4 (c) Form of Roth IRA Endorsement

"The Family Fraternity"(R)

FORM ###-##-#### Page 1 123456789

2002 BISYS Retirement Services

ENDORSEMENT

ROTH INDIVIDUAL RETIREMENT ANNUITY

EFFECTIVE DATE [December 1, 2002]

CERTIFICATE NUMBER [123456789]

ROTH IRA OWNER [John S. Woodmen]

ARTICLE I

      1.01 Purpose: The purpose of this Endorsement, which is attached to and
made a part of the annuity Contract issued by the Issuer, is to qualify the
Contract as a Roth individual retirement annuity (IRA) under Code sections 408A
and 408(b) to provide for the Roth IRA Owner's retirement and for the support of
his or her Beneficiary(ies) after death. The Contract is established for the
exclusive benefit of the Roth IRA Owner and his or her Beneficiary(ies). If any
provisions of the Endorsement are inconsistent with the Contract, or any Rider
of the Contract, the provisions of this Endorsement will apply.

      1.02 Ownership Provisions: The Roth IRA Owner's interest in the Contract
is nonforfeitable and nontransferable and the Roth IRA Owner may exercise all
rights under the Contract during his or her lifetime. In addition, the Contract
may not be sold, assigned, discounted, or pledged as collateral or as security
for the performance of an obligation or for any other purpose.

      1.03 For More Information: To obtain more information concerning the rules
governing this Endorsement, contact the Issuer listed on the Application.

ARTICLE II - DEFINITIONS

      The following words and phrases, when used in this Endorsement with
initial capital letters, shall, for the purpose of this Endorsement, have the
meanings set forth below unless the context indicates that other meanings are
intended.

      2.01 Application: Means the document executed by the Roth IRA Owner
through which the Roth IRA Owner adopts this Endorsement and thereby agrees to
be bound by all terms and conditions of this Endorsement.

      2.02 Beneficiary: Means the individual(s) or entity(ies) properly named to
receive any remaining IRA benefits upon the death of the Roth IRA Owner.




      2.03 Code: Means the Internal Revenue Code of 1986, as amended from time
to time.

      2.04 Contract: Means the annuity certificate used in conjunction with this
Endorsement.

      2.05 Conversion Premium: Means a contribution described in Section 408A(e)
of the Code from a Traditional or SIMPLE IRA to a Roth IRA.

      2.06 Designated Beneficiary: Means the Beneficiary named as of the date of
the Roth IRA Owner's death who remains Beneficiary as of September 30 of the
year following the year of the Roth IRA Owner's death.

      2.07 Endorsement: Means this IRA Endorsement attached to this Contract.

      2.08 Issuer: Means Woodmen of the World Life Insurance Society.

      2.09 IRA: Means a Roth Individual Retirement Annuity as defined in Code
sections 408(A) and 408(b) unless otherwise indicated.

      2.10 Premium: Means any payments made to the IRA.

      2.11 Regulations: Means the Treasury regulations.

      2.12 Roth IRA Owner: Means the individual who participates in this
individual retirement annuity and is the owner of the Contract.

      2.13 SIMPLE IRA: Means an IRA which satisfies the requirements of Code
sections 408(b) and 408(p).

"The Family Fraternity"(R)

FORM ###-##-#### Page 2 123456789

2002 BISYS Retirement Services

ARTICLE III - PREMIUM LIMITS

         3.01 Maximum Permissible Amount. Except in the case of a rollover
Premium described in Code section 408A(e), a recharacterized Premium described
in Code section 408A(d)(6), or a Conversion Premium, no Premiums will be
accepted unless they are in cash, and the total of such Premiums shall not
exceed the lesser of 100 percent of the Roth IRA Owner's Compensation, or:
$3,000 for any taxable year beginning in 2002 through 2004; $4,000 for any
taxable year beginning in 2005 through 2007; and $5,000 for any taxable year
beginning in 2008 and years thereafter. After 2008, the applicable Premium limit
may be adjusted by the Secretary of the Treasury for cost-of-living increases
under Code section 219(b)(5)(C). Such adjustments will be in multiples of $500.




         If the Roth IRA Owner makes regular Premiums to both Roth and
Traditional IRAs for a taxable year, the maximum regular Premium that can be
made to all the Roth IRA Owner's IRAs for that taxable year is reduced by the
regular Premiums made to the Roth IRA Owner's Traditional IRAs for the taxable
year. Premiums may be further limited if the Roth IRA Owner's modified adjusted
gross income (MAGI) exceeds the limits described in paragraph 3.03 of this
Endorsement. Qualified rollover contribution means a rollover contribution that
meets the requirements of Sec. 408(d)(3) of the Internal Revenue Code, except
the one-rollover-per-year rule of Sec. 408(d)(3)(B) does not apply if the
rollover contribution is from an IRA other than a Roth IRA.

         3.02 Catch-Up Premiums. In the case of a Roth IRA Owner who is age 50
or older by the close of the taxable year, theannual Premium is increased by
$500 for any taxable year beginning in 2002 through 2005; and $1,000 for any
taxable year beginning in 2006 and years thereafter.

         3.03 Regular Premium Limit. If a Roth IRA Owner's MAGI falls within
certain limits, as described in the following table, the maximum regular Premium
that can be made to all the Roth IRA Owner's IRAs for a taxable year is phased
out ratably in accordance with the following table:

Full Phase-Out Range No

Filing Status Premium MAGI Premium

Single or Head $95,000 or less Between $95,000 $110,000

of Household and $110,000 or more

Joint Return $150,000 or less Between $150,000 $160,000

or Qualifying and $160,000 or more

Widow(er)

Married - $0 Between $0 $10,000

Separate Return and $10,000 or more

         If the Roth IRA Owner's MAGI for a taxable year is in the phase-out
range, the maximum regular Premium determined under this table for that taxable
year is rounded up to the next multiple of $10 and is not reduced below $200.

         3.04 Conversion Premium Limit. A conversion from a Traditional or
SIMPLE IRA cannot be made to this IRA if, in the year the amount is distributed
from the Traditional or SIMPLE IRA:

         1. the Roth IRA Owner is married and files a separate return,

         2. the Roth IRA Owner is not married and has MAGI in excess of $100,000
or




         3. the Roth IRA Owner is married and together the Roth IRA Owner and
the Roth IRA Owner's spouse have MAGI in excess of $100,000.

         For purposes of the preceding sentence, a husband and wife are not
treated as married for a taxable year if they have lived apart at all times
during that taxable year and file separate returns for the taxable year.

         3.05 Recharacterization. A regular Premium to a Traditional IRA may be
recharacterized pursuant to the rules in Regulations section 1.408A-5 as a
regular Premium to this IRA, subject to the limits in paragraph 3.03 of this
Endorsement.

         3.06 Modified Adjusted Gross Income. For purposes of paragraphs 3.03
and 3.04 of this Endorsement, a Roth IRA Owner's MAGI for a taxable year is
defined in Code section 408A(c)(3)(C)(i) and does not include any amount
included in adjusted gross income as a result of a conversion from a Traditional
or SIMPLE IRA.

"The Family Fraternity"(R)

FORM ###-##-#### Page 3 123456789

?2002 BISYS Retirement Services

         3.07 Compensation. For purposes of paragraph 3.01 of this Endorsement,
compensation means wages, salaries, professional fees, or other amounts derived
from or received for personal services actually rendered (including, but not
limited to commissions paid salesmen, compensation for services on the basis of
a percentage of profits, commissions on insurance premiums, tips, and bonuses).
Compensation for a self-employed individual includes earned income, as defined
in Code section 401(c)(2) (reduced by the deduction the self employed Roth IRA
Owner takes for contributions made to a self-employed retirement plan). For
purposes of this definition, Code section 401(c)(2) shall be applied as if the
term trade or business for purposes of Code section 1402 included service
described in Code section 1402(c)(6).

         Compensation shall include any amount includible in the Roth IRA
Owner's gross income under Code section 71 with respect to a divorce or
separation instrument. In the case of a married individual filing a joint
return, the greater compensation of his or her spouse is treated as his or her
own compensation, but only to the extent that such spouse's compensation is not
being used for the purposes of the spouse making a contribution to a Roth IRA or
a deductible contribution to a non-Roth IRA.

         Compensation does not include amounts derived from or received as
earnings or profits from property (including but not limited to interest and
dividends) or amounts not includible in gross income. Compensation also does not
include any amount received as a pension or annuity or as deferred compensation.

         3.08 Excess Premium. Any refund of Premiums (other than those
attributable to excess Premiums) will be applied, before the close of the
calendar year following the year of the refund, toward the payment of future
Premiums or the purchase of additional benefits.




         3.09 Contract Requirements. If Premiums are interrupted, the contract
will be reinstated at any date prior to maturity upon payment of a Premium other
than a rollover or transfer Premium, to the Issuer, and the minimum Premium
amount for reinstatement shall be $20. However, the Issuer may, at its option,
either accept additional future payments or terminate the contract by payment in
cash of the then present value of the paid up benefit if no Premiums have been
received for two full consecutive policy years and the paid up annuity benefit
at maturity would be less than $20 per month.

         3.10 SIMPLE IRA. No premiums will be accepted under a SIMPLE IRA plan
established by any employer pursuant to code section 408(p). Also, no transfer
or rollover of funds attributable to premiums made by a particular employer
under its SIMPLE IRA plan, that is, an IRA in conjunction with a SIMPLE IRA
plan, prior to the expiration of the two-year period beginning on the date the
employee first participated in that employer's SIMPLE IRA plan.

ARTICLE IV - DISTRIBUTION REQUIREMENTS

         4.01 Roth IRA Owner Distributions. No amount is required to be
distributed from the Contract prior to the death of the Roth IRA Owner for whose
benefit the contract was originally established.

         4.02 Beneficiary Rights. If the Roth IRA Owner dies before his or her
entire interest is distributed to him or her, the entire remaining interest will
be distributed as follows.

         A. Notwithstanding any provision of this IRA to the contrary, the
distribution of the Roth IRA Owner's interest in the IRA shall be made in
accordance with the requirements of Code section 408(b)(3), as modified by Code
section 408A(c)(5), and the Regulations thereunder, the provisions of which are
herein incorporated by reference. If distributions are not made in the form of
an annuity on an irrevocable basis (except for acceleration), then distribution
of the interest in the IRA (as determined under paragraph 4.02(C) of this
Endorsement) must satisfy the requirements of Code section 408(a)(6), as
modified by Code section 408A(c)(5), and the Regulations thereunder, rather than
the distribution rules in paragraphs 4.02(B), (C), (D) and (E) of this
Endorsement.

         B. Upon the death of the Roth IRA Owner, his or her entire interest
will be distributed at least as rapidly as follows:

         1. If the Designated Beneficiary is someone other than the Roth IRA
Owner's surviving spouse, the entire interest will be distributed, starting by
the end of the calendar year following the calendar year of the Roth IRA Owner's
death, over the remaining life expectancy of the Designated Beneficiary, with
such life expectancy determined using the age of the Designated Beneficiary as
of his or her birthday in the year following the year of the Roth IRA Owner's
death, or, if elected, in accordance with paragraph 4.02(B)(3) of this
Endorsement.




"The Family Fraternity"(R)

FORM ###-##-#### Page 4 123456789

2002 BISYS Retirement Services

         2. If the Roth IRA Owner's Designated Beneficiary is the Roth IRA
Owner's surviving spouse, the entire interest will be distributed, starting by
the end of the calendar year following the calendar year of the Roth IRA Owner's
death (or by the end of the calendar year in which the Roth IRA Owner would have
attained age 701/2, if later), over such spouse's life, or, if elected, in
accordance with paragraph 4.02(B)(3) of this Endorsement. If the surviving
spouse dies before required distributions commence to him or her, the remaining
interest will be distributed, starting by the end of the calendar year following
the calendar year of the spouse's death, over the spouse's Designated
Beneficiary's remaining life expectancy determined using such Beneficiary's age
as of his or her birthday in the year following the death of the spouse, or, if
elected, will be distributed in accordance with paragraph 4.02(B)(3) of this
Endorsement. If the surviving spouse dies after required distributions commence
to him or her, any remaining interest will continue to be distributed under the
Contract option chosen.

         3. If there is no Designated Beneficiary, or if applicable by operation
of paragraph 4.02(B)(1) or (B)(2) of this Endorsement, the entire interest will
be distributed by the end of the calendar year containing the fifth anniversary
of the Roth IRA Owner's death (or of the spouse's death in the case of the
surviving spouse's death before distributions are required to begin under
paragraph 4.02(B)(2) of this Endorsement).

         4. Life expectancy is determined using the Single Life Table in Q&A-1
of Regulations section 1.401(a)(9)-9. If distributions are being made to a
surviving spouse as the sole Designated Beneficiary, such spouse's remaining
life expectancy for a year is the number in the Single Life Table corresponding
to such spouse's age in the year. In all other cases, remaining life expectancy
for a year is the number in the Single Life Table corresponding to the
Designated Beneficiary's age in the year specified in paragraph 4.02(B)(1) or
(2) of this Endorsement, and reduced by one for each subsequent year.

         C. The value of the IRA for purposes of this Article is the prior
December 31 balance adjusted to include the amount of any outstanding rollovers,
transfers and recharacterizations under Q&As-7 and -8 of Regulations section
1.408-8 and the actuarial value of any other benefits provided under the IRA,
such as guaranteed death benefits.

         D. For purposes of paragraph 4.02(B)(2) of this Endorsement, required
distributions are considered to commence on the date distributions are required
to begin to the surviving spouse under such paragraph. However, if distributions
start prior to the applicable date in the preceding sentence, on an irrevocable
basis (except for acceleration) under an annuity contract meeting the
requirements of Regulations section 1.401(a)(9)-6T, then required distributions
are considered to commence on the annuity starting date.




         E. If the Designated Beneficiary is the Roth IRA Owner's surviving
spouse, the spouse may elect to treat the IRA as his or her own IRA. This
election will be deemed to have been made if such surviving spouse, who is the
sole Beneficiary of the IRA, makes a Premium to the IRA or fails to take
required distributions as a Beneficiary. F. If the Beneficiary payment election
described above is not made by December 31 of the year following the year the
Roth IRA Owner dies, the Issuer reserves the right to elect, in its complete and
sole discretion, to do any one of the following:

            o     make no distribution until the Beneficiary(ies) provides a
                  proper withdrawal request;

            o     distribute the entire IRA to the Beneficiary(ies) in a single
                  sum payment; or

            o     distribute the entire remaining interest to the
                  Beneficiary(ies) pursuant to the applicable option in
                  paragraph 4.02(B) of this Endorsement.

         The Issuer will not be liable for any penalties or taxes related to the
Beneficiary's failure to take a required minimum distribution.

ARTICLE V - REPORTING

         The Roth IRA Owner agrees to provide the Issuer with information
necessary for the Issuer to prepare any report(s) required under the Code and
related Regulations including Code sections 408(i) and 408A(d)(3)(D) and
Regulations sections 1.408-5 and 1.408-6 and under guidance published by the
Internal Revenue Service (IRS). The Issuer shall furnish annual calendar year
reports concerning the status of the annuity and such information concerning
required minimum distributions as is prescribed by the IRS.

"The Family Fraternity"(R)

FORM ###-##-#### Page 5 123456789

2002 BISYS Retirement Services

ARTICLE VI - AMENDMENTS

         Any amendment made for the purpose of complying with provisions of the
Code and related Regulations may be made without the consent of the Roth IRA
Owner. The Roth IRA Owner will be deemed to have consented to any other
amendment unless the Roth IRA Owner notifies the Issuer that he or she does not
consent within 30 days from the date the Issuer mails the amendment to the Roth
IRA Owner.




ARTICLE VII - RESPONSIBILITY OF THE PARTIES

         The Issuer shall not be responsible for any penalties, taxes, judgments
or expenses incurred by the Roth IRA Owner in connection with this IRA and shall
have no duty to determine whether any Premiums to or distributions from this IRA
comply with the Code, Regulations, rulings or this Endorsement.

WOODMEN OF THE WORLD LIFE INSURANCE SOCIETY

Danny E. Cummins

SECRETARY