0000950148-07-000268 Sample Contracts

s/ Jay S. Wintrob ------------------------------ Jay S. Wintrob President INDIVIDUAL FIXED AND VARIABLE ANNUITY CONTRACT Nonparticipating

Annuity Contract • October 30th, 2007 • Fs Variable Separate Account • New York

• Contract Type
  Annuity Contract
• Filed
  October 30th, 2007
• Company
  Fs Variable Separate Account
• Jurisdiction
  New York