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HomeMy WebLinkAboutRetirement Plan Services Agreement with Valic~' ~ E,ECEI~E . IRC Section 457 Deferred Compensation Plan ` ~ Adoption Agreement ~~.~ - ~ ~:i~n . EMPLOYER INFORMATION , NameofEmployer Cti~cf a(i Men~.dd.an Address 33 ~. Idaha S~. City. Men~.d.~an State Id. 83642 Zip Telephone (2 0 8 1 8 8 8- 4 4 3 3 Employer's Federal Tax Identification Number 8 2- 6 0 0 0 2 2 5 Plan Year End D e c e m b en 3 l Type of Entity. Select one. ^ State Governmental Unit Political Subdivision of a State ^ Agency or Instrumentality of State or Political Subdivision of State ^ Tax Exempt Organization Operating as a: (Select one) ^ Corporation ^ Association ^ Trust NOTE: A Section 457 Deferred Compensation Plan adopted by a tax exempt organization must limit participation to a select group of management or highly compensated employees within the meaning of Section 201(2), 301(a)(3) and 401(a)(1) of ERISA. '. ., SECTION 1, EFFECTIVE DATES Complete PartA orB Part A. Effective Date This is the initial adoption of a Section 457 Deferred Compensation Plan by the Employer. The Effective Date of this Plan is NOTE: The Effective Date is usually the first day of the Plan Year in which this Adoption Agreement is signed and may not be earlier than January 1, 2002. Part B. Restatement Date This is an amendment and restatement of a$ elcistine S~c~ion 457 Deferred Compensation Plan (a Prior Plan). The Prior Plan was initially effective on 1 0 ] S The Effective Date of this restatement is l / 1 / 0 3 NOTE: The Effective Date is usually the first day of the Plan Year in which this Adoption Agreement is signed and may not be earlier than January 1, 2002. SECTION 2. ELIGIBILITY REQUlRE1VtENTS Complete Parts A and B° ,: Part A. Eligible Employees For purposes of this Plan, Eligible Employees include: (Select any that apply) ^ All Employees. ^ All independent contractors who perform services for the Employer from time to time. Employees in the following class or classes. (Specify) APP omn.P_auo_t?_d wonFztina 40 hound den weeEz__8 e.~ec~ed a~~~.c~.a.~d Part B. Entry Dates The Entry Dates for participation shall be: (Select one) Option 1: ^ The fast day of the Plan Yeaz and the first day of the seventh month of the Plan Yeaz. Option 2: ® Other(Spec~) by the 20~h a~ any man~h NOTE: If no option is selected, Option 1 shall be deemed to be selected. p1706 (6!2002) ®2002 BISYS Retvement Service Page 2 SECTION'S. CONTRIBITITONS Complete Parts A through;D . Part A. Elective Deferrals Each Participant may elect under a Salary Reduction Agreement to have his or her Compensation reduced by an amount as described below: 1. Limits on Elective Deferrals (Select one) Option 1: ®C An amount equal to the maximum amount allowable under the limits of Section 457 of the Code. Option 2: ^ An amount equal to a percentage of the Participant's Compensation from percent to percent in increments of percent. Option 3: ^ An amount of the Participant's Compensation not less than $ and not more than $ in increments of $ NOTE: If no option is selected, Option I shall be deemed to be selected. Commencement of Elective Deferrals Elective Deferrals may commence on l / 1 / 0 3 NOTE: This date may be no earlier than the date this Adoption Agreement is signed because Elective Deferrals cannot be made retroactively. 2. Minimum Elective Deferral Requirement (Select one) Must each Participant's Elective Deferrals be equal to or greater than a nununum amount each time period as specified by the Employer? Option 1: ® Yes. Option 2: ^ No. NOTE: If no option is selected, Option 2 shall be deemed to be selected. If Option 1 is selected, Elective Deferrals under this Plan must equal or exceed N / A percent of Compensation or $ 2 5 per r7uN Y~en~~c~ time period, i.e., pay period, month, etc.) 3. Elective Deferrals and Special Pay May a Participant elect to defer accumulated sick pay, accumulated vacation pay, and back pay? (Select one) Option 1: ^ Yes. Option 2: ® No. NOTE: If no option is selected, Option 1 shall be deemed to be selected. 4. Catch-up Contributions May an Eligible Employee elect to make catch-up contributions under the terms of Section 3.03 of the Plan? (Select one) Option 1: ~ Yes. Option 2: ^ No. NOTE: If no option is selected, Option 1 shall be deemed to be selected. NOTE: Compensation may not be deferred until a Salary Reduction Agreement is completed by a Participant. Part B. Matching Contributions Authorization of Matching Contributions Will the Employer make Matching Contributions to the Plan on behalf of a Participant? (Select one) Option 1: ^ Yes. Option 2: ® No. NOTE: If no option is selected, Option 2 shall be deemed to be selected. 2. Matching Contribution Formula If the Employer will make Matching Contributions, then the amount of such Matching Contributions made on behalf of a Participant each Plan Year shall be: (Select one) Option 1: ^ An amount equal to percent of such Participant's Elective Deferral which does not exceed percent of the portion of such Participant's Compensation. p1306(S/2002) ®2002 BISYS Retvement Smica Page 3 t- Option 2: ^ An amount equal to the sum of percent of the portion of such Participant's Elective Deferral which does not exceed percent of the Participant's Compensation plus percent of the portion of such Participant's Elective Deferral which exceeds percent of the Participant's Compensation. Option 3: ^ Such amount, if any, equal to that percentage of each Participant's Elective Deferral which the Employer, in its sole discretion, determines from year to year. Option 4: ^ Other Formula. (Specify) NOTE: If Option 4 is selected, the formula specified can only allow Matching Contributions to be made with respect to a Participant's Elective Deferrals. 3. Plan Year Linut on Matching Contributions Notwithstanding the Matching Contribution formula specified above, no Matching Contribution will be made with respect to a Participant's Elective Deferrals in excess of $ or percent of such Participant's Compensation. Part C. Formula Contributions 1. Authorization of Formula Contributions Will the Employer make Formula Contributions to the Plan on behalf of a Participant each Plan Year? (Select one) Option 1: ^ Yes. Option 2: ® No. NOTE: If no option is selected, Option 2 shall be deemed to be selected. 2. Contribution Formula (Select one) Option 1: ^ An amount equal to that percentage of each Participant's Compensation for the Plan Year while he or she is a Participant which the Employer, in its sole discretion, determines from year to year. Option 2: ^ An amount equal to percent of such Participant's Compensation for the Plan Year, while he or she is a Participant. Option 3: ^ Other Formula (Sped) NOTE: If no option is selected, Option 1 shall be deemed to be selected. Part D. Other Contributions 1. Transfer Contributions May a Participant make transfer contributions from other eligible deferred compensation plans. pursuant to Section 3.04 of the Plan? (Select one) Option 1: .~ Yes. Option 2: •;~ No. NOTE: If no option is selected, Option 1 shall be deemed to be selected. 2. Rollover Contributions May a Participant in a State Plan make rollover contributions pursuant to Section 3.07 of the Plan? (Select one) Option 1: ~ Yes. Option 2: ^ No. NOTE: If no option is selected, Option 1 shall be deemed to be selected. - SECTION 4: DIST~BUTION6 AlyFD LOANS Qw • ~ ~ ' ~ C,"omplete Farts A tbroug~ G° " Part A. Unforeseeable Emergencies Will distributions be allowed for unforeseeable emergencies as described under Section 457(d)(1)(A) of the Code and the regulations thereunder? (Select one) Option 1: ~ Yes. Option 2: ^ No. NOTE: If no option is selected, Option 1 shall be deemed to be elected. ®2002 B1SYS Retvetrcnt St:rvica ri1306(8/2002) t~, Page 4 Part B. Loans Will loans to Participants be permitted under the Plan, if it is a State Plan. (Select one) Option 1: ^ Yes. Option 2: ~ No. NOTE: If no option is selected, Option 2 shall be deemed to be selected. Part C. Transfers May a Participant transfer all or a portion of his or her Account to another eligible deferred compensation plan? (Select one) Option 1: ~ Yes. Option 2: ^ No. NOTE: If no option is selected, Option 1 shall be deemed to be selected. Part D. Cash-Out Determinations Will the determination of whether or not a Participant's individual Account does or does not exceed $5,000 be determined without regazd to that portion of the Participant's Account that is attributable to rollover contributions (and earnings allocable thereto) within the meaning of Sections 402(c), 403(a)(4), 403(b)(8), 408(d)(3)(A)(ii), and 457(e)(16) of the Code? (Select one) Option 1: ~ Yes. Option 2: ^ No. NOTE: If no option is selected, Option 1 shall be deemed to be selected. Part E. Involuntary In-Service Distributions Will a Participant who is an active Employee of the Employer receive a distribution equal to the total amount payable to the Participant under the Plan (other than rollover contributions) in accordance with Section 4.12(A) of the Plan if the amount payable does not exceed the applicable dollar amount specified below by the Employer? (Select one) Option 1: ^ Yes. Option 2: ~ No. NOTE: If no option is selected, Option 2 shall be deemed to be selected. If Option 1 is selected, the applicable dollaz amount shall be $ (must not exceed the dollar limit of Section 4119(a)(11)(A) of the Code ($5,000 for 2002)). Part F. Voluntary In-Service Distributions May a Participant who is an active Employee of the Employer receive a distribution equal to the total amount payable to the Participant under the Plan (other than rollover contributions) in accordance with Section 4.12(B) of the Plan if such amount does not exceed the applicable dollaz amount specified below by the Employer? (Select one) Option 1: ^ Yes. Option 2: ® No. NOTE: If no option is selected, Option 1 shall be deemed to be selected. If Option 1 is selected, the applicable dollaz amount shall be $ (must not exceed the dollar limit of Section 4119(a)(11)(A) of the Code ($5,000 for 2002)). Part G. Delayed Distributions for Independent Contractors Will Participants who are independent contractors be required to wait 12 months from the expiration of their contracts to be eligible to receive distributions from the Plan pursuant to Section 4.01(A)(6)? (Select one) Option 1: ^ Yes. Option 2: ^ No. NOTE: If no option is selected, Option 2 shall be deemed to be selected. (~ ; ..' :. • SE C mplete Partsd B NS ` I~ Part A. Normal Retirement Age The Normal Retirement Age under the Plan is age ~ (not to exceed 70'/:). when e.2d: g -% 6.2 e ~ a n ~ u2.~ NOTE: If left blank, the Normal Retirement Age will be deemed to be age 70'/::. P ~ R S 1 b e n e b tied #1306(8/2002) ®'1002 BISYS Retvmient Smica ' Page 5 For purposes of the limited catch-up rule described in Section 3.02(A)(2) of the Plan, select the following item(s), if applicable, by checking the appropriate box. If a box is not checked for an item, the item shall not be part of the Plan. ^ A Participant may designate a Normal Retirement Age within the range of ages permitted by the Plan. ® If the Plan has Participants that include qualified police officers or firefighters, then the range from which that designation maybe made shall be age 4 0 through age? 0 l / ages from age 40 through age 70%s may be specified). Part B. Required Beginning Date For purposes of determining when required minimum distributions must begin to be made to each Participant, the required beginning date shall mean (Select one) Option 1: ^ April 1 of the calendaz year following the calendaz yeaz in which the Participant attains age 70'/:. Option 2: ~ April 1 of the calendaz yeaz following the later of the calendaz year in which the Participant attains age 70'/z or the calendar yeaz in which the Participant incurs a Severance From Employment. NOTE: If no option is selected, Option l shall be deemed to be selected. SECTION 6. NIISCEI~LANEOUS .: Comp(ete`Parts A and if aPPlicable; Part B Part A. Participant Direction Will Participants be permitted to direct the investment of their individual Accounts pursuant to Section 6.09 of the Plan? (Select one) Option 1: ~ Yes. Option 2: ^ No. NOTE: If no option is selected, Option 1 shall be deemed to 6e selected. Part B. If the Employer is a State, political subdivision of a State, or any agency or instrumentality of a State or political subdivision of a State, as identified in the Employer Information Section of this Adoption Agreement, Plan assets shall be held in accordance with the following as further described in Section 6.10 of the Basic Plan Document. (Select one) Option 1: ^ Plan assets shall be held in trust for the exclusive benefit of Participants and Beneficiaries pursuant to the trust agreement set forth in Section 6.11 of the Basic Plan Document. Option 2: ^ Plan assets shall be held in one or more annuity contracts, as defined in Section 401(g) of the Code, issued by an insurance company qualified to do business in the state where the contract was issued, for the exclusive benefit of Participants and Beneficiaries under the Plan. Option 3: ~ Plan assets shall be held in one or more custodial accounts for the exclusive benefit of Participants and Beneficiaries under the Plan. NOTE: If Option 1 is selected, the Adoption Agreement must be signed below by a Trustee. The undersigned Trustee, domiciled in the State of ,hereby accepts appointment as Trustee pursuant to the terms of the trust set forth is Section 6.11 of the Basic Plan Document: Signature of Trustee Type Name Date _ ~, SECTION ,7. EMPLOYER SIGNATURE _ ~` .. ~.` . ~ : Impa~tant: Please read'before signing. I am an authorized representative of the Employer named above and I state the following: 1. I acknowledge that I have relied upon my own advisors regazding the completion of this Adoption Agreement and the legal and tax implications of adopting this 457 Deferred Compensation Plan. 2. I have received a copy of tion Agreement and the corresponding Basic Plan Document. Signature of Employer ~ Date ?~ d Type Name Rob2n~ 'D. C~nn~,e ®zooz a~srs Retuemau s~« aisoe ~anooz) VALIC FINANCIAL ADVISORS, INC. Guided Portfolio Services Program Plan Services Agreement © 2003 AIG VALIC, Houston, Texas www.aigvalic.com ®VALIC VL 15072 (3/2003) VALIC FINANCIAL ADVISORS, INC. Guided Portfolio Services Program PLAN SERVICES AGREEMENT This Plan Services Agreement (Plan Agreement) is entered into between you (Plan Representative, or You) and VALIC Financial Advisors, Inc. (VFA), a Texas corporation registered as an investment advisor with the United States Securities and Exchange Commission, for the investment advisory services program (Guided Portfolio Services Program) described in this Plan Agreement to participants in your employer-sponsored retirement plan or plans (Plan): I .Investment Advisorx Services Each Plan participant, beneficiary or alternate payee (as permitted under the Plan; hereinafter collectively referred to as "Participant") electing to have investment advisory services provided by VFA must complete the Investment Advisory Services Agreement (Participant Agreement), which describes the features of the program as well as the rights and responsibilities of the Participant under the program. By entering into this Plan Agreement, you acknowledge and agree that you have received and reviewed, and to the extent appropriate or necessary your legal counsel has received and reviewed, this Plan Agreement and the Participant Agreement, including the terms, conditions, and details of the Guided Portfolio Services Program described in those agreements, and that as a Plan Fiduciary: • By init'aling below, You hereby select the Guided Portfolio Se rogram and designate the following services to be vailable to Plan participants: "~ ortfolio Advisor Service: This service enables a ~ `Participant to obtain individualized advice, including individualized investment allocation recommendations from VFA, via an online program created for VFA which applies methodology developed, maintained and overseen by an independent financial expert, Ibbotson Associates, Inc. (Ibbotson). The recommendations will consist of model portfolios constructed by Ibbotson from the investment options selected by You or by another Plan representative (which does not include VFA), applied to the Participant's individual information and account. The advice is based upon a wealth forecast that takes into account not only the Participant's plan account values and contribution rates, but also, to the extent provided by the Participant and relevant to the forecast, other assets held by the Participant or the Participant's spouse or family member. The advice reflects the results of Monte Carlo simulations to determine the probable result of various account allocations, savings rates, etc. The Participant may elect whether to use this service, and if so, when and how often to use it. The Participant will be responsible for implementing any advice recommendations using the ordinary means available under the Plan, and For subsequent mo or review of the account and of the information iving at the advice. a` ..-'~ort anager Service: Under this service, a Participant requests that VFA exercise discretionary authority to allocate and reallocate his or her account, to implement individualized advice generated from a program created by Ibbotson, acting as an independent financial expert. The advice is the same as that provided under the Portfolio Advisor service. However, the advice is implemented by VFA. Initially and once each year thereafter, the Participant is given an opportunity to review and confirm the accuracy and completeness of the information upon which the advice is based, before the allocations or reallocations are implemented. For all other periods any reallocations are processed automatically following the end of a calendar quarter. Because the Participant is directing VFA to manage the account on his or her behalf, certain automatic transactions otherwise available under the account, such as contribution and account allocation and reallocation, either systematic or otherwise, will not be processed unless or until the Participant has terminated participation in the Portfolio Manager service. A Participant's request fors h an allocation or reallocation may be interprete ' ection to terminate the Portfolio Manager service pant's account. w ~~' ervices: \~ Portfolio Advisor and Portfolio Manager VFA Financial Advisors will also provide plan investments and services, as separately selected by you or by another plan representative, including education services. • The Service(s) will be available for the Following Plan(s): 5 l7S P ~a~ 1 (20 c,i= • If the Plan is subject to the requirements of the Employee Retirement Income Security Act of 1974, as amended (ERISA), you are designating VFA as a Plan Fiduciary solely For the provision of investment advice under this Agreement. Plan Services Agreement -Page 1/5 VALIC • You have determined that the compensation to VFA for services under the Guided Portfolio Services Program, taking into account any other compensation to VFA or its affiliates for investments and services provided to Plan accounts, is reasonable in light of the investment advisory services to be rendered. • You have designated, or you will designate, the individual investment products offered by VFA that will be available to participants under the Plan and under the Program and they are or will be listed in Appendix A to this Plan Agreement. In making such designation, you acknowledge and agree to any limits on the VFA-provided investment options to which the advice may apply, and to any limitations imposed by the investment option or by the Plan, provided that, except in the case of Plan limitations, such limitations have been disclosed to you prior to making such designation. • You will receive regular periodic summaries of the performance of the underlying Plan investment options used in the Guided Portfolio Services Program, including rates of return, as well as periodic information regarding the fees assessed by the underlying investment option and the fees assessed for the Guided Portfolio Services Program. 2. Status of Plan VFA or an affiliate may be providing additional services, including investment, plan recordkeeping, plan compliance, and other related plan administrative services. However, the Plan Representative retains the responsibility for ensuring the qualification of the Plan. If the Plan is subject to the requirements of ERISA, the Plan Representative must be a Plan Fiduciary. 3. Prohibited Transactions If the Plan is described in section 401(a) of the Internal Revenue Code (Code), or if the Plan is subject to the requirements of ERISA, certain types of transactions are prohibited, including, generally, the provision of investment advice by an entity or an individual that is providing other services to the Plan for compensation. VFA cannot provide tax or legal advice to you or to the Plan. The United States Department of Labor ("DOL") has issued Advisory Opinion 2001-09A ("Advisory Opinion") to SunAmerica Retirement Markets, Inc. ("AIG SunAmerica"), a sister company of VFA. The Advisory Opinion provides that investment advice that is based on a computer program controlled by an independent financial expert ("IFE") and delivered to a Participant by an organization or advisor that is also providing plan investments from which it receives income, will not. constitute a prohibited transaction if certain requirements are satisfied. The Advisory Opinion was issued by the DOL in response to a request fora prohibited transaction exemption ("PTE") by AIG SunAmerica. The AIG Plan Services Agreement -Page 2/5 SunAmerica PTE request identified Ibbotson as the IFE for the AIG SunAmerica program. AIG SunAmerica, Inc. and VFA have entered into an agreement with Ibbotson to provide the services described in AIG SunAmerica's PTE request and in the Advisory Opinion. A VFA financial advisor(s) will be, or is already, providing services to your Plan, which may include enrollment and contribution processing, plan recordkeeping and compliance, education, and other services. Based upon your selections above, VFA will also provide investment advisory services. As described above, VFA will provide advice under the Portfolio Advisor service through an online program that the Participant may use at any time the system is available, and as frequently as desired. VFA will provide advice under the Portfolio Manager service through a VFA Investment Advisor Representative (Facilitator). The Facilitator will continue to provide many of the same plan and investment services to the Plan that he or she would otherwise provide, in the absence of the selected investment advice services. However, pursuant to the Advisory Opinion, the Facilitator will present the advice exactly as it has been determined under the computer program developed by Ibbotson, and may not alter that advice or provide other investment advice. 4. Investment Advice Process From the investment options that you select to be available to Plan participants, Ibbotson will select the funds to be included in the model advice portfolios under the Guided Portfolio Services Program. The list of funds selected by Ibbotson will be attached hereto as Appendix B. (You will be notified by VFA if the investment options you select fail to include one or more asset categories required by the Ibbotson portfolios.) If advice is being provided for a Participant's accounts in multiple plans, or for multiple accounts on separate recordkeeping systems under a single plan, the advice will be provided separately for each such plan or account. On an ongoing basis Ibbotson will monitor the asset-class portfolios and the individual investment options included in the advice portfolios, and make changes to either or both as appropriate. With certain exceptions, any such changes will generally occur not more Frequently than quarterly. For purposes of either the Portfolio Advisor or the Portfolio Manager service, each Plan participant selecting the program will be assigned to one of a fixed number of model portfolios based upon the information provided to VFA by the Plan or by the Participant. As described in the Participant Agreement, a minimum set of data items will be required in order to assign the Participant to a model portfolio. They include: gender, date of birth, state of residence, annual earned income, current annual plan savings rate, employment date, number of dependents, desired retirement age, and desired retirement need (% or $). Additional information can be provided, by the Plan or the VALIC Participant, to further assist in selection of the appropriate portfolio, including additional information about the Participant and/or the Participant's spouse and/or family, if applicable. This additional information can include (but is not limited to): Outside Plan Assets: Account Type; Account Name; Annual Contribution $; Annual Contribution %; Fund Name; Ticker/Symbol/CUSIP; Qty/# of Units; Market Price per Share; Cost Basis per Share; Market Value; Cash; Stock Option Grant Year; Vest Year; Qualified; Asset Class; Qty; Strike Price; Underlying Price; Expiration Year; Cash Equivalents; Other Assets Liabilities: Loan ID; Effective Date; Maturity Date; Balance; Repayment Amount; Interest Rate; Repayment Frequency; Loan Name; Loan Start Date; Loan End Date; Loan Payment; Interest Rate; Appraisal Value Cash Flow: Cash Flow Type (income or expense); Begin Date; End Date; Amount; Premium over Inflation (%); Adjust for Inflation (now, later, no); College Cost Begin Year; College Cost End Year; Type of School; Cost Benefits/Retirement Information: Pension Description; Start Age; Inflation Premium; Pension Monthly Payment; Inflation Adjust; Social Security Description; Monthly Estimate ($); Age to Collect; °k Reduction About Your Spouse: First Name; Last Name; Date of Birth; Number of Dependents; Gender; Annual Savings Rate $; Annual Savings Rate %; State of Residence; Employment Date; Annual Salary; Retirement Age; Retirement Needs $; Retirement Needs %; Pre-Tax Match Calculation %; Max Pre-Tax % Saved; Dollar Cap for Pre-Tax Match; Max Pre-Tax Employee Svgs Rate; Company Stock Match Pre-Tax %; Profit Sharing Match Pre-Tax %; Employer Profit Sharing %; Post-Tax Match Calculation %; Max Post-Tax % Saved; Dollar Cap for Post-Tax Match; Max Post -Tax Employee Svgs Rate; Company Stock Match Post-Tax °~; Profit Sharing Match Post-Tax %; Other Employee Match Assets: Account Type; Account Name; Annual Contribution $; Annual Contribution %; Fund Name; Ticker/SymboVCUSIP; Qty/l,lnits; Market Price per Share; Cost Basis per Share; Market Value; Cash; Stock Option Grant Year; Vest Year; Qualified; Asset Class; Qty; Strike Price; Underlying Price; Expiration Year; Cash Equivalents; Other Assets Plan participants will be permitted to enroll in the Guided Portfolio Services Program at any time, provided however that, in the case of a Plan participant electing the Portfolio Manager service, if the Participant previously terminated the service with respect to a Plan, he or she must wait at least twelve months before re-enrolling in the service for that Plan. Upon enrollment in the Portfolio Advisor service, the Plan participant may use the online advice service as often as Plan Services Agreement -Page 3/5 desired, in the manner (and subject to any limitations) described in the Participant Agreement. A Plan participant enrolling in Portfolio Manager will receive a statement summarizing the data provided to VFA that will be used to formulate the advice, and will be given an opportunity to correct or modify that data before the service is initiated. Thereafter, the Participant can revise, add, or change his or her data at any time during VF.4's normal operating hours, and he or she will also receive a summary of his or her data in a quarterly advice statement. The Participant enrolled in the Portfolio Manager service will be further contacted at least once per year, and may ask to speak with a VFA Facilitator at any time. A comprehensive review of Portfolio Manager accounts will be performed annually by Ibbotson, and the accounts will be rebalanced quarterly if thresholds established by Ibbotson are exceeded. Participants are responsible for contacting VFA with any new or revised information that might warrant an additional review and/or rebalancing of the account. Allocations or reallocations may be limited by the Plan or by the underlying investment. Such limitations will be taken into account by Ibbotson in the development and implementation of the advice. 5. Cost Assessed to Participant Accounts For Portfolio Manager, the cost assessed to Plan Participant accounts is reflected in .the enclosed Fee Schedule. The cost will be applied to the account of each participant not less than 6 and not more than 15 days following the end of a calendar quarter. The cost will be calculated as a percentage of account value and applied to the account as a fixed dollar amount, as described in the Participant Agreement. For Portfolio Advisor, a fixed annual fee will be charged to the Participant's account following enrollment, and will entitle the Participant to use of the service For one year. At the end of that year, and each succeeding year for which the advice is initiated or continued, the Participant will be required to re-enroll in order to continue receiving the service. Plan Representative hereby directs that these costs be withdrawn from Participant accounts as an expense of the plan. You will be provided at least 90 days advance written notice of any change in the rate of fees assessed to Participant accounts. Fees will be assessed to Participant accounts on a pro-rata basis among investments. 6. Cost Assessed to Plan Sponsor You are responsible for an annual Eee of $~ related to the portfolio construction, monitoring, maintenance, and reporting performed by Ibbotson under the Guided Portfolio Services Program. You will be sent at least 90 days advance written notice of any change in the rate of fees assessed to the Plan. Circle one Standard Portfolio Set ustom Portfolio Set VALIC 7. Term and Termination of Guided Portfolio Services Program This Agreement will become effective on the last signature date hereof, and will remain in effect from calendar quarter to calendar quarter until otherwise terminated. A termination will be effective with respect to all plans identified in this Agreement unless otherwise specified by You and agreed by VFA following provision of not less than 90 days advance written notice, provided however that some or all of the notice period may be waived upon a demonstration that only an earlier termination will comply with the independent Fiduciary's fiduciary duties. You or another authorized Plan Representative may terminate the services at any time for all Plan participants, subject to a reasonable advance written notice requirement consistent with applicable law. Such termination shall be effective as soon as reasonably practicable thereafter. A Plan participant may terminate the Portfolio Manager services with respect to his or her account, subject to a reasonable advance written notice requirement consistent with applicable law. Such termination shall be effective as soon as reasonably practicable thereafter. VFA may terminate the Portfolio Manager services to the Plan, including all participants thereunder, by not less than 90 days advance written notice to the Plan and to each Plan participant that is enrolled in the Guided Portfolio Services Program. 8. otice Any notice permitted or required under this Plan Agreement shall be provided as follows: Notice to Plan Reprlelsentative: C ~ ~~ o~ /I/I er• C ~ a ~^ 0.wl~ile SK"f4.5 r ~la.. AQrN...irS/YP/10~ M~:~;a~ ~ ~ . 83c~~Z Notice to VFA: VALIC Financial Advisors, Inc. Guided Portfolio Services Program c/o Advisory Services Team 2929 Allen Parkway Houston, Texas 77019 9. No Guarantee You understand, acknowledge and accept that the advice provided hereunder relies on historical performance and other data, all of which have limitations. Past performance of investments is no guarantee of future results. The analysis and advice provided depends upon a number of factors, including the information provided, various assumptions and estimates and other considerations. As a result, the wealth forecast developed and advice and recommendation provided are not guarantees that a Plan participant will achieve his or her retirement goals or anticipated returns. You understand that there remains a risk of loss within variable investment options. 10. Form ADV Part II of VFA's Form ADV, the registration document filed with the United States Securities and Exchange Commission, contains additional information about the advice VFA will provide. By entering into this Agreement, you represent that you received and reviewed a copy of Part II of VFAs Form ADV. 1 1. Limitation of Liability The use and storage by the Plan or a participant of any information including, without limitation, account numbers, passwords, identification, portfolio information, account balances and any other information available on an employer's or a participant's personal computer is the sole risk and responsibility of the employer and/or the participant. VFA is not responsible for providing and maintaining the communications and equipment (including personal computers and modems) and telephone or alternative services required for accessing and utilizing electronic or automated services, or for communications service fees and charges incurred by the Plan or a participant in accessing these services. You understand and agree that there is no guarantee that the recommendations generated by VFA or pursuant to the computer program developed by Ibbotson will be successful. You acknowledge that the outcome of the Guided Portfolio Services Program's calculations are estimates only, and there is no guarantee of the future financial performance of your investments or that you will meet your desired goal(s). You agree, understand, and acknowledge that we are basing our advice on the responses provided and other information furnished to us through the Advice Program and updated as necessary. We shall not be liable for any misstatement or omission contained in the information furnished to us, or any loss, liability, claim damage or expense whatsoever arising out of or attributable to such misstatement or omission. 12. Assignability This Agreement shall not be assignable by any party without the prior written consent of the other party. 13. Extraordinary Events We shall not be liable for loss caused directly or indirectly by governmental restrictions, exchange or market rulings, suspension of trading, war, strikes, or other conditions beyond our control. We shall not be responsible for loss or damages caused by equipment failure, communications lines failure, Plan Services Agreement -Page 4/5 ~ VAZ]lC unauthorized access, theft, systems failure and other of the information. consequences beyond our control. 15. Separability 14. Privacy Protection of Nonpublic Personal Information. VFA is subject to various privacy requirements for the protection of its clients under the Gramm-Leach-Bliley Act ("Act") and regulations promulgated pursuant to the Act. Definition of Nonpublic Personal Information. Nonpublic personal information ("NPI") of customers or consumers includes, but is not limited to, names, addresses, account balances, account numbers, account activity, social security numbers, taxpayer identification numbers, and sensitive financial and health information. NPI includes information on our Forms or in a database of any kind, information created by us, information collected by or on behalf of us and personally identifiable information derived from NPI. Disclosure and Use of NPI. All NPI that VFA obtains as a result of this relationship shall not be used, disclosed, reused or redisclosed to any unaffiliated third party, except to carry out the purposes for which the information was disclosed. All NPI shall be held in confidence to the same extent and in at least the same manner as VFA protects its own NPI, but in no case in a lesser manner than a reasonable degree of care under the If any provision or condition of this Agreement shall be held to be invalid or unenforceable by any court or regulatory or self- regulatory agency or body, such invalidity or unenforceability shall attach only to such provision or condition. The validity of the remaining provisions and conditions shall not be affected thereby and this Agreement shall be carried out as if any such invalid or unenforceable provision or condition were not contained herein. 16. Entire Agreement; Governing Law This Agreement represents the entire agreement between the parties with respect to the subject matter hereof and may not be modified or amended except in writing signed by You and VFA. It shall be governed by and construed and enforced under the Laws of the State of Texas. circumstances. VFA shall be permitted to disclose relevant aspects of the NPI to its officers, agents, subcontractors, independent financial expert and employees only to the extent that such disclosure is reasonably necessary for the performance of its duties and obligations under the Agreement; provided that VFA shall take all reasonable measures to ensure that the NPI is not disclosed or reproduced in contravention of the provisions of this Section by VFA officers, agents, subcontractors, investment subadvisors and employees. The obligations of this Section shall not restrict any disclosure by VFA pursuant to any applicable state or federal laws, or by request or order of any court or government agency (provided that the disclosing party or parties in order that any other party will have a reasonable opportunity to oppose the disclosure, request or order). Second Signature If Required Date Authoriz VALIC Financial Advisors, [nc. Signatory ~2g ~$ T~ C+ ~~ /e3~~~.~ T ~Ol/~.ro ~ Title The obligations of this Section shall not apply to information which, without breach of obligation of confidentiality: (1) is independently developed by us; (2) is or becomes publicly known; (3) is already known by us as evidenced by the written records; or (4) is obtained from an independent source. Security of NPI. VFA further agrees to establish and maintain policies and procedures designed to ensure the confidentiality and security of NPI. This shall include procedures to protect against any anticipated threats or hazards to the security or integrity of the information and unauthorized access to or use Plan Services Agreement -Page 5/5 ~ VA)1')(C Plan Representative Signature VALIC The Variable Annuity Life Insurance Company 2929 Allen Parkway Houston, TX 77019 RECEIVE ~,. .w i~Y.r '.9i7 VL,Ilti9-' December 17, 2002 Dear Group /Plan Administrator: City of Meridian City Clerk Office Thank you for choosing AIG VALIC as a carrier for your retirement plan. Enclosed is the contract associated with the VALIC Portfolio Director Fixed and Variable Annuity application you recently signed authorizing this product in your plan. This contract has information important to the administration of your plan and lists the features of the accounts your participating employees will receive. If you have questions regarding your plan or this contract, please contact your AIG VALIC financial advisor at 1-800-448-2542. We look forward to working with you in the future. Sincerely, Mary C. Birmingham Vice President, Group Plan Services Enclosure: Group Contract Securities and investment advisory services offered through VALIC Financial Advisors, Inc., member NASD/SIPC Member of American International Group, /nc. VALIC ~ A The Variable Annuity Life Insurance Company Member of American /nternationa! Group, Inc. CONTRACT OWNER: CITY OF MERIDIAN CONTRACT NUMBER: 65175 DATE OF ISSUE: 12/11/2002 In return for Purchase Payment(s), VALIC will pay annuity and other benefits as provided in this Contract. PLEASE READ YOUR CONTRACT CAREFULLY See Index on Page 2 • Maintenance Charge -- There is no account maintenance charge. • Separate Account Charge -- There is a daily charge against the Separate Account at an annual rate ranging from 1 % to 1.25% of the average daily net asset value of the Separate Account, based upon the Variable Investment Option to which assets are allocated. This charge only applies to assets under Variable Investment Options. See Section 2.06 for a complete description. • Cash Surrender or Withdrawal Charge -- There is a charge at the time of surrender or withdrawal for transfer to another funding entity or for purposes other than to provide Participant benefits equal to 5% of (i) the amount withdrawn, or (ii) the amount of any Purchase Payments received during the most recent 60 months prior to the surrender or withdrawal, whichever is less. See Sections 4.03 through 4.06 for a complete description and conditions under which there is no charge. The conditions and provisions on this and the following pages are the entire legal Contract between VALIC and the Contract Owner. No agent has the authority to change this Contract or waive any of its provisions. Only the President or a Vice President of VALIC may change this Contract. Any such changes must be in writing. All conditions and provisions are subject to applicable state laws. EXECUTED AT VALIC'S HOME OFFICE ON THE DATE OF ISSUE. (Secretary) (President) ANNUITY PAYMENTS AND SURRENDER VALUES PROVIDED BY THIS CONTRACT WHEN BASED ON INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT. GROUP FIXED AND VARIABLE DEFERRED ANNUITY CONTRACT INDIVIDUAL ALLOCATIONS - NON-PARTICIPATING - UITG•194-SWDCMC PDGCBSWDCMC 100 2929 Allen Parkway • Houston, TX 77019-2155 INDEX Section 1 DEFINITIONS ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 3 4.13 Assumed Investment Rate (AIR)......_...,.,,,,,,,_, 8 Section 2 CONTRACT AND PURCHASE 4.14 Annuity Units and Annuity Unit Value,......., 8 PAYMENTS,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 3 4.15 Betterment of Rates ................................................... 8 2.01 Incontestability,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 3 4.16 Annuity Rate Tables ................................................... 8-13 2.02 Minimum Contract Value ,, ,,,,,,,,,,,,,,,,,,,,,,, 3 4,17 Beneficiaries ..................................................................... 13 2.03 Plan Provisions ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 3 4.18 Death Payment Provisions .................................... 13 2.04 Purchase Payments ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 3 Section 5 CODE REQUIREMENTS AND 2.05 Maintenance Charge ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 3 RETIREMENT PLAN PROVISIONS , ,.. 15 2.06 Separate Account Charge .................................... 3 5.01 Salary Reduction Purchase Payments ,,. 15 Section 3 INVESTMENT OPTIONS ............................ 4 5.02 Minimum Distributions After Age 70 1/2.,,, 15 3.01 Fixed Interest Options ............................................. 4 5.03 Minimum Death Benefit Distributions ,.,.,.. 15 3.02 Variable Investment Options .......................... 4 5.04 Direct Rollovers ............................................................. 16 3.03 Accumulation Unit ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 4 5.05 Plan Provisions ............................................................... 16 3.04 Accumulation Unit Value . ............................... 4 5.06 Nonqualified Deferred Compensation 3.05 Transfers During the Accumulation Plans ,;,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 16 Period .................................................................................... 4 Section 6 GENERAL PROVISIONS...................................... 17 3.06 Transfers During the Annuity Period, ,.,...... 5 6.01 Participant Certificates .............................................. 17 Section 4 BENEFITS ........................................................................ 6 6.02 Assignment....................................................................... 17 4.01 Cash Surrender ........................................................... 6 6.03 Vesting................................................................................... 17 4.02 Withdrawals ..................................................................... 6 6.04 Written Notices to Us................................................. 17 4.03 Charges for Cash Surrender or 6.05 Change of Contract .................................................... 17 . Withdrawal ........................................................................ 6 6.06 Future Participants..................................................... . 17 4.04 Conditions Under Which No Surrender or 6.07 ,,,,;,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, Reports , 1 ~ Withdrawal Charges Will Be Deducted .. 6 ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 17 6.08 Voting Rights ........ ......... .......... . 4.05 Annuity Period ............................................................... 7 6.09 ............. . Suspension of Payments ................................ . 17 4.06 Starting Annuity Income Benefits ....,...... 7 6.10 Deferral of Cash Surrender or 4.07 Partial Annuitization ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,„ 7 Withdrawal ........................................................................ 17 . 4.08 Minimum Annuity Payments ........................... 7 6,11 . Proof of Survival ........................................................... 17 . 4.09 Misstatement of Age,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 7 6.12 Substitution of Investment Fund 4.10 Annuity Income (Payment) Options ............. 7 Shares 17 4.11 Fixed or Variable Annuity Basis ............. 7 6.13 Minimum Benefit ........................................................... 17 . 4.12 Variable Annuity Payments,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,„ 8 6.14 Separate Account ........................................................ 18 . 2 U ITG-194-SW oao~zsrz Section 1 -DEFINITIONS Accumulation Period -the time between the date of the first Purchase Payment and the Annuity Date for a Participant. Accumulation Value -equals the sum of the values of the Fixed Interest Options and Variable Investment Options allocated to a Participant Account that have not been applied to provide annuity payments. Annuity Period - the time during which VALIC makes annuity payments. Certificate Year - a twelve month period starting with the issue date of a Participant's certificate and each anniversary of that date. Code - the Internal Revenue Code of 1986, as amended. Company Reference - "We," "Our," "Us," or "VALIC," means The Variable Annuity Life Insurance Company. Contract Owner -the employer or other entity that makes application for the Contract. Investment Fund - an investment portfolio which is the underlying investment medium for a Variable Investment Option. General Account -the assets of VALIC other than those in the Separate Account or any other segregated asset account. Home Office -the principal office of VALIC. Participant - a person for whom or with respect to whom Purchase Payments are made under the Contract. Participant Account - an individual account which is established for a Participant to record the Accumulation Value for the Participant. Plan - the employer-sponsored retirement plan, annuity purchase arrangement, or deferred compensation program for which this Contract is issued. Purchase Payment - an amount paid to VALIC for allocation to a Participant Account. Separate Account - a segregated asset account established under the Texas Insurance Code (known as Separate Account A). Surrender Value -the Accumulation Value of a Participant Account less any applicable surrender charge. Section 2 -CONTRACT AND PURCHASE PAYMENTS 2.01 Incontestability - This Contract is incontestable. This Contract is non-participating and does not share in the profits or surplus of VALIC. 2.02 Minimum Contract Value - We can distribute the Surrender Value if the Accumulation Value for the Participant Account falls below $300 and there are no Purchase Payments for two Certificate Years. UITG-194-SWMC 2.03 Plan Provisions - As further explained in Section 5, this Contract is subject to the provisions of the Plan. To the extent provided by the Plan, any rights that may be exercised by a Participant under this Contract may instead be exercised by the Contract Owner or a Plan representative. 2.04 Purchase Payments -Purchase Payments may be made at any time during the Accumulation Period and may include amounts that are rolled over or directly transferred from another plan. We require no payment beyond the first. There is no penalty if any scheduled payments are omitted or stopped. If only one Purchase Payment is to be allocated to a Participant's Account, it must be at least $1,000. Periodic payments must be at least $30 each. VALIC may waive this minimum. We may deduct amounts from Purchase Payments or from the Accumulation Value for applicable premium taxes. We will allocate the net Purchase Payment to one or more Investment Options according to the Participant's directions unless the Contract Owner has retained that right under the Plan. 2.05 Maintenance Charge -There is no maintenance charge. 2.06 Separate Account Charge - We deduct a daily charge from the Separate Account. The amount of the charge depends on the Variable Investment Option from which it is deducted, and is imposed at an annual rate which ranges from 1 % to 1.25% of the assets of the Variable Investment Option. 3 QROGTST3 Section 3 -INVESTMENT OPTIONS We will allocate Purchase Payments (less any charges) to one or more Investment Options selected by the Participant. We reserve the right to limit allocations among Investment Options to seven at any one time. Each selection must be a whole percentage of Purchase Payments. 3.01 Fixed Interest Options -Fixed Interest Options are based on the General Account. Allocations to Fixed Interest Options earn interest as credited by VALIC during the Accumulation Period. The interest credited will be at least 3% per year. There are two Fixed Interest Options: Short Term Fixed Account and Fixed Account Plus. (a) Short Term Fixed Account. We will credit interest to the Short Term Fixed Account on a portfolio basis. On the portfolio basis, all amounts accumulated will be credited with the same rate of interest for the current period. (b) Fixed Account Plus. We will credit interest to the Fixed Account Plus on the following basis. Periodically, but not less than annual- ly, We will declare interest rates that apply separately to amounts accumulated in sepa- rate time periods. 3.02 Variable Investment Options -Variable Invest- ment Options are based upon Investment Funds available within Separate Account A. Separate Account A invests in a number of Investment Funds. Each Investment Fund underlying a Vari- able Investment Option has a different investment objective. Investment returns on Variable InvestmentOptions may be positive or negative. 3.03 Accumulation Unit - An Accumulation Unit is a measuring unit for amounts allocated to a Variable Investment Option before annuity payments begin. The value of an Accumulation Unit will vary with the net investment return of the respective under- lying Investment Fund. Accumulation Units may be credited to the Participant's Account due to a Purchase Payment or a transfer from another Investment Option. The number of Accumulation Units credited to the Participant's Account is deter- mined by dividing the dollar amount of the trans- action by the Accumulation Unit Value for that Variable Investment Option at the next time it is computed. 3.04 Accumulation Unit Value -The Accumulation Unit Value is the value of one Accumulation Unit of a Variable Investment Option. We will calculate it at the end of trading each day the New York Stock Exchange ~is open, except as otherwise permitted by the Securities and Exchange Commission. The value of an Accumulation Unit of a Variable Invest- U ITG-194-SW ment Option is the Accumulation Unit Value last computed, multiplied by one plus the Investment Rate for the period. The Investment Rate may be positive or negative. The Investment Rate is the change in the value of the Investment Fund's portfolio (capital gains and losses whether or not realized and investment income) since the last computation, divided by the amount of assets at the beginning of the period, less a factor for (a) the Separate Account Charge for the period at the applicable annualized rate ranging from 1 % to 1.25%, and (b} any taxes attributable to the Separate Account or reserve held for such taxes. 3.05 Transfers During the Accumulation Period - During the Accumulation Period, the Participant may transfer amounts among Investment Options, except as provided below. (a} We reserve the right to limit allocations among Investment Options to seven at any one time. (b) We reserve the right to require transfers to be at least 30 days apart. (c) Transfers from the Short Term Fixed Account. After a transfer to the Short Term Fixed Account, the Participant may not make any transfer from the Short Term Fixed Account for 90 days. We may change this transfer restriction at any time. However, the transfer restriction period may not exceed 180 days. (d) Transfers from Fixed Account Plus. The Part- icipant may transfer up to 20% of the Accum- ulation Value allocated to Fixed Account Plus during each Certificate ,Year. If multiple transfers are made in a Certificate Year, the percentages of the Accumulation Value transferred each time will be added together to determine the 20% transfer limit for that Certificate Year. For each transfer, the percentage transferred is the ratio of the amount transferred to the portion of the Accumulation Value allocated to Fixed Account Plus immediately prior to the transfer. However, if following a 20% transfer, the remaining amount allocated to Fixed Account Plus would be less than $500, the Participant may transfer the remaining amount. 4 QRDG25T4 3.06 Transfers During the Annuity Period -During the Annuity Period, the Participant may transfer Annuity Unit values among the Variable Investment Options. The Participant may also transfer Annuity Unit values from the Variable Investment Options underlying a Variable Annuity to provide a Fixed Annuity. Transfers must be at least 365 days apart. We will not permit any transfer from a Fixed Annuity during the Annuity Period. U ITG-194-SW oaoczsrs Section 4 -BENEFITS under any of the following conditions: 4.01 Cash Surrender -Subject to the restrictions in (ai The Participant elects an Annuity Income Sections 5.01 and 5.05, the Participant may Option; or surrender the Participant Account before the (b) After the death of the Participant; or Annuity Date for a cash payment equal to the (c) The Participant has become totally and Surrender Value as of the date We receive the permanently disabled. This means that the request at the Home Office. The Surrender Value Participant is unable, because of physical or is the Accumulation Value less any charges, as mental impairment, to pertorm the material described below. and substantial duties of any occupation for The Surrender Value of the Fixed Interest Options which the Participant is suited by means of will never be less than the amount of all Purchase education, training or experience. The Payments allocated to the Fixed Interest Options, impairment must have been in existence for less any amounts transferred to Variable more than 180 days to qualify for this benefit. Investment Options or withdrawn. Such impairment must be expected to result 4.02 Withdrawals - Subject to the restrictions in in death or be long-standing and indefinite. Sections 5.01 and 5.05, the Participant may We require proof of disability. We will accept withdraw a portion of the Accumulation Value in a certified Social Security finding of disability cash at any time before the Annuity Date. We may or a doctor's verification; or deduct a charge as described below. (d} The withdrawal and any earlier withdrawals 4.03 Charges for Cash Surrender or Withdrawal he same from the Participant Account during t ° Certificate Year do not exceed 10 /o of the (a) General. The Cash Surrender or Withdrawal Accumulation Value (see Section 4.03); or charges under this Contract will not apply (e) The Participant is separated from service unless the Contract Owner makes a with the employer that maintains the Plan; or surrender or withdrawal for transfer to another funding entity or for purposes other (f) No Purchase Payments were made to the than to provide Participant benefits under the Participant Account in the five years applicable Deferred Compensation Plan. The preceding the date of the surrender or charge is 5% of (1) the amount withdrawn, or withdrawal; or (2) the amount of any Purchase Payments (g) The Participant is at least 591/2 years old received during the most recent 60 months and the Participant Account was established prior to the surrender or withdrawal, at least five years before the date of the whichever is less, surrender or withdrawal; or For purposes of this charge, We treat (h) The Participant Account was established at withdrawals as withdrawals of Purchase least fifteen years before the date of the Payments before any earnings. We treat the surrender orwithdrawat; or most recent Purchase Payments as being (i) The Participant is retired from service with withdrawn first. the employer that maintains the Plan; or (b} 10% Withdrawal in Certificate Year. Subject (j) To the extent that a withdrawal or surrender to the provisions of Sections 4.04 and 4.05, is made on account of an unforeseen in any Certificate Year the Participant may emergency under the terms of the withdraw up to 10% of the Accumulation employer's Plan. Value without a charge. The surrender The surrender charge may be waived or reduced charge will be applicable only to the amount uniformly on all Participant Accounts for contracts withdrawn that exceeds 10%. The issued under certain plans or arrangements which percentage withdrawn will be calculated as are expected to result in administrative cost the ratio of the amount withdrawn to the savings. No reduction or waiver will be made that Accumulation Value immediately prior to the is unfairly discriminatory to any person. withdrawal. If multiple withdrawals are made We may waive any withdrawal or surrendercharge in a Certificate Year, the percentages attributable to Purchase Payments received during withdrawn for each withdrawal will be added specific periods of time, and under conditions and together to determine whether the 10% limit limitations set by Us. Any such waiver will be made has been exceeded. by Resolution of the Board of Directors. Notice of 4.04 Conditions Under Which No Surrender or the right to surrender without charge will be mailed Withdrawal Charges Will Be Deducted - We will to the Contract Owner when such waiver is not deduct charges from a participant Account declared by the Board of Directors. 6 U ITG-194-SWDC QR~ caws 4.05 Annuity Period -The Annuity Period begins at the any of the Annuity Income Options below or any Annuity Date, when the Participant's Accumulation other option agreed to by VALIC. Any option Value is applied under an Annuity Income Option. chosen must comply with applicable state and The Participant may change the Annuity, Date federal laws and regulations. shown on the first page of the Participant FIRST OPTION -Life Annuity With No Guarantee Certificate by giving Us at least 30 days notice. Period - An income payable during the Partio- The selected Annuity. Date may be the first day of ipant's life. All payments cease at the Participant's any calendar month, but if the Participant chooses death with no further amounts payable. a life income option, the Annuity Date may not SECOND OPTION -Life Annuity With Guarantee precede the Participant's 50th birthday without Our Period of 5, 10, 15, or 20 Years - An income permission. payable during the Participant's life. If, at the 4.06 Starting Annuity Income Benefits - At least 30 Participant's death, We have made payments for days in advance of the Annuity Date, the fewer than the number of years selected, We will Participant must choose one of the Annuity Income continue payments to the Beneficiary for the Options in Section 4.10 and provide acceptable remainder of the guarantee period. proof of age for any person whose age is taken THIRD OPTION -Life Annuity wth Cash or Unit into account under a life income option. If the Refund Option - An income payable during the Participant fails to select another Annuity Income Participant's life. Payments cease at the Option, annuity payments will be made on the Participant's death. However, the Beneficiary may basis of the Second Option with payments receive an additional payment. guaranteed for aten-year period, commencing on For payments on a Fixed Annuity basis, the the Annuity Date. additional payment, if any, will be the Accumulation 4.07 Partial Annuitization - The Participant may Value applied to this option less the total of all prior choose to apply less than the full Accumulation payments. Value under an Annuity Income Option and may For payments on a Variable Annuity basis, the choose different Annuity Dates and different additional payment, if any, will be the current value Annuity Income Options for different portions of the of the number of Annuity Units credited at the Accumulation Value. Therefore, the Contract may, Annuity Date less the number of Annuity Units that at times, be in both an Accumulation Period and an have been paid. For this purpose, the number of Annuity Period. If the Participant chooses to do Annuity Units credited equals the Accumulation this, the provisions of the Contract relating to the Value applied to this option divided by the Annuity Accumulation Period and the Annuity Period will be Unit Value at the date used to calculate the first applied as though there were separate Contracts. annuity payment. 4.08 Minimum Annuity Payments -The Participant FOURTH OPTION - Joint and Survivor Life may not choose any Annuity Income Option if the Annuity - An income payable during the joint lives resulting initial payment would be less than $25 of the Participant and a second person and under either a Fixed or Variable Annuity. We thereafter during the life of the survivor. reserve the right to convert monthly payments to FIFTH OPTION -Payments for a Designated quarterly, semi-annual or annual payments so the Period - An income payable for a selected number initial payment will be at least $25. of years between five and thirty. This option is 4.09 Misstatement of Age - If annuity payments available for Fixed Annuities only. depend upon an individual's survival and the date 4.11 Fixed or Variable Annuity Basis - A Fixed of birth of any individual was misstated, We will Annuity provides benefit payments of a fixed dollar adjust the remaining payments. The amount amount. A Variable Annuity provides benefit remaining to be paid will be the amount that should payments which vary with the investment return of have been paid with the correct information. We the chosen Variable Investment Options. will credit or charge the amount of any The Participant may elect to receive payments underpayment or overpayment against the next under any annuity option as a Fixed Annuity, a succeeding payment or payments, if any remain. Variable Annuity, or a combination Fixed and We reserve the right to collect any overpayment Variable Annuity. If the Participant makes no directly from the payee. election, amounts in Fixed Interest Options will 4 10 Annuity Income (Payment) Options - The provide a Fixed Annuity and amounts in Variable . Participant may choose to receive payments under Investment Options will provide a Variable Annuity. 7 U ITG-194-SW aRO~2sn 4.12 Variable Annuity Payments - We will determine the amount of each Variable Annuity payment by multiplying the number of Annuity Units payable by the Annuity Unit Value on the tenth day (or the preceding business day if the tenth day is not a business day} prior to the payment due date. We will determine the number of Annuity Units payable at the beginning of the Annuity Period. We will divide the dollar amount of the first payment by the Annuity Unit Value for that Variable Investment Option on the tenth day before the Annuity Date. The number of Annuity Units payable from each Variable Investment Option remains constant unless the Participant transfers a portion of the annuity benefit between the Variable Investment Options or from a Variable Annuity to a Fixed Annuity. However, the dollar amount payable is not fixed and may change from month to month. 4.13 Assumed Investment Rate (AIR) - Since the future rate of return on Variable Options is un- known, the Participant must choose an Assumed Investment Rate (AIR). The AIR is the assumed rate of return used to determine the first annuity payment for a Variable Annuity Option. Rates of 3%, 3 1/2%, 4 1/2%, 5% or a higher rate may be chosen if permitted by state law and regulations. If no AIR is chosen, the AIR will be 3 1/2%. A higher AIR will result in a higher initial payment. Choice of a lower AIR will result in a lower initial payment. Payments will increase whenever the actual return exceeds the chosen AIR. Payments will decrease whenever the actual return is less than the chosen AIR. 4.14 Annuity Units and Annuity Unit Value - An Annuity Unit is a measuring unit We use to deter- mine the amount of the annuity payments to be made. All or a portion of the Accumulation Value is used to purchase a stream of annuity payments represented by a number of Annuity Units payable each period. The value of these Annuity Units represents the benefit amount paid each period. For Fixed Annuity options the number of Annuity Units equals the dollar amount of each payment since the Annuity Unit Value is fixed at $1.00. For Variable Annuity options, the Annuity Unit Value varies with the investment rate each period. The Annuity Unit Value is 'the value of one Annuity Unit of an Investment Option. The value of a Variable Annuity Unit is A multiplied by B multiplied by C (AxBxC). A = .the Annuity Unit Value for the Variable Investment Option at the immediately preceding computation date B = 1 + the investment rate for the variable fund for the period C = the applicable AIR Factor from the following table raised to the power of the number of days in the period. AIR AIR Factor 3 % 0.999919 3 1 /2 % 0.999906 4 1 /2 % 0.999879 5 % 0.999866 4.15 Betterment of Rates -Fixed Annuity - We will use the applicable current settlement option rates if these will provide higher fixed annuity payments to the Participant. If a commutation (cash out of remaining annuity payments) is allowed, the rates previously used to calculate the annuity payments will be used for the commutation request. 4.16 Annuity Rate Tables -The value We use to deter- mine annuity payments will be the applied portion of the Accumulation Value on the tenth day (or the preceding business day if the tenth day is not a business day) preceding the date of the first annu- ity payment, less any applicable premium taxes. The following tables are based on the 1983a mortality table and assume births in the year 1900. The tables show the amount required to purchase a first monthly payment of $1.00. Quarterly, semiannual, and annual payments may also be selected. The amount of each payment will depend upon the Annuitant's adjusted age at the time the first payment is due. Adjusted age will be determined in accordance with the following: Calendar Year Adjusted Age is of Birth Actual Age Minus Before 1916 0 1916- 1935 1 1936 - 1955 2 1956 - 1975 3 After 1975 4 Actual age, as used above, means the Annuitant's age at the birthday nearest to the Annuity Date. Table A is the Table to use for Variable Annuities with a 3% AIR (see Section 4.13) and to determine the minimum guarantees for Fixed Annuities. Tables B, C, and D are to be used for Variable Annuities with 3 1/2%, 4 1/2% and 5% AIRs respectively. UITG-194-SW H QROG2ST8 TABLE A DOLLAR AMOUNT REDUIRED TO PURCHASE AN ANNUITY WITH A FIRST MONTHLY PAYMENT OF $1.00 AT AN ASSUMED INVESTMENT RATE OF 3% Options 1, 2 and 3 -- Single Life Annuities Age. 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 None $250.48 246.41 242.26 238.03 233.73 229.35 224.89 220.34 215.71 210.99 206.19 201.30 196.35 191.32 186.24 181.11 175.92 170.70 165.43 160.13 154.78 149.41 144.01 138.61 133.21 127.84 Option 4 --Joint and Survivor Life Annuity Monthly Payments Guaranteed 60 120 180 240 Unit Refund $250,83 $251.98 $254.04 $257.21 $259.24 246.79 248.04 250.27 253.72 255.69 242.68 244.03 246.45 250.21 252.09 238.49 239.95 242.58 246.69 248.43 234.23 235.81 238.67 243.15 244.71 229.88 231.60 234.72 239.60 ' 240:94 225.46 227.32 230.73 236.05 237:12. 220.96 222.98 226.71 232.52 233.24 216.38 218.59 222.65 229.01 229.31 211.72 214.14 218.58 225.54 225.33 206.99 209.63 214.50 222.12 221.29 202.18 205.08 210.42 218.75 217.19 197.31 200.50 206.34 215.47 213.04 192.39 195.88 202.30 212.28 208.83 187.41 191.25 198.29 209.20 204.54 182.40 186.61 194.34 206.25 200.18 177.34 181.97 190.46 203.44 195.73 172.26 177.35 186.66 200.79 191.41 167.15 172.75 182.97 198.31 186.93 162.01 168.18 179.39 196.00 182.35 156.86 163.66 175.95 193.89 178.01 151.71 159.21 172.66 191.97 173.43 146.56 154.85 169.54 190.26 169.01 141.44 150.59 166.61 188.7 3 164.46 136.35 146.45 163.88 187.41 159.83 131.33 142.46 161.36 186.26 155.48 Younger Annuitant: Age of Older Number of Years Younger Than Older Annuitant Annuitant 0 1 2 3 4 5 6 7 8 9 10 50 $280.54 $282.36 $284.24 $286.16 $288.12 $290.13 $292.17 $294.25 $296.35 $298.47 $300.61 51 276.91 278.78 280.70 282.67 284.69 286.75 288.85 290.98 293.13 295.31 297.51 52 273.19 275.10 _ 277.07 279.10 281.17 283.28 285.43 287.62 289.83 292.07 294.33 53 269.37 271.34 273.36 275.43 277.55 279.72 281.93 284.17 286.45 288.74 291.06 54 265.46 267.47 269.54 271.67 273.85 276.07 278.33 280.64 282.97 285.33 287.71 55 261.45 263.51 265.64 267.81 270.05 272.33 274.65 277.01 279.40 281.83 284.27 56 257.34 259.46 261.63 263.86 266.15 268.49 270.87 273.29 275.75 278.23 280.74 57 253.13 255.30 257.53 259.82 262.16 264.56 267.00 269.48 272.00 274.55 277.12 58 248.82 251.04 253.32 255.67 258.07 260.53 263.03 265.58 268.16 270.77 273.40 59 244.40 246.67 249.01 251.42 253.88 256.40 258.97 261.57 264.22 266.90 269.60 60 239.88 242.21 244.60 247.07 249.59 252.17 254.80 257.48 260.19 262.93 265.70 61 235.26 237.64 240.09 242.61 245.20 247.84 250.54 253.28 256.06 258.87 261.71 62 230.54 232.97 235.47 238.06 240.70 243.41 246.17 248.98 251.83 254.71 257.62 63 225.71 228.19 230.76 233.40 236.11 238.88 241.71 244.58 247.50 250.46 253.44 64 220.79 223.32 225.94 228.64 231.41 234.25 237.14 240.09 243.08 246.10 249.16 65 215.78 218.35 221.02 223.78 226.61 229.51 232.47 235.49 238.55 241.65 244.78 66 210.67 213.30 216.02 218.82 221.71 224.68 227.71 230.79 233.93 237.10 240.31 67 205.48 208.15 210.92 213.78 216.72 219.75 222.84 226.00 229.21 232.45 235.74 68 200.20 202.91 205.73 208.64 211.64 214.73 217.88 221.11 224.38 227.71 231.06 69 194.83 197.59 200.45 203.41 206.47 209.61 212.83 216.12 219.46 222.86 226.30 70 189.39 192.19 195.09 198.10 201.21 204.41 207.68 211.03 214.45 217.92 221.43 71 183.87 186.70 189.66 192.71 195.87 199.12 202.45 205.86 209.34 212.88 216.47 72 178.28 181.15 184.14 187.24 190.45 193.75 197.14 200.61 204.15 207.76 211.41 73 172.63 175.53 178.56 181.70 184.96 188.31 191.75 195.28 198.88 202.55 206.27 74 166.94 169.86 172.92 176.10 179.40 182.80 186.29 189.87 193.53 197.26 201.05 75 161.21 164.15 167.23 170.44 173.78 177.22 180.77 184.40 188.11 191.90 195.75 9 QROG2ST9 U ITG-194-SW TABLE B DOLLAR AMOUNT REDUIRED TO PURCHASE AN ANNUITY` WITH A FIRST MONTHLY PAYMENT OF $1.00 AT AN ASSUMED INVESTMENT RATE OF 3 1 J2% Options 1, 2 and 3 -- Single Life Annuities Monthly Payments Guaranteed Age None 60 120 180 240 Unit Refund 50 $233.36 $233.71 $234.82 $236.75 $239.66 $240.70 51 229.87 230.25 231.45 233.54 236.72 237.65 52 226.30 226.72 228.01 230.29 233.74 234.54 53 222.65 223.10 224.51 226.98 230.75 231.36 54 218.93 219.41 220.93 223.62 227.73 228.12 55 215.11 215.64 217.28 220.22 224.70 224.82 56 211.21 211.78 213.57 216.77 221.66 221.45 57 207.23 207.84 209.79 213.28 218.62 218.02 58 203.15 203.81 205.94 209.76 215.60 214.53 59 198.98 199.70 202.03 206.21 212.60 210.96 60 194.73 195.51 198.06 202.64 209.63 207.33 61 190.38 191.24 194.04 199.05 206.70 203.63 62 185.95 186.90 189.97 195.47 203.84 199.85 63 161.45 182.50 185.86 191.89 201.06 195.99 64 176.88 178.03 181.73 188.35 198.37 192.18 65 172.25 173.52 177.57 184.84 195.78 188.25 66 167.56 168.95 173.41 181.39 193.31 184.24 67 162.81 164.34 169.24 178.00 190.97 180.31 68 158.01 159.70 165.09 174.70 188.78 176.25 69 153.16 155.01 160.95 171.49 186.75 172.11 70 148.26 150.30 156.85 168.40 184.88 168.10 71 143.31 145.57 152.79 165.44 183.18 163.94 72 138.33 140.83 148.81 162.62 181.65 159.70 73 133.32 136.10 144.91 159.98 180.30 155.66 74 128.31 131.39 141.11 157.51 179.12 151.45 75 123.30 126.73 137.44 155.22 178.10 147.15 Option 4 --Joint and Survivor Life Annuity Younger Annuitant: Age of Older Number of Years Younger Than Older Annuitant Annuitant 0 1 2 3 4 5 6 7 8 9 10 50 $259.51 $261.02 $262.56 $264.14 $265.75 $267.38 $269.05 $270.72 $272.42 $274.13 $275.84 51 256.50 258.05 259.64 261.26 262.92 264.61 266.32 268.06 269.80 271.57 273.33 52 253.39 254.99 256.63 258.30 260.01 261.75 263.52 265.30 267.11 268.92 270.75 53 250.19 251.84 253.53 255.25 257.01 258.80 260.62 262.47 264.33 266.20 268.08 54 246.90 248.59 250.33 252.11 253.92 255.77 257.64 259.54 261.46 263.39 265.33 55 243.51 245.25 247.04 248.87 250.74 252.64 254.57 256.53 258.51 260.50 262.50 56 240.02 241.82 243.66 245.54 247.47 249.42 251.41 253.43 255.46 257.52 259.58 57 236.43 238.28 240.17 242.11 244.09 246.11 248.16 250.23 252.33 254.44 256.57 58 232.74 234.64 236.59 238.58 240.62 242.70 244.81 246.94 249.10 251.28 253.47 59 228.94 230.89 232.90 234.95 237.05 239.19 241.36 243.56 245.78 248.03 250.28 60 225.03 227.04 229.10 231.22 233.38 235.58 237.81 240.08 242.37 244.68 247.00 61 221.02 223.08 225.20 227.38 229.60 231.87 234.17 236.50 238.85 241.23 243.62 62 216.90 219.02 221.20 223.43 225.72 228.05 230.42 232.82 235.24 237.69 240.15 63 212.68 214.85 217.09 219.38 221.73 224.13 226.56 229.03 231.53 234.05 236.58 B4 208.35 210.58 212.87 215.23 217.64 220.10 222.61 225.15 227.71 230.31 232.91 65 203.92 206.20 208.55 210.97 213.44 215.97 218.55 221.16 223.80 226.46 229.15 66 199.40 201.73 204.13 206.60 209.14 211.74 214.38 217.06 219.78 222.52 225.28 67 194.78 197.16 199.61 202.14 204.74 207.40 210.11 212.87 215.66 218.48 221.31 68 190.06 192.49 195.00 197.58 200.24 202.96 205.74 208.57 211.43 214.33 217.24 69 185.25 187.72 190.28 192.92 195.64 198.42 201.27 204.16 207.10 210.07 213.07 70 180.35 182.87 185.48 188.17 190.95 193.79 196.70 199.66 202.67 205.72 208.79 71 175.35 177.92 180.58 183.33 186.16 189.06 192.03 195.06 198.14 201.26 204.41 72 170.28 172.89 175.60 178.40 181.28 184.24 187.27 190.37 193.51 196.70 199.93 73 165.14 167.78 170.53. 173.38 176.32 179.34 182.43 185.58 188.80 192.06 195.36 74 159.93 162.60 165.39 168.29 171.28 174.35 177.50 180.72 183.99 187.32 190.69 75 154.67 157.37 160.19 163.13 166.16 169.29 172.49 175.77 179.11 182.51 185.95 10 UITG-194-SW QROG2STA TABLE C DOLLAR AMOUNT REt~UIRED TO PURCHASE AN ANNUITY WITH A FIRST MONTHLY PAYMENT OF $1.00 AT AN ASSUMEDINVESTMENTRATE OF 41f2% Options 1, 2 and 3 -- Single Life Annuities Monthly Payments Guaranteed Age None 60 120 180 240 Unit Refund 50 $204.42 $204.75 $205.77 $207.48 $209.94 $209.57 51 201.83 202.19 203.30 205.15 207.83 207.29 52 199.16 199.55 200.75 202:77 205.68 204.94 53 196.41 196.84 198.14' 200.33 203.51 202.52 54 193.58 194.05 195.45 197:84 201.30 200.04 55 190.67 191.17 192.70 195.30- 199.07 197.48 56 187.67 188.21 189.87 192:70 196.83 194:84 57 184.58 185.17 186.97 190.07 194.57 192.18 58 181.40 182.04 184.00 187.39 192.31 189.42 59 178.12 178.82 180.97 184.67 190.06 186.59 60 174.75 175.51 177.87 181.92 187.82 183.68 61 171.28 172.12 174.70 179.14 185:60 180.76 62 167.73 168.64 171.48 176.35 183.42 177:73 63 164.09 165.09 168.21 173.55 181.29 174.63 64 160.36 161.48 164.90 170.76 179:22 171.46 65 156.57 157.79 161.55 167.99 177.22 168.31 66 152.70 154.05 158.18 165.24 175.31 165.04 67 148.76 150.24 154.78 162.54 173.49 161.70 68 144.75 146.38 151.38 159.88 171.78 158.28 69 140.67 142.46 147.97 157.30 170.19 154.96 70 136.53 138.50 144.57 154.80 168.72 151.48 71 132.31 134.50 141.20 152.39 167.38 147.92 72 128.04 130.46 137.87 150.10 166.17 144.48 73 123.73 126.41 134.59 147.93 165.10 140.90 74 119.38 122.37 131.39 145.90 164.16 ~ 137.25 75 115.01 118.33 128.27 144.02 163.35 133.53 Option 4 --Joint and Survivor Life Annuity Younger Annuitant: Age of Older Number of Years Younger Than Older Annuitant Annuitant 0 1 2 3 4 5 6 7 8 9 10 50 $224.40 $225.44 $226.49 $227.57 $228.65 $229.75 $230.86 $231.97 $233.08 $234.19 $235.30 51 222.31 223.38 224.48 225.60 226.73 227.87 229.02 230.17 231.33 232.49 233.65 52 220.13 221.25 _ 222.39 223.55 224.72 225.91 227.11 228.31 229.52 230.72 231.93 53 217.87 219.03 220.22 221.42 222.64 223.88 225.12 226.37 227.63 228.88 230.14 54 215.52 216.73 217.96 219.21 220.48 221.76 223.06 224.36 225.66 226.97 228.27 55 213.08 214.34 215.61 216.91 218.23 219.56 220.91 222.26 223.62 224.98 226.33 56 210.55 211.85 213.18 214.53 215.90 217.28 218.68 220.08 221.49 222.91 224.32 57 207.92 209.27 210.65 212.05 213.47 214.91 216.36 217.82 219.29 220.76 222.22 58 205.19 206.59 208.03 209.48 210.96 212.45 213.96 215.48 217.00 218.52 220.05 59 202.36 203.82 205.30 206.81 208.35 209.90 211.46 213.04 214.62 216.20 217.79 60 199.43 200.94 202.48 204.05 205.64 207.25 208.87 210.51 212.15 213.80 215.44 61 196.39 197.95 199.55 201.18 202.83 204.50 206.19 207.89 209.59 211.30 213.01 62 193.24 194.86 196.51 198.20 199.91 201.65 203.40 205.16 206.94 208.71 210.48 63 189.98 191.66 193.37 195.12 196.90 198.70 200.51 202.34 204.18 206.03 207.87 64 186.62 188.35 190.13 191.93 193.77 195.64 197.53 199.42 201.33 203.24 205.16 65 183.16 184.94 186.77 188.64 190.55 192.48 194.43 196.40 198.38 200.36 202.35 66 179.59 181.42 183.31 185.24 187.21 189.21 19123 193.27 195.32 197.38 199.44 67 175.91 177.80 179.75 181.74 183.77 185.83 187.93 190.04 192.16 194.30 196.43 68 172.13 174.07 176.07 178.12 180.22 182.35 184.51 186.70 188.90 191.11 193.32 69 168.24 170.24 172.30 174.41 176.56 178.76 180.99 183.25 185.52 187.81 190.10 70 164.24 166.30 168.41 170.58 172.80 175.06 177.36 179.69 182.04 184.41 186.78 71 160.14 162.25 164.42 166.65 168.94 171.26 173.63 176.03 178.46 180.90 183.35 72 155.95 158.10 160.33 162.62 164.97 167.36 169.80 172.27 174.77 177.28 179.82 73 151.66 153.86 156.15 158.49 160.90 163.36 165.86 168.40 170.97 173.57 176.18 74 147.29 149.54 151.87 154.27 156.74 159.26 161.83 164.44 167.08 169.75 172.44 75 142.84 145.13 147.50 149.96 152.48 155.07 157.70 160.38 163.10 165.84 168.60 11 U ITG-194-SW aRO~zsre TABLE D DOLLAR AMOUNT REQUIRED TO PURCHASE AN ANNUIT`` WITH A FIRST MONTHLY PAYMENT OF $1.00 AT AN ASSUMED INVESTMENT RATE OF 5% Options 1, 2 and 3 -- Single Life Annuities Monthly Payments Guaranteed Age None 60 120 180 240 Unit Refund 50 $192.14 $192.47 $193.45 $195.06 $209.94 $196.46 51 189.89 190.25 191.32 193.06 195.52 194.47 52 187.57 187.96 189.12 191.01 193.69 192.45 53 185.18 185.60 186.85 188.91 191.83 190.34 54 182.70 183.16 184.51 186.76 189.94 188.17 55 180.14 180.64 182.11 184.55 188.03 185.92 56 177.50 178.04 179.63 182.30 186.09 183.60 57 174.77 175.35 177.09 180.00 184.14 181.21 58 171.95 172.58 174.47 177.65 182.18 178.81 59 169.03 169.71 171.79 175.27 180.22 176.29 60 166.02 166.77 169.04 172.85 178.27 173.70 61 162.91 163.73 166.22 170.40 176.34 171.03 62 159.72 160.62 163.35 167.93 174.43 168.35 63 156.43 157.42 160.43 165.45 172.56 165.57 64 153.06 154.16 157.45 162.97 170.74 162.71 65 149.62 150.82 154.44 160.50 168.98 159.78 66 146.09 147.42 151.40 158.04 167.30 156.86 67 142.49 143.95 148.32 155.62 165.69 153.83 68 138.82 140.42 145.24 153.24 164.18 150.73 69 135.07 136.83 142.14 150.92 162.77 147.55 70 131.25 133.19 139.04 148.66 161.46 144.44 71 127.35 129.50 135.96 146.49 160.27 141.20 72 123.39 125.77 132.90 144.42 159.20 137.89 73 119.38 122.02 129.89 142.45 158.24 134.51 74 115.32 118.25 126.94 140.61 157.41 131.31 75 111.23 114.50 124.08 138.90 156.68 127.92 Option 4 --Joint and Survivor Life Annuity Younger Annuitant: Age of Older Number of Years Younger Than Older Annuitant Annuitant 0 1 2 3 4 5 6 7 8 9 10 50 $209.69 $210.56 $211.44 $212.32 $213.22 $214.12 $215.03 $215.93 $216.84 $217.74 $218.64 51 207.94 208.84 209.76 210.69 211.62 212.56 213.51 214.46 215.41 216.35 217.29 52 206.11 207.05 208.01 208.98 209.96 210.94 211.93 212.92 213.91 214.90 215.88 53 204.21 205.19 206.18 207.19 208.21 209.24 210.28 211.31 212.35 213.38 214.40 54 202.21 203.24 204.28 205.33 206.40 207.47 208.55 209.63 210.71 211.79 212.86 55 200.14 201.21 202.29 203.39 204.50 205.62 206.75 207.88 209.01 210.13 211.25 56 197.97 199.09 200.22 201.37 202.53 203.69 204.87 206.05 207.22 208.40 209.57 57 195.72 196.88 198.06 199.26 200.46 201.68 202.91 204.14 205.37 206.60 207.82 56 193.37 194.58 195.81 197.05 198.32 199.59 200.86 202.15 203.43 204.71 205.99 59 190.92 192.18 193.46 194.76 196.07 197.40 198.73 200.07 201.41 202.75 204.08 60 188.36 189.68 191.01 192.37 193.74 195.12 196.51 197.91 199.30 200.70 202.09 61 185.71 187.08 188.47 189.88 191.31 192.75 194.20 195.65 197.11 198.56 200.01 62 182.95 184.37 185.82 187.29 188.78 190.28 191.79 193.31 194.83 196.34 197.65 63 180.09 181.56 183.07 184.60 186.15 187.71 189.28 190.87 192.45 194.03 195.61 64 177.12 178.65 180.21 181.80 183.41 185.04 186.68 188.33 189.98 191.62 193.27 65 174.04 175.63 177.25 178.90 180.57 182.26 183.97 185.69 187.40 189.12 190.83 66 170.86 172.50 174.18 175.89 177.62 179.38 181.16 182.94 184.73 186.52 188.30 67 167.57 169.27 171.00 172.77 174.57 176.40 178.24 180.10 181.96 183.82 185.68 68 164.18 165.93 167.72 169.55 171.41 173.30 175.21 177.14 179.08 181.01 182.95 69 160.67 162.48 164.33 166.22 1 B8.14 170.10 172.08 174.08 176.09 178.10 180.11 70 157.06 158.92 1 B0.83 162.78 164.77 166.79 168.84 170.91 173.00 175.09 177.18 71 153.34 155.25 157.22 159.23 161.29 163.38 165.50 167.64 169.80 171.96 174.13 72 149.51 151.48 153.51 155.58 157.70 159.86 162.05 164.26 166.49 168.74 170.98 73 145.59 147.61 149.69 151.83 154:01 156.24 158.49 160.78 163.08 165.40 167.73 74 141.58 143.65 145.78 147.97 150.22 152.51 154.84 157.19 159.57 161.97 164.37 75 137.49 139.59 141.77 144.02 146.33 148.68 151.08 153.51 155.96 158.43 160.91 12 QROG2STC U ITG-194-SW DOLLAR AMOUNT REQUIRED TO' PURCHASE AN ANNUITY WITH A FIRST MONTHLY PAYMENT OF $1 Aa' ' Option 5 -- Payment for a Designated Period Years of Payment Year~f Payment 5 $ 55.83 18 $167.79 6 86.05 19 174.52 7 75.99 20 181.49 8 85.62 21 187.97 9 94.97 22' 194.17 10 104.06 23 200.40 11 112.87 24 206.61 12 121.36 25, 212.31 13 129.70 26 217.86 14 137.74 27 223.71 15 145.56 28 228.83 16 153.14 29 234.19 17 160.51 30 239.23 Frequency of Payments. Annuity payments under this Contract will be made monthly. If such payments would amount to less than $25 each, We reserve the right to make less frequent payments. If at any time the annual rate of payment to any payee is less than $100, We may make a lump sum payment of the remaining annuity value. 4.17 Beneficiaries and make payments on that basis. (a) Definition of Beneficiary. A Beneficiary is the (e} Multiple Beneficiaries. The Participant may person or entity the Participant designates to designate two or more Beneficiaries to receive receive any benefits payable upon the separate percentage interests in the death Participant's death. benefits payable under this Contract. Each (b) Designation of Beneficiary. During the Partio- such Beneficiary may separately exercise the ipant's lifetime, he or she has the right to rights that a Beneficiary has under this designate a Beneficiary and to change the Contract. designation. The change may be made by (f) Trust or Estate as Beneficiary. Payments to a sending a written request to Our Home Office. beneficiary that is a trust or estate will be The change will take effect when We have made only in a lump sum or in installments recorded the change. However, after the over a period not to exceed five years. change is recorded, the change will be 4.18 Death Payment Provisions deemed effective as of the date of the written (a) Death During Accumulation Period. If the request for change. The change will be Participant dies during the Accumulation subject to any payment made or action taken Period, a death benefit described in (1) or (2) by Us before the request is recorded. below is payable. (c) Payments to Beneficiary. Unless otherwise (1 } If the Participant dies on or after age 70, provided in the Beneficiary designation: the death benefit is the greater of (a) the (1) If any Beneficiary dies prior to the Accumulation Value of the Participant's Participant, that Beneficiary's interest will Account on the date We receive proof of pass to any other Beneficiary according to death, or (b} 100% of Purchase Payments the surviving Beneficiary's respective reduced by the amount of any prior with- interest. drawals and further reduced by any (2) If no Beneficiary survives the Participant, portion of the Accumulation Value that has death benefits will be paid to the been applied under an Annuity Income Participant's estate. Option. (3) If any Beneficiary dies after the Partic- (2) If the Participant dies before age 70, the ipant, that Beneficiary's interest will pass death benefit is the sum of the benefits to his or her Beneficiary or, if none, to his under the Fixed Interest Options and the or her estate. Variable Investment Options, as follows: (d) Simultaneous Death Provision. If We cannot The benefit under the Fixed Interest determine whether the Participant or a Options is the greater of: Beneficiary died first in a common disaster, We will assume that the Beneficiary died first U ITG-194-SW 13 ~ROG2STD (a) the Fixed Interest Option Values on the date We receive proof of death; or (b) 100% of Purchase Payments allo- cated to the Fixed Interest Options. reduced by the amount of any prior withdrawals or transfers from Fixed Interest Options and further reduced by any portion of the Accumulation Value that has been applied under an Annuity Income Option. The benefit under the Variable Investment Options is the greater of: (a) the Variable Investment Option Values on the date We receive proof of death, or (b) 100% of Purchase Payments allo- cated to Variable Investment Options reduced by the amount of any prior withdrawals or transfers from the Variable Investment Options, plus interest at an annual rate of 3%. For this purpose, all amounts transferred into Variable Investment Options are considered Purchase Payments allo- cated to Variable Investment Options. Subject to Section 5.03, the death benefit is payable at any time the Participant's Bene- ficiary selects and in any form the Participant could have selected under this Contract. (b) Death During Annuity Period. If the Partic- ipant dies during the Annuity Period, the amount of the death benefit, if any, will be based on the terms of the Annuity Income Option. Unless the Participant elected the Fourth Option, the Beneficiary may elect to receive the death benefit in .one of the following forms: (1) Continuing annuity payments under the terms of the Participant's Annuity Income Option with the right, for Variable Annuities only, to receive the remaining payments in a lump sum at any time thereafter; (2} A lump sum; or (3} Annuity payments under another Annuity Income Option, based on the available lump sum and subject to the limitations of Section 5.03. The lump sum available under these alter- natives is the present value of remaining pay- ments, discounted at the Assumed Investment Rate, and based on the current Annuity Unit Value for (2) and (3), or the value next determined after receipt of the request at VALIC's Home Office for (1 }, (c) Investment Options and Other Rights, Until the death benefits have been fully paid, the Participant's Beneficiary will be entitled to exercise all the Investment Options and other rights the Participant can exercise under this Contract. Unpaid death benefits that have not been applied under an Annuity Income Option will have an Accumulation Value determined in the same manner as the Participant's Accumulation Value. (d) Proof of Death Proof of death may be made by sending VALIC a certified copy of the death certificate, a certified copy of a decree of a court of competent jurisdiction as to death, a written statement by an attending physician, or any other proof satisfactory to VALIC , 14 U ITG-194-SW QROG2STE Section 5 -CODE REQUIREMENTS AND RETIREMENT ~ (b} Minimum Annual Withdrawals. The minimum PLAN PROVISIONS withdrawaV is set each year based on the 5.01 Salary Reduction Purchase Payments - If the Accumulation Value and the life expectancy ' Participant's Purchase Payments are made under a s of the Participant and the Participant voluntary salary reduction agreement as part of a Beneficiary. The Participant may elect to have ' Tax-Deferred Annuity arrangement under Section s life expectancies computed for each year 403(b) of the Code, i) there may not be a separate distribution, or to use the life expectancies Plan document, in which case the Contract is the computed at the first distribution (reduced by Plan, and ii) in either case the following restrictions one year for each annual withdrawal) for all ' apply: s later distributions. If the Participant ' s spouse, Beneficiary is not the Participant (a) Limit on Purchase Payments. A Participant's the annual withdrawal must meet the salary reduction Purchase Payments may not minimum distribution incidental benefit exceed the limits of Section 402(g) of the requirements. Code. We reserve the right to refund excess Purchase Payments. (c) Annuity Income Option. If the Participant elects payments under an Annuity Income (b) Withdrawal Restrictions. The Participant's Option, the guaranteed or expected period of Accumulation Value attributable to salary payments under the Annuity Income Option reduction Purchase Payments cannot be with- may not exceed the Participant's life drawn or otherwise distributed before the expectancy and that of the Participants Bene- Participant is 59 1/2 years old, unless the ficiary at the Annuity Date, or a shorter period Participant (1) has separated from service if the Participant's Beneficiary is not the with the employer maintaining the Plan, (2) Participant's spouse. dies, (3) becomes disabled (see Section 4.06(c)), or (4) has incurred a hardship (d) 403(b) Exception to General Rule. Any (hardship withdrawals are not available for amount added to the Contract which was earnings on salary reduction purchase initially within a Section 403(b) contract prior payments). This limitation will be applied in a to January 1, 1987 and continually since then, manner consistent with the requirements of may either be paid in a manner which meets Section 403(b)(11) of the Code. Equivalent these rules or must (1) begin to be paid when withdrawal restrictions apply to any portion of the Participant is age 75; and (2) the present the Accumulation Value that is attributable to value of payments expected to be made to the Purchase Payments representing amounts Participant, over life, under the option chosen directly transferred from a custodial account must exceed 50% of the present value of all " under Section 403(b)(7) of the Code. the 50% payments expected to be made ( ' s entire rule"). Notwithstanding, the Participant 5.02 Minimum Distributions After Age 701/2 Section 403(b) Contract balance must meet (a) General Rules. The Participant's benefits the minimum distribution incidental benefit under the Contract must satisfy minimum requirement of Section 403(b)(10). distribution rules of the applicable section of the Code and regulations issued by the 5.03 Min imum Death Benefit Distributions Secretary of the Treasury under the (a) General Rules. The death benefit, if any, pay- applicable section. These minimum able to the Participant's Beneficiary must also distribution rules generally require that satisfy the rules of Section 401(a)(9)(B), benefits begin after the Participant is 70 1/2 Section 403(b}(10) or Section 457(d), years old and that the minimum amount is whichever may be applicable, and the paid each year. Payments may be made in regulations issued under such sections by the the form of annual withdrawals or under an Secretary of the Treasury. The post-death Annuity Income Option. rules of these sections limit the extent to Code Sections which apply are: (i) Section which a Beneficiary may delay payment of 401(a)(9) for contracts issued for a Plan death benefits. The Participant's Beneficiary intended to meet Sections 401(a} and/or may satisfy these rules by receiving a lump 403(a), (ii) Section 403(b)(10) for Section 403(b) contracts, and (iii} Section 457(d) for deferred compensation plans under Section 457. U ITG-194-SW 15 QROG2STF sum, annual withdrawals, or payments under an Annuity Income Option. (b) Death Before Distributions Begin. If the Partic- ipant dies before payments under an Annuity Income Option (or post-age 70 1/2 withdrawals) have begun, the Participant's Beneficiary must either receive the whole benefit by the end of the fifth year following the year of the Participant's death or receive the benefit in installment payments over his or her life or life expectancy if payments begin by the calendar year following the year of the Participant's death. The Participant's spouse beneficiary may delay distributions until the Participant would have reached age 70 1/2. (c} Death After Distributions Begin. If the Partic- ipant dies after payments under an Annuity Income Option (or post-age 70 1/2 with- drawals) have begun, the death benefit must be paid at least as fast as under the method the Participant selected. 5.04 Direct Rollovers - If any benefit payable under this Contract constitutes an "eligible rollover distribution" within the meaning of Section 402 of the Code, the Participant has the right to elect to have such distri- bution paid directly to an "eligible retirement plan" in a transaction designated under the Code as a "direct rollover." Before any eligible rollover distri- bution is made to the Participant, we will provide the Participant with a written explanation of the Participant's right to make a direct rollover and the tax consequences of making or not making a direct rollover. No surrender, withdrawal, or other benefit distribution that constitutes an eligible rollover distribution will be made to the Participant under this Contract, unless the Code's requirements applicable to eligible rollover distributions have been satisfied. Except for eligible rollover distributions, We reserve the right to make payments only to the Participant or the Participant's Beneficiary. 5.05 Plan Provisions -The Plan, including certain Plan provisions required by the Employee Retirement Income Security Act of 1974 (FRIBA) or other applicable law, may limit the Participant's rights under this Contract. The Plan provisions may: (a) Limit the Participant's right to make Purchase Payments; (b) Restrict the time when the Participant may elect to receive payments under this Contract; (c) Require the consent of the Participant's spouse before the Participant may elect to receive payments under this Contract; (d) Require that all distributions be made in the form of a joint and survivor annuity for the Participant and the Participant's spouse, unless both consent to a different form of distribution; (e} Require that the Participant's spouse be designated as Beneficiary; (f) Require that the Participant remain employed with the Contract Owner for a specified period of time before the Participant's rights under the Contract become fully vested; or (g) Otherwise restrict the Participant's exercise of rights under the Contract or give the Contract Owner (or a Plan representative) the right to exercise certain rights on the Participant's behalf. No such Plan provision shall limit a Participant's rights under this Contract, unless the Contract Owner has provided VALIC with written notification of such provision. In no event shall any such Plan provision enlarge VALIC's obligations under this Contract. 5.06 Nonqualified Deferred Compensation Plans - If the Contract has been issued for a nonqualified and unfunded deferred compensation plan, the Contract Owner possesses all rights under the Contract. No Participant or Beneficiary will have any enforceable right to make elections under this Contract or to receive benefits from VALIC. The Contract Owner may direct that all benefit payments be made to the Contract Owner, or the Contract Owner may authorize VALIC to make benefit payments directly to Participants and Beneficiaries as the Contract Owner's payment agent under the Plan. The Contract Owner may also authorize VALIC to follow Participant requests with regard to the allocation of Purchase Payments among Investment Options, transfers among Investment Options, and other elective rights provided by this Contract. If the Contract Owner authorizes VALIC to act as payment agent under the Plan or to follow Participant requests, the Contract Owner may revoke or modify that authorization at any time without prior notice to Participants. 16 U ITG-194-SW QROG2STG Section 6 -GENERAL PROVISIONS 6.01 Participant Certificates - We will issue certificates to each Participant unless this Contract is issued with respect to a nonqualified and unfunded deferred compensation plan. Each certificate will set forth the benefits to which the Participant is entitled under the Contract. Certificates are not a part of this Contract. 6.02 Assignment - This Contract cannot be sold, assigned, discounted, or pledged as collateral for a loan or as security for the pertormance of an obligation. The benefits, values, and rights under this Contract are not subject to any creditor claims to the fullest extent permitted by law. This Contract and its rights cannot be transferred to anyone other than Us, except as provided under the Plan or under a domestic relations order properly issued by a court of competent jurisdiction and that complies with ERISA, if applicable. To the extent permitted by the Code and applicable law, We will make a Cash Surrender or Withdrawal payable to a third parry upon the Participant's request. 6.03 Vesting - Except as may be provided in the Plan, the Participant's rights under this Contract are fully vested and nonforfeitable. Separate Account A holds all assets for Variable Investment Options for the exclusive benefit of Participants, Beneficiaries, and other holders of annuity contracts. 6.04 Written Notices to Us - Except as specifically provided otherwise, any Notice of change, election, choice, option or other exercise of right given under the Contract must be in writing on a form provided by Us, or on a form and in a manner acceptable to Us. Such Notice will be effective when it is received in Our Home Office. 6.05 Change of Contract - We may change this Contract to the extent it is required or deemed advisable to do so in order to conform the Contract to applicable law. In addition, upon at least 30 days written notice to the Contract Owner, we may make other changes to this Contract that will apply only to individuals who become Participants after the effective date of such change. All changes We make will be subject to any applicable regulatory requirements. 6.06 Future Participants - We may at our discretion curtail or prohibit new Participants under this Contract upon written notice to the Contract Owner. 6.07 Reports - We will send the Participant a Separate Account financial report twice each year if the Participant has values in any Variable Investment Option. We will send to the Participant, at least annually, a statement showing the dollar value of all investment options, investment performance since the prior statement, and as applicable, the number and value of any Variable Accumulation Units credited to the Participant's ,Account. All .statements will be mailed within two months of the date of the information. 6.08 Voting Rights - We will.. hold tl~e voting rights on all shares- held in the. Separate: Account. To the extent of this Contract's participation- in the Separate Account through one or more Variable Investment Options, We will vote those shares as instructed. The Participant, or the Beneficiary, if the Participant has died, will have the voting instruction rights prior to the Annuity Date. The annuity payee will have the voting instruction rights on and after the. Annuity Date. 6.09 Suspension of Payments -VALIC reserves the right to suspend payments under the Separate Account for any period when: (a) the New York Stock Exchange is closed (other than customary weekend. and holiday closings); (b) when trading on the Exchange is restricted; (c) when an emergency prevents disposal of securities held in the Separate Account or it is not reasonably practicable to determine the value of the Separate Account's net assets; or (d) during any other period when the Securities and Exchange Commission, by order, so permits for the protection of security holders. 6.10 Deferral of Cash Surrender or Withdrawal- - VALIC may defer payment of any surrender of amounts accumulated in Fixed Interest Options. Deferral shall not exceed six months from the receipt of written notice at the Home Office. Interest shall be paid if payment is deferred for thirty days or more at a rate as determined by VALIC. 6.11 Proof of Survival - We reserve the right to require satisfactory proof that the Participant and any payee is alive on the date any benefit payment is due. If this proof is not received after requested in writing, VALIC will have the right to make reduced payments or to withhold payments entirely until such proof is received. 6.12 Substitution of Investment Fund Shares - If shares of a particular Investment Fund are not available or if, in the judgment of VALIC, such shares are no longer appropriate for a Variable Investment Option, shares of another Investment Fund may be substituted for the Investment Fund shares already held under the Variable Investment Option and for those to be purchased by future Purchase Payments or transfers under this Contract. In the event any substitution occurs, VALIC will notify the Contract Owner within five days. 6.13 Minimum Benefit - The paid up annuity, cash surrender or death payment available under this Contract will not be less than the minimum benefits required by any statute of the state in which the Contract is delivered. 17 U ITG-194-SW QROG2STH 6.14 Separate Account -That portion of the assets of the Separate Account equal to the reserves and other contract liabilities with respect to the Separate Account shall not be chargeable with liabilities arising out of any other business We may conduct. Income, gains and losses, whether or not realized, from assets allocable to the Separate Account are credited to or charged against such account without regard to Our other income, gains or losses. 18 U ITG-194-SW QROG2ST1 SECTION 457 DEFERRED COMPENSATION PLAN ADOPTION AND SERVICES AGREEMENT This agreement ("Agreement") co prises the General Terms below and Addenda attached hereto, effective ____ ~ _L_____, 20 c~zand continuing until terminated as provided herein, which Addenda i clude the following as indicated: _ ~ Administrative Services Addendum, an agreement for administrative services pertaining to accounting for deferrals, disbursements of funds, proper reporting to Participants and the Internal Revenue Service, and withholding of taxes, if applicable, between the employer designated in Section I ("Employer") and the Service Provider designated in the Administrative Services Addendum; and _____ Custodial Account Addendum, an agreement for custodial services between Employer and the Custodian designated therein; and/or _____ Rabbi Trust Addendum, an agreement for trust services between Employer and the Trustee designated therein. This Agreement also constitutes an adoption by Employer of an eligible deferred compensation plan under section 457 of the Internal Revenue Code of 1986, as amended, as described in the Plan Document Addendum attached hereto. GENERAL TERMS I. Employer: The Employer is Employer's address is:_3 ? _ t ___T Employer's Tax ID Number is: ___ C l`'1' o r MPS ~ C i a ~1 2- Ca~voZZ-s" tl. Plan: Employer hereby adopts effective =.~,~ ~~~_ (insert date) the plan that is set forth in its entirety in the Plan Document Addendum, as a (_/) new plan known as G,f~ of M~_~: u.,__~e ~~~-~_ ~? ~ ~fi~~ =____ Plan/( __) amendment and restatement of an existing plan originally effective __.~/~ _____. (Mark one; if restatement, identify the pl~~ being amended and restated here; otherwise, enter "N/A": ---------------------f-V-----------------------------------------------~. Employer warrants that it possesses sufficient authority to adopt or amend its plan as set forth herein. Employer shall have exclusive authority to amend the Plan Document Addendum. However, no such amendment shall alter the rights or responsibilities of the Service Provider, Custodian or Trustee without its advance written consent. III. Governing Law; Counterparts: Except where Federal laws would otherwise control or as otherwise provided herein, this Agreement shall be interpreted under the laws of the state in which the Employer is located. This Agreement shall be subject to any applicable State, county or local deferred compensation rules and regulations. This Agreement may be executed in any number of counterparts, each of which shall be considered an original of this Agreement. Z GENERAL 8~ GQDC IV. Amendment: Except as otherwise provided herein, any amendments to this Agreement or to the Plan Document Addendum (except as otherwise provided in Section II hereof) must be in writing and signed by the Employer and, as applicable, Service Provider, Custodian or Trustee. V. Entire Agreement: Executed by the authorized representatives of the parties, this Agreement together with the referenced Addenda constitutes the entire intent of the parties hereto, and supersedes all prior agreements and understandings, both written and oral, between the parties with respect to the subject matter of the Agreement. By signature below, the duly authorized representative of Employer acknowledges and represents that Employer has read and understands the terms and conditions of the Agreement and agrees to be legally bound by such terms and conditions. EMPLOYER: ~~ ------~ ~~~~ ----------------- Signature PRINT N1 ~-ME: _ ~ ~` ~~R-_ S~e ~___ DATE:__ 11-~~~z-------------- SERV E PRO IDER: -- -- ~_- -- -- ---- ~A L ! G- Signature PRINTN~E:_Er_l.~_S_ e^s¢~___--_ TITLE:__ ,~ u ~, a (_ A dam; s ~ r ----- -- - DATE:----~-~__ t t _o?='-=--------- GENERAL & GQDC VALI C The Variable Annuity Life Insurance Comparry A Member of American 6nernational Group, Inc. AIG Portfolio Director Group Master Application Please print clearly, do not highlight or write in margins. APPLICANT I~ Employer OR ~~ Other: Name: Grfti cF /f'fe~'~rk~ r~~~~~ S~cP.aeC ` Tax ID#: ~ 000 22-5 - /I Address: 33 ~. J-Cts`lo /e Clty: Nie r~ d . u ~ State: ! ~ ZIP: ~3 ~ `~ Z Plan Administrator Address (if different from above) Atldress-~ City: State: ZIP: Telephone#: 2 0 ~ ' $S~$ - `f`f 3 3 OWNERSHIP/CONTROL For Deferred Compensation: For other Lines of Business (choose one): ~1 Employer ^ Trustee O Other: STATEMENTS AND AGREEMENTS A current prospectus for the Company's Separate Account with Privacy Notice for the contract was provided with this application. The prospect for the Separate Account provides sales expenses and other data. It is understood that annuity payments (and termination values, if any) provided by the contract applied for are variable and not guaranteed as to dollar amount when based on the investment experience of the Company's Separate Account. I understand chat I am applying for an annuity that may offer aMulti-Year Enhanced Fixed Option that may t subject to a market value adjustment, as regulated by state law. If su option is allowed in the state governing my plan and Is selected, the account value Is subject to an adjustment if funds are withdrawn prio io the end of the applicable term. The adjustment may increase or decrease the account values. Assets in such option may be invested either the general asseis of the Company or in a Separate Account of Company, depending on state requirements. it is understood and agrE that the investment options under the contract will be limited to those options selected except as otherwise modified by agreement between th TYPE OF PLAN (choose one) Company and the Applicant, and will be subject to any other limitations :.', 403(b) Voluntary Deferred Annuity described in the contract. I hereby acknowledge that I have read and L; 403(b) State Optional Retirement Plan understand the Information and Instructions page. r-~ 403(b) Employer Retirement Plan ld'Deferred Compensation Plan (choose one): REPLACEMENT J~457(b) Public Employer Is this a replacement of an existing group contract? ~=Plo n Yes (-) 457(b) Private Non-Profit If yes, complete the following: i-1 Other: CJ 401 (a) or 403(a) Employer Retirement Plan Contract Owner: is--; 401(a) or 403(a) Self Employed Retirement Plan 401 (k) Cash or Deferred Arrangement Provider Name: LJ Other: Policy Number(s): Name of Plan: r'F ~ . u ¢ e Cow, ,.-Safi°^ ~k N REQUIRED SIGNATURE TYPE OF ORGANIZATION (choose one) [~ PS -Public Educational Institutions ~ NP -Non-Profit Organizations (choose one): C~ 501(c)(3) -Attach IRS determination letter ~ Other !:__ PFP -Private For-Profit Organizations pcSLGOV - State and Local Governments l ..;SELF -Self Employed Individuals Nature of Business: C ~~., CroVe~~ rne~} INVESTMENT OPTIONS Fixed Account Plus and Short-Term Fixed Account are automatically included; all of the other investment options may be selected by the group contract owner and must include a Money Market Funtl. 1. I choose to select all investment options as listed on the Information and Instructions page that are available for my plan type and any future options that VALIC may make available from time to time. Select one of the fallowing: Qualified Plan - 401(a), 403(a), 4O1(k), 403(b) annuities and 457(b) eligible deferred compensation plans. ;:; Non-Qualified Plan - NODAs (non-qualified deferred annuities) under IRC Section 72, ineligible deferred compensation 457(f) plans and for- profittop hat plans. OR I choose to tailor the Plan investment options with those selected on the attached Group Investment Option Selection Form (VL12849). ~ I2, )~ ~Z Applicant S' n ure Date Inn d o ~2.$ ~ 1,~. r~ O~ t`frc,'(~o ~ m Dated at (City, State) Rep: I ^ do ^ do not have reason to believe this is a replacement cont j ~ v ~ i~ License A URegisteretl Representative Signature Date /j Ems;(,`. ~e,/rSC~ ~l,oSsUy Licensed AgenURegistered Representative (print name) State Licer Principal Signature VL 12848 12/01 VEN Information and Instructions FRAUD WARNING In some states we are required to advise you of the following: Any person who knowingly intends to defraud or facilitates a fraud against an insurer by submitting an application or filing a false claim, or makes an incomplete or deceptive statement of a material fact, may be guilty of insurance fraud. Arkansas, North Dakota, South Dakota, and Texas Residents Only: Any person who, with intent to defraud or knowing that he/she is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement, commits insurance fraud, which may be a crime and may subject the person to civil and criminal penalties. District of Columbia, Colorado, Kentucky, New Mexico and Pennsylvania Residents Only: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties. Florida Residents Only: Any person who knowingly and with intent to injure, defraud or deceive any insurer, files a statement of claim or an application containing any false, incomplete or misleading information, is guilty of a felony of the third degree. Louisiana Residents Only: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. New Jersey Residents Only: Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties. Virginia Residents Only: It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties include imprisonment, fines and denial of insurance benefits. Washington Residents Only: Any person who knowingly presents a fraudulent claim for payment of a loss or knowingly makes a false statement in an application for insurance may be guilty of a criminal offense under state law. PREMIUM PAYMENT PROCESSING VAUC has established certain standards for group premium remittances and premium processing instructions to facilitate efficient processing of premium payments. Premium processing instructions should be provided before or concurrent with the group premium remittance. The instructions and remittance should be in balance. VALIC$ standards may require that premium processing instructions be provided in one of several approved electronic formats, depending upon the number of participants included in the remittance. RECEIPT OF PREMIUM PAYMENTS PRIOR TO ESTABLISHING AN ACCOUNT If we receive Purchase Payments for a participant before we receive the participant's application or enrollment form, we will not be able to establish a permanent account for that participant. Under those circumstances, we will take one of the following actions: Return Purchase Payments. If we do not have the participant's name, address or social security number, we will return the Purchase Payment to you unless this information is immediately provided to us. Starter Account. We make every attempt to get complete information for all participants that direct contributions to us. If we receive contributions but have insufficient information to establish a personal account for the participant, you as the plan sponsor agree to provide information [full name, SSN, date of birth, current address, marital status) and direct us to invest contributions in the Money Market II Fund pending alternative direction from the participant. INVESTMENT OPTIONS "::; ra Fixed Account Plus (1 ] ^ Short-Term Fixed Account [2] C:~ ^ Multi-Year Enhanced Fixed Option: Syr, Syr, Tyr, 10yr (10yr not available in Oregon). Minimum of $25,000 is required for each Multi-Year Enhanced Fixed Option band. `r: Aggressive Growth Lifestyle Fund [48] ^ American Century Ultra Fund [31] ] O ^ Asset Allocation Funtl [5] n ^ Blue Chip Growth Fund (T. Rowe Price) [72] <._` ^ Capital Appreciation Fund (Credit Suisse) [39] ~:? [~ Capital Conservation Fund [7] C:) o Conservative Growth Lifestyle Fund [50] c::; ^ Core Bontl Funtl [58] C~? ^ Core Equity Fund (Wellington/WAMU) [15] ^ Credit Suisse Small Cap Growth Funtl [63] ^ Dreyfus Basic GNMA Fund [71] ^ Evergreen Growth and Income Fund [56] ^ Evergreen Small Cap Value Fund [55] ^ Evergreen Special Equity Fund [65) o Evergreen Value Fund [57] ~) ^ Government Securities Funtl [8] c; ^ Growth & Income Fund (SunAmerica) [16] c) ^ Health Sciences Fund (T. Rowe Price) [73] c:i ~_~ High Yield Bond Fund [60] i:~~^ Income & Growth Fund (American Century) [21] o^ International Equities Fund [11] ~~ ^ International Government Bond Fund [13] C:; [:~ International Growth I Funtl (American Century) [20] ~) ^ International Growth II Fund (Putnam) (33] ^ INVESCO Growth Funtl [62] ^ Janus Adviser Worldwide Fund [47] is i c:t Large Cap Growth Fund (SunAmerica) (30J C; ^ Large Cap Value fund (State Street) [40] ^ Lou Holland Growth Fund [70] C> ^ Mid Cap Growth Fund (INVESCO) [37] i7 ^ Mid Cap Index Fund [4] ~:.:> ^ Mid Cap Value Fund (Wellington) [38] ~:~:? ^ Moderate Growth Lifestyle Fund [49j O ^ Money Market I Fund [6] i 7 ^ Money Market II Fund [44] ^ Morgan Stanley Institutional Fund Trust Mid Cap Growth Portfolio i::~ ^ Nasdaq-100" Index Fund [46] O ^ Opportunities fund (Putnam) [45] ^ Putnam Global Growth Fund [28] ^ Putnam New Opportunities Fund [26] ^ Putnam OTC & Emerging Growth Fund [27] iii ^ Science & Technology Fund (T. Rowe Price) [17] ^ Sit Mid Cap Growth Fund [67] ^ Sit Small Cap Growth Fund [66] i~ ^ Small Cap Growth Funtl (Franklin) [35] i:> ^ Small Cap Fund (Founders/T. Rowe Price) [18] C:~ ^ Small Cap Index Fund [14] O ^ Small Cap Value Fund (One Group) [36] O ^ Social Awareness Fund [12J O ^ Socially Responsible Fund [41 j ~~ r_i Stock Index Fund [10] ~ ^ Strategic Bond fund [59] ^ Templeton Asset Strategy Fund [19] ^ Templeton Foreign Funtl [32] ^ Value Fund (Putnam) [74] ^ Vanguard LifeStrategy Conservative Growth Fund [54] ^ Vanguard LifeStrategy Growth Fund [52] ^ Vanguard LifeStrategy Moderate Growth Fund [53] o Vanguard Long-Term Corporate Fund [22] Vanguard Long-Term Treasury Fund [23] ^ Vanguard Wellington Fund [25] a Vanguard Windsor II Fund [24] r.:i These are the investment options available in qualified plans. C~ These are the only investment options available in non-qualified ply VAUC HOME OFFICE 2929 Allen Parkway Houston, TX 77019 Call 1-800-448-2542 for assistance.