0001193125-11-129857 Sample Contracts

EXHIBIT (4)(a) FORM OF POLICY
Annuity Policy • May 6th, 2011 • Separate Account VA QQ

This is a legal contract between the Owner and Transamerica Financial Life Insurance Company, a Stock Company (Hereafter called the Company, we, our or us.) The Company will provide annuity and other benefits as set out in this annuity policy, subject to its provisions. This annuity policy is delivered in, and is governed by the laws of, the State of New York.