0001193125-04-210437 Sample Contracts

WITNESSETH:

Fund Participation Agreement • December 10th, 2004 • Fs Variable Annuity Account Five • California

• Contract Type
  Fund Participation Agreement
• Filed
  December 10th, 2004
• Company
  Fs Variable Annuity Account Five
• Jurisdiction
  California

INDIVIDUAL FIXED AND VARIABLE DEFERRED ANNUITY CONTRACT Nonparticipating

Annuity Contract • December 10th, 2004 • Fs Variable Annuity Account Five

• Contract Type
  Annuity Contract
• Filed
  December 10th, 2004
• Company
  Fs Variable Annuity Account Five

Selling Agreement

Selling Agreement • December 10th, 2004 • Fs Variable Annuity Account Five • New York

• Contract Type
  Selling Agreement
• Filed
  December 10th, 2004
• Company
  Fs Variable Annuity Account Five
• Jurisdiction
  New York