THE MINNESOTA MUTUAL LIFE INSURANCE COMPANY
▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇, ▇▇▇▇▇▇▇▇▇
organized in 1880
▇▇▇▇▇▇ AGREES TO THE TERMS AND PROVISIONS CONTAINED IN THIS POLICY
The Minnesota Mutual Life Insurance Company (herein called Minnesota Mutual)
agrees to pay at its Home Office in St. ▇▇▇▇, Minnesota, the benefits provided
by this contract.
This contract is issued in consideration of the application therefor and the
payment by the Contract Owner of purchase payments as hereinafter provided.
This contract is executed by Minnesota Mutual at its Home Office in St. ▇▇▇▇,
Minnesota, to take effect as of the Effective Date.
/s/ ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ /s/ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇
Secretary Registrar President
GROUP ACCUMULATION ANNUITY CONTRACT
VARIABLE ANNUITY BENEFITS--
FIXED DOLLAR ANNUITY BENEFITS--PARTICIPATING
INDIVIDUAL ALLOCATION
ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT, WHEN BASED ON
INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE
AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT
F.17097 3-70 Page 1
TABLE OF CONTENTS
SECTION DESCRIPTION PAGE
------- ----------- ----
1. . . . . . . . DEFINITIONS . . . . . . . . . . . . . . . . . . . . . . 3
2. . . . . . . . ANNUITY PROVISIONS. . . . . . . . . . . . . . . . . . 3-6
2.01. . . . . Annuity Commencement Date . . . . . . . . . . . . . . . 3
2.02. . . . . Election of Optional Annuity Forms. . . . . . . . . . . 3
2.03. . . . . Application of Accumulation Value . . . . . . . . . . . 3
2.04. . . . . Optional Annuity Forms. . . . . . . . . . . . . . . . . 3
2.05. . . . . Determination of First Payment. . . . . . . . . . . . . 5
2.06. . . . . Variable and Fixed Dollar Annuities . . . . . . . . . . 5
2.07. . . . . Allocation of Annuity . . . . . . . . . . . . . . . . . 6
2.08. . . . . Lump Sum Settlement . . . . . . . . . . . . . . . . . . 6
3 . . . . . . . PURCHASE PAYMENTS . . . . . . . . . . . . . . . . . . . 6
3.01. . . . . . . .Amount of Purchase Payments. . . . . . . . . . . . 6
3.02. . . . . . . .Application of Purchase Payments . . . . . . . . . 6
3.03. . . . . . . .Limitations on Purchase Payments . . . . . . . . . 6
4 . . . . . . . VALUATION . . . . . . . . . . . . . . . . . . . . . . 6-7
4.01. . . . . . . .Net Investment Rate and Net
Investment Factor. . . . . . . . . . . . . . . . 6
4.02. . . . . . . .Accumulation Unit Value. . . . . . . . . . . . . . 7
4.03. . . . . . . .Annuity Unit Value . . . . . . . . . . . . . . . . 7
4.04. . . . . . . .Participant's Accumulation Value . . . . . . . . . 7
4.05. . . . . . . .Valuation of Separate Account Assets . . . . . . . 7
5 . . . . . . . DEATH AND OTHER TERMINATION BENEFITS. . . . . . . . . 7-8
5.01. . . . . . . .Death Benefits . . . . . . . . . . . . . . . . . . 7
5.02. . . . . . . .Termination Benefits . . . . . . . . . . . . . . . 7
5.03. . . . . . . .Non-Vested Accumulation Value. . . . . . . . . . . 8
6 . . . . . . . DISCONTINUANCE OF PURCHASE PAYMENTS . . . . . . . . . . 8
6.01. . . . . . . .Effective Date . . . . . . . . . . . . . . . . . . 8
6.02. . . . . . . .Effect of Discontinuance of Purchase
. . . . . . . . . .Payments . . . . . . . . . . . . . . . . . . . . . 8
7 . . . . . . . GENERAL PROVISIONS. . . . . . . . . . . . . . . . . .8-10
7.01. . . . . . . .Contract . . . . . . . . . . . . . . . . . . . . . 8
7.02. . . . . . . .Modification of Contract . . . . . . . . . . . . . 8
7.03. . . . . . . .Beneficiary. . . . . . . . . . . . . . . . . . . . 8
7.04. . . . . . . .Participation in Divisible Surplus . . . . . . . . 9
7.05. . . . . . . .Certificates and Statements. . . . . . . . . . . . 9
7.06. . . . . . . .Information To Be Furnished. . . . . . . . . . . . 9
7.07. . . . . . . .Adjustments on Account of
Misstatements. . . . . . . . . . . . . . . . . 9
7.08. . . . . . . .Facility of Payment. . . . . . . . . . . . . . . . 9
Page 2
(17097 3-70)
7.09. . . . . . . .Evidence of Survival . . . . . . . . . . . . . . . 9
7.10. . . . . . . .Assignment . . . . . . . . . . . . . . . . . . . . 9
7.11. . . . . . . .Reserves . . . . . . . . . . . . . . . . . . . . . 9
7.12. . . . . . . .Voting Rights. . . . . . . . . . . . . . . . . . . 9
7.13. . . . . . . .Relation of This Contract to
Separate Account . . . . . . . . . . . . . . . . . 9
7.14. . . . . . . .Deferment of Payments. . . . . . . . . . . . . . . 9
7.15. . . . . . . .Termination of Contract. . . . . . . . . . . . . .10
CONTRACT OWNER:
EFFECTIVE DATE:
CONTRACT NUMBER:
JURISDICTION:
PLAN:
SECTION 1. DEFINITIONS
1.01 PLAN
"Plan" means the Plan specified on Page 2 hereof. The Contract Owner will
furnish Minnesota Mutual with a copy of the Plan and with a copy of any
subsequent amendment or modification thereof. The terms of this contract will
apply to the Plan as constituted on the Effective Date of this contract and, if
Minnesota Mutual consents, to each amendment or modification of the Plan which
is placed on file with Minnesota Mutual.
1.02 PARTICIPANT
A person eligible to participate under the Plan, and on whose behalf purchase
payments have been or are being made under this contract.
1.03 CONTRACT ANNIVERSARY
An anniversary of the Effective Date of this contract.
1.04 CONTRACT YEAR
A period of one year commencing with the Effective Date or with any Contract
Anniversary.
1.05 ANNUITY PAYMENTS
A series of payments purchased under this contract for a Participant.
1.06 ANNUITY COMMENCEMENT DATE
The date upon which Annuity Payments begin, as determined in accordance with the
Plan.
1.07 NORMAL ANNUITY FORM
The form of Annuity Payments so designated in the Plan.
Page 3
(17097 3-70)
1.08 OPTIONAL ANNUITY FORM
A form of Annuity Payments (other than the Normal Annuity form) specified in
Section 2.
1.09 SEPARATE ACCOUNT
Those assets of Minnesota Mutual in a separate investment account entitled
"Minnesota Mutual Variable Fund D", established by Minnesota Mutual for this
class of contracts in accordance with the laws of Minnesota.
1.10 GENERAL ACCOUNT
All assets of Minnesota Mutual other than those in Variable Fund D or in other
separate accounts established by Minnesota Mutual.
1.11 VALUATION DATE
Each date on which the New York Stock Exchange is open for trading, with the
valuation occurring as of the close of business of the Exchange on such date. A
valuation period is the period between successive Valuation Dates.
1.12 PARTICIPANT'S INDIVIDUAL ACCOUNT
The sum of the Accumulation Units credited to the Participant.
1.13 PARTICIPANT'S ACCUMULATION VALUE
The dollar value of the Participant's Individual Account, as determined in
accordance with Section 4.04.
SECTION 2. ANNUITY PROVISIONS
2.01 ANNUITY COMMENCEMENT DATE
The Contract Owner shall notify Minnesota Mutual in writing at its Home Office
to effect Annuity Payments for a Participant, specifying the date such Annuity
Payments are to commence. Unless limited otherwise by the Plan, such date may
be the first day of any calendar month following the Participant's 50th
birthday, provided that it may not be earlier than 30 days following the date
such notice is given, and provided further that it may not be later than the
Participant's 75th birthday.
2.02 ELECTION OF OPTIONAL ANNUITY FORMS
The Contract Owner or the Participant may elect to have Annuity Payments made
under any of the Optional Annuity Forms prescribed in Section 2.04, provided
such election is received in writing by Minnesota Mutual at its Home Office at
least 30 days prior to the Annuity Commencement Date. If no such election is
received by Minnesota Mutual, Annuity Payments will be made in accordance with
the Normal Annuity Form.
Page 4
(17097 3-70)
2.03 APPLICATION OF ACCUMULATION VALUE
As of the Annuity Commencement Date, Minnesota Mutual shall apply the
Participant's Accumulation Value to provide Annuity Payments under the Optional
Annuity Form determined in accordance with Section 2.02; provided, however, that
the first monthly payment under such Optional Annuity Form must be at least
$20.00 in amount. If such first monthly payment would be less than $20,00 in
amount, the Participant's Accumulation Value will be paid to the Participant in
a lump sum as of his Annuity Commencement Date, and the Participant shall
thereafter have no further rights under this contract. The requirement that the
first monthly payment be at least $20.00 shall be imposed separately for that
portion of Annuity Payments payable as a fixed dollar annuity and as a variable
annuity.
2.04 OPTIONAL ANNUITY FORMS
Option 1--Life Annuity--An annuity payable monthly during the lifetime of the
Participant and terminating with the last monthly payment preceding the death of
the Participant.
Option 2--Life annuity with a Period Certain of 120 months (Option 2A), 180
months (Option 2B), or 240 months Option 2C)--An annuity payable monthly during
the lifetime of the Participant, with the guarantee that if the Participant dies
before payments have been made for the Period Certain elected, payments will
continue to the beneficiary during the remainder of such Period Certain; or, if
the beneficiary so elects, the present value of the remaining guaranteed number
of payments, based on the then current dollar amount of one such payment and
commuted on the basis of 3.5% interest compounded annually, shall be paid in a
single sum to the beneficiary.
Option 3--Joint and Last Survivor Annuity--An annuity payable monthly during the
joint lifetime of the Participant and a designated joint annuitant and
continuing thereafter during the remaining lifetime of the survivor.
Option 4--Period Certain Annuity--An annuity payable monthly for a Period
Certain of from 1 to 15 years, as elected. If the Participant dies before
payments have been made for the Period Certain elected, payments will continue
to the beneficiary during the remainder of such Period Certain. At any time
during the payment period, the payee may elect that (1) the present value of the
remaining guaranteed number of payments, based on the then current dollar amount
of such payment and commuted on the basis of 3.5% interest compounded annually,
shall be paid in a single sum, or (2) such commuted amount shall be applied to
effect a life annuity under Option 1 or Option 2.
The first payment under any of these Optional Annuity Forms will be determined
in accordance with Section 2.05. The second and subsequent payments will be
determined in accordance with Section 2.06. Minnesota Mutual reserves the right
to require proof satisfactory to it of the age of the Participant and any joint
annuitant prior to making the first payment under any Optional Annuity Form.
Page 5
(17097 3-70)
DOLLAR AMOUNT OF THE FIRST MONTHLY PAYMENT WHICH IS PURCHASED
WITH EACH $1,000 OF VALUE APPLIED
ADJUSTED AGE
OF ANNUITANT SINGLE LIFE ANNUITIES
------------- ------------------------------------------------------
MALE FEMALE OPTION 1 OPTION 2A OPTION 2B OPTION 2C
----- ------ -------- --------- --------- ----------
50 54 $4.74 $4.69 $4.62 $4.52
51 55 4.84 4.78 7.70 4.58
52 56 4.94 4.87 4.78 4.65
53 57 5.04 4.97 4.87 4.71
54 58 5.16 5.07 4.95 4.78
55 59 5.28 5.18 5.04 4.85
56 60 5.40 5.29 5.13 4.91
57 61 5.54 5.41 5.23 4.98
58 62 5.69 5.53 5.33 5.05
59 63 5.84 5.66 5.43 5.11
60 64 6.01 5.79 5.53 5.18
61 65 6.18 5.94 5.63 5.24
62 66 6.37 6.08 5.74 5.30
63 67 6.57 6.24 5.84 5.36
64 68 6.79 6.40 5.95 5.41
65 69 7.02 6.57 6.05 5.46
66 70 7.27 6.74 6.15 5.51
67 71 7.54 6.91 6.26 5.55
68 72 7.83 7.10 6.35 5.59
69 73 8.14 7.28 6.45 5.62
70 74 8.48 7.47 6.54 5.65
71 75 8.84 7.66 6.62 5.68
72 76 9.23 7.85 6.70 5.70
73 77 9.65 8.04 6.77 5.71
74 78 10.11 8.23 6.83 5.72
75 79 10.61 8.41 6.88 5.73
Page 6
(17097 3-70)
OPTION 3-JOINT AND LAST SURVIVOR LIFE ANNUITY
ADJUSTED AGED OF
JOINT ANNUITANT* ADJUSTED AGE OF ANNUITANT*
---------------- -------------------------------------------------------------------
M-51 M-56 M-58 M-61 M-63 M-66 M-71
MALE FEMALE F-55 F-60 F-62 F-65 F-67 F-70 F-75
----- ------- ------ ----- ----- ----- ---- ---- -----
50 54 $4.21 $4.35 $4.40 $4.47 $4.51 $4.57 $4.64
55 59 4.37 4.58 4.66 4.78 4.85 4.94 5.07
57 61 4.43 4.67 7.77 4.90 4.99 5.10 5.26
60 64 4.51 4.80 4.92 5.09 5.20 5.36 5.59
62 66 4.55 4.88 5.01 5.22 5.35 5.54 5.82
65 69 4.62 4.99 5.15 5.39 5.56 5.81 6.19
70 74 4.70 5.14 5.34 5.65 5.88 6.23 6.83
* Dollar amounts of the first monthly payments for ages not shown in this
table will be calculated on the same basis as those shown and may be obtained
from Minnesota Mutual.
OPTION 4-- PERIOD CERTAIN ANNUITY
PERIOD CERTAIN DOLLAR AMOUNT PERIOD CERTAIN DOLLAR AMOUNT
(YEARS) OF FIRST PAYMENT (YEARS) OF FIRST PAYMENT
-------------- ---------------- --------------- ----------------
1 $84.65 9 $10.75
2 43.05 10 9.83
3 29.19 11 9.09
4 22.27 12 8.46
5 18.12 13 7.94
6 15.35 14 7.49
7 13.38 15 7.10
8 11.90
2.05 DETERMINATION OF FIRST PAYMENT
The tables contained herein are used to determine the first monthly annuity
payment. they show the dollar amount of the first monthly payment which can be
purchased with each $1,000 of Accumulation Value, after deduction of any
applicable premium taxes not previously deducted under the provisions of Section
3.03. Amounts shown in the tables are based on the Progressive Annuity Table
with interest at the rate of 3.5% per annum and assume births in the year 1900.
The amount of each payment depends upon the sex and adjusted age of the
Participant and any joint annuitant. The adjusted age is determined from the
actual age nearest birthday at the time and the first payment is due in the
following manner:
Page 7
(17097 3-70)
CALENDAR YEAR ADJUSTED AGE IS
OF BIRTH EQUAL TO----
------------- -------------------
Prior to 1900 Actual Age Plus 1
1900-1919 Actual Age
1920-1939 Actual Age Minus 1
1940-1959 Actual Age Minus 2
1960 and Later Actual Age Minus 3
2.06 VARIABLE AND FIXED DOLLAR ANNUITIES
(a) Variable Annuity--A variable annuity is an annuity with payments
varying in amount in accordance with the net investment result of the
Separate Account. A number of Separate Account annuity units is determined
by dividing the first monthly payment, determined as described in Section
2.05, by the Separate Account annuity unit value at the Annuity
Commencement Date. The number of such annuity units remains unchanged
during the period of Annuity Payments.
The dollar amount of the second and subsequent payments is not
predetermined, and may change from month to month. The dollar amount of
each such payment is determined by multiplying the number of Separate
Account annuity units by the Separate Account annuity unit value at the due
date of such payment.
Minnesota Mutual guarantees that the dollar amount of each such annuity
payment will not be affected by adverse mortality experience or by an
increase in Minnesota Mutual's expenses in excess of the expense deductions
provided for in the contract.
(b) Fixed Dollar Annuity--A fixed dollar annuity is an annuity payable
from the General Account, with payments which remain fixed as to dollar
amount throughout the period of Annuity Payments. A number of General
Account annuity units is determined when payments commence, but the General
Account annuity unit value is always $1.00. The number of such annuity
units remains unchanged during the period of Annuity Payments.
2.07 ALLOCATION OF ANNUITY
Unless Minnesota Mutual shall be notified in writing to the contrary by the
Contract Owner at least 30 days prior to the Annuity Commencement Date, General
Account accumulation units will be applied to provide a fixed dollar annuity and
Separate Account accumulation units will be applied to provide a variable
annuity.
2.08 LUMP SUM SETTLEMENT
By written notice to Minnesota Mutual by the Contract Owner at least 30 days
prior to the Annuity Commencement Date, a lump sum settlement of a Participant's
Accumulation Value may be elected in lieu of the application of such value to
provide Annuity Payments for the
Page 8
(17097 3-70)
Participant under an Optional Annuity Form. After such lump sum settlement has
been made, the Participant shall have no further rights under this contract.
SECTION 3. PURCHASE PAYMENTS
3.01 AMOUNT OF PURCHASE PAYMENTS
The aggregate amount of purchase payments to be paid by the Contract Owner in
each Contract Year shall be determined by the Contract Owner in accordance with
the provisions of the Plan. such purchase payments will be applied by Minnesota
Mutual to provide accumulation units for each Participant in accordance with
Section 3.02. Purchase payments for each Participant shall be allocated to the
General Account or the Separate Account in accordance with the instructions of
the Participant or Contract Owner. Such allocation may be changed as to future
purchase payments by written notice to Minnesota Mutual by the Participant or
Contract Owner, provided such notice is received by Minnesota Mutual at its Home
Office on or prior to the date of receipt of such purchase payments. All
purchase payments are payable at the Home Office of Minnesota Mutual.
3.02 APPLICATION OF PURCHASE PAYMENTS
Deductions totaling 7% plus any applicable premium taxes on the purchase
payments shall be made by Minnesota Mutual from each purchase payment received.
The balance of each purchase payment remaining after these deductions is
hereinafter called the net purchase payment. Minnesota Mutual shall determine
the number of accumulation units provided by the net purchase payment by
dividing the net purchase payment by the then current accumulation unit value.
Such determination shall be made as of the Valuation Date coincident with or
next following the date on which such purchase payment is received by Minnesota
Mutual at its Home Office, and shall be made separately for net purchase
payments allocated to the General Account and the Separate Account. The number
of accumulation units so determined shall not be affected by any subsequent
change in the accumulation unit value. The General Account accumulation unit
value will increase at the net investment rate specified in Section 4.01(a), but
the Separate Account accumulation unit value may vary from period to period.
3.03 LIMITATIONS ON PURCHASE PAYMENTS
The minimum purchase payment which may be made at any time on behalf of each
participant is $10.00; provided, however, that if such purchase payments are to
be allocated to both the General and the Separate Account, the minimum purchase
payment which may be allocated at any time to either Account shall be $10.00.
As to any Participant, Minnesota Mutual may limit the maximum purchase payments
which will be accepted under the contract for any Contract Year to the greater
of (a) the purchase payments made under the contract on behalf of such
Participant for the immediately preceding Contract Year, or (b) the average
purchase payments made under the contract on behalf of such Participant for all
prior Contract Years.
Page 9
(17097 3-70)
SECTION 4. VALUATION
4.01 NET INVESTMENT RATE AND NET INVESTMENT FACTOR
(a) The General Account net investment rate for each valuation period
shall not be less than the equivalent of an investment rate of 4 1/2%
compounded annually during the first 5 Contract Years, 4% compounded
annually during the 6th through 10th Contract Years, and 3 1/2% compounded
annually thereafter.
(b) The Separate Account net investment rate for any valuation period is
equal to the gross investment rate expressed in decimal form to six places,
less a deduction of not more than .0106 per annum. The amount of the
deduction may be changed from time to time by Minnesota Mutual, but not
more often than annually, and in no event will the deduction exceed .0106
per annum. Such gross investment rate is equal to (1) the investment
income and capital gains and losses, whether realized or unrealized, on the
assets of the Separate Account during such valuation period, less a
deduction for any applicable income taxes arising from such income and
realized and unrealized capital gains, divided by (2) the value of such
assets at the beginning of the valuation period. Such gross investment
rate may be either positive or negative.
(c) The net investment factor for each Account is the sum of 1.000000 plus
the net investment rate for the Account.
4.02 ACCUMULATION UNIT VALUE
The General Account and Separate Account accumulation unit values were set at
$1.000000 on the first Valuation Date of the Separate Account. The respective
accumulation unit values in each Account on any subsequent Valuation Date are
determined by multiplying the accumulation unit value on the immediately
preceding Valuation Date by the net investment factor for that Account for the
valuation period just ended. The accumulation unit value as of any date other
than a Valuation Date is equal to its value on the next succeeding Valuation
Date.
4.03 ANNUITY UNIT VALUE
The value of a General Account annuity unit will always be $1.00. the value of
a Separate Account annuity unit is determined monthly as of the first day of
each month. The value of a Separate Account annuity unit on the first day of
each month is equal to its value on the first day of the preceding month
multiplied by the product of (a) .997137, and (b) the ratio of the Separate
Account accumulation unit value for the Valuation Date next following the
fourteenth day of the preceding month to the corresponding accumulation unit
value for the Valuation Date next following the fourteenth day of the second
preceding month. The value of an annuity unit on any date other than the first
day of a month is equal to its value on the first day of the next succeeding
month.
Page 10
(17097 3-70)
4.04 PARTICIPANT'S ACCUMULATION VALUE
The Participant's Accumulation Value as of any date is equal to the product of
(a) the Participant's Individual Account, and (b) the accumulation unit value.
Such calculation shall be made separately for the portions of the Participant's
Individual Account made up of General Account and Separate Account accumulation
units. The applicable General Account or Separate Account accumulation unit
value is the accumulation unit value for the Valuation Date coincident with or
next following the date on which the Participant's Accumulation Value is being
determined; provided, however, that for purposes of determining the first
monthly Annuity Payment pursuant to Section 2.05, the applicable accumulation
unit value is the value on the Valuation Date next following the fourteenth day
of the month preceding the Annuity Commencement Date.
4.05 VALUATION OF SEPARATE ACCOUNT ASSETS
The valuation of all assets in the Separate Account shall be determined in
accordance with the provisions of the rules and regulations of the Separate
Account.
SECTION 5. DEATH AND OTHER TERMINATION BENEFITS
5.01 DEATH BENEFITS
In the event of the death of a Participant prior to his Annuity Commencement
Date, the beneficiary of the Participant will receive as a death benefit the
Participant's Accumulation Value, determined as of the valuation Date coincident
with or next following the date due proof of death is received by Minnesota
Mutual at its Home Office. The death benefit will be paid in a single sum; or,
at the option of the beneficiary, may be applied under Option 1, Option 2, or
Option 4, of the Optional Annuity Forms specified in Section 2.04, subject to
the minimum payment requirements of Section 2.03.
5.02 TERMINATION BENEFITS
In the event that purchase payments for an individual Participant are terminated
before his Annuity Commencement Date, the Participant shall be entitled to a
vested interest in his Individual Account to the extent specified in the Plan.
The Contract Owner will notify Minnesota Mutual as to the manner in which the
Participant's vested interest shall be disbursed, in accordance with one of the
following provisions:
(a) The Accumulation Value of the Participant's vested interest in his
Individual Account shall be paid in a single sum to the Participant.
(b) The vested portion of the Participant's Individual Account shall be
continued under the contract, but with no further purchase payments being
made on the Participant's behalf, for later application to provide Annuity
Payments at the Participant's Annuity Commencement Date. At any time prior
to such Annuity Commencement Date, the Participant, with the written
consent of the Contract Owner, may receive in a single sum the then current
Accumulation Value of his vested interest in his Individual Account.
Page 11
(17097 3-70)
If permitted by the Plan, a partial payment of the Accumulation Value of the
Participant's vested interest in his Individual Account may be made under
paragraphs (a) and (b) above. However, no such partial payment will be allowed
for an amount of less than $250. In the event of any such payment, that portion
of the Participant's Individual Account having an Accumulation Value equal to
the dollar amount withdrawn shall be cancelled.
5.03 NON-VESTED ACCUMULATION VALUE
Any portion of a Participant's Individual Account which does not vest in him in
accordance with the Plan in the event of termination of purchase payments shall
be cancelled as of the same date on which the Participant's vested interest is
determined. Unless otherwise specified in the Plan, the Accumulation Value of
such non-vested portion of the Participant's Individual Account shall be applied
by Minnesota Mutual to reduce future purchase payments payable by the Contract
Owner under this contract.
6.01 DISCONTINUANCE OF PURCHASE PAYMENTS
Purchase payments may be discontinued under either of the following
circumstances:
(a) The Contract Owner may discontinue purchase payments as of a date
specified in a written notice to Minnesota Mutual at its Home Office,
provided that such date may not be earlier than the date of receipt of such
notice by Minnesota Mutual.
(a) Minnesota Mutual may discontinue acceptance of purchase payments as of
a date specified in a written notice to the Contract Owner if the contract
is no longer part of a plan qualified under Section 401 (a), 403(a),
403(b), or other provision of the Internal Revenue Code allowing similar
tax treatment.
6.02 EFFECT OF DISCONTINUANCE OF PURCHASE PAYMENTS
Discontinuance of purchase payments will have no effect on Participants as to
whom Annuity Payments have commenced.
All other Participants shall have a 100% vested interest in their Individual
Accounts, which shall be subject to the provisions of Section 5.02. After
discontinuance of purchase payments as provided herein, purchase payments may
subsequently be resumed only with the written consent of Minnesota Mutual.
SECTION 7. GENERAL PROVISIONS
7.01 CONTRACT
This contract and the application therefor, which is attached hereto, constitute
the entire contract between the parties. This contract is delivered in, and
shall be construed according to the laws of the jurisdiction specified on Page 2
hereof. With respect to all transactions regarding this contract, except as may
be otherwise specifically provided, Minnesota Mutual may deal with the
Page 12
(17097 3-70)
Contract Owner on the basis that the Contract Owner has full ownership and
control of the contract.
7.02 MODIFICATION OF CONTRACT
This contract may be modified at any time by written agreement between Minnesota
Mutual and the Contract Owner. However, no such modification will adversely
affect the rights of any Participant unless the modification is made to comply
with a law or government regulation.
No person except the President, a Vice President, the Secretary, or an Assistant
Secretary of Minnesota Mutual has authority on behalf of Minnesota Mutual to
modify the contract or to waive any requirement of the contract. Minnesota
Mutual shall not be bound by any promise or representation made by or to any
agent or person other than as above.
7.03 BENEFICIARY
A Participant may designate a beneficiary to receive any amount which may become
payable to such beneficiary under the terms of the Plan. The designation may be
made or changed by the Participant at any time during his lifetime by filing
satisfactory written notice with Minnesota Mutual at its Home Office. The new
designation shall take effect only upon being recorded by Minnesota Mutual at
its Home Office. When so recorded, even in the Participant is not then living,
it shall take effect as of the date the notice was signed, subject to any
payment made by Minnesota Mutual before recording the change.
The interest of any beneficiary who dies before the Participant shall terminate
at the death of that beneficiary. If the interest of all designated
beneficiaries has terminated, any proceeds payable at the Participant's death
shall be paid to the persons who, by evidence satisfactory to Minnesota Mutual,
appear to be the lawful children of the Participant. The proceeds shall be
divided equally among those children. If no child is living, the proceeds shall
be payable to the Participant's estate. "Child" and "children" refer only to
the first generation.
7.04 PARTICIPATION IN DIVISIBLE SURPLUS
This is a participating contract. The portion, if any, of the divisible surplus
of Minnesota Mutual accruing upon this contract shall be determined annually by
Minnesota Mutual and shall be credited to the contract on such basis as is
determined by Minnesota Mutual.
7.05 CERTIFICATES AND STATEMENTS
Minnesota Mutual shall issue to each Participant as to whom Annuity Payments are
provided hereunder an individual certificate setting forth the amount and terms
of such Annuity Payments. At least once in each Contract Year, Minnesota Mutual
will furnish the Contract Owner a statement of each Participant's Individual
Account, the current accumulation unit value, and each Participant's
Accumulation Value. Such statement shall be as of a date within four months of
the mailing of the statement.
Page 13
(17097 3-70)
7.06 INFORMATION TO BE FURNISHED
The Contract Owner shall furnish any information or evidence which Minnesota
Mutual may reasonably require in order to administer this contract. If the
Contract Owner cannot furnish any required item of information, Minnesota Mutual
may request the person concerned to furnish such information. Minnesota Mutual
shall not be liable for the fulfillment of any obligation in any way dependent
on such information until it receives such information in a form satisfactory to
it.
Information furnished to Minnesota Mutual may be corrected for demonstrated
errors therein except that such correction will be at the option of Minnesota
Mutual when it has already acted to its prejudice by relying on such
information.
7.07 ADJUSTMENTS ON ACCOUNT OF MISSTATEMENTS
If it shall be found that the age or sex of any person with respect to whom an
annuity shall have been purchased hereunder shall have been misstated, the
amount of the annuity payable by Minnesota Mutual shall be that provided by the
number of accumulation units allocated to effect such annuity on the basis of
the corrected information without changing the date of the first payment of the
annuity. The dollar amount of any underpayment made by Minnesota Mutual shall
be paid in full with the next payment due such person or his beneficiary. The
dollar amount of any overpayment made by Minnesota Mutual shall be deducted from
payments subsequently accruing to such person or his beneficiary under this
contract.
7.08 FACILITY OF PAYMENT
If Minnesota Mutual receives evidence satisfactory to it that any person is
legally, physically or mentally incapable of giving a valid release for any
payment due such person under this contract, Minnesota Mutual may make payment
thereof to such other person, persons, or institution who appear to Minnesota
Mutual as having assumed the custody and principal support of the person to whom
such payment is due. Minnesota Mutual shall be released from liability to the
extent of such payment.
7.09 EVIDENCE OF SURVIVAL
When any payment under this contract is contingent upon the survival of any
person, evidence of such person's survival must be furnished to Minnesota Mutual
either by personal endorsement of the check drawn for said payment or by other
means satisfactory to Minnesota Mutual.
7.10 ASSIGNMENT
This contract may not be assigned, sold, transferred, discounted, or pledged as
collateral for a loan or as security for the performance of an obligation or for
any other purpose, and, to the maximum extent permitted by law, benefits payable
under this contract shall be exempt from the claims of creditors.
Page 14
(17097 3-70)
7.11 RESERVES
The reserve held by Minnesota Mutual for any Annuity Payments hereunder shall be
not less than the reserve liability determined by Minnesota Mutual in accordance
with the mortality table and interest rate used to establish the amount of the
first such Annuity Payment.
7.12 VOTING RIGHTS
Each Participant shall have the right to vote at the meetings of owners of
contracts for which reserves are maintained in the Separate Account, and shall
cast the votes attributable to this contract in conformity with the provisions
of the rules and regulations of the Separate Account.
713 RELATION OF THIS CONTRACT TO SEPARATE ACCOUNT
Minnesota Mutual shall have exclusive and absolute ownership and control of the
assets of both its General Account and its Separate Account.
7.14 DEFERMENT OF PAYMENTS
Whenever any payment under this contract is to be made in a single sum, payment
will be made within 7 days after the date written request for such payment is
received by Minnesota Mutual at its Home Office, except that payment in a single
sum of any death benefit payable to a beneficiary will be made within 7 days
after the date due proof of death is received by Minnesota Mutual at its Home
Office and except as Minnesota Mutual may be permitted to defer any payment
under the Investment Company Act of 1940.
7.15 TERMINATION OF CONTRACT
This contract shall finally terminate and cease to be in effect when Minnesota
Mutual shall have completed all payments due hereunder.
APPLICATION IS HEREBY MADE TO
THE MINNESOTA MUTUAL LIFE INSURANCE COMPANY
SAINT ▇▇▇▇, MINNESOTA 55101
for a Group Contract providing Variable and/or Fixed Dollar annuity benefits.
1. The contract shall cover employees of:
______________________________________________________________________
(Employer name as appears above will be used in legal documents-BE
ACCURATE)
Address__________________________________________________________________
_________________________________________________________________________
2. If Contract Owner will be a Trust give EXACT name of
Trust_______________________
Page 15
(17097 3-70)
3. Type of contract applied for:
/ / Group Accumulation Annuity
/ / Group Deposit Administration
4. Until further notice, the allocation of contributions to the Separate
Account and the General Account shall be:
To Separate Account____________%
To General Account ____________%
/ / Optional (for Group Accumulation Annuity Contract only)
Each participant may elect the % allocation.
5. Effective Date requested___________________________________________
6. SPECIFICATIONS OF THE PLAN: If Contract Owner is Employer, complete all
items on Plan Specification Form 17171 and submit with this application.
If Contract Owner is a Trust, submit executed copy of Trust Agreement.
This application will be superseded by a final application to be made by
the Contract Owner when the contract is delivered and its terms accepted.
IT IS UNDERSTOOD THAT ALL PAYMENTS AND VALUES OF ANY CONTRACT ISSUED, WHEN BASED
ON THE INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT
GUARANTEED AS TO FIXED DOLLAR AMOUNT. RECEIPT OF A CURRENT VARIABLE ANNUITY
PROSPECTUS FOR MINNESOTA MUTUAL VARIABLE FUND D IS HEREBY ACKNOWLEDGED.
Signed at___________________________ this date_______________________________
I certify that a current prospectus was delivered, __________________________
and that no written sales materials other than (Contract Owner)
those furnished by the Home Office were used.
By________________________
Title_____________________
__________________________________ __________
Registered Representative Code
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
Page 16
(17097 3-70)
FOR HOME OFFICE USE ONLY
Accepted by_______________________ Date_____________________Contract No._______
F. 17170 5-70
Page 17
(17097 3-70)
APPLICATION
IS ▇▇▇▇▇▇ MADE TO
THE MINNESOTA MUTUAL LIFE INSURANCE COMPANY
VICTORY SQUARE, SAINT ▇▇▇▇, MINNESOTA
for Contract Number____________________. Said contract is hereby approved and
the terms thereof are hereby accepted.
This application is executed in duplicate, one copy being attached to said
contract and the other being returned to The Minnesota Mutual Life Insurance
Company.
It is agreed that this application supersedes any previous application for the
said contract.
Executed at_______________________________________Date_________________________
For_____________________________________________________, the Contract Owner
By____________________________Title___________________________________________
__________________________________ _______ _______________________
Signature of Registered Representative Code Broker-Dealer
F. 16847 Rev. 3-70
GROUP ACCUMULATION ANNUITY CONTRACT
VARIABLE ANNUITY BENEFITS
FIXED DOLLAR ANNUITY BENEFITS
PARTICIPATING INDIVIDUAL ALLOCATION
The owner is hereby notified that by virtue of his Policy he is a member of The
Minnesota Mutual Life Insurance Company, and that the annual Meetings of said
Company are held at its Home Office on the first Tuesday in March of each year
at three o'clock in the afternoon.
THE MINNESOTA MUTUAL LIFE INSURANCE COMPANY
▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇, ▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇
▇▇▇▇▇▇▇▇▇ IN 1880
Page 18
(17097 3-70)