charge or for the purposes of calculating
penalty-free earnings in the Contract. As a result, You will not receive the
benefit of a Penalty-Free Withdrawal in a full surrender.
SYSTEMATIC WITHDRAWAL PROGRAM
Prior to the Annuity Date, You may elect to participate in the Systematic
Withdrawal Program by informing Us at Our Annuity Service Center. The Systematic
Withdrawal Program allows You to make automatic withdrawals from Your account
monthly, quarterly, semiannually or annually. The minimum systematic withdrawal
amount is $100. Any amount withdrawn through the Systematic Withdrawal Program
may be subject to a Withdrawal Charge as discussed in the WITHDRAWAL CHARGE and
PENALTY-FREE WITHDRAWALS provisions. You may terminate Your participation in the
Systematic Withdrawal Program at any time by sending Us a written request. We
reserve the right to modify, suspend or terminate the Systematic Withdrawal
Program at any time.
Systematic withdrawals will be deducted from the Penalty-Free Withdrawal amount
available each Contract Year.
DEATH PROVISIONS
Notwithstanding any provision of this Contract to the contrary, all payments of
benefits under this Contract will be made in a manner that satisfies the
requirements of IRC Section 72(s), as amended from time to time. If the Contract
is owned by a trust or other non-natural person, We will treat the death of any
Annuitant as the death of the "Primary Annuitant", as defined in IRC Section
72(s)(6), as the death of any Owner.
DUE PROOF OF DEATH
Due Proof of Death means:
1. a certified copy of a death certificate; or
2. a certified copy of a decree of a court of competent jurisdiction as to the
finding of death; or
3. a written statement by a medical doctor who attended the deceased Owner at
the time of death; or
4. any other proof satisfactory to Us.
DEATH OF OWNER BEFORE THE ANNUITY DATE
We will calculate and pay a death benefit to the Beneficiary upon Our receiving:
(a) due proof that the Owner died before the Annuity Date, (b) an election form
specifying the payment option and (c) any other documentation We may require.
Unless You have previously designated a payment option on behalf of the
Beneficiary, the Beneficiary must select one of the following payment options:
1. Immediately collect the death benefit in a lump sum. If a lump sum payment is
elected, payment will be in accordance with any applicable laws and
regulations governing payments and death; or
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2. Collect the death benefit in the form of one of the Annuity Payment Options.
If an Annuity Payment Option is desired, an option must be elected within 60
days of Our receipt of: (a) Due Proof of Death of the Owner; (b) an election
form specifying the payment option and (c) any other documentation We may
require. The payments must be over the life of the Beneficiary or over a
period not extending beyond the life expectancy of the Beneficiary. Payments
under this death benefit option must commence within one year after the
Owner's death, otherwise, the death benefit will be paid in accordance with
death benefit option 1; or
3. If eligible, continue the Contract as a Spousal Beneficiary. On the
Continuation Date, We will contribute to the Contract any amount by which the
Death Benefit exceeds the Contract Value, calculated as of the Owner's date
of death. This amount is not considered a Purchase Payment. If an amount is
contributed on the Continuation Date, then upon death of the Spousal
Beneficiary the subsequent death benefit will be calculated as if the
Contract was issued to the Spousal Beneficiary on the Continuation Date.
Otherwise, the death benefit payable upon death of the Spousal Beneficiary
will be calculated as if the Contract was issued to the Spousal Beneficiary
on the original Contract Date.
You cannot change any elected death benefit option specified on the Contract
Data Page. Your Spousal Beneficiary may discontinue any elected death benefit
option on the Continuation Date. Upon the Spousal Beneficiary's death, the
entire interest of the Contract must be distributed immediately under option
1 or 2 as provided under DEATH OF OWNER BEFORE THE ANNUITY DATE.
In any event, the entire interest in the Contract will be distributed within
five years from the date of death of the Owner unless payment option 2 or 3 as
provided under DEATH OF OWNER BEFORE THE ANNUITY DATE is elected.
AMOUNT OF DEATH BENEFIT
The death benefit is equal to the greater of:
1. the Contract Value at the end of the NYSE business day during which We
receive, at Our Annuity Service Center, due proof of the Owner's death and an
election of the type of payment to be made; Or
2. Net Purchase Payments.
DEATH OF OWNER OR ANNUITANT ON OR AFTER THE ANNUITY DATE
If any Owner or Annuitant dies on or after the Annuity Date and before the
entire interest in the Contract has been distributed, We will pay the remaining
portion of the interest of the Contract under the Annuity Payment Option being
distributed on the date of death upon Our receipt of Due Proof of Death. For
further information pertaining to death of the Annuitant, see ANNUITY PAYMENT
OPTIONS.
BENEFICIARY
The Beneficiary is selected by the Owner. While (a) the Owner is living; and (b)
before the Annuity Date, the Owner may change the Beneficiary by written notice
in a form satisfactory to Us. A change in Beneficiary will take effect on the
date the notice of change was signed. Such change, however, will not apply to
any payment or action taken by Us before the notice was received at Our Annuity
Service Center. If two or more persons are named, (a) those surviving the Owner
will share equally unless otherwise stated; and (b) the Beneficiaries must elect
to receive their respective portions of the death benefit according to the
options listed under DEATH OF OWNER BEFORE THE ANNUITY DATE. If the Annuitant
survives the Owner, and there are no surviving Beneficiaries, the Annuitant will
be deemed the Beneficiary.
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Joint Owners, if applicable, shall be each other's primary Beneficiary. Joint
Annuitants, if any, when the Owner is a non-natural person, shall be each
other's primary Beneficiary. Any other Beneficiary designated on the Application
will be treated as a contingent Beneficiary.
If the Owner is also the Annuitant and there are no surviving Beneficiaries at
the death of the Owner, the death benefit will be paid to the estate of the
Owner in accordance with option 1, under DEATH OF OWNER BEFORE THE ANNUITY DATE.
ANNUITY PROVISIONS
ANNUITY DATE
The Owner specifies an anticipated Annuity Date (the date on which annuity
payments are to begin). The date provided by the Owner to Us at the time of
application is shown on the Contract Data Page as the Specified Annuity Date.
The Owner may change the Specified Annuity Date at any time, at least seven days
prior to the Annuity Date, by written notice to the Company at its Annuity
Service Center. The Annuity Date must always be the first day of the calendar
month and must be at least two years after the Contract Date, but not beyond the
later of the Owner's 90th birthday or ten years after the Contract Date. If the
Owner is a non-natural person, the latest Annuity Date is the later of the
Annuitant's 90th birthday or ten years after the Contract Date. If no Annuity
Date is specified, the Annuity Date will be the latest Annuity Date, as set by
the Company.
PAYMENTS TO OWNER
Unless You request otherwise, We will make annuity payments to You. If You want
the annuity payments to be made to some other Payee, We will make such payments
subject to receipt of a written request filed at the Annuity Service Center no
later than thirty (30) days before the due date of the first annuity payment.
Any such request is subject to the rights of any assignee. No payments available
to or being paid to the Payee while the Annuitant is alive can be transferred,
commuted, anticipated or encumbered.
FIXED ANNUITY PAYMENTS
If a Fixed Annuity payment option has been elected, the proceeds payable under
this Contract less any applicable premium taxes, shall be applied to the payment
of the Fixed Annuity payment option elected at rates which are at least equal to
the annuity rates as specified under the BASIS OF COMPUTATION FOR FIXED ANNUITY
PAYMENTS. In no event will the Fixed Annuity payments be changed once they
begin.
AMOUNT OF FIXED ANNUITY PAYMENTS
The amount of each Fixed Annuity payment will be determined by applying the
portion of the Contract Value allocated by You for Fixed Annuity payments less
any applicable premium taxes to the annuity table applicable to the Fixed
Annuity payment option chosen.
BASIS OF COMPUTATION FOR FIXED ANNUITY PAYMENTS
The actuarial basis for the Table of Annuity Rates is the 1983a Individual
Annuity Mortality Table with projection and a guaranteed interest rate of 3%.
The mortality table is projected using Projection Scale G factors. The Fixed
Annuity Payment Options Table does not include any applicable premium tax.
AMOUNT OF VARIABLE ANNUITY PAYMENTS
(a) FIRST VARIABLE ANNUITY PAYMENT: The dollar amount of the first Variable
Annuity payment will be determined by applying the portion of the
Contract Value allocated by You to the Subaccount(s), less any applicable
premium taxes, to the annuity table applicable to the Variable Annuity
payment option chosen. If the Contract Value is allocated to more than
one Subaccount, the value of Your interest in each Subaccount
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is applied separately to the annuity table to determine the amount of the first
annuity payment attributable to each Subaccount.
(b) NUMBER OF VARIABLE ANNUITY UNITS: The number of Annuity Units for each
applicable Subaccount is the amount of the first annuity payment
attributable to that Subaccount divided by the value of the applicable
Annuity Unit for that Subaccount as of the Annuity Date. The number will
not change as a result of investment experience.
(c) VALUE OF EACH VARIABLE ANNUITY UNIT: The value of an Annuity Unit may
increase or decrease from one month to the next. For any month, the value
of an Annuity Unit of a particular Subaccount is the value of that
Annuity Unit as of the last NYSE business day of the preceding month,
multiplied by the Net Investment Factor for that Subaccount for the last
NYSE business day of the current month.
The Net Investment Factor for any Subaccount for a certain month is determined
by dividing (1) by (2) where:
(1) is the Accumulation Unit Value of the Subaccount determined as of
the last business day at the end of that month, and
(2) is the Accumulation Unit Value of the Subaccount determined as of
the last business day at the end of the preceding month.
The result is then multiplied by a factor that neutralizes the assumed
investment rate of 3.5% per annum upon which the annuity payment tables are
based. The monthly factor that neutralizes the assumed investment rate of 3.5%
per annum is: 1/[(1.035)(1/12)] = 0.99713732.
(d) SUBSEQUENT VARIABLE ANNUITY PAYMENTS: After the first Variable Annuity
payment, payments will vary in amount according to the investment
performance of the applicable Subaccount(s) to which Your Purchase
Payments are allocated. The amount may change from month to month. The
amount of each subsequent payment for each Subaccount is:
The number of Annuity Units for each Subaccount as determined for the first
annuity payment
Multiplied by
The value of an Annuity Unit for that Subaccount at the end of the month
immediately preceding the month in which payment is due.
We guarantee that the amount of each Variable Annuity payment will not be
affected by variations in expenses or mortality experience.
BASIS OF COMPUTATION FOR VARIABLE ANNUITY PAYMENTS
The actuarial basis for Variable Annuity payments is the 1983a Annuity Mortality
Table with projection and an effective annual Assumed Investment Rate of 3.5%.
The mortality table is projected using Projection Scale G factors.
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ANNUITY PAYMENT OPTIONS
During the Annuitant's life, upon written election and the return of this
Contract to the Company at its Annuity Service Center, the Contract Value may be
applied to provide one of the following options or any annuity payment option
that is mutually agreeable. After two years from the Contract Date, and prior to
the Annuity Date, You can choose one of the options described below. If no
option has been selected by the Annuity Date, You will automatically receive
option 4, below, with 120 monthly payments guaranteed.
OPTIONS 1 - LIFE ANNUITY, LIFETIME MONTHLY PAYMENTS GUARANTEED
Payments payable to a Payee during the lifetime of the Annuitant. No further
payments are payable after the death of the Annuitant.
OPTIONS 2 - JOINT AND SURVIVOR LIFE ANNUITY
Payments payable to the Payee during the lifetime of the Annuitant and during
the lifetime of a designated second person. No further payments are payable
after the deaths of both the Annuitant and the designated second person.
OPTIONS 3 - JOINT AND SURVIVOR LIFE ANNUITY - 120 OR 240 MONTHLY PAYMENTS
GUARANTEED
Payments are payable to the Payee during the lifetime of the Annuitant and
during the lifetime of a designated second person. If, at the death of the
survivor, payments have been made for less than 120 or 240 monthly periods, the
remaining guaranteed annuity payments will be continued to the Beneficiary.
OPTIONS 4 - LIFE ANNUITY WITH 120 OR 240 MONTHLY PAYMENTS GUARANTEED
Payments payable to the Payee during the lifetime of the Annuitant. If, at the
death of the Annuitant, payments have been made for less than the 120 or 240
monthly periods, as selected at the time of annuitization, the remaining
guaranteed annuity payments will be continued to the Beneficiary.
OPTIONS 5 - FIXED PAYMENTS FOR A SPECIFIED PERIOD CERTAIN
Payments are payable to the Payee for any specified period of time of five (5)
years or more, but not exceeding thirty (30) years, as selected at the time of
annuitization. The selection must be made for full twelve-month periods. In the
event of death of the Annuitant, any remaining annuity payments will be
continued to the Beneficiary. If Variable Annuity Payments are elected under
this Annuity Payment Option, any remaining guaranteed Variable Annuity payments
may be redeemed for a discounted value determined by Us. Any applicable
Withdrawal Charges will be deducted from the discounted value as if You fully
surrendered Your Contract.
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First SunAmerica Life Insurance Company
A STOCK COMPANY LOS ANGELES, CALIFORNIA
INDIVIDUAL
VARIABLE ANNUITY CONTRACT
Nonparticipating
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