-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, QzuzuSigy+c9OCB9AbCevkQDo1MqMrJKPu5jLoelOd3jRUdhpU+EZf1RO8ec4nJw lqft8oTxV5KavWwCwLsoyA== 0000089024-98-000002.txt : 19980714 0000089024-98-000002.hdr.sgml : 19980714 ACCESSION NUMBER: 0000089024-98-000002 CONFORMED SUBMISSION TYPE: 485BPOS PUBLIC DOCUMENT COUNT: 26 FILED AS OF DATE: 19980710 EFFECTIVENESS DATE: 19980710 SROS: NONE FILER: COMPANY DATA: COMPANY CONFORMED NAME: SEPARATE ACCOUNT A OF EQUITABLE LIFE ASSU SOC OF THE US CENTRAL INDEX KEY: 0000089024 STANDARD INDUSTRIAL CLASSIFICATION: [] IRS NUMBER: 135570651 STATE OF INCORPORATION: NY FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 485BPOS SEC ACT: SEC FILE NUMBER: 002-30070 FILM NUMBER: 98664403 BUSINESS ADDRESS: STREET 1: 1290 AVE OF THE AMERICAS CITY: NEW YORK STATE: NY ZIP: 10104 BUSINESS PHONE: 2126416277 MAIL ADDRESS: STREET 1: 1290 AVE OF THE AMERICAS CITY: NEW YORK STATE: NY ZIP: 10104 FORMER COMPANY: FORMER CONFORMED NAME: SEPARATE ACCOUNT A OF THE EQUITABLE LIFE ASSU SOC OF THE US DATE OF NAME CHANGE: 19920703 485BPOS 1 EQUI-VEST POST EFFECTIVE AMENDMENT Registration No. 2-30070 Registration No. 811-1705 - ------------------------------------------------------------------------------- SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 ----------------------------------- FORM N-4 REGISTRATION STATEMENT UNDER THE SECURITIES ACT OF 1933 | | Pre-Effective Amendment No. | | ---- |X| Post-Effective Amendment No. 62 ---- AND/OR REGISTRATION STATEMENT UNDER THE INVESTMENT COMPANY ACT OF 1940 | | |X| Amendment No. 64 ---- (Check appropriate box or boxes) -------------------------------- SEPARATE ACCOUNT A of THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES (Exact Name of Registrant) -------------------------- THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES (Name of Depositor) 1290 Avenue of the Americas, New York, New York 10104 (Address of Depositor's Principal Executive Offices) Depositor's Telephone Number, including Area Code: (212) 554-1234 ---------------------------- MARY P. BREEN VICE PRESIDENT AND ASSOCIATE GENERAL COUNSEL The Equitable Life Assurance Society of the United States 1290 Avenue of the Americas, New York, New York 10104 (Names and Addresses of Agents for Service) -------------------------------- Please send copies of all communications to: PETER E. PANARITES, ESQ. Freedman, Levy, Kroll & Simonds 1050 Connecticut Avenue, N.W., Suite 825 Washington, D.C. 20036 --------------------------------- Approximate Date of Proposed Public Offering: Continuous It is proposed that this filing will become effective (check appropriate box): |X| Immediately upon filing pursuant to paragraph (b) of Rule 485. | | On May 1, 1998 pursuant to paragraph (b) of Rule 485. | | 60 days after filing pursuant to paragraph (a)(1) of Rule 485. | | On (date) pursuant to paragraph (a)(1) of Rule 485. | | 75 days after filing pursuant to paragraph (a)(2) of Rule 485. | | On (date) pursuant to paragraph (a)(3) of Rule 485. If appropriate, check the following box: | | This post-effective amendment designates a new effective date for previously filed post-effective amendment. --------------------------------- Title of Securities Being Registered: Units of interest in Separate Account under variable annuity contracts. NOTE This Post Effective Amendment No. 62 ("PEA") to the Form N-4 Registration Statement No. 2-30070 ("Registration Statement") of The Equitable Life Assurance Society of the United States and its Separate Account A is being filed solely for the purpose of filing electronically in Edgarized form, the exhibits listed under Part C. All of such exhibits were previously filed with the Registration Statement in paper format. The PEA does not amend or delete any other part of the Registration Statement. PART C OTHER INFORMATION ----------------- This Part C is amended solely for the purpose of adding Edgarized Exhibits 1(a), 1(b), 3(a)-(e), 4(a)-(i), 5(a), 5(b), 9(a)-(c), 10(b) and 13(a)-(c) to Item 24(b), and refiling such exhibits electroncially herewith. No amendment or deletion is made of any of the other information set forth under Part C of the Registration Statement. Item 24. Financial Statements and Exhibits ---------------------------------- (b) Exhibits. The following exhibits are refiled herewith in EDGAR format: 1. (a) Resolutions of the Board of Directors of The Equitable Life Assurance Society of the United States ("Equitable") authorizing the establishment of the Registrant, previously filed with this Registration Statement No. 2-30070 on October 27, 1987, refiled electronically herewith. (b) Resolutions of the Board of Directors of Equitable dated October 16, 1986 authorizing the reorganization of Separate Accounts A, C, D, E, J and K into one continuing separate account, previously filed with this Registration Statement No. 2-30070 on April 24, 1995, refiled electronically herewith. 3. (a) Sales Agreement, dated September 30, 1991 among Equitable, Separate Account A and Equitable Variable Life Insurance Company, as principal underwriter for the Hudson River Trust, previously filed with this Registration Statement No. 2-30070 on April 24, 1995, refiled electronically herewith. (b) Sales Agreement, dated as of July 22, 1992, among Equitable, Separate Account A and Equitable Variable Life Insurance Company, as principal underwriter for the Hudson River Trust, previously filed with this Registration Statement No. 2-30070 on April 26, 1993, refiled electronically herewith. C-1 (c) Distribution and Servicing Agreement among Equico Securities, Inc. (now EQ Financial Consultants, Inc.), Equitable and Equitable Variable Life Insurance Company, dated as of May 1, 1994, previously filed with this Registration Statement No. 2-30070 on February 14, 1995, refiled electronically herewith. (d) Distribution Agreement dated as of January 1, 1995 by and between The Hudson River Trust and Equico Securities, Inc. (now EQ Financial Consultants, Inc.), previously filed with this Registration Statement No. 2-30070 on April 24, 1995, refiled electronically herewith. (e) Sales Agreement, dated as of January 1, 1995, by and among Equico Securities, Inc. (now EQ Financial Consultants, Inc.), Equitable, Separate Account A, Separate Account No. 301 and Separate Account No. 51, previously filed with this Registration Statement No. 2-30070 on April 24, 1995, refiled electronically herewith. 4. (a) Form of Group Annuity Contract No. 11929 CI, amendments and endorsements thereto; Application for Group Annuity Contract; Form of Certificate No. 119331; Form of Group Annuity Contract 11930 CT, endorsements and amendments thereto; Form of Certificate No.11934 T; Form of Group Annuity Contract No. 11931 CH, endorsements and amendments thereto; Form of Certificate No. 11935 CH; Form of Group Annuity Contract No. 11932 CP, endorsements and amendments thereto, Form of Certificate No. 11936P; Form of Group Annuity contract No. 11938 C-C, amendments and endorsements thereto; Form of Certificate No. 11938C; Form of Group Annuity Contract No. 11937C NQ, endorsements and amendments thereto; Form of Certificate No. 11937 NQ and amendment thereto; and, Form of Certificate No. 11939C NQ-I; previously filed with this Registration Statement No. 2-30070 on April 24, 1995, refiled electronically herewith. (b) Additional amendments to Group Annuity Contracts and Certificates listed in Exhibit 4(a) above, previously filed with this Registration Statement File No. 2-30070 on March 2, 1990, refiled electronically herewith. (c) Unit Investment Trust Endorsement, previously filed with this Registration Statement File No. 2-30070 on December 21, 1987, refiled electronically herewith. (d) Form of Individual Annuity Contracts No. 92CTRA, No. 92CTRB, No. 92 EDCB, 92HR1A, 92HR1B, 92IRAA, 92IRAB, 92NQCA, 92NQCB, 92PEDB, 92QPIA, 92SEPA, 92SEPB, 92TSAA, 92TSAB, 92TSUA, 92TSUB, 92UTRA, and forms of Application No. 180-1000 used with individual qualifed variable annuity contracts and No. 180-1001 used with individual non-qualifed variable annuity contracts, previously filed with this Registration Statement File No. 2-30070 on May 27, 1992, refiled electronically herewith. (e) Form of Group Annuity Contract No. AC0000; Form of Certificate No. 11993AC; Endorsements applicable to IRA and SEP Certificates, previously filed with this Registration Statement File No. 2-30070 on April 24, 1995, refiled electronically herewith. (f) Form of Group Annuity Contract No. 1050-94IC, previously filed with this Registration Statement No. 2-30070 on April 24, 1995, refiled eletronically herewith. (g) Forms of Group Annuity Certificate Nos. 94ICA and 94ICB, previously filed with this Registration Statement No. 2-30070 on April 24, 1995, refiled eletronically herewith. (h) Forms of Endorsement Nos. 94ENIRAI, 94ENNQI and 94ENMVAI to Contract No. 1050-94IC, previously filed C-2 with this Registration Statement No. 2-30070 on April 24, 1995, refiled electronically herewith. (i) Forms of Data Pages to Endorsement Nos. 94ENIRAI, 94ENNQI and 94ENMVAI, previously filed with this Registration Statement No. 2-30070 on April 24, 1995, refiled electronically herewith. 5. (a) Forms of Applications and Requests for Enrollment for EQUI-VEST Qualified and Non-Qualified plans, previously filed with this Registration Statement, File No. 2-30070 on October 27, 1987, refiled electronically herewith. (b) Form of application used with the variable annuity contracts offered under EQUI-VEST PERSONAL RETIREMENT PROGRAMS, previously filed with this Registration Statement No. 2-30070 on April 24, 1995, refiled electronically herewith. C-3 9. (a) Opinion and Consent of Herbert P. Shyer, Esq., Executive Vice President and General Counsel of Equitable, as to the legality of the securities being registered, previously filed with this Registration Statement No. 2-30070 on December 21, 1987, refiled electronically herewith. (b) Opinion and Consent of Jonathan E. Gaines, Esq., Vice President and Associate General Counsel of Equitable, as to the legality of the securities being registered, previously filed with this Registration Statement No. 2-30070 on July 17, 1992, refiled electronically herewith. (c) Opinion and Consent of Jonathan E. Gaines, Esq., Vice President and Associate General Counsel of Equitable, as to the legality of the securities being registered, previously filed with this Registration Statement No. 2-30070 on April 24, 1995, refiled electronically herewith. 10. (b) Notice concerning regulatory relief, previously filed with this Registration Statement No. 2-30070 on May 27, 1992, refiled electronically herewith. 13. (a) Schedules for computation of Money Market Fund Yield quotations, previously filed with this Registration Statement No. 2-30070 on April 28, 1994, refiled electronically herewith. (b) Formulae for Determining "30-Day Yields" for Equi-Vest Series Contracts Invested In One Investment Fund (Intermediate Government Securities, Quality Bond or High Yield) of The Hudson River Trust, previously filed with this Registration Statement No. 2-30070 on April 24, 1995, refiled electronically herewith. (c) Separate Account A Performance Values Worksheets One-Year Standardized Performance, previously filed with this Registration Statement No. 2-30070 on April 28, 1994, refiled electronically herewith. C-4 SIGNATURES As required by the Securities Act of 1933 and the Investment Company Act of 1940, the Registrant certifies that it meets the requirements of Securities Act Rule 485(b) for the effectiveness of this amendment to the Registration Statement and has duly caused this amendment to the Registration Statement to be signed on its behalf, in the City and State of New York, on the 10th day of July, 1998. SEPARATE ACCOUNT A OF THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES (Registrant) By: The Equitable Life Assurance Society of the United States By: /s/ Naomi Weinstein ------------------------- Naomi Weinstein Vice President The Equitable Life Assurance Society of the United States SIGNATURES As required by the Securities Act of 1933 and the Investment Company Act of 1940, the Depositor has duly caused this Registration Statement or amendment thereto to be signed on its behalf, in the City and State of New York, on the 10th day of July, 1998. THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES (Depositor) By: /s/ Naomi Weinstein ------------------------ Naomi Weintein Vice President The Equitable Life Assurance Society of the United States As required by the Securities Act of 1933 and the Investment Company Act of 1940, this amendment to the Registration Statement or amendment thereto has been signed by the following persons in the capacities and on the date indicated: PRINCIPAL EXECUTIVE OFFICERS: Edward D. Miller Chairman of the Board, Chief Executive Officer and Director Michael Hegarty President, Chief Operating Officer and Director PRINCIPAL FINANCIAL OFFICER: Stanley B. Tulin Vice Chairman of the Board, Chief Financial Officer and Director PRINCIPAL ACCOUNTING OFFICER: Senior Vice President and Controller - --------------------- Alvin H. Fenichel July 10, 1998 DIRECTORS: Francoise Colloc'h Donald J. Greene George T. Lowy Henri de Castries John T. Hartley Edward D. Miller Joseph L. Dionne John H.F. Haskell, Jr. Didier Pineau-Valencienne Denis Duverne Michael Hegarty George J. Sella, Jr. William T. Esrey Mary R. (Nina) Henderson Stanley B. Tulin Jean-Rene Fourtou W. Edwin Jarmain Dave H. Williams Norman C. Francis G. Donald Johnston, Jr. By: /s/ Naomi Weinstein ------------------------- Naomi Weinstein Attorney-in-Fact July 10, 1998 C-3 EXHIBIT INDEX --------------
EXHIBIT NO. TAG VALUE - ----------- -------- 1(a) Resolutions of the Board of Directors of The EX-99.1a RESOLUTIONS Equitable Life Assurance Society of the United States ("Equitable") authorizing the establishment of the Registrant. 1(b) Resolutions of the Board of Directors of EX-99.1b RESOLUTIONS Equitable dated October 16, 1986 authorizing the reorganization of Separate Accounts A, C, D, E, J and K into one continuing separate account. 3(a) Sales Agreement dated September 30, 1991 among Equitable, EX-99.3a SALES AGREE Separate Account A and Equitable Variable Life Insurance Company, as principal underwriter for the Hudson River Trust. 3(b) Sales Agreement, dated as of July 22, 1992, among EX-99.3b SALES AGREE Equitable, Separate Account A and Equitable Variable Life Insurance Company, as principal underwriter for the Hudson River Trust. 3(c) Distribution and Servicing Agreement among Equico EX-99.3c DIST AGREE Securities, Inc. (now EQ Financial Consultants, Inc.), Equitable and Equitable Variable Life Insurance Company, dated as of May 1, 1994. 3(d) Distribution Agreement dated as of January 1, 1995 by EX-99.3d DIST AGREE and between The Hudson River Trust and Equico Securities, Inc. (now EQ Financial Consultants, Inc.). 3(e) Sales Agreement, dated as of January 1, 1995, by and EX-99.3e SALES AGREE among Equico Securities, Inc. (now EQ Financial Consultants, Inc.), Equitable, Separate Account A, Separate Account No. 301 and Separate Account No. 51. 4(a) Form of Group Annuity Contract No. 11929 CI, EX-99.4a CONTRACTS amendments and endorsements thereto; Application for Group Annuity Contract; Form of Certificate No. 119331; Form of Group Annuity Contract 11930 CT, endorsements and amendments thereto; Form of Certificate No.11934 T; Form of Group Annuity Contract No. 11931 CH, endorsements and amendments thereto; Form of Certificate No. 11935 CH; Form of Group Annuity Contract No. 11932 CP, endorsements and amendments thereto, From of Certificate No. 11936P; Form of Group Annuity contract No. 11938 C-C, amendments and endorsements thereto; Form of Certificate No. 11938C; Form of Group Annuity Contract No. 11937C NQ, endorsements and amendments thereto; Form of Certificate No. 11937 NQ and amendment thereto; and, Form of Certificate No. 11939C NQ-I. 4(b) Additional amendments to Group Annuity Contracts and EX-99.4b AMENDMENTS Certificates listed in Exhibit 4(a) above. 4(c) Unit Investment Trust Endorsement. EX-99.4c ENDORSEMENT 4(d) Form of Individual Annuity Contracts No. 92CTRA, No. EX-99.4d CONTRACTS 92CTRB, No. 92 EDCB, 92HR1A, 92HR1B, 92IRAA, 92IRAB, 92NQCA, 92NQCB, 92PEDB, 92QPIA, 92SEPA, 92SEPB, 92TSAA, 92TSAB, 92TSUA, 92TSUB, 92UTRA, and forms of Application No. 180-1000 used with individual qualifed variable annuity contracts and No. 180-1001 used with individual non-qualifed variable annuity contracts. 4(e) Form of Group Annuity Contract No. AC0000; Form of EX-99.4e CONTRACTS Certificate No. 11993AC; Endorsements applicable to IRA and SEP Certificates. 4(f) Form of group annuity contract no. 1050-94IC. EX-99.4f CONTRACTS 4(g) Forms of group annuity certificate nos. 94ICA and EX-99.4g CERTIFICATE 94ICB. 4(h) Forms of endorsement nos. 94ENIRAI, 94ENNQI and EX-99.4h CERTIFICATE 94ENMVAI to contract no. 1050-94IC 4(i) Forms of data pages to endorsement nos. 94ENIRAI, EX-99.4i DATA PAGES 94ENNQI and 94ENMVAI. 5(a) Forms of Applications and Requests for Enrollment for EX-99.5a APPLICATION EQUI-VEST Qualified and Non-Qualified Plans. 5(b) Form of application used with the variable annuity EX-99.5b APPLICATION contracts offered under EQUI-VEST PERSONAL RETIREMENT PROGRAMS. 9(a) Opinion and Consent of Herbert P. Shyer, Esq., Executive EX-99.9a OPINION Vice President and General Counsel of Equitable, as to the legality of the securities being registered. 9(b) Opinion and Consent of Jonathan E. Gaines, Esq., Vice EX-99.9b OPINION President and Associate General Counsel of Equitable, as to the legality of the securities being registered. 9(c) Opinion and Consent of Jonathan E. Gaines, Esq., Vice EX-99.9c OPINION President and Associate General Counsel of Equitable, as to the legality of the securities being registered. 10(b) Notice concerning regulatory relief. EX-99.10b NOTICE 13(a) Schedules for computation of Money Market Fund Yield EX-99.13a SCHEDULES quotations. 13(b) Formulae for Determining "30-Day Yields" for EQUI-VEST EX-99.13b FORMULAE Series Contracts Invested In One Investment Fund (Intermediate Government Securities, Quality Bond or High Yield) of The Hudson River Trust. 13(c) Separate Account A Performance Values Worksheets One-Year EX-99.13c PERF VALUE Standardized Performance.
C-4 EX-99.1ARESOLUTIONS 2 RESOLUTIONS OF THE BOARD OF DIRECTORS OFFICIAL NOTICE Res. No. 35-68 adopted by Board of Directors July 18, 1968 To: Messrs. McVity (3), Kernan, Sommers, Beesley, Erway, Smith, Secretary Keehn, Miller, Hering, Stocker and Ferguson, Whitenight RESOLUTION RE INDIVIDUAL VARIABLE ANNUITIES - ESTABLISHMENT OF SEPARATE ACCOUNT A AND REGISTRATION THEREOF UNDER THE INVESTMENT COMPANY ACT OF 1940, ETC. --------------------------------- RESOLVED, That, pursuant to section 227 of the Insurance Law of the State of New York, authority is hereby given to establish a separate account designated "Separate Account A"; FURTHER RESOLVED, That Separate Account A shall constitute a funding medium in connection with such agreements issued and administered by the Society as the Society may designate and in furtherance thereof Separate Account A is hereby empowered to: (a) received, hold, invest and reinvest amounts arising from (i) amounts received by the Society pursuant to such agreements, (ii) such other assets of the Society as the Society may deem necessary to establish Separate Account A or to support the operation of such agreements, and (iii) the income and gains arising from the foregoing; (b) to the extent required by the Investment Company Act of 1940, register under such Act and make application for exemption from such provisions thereof as may appear to be necessary or desirable; (c) to the extent required by the Securities Act of 1933, effect one or more registrations thereunder and in connection with such registrations file one or more registration statements thereunder, including any documents required as a part thereof; (d) provide for investment management services; (e) provide for the sale of agreements issued and administered by the Society, to the extent such agreements provide for allocation of amounts to Separate Account A; (f) select an independent public accountant to audit the books and records of Separate Account A; and (g) perform such additional functions and take such additional action as may be necessary or desirable to carry out the foregoing and the intent and purpose thereof or as from time to time may be authorized by or pursuant to a resolution of the Board of Directors or any committee thereof; -2- FURTHER RESOLVED, That, pursuant to section 227(6) of the Insurance Law of the State of New York, Separate Account A shall have a committee designated the "Separate Account A Committee" ("SAA Committee") initially to consist of five members to be designated by the Chairman of the Board, the Vice-Chairman of the Board, or the President of the Society, each of whom shall serve until the first meeting of persons having voting rights in respect of Separate Account A, as provided by its Rules and Regulations to be hereafter adopted or approved, and until his successor shall qualify, and thereafter the members of the SAA Committee shall be elected by a plurality of the votes cast by such persons having such voting rights; FURTHER RESOLVED, That, pursuant to section 5.5 of the By-Laws of the Society, as amended, in consideration of each member's agreement to serve as a member of the SAA Committee at the Society's request and because of the Society's interest in Separate Account A, the Society shall indemnify, to the extent permitted by the law of the State of New York and subject to all applicable requirements thereof, any person made or threatened to be made a party to any action or proceeding, whether civil or criminal, by reason of the fact that he, his testator or intestate is or was a member of the SAA Committee, provided that, unless and until renewed by resolution of the Board of directors, such indemnification shall be in respect of action taken or omitted only during the period ending with the first meeting of persons having voting rights in respect of Separate Account A; FURTHER RESOLVED, That the Society shall offer to provide to Separate Account A services relating to investment management and sales at rates of compensation for such services as may be approved by the officers of the Society; and the offices of the Society and each of them is hereby authorized to execute all agreements on behalf of the Society with respect thereto containing such provisions as he may deem necessary or appropriate, including such provisions as shall satisfy the requirements of the Investment Company Act of 1940 and the regulations issued thereunder; FURTHER RESOLVED, That, in cooperation with the SAA Committee, authority is hereby given to effect such registrations with the Securities and Exchange Commission under the Securities Act of 1933, with respect to any agreements providing for allocation of amounts to Separate Account A and related units or interests in Separate Account A which the Society from time to time may propose to offer in connection with plans and agreements qualified under sections 401 or 403(a) or purchased under section 403(b) of the Internal Revenue Code, as the officers of the Society may deem necessary or appropriate; FURTHER RESOLVED, That, in connection with such registrations, the officers of the Society and each of them is hereby authorized, with the assistance of the Society's special S.E.C. counsel, Freedman, Levy, Kroll & Simonds, and the Society's independent public accountants, Haskins & Sells, to prepare, execute and file with the Securities and Exchange Commission, in the name and on behalf of the Society, such registration statements under the Securities Act of 1933, including prospectuses, supplements, exhibits and other documents relating thereto, and amendments to the foregoing, in such form as the officer executing the same may deem necessary or appropriate; -3- FURTHER RESOLVED, That Davidson Sommers is hereby appointed as agent for service under any such registration statement duly authorized to receive communications and notices from the Securities and Exchange Commission with respect to the registration statement; FURTHER RESOLVED, That each officer and each director of the Society who is or may be required to execute any such registration statement or any amendment thereof, whether on behalf of the Society or as an officer or director thereof or by attesting the seal of the Society or otherwise, is hereby authorized to execute a power of attorney appointing J. Henry Smith and Davidson Sommers, and each of them, severally, his true and lawful attorney and agent, with full power of substitution to each, to execute in his name, place and stead and in any such capacity, said registration statement and all amendments thereto, and all instruments necessary or appropriate in connection therewith, to attest the seal of the Society thereon, and to file the same with the Securities and Exchange Commission, each of said attorneys and agents, and his or their substitutes, to be empowered to act with or without the others or other, and to have full power and authority to do or cause to be done in the name and on behalf of the Society and said officers and directors, or any one or more of them, every act and thing with respect thereto as fully and to all intents and purposes as any such officer or director might or could do in person; FURTHER RESOLVED, That, in cooperation with the SAA Committee, the officers of the Society and each of them is hereby authorized, with the assistance of counsel and accountants for the Society, to prepare, execute and file with the Securities and Exchange Commission an application for an order under section 6(c) of the Investment Company Act of 1940 for such exemptions from the provisions of such Act as he may deem necessary or desirable; FURTHER RESOLVED, That the officers of the Society and each of them is hereby authorized, with the assistance of counsel and accountants for the Society, to effect, in the name and on behalf of the Society, all such registrations, filings and qualifications under the Securities Exchange Act of 1934 as a broker or dealer and under Blue Sky or Securities laws and under Insurance Securities laws of such states and other jurisdictions as he may deem necessary or appropriate, with respect to the Society and with respect to the Society's agreements providing for allocation of amounts to Separate Account A and related units or interests in Separate Account A in connection with plans and agreements qualified under sections 401 or 403(a) or purchased under section 403(b) of the Internal Revenue Code; such authorization to include registration, filing and qualification of the Society and of said agreements and related units or interests, as well as registration, filing and qualification of officers, employees and agents of the Society as brokers, dealers, agents, salesmen, or otherwise; and such authorization shall also include, in connection therewith, authority to prepare, execute, acknowledge and file all such applications, applications for exemptions, certificates, affidavits, covenants, consents to service of process and other instruments and to take all such action as the officer executing the same or taking such action may deem necessary or desirable; -4- FURTHER RESOLVED, That the Chairman of the Board, the Vice-Chairman of the Board, and the President and each of them is hereby authorized to change the designation of Separate account A and the Separate Account A Committee, or either of them, to such other designation or designations as he may deem necessary or desirable; and FURTHER RESOLVED, That the officers of the Society and each of them is hereby authorized to execute and deliver all such documents and papers and to do or cause to be done all such acts and things as he may deem necessary or desirable to carry out the foregoing resolutions and the intent and purpose thereof. EX-99.1BRESOLUTIONS 3 RESOLUTIONS OF THE BOARD OF DIRECTORS JOAN B. MIASTKOWSKI Assistant Vice President [Equitable Logo] and Assistant Secretary I, JOAN B. MIASTKOWSKI, ASSISTANT VICE PRESIDENT AND ASSISTANT SECRETARY of THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES, do hereby certify that attached hereto marked "EXHIBIT A" is a true and correct copy of Resolution No. 86-86, duly adopted by the Board of Directors at a meeting held on October 16, 1986, at which a quorum was present and acting throughout; that said resolution has not been amended, annulled, rescinded, or revoked; and that said resolution is now in full force and effect. IN WITNESS WHEREOF, I have hereunto affixed my signature and the Seal of said Society this 26th day of May, 1987. /s/ Joan B. Miastkowski ------------------------------- Assistant Vice President and Assistant Secretary EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES 787 Seventh Avenue, New York, N.Y. 10019 Exhibit A PROPOSED RESOLUTIONS RE REORGANIZATION OF SEPARATE ACCOUNTS A, C, D, E, J and K ------------------------------------------------------- WHEREAS, it has been recommended (i) that Equitable reorganize Separate Accounts A, C, D, E, J and K (the "Separate Accounts") into one separate account organized as a unit investment trust ("UIT") with an underlying mutual fund (the "Fund") in the form of a Massachusetts Business Trust, (ii) that Equitable's Equivest and Equiplan new and existing group deferred variable annuity contracts for the IRA, TSA and other tax-favored (qualified or non-qualified) markets (the "Contracts") currently being funded through the Separate Accounts be funded through the UIT, and (iii) that Equitable continue to perform administrative, recordkeeping and, along with Equitable Investment Management Corporation, investment advisory functions for the Contracts and the UIT, all as more fully set forth in the memorandum dated October 3, 1986, from Executive Vice President Barth to Senior Executive Vice President and Chief Operating Officer Walsh submitted to and filed with the records of this meeting; and WHEREAS, it is necessary or desirable to enter into, amend or terminate various agreements among Equitable, the Separate Accounts, the Fund, and various other parties, pursuant to and contingent upon the proposed reorganization; NOW, THEREFORE, BE IT RESOLVED, That the proposed reorganization of the Separate Accounts (the "reorganization"), as set forth in the memorandum of Executive Vice President Barth, is hereby authorized and approved; and FURTHER RESOLVED, That all matters contemplated by the reorganization, including but not limited to: 1) the combination of the Separate Accounts into one separate account organized as a UIT, 2) organization of the Fund as a Massachusetts Business Trust and the investment of the assets of the UIT in the Fund, and 3) the retention of administrative, recordkeeping and investment responsibilities for the Contracts and the Fund by Equitable, are hereby authorized and approved, subject to any necessary regulatory and participant approval of the reorganization; and FURTHER RESOLVED, That all Committees of the Separate Accounts will be dissolved, effective with and contingent upon the reorganization; and -2- FURTHER RESOLVED, That Deloitte Haskins & Sells shall continue as independent auditors of the UIT; and FURTHER RESOLVED, That authority is hereby granted to seek all necessary regulatory approvals including, without limitation, the amendment of the registration statements of the Separate Accounts and the filing of exemptive applications and amendments thereto, and to take all further necessary or desirable actions in connection with the reorganization and the organization and registration of the Fund, and the retention of administration of the Contracts by Equitable; and FURTHER RESOLVED, That any Executive Vice President is hereby authorized and directed, on behalf of Equitable, as initial shareholder of the Fund, in connection with the Initial Special Shareholder's Meeting of the Fund, to vote shares held by Equitable in the Fund, in accordance with instructions given by the participants executing the proxies solicited by the Separate Account Committees and, to the extent instructions are not given, to vote the proxies as follows: 1) FOR the election of the members of the Board of Directors or trustees of the fund, the number of members to be 7; 2) FOR the combination of Separate Account C with and into Separate Account A, and the modernization of investment policies generally, including addition of provisions for hedging; 3) FOR the selection of Deloitte Haskins & Sells as the independent auditors of the fund for the year 1987; and 4) FOR approval of the Investment Advisory Agreement of the Fund as described in the Proxy Statement; and FURTHER RESOLVED, That any Executive Vice President is authorized, from time to time, to vote the shares held by Equitable in the Fund, with or, unless required by law, without participant instructions; and FURTHER RESOLVED, That amendment or termination of the custody agreements between the Separate Accounts and their custodians, the Investment Management Agreements among Equitable, the Separate Accounts and Equitable Investment Management Corporation and the Sales and Administration Agreements between Equitable and the Separate Accounts, and/or the entry into new similar agreements with substantially similar terms among the custodians, Equitable, the UIT, Equitable Investment Management Corporation and the Fund, as appropriate, contingent upon the reorganization, is hereby authorized and approved; and FURTHER RESOLVED, That the entry into Servicing Agreements between the Equitable and the UIT and the Fund, as appropriate, contingent upon the reorganization and subject to any necessary approval of the participants, is hereby authorized and approved; and FURTHER RESOLVED, That authority is hereby granted to take all actions, necessary or desirable to operate the UIT, including without limitation, the creation of new divisions and the modification or elimination of divisions, and to administer the Contracts. EX-99.3ASALESAGREE 4 SALES AGREEMENT SALES AGREEMENT AGREEMENT, dated as of September 30,1991, by and among Equitable Variable Life Insurance Company ("Equitable Variable"), The Equitable Life Assurance Society of the United States, ("Equitable"), and Equitable's Separate Account A ( the "Separate Account"). WITNESSETH: WHEREAS, Equitable Variable is a principal underwriter of The Hudson River Trust ( the "Trust"), a series mutual fund whose shareholders are separate accounts ("Eligible Separate Accounts") of insurance companies ("Participating Insurance Companies"), pursuant to a Distribution Agreement dated as of September 30, 1991 ("Distribution Agreement"); WHEREAS, such Participating Insurance Companies issue, among other products, variable life insurance and annuity products ("Variable Products") whose net premiums, contributions or other considerations are allocated to Eligible Separate Accounts for investment in the Trust, and shares of the Trust are not sold except in connection with such Variable Products; - 2 - WHEREAS, the Trust is registered as an open-end investment company under the Investment Company Act of 1940 ( the "1940 Act"); WHEREAS, the Board of Trustees of the Trust may, in its sole discretion, determine that certain portfolios shall be available only to certain types of Variable Products or to a single insurer and its affiliates; WHEREAS, Equitable issues Variable Products, whose net premiums are allocated to the Separate Account, and which are eligible for investment in the Trust's portfolios; WHEREAS, Equitable will distribute the Variable Products, either directly or indirectly through one or more affiliated or nonaffiliated broker-dealers with whom Equitable has selling agreements; WHEREAS, Equitable and Equitable Variable are each registered as a broker-dealer under the Securities Exchange Act of 1934 ( the "1934 Act") and each is a member of the National Association of Securities Dealers, Inc. (the "NASD"); WHEREAS, Equitable Variable and Equitable wish to define and describe the conditions under which shares of the Trust will be made available for investment by the Separate Account. - 3 - NOW THEREFORE, Equitable Variable, Equitable and the Separate Account hereby agree as follows: 1. The Board of Trustees of the Trust has adopted a Policy on Conflicts (the "Policy"). This Agreement shall be subject to the provisions of the Policy, the terms of which shall be incorporated herein by reference, made a part hereof and controlling. The Policy may be amended or superseded, without prior notice, and this agreement shall be deemed amended to the extent the Policy is amended or superseded. Equitable and the Separate Account each represent and warrant that it will act in a manner consistent with such Policy as so set forth and as it may be amended or superseded, so long as it owns any Trust shares. This provision shall survive the termination of this Agreement. 2. Equitable Variable will make available to the Separate Account shares of the Trust's portfolios in connection with Variable Products funded by the Separate Account only as set forth on Schedule A hereto. Schedule A may be modified from time to time by written agreement of the parties. 3. Purchases and redemptions of shares will be at net asset value for the appropriate portfolio, computed as set forth in the most recent Trust prospectus and Statement of Additional Information (respectively, "Trust Prospectus" and "SAI") and any supplements thereto, and shall be submitted by Equitable to the - 4 - Trust's transfer agent pursuant to procedures and in accordance with payment provisions adopted by the parties from time to time. Trust shares may not be sold or transferred except to an Eligible Separate Account and only in accordance with Schedule A. 4. (a) In good faith and as soon as practicable, Equitable Variable will provide at Trust expense camera ready copy of the current Prospectus and SAI and any supplements thereto for printing and distribution by Equitable with the prospectus for the Variable Products. Equitable Variable will also provide camera ready copy of Trust proxy materials and semi-annual reports, and any supplements thereto. Equitable Variable will use its best efforts to coordinate with Equitable and to provide notice of anticipated filings or supplements. Equitable may alter the form of the prospectus, SAI, semi-annual reports, proxy statements or other Trust documents, with the prior approval of the Trust's officers. Equitable shall bear all costs associated with such alteration of form. Equitable is not authorized (i) to give any information or make any representations concerning the Trust, its shares or operations except those contained in the most recent Trust Prospectus and SAI and any supplements thereto, or (ii) to use any description of the Trust in any sales literature or advertising (including brochures, letters, illustrations and other similar materials, whether transmitted directly to potential purchasers of Variable - 5 - Products or published in print or audio-visual media), except in either case as Equitable Variable or officers of the Trust may authorize in advance, which authorization will not be unreasonably withheld or delayed. Equitable shall indemnify and hold harmless Equitable Variable from any and all losses, claims, damages or liabilities (or actions in respect thereof) to which Equitable Variable may be subject, insofar as such losses, claims, damages or liabilities (or actions in respect thereof) arise out of or result from negligent, improper, fraudulent or unauthorized acts or omissions by Equitable, its employees, agents or representatives, including but not limited to improper solicitation of applications for Variable Products. (b) Equitable Variable will indemnify and hold harmless Equitable and the Separate Account against any losses, claims, damages or liabilities, to which Equitable or the Separate Account may become subject, insofar as such losses, claims, damages or liabilities (or actions in respect thereof) arise out of or are based upon (i) any untrue statement or alleged untrue statement of any material fact contained in the Trust Prospectus and/or SAI or any supplements thereto, (ii) the omission or alleged omission to state any material fact required to be stated in the Trust Prospectus and/or SAI or any supplements thereto or necessary to make the statements therein not misleading, or (iii) other misconduct or negligence of - 6 - Equitable Variable in its capacity as a distributor of the Trust; and will reimburse Equitable or the Separate Account for any legal or other expenses reasonably incurred by it in connection with investigating or defending against such loss, claim, damage, liability or action; provided, however, that Equitable Variable shall not be liable in any such case to the extent that any such loss, claim, damage or liability arises out of or is based upon an untrue statement or alleged untrue statement or omission or alleged omission made in the Trust Prospectus and/or SAI or any such supplement in good faith reliance upon and in conformity with written information furnished by Equitable specifically for use in the preparation thereof. Equitable Variable shall not indemnify Equitable or the Separate Account for any action where an applicant for the Variable Products or a policyholder was not furnished or sent or given, at or prior to written confirmation of the sale of the Variable Products and at such later times as required by state or federal securities laws, a copy of the prospectus relating to the Variable Products together with the Trust Prospectus, any supplements to the Trust Prospectus Equitable Variable may furnish to Equitable and, if requested by the applicant from Equitable or required by applicable law, the Trust SAI and any supplements thereto and, as required by applicable law, the Trust's annual and semi-annual reports, other required reports and proxy statements. - 7 - 5. This Agreement shall terminate automatically if it shall be assigned. The Agreement shall also terminate automatically if the Distribution Agreement shall terminate. 6. This Agreement may not be terminated by any party at any time prior to April 1, 1992; provided, however, that Equitable Variable may terminate this Agreement prior to April 1, 1992, without the payment of any penalty, if Equitable Variable shall cease to be the principal underwriter of the Trust pursuant to the Distribution Agreement. If Equitable Variable is notified that the Distribution Agreement will be terminated and that it shall cease to be the principal underwriter of the Trust, Equitable Variable shall immediately notify the other parties in writing of such termination, and this Agreement shall continue in effect until the effective date of the termination of the Distribution Agreement. This Agreement may be terminated by any party at any time after March 31, 1992, on one hundred eighty days' written notice to the other parties, without the payment of any penalty. 7. This Agreement shall be subject to the provisions of the 1940 Act, the 1934 Act and the Securities Act of 1933 and the rules, regulations, and rulings thereunder and of the NASD, from time to time in effect, including such exemptions from the 1940 Act and no action positions as the Securities and Exchange Commission or its staff may grant, and the terms hereof shall be interpreted and construed in accordance therewith. Without - 8 - limiting the generality of the foregoing, the term "assigned" shall not include any transaction exempt from section 15 (b)(2) of the Investment Company Act by order of the Securities and Exchange Commission or any transaction as to which the staff of the Securities and Exchange Commission has taken a no action position. Equitable shall, in connection with its obligations hereunder, comply with all laws and regulations applicable thereto, whether Federal or state, and whether relating to insurance, securities or other general areas, including but not limited to the record keeping and sales supervision requirements of such laws and regulations. Equitable Variable shall immediately notify Equitable of the issuance by any regulatory body of any stop order with respect to the Trust Prospectus or SAI or the initiation of any proceeding for that purpose or for any other purpose relating to the registration or an offering of shares of the Trust and of any other action or circumstances that may prevent the lawful offer or sale of shares of the Trust in any state or jurisdiction. 8. Equitable and Equitable Variable shall submit to all regulatory and administrative bodies having jurisdiction over the operations of Equitable, Equitable Variable or the Trust, present or future, any information, reports or other material - 9 - which any such body by reason of this Agreement may request or require as authorized by applicable laws or regulations. Equitable Variable shall keep confidential any information about Equitable's Variable Products or policyowners obtained pursuant to this Agreement and shall disclose such information only if Equitable has authorized such disclosure, or if such disclosure is required by state or Federal regulatory bodies, as authorized by applicable law. Equitable Variable will notify Equitable of disclosures required by regulatory bodies as soon as possible. Equitable Variable agrees that all records and other data pertaining to the Variable Products are the exclusive property of Equitable and that any such records and other data, whether maintained in written or electronic format, shall be furnished to Equitable by Equitable Variable upon termination of this Agreement for any reason whatsoever. This shall not preclude Equitable Variable from keeping copies of such data or records for its own files subject to the provisions of this paragraph. 9. Equitable retains the ultimate right of control over, and responsibility for, marketing the Variable Products. - 10 - 10. Equitable Variable represents that neither Equitable Variable nor any person employed in any material connection with respect to the services provided pursuant to this Agreement: (a) Within the last 10 years has been convicted of any felony or misdemeanor arising out of conduct involving embezzlement, fraudulent conversion, or misappropriation of funds or securities, or involving violations of Secs. 1341, 1342, or 1343 of Title 18, United States Code; or (b) Within the last 10 years has been found by any state regulatory authority to have violated or has acknowledged violation of any provision of any state insurance law involving fraud, deceit or knowing misrepresentation; or (c) Within the last 10 years has been found by any federal or state regulatory authorities to have violated or have acknowledged violation of any provision of federal or state securities laws involving fraud, deceit or knowing misrepresentation. 11. Equitable Variable and Equitable each represent that no commission or other fee shall be charged or paid to any person or entity in connection with the sale or purchase of the Trust's shares to or from the Separate Account, other than regular salary or wages. - 11 - 12. This Agreement may be executed in multiple counterparts, each of which shall be deemed an original, but all of which shall constitute one and the same instrument. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be duly executed as of the day and year first above written. EQUITABLE VARIABLE LIFE INSURANCE COMPANY Attest: /s/ Linda Galasso By: /s/ Mel H. Gregory - ------------------------- ----------------------------- President THE EQUITABLE LIFE INSURANCE SOCIETY OF THE UNITED STATES Attest: /s/ Linda Galasso By: /s/ Gordon Dinsmore, Jr. - ------------------------- ---------------------------- SEPARATE ACCOUNT A By: THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES as depositor Attest: /s/ Linda Galasso By: /s/ Gordon Dinsmore, Jr. - ------------------------- ---------------------------- 0334i - 12 - SCHEDULE A All Hudson River Trust Portfolios are available to the Separate Account for premiums and contributions associated with all variable products funded by the Separate Account. EX-99.3BSALESAGREE 5 SALES AGREEMENT DATED AS OF JULY 22, 1992 SALES AGREEMENT AGREEMENT, dated as of July 22, 1992, by and among Equitable Variable Life Insurance Company ("Equitable Variable"), The Equitable Life Assurance Society of the United States, ("Equitable"), and Equitable's Separate Account A (the "Separate Account"). WITNESSETH: WHEREAS, Equitable Variable is a principal underwriter of The Hudson River Trust (the "Trust"), a series mutual fund whose shareholders are separate accounts ("Eligible Separate Accounts") of insurance companies ("Participating Insurance Companies"), pursuant to a Distribution Agreement dated as of July 22, 1992 ("Distribution Agreement"); WHEREAS, such Participating Insurance Companies issue, among other products, variable life insurance and annuity products ("Variable Products") whose net premiums, contributions or other considerations are allocated to Eligible Separate Accounts for investment in the Trust, and shares of the Trust are not sold except in connection with such Variable Products; - 2 - WHEREAS, the Trust is registered as an open-end investment company under the Investment Company Act of 1940 ( the "1940 Act"); WHEREAS, the Board of Trustees of the Trust may, in its sole discretion, determine that certain portfolios shall be available only to certain types of Variable Products or to a single insurer and its affiliates; WHEREAS, Equitable issues Variable Products, whose net premiums are allocated to the Separate Account, and which are eligible for investment in the Trust's portfolios; WHEREAS, Equitable will distribute the Variable Products, either directly or indirectly through one or more affiliated or nonaffiliated broker-dealers with whom Equitable has selling agreements; WHEREAS, Equitable and Equitable Variable are each registered as a broker-dealer under the Securities Exchange Act of 1934 ( the "1934 Act") and each is a member of the National Association of Securities Dealers, Inc. (the "NASD"); WHEREAS, Equitable Variable and Equitable wish to define and describe the conditions under which shares of the Trust will be made available for investment by the Separate Account. - 3 - NOW THEREFORE, Equitable Variable, Equitable and the Separate Account hereby agree as follows: 1. The Board of Trustees of the Trust has adopted a Policy on Conflicts (the "Policy"). This Agreement shall be subject to the provisions of the Policy, the terms of which shall be incorporated herein by reference, made a part hereof and controlling. The Policy may be amended or superseded, without prior notice, and this agreement shall be deemed amended to the extent the Policy is amended or superseded. Equitable and the Separate Account each represent and warrant that it will act in a manner consistent with such Policy as so set forth and as it may be amended or superseded, so long as it owns any Trust shares. This provision shall survive the termination of this Agreement. 2. Equitable Variable will make available to the Separate Account shares of the Trust's portfolios in connection with Variable Products funded by the Separate Account only as set forth on Schedule A hereto. Schedule A may be modified from time to time by written agreement of the parties. 3. Purchases and redemptions of shares will be at net asset value for the appropriate portfolio, computed as set forth in the most recent Trust prospectus and Statement of Additional Information (respectively, "Trust Prospectus" and "SAI") and any supplements thereto, and shall be submitted by Equitable to the - 4 - Trust's transfer agent pursuant to procedures and in accordance with payment provisions adopted by the parties from time to time. Trust shares may not be sold or transferred except to an Eligible Separate Account and only in accordance with Schedule A. 4. (a) In good faith and as soon as practicable, Equitable Variable will provide at Trust expense camera ready copy of the current Prospectus and SAI and any supplements thereto for printing and distribution by Equitable with the prospectus for the Variable Products. Equitable Variable will also provide camera ready copy of Trust proxy materials and semi-annual reports, and any supplements thereto. Equitable Variable will use its best efforts to coordinate with Equitable and to provide notice of anticipated filings or supplements. Equitable may alter the form of the prospectus, SAI, semi-annual reports, proxy statements or other Trust documents, with the prior approval of the Trust's officers. Equitable shall bear all costs associated with such alteration of form. Equitable is not authorized (i) to give any information or make any representations concerning the Trust, its shares or operations except those contained in the most recent Trust Prospectus and SAI and any supplements thereto, or (ii) to use any description of the Trust in any sales literature or advertising (including brochures, letters, illustrations and other similar materials, whether transmitted directly to potential purchasers of Variable - 5 - Products or published in print or audio-visual media), except in either case as Equitable Variable or officers of the Trust may authorize in advance, which authorization will not be unreasonably withheld or delayed. Equitable shall indemnify and hold harmless Equitable Variable from any and all losses, claims, damages or liabilities (or actions in respect thereof) to which Equitable Variable may be subject, insofar as such losses, claims, damages or liabilities (or actions in respect thereof) arise out of or result from negligent, improper, fraudulent or unauthorized acts or omissions by Equitable, its employees, agents or representatives, including but not limited to improper solicitation of applications for Variable Products. (b) Equitable Variable will indemnify and hold harmless Equitable and the Separate Account against any losses, claims, damages or liabilities, to which Equitable or the Separate Account may become subject, insofar as such losses, claims, damages or liabilities (or actions in respect thereof) arise out of or are based upon (i) any untrue statement or alleged untrue statement of any material fact contained in the Trust Prospectus and/or SAI or any supplements thereto, (ii) the omission or alleged omission to state any material fact required to be stated in the Trust Prospectus and/or SAI or any supplements thereto or necessary to make the statements therein not misleading, or (iii) other misconduct or negligence of - 6 - Equitable Variable in its capacity as a distributor of the Trust; and will reimburse Equitable or the Separate Account for any legal or other expenses reasonably incurred by it in connection with investigating or defending against such loss, claim, damage, liability or action; provided, however, that Equitable Variable shall not be liable in any such case to the extent that any such loss, claim, damage or liability arises out of or is based upon an untrue statement or alleged untrue statement or omission or alleged omission made in the Trust Prospectus and/or SAI or any such supplement in good faith reliance upon and in conformity with written information furnished by Equitable specifically for use in the preparation thereof. Equitable Variable shall not indemnify Equitable or the Separate Account for any action where an applicant for the Variable Products or a policyholder was not furnished or sent or given, at or prior to written confirmation of the sale of the Variable Products and at such later times as required by state or federal securities laws, a copy of the prospectus relating to the Variable Products together with the Trust Prospectus, any supplements to the Trust Prospectus Equitable Variable may furnish to Equitable and, if requested by the applicant from Equitable or required by applicable law, the Trust SAI and any supplements thereto and, as requried by applicable law, the Trust's annual and semi-annual reports, other required reports and proxy statements. - 7 - 5. This Agreement shall terminate automatically if it shall be assigned. The Agreement shall also terminate automatically if the Distribution Agreement shall terminate. 6. If Equitable Variable is notified that the Distribution Agreement will be terminated and that it shall cease to be the principal underwriter of the Trust, Equitable Variable shall immediately notify the other parties in writing of such termination, and this Agreement shall continue in effect until the effective date of the termination of the Distribution Agreement. This Agreement may be terminated by any party at any time on one hundred eighty days' written notice to the other parties, without the payment of any penalty. 7. This Agreement shall be subject to the provisions of the 1940 Act, the 1934 Act and the Securities Act of 1933 and the rules, regulations, and rulings thereunder and of the NASD, from time to time in effect, including such exemptions from the 1940 Act and no action positions as the Securities and Exchange Commission or its staff may grant, and the terms hereof shall be interpreted and construed in accordance therewith. Without limiting the generality of the foregoing, the term "assigned" shall not include any transaction exempt from section 15(b)(2) of the Investment Company Act by order of the Securities and Exchange Commission or any transaction as to which the staff of the Securities and Exchange Commission has taken a no action position. - 8 - Equitable shall, in connection with its obligations hereunder, comply with all laws and regulations applicable thereto, whether Federal or state, and whether relating to insurance, securities or other general areas, including but not limited to the record keeping and sales supervision requirements of such laws and regulations. Equitable Variable shall immediately notify Equitable of the issuance by any regulatory body of any stop order with respect to the Trust Prospectus or SAI or the initiation of any proceeding for that purpose or for any other purpose relating to the registration or an offering of shares of the Trust and of any other action or circumstances that may prevent the lawful offer or sale of shares of the Trust in any state or jurisdiction. 8. Equitable and Equitable Variable shall submit to all regulatory and administrative bodies having jurisdiction over the operations of Equitable, Equitable Variable or the Trust, present or future, any information, reports or other material which any such body by reason of this Agreement may request or require as authorized by applicable laws or regulations. Equitable Variable shall keep confidential any information about Equitable's Variable Products or policyowners obtained pursuant to this Agreement and shall disclose such information only if Equitable has authorized such disclosure, or - 9 - if such disclosure is required by state or federal regulatory bodies, as authorized by applicable law. Equitable Variable will notify Equitable of disclosures required by regulatory bodies as soon as possible. Equitable Variable agrees that all records and other data pertaining to the Variable Products are the exclusive property of Equitable and that any such records and other data, whether maintained in written or electronic format, shall be furnished to Equitable by Equitable Variable upon termination of this Agreement for any reason whatsoever. This shall not preclude Equitable Variable from keeping copies of such data or records for its own files subject to the provisions of this paragraph. 9. Equitable retains the ultimate right of control over, and responsibility for, marketing the Variable Products. 10. Equitable Variable represents that neither Equitable Variable nor any person employed in any material connection with respect to the services provided pursuant to this Agreement: (a) Within the last 10 years has been convicted of any felony or misdemeanor arising out of conduct involving embezzlement, fraudulent conversion, or misappropriation of funds or securities, or involving violations of Secs. 1341, 1342, or 1343 of Title 18, United States Code; or - 10 - (b) Within the last 10 years has been found by any state regulatory authority to have violated or has acknowledged violation of any provision of any state insurance law involving fraud, deceit or knowing misrepresentation; or (c) Within the last 10 years has been found by any federal or state regulatory authorities to have violated or have acknowledged violation of any provision of federal or state securities laws involving fraud, deceit or knowing misrepresentation. 11. Equitable Variable and Equitable each represent that no commission or other fee shall be charged or paid to any person or entity in connection with the sale or purchase of the Trust's shares to or from the Separate Account, other than regular salary or wages. 12. This Agreement may be executed in multiple counterparts, each of which shall be deemed an original, but all of which shall constitute one and the same instrument. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be duly executed as of the day and year first above written. EQUITABLE VARIABLE LIFE INSURANCE COMPANY Attest: /s/ Linda Galasso By: /s/ Mel H. Gregory - ------------------------- ----------------------------- - 11 - THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Attest: /s/ Linda Galasso By: /s/ Gordon Dinsmore, Jr. - ------------------------- ---------------------------- SEPARATE ACCOUNT A By: THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES as depositor Attest: /s/ Linda Galasso By: /s/ Gordon Dinsmore, Jr. - ------------------------- ---------------------------- 0334i 08/24/92 - 12 - SCHEDULE A All Hudson River Trust Portfolios are available to the Separate Account for premiums and contributions associated with all variable products funded by the Separate Account. EX-99.3CDISTAGREE 6 DISTRIBUTION AND SERVICING AGREEMENT MAY 1, 1994 DISTRIBUTION AND SERVICING AGREEMENT This DISTRIBUTION AND SERVICING AGREEMENT, dated as of May 1, 1994, is made by and among Equico Securities, Inc. ("Equico"), The Equitable Life Assurance Society of the United States ("Equitable") and Equitable Variable Life Insurance Company ("Equitable Variable"), as follows: WHEREAS, pursuant to a Distribution Agreement, dated as of May 1, 1994, Equico is the principal underwriter of The Hudson River Trust ("Trust"), a series mutual fund registered under the Investment Company Act of 1940 ("1940 Act") whose shareholders are separate accounts of Equitable and Equitable Variable and of other insurance companies; WHEREAS, both Equitable and Equitable Variable issue variable insurance contracts ("Variable Contracts") whose net premiums or considerations are allocated in whole or in part to the respective separate accounts of Equitable and Equitable Variable for investment in the Trust, for direct investment or for investment in other funding media ("Separate Accounts"); WHEREAS, units of interest in the Separate Accounts are registered under the Securities Act of 1933 ("1933 Act") to the extent such registration is required; WHEREAS, Equitable and Equitable Variable are each broker-dealers registered under the Securities Exchange Act of 1934, as amended ("1934 Act"), and each is a member of the National Association of Securities Dealers, Inc. ("NASD"); -2- WHEREAS, the Variable Contracts (including all Variable Contracts issued by Equitable Variable) are offered and sold by members of Equitable's agency force, or by insurance brokers under contract with Equitable, who are also registered representatives of Equico and of Equitable ("Agents"); WHEREAS, Equitable and Equitable Variable each desire to engage Equico, a wholly-owned subsidiary of Equitable which is a registered broker-dealer under the 1934 Act and a member of the NASD, to assume the responsibilities set forth in this Agreement with respect to the distribution of the Variable Contracts, including in particular the responsibility for compliance with broker-dealer requirements under federal and any applicable state or foreign securities laws and the NASD Rules of Fair Practice ("NASD Rules") with respect to the offering of the Variable Contracts, and Equico desires to assume such responsibilities; WHEREAS, Equico desires to utilize Equitable's services and personnel in carrying out certain of its responsibilities under this Agreement, and Equitable is willing to furnish the same on the terms and conditions hereinafter set forth; NOW, THEREFORE, the parties hereto agree as follows: ARTICLE I Distribution Responsibility for the Variable Contracts Sec. 1.1 Equitable and Equitable Variable authorize Equico to act, and Equico agrees to serve Equitable, as broker-dealer in connection with the distribution of their respective Variable Contracts to the extent provided in this -3- Agreement. Equico shall be fully responsible for carrying out all compliance and supervisory obligations in connection with the distribution of the Variable Contracts, as required by the NASD Rules and by federal and any applicable state or foreign securities laws. Equitable shall be fully responsible for compensating the Agents for their sales of Variable Contracts, as provided in Section 1.4. Sec. 1.2 Without limiting the generality of Section 1.1, Equico agrees that it shall be fully responsible for: (A) Requiring that each person who is authorized to offer and sell the Variable Contracts is duly registered as a representative of Equico and is appropriately licensed, registered or otherwise qualified to offer and sell the Variable Contracts under the federal securities laws and any applicable securities laws of each state or other jurisdiction in which the Variable Contracts offered by such person may be lawfully sold; (B) Training, supervising and directing the Agents for purposes of complying on a continuous basis with the NASD Rules and with federal and state securities laws applicable in connection with the offer and sale of the Variable Contracts. In this connection, Equico shall: (i) Establish and implement reasonable written procedures which provide for diligent supervision of sales practices of the Agents; (ii) Require that Agents shall recommend the purchase of Variable Contracts only upon reasonable grounds to believe that the purchase is -4- suitable for each prospective purchaser, and verify their compliance with such requirement; (iii) Provide a sufficient number of registered principals and an adequate compliance staff to carry out the responsibilities set forth herein; and (iv) Impose disciplinary measures on the Agents. (C) Oversight of the securities activities of all persons engaged directly or indirectly in operations of Equico, Equitable and Equitable Variable related to the offer or sale of the Variable Products, each of whom shall be considered a "person associated" with Equico, as defined in Section 3(a)(18) of the 1934 Act. Equico shall have full responsibility for each such person with regard to his or her training, supervision and control, as contemplated by Section 15 of the 1934 Act, and, in that connection, shall have the authority to require that disciplinary action be taken with respect to such persons. Sec. 1.3 Equico represents that it is a broker-dealer duly registered under the 1934 Act and is a member in good standing of the NASD and, to the extent necessary to perform the activities contemplated hereunder, is duly registered, or otherwise qualified, under the securities laws of every state or other jurisdiction in which the Variable Contracts are available for sale, and Equico agrees to maintain such status. Consistent with its designation as distributor of the Variable Contracts, as provided in Section 1.1 of this Agreement, Equico acknowledges that it may be deemed to be an "underwriter" or a "principal underwriter" of the Separate Accounts under the federal securities laws. -5- Sec. 1.4 Equitable shall have exclusive responsibility for the payment of commissions or other fees in accordance with the applicable agreements between each Agent and Equitable relating to the Variable Contracts. All compensation paid by Equitable to the Agents with respect to sales of the Variable Contracts shall be paid by Equitable on its own behalf or on behalf of Equitable Variable (with respect to sales of Variable Contracts issued by Equitable Variable), and shall be reflected on the books and records of Equitable and, to the extent related to Variable Contracts issued by Equitable Variable, on the books and records of Equitable Variable. The responsibility of Equitable shall include the performance of all activities necessary in order that the payment of compensation hereunder complies with all applicable federal securities laws and state securities and insurance laws. Equitable and Equitable Variable retain the ultimate right to determine the rates of commission and other fees to be paid to the Agents in connection with their respective Variable Contracts. Nothing contained in this Agreement shall obligate Equico to pay any commissions or other fees to Agents or to reimburse any Agents for expenses incurred by them, nor shall Equico have any responsibility for the adequacy or accuracy of any amount paid to an Agent in connection with the sale of the Variable Contracts. Equico shall have no right or interest whatsoever in any commissions or other fees payable to Agents by Equitable or by Equitable Variable. Sec. 1.5 Equitable represents that it is a broker-dealer duly registered under the 1934 Act and is a member in good standing of the NASD. If Equitable shall determine, in sole judgment, that such status is not required for the purpose of properly discharging its responsibility under Section 1.4 of this Agreement, -6- Equitable may terminate its status as a registered broker-dealer without notice to the other parties hereto. Sec. 1.6 Equitable Variable agrees to cooperate fully with Equico and with Equitable in the proper discharge of the responsibilities allocated to them under this Article I. While undertaking to provide such cooperation and to perform various activities on its own behalf hereunder, Equitable Variable assumes no duties or responsibilities under this Agreement in its capacity as a registered broker-dealer and, accordingly, shall be under no obligation to maintain such status. Sec. 1.7 Equico, Equitable and Equitable Variable shall each cause to be maintained and preserved such accounts, books and other documents as are required by the 1934 Act and 1940 Act and any other applicable laws and regulations. In particular, without limiting the foregoing, Equico shall cause all the books and records in connection with the offer and sale of the Variable Contracts to be maintained and preserved in conformity with the requirements of Rules 17a-3 and 17a-4 under the 1934 Act, to the extent that such requirements are applicable to the Variable Contracts. The payment of premiums, purchase payments, commissions and other fees and payments in connection with the Variable Contracts shall be reflected on the books and records of Equitable and of Equitable Variable, as provided in Section 1.4 hereof and as may otherwise be required under applicable NASD regulations and federal and applicable state securities laws requirements. Sec. 1.8 Equico, Equitable and Equitable Variable shall each submit to all regulators and administrative bodies having jurisdiction over the sales of the -7- Variable Contracts, present or future, any information, reports, or other material that any such body by reason of this Agreement may request or require pursuant to applicable laws or regulations. In particular, without limiting the foregoing, Equitable and Equitable Variable agree that any books and records which they maintain pursuant to Section 1.5 of this Agreement which are required to be maintained under Rule 17a-3 or 17a-4 of the 1934 Act shall be subject to inspection by the Securities and Exchange commission ("SEC") in accordance with Section 17(a) of the 1934 Act. Sec. 1.9 Equico and Equitable each agree and understand that all documents, reports, records, books, files and other materials required under applicable NASD regulations and federal and state securities laws relative to the sales of Variable Contracts shall be the property of Equico, with the exception of those books and records maintained by Equitable pursuant to Section 1.4 which relate to sales compensation and shall be the joint property of Equitable and Equico. If, however, such documents, reports, records, books, files and other materials which are the property of Equico are required by applicable regulation or law to be maintained also by Equitable or by Equitable Variable, such material shall be the joint property of Equico, Equitable or Equitable Variable. All other documents, reports, records, books, files and other materials maintained relative to this Agreement shall be the property of Equitable or of Equitable Variable, depending upon the identity of the issuer of the Variable Contracts involved. Upon the termination of this Agreement, all such material shall be returned to the applicable party. Sec. 1.10 Equico, Equitable and Equitable Variable from time to time during the term of this Agreement, shall allocate among themselves, subject to a right of -8- further delegation, the administrative responsibility for maintaining and preserving the books, records and accounts kept in connection with the Variable Contracts; provided, however, in the case of books, records and accounts kept pursuant to a requirement of applicable law or regulation, the ultimate responsibility for maintaining and preserving such books, records and accounts shall be that of the party which is required to maintain or preserve such books, records and accounts under the applicable law or regulation, and such books, records and accounts shall be maintained and preserved under the supervision of that party. Equico, Equitable and Equitable Variable shall cause each other to be furnished with such reports as each may reasonably request for the purpose of meeting its respective reporting and recordkeeping requirements under such regulations and laws and under the insurance laws of the State of New York and any other applicable states or jurisdictions. ARTICLE II Procedures for Sale of Variable Contracts Sec. 2.1 Equitable and Equitable Variable each represent and warrant that units of interest of their respective Separate Accounts offered under the Variable Contracts are registered under the 1933 Act to the extent such registration is required, that the Separate Accounts are registered under the 1940 Act unless exempt from such registration, and that the Variable Contracts are qualified to be sold under the insurance laws and any applicable securities laws of all states and other jurisdictions in which the Variable Contracts are authorized for sale. Equitable and Equitable Variable each further represent and warrant that each of them is a life insurance company duly organized under the laws of the State of -9- New York and in good standing and authorized to conduct business under the laws of each state in which the Variable Contracts are offered and sold. Sec. 2.2 Equico will require that the Agents use only the effective prospectuses, statements of additional information ("SAIs") and other authorized materials in soliciting and selling the Variable Contracts. Equico is not authorized to give any information or to make any representations concerning the Variable Contracts other than those contained in the current prospectus or SAI therefor filed with the SEC or in such materials as may be authorized by Equitable or by Equitable Variable. Sec. 2.3 All applications for Variable Contracts shall be made on application forms supplied by Equitable or by Equitable Variable, as appropriate, and all payments collected by Equico shall be remitted by Equico promptly in full, together with such application or enrollment forms and any other required documentation, directly to Equitable or to Equitable Variable, as appropriate, at the address indicated on such application or to such other address as Equitable or Equitable Variable may, from time to time, designate in writing. Equico shall review all such applications for suitability. Checks or money orders in payment on any Variable Contract shall be drawn to the order of "The Equitable Life Assurance Society of the United States" or "Equitable Variable Life Insurance Company", as appropriate. All applications for Variable Contracts shall be subject to acceptance or rejection by Equitable or by Equitable Variable at their respective discretion. Sec. 2.4 All money payable in connection with any of the Variable Contracts, whether as premiums, purchase payments or otherwise, and whether paid by, or on -10- behalf of any applicant or contractowner, is the property of Equitable or of Equitable Variable and shall be transmitted promptly in accordance with the administrative procedures of Equitable and Equitable Variable without any deduction or offset for any reason, including by example but not limitation, any deduction or offset for compensation claimed by Equico or payable to the Agents. No cash payments shall be accepted by Equico in connection with the Variable Contracts. Sec. 2.5 Equitable and Equitable Variable shall be responsible for payment of the costs of printing the prospectuses, SAIs and sales material used in connection with the solicitation of applications for the Variable Contracts and to allocate such costs between themselves. Equitable and Equitable Variable shall provide to Equico copies of such prospectuses, SAIs and sales material in such number as Equico shall reasonably request. Equitable and Equitable Variable shall make available to Equico copies of all financial statements and other documents that Equico shall reasonably request for use in connection with the distribution of the Variable Contracts. Sec. 2.6 Notwithstanding anything in this Agreement to the contrary, Equico may enter into sales agreements with independent broker-dealers for the sale of the Variable Contracts, subject to the prior written approval of Equitable and of Equitable Variable of each such sales agreement and the terms thereof. All such sales agreements entered into by Equico shall provide that each independent broker-dealer will assume full responsibility for continued compliance by itself and its associated persons with the NASD Rules and applicable federal and state securities and insurance laws. All associated persons of such independent broker-dealer soliciting applications for the Variable Contracts shall be duly and -11- appropriately licensed or appointed for the sale of the Variable Contracts under the NASD Rules and federal and state securities and insurance laws in which such person shall offer or sell the Variable Contracts. Sec. 2.7 Equitable shall apply for and maintain the proper insurance licenses for each of the Agents selling the Variable Contracts in all states or jurisdictions in which the Variable Contracts are offered for sale by such Agent. Equitable and Equitable Variable reserve the right to refuse to appoint any proposed agent, or independent broker-dealer, and to terminate an Agent or independent broker-dealer once appointed. Equitable and Equitable Variable shall promptly notify Equico of each such termination. Equitable agrees to be responsible for all licensing or other fees required under pertinent state insurance laws to properly authorize Agents for the sale of the Variable Contracts; however, the foregoing shall not limit Equitable's right to collect such amount from any person or entity other than Equico. Sec. 2.8 The parties hereto recognize that any person selling the Variable Contracts as contemplated by this Agreement shall be acting as an insurance agent of Equitable or of Equitable Variable or as an insurance broker, and that the rights of Equico to supervise such persons shall be limited to the extent specifically described herein or required under applicable federal or state securities laws or NASD regulations. Such persons shall not be considered employees of Equico and shall be considered agents of Equico only as and to the extent required by such laws and regulations. Further, it is intended by the parties hereto that such persons are and shall continue to be considered to have a common law independent contractor relationship with Equitable and Equitable Variable and not to be common law employees of Equitable or of Equitable Variable, unless any contract -12- between Equitable and any person selling the Variable Contracts specifically provides otherwise. Sec. 2.9 Consistent with the responsibility of Equico to discharge all compliance and supervisory obligations relating to the distribution of the Variable Contracts as provided in this Agreement and consistent with the authority given to Equico hereunder, Equitable and Equitable Variable shall retain the ultimate right of control over, and responsibility for, the issuance, servicing and marketing of their respective Variable Contracts. In that connection, Equitable and Equitable Variable shall review and approve all advertising concerning the Variable Contracts issued by each of them; however, Equico shall be responsible for filing such materials, as required, with the NASD and with state securities regulators and for obtaining such approvals as may be necessary. Sec. 2.10 Unless otherwise agreed in writing by Equitable or by Equitable Variable, neither Equico nor any Agent nor any independent broker-dealer shall have an interest in any surrender charges, deductions or other fees payable to Equitable or to Equitable Variable. ARTICLE III Services and Personnel Provided by Equitable Sec. 3.1 Equitable agrees to furnish compliance and related support services, including personnel, to assist Equico in the performance of the services which Equico is required to provide hereunder. In furnishing such services, all personnel of Equitable shall be subject at all times to the supervision and control of Equico. -13- ARTICLE IV Compensation and Expenses Sec. 4.1 Equico shall be compensated, not less frequently than quarterly, by Equitable and by Equitable Variable for its services under this Agreement in an aggregate annual amount which shall be equal to the actual expenses incurred by Equico to provide compliance and related support services, plus a percentage of such expenses which shall approximate the annual rate of profit earned by Equico from its performance of comparable services for unaffiliated clients. Sec. 4.2 Equico shall pay the costs and expenses, direct and indirect, incurred by Equitable in furnishing services and personnel, pursuant to Article III of this Agreement. In determining the basis for the apportionment of expenses, specific identification or estimates based on time, company assets, square footage or any other mutually agreeable method providing for a fair and reasonable allocation of cost may be used, provided such method is in conformity with the requirements of Section 1712 of the New York Insurance Law and New York Insurance Department Regulation No. 33. The charge to Equico for such apportioned expenses shall be at cost as described in this Section 4.2. Sec. 4.3 Within 45 days after the end of each calendar quarter, and more often if desired, Equitable shall submit to Equico a statement of apportioned expenses showing the basis for such apportionment; and settlement shall be made within 15 days thereafter. The statement of apportioned expenses shall set forth in reasonable detail the nature of the expenses being apportioned and other relevant information to support the charge. -14- Sec. 4.4 To enable Equitable to compensate Agents for the sale of Variable Contracts issued by Equitable Variable, Equitable Variable shall furnish Equitable with a schedule of the commissions and other fees payable with respect to each form of Variable Contract issued by it, together with a list of rules and procedures applicable to the payment of such compensation. Equitable Variable agrees to reimburse Equitable for commissions and service fees (not in excess of the amounts specified by Equitable Variable) paid to the Agents for the sale of its Variable Contracts pursuant to Section 1.4 of this Agreement. ARTICLE V Term of Agreement Sec. 5.1 Subject to termination as herein provided, this Agreement shall remain in full force and effect for a two-year period commencing on the date first above written, and this Agreement shall continue in full force and effect from year-to-year thereafter, until terminated as herein provided. Sec. 5.2 This Agreement may be terminated by any party hereto on not less than 60 days' prior written notice to the other parties or by an agreement in writing signed by all of the parties hereto, except that data processing services may not be terminated on less than 180 days' prior written notice, if requested by Equico in writing promptly following its receipt of written notice of termination of this Agreement. This Agreement shall automatically be terminated in the event of its assignment. Sec. 5.3 Upon termination of this Agreement, all authorizations, rights, and obligations shall cease except the obligations to settle accounts hereunder, -15- including the settlement of monies due in connection with Variable Contracts in effect at the time of termination or issued pursuant to applications received by Equitable or by Equitable Variable prior to termination. ARTICLE VI Miscellaneous Sec. 6.1 Should an irreconcilable difference of opinion arise between or among the parties to this Agreement as to the interpretation of any matter respecting this Agreement, it is hereby mutually agreed that such differences shall be submitted to arbitration as the sole remedy available to the parties. Such arbitration shall be in accordance with the rules of the American Arbitration Association, the arbitrators shall have extensive experience in the insurance industry, and the arbitration shall take place in New York, New York. Sec. 6.2 For purposes of this Agreement, the term "Variable Contracts" shall not include any variable insurance contract issued by Equitable which is not offered and sold by employees or agents of Equitable. Sec. 6.3 This Agreement replaces the Sales Agreement, dated December 23, 1985, as amended, between Equitable Variable and Equitable, which shall terminate on the effective date hereof. Sec. 6.4 If any provision of this Agreement shall be held or made invalid by a court decision, statute, rule, or otherwise, the remainder of this Agreement shall not be affected thereby. -16- Sec. 6.5 This Agreement constitutes the entire agreement between the parties hereto and may not be modified except in a written instrument executed by all parties hereto. Sec. 6.6 This Agreement shall be subject to the provisions of the 1934 Act and, to the extent applicable, the 1940 Act and the rules, regulations and rulings thereunder and of the NASD, from time-to-time in effect, including such exemptions from the 1940 Act as the SEC may grant, and the terms hereof shall be interpreted and construed in accordance therewith. Sec. 6.7 This Agreement shall be interpreted in accordance with the laws of the State of New York. -17- IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be signed by their respective officials thereunto duly authorized, as of the day and year first above written. THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES By: /s/Joseph J. Melone --------------------------------- Joseph J. Melone Chairman and Chief Executive Officer EQUITABLE VARIABLE LIFE INSURANCE COMPANY By: /s/Samuel B. Shlesinger --------------------------------- Samuel B. Shlesinger Senior Vice President EQUICO SECURITIES, INC. By: /s/Richard V. Silver --------------------------------- Richard V. Silver President and Chief Operating Officer [5292/430_1] 23208/HWO_1 EX-99.3DDISTAGREE 7 DISTRIBUTION AGREEMENT DATED AS OF JANUARY 1, 1995 DISTRIBUTION AGREEMENT AGREEMENT, dated as of January 1, 1995, by and between The Hudson River Trust (the "Trust") and Equico Securities, Inc. ("Equico"). W I T N E S S E T H : WHEREAS, the Trust is a Massachusetts business trust whose shareholders are and will be separate accounts in unit investment trust form ("Eligible Separate Accounts") of insurance companies; WHEREAS, variable insurance and annuity product ("Variable Products") net premiums, contributions and considerations will be allocated to Eligible Separate Accounts for investment in the Trust; WHEREAS, the Trust's shares may not be sold separately from the Variable Products; WHEREAS, the Trust desires Equico to undertake marketing activities with respect to Trust shares; WHEREAS, the Trust is registered as an open end investment company under the Investment Company Act of 1940 ("Investment Company Act"); WHEREAS, the Investment Company Act prohibits any principal underwriter for a registered open end investment company from offering for sale, selling, or delivering after sale any security of which such company is the issuer, except pursuant to a written contract with such company, and Equico will be a principal underwriter for sale of securities issued by the Trust; WHEREAS, Equico is registered as a broker-dealer under the Securities Exchange Act of 1934 ("Securities Exchange Act") and is a member of the National Association of Securities Dealers, Inc. ("NASD"); NOW THEREFORE, the Trust and Equico agree as follows: Section 1. The Trust has ratified a Policy on Conflicts (the "Policy"), which was adopted by the Board of Directors of the Hudson River Fund, Inc., predecessor of the Trust. This Agreement shall be subject to the provisions of the Policy, the terms of which are incorporated herein by reference, made a part hereof and controlling. The Policy may be amended or superseded, without prior notice, and this Agreement shall be deemed amended to the extent the Policy is amended or superseded. Equico represents and warrants that it will act in a manner consistent with such Policy as so set forth and as it may be amended or superseded, so long as it is a principal underwriter of the Trust. This provision shall survive the termination of this Agreement. Section 2. Equico is hereby authorized, from time to time, to enter into separate written agreements ("Sales Agreements" or, individually, a "Sales Agreement"), on terms and conditions not inconsistent with this Agreement, with insurance companies which have Eligible Separate Accounts and which agree to participate in the 2 distribution of Trust shares, directly or through affiliated broker dealers (collectively, with the insurance companies the "Participating Insurance Companies"), by means of distribution of Variable Products and to use their best efforts to solicit applications for Variable Products. Equico may not enter into any Sales Agreement with any Participating Insurance Company that is more favorable than that maintained with any other Participating Insurance Company and Eligible Separate Account, except that not all portfolios of the Trust need be made available for investment by all Participating Insurance Companies, Eligible Separate Accounts or Variable Products. Each Sales Agreement shall be entered into jointly with the Participating Insurance Company and the Eligible Separate Account. Section 3. Such Participating Insurance Companies and their agents or representatives soliciting applications for Variable Products shall be duly and appropriately licensed, registered or otherwise qualified for the sale of Variable Products under any applicable insurance laws and any applicable securities laws of one or more states or other jurisdictions in which Variable Products may be lawfully sold. Each such Participating Insurance Company shall, when required by law, be both registered as a broker dealer under the Securities Exchange Act and a member of the NASD. Each such Participating Insurance Company shall agree to comply with all laws and regulations, whether federal or state, and whether relating to insurance, securities or other general areas, including but not limited to the record-keeping and sales supervision requirements of such laws and regulations. Section 4. The Trust's shares are divided into series, each representing a different portfolio of investments ("Portfolios"). The Trust Portfolios and any restrictions on availability relating thereto are set forth in Schedule A hereto, which may be amended from time to time. 3 Purchases and redemptions of Trust shares shall be at the net asset value for the appropriate Portfolio, computed as set forth in the most recent Prospectus and Statement of Additional Information relating to the Trust contained in its Registration Statement of Form N-1A, File No. 2-94996, or any amendments thereto (respectively, "Trust Prospectus" and "SAI"), and any supplements thereto. Trust shares may not be sold or transferred except to an Eligible Separate Account with the prior approval of the Trust's Board of Trustees. Section 5. The Trust shall not pay any compensation to Equico for services as principal underwriter herein, nor shall the Trust reimburse Equico for any expenses related to such services. Equico may, but need not, pay or charge Participating Insurance Companies pursuant to agreements as described in Section 2. Section 6. The Trust represents to Equico that the Trust Prospectus and SAI, as of their respective effective dates, contain all statements and information which are required to be stated therein by the Securities Act of 1933 and in all respects conform to the requirements thereof, and neither the Trust Prospectus nor the SAI include any untrue statement of a material fact or omit to state any material fact required to be stated therein or necessary to make the statements therein not misleading; provided, however, that the foregoing representations shall not apply to information contained in or omitted from the Trust Prospectus and SAI in reliance upon, and in conformity with, written information furnished by Equico specifically for use in the preparation thereof. In this connection, Equico acknowledges that the day-to-day operations of the Trust, including without limitation, investment management, securities brokerage 4 allocation, cash control, accounting, record keeping and other administrative, marketing and regulatory compliance functions, are carried on and may in the future be carried on by The Equitable Life Assurance Society of the United States ("Equitable"), affiliates of Equitable, and other parties unaffiliated with Equitable on behalf of the Trust (collectively, the "Preparing Parties"), under various agreements and arrangements, and that such activities in large measure provide the basis upon which statements and information are included or omitted from the Trust Prospectus and SAI. Equico further acknowledges that because of the foregoing arrangements, the preparation of the Trust Prospectus and SAI is substantially in the control of the Preparing Parties, subject to the broad supervisory authority and responsibility of the Trust's Board of Trustees, and that, essentially, the only Trust Prospectus or SAI information not independently known to, or prepared by, the Preparing Parties is personal information as to each Trustee's full name, age, background, business experience and other personal information that may require disclosures under securities laws and for which the Preparing Parties necessarily must rely on each such Trustee to produce. Section 7. The Trust will periodically prepare Trust Prospectuses (and, if applicable, SAIs) and any supplements thereto, proxy materials and annual and semi-annual reports (collectively, the "Documents") and shall make camera ready copy available to Equico for reproduction by Equico or the Participating Insurance Companies. Subject to the prior approval of the Trust's officers, the Trust shall pay the cost of printing and mailing Documents which are distributed to existing owners of Variable Products, provided that Equico or the Participating Insurance Companies shall be required to submit documentation in support of such expenses which is satisfactory to the officers of the Trust. The Trust shall not pay the cost of printing or mailing Documents except as specified in this Section 7. The Trust will use its best efforts 5 to provide notice to Equico of anticipated filings or supplements. Equico or the Participating Insurance Companies may alter the form of some or all of the Documents, with the prior approval of the Trust's officers. Any preparation costs associated with altering the form of the Documents will be borne by Equico or the Participating Insurance Companies, not the Trust. Section 8. Equico and officers of the Trust may from time to time authorize descriptions of the Trust for use in sales literature or advertising by the Participating Insurance Companies (including brochures, letters, illustrations and other similar materials, whether transmitted directly to potential applicants or published in print or audio-visual media), which authorization will not be unreasonably withheld or delayed. Section 9. Equico shall furnish to the Trust, at least quarterly, reports as to the sales of Trust shares made pursuant to this Agreement. These reports may be combined with any similar report prepared by Equico or any of the Preparing Parties. Section 10. Equico shall submit to all regulatory and administrative bodies having jurisdiction over the operations of Equico, the Trust, or any Participating Insurance Company, present or future, any information, reports or other material which any such body by reason of this Agreement may request or require as authorized by applicable laws or regulations. Section 11. This Agreement shall be subject to the provisions of the Investment Company Act, the Securities Exchange Act and the Securities Act of 1933 and the rules, regulations, and rulings thereunder and of the NASD, from time to time in effect, including such exemptions from the Investment Company Act and no action 6 positions as the Securities and Exchange Commission or its staff may grant, and the terms hereof shall be interpreted and construed in accordance therewith. Without limiting the generality of the foregoing, (a) the term "assigned" shall not include any transaction exempted from section 15(b)(2) of the Investment Company Act and (b) the vote of the persons having voting rights in respect of the Trust referred to in Section 12 shall be the affirmative votes of the lesser of (i) the holders of more than 50% of all votes entitled to be cast in respect of the Trust or (ii) the holders of at least 67% of the votes which are present at a meeting of such persons if the holders of more than 50% of all votes entitled to be cast in respect of the Trust are present or represented by proxy at such meeting, in either case voted in accordance with the provisions of the Policy. Section 12. This Agreement shall continue in effect only so long as such continuance is specifically approved at least annually by a majority of the Trustees of the Trust who are not interested persons of the Trust or Equico and by (a) persons having voting rights in respect of the Trust, by the vote stated in Section 11, voted in accordance with the provisions of the Policy, or (b) the Board of Trustees of the Trust. Section 13. This Agreement shall terminate automatically if it shall be assigned. 7 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be duly executed as of the day and year first above written. THE HUDSON RIVER TRUST Attest: /s/[Illegible] By: /s/ Barbara Krumsiek - ------------------ ---------------------- EQUICO SECURITIES, INC. Attest: /s/ Loraine Herzog By: /s/ Michael F. McNelis - ------------------ ---------------------- President and Chief Operating Officer FFR_1.DOC/20007 1/11/95 8 Schedule A Portfolios of The Hudson River Trust ------------------------------------ Common Stock Money Market Balanced Aggressive Stock High Yield Global Conservative Investors Growth Investors Government Securities Quality Bond Growth and Income Equity Index International (as of second quarter of 1995) Restrictions ------------ None 20007 1/11/95 9 EX-99.3ESALESAGREE 8 SALES AGREEMENT, DATED AS OF JANUARY 1, 1995 THE HUDSON RIVER TRUST SALES AGREEMENT AGREEMENT, dated as of January 1, 1995, by and among Equico Securities, Inc. ("Equico"), The Equitable Life Assurance Society of the United States ("Equitable"), and Equitable's Separate Account A, Separate Account No. 301 and Separate Account No. 51 (each, a "Separate Account" and, collectively, the "Separate Accounts"). W I T N E S S E T H: WHEREAS, Equico is a principal underwriter of The Hudson River Trust (the "Trust"), a series mutual fund whose shareholders are separate accounts ("Eligible Separate Accounts") of insurance companies ("Participating Insurance Companies"), pursuant to a Distribution Agreement ("Distribution Agreement"); WHEREAS, such Participating Insurance Companies issue, among other products, variable life insurance and annuity products ("Variable Products") whose net premiums, contributions or other considerations are allocated to Eligible Separate Accounts for investment in the Trust, and shares of the Trust are not sold except in connection with such Variable Products; WHEREAS, the Trust is registered as an open-end investment company under the Investment Company Act of 1940 (the "1940 Act"); WHEREAS, the Board of Trustees of the Trust may, in its sole discretion, determine that certain portfolios shall be available only to certain types of Variable Products or to a single insurer and its affiliates; WHEREAS, Insurer issues Variable Products, whose net premiums are allocated to the Separate Account, and which are eligible for investment in the Trust's portfolios; WHEREAS, Broker-Dealer, an affiliate of Insurer, will distribute the Variable Products, either directly or indirectly under selling agreements with one or more affiliated or non-affiliated broker-dealers; WHEREAS, Broker-Dealer and Equico are each registered as a broker-dealer under the Securities Exchange Act of 1934 (the "1934 Act") and each is a member of the National Association of Securities Dealers, Inc. (the "NASD"); WHEREAS, Equico, Insurer and Broker-Dealer wish to define and describe the conditions under which shares of the Trust will be made available for investment by the Separate Account. NOW, THEREFORE, Equico, Insurer, Broker-Dealer and the Separate Account hereby agree as follows: 1. The Board of Trustees of the Trust has adopted a Policy on Conflicts (the "Policy"). This Agreement shall be subject to the provisions of the Policy, the terms of which shall be incorporated herein by reference, made a part hereof and controlling. The Policy may be amended or superseded, without prior -2- notice, and this Agreement shall be deemed amended to the extent the Policy is amended or superseded. Insurer, Broker-Dealer and the Separate Account each represent and warrant that it will act in a manner consistent with such Policy as so set forth and as it may be amended or superseded, so long as it owns any Trust shares. This provision shall survive the termination of this Agreement. 2. Equico will make available to the Separate Account shares of the Trust's portfolios in connection with Variable Products funded by the Separate Account only as set forth on Schedule A hereto. Schedule A may be modified from time to time by written agreement of the parties. 3. Purchases and redemptions of shares will be at net asset value for the appropriate portfolio, computed as set forth in the most recent Trust prospectus and Statement of Additional Information (respectively, "Trust Prospectus" and "SAI") and any supplements thereto, and shall be submitted by Insurer to the Trust's transfer agent pursuant to procedures and in accordance with payment provisions adopted by the parties from time to time. Trust shares may not be sold or transferred except to an Eligible Separate Account and only in accordance with Schedule A. 4. (a) In good faith and as soon as practicable, Equico will provide, at Trust expense, camera ready copy of the current Trust Prospectus and SAI and any supplements thereto for distribution by Insurer with the prospectus for the Variable Products, and camera ready copy of Trust proxy materials, annual and semi-annual reports, and any supplements thereto. To the extent that the foregoing documents are distributed by Insurer to existing owners of Variable -3- Products, Equico will request reimbursement from the Trust for the printing and mailing costs associated with such distribution, upon receipt from Insurer of adequate documentation for presentation to the Trust. Equico will use its best efforts to coordinate with Insurer and to provide notice of anticipated filings or supplements. Insurer may alter the form of the Trust Prospectus, SAI, annual and semi-annual reports, proxy statements or other Trust documents, with the prior approval of the Trust's officers. Insurer shall bear all costs associated with such alteration of form. Insurer is not authorized (i) to give any information or make any representations concerning the Trust, its shares or operations except those contained in the most recent Trust Prospectus and SAI and any supplements thereto, or (ii) to use any description of the Trust in any sales literature or advertising (including brochures, letters, illustrations and other similar materials, whether transmitted directly to potential purchasers of Variable Products or published in print or audio-visual media), except in either case as Equico or officers of the Trust may authorize in advance, which authorization will not be unreasonably withheld or delayed. Insurer and Broker-Dealer shall indemnify and hold harmless Equico from any and all losses, claims, damages or liabilities (or actions in respect thereof) to which Equico may be subject, insofar as such losses, claims, damages or liabilities (or actions in respect thereof) arise out of or result from negligent, improper, fraudulent or unauthorized acts or omissions by Insurer or Broker-Dealer or their respective employees, agents or representatives, including but not limited to improper solicitation of applications for Variable Products. (b) Equico will indemnify and hold harmless Insurer, Broker-Dealer and the Separate Account against any losses, claims, damages or -4- liabilities, to which Insurer or the Separate Account may become subject, insofar as such losses, claims, damages or liabilities (or actions in respect thereof) arise out of or are based upon (i) any untrue statement or alleged untrue statement of any material fact contained in the Trust Prospectus and/or SAI or any supplements thereto, (ii) the omission or alleged omission to state any material fact required to be stated in the Trust Prospectus and/or SAI or any supplements thereto or necessary to make the statements therein not misleading, or (iii) other misconduct or negligence of Equico in its capacity as a distributor of the Trust; and will reimburse Insurer, Broker-Dealer or the Separate Account for any legal or other expenses reasonably incurred by it in connection with investigating or defending against such loss, claim, damage, liability or action; provided, however, that Equico shall not be liable in any such case to the extent that any such loss, claim, damage or liability arises out of or is based upon an untrue statement or alleged untrue statement or omission or alleged omission made in the Trust Prospectus and/or SAI or any such supplement in good faith reliance upon and in conformity with written information furnished by Insurer or Broker-Dealer specifically for use in the preparation thereof. Equico shall not indemnify Insurer, Broker-Dealer or the Separate Account for any action where an applicant for the Variable Products or a policyholder was not furnished or sent or given, at or prior to written confirmation of the sale of the Variable Products and at such later times as required by state or federal securities laws, a copy of the prospectus relating to the Variable Products together with the Trust Prospectus, any supplements to the Trust Prospectus Equico may furnish to Insurer and, if requested by the applicant from Insurer or required by applicable law, the Trust SAI and any supplements -5- thereto and, as required by applicable law, the Trust's annual and semi-annual reports, other required reports and proxy statements. 5. This Agreement shall terminate automatically if it shall be assigned. The Agreement shall also terminate automatically if the Distribution Agreement shall terminate. 6. If Equico is notified that the Distribution Agreement will be terminated and that it shall cease to be the principal underwriter of the Trust, Equico shall immediately notify the other parties in writing of such termination, and this Agreement shall continue in effect until the effective date of the termination of the Distribution Agreement. This Agreement may be terminated by any party at any time on one hundred eighty days' written notice to the other parties, without the payment of any penalty. 7. This Agreement shall be subject to the provisions of the 1940 Act, the 1934 Act and the Securities Act of 1933 and the rules, regulations, and rulings thereunder and of the NASD, from time to time in effect, including such exemptions from the 1940 Act and no-action positions as the Securities and Exchange Commission or its staff may grant, and the terms hereof shall be interpreted and construed in accordance therewith. Without limiting the generality of the foregoing, the term "assigned" shall not include any transaction exempt from section 15(b)(2) of the Investment Company Act by order of the Securities and Exchange Commission or any transaction as to which the staff of the Securities and Exchange Commission has taken a no-action position. -6- Insurer and Broker-Dealer shall each, in connection with its obligations hereunder, comply with all laws and regulations applicable thereto, whether federal or state, and whether relating to insurance, securities or other general areas, including but not limited to the record keeping and sales supervision requirements of such laws and regulations. Equico shall immediately notify Insurer and Broker-Dealer of the issuance by any regulatory body of any stop order with respect to the Trust Prospectus or SAI or the initiation of any proceeding for that purpose or for any other purpose relating to the registration or an offering of shares of the Trust and of any other action or circumstances that may prevent the lawful offer or sale of shares of the Trust in any state or jurisdiction. 8. Insurer, Broker-Dealer and Equico shall submit to all regulatory and administrative bodies having jurisdiction over the operations of Insurer, Broker-Dealer, Equico or the Trust, present or future, any information, reports or other material which any such body by reason of this Agreement may request or require as authorized by applicable laws or regulations. Equico shall keep confidential any information about Insurer's Variable Products or policy owners obtained pursuant to this Agreement and shall disclose such information only if Insurer or Broker-Dealer has authorized such disclosure, or if such disclosure is required by state or federal regulatory bodies, as authorized by applicable law. Equico will notify Insurer and Broker-Dealer of disclosures required by regulatory bodies as soon as possible. -7- Equico agrees that all records and other data pertaining to the Variable Products are the exclusive property of Insurer and that any such records and other data, whether maintained in written or electronic format, shall be furnished to Insurer by Equico upon termination of this Agreement for any reason whatsoever. This shall not preclude Equico from keeping copies of such data or records for its own files subject to the provisions of this paragraph. 9. Insurer retains the ultimate right of control over, and responsibility for marketing the Variable Products. 10. Equico represents that neither Equico nor any person employed in any material connection with respect to the services provided pursuant to this Agreement: (a) Within the last 10 years has been convicted of any felony or misdemeanor arising out of conduct involving embezzlement, fraudulent conversion, or misappropriation of funds or securities, or involving violations of Sections 1341, 1342, or 1343 of Title 18, United States Code; or (b) Within the last 10 years has been found by any state regulatory authority to have violated or has acknowledged violation of any provision of any state insurance law involving fraud, deceit or knowing misrepresentation; or (c) Within the last 10 years has been found by any federal or state regulatory authorities to have violated or have acknowledged violation of -8- any provision of federal or state securities laws involving fraud, deceit or knowing misrepresentation. 11. Equico, Broker-Dealer and Insurer each represent that no commission or other fee shall be charged or paid to any person or entity in connection with the sale or purchase of the Trust's shares to or from the Separate Account, other than regular salary or wages. 12. This Agreement may be executed in multiple counterparts, each of which shall be deemed an original, but all of which shall constitute one and the same instrument. -9- IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be duly executed as of the day and year first above written. The effective date of this Agreement shall be the date first above written. EQUICO SECURITIES, INC. Attest: /s/ Loraine Herzog By: /s/ Michael F. McNelis - ------------------ ---------------------- THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Attest: /s/ Linda Galasso By: /s/ Gordon Dinsmore, Jr. - ----------------- ------------------------ SEPARATE ACCOUNT A, SEPARATE ACCOUNT 301 and SEPARATE ACCOUNT NO. 51 By: THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES, as depositor of each Separate Account Attest: /s/ Linda Galasso By: /s/ Gordon Dinsmore, Jr. - ----------------- ------------------------ FFQ_1DOC/20006 1GG_1.DOC/23920 - --------------- -10- SCHEDULE A All portfolios of The Hudson River Trust are available to the Separate Accounts for premiums, contributions and other considerations associated with all variable products funded by the Separate Accounts. FFQ_1DOC/20006 1GG_1.DOC/23920 - --------------- -11- EX-99.4ACONTRACTS 9 GROUP ANNUITY CONTRACTS AND IND ANNUITY CERTS [EQUITABLE LOGO] THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES 1285 AVENUE OF THE AMERICAS, NEW YORK, NEW YORK 10019 EQUI-PENSION-GV CONTRACT GROUP ANNUITY CONTRACT NO. 11929 CI CONTRACT HOLDER: UNITED STATES TRUST COMPANY OF NEW YORK CONTRACT CHANGE DATE: DECEMBER 31, 1984 The Initial Guaranteed Interest Rate is 10% and is effective until December 31, 1980. The Guaranteed Interest Rate after December 31, 1980 for a Class of Participants will be established before the beginning of each calendar year, but will not be less than the Minimum Guaranteed Interest Rate for such year and Class of Participants. This contract ("the Contract") is issued in consideration of the payment to Equitable of the contributions made under the Contract. Equitable will issue to each Participant an individual certificate setting forth a statement in substance of the benefits to which such Participant is entitled under the Contract. The provisions on the following pages are part of the Contract. FOR THE CONTRACT HOLDER: FOR THE EQUITABLE: By /s/ Signature Unreadable By /s/ Coy Eklund President Title Vice President By /s/ Rodney L. Enochs Vice President and Secretary Dated 3/7/80 Date of Issue Mar 7 1980 At New York, New York (Head Office) No. 11929CI PARTICIPATING This page 2 reserved for information in connection with the issuance of certificates under this Contract. PAGE 2 This page 3 reserved for information in connection with the issuance of certificates under this Contract. PAGE 3 PART I -- DEFINITIONS SECTION 1.01 EMPLOYER The term "Employer" means the sole proprietor, partnership or corporation which has adopted a Plan. A sole proprietor is deemed to be his own Employer and a partnership is deemed to be the Employer of each partner. Any self-employed individual and any employee of a partnership or corporation who is not covered under a Plan is deemed to be his own Employer if he elects to be enrolled under the Contract as a Participant. SECTION 1.02 PLAN The term "Plan" means (i) a program established by an Employer which requires amounts contributed thereunder to be applied to the purchase of individual retirement annuities within the meaning of Section 408(b) of the Code and (ii) a written program established by an Employer constituting a "Simplified Employee Pension" under Section 408(k) of the Code which requires amounts contributed thereunder to be applied to the purchase of individual retirement annuities within the meaning of Section 408(b) of the Code. SECTION 1.03 ANNUITY The term "Annuity" means an individual retirement annuity meeting the requirements of Section 408(b) of the Code. SECTION 1.04 ANNUITY BENEFIT The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Section 3.03 of the Contract. SECTION 1.05 PARTICIPANT The term "Participant" means a person who has been enrolled by Equitable under the Contract and for whom the Employer has purchased an Annuity under the Contract. A person shall become enrolled under the Contract upon receipt by Equitable of an enrollment form made available by Equitable and completed in a manner satisfactory to Equitable. A person who has been enrolled under the Contract shall be a participant-owner under the certificate issued thereunder and such participant-owner shall thereafter at all times be the annuitant under the certificate during his lifetime. An Annuity is purchased for a person enrolled under the Contract upon receipt by Equitable of an initial Contribution by the Employer. SECTION 1.06 CONTRIBUTION The term "Contribution" means a payment made to Equitable for a Participant with respect to an Annuity purchased for such Participant under the Contract. Equitable is under no obligation to accept any Contribution less than $20.00. The aggregate amount of such Contributions shall not exceed $1,500 with respect to any taxable year of the Participant, except that if such Contributions are made under a Plan described in clause (ii) of Section 1.02 constituting a "Simplified Employee Pension", the aggregate amount of such Contributions shall not exceed $7,500 with respect to any taxable year of the Participant. Amounts transferred to the Contract from an individual retirement account or annuity which meets the requirements of Section 408(a) or (b), respectively, of the Code or from a Pension Plan Endowment contract issued by Equitable as an individual retirement annuity are not included in such aggregate amount of Contributions. SECTION 1.07 PARTICIPATION DATE The term "Participation Date" with respect to a Participant means the date as of which Equitable has enrolled such Participant under the terms of the Contract. SECTION 1.08 PARTICIPATION YEAR The term "Participation Year" with respect to a Participant means the twelve month period beginning on (i) the Participation Date, and (ii) each anniversary thereof, unless otherwise agreed to in writing by Equitable. SECTION 1.09 CLASS OF PARTICIPANTS Except as provided in Section 1.10, the term "Class of Participants" refers to all Participants whose Participation Date is in the same calendar year. SECTION 1.10 GUARANTEED INTEREST RATE For each Guaranteed Interest Account, the term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in such Account. Interest accrues daily. The Guaranteed Interest Rate will never be less than 3% per annum. Equitable will from time to time establish and make available for new Participants (i) an Initial Guaranteed Interest Rate, (ii) one or more Minimum Guaranteed Interest Rates and (iii) the applicable effective period(s) for such Rates. A new Class of Participants will be established effective with the effective date of the occurrance of (i), (ii) or (iii) above or any combination thereof. No. 11929CI Page 4 DEFINITIONS (continued) For the calendar year next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent calendar year thereafter, Equitable will determine for each established Class of Participants before the beginning of such calendar year a Yearly Guaranteed Interest Rate for such Class, which Yearly Guaranteed Interest Rate will not be lower than the effective Minimum Guaranteed Interest Rate applicable for such Class for such year. For any established Class of Participants, Equitable reserves the right to change the Minimum Guaranteed Interest Rate and the applicable period therefor, provided that any such Minimum Guaranteed Interest Rate will not be lower than the Minimum Guaranteed Interest Rte that would have been in effect in the absence of such change. Equitable will notify each Participant in a Class in writing of any change in the Minimum Guaranteed Interest Rate at least 15 days prior to its effective date. SECTION 1.11 RETIREMENT DATE The term "Retirement Date" means the date on which the Participant is to attain the retirement age specified in the Participant's enrollment form. Before the Retirement Date the Participant may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be earlier than the date of attainment of age 59 years and six months nor shall be later than the date of attainment of age 70 years and six months. Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Home Office. SECTION 1.12 NORMAL FORM The "Normal Form" of an Annuity Benefit under the Contract means, (i) if the Participant has a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (100% continuation), and (ii) if the Participant does not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.13 JOINT AND SURVIVOR LIFE ANNUITY FORM The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depends is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by the Participant. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.14 LIFE ANNUITY FORM The term "Life Annuity Form" means an annuity providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.15 ANNUITY VALUE The term "Annuity Value" with respect to a Participant's Guaranteed Interest Account means the amount in such Account pursuant to Section 2.02 SECTION 1.16 CASH VALUE With respect to a Participant for whom no cash value(s) of existing contract(s) issued by Equitable is (are) transferred to the Contract pursuant to Section 2.01, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account means an amount equal to the Annuity Value after either (i) the later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and six months, or (ii) the Participant's attainment of age 70 years and six months. Prior to such time, the Cash Value of such Participant's Guaranteed Interest Account will equal the greater of (a) 94% of the Annuity Value of such Account and (b) the Annuity Value of such Account minus an amount equal to the excess, if any, of (i) 9% of the total Contributions made on behalf of such Participant during the current Participation Year and the preceding nine completed Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Section 2.05. With respect to a Participant for whom cash value(s) of existing contract(s) issued by Equitable is (are) transferred to the Contract pursuant to Section 2.01, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account means an amount equal to the Annuity Value after such Participant attains age 59 years and six months. Prior to such time, the Cash Value of such Participant's Guaranteed In- Page 5 terest Account will equal the Annuity Value of such Account minus an amount equal to the lesser of (a) and (b) where: (a) is the sum of: (1) 2% of the excess, if any, of (i) the first $10,000 of Separate Account Transfers over (ii) the cumulative total of any previous withdrawals made pursuant to subsection (a) of the third paragraph of Section 2.05 and (2) 6% of the excess, if any, of (i) the Annuity Value over (ii) the total amount of Separate Account Transfers minus the cumulative total of any withdrawals made pursuant to Section 2.05 (but such amount shall not be less than zero). (b) is the excess, if any, of: (1) the sum of (i) 2% of the first $10,000 of Separate Account Transfers made during the current Participation Year and the preceding nine Participation Years and (ii) 9% of all other Contributions (excluding Separate Account Transfers) made on behalf of the Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any withdrawal charges made pursuant to Section 2.05. SECTION 1.17 CODE The term "Code" means the Internal Revenue Code of 1954, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.18 SEPARATE ACCOUNT TRANSFERS The term "Separate Account Transfers" with respect to a Participant means the amount of cash value(s) transferred to the Contract from separate investment account(s) maintained by Equitable, pursuant to Section 2.01. PART II -- PARTICIPANT'S ACCOUNT SECTION 2.01 CONTRIBUTIONS The Employer is to make Contributions from time to time on such dates and in such amounts as determined by the Employer pursuant to the terms of the Plan or, if the Employer has no Plan, as determined by the Employer at its sole discretion. The Employer is to specify the Participant with respect to whom each such Contribution is being made. Each Contribution received by Equitable with respect to a participant will, before its allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable, and by the amount of any applicable deduction in accordance with Section 2.08. A Participant may, with Equitable's agreement, transfer to the Contract any amount held with respect to such Participant under an individual retirement account or annuity meeting the requirements of Section 408(a) or (b), respectively, of the Code issued by Equitable or otherwise, of a Pension Plan Endowment contract issued by Equitable as an individual retirement annuity, except an individual retirement account or annuity contract containing any "rollover amounts" within the meaning of Section 402(a)(5) of the Code. Any amount so transferred from an individual retirement account or annuity contract not issued by Equitable will, before allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable. Equitable will issue to each Participant an individual certificate setting forth a statement in substance of the benefits to which such Participant is entitled under the Contract. SECTION 2.02 GUARANTEED INTEREST ACCOUNT Equitable maintains a Guaranteed Interest Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the Guaranteed Interest Account becomes part of the general assets of Equitable, which support the guarantees of the Contract and other contracts. The amount in a Guaranteed Interest Account at any time is equal to the sum of all amounts that have been allocated to such Guaranteed Interest Account pursuant to Section 2.01 and Section 2.03 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn pursuant to Section 2.05 and Section 2.06 from such Account and less the sum of any annual administrative charges accrued but not made. Equitable Page 6 PARTICIPANT'S ACCOUNT (continued) guarantees that the amount in a Guaranteed Interest Account at any time before the Retirement Date will not be less than the sum of all amounts allocated to such Account pursuant to Section 2.01 and less the sum of all amounts that have been withdrawn from such Account pursuant to Section 2.05, all accumulated at 3% interest, compounded annually. In any Participation Year in which no Contribution is allocated to the Guaranteed Interest Account, the amount in such Account at the end of the Participation Year shall not be less than the amount in such Account at the beginning of the Participation Year less the sum of all amounts withdrawn from such Account pursuant to Section 2.05, all accumulated at 3% interest, compounded annually. A Guaranteed Interest Account for a Participant terminates on the earliest of (i) the Retirement Date, (ii) the death of the Participant, and (iii) termination of participation pursuant to Section 2.04. SECTION 2.03 ALLOCATION TO ACCOUNT Each Contribution made with respect to a Participant pursuant to Section 2.01, after deduction for any applicable taxes, will be allocated, as of the date by which Equitable has received such Contribution, to the Guaranteed Interest Account. Interest is allocated to the Guaranteed Interest Account at the end of each Participation Year, at the time of withdrawal pursuant to Sections 2.05 and 2.07, at the time of application of amounts in the Guaranteed Interest Account to provide Annuity Benefits, and upon termination of participation pursuant to Section 2.04. SECTION 2.04 TERMINATION OF PARTICIPATION On or before a Participant's Retirement Date, such Participant may elect by written notice to terminate participation under the Contract. Upon receipt of such notice, Equitable will determine the Cash Value, as of the date Equitable received such notice, of the Guaranteed Interest Account maintained for such Participant. The payment of such Cash Value to the Participant may be deferred by Equitable in accordance with the provisions of Section 4.08. Prior to a Participant's Retirement Date, Equitable reserves the right to withdraw the Annuity Value of the Participant's Guaranteed Interest Account, pay such Annuity Value and terminate such Participant's participation under the Contract. This right may be exercised with respect to the Participant only if both (i) no Contributions have been made under the Contract during the last three completed Participation Years, and (ii) such Annuity Value is $500 or less. Equitable reserves the right to terminate a Participant's participation under the Contract if at least 120 days have elapsed since the issue date shown on the certificate issued to such Participant under the Contract and no Contributions have been made under the Contract with respect to such Participant. Upon payment of such Cash Value or Annuity Value, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Cash Value or Annuity Value arose. SECTION 2.05 PARTIAL WITHDRAWALS A Participant may elect by written notice to Equitable to make a partial withdrawal from the Guaranteed Interest Account maintained for such Participant before such Participant's Retirement Date. With respect to partial withdrawals requested by a Participant for whom no cash value(s) of existing contract(s) issued by Equitable is (are) transferred to the Contract, Equitable will withdraw from such Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the Annuity Value of such Account, provided the request for partial withdrawal is made after either (i) the later of (a) the completion of five Participation years with respect to such Participant and (b) such Participant's attainment of age 59 years and six months, or (ii) such Participant's attainment of age 70 years and six months. If a partial withdrawal with respect to such Participant is made prior to such time, Equitable will withdraw from such Account an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. Such withdrawal charge will equal the lesser of (a) 6% of the total amount to be withdrawn from the Account pursuant to this Section (including such charge) and (b) the excess, if any, of (i) 9% of the total Contributions made on behalf of such Participant during the current Participation year and the preceding nine completed Participation years over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. With respect to partial withdrawals requested by a Participant for whom cash value(s) of existing contract(s) issued by Equitable is (are) transferred to the contract pursuant to Section 2.01, Equitable will withdraw from such Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the Annuity Value of such Account, provided the request for partial withdrawal is made Page 7 PARTICIPANT'S ACCOUNT (continued) after such Participant's attainment of age 59 years and six months. If a partial withdrawal with respect to such Participant is made prior to such time, Equitable will withdraw from such Account an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. Such withdrawal charge will be an amount equal to the sum of the charges described in subsections (a) and (b) below; provided, however, that in no event will such withdrawal charge exceed an amount described in subsection (c) below: (a) With respect to the amount of any withdrawal made up to the excess, if any, of (1) the cumulative total of all Separate Account Transfers made on the Participant's behalf over (2) the cumulative total of prior withdrawals made to which the withdrawal charge described in this subsection was applied, an amount equal to the lesser of (i) 2% of the total amount to be withdrawn pursuant to this subsection (including such charge) and (ii) $200 minus the cumulative total of any prior withdrawal charges made pursuant to this subsection. (b) With respect to any withdrawal made to which the withdrawal charge described in subsection (a) does not apply, 6% of such amount to be withdrawn (including such charge). (c) is the excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Separate Account Transfers made during the current Participation Year and the preceding nine Participation Years and (ii) 9% of all other Contributions (excluding Separate Account Transfers) made on behalf of the Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any prior withdrawal charges made pursuant to this Section. Upon withdrawal pursuant to either of the preceding two paragraphs, Equitable will pay the lesser of the Cash Value of such Account or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by such Participant. Upon any payment to a Participant pursuant to this Section, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Payments to the Participant pursuant to this Section may be deferred by Equitable in accordance with the provisions of Section 4.08. Equitable is under no obligation to process any request for partial withdrawal of less than $300. If a withdrawal from the Account made pursuant to this Section would result in an Annuity Value of less than $200, Equitable will withdraw the Annuity Value of the Account, pay the Cash Value of the Account to the Participant, and will terminate such Participant's participation under the Contract. SECTION 2.06 ANNUAL ADMINISTRATIVE CHARGE As of the last day of each Participation year before a Participant's Retirement Date, Equitable will withdraw from the Guaranteed Interest Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, an annual administrative charge equal to the lesser of $30 and 2% of the sum of (i) the Annuity Value of the Guaranteed Interest Account at the end of that Participation Year and (ii) any withdrawals made from such Account pursuant to Section 2.05 during that Participation Year. As of a Participant's Retirement Date and before application of the Annuity Value of such Participant's Account pursuant to Section 3.02, or upon termination of such Account pursuant to Section 2.04 or Section 2.07 during a Participation Year, Equitable will withdraw the administrative charge described in this Section for the applicable part of that Participation Year. SECTION 2.07 DEATH BENEFIT If the Employer reports to Equitable, or if Equitable otherwise ascertains, that a Participant has died while an Account for such Participant is maintained under the Contract and before such Participant's Retirement Date, Equitable, upon receipt of due proof of such death, will pay in a single sum to the beneficiary designated by such Participant to receive such payment the amount of death benefit payable with respect to such Participant. The amount of the death benefit with respect to a Participant at any time prior to the Retirement Date is equal to the greater of (i) the Annuity Value of the Guaranteed Interest Account maintained under the Contract for such Participant and (ii) the minimum death benefit with respect to such Participant. Such minimum death benefit is the sum of all Contributions made with respect to such Participant pursuant to Section 2.01 (before reduction pursuant to said Section) less an adjustment for any withdrawals made pursuant to Section 2.05 from the Account maintained under the Contract for such Participant. Any such withdrawal will reduce the minimum death benefit (as adjusted by an previous such withdrawal) by an amount which is in the same proportion as the amount being withdrawn is to the Annuity Value then in the Guaranteed Interest Account maintained under the Contract for such Participant. If, in accordance with the provisions of Section 2.01, the cash value of an Annuity contract issued by Equitable, which provides for a death benefit before retirement equal to the greater of the contract cash Page 8 PARTICIPANT'S ACCOUNT (continued) value or an alternative amount based on premiums paid or contributions made under the Annuity contract, is transferred to the Contract, such alternative amount as of the date of transfer will be included in the "sum of all Contributions" in lieu of the amount of cash value transferred, for purposes of the death benefit under the Contract. The amount of any death benefit payable with respect to a Participant will, to the extent such Account is sufficient therefor, be withdrawn from the Guaranteed Interest Account maintained with respect to such Participant under the Contract. Upon such payment, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Annuity Value arose. SECTION 2.08 CHANGE OF DEDUCTIONS FOR NEW PARTICIPANTS Equitable reserves the right to make deductions to the extent permitted by applicable law from Contributions made on behalf of new Participants at any time on or after the Contract Change Date, by at least 90 days advance written notice to the Contract Holder and by amendment to the Contract. Equitable will thereupon establish a new Contract Change Date which shall be at least 5 years later. Equitable may lower the amount of the administrative charge described in Section 2.06 for new Participants at any time, by at least 15 days advance written notice to the Contract Holder. SECTION 2.09 CHANGE OF DEDUCTIONS AND CHARGES FOR EXISTING PARTICIPANTS Equitable may lower the amount of the administrative charge described in Section 2.06 for existing Participants at any time, by at least 15 days advance written notice to the Contract Holder and to such Participants. PART III -- ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Value of such Participant's Guaranteed Interest Account shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of such Account in a single sum or (ii) to apply such Annuity Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.03, to provide an Annuity Benefit on any other annuity form offered by Equitable, as elected by the Participant, subject to Equitable's rules then in effect and any applicable requirements under the Code. Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate participation under the Contract pursuant to Section 2.04 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Value of such Participant's Guaranteed Interest Account. Equitable will have the right to require the Participant to furnish pertinent facts and determinations to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.03 and 3.04. Equitable may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form. SECTION 3.03 AMOUNT OF ANNUITY BENEFITS If a Participant elects pursuant to the first paragraph or third paragraph of Section 3.02 to receive an Annuity Benefit in lieu of the Cash Value of the Guaranteed Interest Account, the amount applied to provide the Annuity Benefit will be (i) the Annuity Value of such Account if the payments under the annuity form elected are contingent upon the survival of a person, or (ii) the Cash Value of such Account if the payments under the annuity form elected are not contingent upon the survival of a person. Page 9 ANNUITY BENEFITS (continued) The amount applied to provide an Annuity Benefit shall be reduced by the amount, as determined by Equitable, of any applicable taxes on annuity considerations. If such amount is applied on or after the completion of five Participation Years with respect to such Participant, or if such amount is applied on behalf of a Participant for whom cash value(s) of existing contract(s) issued by Equitable was (were) transferred to the Contract pursuant to Section 2.01, the balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. If the amount applied to provide an Annuity Benefit is applied before the completion of five Participation Years with respect to a participant for whom no cash value(s) of existing contract(s) issued by Equitable was (were) transferred to the Contract, the balance, after any applicable tax on annuity considerations, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the Guaranteed Interest Account maintained for such Participant shall terminate. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity value will provide under the Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (100% continuation). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, are based on 3 1/4% interest and the 1971 ELAS Mortality Table. Equitable may change the monthly income amounts contained in the Tables of Guaranteed Annuity Payments and the bases for determining such amounts, for new Participants, by at least 90 days advance notice to the Contract Holder and by an amendment to the Contract. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on 3 1/4% interest and the 1971 ELAS Mortality Table. SECTION 3.04 PAYMENT OF ANNUITY BENEFITS The entire interest of a Participant will be distributed to such Participant not later than the close of such Participant's taxable year of attainment of age 70 years and six months, or will be distributed in equal or substantially equal installments over (A) the life of such Participant and such Participant's spouse, or (B) a period not extending beyond the life expectancy of such Participant or the life expectancy of such Participant or the life expectancy of such Participant and such Participant's spouse. If the Participant dies before such Participant's interest has been distributed to such Participant, or if distribution has been commenced as provided in the first paragraph of this Section to such Participant's spouse, and such spouse dies before the entire interest has been distributed to such spouse, the entire interest (or the remaining part of such interest if the distribution thereof has commenced) will, within five years after the death of such Participant (or the death of such Participant's surviving spouse), be distributed, or applied to the purchase of an annuity for the beneficiary or beneficiaries of such Participant (or such Participant,s surviving spouse) which will be payable for the life of such beneficiary or beneficiaries (or for a term certain not extending beyond the life expectancy of such beneficiary or beneficiaries) and which annuity will be immediately distributed to such beneficiary or beneficiaries. The preceding sentence shall have no application if distributions over a term certain commenced before the death of the Participant and the term certain is for a period permitted under the first paragraph of this Section. Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payable under the Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by Equitable will be Page 10 ANNUITY BENEFITS (continued) charged against and underpayments will be added to any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may make the payments (in the case of a minor, at a rate not exceeding $50 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If an annuity form made available by Equitable provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Upon election by a Participant pursuant to Section 3.02 of an annuity form providing payments for a period certain, such Participant may designate (with the right to change such designation) a person or persons to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's executors or administrators in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, Equitable will pay in a single sum to such payee's executors or administrators the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.02. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. Equitable will require satisfactory evidence of age of any person upon whose life an annuity form depends. TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Value)
- ---------------------------------------------------------------------------------------------------------------------------------- Male Female Age Age 60 61 62 63 64 65 66 67 68 69 70 - ---------------------------------------------------------------------------------------------------------------------------------- 60 4.52 4.58 4.64 4.70 4.76 4.82 4.88 4.94 5.00 5.05 5.11 61 4.55 4.62 4.68 4.74 4.81 4.87 4.93 5.00 5.06 5.12 5.18 62 4.58 4.65 4.72 4.78 4.85 4.92 4.99 5.05 5.12 5.19 5.25 63 4.61 4.68 4.75 4.82 4.89 4.97 5.04 5.11 5.18 5.25 5.32 64 4.64 4.71 4.79 4.86 4.94 5.01 5.09 5.17 5.24 5.32 5.40 65 4.67 4.74 4.82 4.90 4.98 5.06 5.14 5.22 5.30 5.36 5.47 66 4.69 4.77 4.85 4.93 5.02 5.10 5.18 5.27 5.35 5.44 5.53 67 4.72 4.80 4.88 4.97 5.05 5.14 5.23 5.31 5.40 5.50 5.59 68 4.74 4.82 4.91 5.00 5.09 5.18 5.27 5.36 5.45 5.55 5.65 69 4.76 4.85 4.94 5.03 5.12 5.22 5.31 5.41 5.50 5.60 5.73 70 4.78 4.87 4.96 5.06 5.16 5.26 5.36 5.45 5.56 5.65 5.76
FIXED ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) Age Males Females - --- ----- ------- 60 5.88 4.99 61 6.04 5.11 62 6.21 5.24 63 6.38 5.38 64 6.57 5.53 65 6.77 5.68 66 6.98 5.84 67 7.19 6.01 68 7.42 6.20 69 7.67 6.39 70 7.93 6.67 Page 11 ANNUITY BENEFITS (continued) Any election, change, revocation or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a commutation right under an Annuity Benefit is exercised, Equitable may defer payment in accordance with Section 4.08. PART IV -- GENERAL PROVISIONS SECTION 4.01 CONTRACT The Contract constitutes the entire Contract between the parties and the provisions of the Contract alone will govern with respect to the rights and obligations of Equitable. The provisions of the Contract will be applied separately with respect to each Participant. Nothing in the enrollment form referred to in Section 1.05, the Plan or custodial agreement referred to in Section 4.10 nor any modification, amendment, or supplement to any such documents will in any way be construed to enlarge, change, vary or in any other way affect the obligations of Equitable as expressly provided in the Contract. The Contract may not be modified as to Equitable, nor may any of Equitable's rights or requirements be waived, except in writing and by an authorized officer of Equitable. The Contract may be changed by amendment or replacement upon agreement between the Contract Holder and Equitable without the consent of any other person provided that such change does not reduce any Annuity Benefit provided before such change and provided that no rights, privileges or benefits which have accrued to any Participant under the Contract may be reduced or forfeited except by the express consent of such Participant. SECTION 4.02 STATUTORY COMPLIANCE Equitable reserves the right to amend the Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the Contract and any certificate to reflect changes in the Code, or in regulations or published rulings of the Internal Revenue Service, so that each such certificate will continue to be an Annuity. Any Annuity Benefit, Cash Value or death benefit available under a certificate issued pursuant to the Contract shall not be less than the minimum benefits required by any statute of the state in which the certificate is delivered. SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY The entire interest of any Participant under the Contract is nonforfeitable. No interest of a Participant under the Contract may be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than Equitable. No amount payable under the Contract may be assigned, commuted, or encumbered by the payee, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. SECTION 4.04 PARTICIPATION IN SURPLUS The Contract and all other contracts in the same class of contracts shall be combined for the purpose of ascertaining the annual surplus of Equitable to be apportioned to said contracts as a dividend, and the portion of any such dividend that is to be allocated to the Contract shall be determined by Equitable. The participation of this class of contracts in annual surplus is, however, expected to be minimal. Any amount so allocated to the Contract shall be payable as of January 1 of the calendar year in which a dividend is apportioned and will be payable in cash and shall be equitably allocated by Equitable to the Guaranteed Interest Accounts maintained hereunder for Participants. No Annuity Benefit will enter into the determination of any surplus to be apportioned to the Contract as a dividend., SECTION 4.05 BENEFICIARY Each Participant, as of such Participant's Participation Date is to provide Equitable with an initial designation of the beneficiary entitled to receive any death benefit payable with respect to such Participant pursuant to Section 2.07. The Participant may change such designation from time to time during such Participant's lifetime and while Accounts for such Participants are being maintained hereunder. Any such designation or change will be made by written notice in a form satisfactory to Equitable. A change will, upon receipt at a designated Equitable Office, take effect as of the time the written notice was signed, whether or not the Participant is living on the date of receipt, but without further liability as to any pay- Page 12 GENERAL PROVISIONS (continued) ment or other settlement made by Equitable before receipt of such change. Unless otherwise specified in the designation, if a Participant has designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive the Participant, and if more than one survive they will share equally. Any part of a death benefit payable with respect to a Participant pursuant to Section 2.07 for which there is no designated beneficiary living at the death of the Participant will be payable in a single sum to the children of the Participant who survive the Participant, in equal shares, or should none survive, then to the Participant's executors or administrators. If a Participant so elects in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by the Participant, with respect to the beneficiary, subject to Equitable's rules then in effect. If at the death of a Participant there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. SECTION 4.06 DISQUALIFICATION In the event that an annuity purchased hereunder with respect to a Participant fails to qualify as an Annuity as described in Section 1.03, Equitable shall have the right, upon receiving notice of such fact before the Retirement Date, to terminate participation with respect to such Participant under the Contract and pay to such Participant the amount in the Account maintained with respect to such Participant less a deduction for the appropriate part attributable to such Participant of any Federal income tax payable by Equitable which would not have been payable if such Participant had an Annuity under the Contract. SECTION 4.07 FUTURE PARTICIPANTS Equitable reserves the right at its sole discretion to curtail or prohibit further enrollment as Participants under the Contract of any individuals who are not currently participating under the Contract as of such date of curtailment or prohibition. SECTION 4.08 DEFERMENT Payments by Equitable from the Participant's Guaranteed Interest Account pursuant to the provisions of Section 2.04, Section 2.05 and Section 2.07, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.04, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.04. Interest at the current Guaranteed Interest Rate for such Participant's Guaranteed Interest Account will be allowed on any such payment deferred for 30 days or more. SECTION 4.09 ANNUAL NOTICE At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Guaranteed Interest Account, (2) the Cash Value of the Guaranteed Interest Account, and (3) the amount of death benefit payable with respect to the Participant. SECTION 4.10 CONTRACT HOLDER RESPONSIBILITY The sole responsibility of the Contract Holder is to serve as party to the Contract. The Contract Holder will have no responsibility for the administration of any Plan, for payments to the Guaranteed Interest Account, or any payments or other distributions hereunder. Equitable will deal with the Contract Holder in accordance with the terms and conditions of the custodial agreement pursuant to which the Contract Holder agreed to act as such and the Contract and in such manner as the Contract Holder and Equitable may agree, without the consent of any other person. Any Employer making Contributions under the Contract shall be deemed to have adopted and accepted the custodial agreement as part of the Plan with respect to which such Contributions are made. SECTION 4.11 AGE AND SEX If the Annuitant's age or sex has been misstated, any benefits will be those which would have been purchased at the correct age and sex. Any overpayments or underpayments made by Equitable will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. Page 13 APPLICATION FOR GROUP ANNUITY CONTRACT To: THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES [EQUITABLE LOGO] UNITED STATES TRUST COMPANY OF NEW YORK - -------------------------------------------------------------------------------- (hereinafter called the Applicant) of 45 Wall Street, New York, New York 10005 - -------------------------------------------------------------------------------- (Applicant's Head Office Address) HEREBY APPLIES for a Group Annuity contract in the form attached, and approves and accepts the terms of such Group Annuity contract. This application supersedes any application for the said contract previously signed by the Applicant. This contract will take effect as of March 7, 1980. ---------------- Dated at New York, New York March 7, 1980 -------------------------------------- Signature of Applicant /s/ Signature Unreadable ------------------------------------- ----------------------------------------------- ----------------------------------------------- Official Title Vice President -------------------------------- PF 92.580 Attached to and made part of Group Annuity Contract No. 11929CI between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective August 15, 1981, said contract is amended as follows: 1. Contributions made to the contract, less applicable premium taxes, as determined by Equitable, may be allocated to the Guaranteed Interest Account or Stock Account maintained for the Participant, or in part to both, as directed by the Participant. 2. At the Retirement Date, if the Participant is then living, the amount in the Guaranteed Interest Account and Stock Account will be applied to provide the Participant with an Annuity Benefit or Cash Value Benefit. 3. ASSETS HELD IN CONNECTION WITH THE CONTRACT MAY BE HELD IN A SEPARATE ACCOUNT MAINTAINED BY EQUITABLE AND MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THE CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE SEPARATE ACCOUNT IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.20 IS 5% OR 3 1/2%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE OF 1.75% FOR INVESTMENT MANAGEMENT, FINANCIAL ACCOUNTING, THE ANNUITY RATE GUARANTEE AND MINIMUM DEATH BENEFIT, EXPENSES AND EXPENSE RISK, BUT AFTER ANY DEDUCTIONS TO PROVIDE FOR TAXES. THIS CONTRACT MAY NOT BE SUITABLE FOR A PARTICIPANT IF THE ONLY CONTRIBUTION TO BE MADE ON SUCH PARTICIPANT'S BEHALF IS A SUBSTANTIAL SINGLE SUM CONTRIBUTION. PF 14101CI Page 1 4. The following provisions are added to your Certificate: To Part 1 of your Certificate SECTION 1.05A EXISTING PARTICIPANT The term "Existing Participant" means a Participant for whom Cash Values of existing annuity contract(s) issued by Equitable is (are) eligible to be transferred to the Contract pursuant to Section 2.01. SECTION 1.05B NEW PARTICIPANT The term "New Participant" means a Participant who is not an Existing Participant. SECTION 1.14B ELIGIBLE ANNUITY CERTAIN The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by Equitable which extends beyond the Participant's attainment of age 59 years and six months and does not permit any prepayment of the unpaid principal prior to the participant's attainment of age 59 years and six months. SECTION 1.19 THE SEPARATE ACCOUNT The term "Separate Account" means Separate Account A, a separate investment account maintained by Equitable to which portions of its assets have been allocated for the Contract and certain other contracts. Equitable reserves the right to withdraw form the Separate Account and allocate to another separate account assets determined by Equitable to be associated with the class of contracts to which the Contract belongs. In any such event, to the extent practicable and permissible under applicable laws and regulations, the withdrawal shall be made by withdrawing the same percentage of each investment in the Separate Account, with appropriate adjustments to avoid odd lots and fractions. On and after the date of any such withdrawal the term "Separate Account" in the Contract shall mean such other separate account to which the withdrawn assets were allocated. It is contemplated that investments in the Separate Account will, at most times, consist primarily of common stock and other equity-type investment. Equitable may, however, at its discretion invest the assets of the Separate Account in any investment permitted by applicable law. Equitable may rely conclusively on the opinion of counsel (including attorneys in its employ) as to what investments it is permitted by law to make. In lieu of making such investments directly, Equitable reserves the right to operate the Separate Account as a unit investment trust, or in any other form permitted by law, investing all or part of its assets in shares or units of a fund, the investment adviser of which may be Equitable or controlled by Equitable. The fund assets would be invested as provided above with respect to the Separate Account. Equitable reserves the right: (i) to cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such committee at any time; and (iii) restrict or eliminate any voting rights of participants or other persons who have voting rights as to the Separate Account. Assets of the Separate Account attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, consisting of .15% for investment management, .35% for financial accounting, .35% for the annuity rate guarantee and the minimum death benefit, and .90% for expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.20. The assets of the Separate Account are the property of Equitable; however, the portion of the assets of the Separate Account equal to the reserves and other contract liabilities with respect to such Account shall not be chargeable with liabilities arising out of any other business Equitable may conduct. Equitable reserves the right to transfer assets of the Separate Account in excess of such reserves and contract liabilities to the general account of Equitable. SECTION 1.20 DEFINITIONS RELATING TO THE SEPARATE ACCOUNT VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business day immediately preceding such business day will constitute a Valuation Period. A PF 14101CI Page 2 business day is any day on which there is a sufficient degree of trading in the portfolio securities of the Separate Account that the Accumulation Unit Value or Annuity Unit Value might be materially affected by changes in the value of the portfolio securities in the Separate Account, as determined by Equitable. NET INVESTMENT FACTOR: For the Separate Account the Net Investment Factor for a Valuation Period is (a) divided by (b), minus (c), where (a) is(1) the value of the assets in the Separate Account at the close of business of the preceding Valuation Period plus (2) the investment income and the capital gains, realized or unrealized, credited to the assets of the Separate Account in the Valuation Period for which the Net Investment Factor is being determined, minus (3) the capital losses, realized or unrealized, charged against such assets in such Valuation Period, minus (4) any amount charged against the Separate Account in such Valuation Period for taxes or for amounts set aside by Equitable as a reserve for taxes attributable to the maintenance or operation of the Separate Account; (b) is the value of the assets in the Separate Account at the close of business of the preceding Valuation Period; and (c) is the daily charge, for each calendar day in such Valuation Period of .00004837 for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The value of the assets in the Separate Account, referred to above, shall be taken at their fair market value, or where there is no readily available market, their fair value, as determined in accordance with accepted accounting practices and applicable laws and regulations. ACCUMULATION UNIT: The Accumulation Unit is a unit used in determining the value of the interest of a Participant's Stock Account in the Separate Account on or before the Retirement Date. NEW ACCUMULATION UNIT VALUE: The initial New Accumulation Unit Value for the Separate Account has been established at $10.00 as of November 1, 1968. The New Accumulation Unit Value for each subsequent valuation Period is the New Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such subsequent Valuation Period. ANNUITY UNIT: The Annuity Unit is a unit used in determining amount payable from the Separate Account under a Variable Annuity Benefit. NEW ANNUITY UNIT VALUE: The initial New Annuity Unit Value has been established at $1.00 on November 1, 1968. The New Annuity Unit Value for any subsequent Valuation Period is the New Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE NEW ANNUITY UNIT VALUE: The Average New Annuity Unit Value for a calendar month is equal to the average of the New Annuity Unit Values of the Valuation Periods ending in such month. To Part II of your Certificate SECTION 2.10 STOCK ACCOUNT Equitable maintains a Stock Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to a Stock Account becomes part of the Separate Account. Any amount withdrawn from a Stock Account will no longer be part of the Separate Account. On any date when an amount is allocated to or withdrawn from a Stock Account, the Stock Ac- PF 14101CI Page 3 count will be credited or charged, as the case may be, with a number of Accumulation Units determined by dividing said amount by the New Accumulation Unit Value for the Separate Account for the Valuation Period which includes that date. The number of Accumulation Units in a Stock Account on any date is equal to (i) the sum of any Accumulation Units that have been credited to the Stock Account minus (ii) the sum of any Accumulation Units that have been charged to the Stock Account. The amount in a Stock Account on any date is equal to the product of (i) the number of Accumulation Units in the Stock Account on that date and (ii) the Accumulation Unit Value for the Separate Account for the Valuation Period which includes that date. SECTION 2.11 TRANSFERS BETWEEN ACCOUNTS At any time before a Participant's Retirement Date, such Participant, upon written request, may transfer all or a part of the amounts from the Stock Account maintained for such Participant to the Guaranteed Interest Account maintained for such Participant, or may transfer all or a part of the amounts in the Guaranteed Interest Account maintained for such Participant to the Stock Account maintained for such Participant. Such transfers will be made as of the later of (i) the date specified in such request and (ii) the date Equitable receives such request, and will be subject to Equitable's rules in effect at the time of transfer. To Part III of your Certificate SECTION 3.05 VARIABLE ANNUITY BENEFIT The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Separate Account. The amount of the first, second, and third payments under any Variable Annuity Benefit provided under the Contract with respect to a payee may increase or decrease depending on the investment experience of the Separate Account. The amount of the first, second, and third payments under any Variable Annuity Benefit provided under the Contract with respect to a payee is the monthly amount provided with respect to the payee pursuant to Section 3.03. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average New Annuity Unit Value for the second calendar month immediately preceding the date of the payment. The fourth and subsequent annuity payments under a Variable Annuity Benefit will not be increased or decreased in amount because of mortality or expense experience. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the New Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. 5. The following sections of your Certificate are amended or modified as follows: A. Section 1.15, ANNUITY VALUE, is amended to provide that the "Annuity Value" with respect to a Participant's Guaranteed Interest Account and Stock Account shall mean the amounts in such Accounts described in Section 2.02 and 2.10 B. Section 1.16 CASH VALUE, shall read as follows: SECTION 1.16 CASH VALUE -- NEW PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to a New participant, the term "Cash Value' with respect to such Participant's Guaranteed Interest Account and Stock Account means an amount equal to the Annuity Values of such Accounts after the earliest of the Following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and six months, or (ii) the Participant's attainment of age 70 years and six months, or (iii) the completion of 25 Participation Years with respect to such Participant, or (iv) if the Participant has attained age 55, completed five Participation Years, and the Cash Values are to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. PF 14101CI Page 4 WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% of the sum of the Annuity Values of such Accounts. (b) is an amount equal to the excess, if any, of (i) 8% of the cumulative contributions made on behalf of such Participant over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.05 and 2.05A. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% of the excess of (i) the sum of the Annuity Values of such Accounts over (ii) the Free Corridor Amount defined in Section 2.05C. (b) is the excess, if any, of (i) 8% of the total contributions made on behalf of such Participant during the current Participation Year and the preceding nine participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.05 and 2.05A. The Cash Value of the Guaranteed Interest Account and the Cash Value of the Stock Account will be in the same proportion as are the Annuity Values of such Account. SECTION 1.16B CASH VALUE - EXISTING PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to an Existing Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account and Stock Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The Participant's attainment of age 59 years and six months, (ii) the completion of 20 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55 and the Cash Values are to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a) and (b) below; provided, however, that such charge does not exceed the amount described in subsection (c) below where: (a) is an amount equal to 2% of any Preferred Withdrawal Amounts (defined in Section 2.05B) that have not previously been withdrawn pursuant to Section 2.05 and 2.05B. (b) is an amount equal to 6% of any Regular Withdrawable Amounts (defined in Section 2.05B) that have not previously been withdrawn pursuant to Section 2.05 and 2.05B. (c) is an amount equal to the sum of (a) above, and 6% of the excess, if any, of (i) the sum of the Annuity Values of such Accounts over (ii) the cumulative total of Equitable Transferred Funds made with respect to the Participant that have not previously been withdrawn pursuant to Section 2.05 and 2.05B. WITHDRAWAL CHARGE AFTER FIVE YEARS: After five Participation Years have been completed with respect to the Participant, Equitable (i) will first withdraw, pursuant to Section 2.05B, the Free Corridor Amount defined in Section 2.05C and (ii) next withdraw the remaining portion of the sum of the Annuity Values of such Accounts. A withdrawal charge will apply to the amount in (ii) above, and will equal the sum of the PF 14101CI Page 5 charges described in subsection (a) and (b) of the preceding subsection; provided, however, that such charge will not exceed an amount equal to the lesser of the charges defined in (d) and (e) below: (d) is an amount equal to the sum of (a) in the preceding subsection, and 6% of the excess, in any, of (i) the sum of the Annuity Values of such Accounts (after withdrawal of the Free Corridor Amount) over (ii) the cumulative total of Equitable Transferred Funds made on behalf of the Participant that have not previously been withdrawn pursuant to Section 2.05 and 2.05B. (e) is an amount equal to the excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other contributions (excluding Equitable Transferred Funds) made on behalf of such Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any withdrawal charges made pursuant to Section 2.05 and 2.05B. The Cash Value of the Guaranteed Interest Account and the Cash Value of the Stock Account will be in the same proportion as are the Annuity Values of such Accounts. C. Section 1.18, SEPARATE ACCOUNT TRANSFERS, shall read as follows: SECTION 1.18 EQUITABLE TRANSFERRED FUNDS The term "Equitable Transferred Funds" with respect to a Participant means the amount of cash value(s) transferred to the Contract from a contract issued by Equitable, pursuant to Section 2.01. D. The second paragraph of Section 2.02, GUARANTEED INTEREST ACCOUNT, is amended as follows: a. References to Section 2.05 are replaced by Sections 2.05, 2.05A and 2.05B. b. The amount in the Guaranteed Interest Account at any time includes the amount transferred into the Account and does not include amounts withdrawn or transferred out of such Account. E. The Sections entitled TERMINATION OF PARTICIPATION (2.04), ANNUAL ADMINISTRATIVE CHARGE (2.06), DEATH BENEFIT (2.07), ELECTION AND COMMENCEMENT OF ANNUITY PAYMENTS (3.02), and CONTRACT HOLDER RESPONSIBILITY (4.10) are amended to change the term "Guaranteed Interest Account" wherever it appears to "Guaranteed Interest Account and Stock Account." F. Section 2.03, ALLOCATION TO ACCOUNT, shall read as follows: SECTION 2.03 ALLOCATION TO ACCOUNT Each Contribution made with respect to a Participant pursuant to Section 2.01, after deduction for any applicable taxes, will be allocated, as of the date by which Equitable has received both such Contribution and direction as to its allocation, to the Guaranteed Interest Account, or Stock Account, or in part to each, at the sole direction of the Participant as specified to Equitable, provided that the percentage allocated to each Account is a whole number. Any amount that a Participant has directed to be transferred to the Guaranteed Interest Account or the Stock Account pursuant to Section 2.11 will be allocated as of the date of such transfer to the appropriate Account maintained for such Participant. Interest is allocated to the Guaranteed Interest Account at the end of each Participation Year, at the time of each transfer or withdrawal pursuant to Sections 2.05, 2.05A, 2.05B and 2.11 at the time of application of amounts in the Guaranteed Interest Account to provide Annuity Benefits, upon termination of participation pursuant to Section 2.04 and upon death of the Participant pursuant to Section 2.07. PF 14101CI Page 6 G. Section 2.05, PARTIAL WITHDRAWALS, shall read as follows: SECTION 2.05 PARTIAL WITHDRAWALS Subject to any applicable restrictions under the terms of the Plan, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Stock Account and the Guaranteed Interest Account maintained for such Participant before such Participant's Retirement Date. Upon withdrawal pursuant to Section 2.05, 2.05A or 2.05B, Equitable will pay the lesser of the sum of the Cash Values of such Accounts or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by such Participant. Unless instructed otherwise, the amount withdrawn (including the amount of any withdrawal charge) will be allocated between such Accounts in proportion to the Annuity Value of each such Account. Upon any payment to a Participant pursuant to Section 2.05, 2.05A or 2.05B, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Payments to the Participant pursuant to Section 2.05, 2.05A or 2.05B may be deferred by Equitable in accordance with the provisions of Section 4.08. Equitable is under no obligation to process any request for partial withdrawal of less than $300. If a withdrawal from the Accounts made pursuant to Sections 2.05, 2.05A or 2.05B would result in total Annuity Values of less than $200, Equitable will so advise the Participant and reserves the right to withdraw the Annuity Values of the Guaranteed Interest Account and Stock Account, pay the Annuity Values of such Accounts to the Participant, and terminate such Participant's participation under the Contract. If the Participant enrolled in this Contract on or after the effective date of this rider, the $200 amount stated above shall be $500. SECTION 2.05A PARTIAL WITHDRAWALS -- NEW PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a New Participant, Equitable will withdraw from the Stock Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and six months, or (ii) such Participant's attainment of age 70 years and six months, or (iii) the completion of 25 Participation Years with respect to such Participant, or (iv) if the Participant has attained age 55, has completed five Participation Years, and the partial withdrawal is to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: If the Participant has not completed five Participation Years under the Contract, such withdrawal charge will equal the less of (a) or (b) where: (a) is an amount equal to 6% of the total amount to be withdrawn from the account pursuant to this paragraph (including such charge) (b) is the excess, if any, of (i) 8% of the cumulative total of Contributions made on behalf of such Participant over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years, with respect to the Participant, there will be no withdrawal charge if the PF 14101CI Page 7 amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.05C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% of the amount withdrawn pursuant to (ii) of the preceding sentence including such charge, and (b) is the excess, if any, of (i) 8% of the cumulative total of contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. SECTION 2.05B PARTIAL WITHDRAWAL -- EXISTING PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by an Existing Participant, Equitable will withdraw from the Stock Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The Participant's attainment of age 59 years and six months, or (ii) the completion of 20 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55 and the partial withdrawal is to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. PREFERRED WITHDRAWABLE AMOUNT: This is an amount equal to the lesser of (a) the total of Equitable Transferred Funds made on behalf of the Participant or (b) $10,000 FREE WITHDRAWABLE AMOUNT: This is an amount equal to the excess , if any, of (a) the total Equitable Transferred Funds made on behalf of the Participant over (b) $10,000. REGULAR WITHDRAWABLE AMOUNT: This is the cumulative total of all Contributions, other than Equitable Transferred Funds, made on behalf of the Participant. ORDER OF WITHDRAWALS: In calculating the withdrawal charge, Equitable will assume that (a) any Preferred Withdrawable Amounts are first withdrawn, (b) any Free Withdrawable Amounts are next withdrawn, (c) any Regular Withdrawable Amounts are next withdrawn, and (d) lastly, any amounts other than the amounts described in (a), (b), and (c) above are withdrawn. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in sub-sections (a), (b), (c) and (d) below: (a) With respect to any withdrawals of Preferred Withdrawable Amounts, a charge of 2% of such withdrawals. (b) With respect to any withdrawals of Free Withdrawable Amounts, no charge. (c) With respect to any withdrawals of Regular Withdrawable Amounts, a charge of 6% of such withdrawals. (d) With respect to any withdrawals of amounts other than the amounts in (a), (b) and (c) above, no charge. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Partici- PF 14101CI Page 8 pant,there will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.05C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (1) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (2) then withdraw from such Accounts an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will equal the sum of the charges described in (a), (b), (c), and (d) above; provided, however, that in no event will such charge exceed an amount equal to the following: The excess , if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other Contributions (excluding Equitable Transferred Funds) made on behalf of the Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any prior withdrawal charges made pursuant to this Section. Whenever an amount is withdrawn from such Accounts that is not greater than the current Free Corridor Amount, such amount is considered to be (1) first, a withdrawal of Regular Withdrawable Amounts, (2) next, a withdrawal of Preferred Withdrawable Amounts, (3) next, a withdrawal of Free Withdrawable Amounts and (4) lastly, a withdrawal of amounts other than the amounts in (1), (2) or (3) above. However, no charge will be assessed with respect to the portion of the withdrawal up to the current Free Corridor Amount. SECTION 2.05C FREE CORRIDOR AMOUNT The term "Free Corridor Amount" with respect to a Participant who has completed five Participation Years means an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Values of the Stock Account and the Guaranteed Interest Account over (ii) cumulative prior withdrawals made pursuant to Section 2.05, 2.05A or 2.05B in the current Participation Year with respect to the Participant. H. The first paragraph of Section 2.06, ANNUAL ADMINISTRATIVE CHARGE, is amended by adding the following: The charge will be allocated between the Stock Account and the Guaranteed Interest Account in proportion to the Annuity Values of such Accounts at the end of the Participation Year. I. Section 2.08, Change of Deductions for New Participants, is deleted as of August 1, 1981 and Section 2.09, Change of Deductions and Charges for Existing Participants, shall not apply to Participants enrolled on or after August 1, 1981. J. With respect to Section 3.03, AMOUNT OF ANNUITY BENEFITS, a. Wherever the term "Guaranteed Interest Account" appears, it shall be changed to "Guaranteed Interest and Stock Account." b. The second and third sentences of paragraph 2 shall apply to a Participant who has completed five Participation Years and to an Existing Participant (as defined in Part 1 of this rider). c. Paragraph 3 shall apply to a New Participant (as defined in Part 1 of this rider) before the completion of five Participation Years. d. The last two paragraphs have been amended to provide that any Variable Annuity Benefit shall be calculated by Equitable on 1979 ELAS Mortality and an Assumed Base Rate of Net Investment Income Return of 5% or 3 1/2%, whichever applies pursuant to Section 1.20. PF 14101CI Page 9 K. Section 3.04 PAYMENT OF ANNUITY PAYMENTS, is amended by the addition of the following: VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3 1/2% (Minimum Monthly Income per $1,000 of Annuity Value)
- ---------------------------------------------------------------------------------------------------------------------------------- FEMALE AGE MALE ----------------------------------------------------------------------------------------------------------------------- AGE 60 61 62 63 64 65 66 67 68 69 70 ----------------------------------------------------------------------------------------------------------------------- 60 4.31 4.35 4.39 4.43 4.47 4.51 4.55 4.59 4.63 4.67 4.71 61 4.35 4.39 4.43 4.48 4.52 4.56 4.61 4.65 4.69 4.73 4.78 62 4.39 4.43 4.48 4.52 4.57 4.61 4.66 4.71 4.75 4.80 4.85 63 4.42 4.47 4.52 4.57 4.62 4.67 4.72 4.77 4.82 4.87 4.92 64 4.46 4.51 4.57 4.62 4.67 4.72 4.77 4.83 4.88 4.94 4.99 65 4.50 4.56 4.61 4.66 4.72 4.78 4.83 4.89 4.95 5.01 5.07 66 4.54 4.60 4.65 4.71 4.77 4.83 4.89 4.95 5.01 5.08 5.14 67 4.58 4.64 4.70 4.76 4.82 4.88 4.95 5.01 5.08 5.15 5.22 68 4.62 4.68 4.77 4.81 4.87 4.95 5.01 5.08 5.15 5.22 5.29 69 4.65 4.72 4.78 4.85 4.92 4.99 5.06 5.14 5.22 5.29 5.37 70 4.69 4.76 4.83 4.90 4.97 5.05 5.12 5.20 5.28 5.36 5.45 - ----------------------------------------------------------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 5% (Minimum Monthly Income per $1,000 of Annuity Value)
- ---------------------------------------------------------------------------------------------------------------------------------- FEMALE AGE MALE ----------------------------------------------------------------------------------------------------------------------- AGE 60 61 62 63 64 65 66 67 68 69 70 ----------------------------------------------------------------------------------------------------------------------- 60 5.19 5.23 5.27 5.31 5.34 5.39 5.42 5.46 5.50 5.54 5.58 61 5.23 5.27 5.31 5.35 5.39 5.43 5.47 5.52 5.56 5.60 5.64 62 5.27 5.31 5.35 5.39 5.44 5.48 5.53 5.57 5.62 5.67 5.71 63 5.31 5.35 5.39 5.44 5.49 5.53 5.58 5.63 5.68 5.73 5.78 64 5.34 5.39 5.44 5.48 5.53 5.59 5.64 5.69 5.74 5.79 5.85 65 5.38 5.43 5.48 5.53 5.58 5.64 5.69 5.75 5.80 5.86 5.92 66 5.42 5.47 5.52 5.58 5.63 5.69 5.75 5.81 5.87 5.93 5.99 67 5.45 5.51 5.56 5.62 5.68 5.74 5.80 5.87 5.93 6.00 6.06 68 5.49 5.55 5.61 5.67 5.73 5.80 5.86 5.93 6.00 6.06 6.14 69 5.53 5.59 5.65 5.71 5.78 5.85 5.92 5.99 6.06 6.13 6.21 70 5.56 5.63 5.69 5.76 5.83 5.90 5.97 6.05 6.13 6.21 6.29 - ----------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) VARIABLE ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS 3 1/2% 5% -------- -------- AGE MALES FEMALES MALES FEMALES --- ----- ------- ----- ------- 60 5.43 4.80 6.36 5.70 61 5.57 4.90 6.50 5.81 62 5.72 5.01 6.65 5.91 63 5.88 5.13 6.81 6.03 64 6.05 5.25 6.97 6.15 65 6.23 5.39 7.16 6.28 66 6.43 5.54 7.35 6.43 67 6.64 5.70 7.56 6.58 68 6.82 5.87 7.79 6.76 69 7.11 6.06 8.03 6.95 70 7.38 6.27 8.30 7.15 Equitable will notify the payee under a Variable Annuity Benefit of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each variable payment. I. Section 4.08 DEFERMENT, shall read as follows: SECTION 4.08 DEFERMENT Payments by Equitable from the Participant's Guaranteed Interest Account pursuant to the provisions of Section 2.04, Sections 2.05, 2.05A and 2.05B, and Section 2.07, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.04, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.04. Interest at the current Guaranteed Interest Rate for such Participant's Guaranteed Interest Account will be allowed on any such payment deferred for 30 days or more. Except as provided in this Section, payments by Equitable from the Participant's Stock Account pursuant to the provisions of Section 2.04, Sections 2.05, 2.05A and 2.05B, and Section 2.07, or any commuted payments arising from a Variable Annuity Benefit pursuant to Section 3.04, will be made within seven days after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.04. During any period when (i) the sale of securities or the determination of the New Accumulation Unit Value or the New Annuity Unit Value is not reasonably practicable because an emergency, defined by the Securities and Exchange Commission, exists, or the New York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may by order permit postponement for the protection of persons having interests in the Separate Account, Equitable reserves the right: PF 14101CI Page 10 (a) to defer determination of Cash Values or Annuity Values and payment of Cash Values and Annuity Values, arising from an amount in a Participant's Stock Account: (b) to defer payment of any portion of the death benefit arising from an amount in a Participant's Stock Account; (c) to defer payment of any variable Annuity Benefit under the Contract or the application of any such Benefit to provide for any other payment called for by the Contract; or (d) in the event of (a) above, to defer application of such amounts to provide any Annuity Benefit permitted under the Contract. M. Section 4.09, ANNUAL NOTICE, shall read as follows: SECTION 4.09 ANNUAL NOTICE At the end of each Participation Year up to an including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Guaranteed Interest Account, (2) the total number of Accumulation Units credited to the Stock Account, (3) the New Accumulation Unit Value, (4) the sum of the Cash Values of the Guaranteed Interest Account and the Stock Account and (5) the amount of death benefit payable with respect to the Participant. After the Retirement Date Equitable will notify the Participant of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By: /s/ Signature Unreadable By /s/ Coy Eklund ------------------------ -------------- President Title S/V/P By /s/ Rodney L. Enochs ----- -------------------- Vice President and Secretary Dated 8/12/81 Date of Issue Aug 12 1981 ------- ----------- At N.Y., N.Y. ---------- PF 14101CI Page 11 Attached to and made part of Group Annuity Contract No. 11929CI between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective January 1, 1982, said contract is amended as follows: 1. The third sentence of Section 1.01 (Employer) shall read as follows: Any self-employed individual and any employee of a partnership or corporation is deemed to be his own Employer if he elects to be enrolled under the Contract as a Participant; the term "Employer" shall also be deemed to include the spouse of a Participant if such spouse has no earned income for the taxable year and if the Participant elects to have such spouse enrolled under the Contract as a Participant. 2. The first sentence of paragraph two of Section 1.06 (Contribution) shall read as follows: The aggregate amount of such Contributions in any taxable year of the Participant shall not exceed (a) $2,000 with respect to amounts contributed under a Plan described in clause (i) of Section 1.02 to purchase an Individual Retirement Annuity and (b) $15,000 with respect to amounts contributed under a plan described in clause (ii) of Section 1.02 constituting a Simplified Employee Pension. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By /s/ [Signature Unreadable] By /s/ Coy Eklund .................................. .................................. President Title Senior Vice President By /s/ Rodney L. Enochs ............................... .................................. Vice President and Secretary Dated December 22, 1981 Date of Issue December 22, 1981 ............................... ....................... At New York, New York .................................. PF 14106 CI Attached to and made part of Group Annuity Contract No. 11929CI between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective January 1, 1982, said contract is amended by adding the following to the third paragraph of Section 1.10 (Guaranteed Interest Rate): For the period (not to exceed one year) next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent period (not to exceed one year) the Equitable may determine for each established Class of Participants a Guaranteed Interest Rate for such Class which exceeds the applicable Yearly Guaranteed Interest Rate. Equitable will notify each Participant in writing of the applicable Guaranteed Interest Rate and duration. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By /s/ [Signature Unreadable] By /s/ Coy Eklund .................................. .................................. President Title Senior Vice President By /s/ Rodney L. Enochs ............................... .................................. Vice President and Secretary Dated December 22, 1981 Date of Issue December 22, 1981 ............................... ....................... At New York, New York .................................. Attached to and made part of Group Annuity Contract No. 11929CI between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective April 15, 1982, said contract and riders are amended as follows: o Contributions made to the Contract after deduction of any applicable taxes, will be allocated to the Stock Account, Money Market Account or the Guaranteed Interest Account maintained for the Participant, in accordance with Sections 2.02 and 2.03, or in part to any one, as directed by the Participant. o The amount in the Stock Account, Money Market Account and the Guaranteed Interest Account will be applied at the Retirement Date to provide the Participant with an Annuity Benefit or a Cash Value Benefit if the Participant is then living, and o The Participant will have other rights and benefits as described herein. ASSETS HELD IN CONNECTION WITH THE CONTRACT MAY BE HELD IN SEPARATE ACCOUNTS MAINTAINED BY EQUITABLE AND MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THE CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF SEPARATE ACCOUNT A. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN SEPARATE ACCOUNT A IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.16 IS 5% OR 3 1/2%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE OF 1.75% FOR INVESTMENT MANAGEMENT, FINANCIAL ACCOUNTING, THE ANNUITY RATE GUARANTEE AND MINIMUM DEATH BENEFIT, EXPENSES AND EXPENSE RISK, BUT AFTER ANY DEDUCTIONS TO PROVIDE FOR TAXES. Equitable will issue to each Participant an individual certificate setting forth a statement in substance of the benefits to which such Participant is entitled under the Contract. The provisions on the following pages are part of the Contract. PF 14111 CI This page 2 reserved for information in connection with the issuance of certificates under this Contract. PAGE 2 This page 3 reserved for information in connection with the issuance of certificates under this Contract. PAGE 3 PART I - DEFINITIONS SECTION 1.01 EMPLOYER The term "Employer" means the sole proprietor, partnership or corporation which has adopted a Plan. A sole proprietor is deemed to be his own Employer and a partnership is deemed to be the Employer of each partner. SECTION 1.02 PLAN The term "Plan" means (i) a program established by an individual which requires amounts contributed thereunder to be applied to the purchase of individual retirement annuities within the meaning of Section 408(b) of the Code and (ii) a written program established by an Employer constituting a "Simplified Employee Pension" under Section 408(k) of the Code which requires amounts contributed thereunder to be applied to the purchase of individual retirement annuities within the meaning of Section 408(b) of the Code. SECTION 1.03 ANNUITY The term "Annuity" means an individual retirement annuity meeting the requirements of Section 408(b) of the Code. PF 14111 CI PAGE 4 DEFINITIONS (continued) SECTION 1.04 ANNUITY BENEFIT The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Section 3.04 of the Contract. SECTION 1.05A PARTICIPANT The term "Participant" means a person who has been enrolled by Equitable under the Contract pursuant to a Plan for the purpose of purchasing an Annuity under the Contract. A person shall become enrolled under the Contract upon receipt by Equitable of an enrollment form made available by Equitable and completed in a manner satisfactory to Equitable. A person who has been enrolled under the Contract shall be a Participant-owner under the certificate during his lifetime. An Annuity is purchased for a person enrolled under the Contract upon receipt by Equitable of an initial Contribution for the Participant. SECTION 1.05B EXISTING PARTICIPANT The term "Existing Participant" means a Participant for whom Cash Values of existing annuity contract(s) issued by Equitable were eligible to be transferred to the Contract pursuant to Section 2.01 and who was enrolled under the Contract on or prior to April 14, 1982. SECTION 1.05C NEW PARTICIPANT The term "New Participant" means a Participant who is not an Existing Participant. SECTION 1.06 CONTRIBUTION The term "Contribution" means a payment made to Equitable for a Participant with respect to an Annuity purchased for such Participant under the Contract. Equitable is under no obligation to accept any Contribution less than $20.00. The aggregate amount of such Contributions in any taxable year of the Participant shall not exceed (a) $2000 with respect to amounts contributed under a Plan described in clause (i) of Section 1.02 to purchase an Individual Retirement Annuity and (b) $15,000 with respect to amounts contributed under a Plan described in clause (ii) of Section 1.02 constituting a Simplified Employer Pension. Amounts transferred to the Contract from an individual retirement account or annuity which meets the requirements of Section 408(a) or (b), respectively, of the Code, from a Pension Plan Endowment contract issued by Equitable as an individual retirement annuity, or amounts contributed under the Rollover Contribution Basis pursuant to subsection B of Section 2.01, are not subject to the above limitations on Contributions. SECTION 1.07 PARTICIPATION DATE The term "Participation Date" with respect to a Participant means the date as of which Equitable has enrolled such Participant under the terms of the Contract. SECTION 1.08 PARTICIPATION YEAR The term "Participation Year" with respect to a Participant means the twelve month period beginning on (i) the Participation Date, and (ii) each anniversary thereof, unless otherwise agreed to in writing by Equitable. SECTION 1.09 CLASS OF PARTICIPANTS Except as provided in Section 1.10, the term "Class of Participants" refers to all Participants whose Participation Date is in the same calendar year. SECTION 1.10 GUARANTEED INTEREST RATE For each Guaranteed Interest Account, the term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in such Account. Interest accrues daily. The Guaranteed Interest Rate will never be less than 3% per annum. Equitable will from time to time establish and make available for new Participants (i) an Initial Guaranteed Interest Rate, (ii) one or more Minimum Guaranteed Interest Rates and (iii) the applicable effective period(s) for such Rates. A new Class of Participants will be established effective with the effective date of the occurrence of (i), (ii) or (iii) above or any combination thereof. For the calendar year next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent calendar year thereafter, Equitable will determine for each established Class of Participants before the beginning of such calendar year a Yearly Guaranteed Interest Rate for such Class, which Yearly Guaranteed Interest Rate will not be lower than the effective Minimum Guaranteed Interest Rate applicable for such Class for such year. For any established Class of Participants, Equitable reserves the right to change the Minimum Guaranteed Interest Rate and the applicable period therefor, provided that any such Minimum Guaranteed Interest Rate will not be lower than the Minimum Guaranteed Interest Rate that would have been in effect in the absence of such PF 14111 CI PAGE 5 DEFINITIONS (continued) change. Equitable will notify each Participant in a Class in writing of the Yearly Guaranteed Interest Rate or of any change in the Minimum Guaranteed Interest Rate at least 15 days prior to its effective date. For the period (not to exceed one year) next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent period (not to exceed one year) the Equitable may determine for each established Class of Participants a Guaranteed Interest Rate for such Class which exceeds the applicable Yearly Guaranteed Interest Rate. Equitable will notify each Participant in writing of the applicable Guaranteed Interest Rate and duration. SECTION 1.11 RETIREMENT DATE The term "Retirement Date" means the date on which the Participant is to attain the retirement age specified in the Participant's enrollment form. Before the Retirement Date the Participant may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be earlier than the date of attainment of age 59 years and six months nor shall be later than the date of attainment of age 70 years and six months. Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Home Office. SECTION 1.12 NORMAL FORM The "Normal Form" of an Annuity Benefit under the Contract means, (i) if the Participant has a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (100% continuation), and (ii) if the Participant does not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.13 JOINT AND SURVIVOR LIFE ANNUITY FORM The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depends is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by the Participant. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.14A LIFE ANNUITY FORM The term "Life Annuity Form" means an annuity providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.14B ELIGIBLE ANNUITY CERTAIN The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by Equitable which extends beyond the Participant's attainment of age 59 years and six months and does not permit any prepayment of the unpaid principal prior to the participant's attainment of age 59 years and six months. SECTION 1.15 THE SEPARATE ACCOUNTS The term "Separate Accounts" means the following separate investment accounts maintained by Equitable to which portions of its assets have been allocated for the Contract and certain other contracts: Name Investments ---- ----------- Separate Account A Primarily common stock and other equity-type investments. Separate Account E Primarily short-term money market instruments. Equitable reserves the right to withdraw from any Separate Account and allocate to another separate account assets determined by Equitable to be associated with the class of contracts to which the Contract belongs. In any such event, to the extent practicable and permissible under applicable laws and regulations, the withdrawal shall be made by withdrawing the same percentage of each investment in the Separate Account, with appropriate adjustments to avoid odd lots and fractions. On and after the date of PF 14111 CI PAGE 6 DEFINITIONS (continued) any such withdrawal the reference in the Contract to such Separate Account shall mean such other separate account to which the withdrawn assets were allocated. It is contemplated that investments in the Separate Accounts will, at most times, consist primarily of the types of investments indicated above. Equitable may, however, at its discretion invest the assets of any Separate Account in any investment permitted by applicable law. Equitable may rely conclusively on the opinion of counsel (including attorneys in its employ) as to what investments it is permitted by law to make. In lieu of making such investments directly, Equitable reserves the right to operate any Separate Account as a unit investment trust, or in any other form permitted by law, investing all or part of its assets in shares or units of a fund, the investment adviser of which may be Equitable or controlled by Equitable. The fund assets would be invested as provided above with respect to the Separate Account. Equitable reserves the right: (i) to cause the registration or deregistration of any Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run any Separate Account under the direction of a committee, and to discharge such committee at any time; and (iii) restrict or eliminate any voting rights of participants or other persons who have voting rights as to the Separate Accounts. Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, consisting of .15% for investment management, .35% for financial accounting, .35% for the annuity rate guarantee and the minimum death benefit, and .90% for expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.16. The assets of Separate Accounts are the property of Equitable; however, the portion of the assets of each Separate Account equal to the reserves and other contract liabilities with respect to such Account shall not be chargeable with liabilities arising out of any other business Equitable may conduct. Equitable reserves the right to transfer assets of the Separate Accounts in excess of such reserves and contract liabilities to the general account of Equitable. SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business day immediately preceding such business day will constitute a Valuation Period. A business day is any day on which there is a sufficient degree of trading in the portfolio securities of a Separate Account that the New Accumulation Unit Value or New Annuity Unit Value might be materially affected by changes in the value of the portfolio securities in a Separate Account, as determined by the Separate Account Committee or, if there is no Committee, by Equitable. NET INVESTMENT FACTOR: For each Separate Account the Net Investment Factor for a Valuation Period is (a) divided by (b), minus (c), where (a) is (1) the value of the assets in the Separate Account at the close of business of the preceding Valuation Period plus (2) the investment income and the capital gains, realized or unrealized, credited to the assets of the Separate Account in the Valuation Period for which the Net Investment Factor is being determined, minus (3) the capital losses, realized or unrealized, charged against such assets in such Valuation Period, minus (4) any amount charged against the Separate Account in such Valuation Period for taxes or for amounts set aside by Equitable as a reserve for taxes attributable to the maintenance or operation of the Separate Account; (b) is the value of the assets in the Separate Account at the close of business of the preceding Valuation Period; and (c) is the daily charge, for each calendar day in such Valuation Period of .00004837 for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit and expenses and expense risk. The value of the assets in the Separate Accounts, referred to above, shall be taken at their fair market value, or where there is no readily available market, PF 14111 CI PAGE 7 DEFINITIONS (continued) their fair value, as determined in accordance with accepted accounting practices and applicable laws and regulations. ACCUMULATION UNIT: The Accumulation Unit is a unit used in determining the value of the interest of a Participant's Stock Account or Money Market Account on or before the Retirement Date. NEW ACCUMULATION UNIT VALUE: The initial New Accumulation Unit Values for the Separate Accounts have been established as follows: Account Value Date ------- ----- ---- Separate Account A $10.00 As of November 1, 1968 Separate Account E $10.00 As of September 4, 1974 The new Accumulation Unit Value for each subsequent Valuation Period is the New Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such subsequent Valuation Period. ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable from Separate Account A under a Variable Annuity Benefit. NEW ANNUITY UNIT VALUE: The initial New Annuity Unit Value for Separate Account A has been established at $1.00 as of November 1, 1968. The Annuity Unit Value for any subsequent Valuation Period is the New Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3 1/2%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE NEW ANNUITY UNIT VALUE: The Average Annuity Unit Value for Separate Account A for a calendar month is equal to the average of the New Annuity Unit Values for the Valuation Periods ending in such month. SECTION 1.17 ANNUITY VALUE The term "Annuity Value" with respect to a Participant's Guaranteed Interest Account, Stock Account and Money Market Account, means the amount in such Accounts pursuant to Sections 2.02 and 2.03. SECTION 1.18A CASH VALUE - NEW PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to a New Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and six months, or (ii) the Participant's attainment of age 70 years and six months, or (iii) the completion of 25 Participation Years with respect to such Participant, or (iv) if the Participant has attained age 55, completed five Participation Years, and the Cash Values are to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% of the sum of the Annuity Values of such Accounts. (b) is an amount equal to the excess, if any, of (i) 8% of the cumulative contributions made on behalf of such Participant over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: PF 14111 CI PAGE 8 DEFINITIONS (continued) (a) equals 6% of the excess of (i) the sum of the Annuity Values of such Accounts over (ii) the Free Corridor Amount defined in Section 2.07C. (b) is the excess, if any, of (i) 8% of the total contributions made on behalf of such Participant during the current Participation Year and the preceding nine Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. The Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. SECTION 1.18B CASH VALUE - EXISTING PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to an Existing Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) the Participant's attainment of age 59 years and six months, (ii) the completion of 20 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55 and the Cash Values are to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a) and (b) below; provided, however, that such charge does not exceed the amount described in subsection (c) below where: (a) is an amount equal to 2% of any Preferred Withdrawable Amounts (defined in Section 2.07B) that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (b) is an amount equal to 6% of any Regular Withdrawable Amounts (defined in Section 2.07B) that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (c) is an amount equal to the sum of (a) above, and 6% of the excess, if any, of (i) the sum of the Annuity Values of such Accounts over (ii) the cumulative total of Equitable Transferred Funds made with respect to the Participant that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. WITHDRAWAL CHARGE AFTER FIVE YEARS: After five Participation Years have been completed with respect to the Participant, Equitable (i) will first withdraw, pursuant to Section 2.07B, the Free Corridor Amount defined in Section 2.07C and (ii) next withdraw the remaining portion of the sum of the Annuity Values of such Accounts. A withdrawal charge will apply to the amount in (ii) above, and will equal the sum of the charges described in subsections (a) and (b) of the preceding subsection; provided, however, that such charge will not exceed an amount equal to the lesser of the charges defined in (d) and (e) below: (d) is an amount equal to the sum of (a) in the preceding subsection, and 6% of the excess, if any, of (i) the sum of the Annuity Values of such Accounts (after withdrawal of the Free Corridor Amount) over (ii) the cumulative total of Equitable Transferred Funds made on behalf of the Participant that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (e) is an amount equal to the excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other contributions (excluding Equitable Transferred Funds) made on behalf of such Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07B. The Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. PF 14111 CI PAGE 9 DEFINITIONS (continued) SECTION 1.19 CODE The term "Code" means the Internal Revenue Code of 1954, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.20 EQUITABLE TRANSFERRED FUNDS The term "Equitable Transferred Funds" with respect to a Participant means the amount of cash value(s) transferred to the Contract from a contract issued by Equitable pursuant to Section 2.01. PART II - PARTICIPANT'S ACCOUNT SECTION 2.01 CONTRIBUTIONS Contributions may be made with respect to a Participant on whichever basis, as described under subsection A and B, below, as specified upon the Participant's enrollment under the Contract. If Contributions are made by or on behalf of a Participant under more than one such basis, Equitable will accept such Contributions if the Participant is separately enrolled under the Contract under each basis, and in such case separate certificates will be issued under the Contract for the Participant reflecting amounts accumulated on the Participant's behalf attributable to Contributions made under each Contribution basis. Each Contribution received by Equitable with respect to a Participant will, before its allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable. A. Flexible Contribution Basis Contributions are to be made from time to time on the dates and in the amounts determined in accordance with the terms of the Plan. With each Contribution there shall be specified the Participant with respect to whom such Contribution is being made and the amount to be allocated to the Stock Account, Money Market Account and the Guaranteed Interest Account. A Participant may, with Equitable's agreement, transfer to the Contract any amount held with respect to such Participant under an individual retirement account or annuity meeting requirements of Section 408(a) or (b), respectively, of the Code issued by Equitable or otherwise, or a Pension Plan Endowment contract issued by Equitable as an individual retirement annuity, except an individual retirement account or annuity contract containing any "rollover account" within the meaning of Section 402(a)(5) or 403(b)(8) of the Code. Any amount so transferred from an individual retirement account or annuity contract not issued by Equitable will, before allocation under the Contract, by reduced by the amount of any applicable taxes, as determined by Equitable. B. Rollover Contribution Basis A Participant may make one or more Contributions which in whole or in part consist of or are derived from "rollover amounts" within the meaning of Section 402(a)(5) or 403(b)(8) of the Code. SECTION 2.02 STOCK AND MONEY MARKET ACCOUNTS Equitable maintains a Stock Account and Money Market Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the (i) Stock Account becomes part of Separate Account A, and (ii) Money Market Account becomes part of Separate Account E. Any amount withdrawn from an Account will no longer be part of the applicable Separate Account. On any date when an amount is allocated to or withdrawn from an Account, the Account will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the New Accumulation Value for the appropriate Separate Account for the Valuation Period which includes that date. The number of Units in an Account on any date is equal to (i) the sum of any Accumulation Units that have been credited to the Account minus (ii) the sum of any Accumulation Units that have been charged to that Account. The amount in the Stock Account or Money Market Account on any date is equal to the product of (i) the number of Accumulation Units in such Account on that date and (ii) the New Accumulation Unit Value for the appropriate Separate Account for the Valuation Period which includes that date. SECTION 2.03 GUARANTEED INTEREST ACCOUNT Equitable maintains a Guaranteed Interest Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the Guaranteed Interest Account becomes part of the general assets of Equitable, which support the guarantees of the Contract and other contracts. The amount in a Guaranteed Interest Account at any time is equal to the sum of all amounts that have been allocated to such Guaranteed Interest Account pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn pursuant to Section 2.07, 2.07A, and 2.07B, and Section 2.08 from such Ac- PF 14111 CI PAGE 10 PARTICIPANT'S ACCOUNT (continued) count, and transferred pursuant to Section 2.05 from such Guaranteed Interest Account, and less the sum of any annual administrative charges accrued but not made. Equitable guarantees that the amount in a Guaranteed Interest Account at any time before the Retirement Date will not be less than the sum of all amounts allocated to such Account pursuant to Section 2.04 or transferred to such Account pursuant to Section 2.05 and less the sum of all amounts that have been withdrawn from such Account pursuant to Sections 2.07, 2.07A and 2.07B, and transferred from such Account pursuant to Section 2.05, all accumulated at 3% interest, compounded annually. In any Participation Year in which no Contribution is allocated to a Guaranteed Interest Account, the amount in such Account at the end of the Participation Year shall not be less than the amount in such Account at the beginning of the Participation Year plus the sum of all amounts transferred to such Account pursuant to Section 2.05 less the sum of all amounts withdrawn and transferred out of such Account pursuant to Sections 2.07, 2.07A and 2.07B, and Section 2.05, all accumulated at 3% interest, compounded annually. A Guaranteed Interest Account for a Participant terminates on the earliest of (i) the Retirement Date, (ii) the death of the Participant, and (iii) termination of participation pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO ACCOUNT Each Contribution made with respect to a Participant pursuant to Section 2.01, after deduction for any applicable taxes, will be allocated, as of the date by which Equitable has received both such Contribution and direction as to its allocation, to the Guaranteed Interest Account, Stock Account, or Money Market Account or in part to each, at the sole direction of the Participant as specified to Equitable, provided that the percentage allocated to each Account is a whole number. Any amount that a Participant has directed to be transferred to the Guaranteed Interest Account or Stock Account pursuant to Section 2.05 will be allocated as of the date of such transfer to the appropriate Account maintained for such Participant. Interest is allocated to the Guaranteed Interest Account at the end of each Participation Year, at the time of each transfer or withdrawal pursuant to Sections 2.05 and 2.07, 2.07A, and 2.07B, at the time of application of amounts in the Guaranteed Interest Account to provide Annuity Benefits, upon termination of participation pursuant to Section 2.06, and upon death of the Participant pursuant to Section 2.09. SECTION 2.05 TRANSFERS AMONG ACCOUNTS At any time before a Participant's Retirement Date, such Participant, upon written request, (i) may transfer all or a part of the amounts from the Stock Account or Money Market Account maintained for such Participant to the Guaranteed Interest Account maintained for such Participant, or (ii) may transfer all or a part of the amounts in the Guaranteed Interest Account or Money Market Account maintained for such Participant to the Stock Account maintained for such Participant. Such transfers will be made as of the later of (i) the date specified in such request and (ii) the date Equitable receives such request, and will be subject to Equitable's rules in effect at the time of transfer. No transfers are permitted from the Guaranteed Interest Account or the Stock Account maintained for the Participant to the Money Market Account. SECTION 2.06 TERMINATION OF PARTICIPATION On or before a Participant's Retirement Date, such Participant may elect by written notice to terminate participation under the Contract. Upon receipt of such notice, Equitable will determine the Cash Value, as of the date Equitable received such notice, of the Guaranteed Interest Account, Stock Account and Money Market Account maintained for such Participant. The payment of such Cash Value to the Participant may be deferred by Equitable in accordance with the provisions of Section 4.08. Prior to a Participant's Retirement Date, Equitable reserves the right to withdraw the Annuity Value of the Participant's Guaranteed Interest Account, Stock Account and Money Market Account, pay such Annuity Values and terminate such Participant's participation under the Contract. This right may be exercised with respect to the Participant only if both (i) no PF 14111CI PAGE 11 PARTICIPANT'S ACCOUNT (continued) Contributions have been made under the Contract during the last three completed Participation Years, and (ii) the sum of such Annuity Values is $500 or less. Equitable reserves the right to terminate a Participant's participation under the Contract if at least 120 days have elapsed since the issue date shown on the certificate issued to such Participant under the Contract and no Contributions have been made under the Contract with respect to such Participant. Upon payment of such Cash Values or Annuity Values, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Cash Values or Annuity Values arose. SECTION 2.07 PARTIAL WITHDRAWALS Subject to any applicable restrictions under the terms of the Plan, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Stock Account, Money Market Account and the Guaranteed Interest Account maintained for such Participant before such Participant's Retirement Date. Upon withdrawal pursuant to Section 2.07, 2.07A or 2.07B, Equitable will pay the lesser of the sum of the Cash Values of such Accounts or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by such Participant. Unless instructed otherwise, the amount withdrawn (including the amount of any withdrawal charge) will be allocated between such Accounts in proportion to the Annuity Value of each such Account. Upon any payment to a Participant pursuant to Section 2.07, 2.07A or 2.07B, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Payments to the Participant pursuant to Section 2.07, 2.07A or 2.07B may be deferred by Equitable in accordance with the provisions of Section 4.08. Equitable is under no obligation to process any request for partial withdrawal of less than $300. If a withdrawal from the Accounts made pursuant to Sections 2.07, 2.07A or 2.07B would result in total Annuity Values of less than $500. Equitable will so advise the Participant and reserves the right to withdraw the Annuity Values of the Guaranteed Interest Account, Stock Account and Money Market Account, pay the Annuity Values of such Accounts to the Participant, and terminate such Participant's participation under the Contract. If the Participant was enrolled in this Contract prior to August 15, 1981, the $500 amount stated above shall be $200. SECTION 2.07A PARTIAL WITHDRAWALS - NEW PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a New Participant, Equitable will withdraw from the Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and six months, or (ii) such Participant's attainment of age 70 years and six months, or (iii) the completion of 25 Participation Years with respect to such Participant, or (iv) if the Participant has attained age 55, has completed five Participation Years, and the partial withdrawal is to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: If the Participant has not completed five Participation Years under the Contract, such withdrawal charge will equal the lesser of (a) or (b) where: (a) is an amount equal to 6% of the total amount to be withdrawn from the Accounts (including such charge) pursuant to this paragraph. (b) is the excess, if any, of (i) 8% of the cumulative total of Contributions made on behalf of such Participant over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Participant, there will be no withdrawal charge if the amount of partial withdrawal requested PF 14111CI PAGE 12 PARTICIPANT'S ACCOUNT (continued) is not greater than the Free Corridor Amount defined in Section 2.07C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% of the amount withdrawn (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the cumulative total of contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. SECTION 2.07B PARTIAL WITHDRAWAL - EXISTING PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by an Existing Participant, Equitable will withdraw from the Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) the Participant's attainment of age 59 years and six months, or (ii) the completion of 20 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55 and the partial withdrawal is to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. PREFERRED WITHDRAWABLE AMOUNT: This is an amount equal to the lesser of (a) the total of Equitable Transferred Funds made on behalf of the Participant or (b) $10,000. FREE WITHDRAWABLE AMOUNT: This is an amount equal to the excess, if any, of (a) the total Equitable Transferred Funds made on behalf of the Participant over (b) $10,000. REGULAR WITHDRAWABLE AMOUNT: This is the cumulative total of all Contributions, other than Equitable Transferred Funds, made on behalf of the Participant. ORDER OF WITHDRAWALS: In calculating the withdrawal charge, Equitable will assume that (a) any Preferred Withdrawable Amounts are first withdrawn, (b) any Free Withdrawable Amounts are next withdrawn, (c) any Regular Withdrawable Amounts are next withdrawn, and (d) lastly, any amounts other than the amounts described in (a), (b), and (c) above are withdrawn. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a), (b), (c) and (d) below: (a) With respect to any withdrawals of Preferred Withdrawable Amounts, a charge of 2% of such withdrawals. (b) With respect to any withdrawals of Free Withdrawable Amounts, no charge. (c) With respect to any withdrawals of Regular Withdrawable Amounts, a charge of 6% of such withdrawals. (d) With respect to any withdrawals of amounts other than the amounts in (a), (b) and (c) above, no charge. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Participant, there will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount. Equitable will (1) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (2) then withdraw from such Accounts an amount equal to the excess of the amount requested over the Free Cor- PF 14111CI PAGE 13 PARTICIPANT'S ACCOUNT (continued) ridor Amount, plus a withdrawal charge. Such withdrawal charge will equal the sum of the charges described in (a), (b), (c), and (d) above; provided, however, that in no event will such charge exceed an amount equal to the following: The excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other Contributions (excluding Equitable Transferred Funds) made on behalf of the Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any prior withdrawal charges made pursuant to this Section. Whenever an amount is withdrawn from such Accounts that is not greater than the current Free Corridor Amount, such amount is considered to be (1) first, a withdrawal of Regular Withdrawable Amounts, (2) next, a withdrawal of Preferred Withdrawable Amounts, (3) next, a withdrawal of Free Withdrawable Amounts and (4) lastly, a withdrawal of amounts other than the amounts in (1), (2), or (3) above. However, no charge will be assessed with respect to the portion of the withdrawal up to the current Free Corridor Amount. SECTION 2.07C FREE CORRIDOR AMOUNT The term "Free Corridor Amount" with respect to a Participant who has completed five Participation Years means an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Values of the Stock Account, Money Market Account and the Guaranteed Interest Account over (ii) cumulative prior withdrawals made pursuant to Section 2.07, 2.07A or 2.07B in the current Participation Year with respect to the Participant. SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE As of the last day of each Participation Year before a Participant's Retirement Date, Equitable will withdraw from the Guaranteed Interest Account, Stock Account and Money Market Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Values of the Guaranteed Interest Account, Stock Account and Money Market Account at the end of that Participation Year and (ii) any withdrawals made from such Accounts pursuant to Section 2.07, 2.07A and 2.07B during that Participation Year. The charge will be allocated between the Stock Account, Money Market Account and Guaranteed Interest Account in proportion to the Annuity Values of each such Account, at the end of the Participation Year. As of a Participant's Retirement Date and before application of the Annuity Values or Cash Values of such Participant's Account pursuant to Section 3.03, or upon termination of such Account pursuant to Section 2.06 or Section 2.09 during a Participation Year, Equitable will withdraw the administrative charge described in this Section for the applicable part of that Participation Year. SECTION 2.09 DEATH BENEFIT If the Employer reports to Equitable, or if Equitable otherwise ascertains, that a Participant has died while Accounts for such Participant are maintained under the Contract and before such Participant's Retirement Date, Equitable, upon receipt of due proof of such death, will pay in a single sum to the beneficiary designated by such Participant to receive such payment the amount of death benefit payable with respect to such Participant. The amount of the death benefit with respect to a Participant at any time prior to the Retirement Date is equal to the greater of (i) the sum of the Annuity Values of the Guaranteed Interest Account, Stock Account and Money Market Account maintained under the Contract for such Participant and (ii) the minimum death benefit with respect to such Participant. Such minimum death benefit is the sum of all Contributions made with respect to such Participant pursuant to Section 2.01 (before reduction of any applicable taxes) less an adjustment for any withdrawals made pursuant to Sections 2.07, 2.07A and 2.07B from the Accounts maintained under the Contract for such Participant. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount being withdrawn is to the Annuity Values then in the Guaranteed Interest Account, Stock Account and Money Market Account maintained under the Contract for such Participant. If, in accordance with the provisions of Section 2.01, the cash value of an Annuity contract issued by Equitable, which provides for a death benefit before retirement equal to the greater of the contract cash value or an alternative amount based on premiums paid or contributions PF 14111CI PAGE 14 PARTICIPANT'S ACCOUNT (continued) made under the Annuity contract, is transferred to the Contract, such alternative amount as of the date of transfer will be included in the "sum of all Contributions" in lieu of the amount of cash value transferred, for purposes of the death benefit under the Contract. The amount of any death benefit payable with respect to a Participant will, to the extent such Account is sufficient therefor, be withdrawn from the Guaranteed Interest Account, Stock Account and Money Market Account maintained with respect to such Participant under the Contract. Upon such payment, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Annuity Values arose. PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of Separate Account A. The amount of the first, second, and third payments under any Variable Annuity Benefit provided under the Contract with respect to a payee is the monthly amount provided with respect to the payee pursuant to Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average New Annuity Unit Value for the second calendar month immediately preceding the date of the payment. The fourth and subsequent annuity payments under a Variable Annuity Benefit will not be increased or decreased in amount because of mortality or expense experience. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the New Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Values of such Participant's Guaranteed Interest Account, Stock Account and Money Market Account shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of such Account in a single sum or (ii) to apply such Annuity Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by Equitable, as elected by the Participant, subject to Equitable's rules then in effect and any applicable requirements under the Code. Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Values of such Participant's Guaranteed Interest Account, Stock Account and Money Market Account. Equitable will have the right to require the Participant to furnish pertinent facts and determinations to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. Equitable may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form. PF 14111CI PAGE 15 ANNUITY BENEFITS (continued) SECTION 3.04 AMOUNT OF ANNUITY BENEFITS If a Participant elects pursuant to the first paragraph or third paragraph of Section 3.03 to receive an Annuity Benefit in lieu of the Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account, the amount applied to provide the Annuity Benefit will be (i) the Annuity Values of such Accounts if the payments under the annuity form elected are contingent upon the survival of a person, or (ii) the Cash Values of such Account if the payments under the annuity form elected are not contingent upon the survival of a person. The amount applied to provide an Annuity Benefit shall be reduced by any applicable tax on annuity considerations, as determined by Equitable. If such amount is applied on or after the completion of five Participation Years with respect to such Participant, or if such amount is applied on behalf of an Existing Participant, the balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. If the amount applied to provide an Annuity Benefit is applied before the completion of five Participation Years with respect to a New Participant, the balance, after any applicable tax on annuity considerations, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the Guaranteed Interest Account, Stock Account and Money Market Account maintained for such Participant shall terminate. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (100% continuation). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity form, are based on 3 1/4% interest and the 1971 ELAS Mortality Table. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on 1979 ELAS mortality and an Assumed Base Rate of Net Investment Return of 3 1/2% or 5%, whichever applies pursuant to Section 1.16. Equitable may change the monthly income amounts contained in the Tables of Guaranteed Annuity Payments and the bases for determining such amounts, for new Participants, by at least 90 days advance notice to the Contract Holder and by an amendment to the Contract. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on 3 1/4% interest and the 1971 ELAS Mortality Table if such annuity form provides for a Fixed Annuity Benefit, and on 1979 ELAS Mortality and an Assumed Base Rate of Net Investment Income Return of 5% or 3 1/2%, whichever applies pursuant to Section 1.16, if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS The entire interest of a Participant will be distributed to such Participant not later than the close of such Participant's taxable year of attainment of age 70 years and six months, or will be distributed in equal or substantially equal installments over: (a) the life of such Participant and such Participant's spouse, or (b) a period not extending beyond the life expectancy of such Participant or the life expectancy of such Participant and such Participant's spouse. If the Participant dies before such Participant's interest has been distributed to such Participant, or if distribution has been commenced as provided in the first paragraph of this Section to such Participant's spouse, and such spouse dies before the entire interest has been distributed to such spouse, the entire interest PF 14111 CI PAGE 16 ANNUITY BENEFITS (continued) (or the remaining part of such interest if the distribution thereof has commenced) will, within five years after the death of such Participant (or the death of such Participant's surviving spouse), be distributed, or applied to the purchase of an annuity for the beneficiary or beneficiaries of such Participant (or such Participant's surviving spouse) which will be payable for the life of such beneficiary or beneficiaries (or for a term certain not extending beyond the life expectancy of such beneficiary or beneficiaries) and which annuity will be immediately distributed to such beneficiary or beneficiaries. The preceding sentence shall have no application if distributions over a term certain commenced before the death of the Participant and the term certain is for a period permitted under the first paragraph of this Section. Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payable under the Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by Equitable will be charged against and underpayments will be added to any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may make the payments (in the case of a minor, at a rate not exceeding $50 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If an annuity form made available by Equitable provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Upon election by a Participant pursuant to Section 3.03 of an annuity form providing payments for a period certain, such Participant may designate (with the right to change such designation) a person or persons to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's executors or administrators in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, Equitable will pay in a single sum to such payee's executors or administrators the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. Equitable will require satisfactory evidence of the age of any person upon whose life an annuity form depends. PF 14111 CI PAGE 17 ANNUITY BENEFITS (continued) TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM - 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Value)
- ------------------------------------------------------------------------------------------------------------------------------------ MALE FEMALE AGE - ------------------------------------------------------------------------------------------------------------------------------------ AGE 60 61 62 63 64 65 66 67 68 69 70 - ------------------------------------------------------------------------------------------------------------------------------------ 60 4.52 4.58 4.64 4.70 4.76 4.82 4.88 4.94 5.00 5.05 5.11 61 4.55 4.62 4.68 4.74 4.81 4.87 4.93 5.00 5.06 5.12 5.18 62 4.58 4.65 4.72 4.78 4.85 4.92 4.99 5.05 5.12 5.19 5.25 63 4.61 4.68 4.75 4.82 4.89 4.97 5.04 5.11 5.18 5.25 5.32 64 4.64 4.71 4.79 4.86 4.94 5.01 5.09 5.17 5.24 5.32 5.40 65 4.67 4.74 4.82 4.90 4.98 5.06 5.14 5.22 5.30 5.38 5.47 66 4.69 4.77 4.85 4.93 5.02 5.10 5.18 5.27 5.35 5.44 5.53 67 4.72 4.80 4.88 4.97 5.06 5.14 5.23 5.31 5.40 5.50 5.59 68 4.74 4.82 4.91 5.00 5.09 5.18 5.27 5.36 5.45 5.55 5.65 69 4.76 4.85 4.94 5.03 5.12 5.22 5.31 5.41 5.50 5.60 5.71 70 4.78 4.87 4.96 5.06 5.16 5.26 5.36 5.45 5.56 5.66 5.76 - ------------------------------------------------------------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM - 100% CONTINUATION - ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3 1/2% (Minimum Monthly Income per $1,000 of Annuity Value)
- ------------------------------------------------------------------------------------------------------------------------------------ MALE FEMALE AGE - ------------------------------------------------------------------------------------------------------------------------------------ AGE 60 61 62 63 64 65 66 67 68 69 70 - ------------------------------------------------------------------------------------------------------------------------------------ 60 4.31 4.35 4.39 4.43 4.47 4.51 4.55 4.59 4.63 4.67 4.71 61 4.35 4.39 4.43 4.48 4.52 4.56 4.61 4.65 4.69 4.73 4.78 62 4.39 4.43 4.48 4.52 4.57 4.61 4.66 4.71 4.75 4.80 4.85 63 4.42 4.47 4.52 4.57 4.62 4.67 4.72 4.77 4.82 4.87 4.92 64 4.46 4.51 4.57 4.62 4.67 4.72 4.77 4.83 4.88 4.94 4.99 65 4.50 4.56 4.61 4.66 4.72 4.78 4.83 4.89 4.95 5.01 5.07 66 4.54 4.60 4.65 4.71 4.77 4.83 4.89 4.95 5.01 5.08 5.14 67 4.58 4.64 4.70 4.76 4.82 4.88 4.95 5.01 5.08 5.15 5.22 68 4.62 4.68 4.77 4.81 4.87 4.95 5.01 5.08 5.15 5.22 5.29 69 4.65 4.72 4.78 4.85 4.92 4.99 5.06 5.14 5.22 5.29 5.37 70 4.69 4.76 4.83 4.90 4.97 5.05 5.12 5.20 5.28 5.36 5.45 - ------------------------------------------------------------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM - 100% CONTINUATION - ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 5% (Minimum Monthly Income per $1,000 of Annuity Value)
- ------------------------------------------------------------------------------------------------------------------------------------ MALE FEMALE AGE - ------------------------------------------------------------------------------------------------------------------------------------ AGE 60 61 62 63 64 65 66 67 68 69 70 - ------------------------------------------------------------------------------------------------------------------------------------ 60 5.19 5.23 5.27 5.31 5.34 5.39 5.42 5.46 5.50 5.54 5.58 61 5.23 5.27 5.31 5.35 5.39 5.43 5.47 5.52 5.56 5.60 5.64 62 5.27 5.31 5.35 5.39 5.44 5.48 5.53 5.57 5.62 5.67 5.71 63 5.31 5.35 5.39 5.44 5.49 5.53 5.58 5.63 5.68 5.73 5.78 64 5.34 5.39 5.44 5.48 5.53 5.59 5.64 5.69 5.74 5.79 5.85 65 5.38 5.43 5.48 5.53 5.58 5.64 5.69 5.75 5.80 5.86 5.92 66 5.42 5.47 5.52 5.58 5.63 5.69 5.75 5.81 5.87 5.93 5.99 67 5.45 5.51 5.56 5.62 5.68 5.74 5.80 5.87 5.93 6.00 6.06 68 5.49 5.55 5.61 5.67 5.73 5.80 5.86 5.93 6.00 6.06 6.14 69 5.53 5.59 5.65 5.71 5.78 5.85 5.92 5.99 6.06 6.13 6.21 70 5.56 5.63 5.69 5.76 5.83 5.90 5.97 6.05 6.13 6.21 6.29 - ------------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value)
- ------------------------------------------------------------------------------------------------------------------------------------ FIXED ANNUITY BENEFIT VARIABLE ANNUITY BENEFIT IF ASSUME BASE RATE OF NET INVESTMENT RETURN IS - ------------------------------------------------------------------------------------------------------------------------------------ 3 1/2% 5% - ------------------------------------------------------------------------------------------------------------------------------------ AGE MALES FEMALES MALES FEMALES MALES FEMALES - ------------------------------------------------------------------------------------------------------------------------------------ 60 5.88 4.99 5.43 4.80 6.36 5.70 61 6.04 5.11 5.57 4.90 6.50 5.81 62 6.21 5.24 5.72 5.01 6.65 5.91 63 6.38 5.38 5.88 5.13 6.81 6.03 64 6.57 5.53 6.05 5.25 6.97 6.15 65 6.77 5.68 6.23 5.39 7.16 6.28 66 6.98 5.84 6.43 5.54 7.35 6.43 67 7.19 6.01 6.64 5.70 7.56 6.58 68 7.42 6.20 6.82 5.87 7.79 6.76 69 7.67 6.39 7.11 6.06 8.03 6.95 70 7.93 6.61 7.38 6.27 8.30 7.15 - ------------------------------------------------------------------------------------------------------------------------------------
Equitable will notify the payee under a Variable Annuity Benefit of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each variable payment. Any election, change, revocation or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a commutation right under an Annuity Benefit is exercised, Equitable may defer payment in accordance with Section 4.08. PF 14111 CI PAGE 18 PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT The Contract constitutes the entire Contract between the parties and the provisions of the Contract alone will govern with respect to the rights and obligations of Equitable. The provisions of the Contract will be applied separately with respect to each Participant. Nothing in the enrollment form referred to in Section 1.05, the Plan or custodial agreement referred to in Section 4.10 nor any modification, amendment, or supplement to any such documents will in any way be construed to enlarge, change, vary or in any other way affect the obligations of Equitable as expressly provided in the Contract. The Contract may not be modified as to Equitable, nor may any of Equitable's rights or requirements be waived, except in writing and by an authorized officer of Equitable. The Contract may be changed by amendment or replacement upon agreement between the Contract Holder and Equitable without the consent of any other person provided that such change does not reduce any Annuity Benefit provided before such change and provided that no rights, privileges or benefits which have accrued to any Participant under the Contract may be reduced or forfeited except by the express consent of such Participant. SECTION 4.02 STATUTORY COMPLIANCE Equitable reserves the right to amend the Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the Contract and any certificate to reflect changes in the Code, or in regulations or published rulings of the Internal Revenue Service, so that each such certificate will continue to be an Annuity. Any Annuity Benefit, Cash Value or death benefit available under a certificate issued pursuant to the Contract shall not be less than the minimum benefits required by any statute of the state in which the certificate is delivered. SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY The entire interest of any Participant under the Contract is nonforfeitable. No interest of a Participant under the Contract may be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than Equitable. No amount payable under the Contract may be assigned, commuted, or encumbered by the payee, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. SECTION 4.04 PARTICIPATION IN SURPLUS The Contract and all other contracts in the same class of contracts shall be combined for the purpose of ascertaining the annual surplus of Equitable to be apportioned to said contracts as a dividend, and the portion of any such dividend that is to be allocated to the Contract shall be determined by Equitable. The participation of this class of contracts in annual surplus is, however, expected to be minimal. Any amount so allocated to the Contract shall be payable as of January 1 of the calendar year in which a dividend is apportioned and will be payable in cash and shall be equitably allocated by Equitable to the Guaranteed Interest Accounts maintained hereunder for Participants. No Annuity Benefit will enter into the determination of any surplus to be apportioned to the Contract as a dividend. SECTION 4.05 BENEFICIARY Each Participant, as of such Participant's Participation Date is to provide Equitable with an initial designation of the beneficiary entitled to receive any death benefit payable with respect to such Participant pursuant to Section 2.09. The Participant may change such designation from time to time during such Participant's lifetime and while Accounts for such Participants are being maintained hereunder. Any such designation or change will be made by written notice in a form satisfactory to Equitable. A change will, upon receipt at a designated Equitable Office, take effect as of the time the written notice was signed, whether or not the Participant is living on the date of receipt, but without further liability as to any payment or other settlement made by Equitable before receipt of such change. Unless otherwise specified in the designation, if a Participant has designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive the Participant, and if more than one survive they will share equally. PF 14111 CI PAGE 19 GENERAL PROVISIONS (continued) Any part of a death benefit payable with respect to a Participant pursuant to Section 2.09 for which there is no designated beneficiary living at the death of the Participant will be payable in a single sum to the children of the Participant who survive the Participant, in equal shares, or should none survive, then to the Participant's executors or administrators. If a Participant so elects in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by the Participant, with respect to the beneficiary, subject to Equitable's rules then in effect. If at the death of a Participant there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. SECTION 4.06 DISQUALIFICATION In the event that an annuity purchased hereunder with respect to a Participant fails to qualify as an Annuity as described in Section 1.03, Equitable shall have the right, upon receiving notice of such fact before the Retirement Date, to terminate participation with respect to such Participant under the Contract and pay to such Participant the amount in the Account maintained with respect to such Participant less a deduction for the appropriate part attributable to such Participant of any Federal income tax payable by Equitable which would not have been payable if such Participant had an Annuity under the Contract. SECTION 4.07 FUTURE PARTICIPANTS Equitable reserves the right at its sole discretion to curtail or prohibit further enrollment as Participants under the Contract of any individuals who are not currently participating under the Contract as of such date of curtailment or prohibition. SECTION 4.08 DEFERMENT Payments by Equitable from the Participant's Guaranteed Interest Account pursuant to the provisions of Section 2.06, Sections 2.07, 2.07A and 2.07B, and Section 2.09, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.05, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. Interest at the current Guaranteed Interest Rate for such Participant's Guaranteed Interest Account will be allowed on any such payment deferred for 30 days or more. Except as provided in the Section, payments by Equitable from the Participant's Stock Account or Money Market Account pursuant to the provisions of Section 2.06, Sections 2.07, 2.07A and 2.07B, and Section 2.09, or any commuted payments arising from a Variable Annuity Benefit pursuant to Section 3.05, will be made within seven days after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. During any period when (i) the sale of securities or the determination of the New Accumulation Unit Value or the Average New Annuity Unit Value is not reasonably practicable because an emergency, defined by the Securities and Exchange Commission, exists, or the New York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may by order permit postponement for the protection of persons having interests in the Separate Accounts, Equitable reserves the right: (a) to defer determination of Cash Values or Annuity Values and payment of Cash Values and Annuity Values, arising from an amount in a Participant's Stock Account or Money Market Account; (b) to defer payment of any portion of the death benefit arising from an amount in a Participant's Stock Account or Money Market Account; (c) to defer the payment of any Variable Annuity Benefit under the Contract or the application of any such Benefit to provide for any other payment called for by the Contract; or (d) in the event of (a) above, to defer application of such amounts to provide any Annuity Benefit permitted under the Contract. SECTION 4.09 ANNUAL NOTICE At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish PF 14111 CI PAGE 20 GENERAL PROVISIONS (continued) the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Guaranteed Interest Account, (2) the total number of Accumulation Units credited to the Stock Account and Money Market Account, (3) the New Accumulation Unit Values, (4) the sum of the Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account and (5) the amount of death benefit payable with respect to the Participant. After the Retirement Date Equitable will notify the Participant of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.10 CONTRACT HOLDER RESPONSIBILITY The sole responsibility of the Contract Holder is to serve as party to the Contract. The Contract Holder will have no responsibility for the administration of any Plan, for payments to the Guaranteed Interest Account, Stock Account or Money Market Account, or any payments or other distributions hereunder. Equitable will deal with the Contract Holder in accordance with the terms and conditions of the custodial agreement pursuant to which the Contract Holder agreed to act as such and with the Contract and in such manner as the Contract Holder and Equitable may agree, without the consent of any other person. Any Employer making Contributions under the Contract shall be deemed to have adopted and accepted the custodial agreement as part of the Plan with respect to which such Contributions are made. SECTION 4.11 AGE AND SEX If the Annuitant's age or sex has been misstated, any benefits will be those which would have been purchased at the correct age and sex. Any overpayments or underpayments made by Equitable will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By /s/ [Signature Unreadable] By /s/ Coy Eklund .................................. .................................. Chairman of the Board Title Senior Vice President By /s/ Rodney L. Enochs ............................... .................................. Vice President and Secretary Dated May 27, 1982 Date of Issue May 1, 1982 ............................... ....................... At New York, New York .................................. PF 14111 CI PAGE 21 Attached to and made part of Group Annuity Contract No. 11929CI between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective August 26, 1983, said contract and riders are amended as follows: 1. with respect to Section 1.18A Cash Value -- New Participants a. the term "25 Participation Years" contained in the paragraph entitled "No Withdrawal Charge" is changed to "12 Participation Years," b. the paragraph entitled "Withdrawal Charge Within First Five Years" is replaced by the following: WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS: Within the first three Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% of the sum of the Annuity Values of such Accounts. (b) is an amount equal to the excess, if any, of (i) 8% of the cumulative contributions made on behalf of such Participant over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. c. the paragraph entitled "Withdrawal Charge After Five Years" is replaced by the following: WITHDRAWAL CHARGE AFTER THREE YEARS: After the completion of three Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% during Participation Years 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the excess of (i) the sum of the Annuity Values of such Accounts over (ii) the Free Corridor Amount defined in Section 2.07C. (b) is the excess, if any of (i) 8% of the total contributions made on behalf of such Participant during the current Participation Year and the preceding nine Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. The Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. PF 17001CI 2. with respect to Section 1.18B Cash Value -- Existing Participants a. the term "20 Participation Years" contained in the paragraph entitled "No Withdrawal Charge" is changed to "12 Participation Years," b. the paragraph entitled "Withdrawal Charge Within First Five Years" is replaced by the following: WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS: Within the first three Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a) and (b) below; provided, however, that such charge does not exceed the amount described in subsection (c) below where: (a) is an amount equal to 2% of any Preferred Withdrawable Amounts (defined in Section 2.07B) that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (b) is an amount equal to 6% during the first five Participation Years 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of any Regular Withdrawable Amounts (defined in Section 2.07B) that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (c) is an amount equal to the sum of (a) above, and 6% of the excess, if any, of (i) the sum of the Annuity Values of such Accounts over (ii) the cumulative total of Equitable Transferred Funds made with respect to the Participant that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. c. the paragraph entitled "Withdrawal Charge After Five Years" is replaced by the following: WITHDRAWAL CHARGE AFTER THREE YEARS: After three Participation Years have been completed with respect to the Participant, Equitable (i) will first withdraw, pursuant to Section 2.07B, the Free Corridor Amount defined in Section 2.07C and (ii) next withdraw the remaining portion of the sum of the Annuity Values of such Accounts. A withdrawal charge will apply to the amount in (ii) above, and will equal the sum of the charges described in subsections (a) and (b) of the preceding subsection; provided, however, that such charge will not exceed an amount equal to the lesser of the charges defined in (d) and (e) below: (d) is an amount equal to the sum of (a) in the preceding subsection, and 6% during Participation Years 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the excess, if any, of (i) the sum of the Annuity Values of such Accounts (after withdrawal of the Free Corridor Amount) over (ii) the cumulative total of Equitable Transferred Funds made on behalf of the Participant that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (e) is an amount equal to the excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other contributions (excluding Equitable Transferred Funds) made on behalf of such Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07B. The Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. 3. with respect to section 2.07A Partial Withdrawals -- New Participants a. the term "25 Participation Years" contained in the provision entitled "No Withdrawal Charge" is changed to "12 Participation Years;" PF 17001CI b. the provision entitled "Withdrawal Charge Within First Five Years" is replaced by the following: WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS: If the Participant has not completed three Participation Years under the Contract, such withdrawal charge will equal the lesser of (a) or (b) where: (a) is an amount equal to 6% of the total amount to be withdrawn from the Accounts (including such charge) pursuant to this paragraph. (b) is the excess, if any, of (i) 8% if the cumulative total of Contributions made on behalf of such Participant over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. c. the provision entitled "Withdrawal Charge After Five Years" is replaced by the following: WITHDRAWAL CHARGE AFTER THREE YEARS: After the completion of three Participation Years with respect to the Participant, there will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Participation Years 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the amount withdrawn (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the cumulative total of contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. 4. with respect to Section 2.07B Partial Withdrawals -- Existing Participants a the term "20 Participation Years" contained in the provision entitled "No Withdrawal Charge" is changed to "12 Participation Years;" b. the provision entitled "Withdrawal Charge Within First Five Years" is replaced by the following: WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS: Within the first three Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a), (b), (c) and (d) below: (a) With respect to any withdrawals of Preferred Withdrawable Amounts, a charge of 2% of such withdrawals. (b) With respect to any withdrawals of Free Withdrawable Amounts, no charge. (c) With respect to any withdrawals of Regular Withdrawable Amounts, a charge of 6% of such withdrawals. (d) With respect to any withdrawals of amounts other than the amounts in (a), (b) and (c) above, no charge. c. the provision entitled "Withdrawal Charge After Five Years" is replaced by the following: WITHDRAWAL CHARGE AFTER THREE YEARS: After the completion of three Participation Years with respect to the Participant, there will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07C. PF 17001CI If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (1) first withdrawn from such Accounts an amount equal to the Free Corridor Amount, and (2) then withdraw from such Accounts and amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will equal the sum of the charges described in (a), (b) and (d) above plus with respect to any withdrawals of Regular Withdrawable Amounts, a charge of 6% during Participation Years 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter provided, however, that in no event will such charge exceed an amount equal to the following: The excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other Contributions (excluding Equitable Transferred Funds) made on behalf of the Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any prior withdrawal charges made pursuant to this Section. Whenever an amount is withdrawn from such Accounts that is not greater than the current Free Corridor Amount, such amount is considered to be (1) first, a withdrawal of Regular Withdrawable Amounts, (2) next, a withdrawal of Preferred Withdrawable Amounts, (3) next, a withdrawal of Free Withdrawable Amounts, and (4) lastly, a withdrawal of amounts other than the amounts in (1), (2), or (3) above. However, no charge will be assesed with respect to the portion of the withdrawal up to the current Free Corridor Amount. 5. with respect to Section 2.07C Free Corridor Amount, the term "five Participation Years" is changed to "three Participation Years." Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By /s/ William H. Schroeder By /s/ John B. Carter ------------------------ ------------------------------ President Title Vice President By /s/ Rodney L. Enochs --------------------- ------------------------------- Vice President and Secretary Dated Aug 19, 1983 Date of Issue --------------------- -------------------- At New York, N.Y. ------------------------ PF 17001CI Attached to and made part of Group Annuity Contract No. 11929CI between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective December 12, 1983, said contract and riders are amended as follows: 1. all references in the contract to the Annuitant's sex are deleted. 2. the phrase "3-1/4% interest and the 1971 ELAS Mortality Table" and the phrase "1979 ELAS Mortality" appearing in Section 3.04 Amount of Annuity Benefits shall be changed to "3-1/2% interest and the 1983 Individual Annuity Mortality Table adjusted to a unisex basis based on a 50-50 split of males and females" and "the projected 1983 Basic Table adjusted to a unisex basis based on a 50-50 split of males and females," respectively, wherever they appear. 3. the Tables of Guaranteed Annuity Payments appearing in Section 3.05 Payment of Annuity Benefits, are replaced by the following Tables. TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Value)
Age Age 60 61 62 63 64 65 66 67 68 69 70 60 4.54 4.58 4.62 4.66 4.70 4.74 4.77 4.81 4.84 4.88 4.91 61 4.62 4.67 4.71 4.76 4.81 4.84 4.88 4.91 4.95 4.99 62 4.72 4.76 4.81 4.85 4.90 4.94 4.98 5.02 5.06 63 4.81 4.86 4.91 4.96 5.01 5.06 5.10 5.14 64 4.92 4.97 5.02 5.08 5.13 5.17 5.22 65 5.03 5.09 5.15 5.20 5.26 5.31 66 5.15 5.21 5.27 5.33 5.39 67 5.28 5.34 5.40 5.47 68 5.41 5.48 5.55 69 5.56 5.63 70 5.71
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3-1/2% (Minimum Monthly Income per $1,000 of Annuity Value)
Age Age 60 61 62 63 64 65 66 67 68 69 70 60 4.40 4.44 4.48 4.51 4.55 4.58 4.61 4.65 4.68 4.71 4.74 61 4.48 4.52 4.56 4.60 4.64 4.67 4.71 4.74 4.78 4.81 62 4.56 4.60 4.65 4.69 4.73 4.77 4.80 4.84 4.88 63 4.65 4.69 4.74 4.78 4.83 4.87 4.91 4.95 64 4.74 4.79 4.84 4.89 4.93 4.98 5.02 65 4.85 4.90 4.95 5.00 5.05 5.10 66 4.95 5.01 5.06 5.11 5.17 67 5.07 5.12 5.18 5.24 68 5.19 5.25 5.32 69 5.32 5.39 70 5.46
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 5% (Minimum Monthly Income per $1,000 of Annuity Value)
Age Age 60 61 62 63 64 65 66 67 68 69 70 60 5.27 5.30 5.34 5.37 5.41 5.44 5.47 5.51 5.54 5.57 5.59 61 5.34 5.38 5.42 5.46 5.49 5.53 5.57 5.60 5.63 5.66 62 5.42 5.46 5.50 5.54 5.58 5.62 5.65 5.69 5.73 63 5.50 5.55 5.59 5.63 5.67 5.71 5.75 5.79 64 5.59 5.64 5.69 5.73 5.78 5.82 5.86 65 5.69 5.74 5.79 5.84 5.89 5.93 66 5.79 5.85 5.90 5.95 6.00 67 5.90 5.96 6.02 6.08 68 6.02 6.08 6.15 69 6.15 6.22 70 6.29
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) VARIABLE ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET FIXED ANNUITY BENEFIT INVESTMENT RETURN IS --------------------- --------------------------- Age 3 1/2% 5% - --- ------ -- 60 5.29 5.08 5.97 61 5.41 5.19 6.08 62 5.55 5.31 6.20 63 5.69 5.44 6.33 64 5.85 5.58 6.46 65 6.01 5.73 6.61 66 6.19 5.89 6.77 67 6.37 6.06 6.94 68 6.58 6.24 7.12 69 6.79 6.43 7.31 70 7.02 6.64 7.52 PF17006CI This amendment was approved by the New York Insurance Department under an accelerated procedure to assist employers in complying with the United States Supreme Court decision in Arizona v. Norris. The Department has reserved the right to require changes in this amendment to comply with applicable New York law and regulations. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By /s/ William H. Schroeder By /s/ John B. Carter ------------------------- ----------------------- President Title Vice President By /s/ Rodney L. Enochs ----------------- ---------------------- Vice President and Secretary Dated Dec 15 1983 Date of Issue ------------- --------------- At New York, N.Y. -------------- PF17006CI Attached to and made part of Group Annuity contract No. 11929CI between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK PART I IT IS HEREBY AGREED that, effective January 1, 1984, said contract and riders are amended as follows: 1. The words "(a) $2000 with respect to amounts contributed under a Plan described in clause (i) of Section 1.02 to purchase an Individual Retirement Annuity and (b) $15,000 with respect to amounts contributed under a Plan described in clause (ii) of Section 1.02 constituting a Simplified Employee Pension" which appear in the first sentence of the second paragraph of Section 1.06 entitled Contribution are changed to "the maximum amount permitted to be contributed under the Code for a taxable year of the Participant under a plan described in clause (i) or (ii) of Section 1.02, whichever is applicable." 2. Subsection B "Rollover Contribution Basis" of Section 2.01 is amended to read as follows: "A Participant may make one or more Contributions which in whole or in part qualify as "rollover amounts" within the meaning of Section 402(a)(5) or 403(b)(8) of the Code or "rollover contributions" within the meaning of Section 408(d)(3) of the Code." 3. The second paragraph of the provision entitled "Payment of Annuity Benefits" is amended to read as follows: "If the Participant dies before such Participant's interest has been distributed to such Participant, or if distribution has been commenced as provided in the first paragraph of this Section to such Participant's spouse, and such spouse dies before the entire interest has been distributed to such spouse, the entire interest (or the remaining part of such interest if the distribution thereof has commenced) will, within five years after the death of such Participant (or the death of such surviving spouse), be distributed to the Participant's or surviving spouse's beneficiary or beneficiaries. The preceding sentence shall have no application if distributions over a term certain commenced before the death of the Participant and the term certain is for a period permitted under the first paragraph of this Section." PART II IT IS HEREBY AGREED THAT, effective May 1, 1984 said contract and riders are amended as follows: 1. The term "Stock Account" has been changed to "Stock Account, Balanced Account and Aggressive Stock Account" wherever it appears except as provided in items 4 and 5 of this rider. 2. The Section entitled "The Separate Accounts" is amended as follows: a. the following Accounts have been added: Name Investments ---- ----------- Separate Account J Primarily common stocks and other equity-type investments, publicly traded debt securities and short term money market instruments. (Continued on next page) PF 17010CI Name Investments ---- ----------- Separate Account K Primarily common stocks issued by high quality small and intermediate size companies with strong growth prospects. b. The sentences "Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, consisting of .15% for investment management, .35% for financial accounting, .35% for the annuity rate guarantee and the minimum death benefit, and .90% for expenses and expense risk. The charge shall be made in connection with (c) of the Net Investment Factor provision in Section 1.16" are amended to read as follows: i. for Participants with a Participation Date prior to May 1, 1984 "Assets of Separate Account A and Separate Account E attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, consisting of .15% for investment management, .35% for financial accounting, .35% for the annuity rate guarantee and the minimum death benefit, and .90% for expenses and expense risk. Assets of Separate Account J and Separate Account K attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The percentage allocation of the components of the charges for Separate Account J and Separate Account K are not necessarily allocated in the same amounts as for Separate Account A and Separate Account E. The charge shall be made in connection with (c) of the Net Investment Factor provision in Section 1.16" ii. for Participants with a Participation Date on or after May 1, 1984 "Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.16." 3. The Section entitled "New Accumulation Unit Value" is amended by the addition of the following Accounts: Account Value Date ------- ----- ---- Separate Account J $10.00 As of May 1, 1984 Separate Account K $10.00 As of May 1, 1984 4. The title and the first two sentences of the Section entitled "Stock and Money market Accounts" shall read as follows: STOCK, BALANCED, AGGRESSIVE STOCK AND MONEY MARKET ACCOUNTS Equitable maintains a Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the (1) Stock Account becomes part of Separate Account A, (2) Balanced Account becomes part of Separate Account J, (3) Aggressive Stock Account becomes part of Separate Account K, and (4) Money Market Account becomes part of Separate Account E. (Continued on next page) PF 17010CI 5. The Section entitled "Transfers Among Accounts" is amended to read as follows: TRANSFERS AMONG ACCOUNTS At any time before a Participant's Retirement Date, such Participant, upon written request, may transfer all or part of the amounts maintained for the Participant to one or more of the other Accounts maintained for such Participant as follows: (1) amounts in the Guaranteed Interest Account, Stock Account, Balanced Account and Aggressive Stock Account may be transferred among such Accounts; (2) amounts in the Money Market Account may be transferred to the other Accounts. Such transfers will be made as of the date Equitable receives such request, and will be subject to Equitable's rules in effect at the time of transfer. No transfers are permitted from the Guaranteed Interest Account, Stock Account, Balanced Account or Aggressive Stock Account maintained for the Participant to the Money Market Account. Notwithstanding the above, transfers to the Balanced Account may be prohibited by Equitable upon 30 days written notice to the Participant. THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By /s/ William H. Schroeder By /s/ John B. Carter -------------------------------- -------------------------------- President Title Vice President By /s/ Rodney L. Enochs ----------------------------- -------------------------------- Vice President and Secretary Dated 06/27/84 Date of Issue ----------------------------- --------------------- At N.Y. N.Y. ------------------------------ PF 17010CI Attached to and made part of Group Annuity Contract No. 11929CI between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective January 1, 1986, said contract and riders are amended as follows: 1. With respect to Section 1.18A CASH VALUE -- NEW PARTICIPANTS, the provisions entitled "WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS" and "WITHDRAWAL CHARGE AFTER THREE YEARS" are replaced by the following: WITHDRAWAL CHARGE: The withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% during Participation Years 1, 2, 3, 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the excess of (i) the sum of the Annuity Values of such Accounts over (ii) the Free Corridor Amount defined in Section 2.07C. (b) is the excess, if any, of (i) 8% of the total contributions made on behalf of such Participants during the current Participation Year and the preceding nine Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Section 2.07 and 2.07A. The Cash Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. 2. With respect to Section 2.07A PARTIAL WITHDRAWALS -- NEW PARTICIPANTS, the provisions entitled "WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS" and "WITHDRAWAL CHARGE AFTER THREE YEARS" are replaced by the following. WITHDRAWAL CHARGE: There will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will: (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Participation Years 1, 2, 3, 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the amount withdrawn (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the cumulative total of contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. 3. With respect to Section 2.07C FREE CORRIDOR AMOUNT: a. the term "who has completed three Participation Years" is changed to "who has completed three Participation Years of attained age 59-1/2" b. the following sentence is added: With respect to a Participant who has not completed three Participation Years or attained age 59-1/2, the Free Corridor Amount is zero. 4. With respect to Section 2.08 ANNUAL ADMINISTRATIVE CHARGE: a. the first paragraph is replaced by the following: As of the last day of each Participation Year before a Participant's Retirement Date, if the sum of the Annuity Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market PF 17015CI Account on that date is less than $10,000.00, Equitable will withdraw from the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account at the end of that Participation Year and (ii) any withdrawals made from such Account pursuant to Section 2.07, 2.07A and 2.07B during that Participation Year. The charge will be allocated between the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Guaranteed Interest Account in proportion to the Annuity Values of each such Account, at the end of the Participation Year. b. the term "or Section 2.09 during a Participation Year," in the second paragraph is changed to "or Section 2.09 during a Participation Year, if the sum of the Annuity Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account, and Money Market Account at that date is less than $10,000.00." VICE PRESIDENT SPECIMEN AND SECRETARY SPECIMEN PRESIDENT PF 17015CI Attached to and made part of Group Annuity Contract No. 11929CI between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective January 1, 1986 for Participants with a Participation Date on or after January 1, 1986, said contract and riders are amended as follows: 1. With respect to the provision entitled NO WITHDRAWAL CHARGE, within the Section entitled CASH VALUE -- NEW PARTICIPANTS: the term "the Participant's attainment of age 70 years and six months, or (iii) the completion of 12 Participation Years with respect to such Participant, or (iv)" is changed to "the completion of 12 Participation Years with respect to such Participant, or (iii)" 2. With respect to the provision entitled NO WITHDRAWAL CHARGE within the Section entitled PARTIAL WITHDRAWAL -- NEW PARTICIPANTS: the term "such Participant's attainment of age 70 years and six months, or (iii) the completion of 12 Participation Years with respect to such Participant, or (iv)" is changed to "the completion of 12 Participation Years with respect to such Participant, or (iii)" Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By By Specimen --------------------------------- --------------------------------- President Title By Specimen ----------------------------- --------------------------------- Vice President and Secretary Dated Date of Issue ----------------------------- --------------------- At -------------------------------- PF 17019CI Attached to and made part of Group Annuity Contract No. 11929CI between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective January 1, 1985, said contract and riders are amended as follows: 1. In Section 1.11 entitled "Retirement Date" the third sentence is amended to read as follows: "No Retirement Date shall be earlier than the date the Participant attains age 59 years and six months nor shall be later than the first day of April following the calendar year in which the Participant attains age 70 years and six months." 2. Section 1.14B "Eligible Annuity Certain" is amended to read as follows: "The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by Equitable, which annuity shall not provide for payments beyond the life expectancy of the Participant or the joint life expectancy of the Participant and the Participant's designated beneficiary. Such annuity shall extend beyond the Participant's attainment of age 59 years and six months and shall not permit any prepayment of principal prior to the Participant's attainment of age 59 years and six months. Life expectancy and joint life expectancy of the Participant and the Participant's designated beneficiary shall be computed by the use of the return multiples contained in Section 1.72-9 of the regulations under the Code." 3. Section 2.01 entitled "Contributions", Subsection B entitled "Rollover Contribution Basis" is amended to read as follows: "A Participant may make one or more Contributions which in whole or in part qualify as "rollover amounts" within the meaning of Sections 402(a)(5), 402(a)(7), 403(a)(4) or 403(b)(8) of the Code or "rollover contributions" within the meaning of Sections 405(d)(3), 408(d)(3) or 409(b)3(C) of the Code." 4. In Section 3.05 entitled "Payment of Annuity Benefits" the first two paragraphs are deleted and replaced with the following: "The entire interest of a Participant will be distributed to such Participant by April 1 of the year following the calendar year in which the Participant attains age 70 years and six months. Or, at the request of the Participant such entire interest shall be distributed beginning not later than such April 1st in equal or substantially equal amounts over: (a) the life of such Participant or the joint lives of such Participant and the Participant's designated beneficiary; or (b) a period no longer than the life expectancy of such Participant or the joint life expectancy of such Participant and the Participant's designated beneficiary. "Or, a Participant's interest shall begin to be distributed no later than such April 1st, in such amounts as the Participant may request, provided such requested amounts are at least equal to the minimum amounts required to be distributed under the Code and provided further that such requested distributions are in accordance with Equitable's rules in effect at the time of each request. At minimum, the Code requires that if a Participant's interest is to be distributed in other than a single payment, then the amount to be distributed each year, beginning by the April 1st of the year following the calendar year in which the Participant attains age 70 years and six months and thereafter by each December 31, must be an amount equal to at least the amount obtained by PF 17023CI dividing such Participant's interest by the Participant's life expectancy or the joint life expectancy of such Participant and the Participant's designated beneficiary. A participant may elect to recalculate the Participant's life expectancy or the joint life expectancy of such Participant and the Participant's spousal beneficiary annually. The life expectancy of any non-spousal beneficiary may not be recalculated after the original determination. "If The Participant dies after distribution of the Participant's interest under this Contract begins, then the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution used before the Participant's death. If the Participant dies before payments of the Participant's interest begins, then either: (a) such entire interest will be distributed within five years after the Participant's death; or (b) upon the Participant's written request, distribution will be made to the Participant's designated beneficiary as follows: (i) the entire interest will be distributed over the life or life expectancy of the designated beneficiary; and (ii) such distribution will begin no later than one year after the Participant's death. The designated beneficiary may elect at any time after the Participant's death to receive greater payments, provided the income arrangement chosen by the participant permits such change. For purposes of this Section 3.05, the life expectancy of the Participant, the joint life expectancy of the Participant and the Participant's designated beneficiary, and the life expectancy of the Participant's designated beneficiary shall be computed by use of the return multiples contained in Section 1.72-9 of the regulations under the Code." Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By By /s/ John B. Carter --------------------------------- --------------------------------- President Title By /s/Rodney L. Enochs ----------------------------- --------------------------------- Vice President and Secretary Dated Date of Issue ----------------------------- --------------------- At -------------------------------- PF 17023CI Attached to and made part of Group Annuity Contract No. 11929CI between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective July 1, 1986, said contract and riders are amended as follows: 1. With respect to PART I -- DEFINITIONS, the following section is added: SECTION 1.14C PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by Equitable which does not permit any prepayment of the unpaid principal. 2. With respect to SECTION 1.18 CASH VALUE, the following text replaces the paragraphs under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to a Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such Annuity is at least ten years. At all other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. 3. With respect to SECTION 2.07A PARTIAL WITHDRAWAL CHARGES, the following paragraph replaces the paragraph under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a Participant, Equitable will withdraw from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such Annuity is at least ten years. At all other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK By________________________________________ Title_____________________________________ Dated_____________________________________ At________________________________________ THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES By________________________________________ President By________________________________________ Vice President and Secretary Date of Issue_____________________________ PF 17034CI [EQUITABLE LOGO] Participant: Certificate Number: Issue Date: Participation Date: Retirement Date: - -------------------------------------------------------------------------------- THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P O Box 2996, New York, New York 10116-2996 AGREES O TO ALLOCATE the Contributions made to the Contract, after deduction of any applicable taxes, to the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division of the Separate Account or to the Guaranteed Interest Division, in accordance with Sections 2.02, 2.03 and 2.04 or in part to any one, as directed by the Participant. O TO APPLY the Annuity Account Value at the Retirement Date to provide the Participant with an Annuity Benefit or a Cash Value benefit if the Participant is then living, and O TO PROVIDE the Participant with the other rights and benefits of this certificate. These agreements are subject to the provisions of this certificate. TEN DAYS TO EXAMINE CERTIFICATE - The Participant may terminate participation under the Contract and cancel this certificate by returning it to Equitable within ten days after receipt of it. Upon such cancellation, Equitable will refund any Contribution made to Equitable on behalf of a Participant under the Contract, plus or minus any investment gain or loss experienced in the Investment Divisions of the Separate Account from the date such Contribution is allocated to such Investment Division to the date of such cancellation. /S/Pauline Sherman /s/Edward D. Miller Pauline Sherman, Vice President, Edward D. Miller Secretary & Associate General Counsel President and Chief Executive Officer ASSETS HELD IN CONNECTION WITH THE CONTRACT MAY BE HELD IN THE SEPARATE ACCOUNT MAINTAINED BY EQUITABLE AND MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THE CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN 1N THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.16 IS 5% OR, 3 1/2%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE NOT TO EXCEED THE MAXIMUM RATE OF 1.75% FOR INVESTMENT MANAGEMENT, FINANCIAL ACCOUNTING, THE ANNUITY RATE GUARANTEE, THE MINIMUM DEATH BENEFIT, EXPENSES AND, EXPENSE RISK, BUT AFTER ANY DEDUCTIONS TO PROVIDE FOR TAXES. NO. 11933I AMENDED BY PF 17006I - PF 17010I - PF 17015I - PF 17019I - PF 17023I PF 17028I - PF 17034I - PF 17048I CONTENTS Part I - Definitions Page 2 Part II - Participant's Annuity Account Value Page 7 Part III - Annuity Benefits Page 9 Part IV - General Provisions Page 13 Equitable certifies that the Participant as named on page 3 is included under the Group Annuity Contract designated on page 3 ("the Contract"), all pertinent provisions of which are set forth below. As described in Section 1.10, Equitable will determine, before the beginning of each calendar year commencing after the period for which the Initial Guaranteed Interest Rate is effective, the Yearly Guaranteed Interest Rate for the calendar year for each Class of Participants, which shall not be lower than the Minimum Guaranteed Interest Rate then in effect. Equitable, from time to time, may declare a Guaranteed Interest Rate for a Class which exceeds the applicable Yearly Guaranteed Interest Rate and a period for which such rate applies. A Guaranteed Interest Rate is subject to annual administrative charges as described in Section 2.08. This certificate is valid only if participation under the Contract has not been terminated as described in the Contract and is subject to amendment as may be required pursuant to Section 4.02. EARLY WITHDRAWAL CHARGE. If a Participant terminates participation at any time after the earliest of the following occurrences: (i) the later of (a) the attainment of age 59 years and six months or (b) the completion of five Participation Years, or (ii) the completion of twelve Participation Years, or (iii) the attainment of age 55, the completion of five Participation Years and the receipt by Equitable of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years and the receipt by Equitable of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such annuity is at least ten years, or (v) for certificates issued prior to January 1, 1986, the attainment of age 70 years and six months, the Cash Value as provided in Section 1.18 will be equal to the Annuity Account Value. At other times, the Cash Value may also be reduced by a withdrawal charge as provided in Section 1.18. The Contract is issued in consideration of the payment to Equitable of the Contributions made under the Contract. The provisions on the following pages are part of this certificate. PART I - DEFINITIONS SECTION 1.01 EMPLOYER. The term "Employer" means the sole proprietor, partnership or corporation which has adopted a Plan. A sole proprietor is deemed to be his own Employer and a partnership is deemed to be the Employer of each partner. SECTION 1.02 PLAN. The term "Plan" means (i) a program established by an individual which requires amounts contributed thereunder to be applied to the purchase of individual retirement annuities within the meaning of Section 408(b) of the Code and (ii) a written program established by an Employer constituting a "Simplified Employee Pension" under Section 408(k) of the Code which requires amounts contributed thereunder to be applied to the purchase of individual retirement annuities within the meaning of Section 408(b) of the Code. SECTION 1.03 ANNUITY. The term "Annuity" means an individual retirement annuity meeting the requirements of Section 408(b) of the Code. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Section 3.04 of the Contract. SECTION 1.05 PARTICIPANT. The term "Participant" means a person who has been enrolled by Equitable under the Contract pursuant to a Plan for the purpose of purchasing an Annuity under the Contract. A person shall become enrolled under the Contract upon receipt by Equitable of an enrollment form made available by Equitable and completed in a manner satisfactory to Equitable. A person who has been enrolled under the Contract shall be a Participant-owner under the certificate during his lifetime. An Annuity is purchased for a person enrolled under the Contract upon receipt by Equitable of an initial Contribution for the Participant. NO. 11933I AMENDED BY PF 17006I - PF 17010I - PF 17015I - PF 17019I - PF 17023I PF 17028I - PF 17034I - PF 17048I -------- Page Two Page Four --------- DEFINITIONS (CONTINUED) SECTION 1.06 CONTRIBUTION. The term "Contribution" means a payment made to Equitable for a Participant with respect to an Annuity purchased for such Participant under the Contract. Equitable is under no obligation to accept any Contribution less than $20.00. The aggregate amount of such Contributions in any taxable year of the Participant shall not exceed the maximum amount permitted to be contributed under the Code for a taxable year of the Participant under a plan described in clause (i) or (ii) of Section 1.02, whichever is applicable. Amounts transferred to the Contract from an individual retirement account or annuity which meets the requirements of Section 408(a) respectively, of the Code, from a Pension Plan Endowment contract issued by Equitable as an individual retirement annuity, or amounts contributed under the Rollover Contribution Basis pursuant to subsection B of Section 2.01, are not subject to the above limitations on Contributions. SECTION 1.07 PARTICIPATION DATE. The term "Participation Date" with respect to a Participant means the date as of which Equitable has enrolled such Participant under the terms of the Contract. SECTION 1.08 PARTICIPATION YEAR. The term "Participation Year" with respect to a Participant means the twelve month period beginning on (i) the Participation Date, and (ii) each anniversary thereof, unless otherwise agreed to in writing by Equitable. SECTION 1.09 CLASS OF PARTICIPANTS. Except as provided in Section 1.10, the term "Class of Participants" refers to all Participants whose Participation Date is in the same calendar year. SECTION 1.10 GUARANTEED INTEREST RATE. For the Guaranteed Interest Division, the term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in such Division. Interest accrues daily. The Guaranteed Interest Rate will never be less than 3 % per annum. Equitable will from time to time establish and make available for new Participants (i) an Initial Guaranteed Interest Rate, (ii) one or more Minimum Guaranteed Interest Rates and (iii) the applicable effective period(s) for such Rates. A new class of Participants will be established effective with the effective date of the occurrence of (i), (ii) or (iii) above or any combination thereof. For the calendar year next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent calendar year thereafter, Equitable will determine for each established Class of Participants before the beginning of such calendar year a Yearly Guaranteed Interest Rate for such Class, which Yearly Guaranteed Interest Rate will not be lower than the effective Minimum Guaranteed Interest Rate applicable for such Class for such year. For any established Class of Participants, Equitable reserves the right to change the Minimum Guaranteed Interest Rate and the applicable period therefor, provided that any such Minimum Guaranteed Interest Rate will not be lower than the Minimum Guaranteed Interest Rate that would have been in effect in the absence of such change. Equitable will notify each Participant in a Class in writing of the Yearly Guaranteed Interest Rate or of any change in the Minimum Guaranteed Interest Rate at least 15 days prior to its effective date. For the period (not to exceed one year) next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent period (not to exceed one year) the Equitable may determine for each established Class of Participants a Guaranteed Interest Rate for such Class which exceeds the applicable Yearly Guaranteed Interest Rate. Equitable will notify each Participant in writing of the applicable Guaranteed Interest Rate and duration. SECTION 1.11 RETIREMENT DATE. The term "Retirement Date" means the date on which the Participant is to attain the retirement age specified in the Participant's enrollment form. Before the Retirement Date the Participant may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be earlier than the date the Participant attains age 59 years and six months nor shall be later than the first day of April following the calendar year in which the Participant attains age 70 years and six months. Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Home Office. SECTION 1.12 NORMAL FORM. The "Normal Form" of an Annuity Benefit under the Contract means, (i) if the Participant has a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (100% continuation) and (ii) if the Participant does not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.13 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depends is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by the Participant. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.14A LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. NO. 11933I AMENDED BY PF 17006I - PF 17010I - PF 17015I - PF 17019I - PF 17023I PF 17028I - PF 17034I - PF 17048I --------- Page Four Page Five --------- DEFINITIONS (CONTINUED) SECTION 1.14B ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by Equitable, which annuity shall not provide for payments beyond the life expectancy of the Participant or the joint life expectancy of the Participant and the Participant's designated beneficiary. Such annuity shall extend beyond the Participant's attainment of age 59 years and six months and shall not permit any prepayment of principal prior to the Participant's attainment of age 59 years and six months. Life expectancy and joint life expectancy of the Participant and the Participant's designated beneficiary shall be computed by the use of the return multiples contained in Section 1.72-9 of the regulations under the Code. SECTION 1.15 THE SEPARATE ACCOUNT. The Separate Account is Separate Account A (in unit investment trust form). Equitable established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited or charged against it without regard to Equitable's other income, gains or losses. Assets are put in the Separate Account to support the certificates issued under the Contract and other variable annuity contracts and certificates. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities and variable insurance. The assets of the Separate Account are the property of Equitable. The portion of its assets equal to the reserves and other contract liabilities with respect to the Separate Account will not be chargeable with liabilities arising out of any other business we conduct. Equitable may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to Equitable's General Account. The Separate Account consists of "Investment Divisions". Each Investment Division may invest its assets in a separate class (or series) of shares of a designated trust or investment company where each class (or series) represents a separate portfolio in the trust or investment company. Equitable retains the right to change the designated trust or investment company or to add designated trusts or investment companies. The Investment Divisions available on the Effective Date of this endorsement are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. Equitable will value the assets of each Investment Division on each business day. A business day is any day on which the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio securities in which an Investment Division is invested that the Accumulation Unit Value or Annuity Unit Value might be materially affected by changes in the value of those securities, as determined by Equitable. Equitable may, at its discretion, invest the assets of any Investment Division in any investment permitted by applicable law. Equitable may rely conclusively on the opinion of counsel (including attorneys in its employ) as to what investments it is permitted by law to make. Equitable reserves the right (i) to cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) to run the Separate Account under the direction of a committee, and to discharge such committee at any time; (iii) to restrict or eliminate any voting rights of Participants or other persons who have voting rights as to the Separate Account; (iv) to operate the Separate Account by making direct investments, or in any other form; (v) to add Investment Divisions (or sub-divisions of Investment Divisions) to, or remove Investment Divisions (or sub-divisions of Investment Divisions) from the Separate Account; (vi) to combine any two or more Investment Divisions (or sub-divisions of Investment Divisions) of the Separate Account; and (vii) to withdraw from any Investment Division and to allocate to another Investment Division assets determined by Equitable to be associated with the class of contracts to which the certificates issued under the Contract belong. The term "Investment Division" in the certificate shall then refer to any other Investment Division in which the assets (of a class of contracts to which the certificates issued under the Contract belong) were placed. If the exercise of these rights results in a material change in the underlying investments of an Investment Division, the Participants will be notified of such exercise. Assets of the Investment Divisions attributable to the certificates issued under the Contract shall be subject to a daily charge at a rate not to exceed the maximum rate of 1.75% per year for investment management, financial accounting, the annuity rate guarantee, the minimum death benefit, expenses and expense risk, but after any deductions to provide for taxes. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.16. The relative proportion of these charges may be modified, but the maximum annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to the certificates may not be altered without approval by the certificate owners. SECTION 1.16 DEFINITIONS RELATING TO THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT. VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business day immediately preceding such business day will constitute a Valuation Period. NET INVESTMENT FACTOR: For the certificates issued under the Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b), minus (c), where NO. 11933I AMENDED BY PF 17006I - PF 17010I - PF 17015I - PF 17019I - PF 17023I PF 17028I - PF 17034I - PF 17048I --------- Page Five Page Six -------- DEFINITIONS (CONTINUED) (a) is the net asset value of the Investment Division at the end of the Valuation Period before giving effect to any amounts allocated or withdrawn from the Investment Division for the Valuation Period, but after any amounts charged against the Investment Division in the Valuation Period for investment expenses or taxes. (b) is the net asset value of the Investment Division at the end of the preceding Valuation Period (after any amounts allocated or withdrawn for that Valuation Period). (c) is the daily asset charge for the certificates issued under the Contract, reduced by the portion of that charge applicable to investment expenses of the Investment Division, times the number of calendar days in the Valuation Period. The value of the assets in the Investment Divisions, referred to above, shall be taken at their fair market value, or where there is no readily available market, their fair value, as determined in accordance with generally accepted accounting practices and applicable laws and regulations. ACCUMULATION UNIT: The Accumulation Unit is a unit used in determining the amount a Participant has in an Investment Division of the Separate Account on or before the Retirement Date. ACCUMULATION UNIT VALUE: With respect to certificates issued under the Contract, the initial Accumulation Unit Value associated with each investment option was established as follows: Investment Option Value Date Established ----------------- ----- ---------------- Stock $10.00 November 1, 1968 Money Market $10.00 September 4, 1974 Balanced $10.00 May 1, 1984 Aggressive Stock $10.00 May 1, 1984 The Accumulation Unit Value for each subsequent Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such Valuation Period. ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable from the Stock Division of the Separate Account under a Variable Annuity Benefit as defined in Section 3.02. ANNUITY UNIT VALUE: With respect to certificates issued under the Contract, the initial Annuity Unit Value was established at $1.00 as of November 1, 1968. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE ANNUITY UNIT VALUE: With respect to certificates issued under the Contract, the Average Annuity Unit Value for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods ending in such month. SECTION 1.17 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts that a Participant has in the Guaranteed Interest Division and the Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03. SECTION 1.18 CASH VALUE NO WITHDRAWAL CHARGE: With respect to a Participant, the term "Cash Value" means an amount equal to the Annuity Account Value after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and six months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such annuity is at least ten years, or (v) for certificates issued prior to January 1, 1986, the Participant's attainment of age 70 years and six months. At other times, the Cash Value equals the Annuity Account Value less a withdrawal charge. WITHDRAWAL CHARGE: The withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% during Participation Years 1, 2, 3, 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the excess of (i) the Annuity Account Value over (ii) the Free Corridor Amount defined in Section 2.07B. NO. 11933I AMENDED BY PF 17006I - PF 17010I - PF 17015I - PF 17019I - PF 17023I PF 17028I - PF 17034I - PF 17048I -------- Page Six Page Seven ---------- DEFINITIONS (CONTINUED) (b) is the excess, if any, of (i) 8% of the total Contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to Section 2.07A. SECTION 1.19 CODE. The term "Code" means the Internal Revenue Code of 1954, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. PART II - PARTICIPANT'S ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. Contributions may be made with respect to a Participant on whichever basis, as described under subsections A and B below, as specified upon the Participant's enrollment under the Contract. If Contributions are made by or on behalf of a Participant under more than one such basis, Equitable will accept such Contributions if the Participant is separately enrolled under the Contract under each basis, and in such case separate certificates will be issued under the Contract for the Participant reflecting amounts accumulated on the Participant's behalf attributable to Contributions made under each Contribution basis. Each Contribution received by Equitable with respect to a Participant will, before its allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable. A. Flexible Contribution Basis Contributions are to be made from time to time on the dates and in the amounts determined in accordance with the terms of the Plan. With each Contribution there shall be specified the Participant with respect to whom such Contribution is being made and the amount to be allocated to the Stock Division, Balanced Division, Aggressive Stock Division, Money Market Division and the Guaranteed Interest Division. A Participant may, with Equitable's agreement, transfer to the Contract any amount held with respect to such Participant under an individual retirement account or annuity meeting the requirements of Section 408(a) or (b), respectively, of the Code issued by Equitable or otherwise, or a Pension Plan Endowment contract issued by Equitable as an individual retirement annuity, except an individual retirement account or annuity contract containing any "rollover amounts" within the meaning of Section 402(a)(5) or 403(b)(8) of the Code. Any amount so transferred from an individual retirement account or annuity contract not issued by Equitable will, before allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable. B. Rollover Contribution Basis A Participant may make one or more Contributions which in whole or in part qualify as "rollover amounts" within the meaning of Section 402(a)(5) or 403(b)(8) of the Code or "rollover contributions" within the meaning of Section 408(d)(3) of the Code. SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any date when an amount is allocated to or withdrawn or transferred from an Investment Division, the Participant will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units a Participant has in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Sections 2.07 or 2.08 or transferred from the Investment Division pursuant to Section 2.05. The amount a Participant has in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units that a Participant has in the Investment Division on that date and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under the Contract terminates on the earliest of (i) the Retirement Date, (ii) the death of the Participant, and (iii) termination of participation pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division becomes part of the general assets of Equitable, which support the guarantees of the Contract and other contracts. The amount a Participant has in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 or Section 2.10 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Section 2.07 or 2.08 or transferred from the Guaranteed Interest Division, pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division pursuant to Section 2.04. Equitable guarantees that the rate at which interest accrues will never be less than 3% per annum. Participation in the Guaranteed Interest Division terminates on the earliest of (i) the Retirement Date, (ii) the death of the Participant, and (iii) termination of participation pursuant to Section 2.06. NO. 11933I AMENDED BY PF 17006I - PF 17010I - PF 17015I - PF 17019I - PF 17023I PF 17028I - PF 17034I - PF 17048I ---------- Page Seven Page Eight ---------- PARTICIPANT'S ANNUITY ACCOUNT VALUE (CONTINUED) SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made with respect to a Participant pursuant to Section 2.01, after deduction for any applicable taxes, will be allocated, as of the date by which Equitable has received at the Processing Office both such Contribution and direction as to its allocation, to one or more Investment Divisions, at the sole direction of the Participant as specified to Equitable, provided that the percentage allocated to each Division is a whole number and the aggregate percentage is 100%. Any amount that a Participant has directed to be transferred to one or more Divisions pursuant to Section 2.05 will be allocated as of the date Equitable receives at the Processing Office the written request for such transfer to the appropriate Investment Division. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division at the end of each Participation Year, at the time of each transfer from the Division pursuant to Section 2.05, at the time of each withdrawal pursuant to Section 2.07, at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, upon termination of participation pursuant to Section 2.06 and upon death of the Participant pursuant to Section 2.09. SECTION 2.05 TRANSFERS AMONG DIVISIONS. At any time before a Participant's Retirement Date, such Participant, upon written request, may transfer all or part of the amount the Participant has in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; (2) amounts in the Money Market Division may be transferred to other Divisions. Such transfers will be made as of the date Equitable receives such request at the Processing Office, and will be subject to Equitable's rules in effect at the time of transfer. No transfers are permitted to the Money Market Division from the other Divisions. Notwithstanding the above, transfers to the Balanced Division may be prohibited by Equitable upon 30 days written notice to the Participants. SECTION 2.06 TERMINATION OF PARTICIPATION. On or before a Participant's Retirement Date, such Participant may elect by written notice to terminate participation under the Contract. Equitable will determine the Cash Value under the Contract as of the date Equitable received such notice at the Processing Office. The payment of such Cash Value to the Participant may be deferred by Equitable in accordance with the provisions of Section 4.08. Prior to a Participant's Retirement Date, Equitable reserves the right to pay the Annuity Account Value under the Contract and terminate such Participant's participation under the Contract. This right may be exercised with respect to the Participant only if both (i) no Contributions have been made under the Contract during the last three completed Participation Years, and (ii) the Annuity Account Value is less than $500. Equitable reserves the right to terminate a Participant's participation under the Contract if at least 120 days have elapsed since the issue date shown on the certificate issued to such Participant under the Contract and no Contributions have been made under the Contract with respect to such Participant. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount a Participant has in the Divisions and the Annuity Account Value shall be zero. Equitable will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under the terms of the Plan, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Divisions before such Participant's Retirement Date. Upon receipt of such notice at the Processing Office, Equitable will pay the lesser of the Cash Value or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by such Participant. The amount paid plus any withdrawal charge applicable pursuant to Section 2.07A will be withdrawn from the amounts the Participant has in the Divisions. Unless instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts that the Participant has in such Divisions. Upon any partial withdrawal payment, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by Equitable in accordance with the provisions of Section 4.08. Equitable may decline to accept a request for a partial withdrawal of less than $300. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, Equitable will so advise the Participant and reserves the right to pay the Annuity Account Value to the Participant, and terminate such Participant's participation under the Contract. For certificates issued prior to August 15, 1981, if a withdrawal made under this Section would result in an Annuity Account Value of less than $200, Equitable will so advise the Participant and reserves the right to pay the Annuity Account Value to the Participant, and terminate such participant's participation under the Contract. SECTION 2.07A PARTIAL WITHDRAWAL CHARGES NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07B or (b) the Cash Value is equal to the Annuity Account Value, pursuant to Section 1.18. NO. 11933I AMENDED BY PF 17006I - PF 17010I - PF 17015I - PF 17019I - PF 17023I PF 17028I - PF 17034I - PF 17048I ---------- Page Eight Page Nine --------- PARTICIPANT'S ANNUITY ACCOUNT VALUE (CONTINUED) WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Divisions an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a partial withdrawal charge. Such partial withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Participation Years 1, 2, 3, 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the amount withdrawn in excess of the Free Corridor Amount (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the total Contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to this Section. SECTION 2.07B FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" with respect to a Participant who has completed three Participation Years or attained age 59 years and six months means an amount equal to the excess, if any, of (i) 10% of the Annuity Account Value over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the current Participation Year with respect to the Participant. With respect to a Participant who has not completed three Participation Years or attained age 59 years and six months, the Free Corridor Amount is zero. SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Participation Year before a Participant's Retirement Date, Equitable will withdraw from the Divisions an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Account Value and (ii) any withdrawals pursuant to Section 2.07 during that Participation Year. The charge will be allocated among the Divisions in proportion to the amounts that the Participant has in the Divisions. As of a Participant's Retirement Date and before application of the Annuity Account Value or Cash Value of the certificate pursuant to Section 3.03, or upon termination of participation under the Contract pursuant to Section 2.06 or Section 2.09 during a Participation Year, Equitable will determine the portion of the administrative charge applicable to the completed portion of the current Participation Year and withdraw such amount in lieu of the annual administrative charge described in this Section for the applicable part of that Participation Year. As of a Participant's Retirement Date and before application of the Annuity Account Value or Cash Value pursuant to Section 3.03, or upon termination of participation pursuant to Section 2.06 or 2.09 during a Participation Year, if the Annuity Account Value on that date is less than $10,000, Equitable will withdraw the administrative charge described in this Section for the applicable part of that Participation Year. SECTION 2.09 DEATH BENEFIT. If the Employer reports to Equitable, or if Equitable otherwise ascertains, that a Participant has died while such Participant has amounts in the Divisions and before such Participant's Retirement Date, Equitable, upon receipt of due proof of such death, will pay in a single sum to the beneficiary designated by such Participant to receive such payment the amount of death benefit payable with respect to such Participant. The amount of the death benefit with respect to a Participant at any time prior to the Retirement Date is equal to the greater of (i) the Annuity Account Value and (ii) the minimum death benefit with respect to such Participant. Such minimum death benefit is the sum of all Contributions made with respect to such Participant pursuant to Section 2.01 (before reduction for any applicable taxes) less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount that was withdrawn is to the Annuity Account Value. If, in accordance with the provisions of Section 2.01, the cash value of an annuity contract issued by Equitable, which provides for a death benefit before retirement equal to the greater of the contract cash value or an alternate amount based on premiums paid or contributions made under the annuity contract, is transferred to the Contract, such alternative amount as of the date of transfer, will be included in the "sum of all Contributions" in lieu of the amount of cash value transferred for purposes of the death benefit under the Contract. Upon payment of the death benefit, the amount a Participant has in the Divisions and the Annuity Account Value shall be zero. Equitable will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. NO. 11933I AMENDED BY PF 17006I - PF 17010I - PF 17015I - PF 17019I - PF 17023I PF 17028I - PF 17034I - PF 17048I --------- Page Nine Page Ten -------- ANNUITY BENEFITS (CONTINUED) SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Stock Division of the Separate Account. The amount of the first, second and third payments under any Variable Annuity Benefit provided under the Contract with respect to a payee is the monthly amount provided with respect to a payee pursuant to Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The fourth and subsequent annuity payments under a Variable Annuity Benefit will not be increased or decreased in amount because of mortality or expense experience. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of the certificate in a single sum or (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by Equitable, as elected by the Participant, subject to Equitable's rules then in effect and any other applicable requirements under the Code. Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Value. Equitable will have the right to require the Participant to furnish pertinent information to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. Equitable may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If a Participant elects pursuant to the first or third paragraph of Section 3.03 to receive an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value if the payments under the annuity form elected are contingent upon the survival of a person or (ii) the Cash Value if the payments under the annuity form elected are not contingent upon the survival of a person. The amount applied to provide an Annuity Benefit shall be reduced by any applicable tax on annuity considerations, as determined by Equitable. If such amount is applied on or after the completion of five Participation Years with respect to such Participant, the balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. If the amount applied to provide an Annuity Benefit is applied before the completion of five Participation Years with respect to a Participant, the balance, after any applicable tax on annuity considerations, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the amounts the Participant has in the Divisions and the Annuity Account Value shall be zero. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (100% continuation). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, are based on 3 1/2% interest and the 1983 Individual Annuity Mortality Table adjusted to a unisex basis based on a 50-50 split of males and females. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on the projected 1983 Basic Table adjusted to a unisex basis based on a 50-50 split of males and females and an Assumed Base Rate of Net Investment Return of 3 1/2% or 5%, whichever applies pursuant to Section 1.16. The Assumed Base Rate of Net Investment Return is 5% for certificates issued for delivery in New York. Equitable may change the monthly income amounts contained in the Tables of Guaranteed Annuity Payments and the basis for determining such amounts, for new Participants, by at least 90 days advance notice to the Contract Holder and by an amendment to the Contract. NO. 11933I AMENDED BY PF 17006I - PF 17010I - PF 17015I - PF 17019I - PF 17023I PF 17028I - PF 17034I - PF 17048I --------- Page Ten Page Eleven ----------- ANNUITY BENEFITS (CONTINUED) Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on 3 1/2% interest and the 1983 Individual Annuity Mortality Table adjusted to a unisex basis based on a 50-50 split of males and females if such annuity form provides for a Fixed Annuity Benefit, and on the projected 1983 Basic Table adjusted to a unisex basis based on a 50-50 split of males and females and an Assumed Base Rate of Net Investment Income Return of 5% or 3 1/2%, whichever applies pursuant to Section 1.16, if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. The entire interest of a Participant will be distributed to such Participant by April 1 of the year following the calendar year in which the Participant attains age 70 years and six months. Or, at the request of the Participant such entire interest shall be distributed beginning not later than such April 1st in equal or substantially equal amounts over: (a) the life of such Participant or the joint lives of such Participant and the Participant's designated beneficiary; or (b) a period no longer than the life expectancy of such Participant or the joint life expectancy of such Participant and the Participant's designated beneficiary. Or, a Participant's interest shall begin to be distributed no later than such April 1st, in such amounts as the Participant may request, provided such requested amounts are at least equal to the minimum amounts required to be distributed under the Code and provided further that such requested distributions are in accordance with Equitable's rules in effect at the time of each request. At minimum, the Code requires that if a Participant's interest is to be distributed in other than a single payment, then the amount to be distributed each year, beginning by the April 1st of the year following the calendar year in which the Participant attains age 70 years and six months and thereafter by each December 31, must be an amount equal to at least the amount obtained by dividing such Participant's interest by the Participant's life expectancy or the joint life expectancy of such Participant and the Participant's designated beneficiary. A participant may elect to recalculate the Participant's life expectancy or the joint life expectancy of such Participant and the Participant's spousal beneficiary annually. The life expectancy of any non-spousal beneficiary may not be recalculated after the original determination. If the Participant dies after distribution of the Participant's interest under this Contract begins, then the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution used before the Participant's death. If the Participant dies before payments of the Participant's interest begins, then either: (a) such entire interest will be distributed within five years after the Participant's death; or (b) upon the Participant's written request, distribution will be made to the Participant's designated beneficiary as follows: (i) the entire interest will be distributed over the life or life expectancy of the designated beneficiary; and (ii) such distribution will begin no later than one year after the Participant's death. The designated beneficiary may elect at any time after the Participant's death to receive greater payments, provided the income arrangement chosen by the Participant permits such change. For purposes of this Section 3.05, the life expectancy of the Participant, the joint life expectancy of the Participant and the Participant's designated beneficiary, and the life expectancy of the Participant's designated beneficiary shall be computed by use of the return multiples contained in Section 1.72-9 of the regulations under the Code. Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payment under the Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by Equitable will be charged against and underpayments will be added to any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may make the payments (in the case of a minor, at a rate not exceeding $50 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If an annuity form made available by Equitable provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Upon election by a Participant pursuant to Section 3.03 of an annuity form providing payments for a period certain, such Participant may designate (with the right to change such designation) a person or persons to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. NO. 11933I AMENDED BY PF 17006I - PF 17010I - PF 17015I - PF 17019I - PF 17023I PF 17028I - PF 17034I - PF 17048I ----------- Page Eleven ----------- Page Twelve ANNUITY BENEFITS (CONTINUED) The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's executors or administrators in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, Equitable will pay in a single sum to such payee's executors or administrators the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03 Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. Equitable will require satisfactory evidence of the age of any person upon whose life an annuity form depends. TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM - 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Account Value)
- ------------------------------------------------------------------------------------------------------------------------------------ AGE 60 61 62 63 64 65 66 67 68 69 70 - ------------------------------------------------------------------------------------------------------------------------------------ 60 4.54 4.58 4.62 4.66 4.70 4.74 4.77 4.81 4.84 4.88 4.91 61 4.62 4.67 4.71 4.76 4.81 4.84 4.88 4.91 4.95 4.99 62 4.72 4.76 4.81 4.85 4.90 4.94 4.98 5.02 5.06 63 4.81 4.86 4.91 4.96 5.01 5.06 5.10 5.14 64 4.92 4.97 5.02 5.08 5.13 5.17 5.22 65 5.03 5.09 5.15 5.20 5.26 5.31 66 5.15 5.21 5.27 5.33 5.39 67 5.28 5.34 5.40 5.47 68 5.41 5.48 5.55 69 5.56 5.63 70 5.71 - ------------------------------------------------------------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM - 100% CONTINUATION - ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3 1/2% (Minimum Monthly Income per $1,000 of Annuity Account Value)
- ------------------------------------------------------------------------------------------------------------------------------------ AGE 60 61 62 63 64 65 66 67 68 69 70 - ------------------------------------------------------------------------------------------------------------------------------------ 60 4.40 4.44 4.58 4.51 4.55 4.58 4.61 4.65 4.68 4.71 4.74 61 4.48 4.52 4.56 4.60 4.64 4.67 4.71 4.74 4.78 4.81 62 4.56 4.60 4.65 4.69 4.73 4.77 4.80 4.84 4.88 63 4.65 4.69 4.74 4.78 4.83 4.87 4.91 4.95 64 4.74 4.79 4.84 4.89 4.93 4.98 5.02 65 4.85 4.90 4.95 5.00 5.05 5.10 66 4.95 5.01 5.06 5.11 5.17 67 5.07 5.12 5.18 5.24 68 5.19 5.25 5.32 69 5.32 5.39 70 5.46 - ------------------------------------------------------------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM - 100% CONTINUATION - ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 5% (Minimum Monthly Income per $1,000 of Annuity Account Value)
- ------------------------------------------------------------------------------------------------------------------------------------ AGE 60 61 62 63 64 65 66 67 68 69 70 - ------------------------------------------------------------------------------------------------------------------------------------ 60 5.27 5.30 5.34 5.37 5.41 5.44 5.47 5.51 5.54 5.57 5.59 61 5.34 5.38 5.42 5.46 5.49 5.53 5.57 5.60 5.63 5.66 62 5.42 5.46 5.50 5.54 5.58 5.62 5.65 5.69 5.73 63 5.50 5.55 5.59 5.63 5.67 5.71 5.75 5.79 64 5.59 5.64 5.69 5.73 5.78 5.82 5.86 65 5.69 5.74 5.79 5.84 5.89 5.93 66 5.79 5.85 5.90 5.95 6.00 67 5.90 5.96 6.02 6.08 68 6.02 6.08 6.15 69 6.15 6.22 70 6.29 - ------------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Account Value) FIXED VARIABLE ANNUITY BENEFIT ANNUITY IF ASSUMED BASE RATE OF AGE BENEFIT NET INVESTMENT RETURN IS - --- ------- ------------------------ 3 1/2% 5% - -------------------------------------------------------------------------------- 60 5.29 5.08 5.97 61 5.41 5.19 6.08 62 5.55 5.31 6.20 63 5.69 5.44 6.33 64 5.85 5.58 6.46 65 6.01 5.73 6.61 66 6.19 5.89 6.77 67 6.37 6.06 6.94 68 6.58 6.24 7.12 69 6.79 6.43 7.31 70 7.02 6.64 7.52 NO. 11933I AMENDED BY PF 17006I - PF 17010I - PF 17015I - PF 17019I - PF 17023I PF 17028I - PF 17034I - PF 17048I ----------- Page Twelve Page Thirteen ------------- ANNUITY BENEFITS (CONTINUED) Equitable will notify the payee under a Variable Annuity Benefit of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each variable payment. Any election, change, revocation or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a commutation right under an Annuity Benefit is exercised, Equitable may defer payment in accordance with Section 4.08. PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT. The Contract constitutes the entire Contract between the parties and the provisions of the Contract alone will govern with respect to the rights and obligations of Equitable. The provisions of the Contract will be applied separately with respect to each Participant. Nothing in the enrollment form referred to in Section 1.05, the Plan or custodial agreement referred to in Section 4.10 nor any modification, amendment, or supplement to any such documents will in any way be construed to enlarge, change, vary or in any other way affect the obligations of Equitable as expressly provided in the Contract. The Contract may not be modified as to Equitable, nor may any of Equitable's rights or requirements be waived, except in writing and by an authorized officer of Equitable. The Contract may be changed by amendment or replacement upon agreement between the Contract Holder and Equitable without the consent of any other person provided that such change does not reduce any Annuity Benefit provided before such change and provided that no rights, privileges or benefits which have accrued to any Participant under the Contract may be reduced or forfeited except by the express consent of such Participant. SECTION 4.02 STATUTORY COMPLIANCE. Equitable reserves the right to amend the Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the Contract and any certificate to reflect changes in the Code, or in regulations or published rulings of the Internal Revenue Service so that each such certificate will continue to be an Annuity. Any Annuity Benefit, Cash Value or death benefit available under a certificate issued pursuant to the Contract shall not be less than the minimum benefits required by any statute of the state in which the certificate is delivered. SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY. The entire interest of any Participant under the Contract is nonforfeitable. No interest of a Participant under the Contract may be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than Equitable. No amount payable under the Contract may be assigned, commuted, or encumbered by the payee, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. SECTION 4.04 PARTICIPATION IN SURPLUS. The Contract and all other contracts in the same class of contracts shall be combined for the purpose of ascertaining the annual surplus of Equitable to be apportioned to said contracts as a dividend and the portion of any such dividend that is to be allocated to the Contract shall be determined by Equitable. The participation of this class of contracts in annual surplus is, however, expected to be minimal. Any amount so allocated to the Contract shall be payable as of January 1 of the calendar year in which a dividend is apportioned and will be payable in cash and shall be equitably allocated by Equitable to the Guaranteed Interest Division on behalf of the Participants. SECTION 4.05 BENEFICIARY. Each Participant, as of such Participant's Participation Date, is to provide Equitable with an initial designation of the beneficiary entitled to receive any death benefit payable with respect to such Participant pursuant to Section 2.09. The Participant may change such designation from time to time during such Participant's lifetime and while a certificate for such Participant is being maintained hereunder. Any such designation or change will be made by written notice in a form satisfactory to Equitable. A change will, upon receipt at the Processing Office, take effect as of the time the written notice was signed, whether or not the Participant is living on the date of receipt, but without further liability as to any payment or other settlement made by Equitable before receipt of such change. Unless otherwise specified in the designation, if a Participant has designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive the Participant, and if more than one survive they will share equally. Any part of a death benefit payable with respect to a Participant pursuant to Section 2.09 for which there is no designated beneficiary living at the death of the Participant will be payable in a single sum to the children of the Participant who survive the Participant, in equal shares, or should none survive, then to the Participant's executors or administrators. NO. 11933I AMENDED BY PF 17006I - PF 17010I - PF 17015I - PF 17019I - PF 17023I PF 17028I - PF 17034I - PF 17048I ------------- Page Thirteen Page Fourteen ------------- GENERAL PROVISIONS (CONTINUED) If a Participant so elects in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by the Participant, with respect to the beneficiary, subject to Equitable's rules then in effect. If at the death of a Participant there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. SECTION 4.06 DISQUALIFICATION. In the event that an annuity purchased hereunder with respect to a Participant fails to qualify as an Annuity as described in Section 1.03, Equitable shall have the right, upon receiving notice of such fact before the Retirement Date, to terminate participation with respect to such Participant under the Contract and pay to such Participant the Annuity Account Value less a deduction for the appropriate part attributable to such Participant of any Federal income tax payable by Equitable which would not have been payable if such Participant had an Annuity under the Contract. SECTION 4.07 FUTURE PARTICIPANTS. Equitable reserves the right at its sole discretion to curtail or prohibit further enrollment as Participants under the Contract of any individuals who are not currently participating under the Contract as of such date of curtailment or prohibition. SECTION 4.08 DEFERMENT. Payments by Equitable from the Guaranteed Interest Division pursuant to the provisions of Section 2.06, 2.07 and 2.09, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.05, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. Interest at the current Guaranteed Interest Rate will be allowed on any such payment deferred for 30 days or more. During any period when (i) the sale of securities or the determination of the New Accumulation Unit Value or the Average Annuity Unit Value is not reasonably practicable because an emergency, defined by the Securities and Exchange Commission, exists, or the New York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may by order permit postponement for the protection of persons having interests in the Separate Account, Equitable reserves the right: (a) to defer determination of Cash Value or Annuity Account Value and payment of Cash Value and Annuity Account Value, arising from an Investment Division of the Separate Account; (b) to defer payment of any portion of the death benefit arising from an Investment Division of the Separate Account; (c) to defer the payment of any Variable Annuity Benefit under the Contract or the application of any such benefit to provide for any other payment called for under the Contract; or (d) in the event of (a) above, to defer application of such amounts to provide any Annuity Benefit permitted under the Contract. SECTION 4.09 ANNUAL NOTICE. At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date: (1) the amount the Participant has in the Guaranteed Interest Division, (2) the total number of Accumulation Units the Participant has in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Values, (4) the amount the Participant has in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the Cash Value and (6) the amount of death benefit payable with respect to the Participant. After the Retirement Date, Equitable will notify the Participant of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.10 CONTRACT HOLDER RESPONSIBILITY. The sole responsibility of the Contract Holder is to serve as party to the Contract. The Contract Holder will have no responsibility for the administration of any Plan or Agreement, or for Contributions or any payments or other distributions hereunder. Equitable will deal with the Contract Holder in accordance with the terms and conditions of the custodial agreement pursuant to which the Contract Holder agreed to act as such and in such manner as the Contract Holder and Equitable agree, without the consent of any other person. Any Employer making Contributions under the Contract shall be deemed to have adopted and accepted the custodial agreement as part of the Plan with respect to which such Contributions are made. SECTION 4.11 AGE. If the Annuitant's age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by Equitable will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. This certificate was approved by the New York Insurance Department under an accelerated procedure to assist employers in complying with the United States Supreme Court decision in Arizona v. Norris. The Department has reserved the right to require changes to comply with applicable New York law and regulations. NO. 11933I AMENDED BY PF 17006I - PF 17010I - PF 17015I - PF 17019I - PF 17023I PF 17028I - PF 17034I - PF 17048I ------------- Page Fourteen THE EQUTIABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Your certificate issued under Group Annuity Contract No. 11929CI is amended as follows: With respect to the language on the front page, the following statement is deleted: "THIS CONRACT MAY NOT BE SUITABLE FOR A PARTICIPANT IF THE ONLY CONTRIBUTION TO BE MADE ON SUCH PARTICIPANT'S BEHALF IS A SUBSTANTIAL SINGLE SUM CONTRIBUTION." SPECIMEN Vice President and Secretary Specimen President PF 170281 THE EQUITABLE Life Assurance Society of the United States Effective January 1, 1985, for Participants with a Participation Date on or after January 1, 1985, your certificate issued under Group Annuity Contract 11929CI is amended as follows: 1. In Section 1.11 entitled "Retirement Date" the third sentence is amended to read as follows: "No Retirement Date shall be earlier than the date the Participant attains age 59 years and six months nor shall be later than the first day of April following the calendar year in which the Participant attains age 70 years and six months." 2. Section 1.14B "Eligible Annuity Certain" is amended to read as follows: "The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by Equitable, which annuity shall not provide for payments beyond the life expectancy of the Participant or the joint life expectancy of the Participant or the joint life expectancy of the Participant and the Participant's designated beneficiary. Such annuity shall extend beyond the Participant's attainment of age 59 years and six months and shall not permit any prepayment of principal prior to the Participant's attainment of age 59 years and six months. Life expectancy and joint life expectancy of the Participant and the Participant's designated beneficiary shall be computed by the use of the return multiples contained in Section 1.72-9 of the regulations under the Code." 3. Section 2.01 entitled "Contributions", Subsection B entitled "Rollover Contribution Basis" is amended to read as follows: "A Participant may make one or more Contributions which in whole or in part qualify as "rollover amounts" within the meaning of Sections 402(a)(5), 402(a)(7), 403(a)(4) or 403(b)(8) of the Code or "rollover contributions" within the meaning of Sections 405(d)(3), 408(d)(3) or 409(b) 3(C) of the Code." 4. In Section 3.05 entitled "Payment of Annuity Benefits" the first two paragraphs are deleted and replaced with the following: "The entire interest of a Participant will be distributed to such Participant by April 1 of the year following the calendar year in which the Participant attains age 70 years and six months. Or, at the request of the Participant such entire interest shall be distributed beginning not later than such April 1st in equal or substantially equal amounts over: (a) the life of such Participant or the joint lives of such Participant and the Participant's designated beneficiary; or (b) a period no longer than the life expectancy of such Participant or the joint life expectancy of such Participant and the Participant's designated beneficiary. Or, a Participant's interest shall begin to be distributed no later than such April 1st, in such amounts as the Participant may request, provided such requested amounts are at least equal to the minimum amounts required to be distributed under the Code and provided further that such requested distributions are in accordance with Equitable's rules in effect at the time of each request. At minimum, the Code requires that if a Participant's interest is to be distributed in other than a single payment, then the amount to be distributed each year, beginning by the April 1st of the year following the calendar year in which the Participant attains age 70 years and six months and thereafter by each December 31, must be an amount equal to at least the amount obtained by PF 17023I dividing such Participant's interest by the Participant's life expectancy or the joint life expectancy of such Participant and the Participant's designated beneficiary. A participant may elect to recalculate the Participant's life expectancy or the joint life expectancy of such Participant and the Participant's spousal beneficiary annually. The life expectancy of any non-spousal beneficiary may not be recalculated after the original determination. If the Participant dies after distribution of the Participant's interest under this Contract begins, then the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution used before the Participant's death. If the participant dies before payments of the Participant's interest begins, then either: (a) such entire interest will be distributed within five years after the Participant's death; or (b) upon the Participant's written request, distribution will be made to the Participant's designated beneficiary as follows: (i) the entire interest will be distributed over the life or life expectancy of the designated beneficiary; and (ii) such distribution will begin no later than one year after the Participant's death. The designated beneficiary may elect at any time after the Participant's death to receive greater payments, provided the income arrangement chosen by the Participant permits such change. For purposes of this Section 3.05, the life expectancy of the Participant, the joint life expectancy of the Participant and the Participant's designated beneficiary, and the life expectancy of the Participant's designated beneficiary shall be computed by use of the return multiples contained in Section 1.72-9 of the regulations under the Code." VICE PRESIDENT SPECIMEN AND SECRETARY SPECIMEN PRESIDENT PF 17023I THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective July 1, 1986, or your Participation Date, whichever is the later, we have amended your Certificate issued under Group Annuity Contract No. 11929CI as follows: 1. With respect to PART I -- DEFINITIONS, the following section is added: SECTION 1.14C PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by Equitable which does not permit any prepayment of the unpaid principal. 2. With respect to SECTION 1.18 CASH VALUE, the following text replaces the paragraphs under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to a Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election from in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such Annuity is at least ten years. At all other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. 3. With respect to SECTION 2.07A PARTIAL WITHDRAWAL CHARGES, the following paragraph replaces the paragraph under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a Participant, Equitable will withdraw from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such Annuity is at least ten years. At all other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. VICE PRESIDENT SPECIMEN AND SECRETARY SPECIMEN PRESIDENT PF 17034I [LOGO] The Equitable Life Assurance Society of The United States 1285 Avenue of the Americas, New York, New York 10019 EQUI-PENSION-GV CONTRACT GROUP ANNUITY CONTRACT NO. 11930 CT CONTRACT HOLDER: UNITED STATES TRUST COMPANY OF NEW YORK CONTRACT CHANGE DATE: DECEMBER 31, 1984 The Initial Guaranteed Interest Rate is 10% and is effective until December 31, 1980. The Guaranteed Interest Rate after December 31, 1980 for a Class of Participants will be established before the beginning of each calendar year, but will not be less than the Minimum Guaranteed Interest Rate for such year and Class of Participants. This contract ("the Contract") is issued in consideration of the payment to Equitable of the contributions made under the Contract. Equitable will issue to each Participant an individual certificate setting forth a statement in substance of the benefits to which such Participants is entitled under the Contract. The provisions on the following pages are part of the Contract. FOR THE CONTRACT HOLDER: FOR THE EQUITABLE: By /s/ [Signature Unreadable] By /s/ Coy Eklund ............................... .................................. President Title Senior Vice President By /s/ Rodney L. Enochs ............................... .................................. Vice President and Secretary Dated 3/7/80 Date of Issue March 7, 1980 ............................... ....................... At New York, New York .................................. (Head Office) No. 11930 T PARTICIPATING This page 2 reserved for information in connection with the issuance of certificates under this Contract. Page 2 This page 3 reserved for information in connection with the issuance of certificates under this Contract. Page 3 PART 1 - DEFINITIONS SECTION 1.01 EMPLOYER The term "Employer" means (i) an educational organization employing a regular faculty which is a State, a political division of a State, or an agency or instrumentality of any one or more of the foregoing (within the meaning of Section 170(b)(1)(A)(ii) of the Code) which has entered into Agreements with its employees, and (ii) an organization described in Section 501(c)(3) of the Code which is exempt from Federal income tax under Section 501(c) of the Code which has either entered into Agreements with its employees or has adopted a Plan. SECTION 1.02 A AGREEMENT The term "Agreement" means an agreement between an Employer and an employee of the Employer, within the meaning of Section 1.403(b) - 1(b)(3) of the Federal income tax regulations, under which the employee agrees to accept a reduction in salary or to forego an increase in salary and to have such amounts applied under the Contract for the employee's behalf. SECTION 1.02 B PLAN The term "Plan" means a defined contribution pension plan established by an Employer described in clause (ii) of Section 1.01 which has been determined by the Internal Revenue Service to meet the requirements for qualification under Section 401(a) of the Code and which permits or requires amounts contributed thereunder to be applied under the Contract on behalf of employees covered under the Plan. SECTION 1.03 ANNUITY The term "Annuity" means an annuity purchased in accordance with the terms of the Agreement or the Plan to the extent the Agreement and the annuity purchased pursuant thereto meet the requirements of Section 403(b) of the Code or the Plan meets the requirements of Section 401(a) of the Code, whichever is applicable. SECTION 1.04 ANNUITY BENEFIT The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Section 3.03 of the Contract. SECTION 1.05 PARTICIPANT The term "Participant" means a person who has been enrolled by Equitable under the Contract and for whom the Employer has purchased an Annuity under the Contract. A person shall become enrolled under the Contract upon receipt by Equitable of an enrollment form made available by Equitable and completed in a manner satisfactory to Equitable. An Annuity is purchased for a person enrolled under the Contract upon receipt by Equitable of an initial Contribution by the Employer. SECTION 1.06 CONTRIBUTION The term "Contribution" means a payment made to Equitable for a Participant with respect to an Annuity purchased for such Participant under the Contract. Equitable is under no obligation to accept any Contribution less than $20.00. SECTION 1.07 PARTICIPATION DATE The term "Participation Date" with respect to a Participant means the date as of which Equitable has enrolled such Participant under the terms of the Contract. SECTION 1.08 PARTICIPATION YEAR The term "Participation Year" with respect to a Participant means the twelve month period beginning on (i) the Participation Date, and (ii) each anniversary thereof, unless otherwise agreed to in writing by Equitable. SECTION 1.09 CLASS OF PARTICIPANTS Except as provided in Section 1.10, the term "Class of Participants" refers to all Participants whose Participation Date is in the same calendar year. SECTION 1.10 GUARANTEED INTEREST RATE For each Guaranteed Interest Account, the term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in such Account. Interest accrues daily. The Guaranteed Interest Rate will never be less than 3% per annum. Equitable will from time to time establish and make available for new Participants (i) an Initial Guaranteed Interest Rate, (ii) one or more Minimum Guaranteed Interest Rates and (iii) the applicable effective period(s) for such Rates. A new Class of Participants will be established effective with the effective date of the occurance of (i), (ii) or (iii) above or any combination thereof. For the calendar year next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent calendar year thereafter, Equitable will determine for each established Class of Participants before the beginning of such calendar year a Yearly Guaranteed Interest Rate for such Class, which Yearly Guaranteed In- No. 11930 T Page 4 DEFINITIONS (continued) terest Rate will not be lower than the effective Minimum Guaranteed Interest Rate applicable for such Class for such year. For any established Class of Participants, Equitable reserves the right to change the Minimum Guaranteed Interest Rate and the applicable period therefor, provided that any such Minimum Guaranteed Interest Rate will not be lower than the Minimum Guaranteed Interest Rate that would have been in effect in the absence of such change. Equitable will notify each Participant in a Class in writing of the Yearly Guaranteed Interest Rate or of any change in the Minimum Guaranteed Interest Rate at least 15 days prior to its effective date. SECTION 1.11 RETIREMENT DATE The term "Retirement Date" means the date on which the Participant is to attain the retirement age specified in the Participant's enrollment form. Before the Retirement Date the Participant may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than 29th, 30th, or 31st day of any month). No Retirement Date shall be earlier than the date of attainment of age 55 years. Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Home Office. SECTION 1.12 NORMAL FORM The "Normal Form" of an Annuity Benefit under the Contract means (i) if the Participant has a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (100% continuation), and (ii) if the Participant does not have a living spouse at the Retirement Date, the Fixed Annuity benefit payable on the Life Annuity Benefit payable on the Life Annuity Form. SECTION 1.13 JOINT AND SURVIVOR LIFE ANNUITY FORM The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100% as elected by the Participant. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.14 LIFE ANNUITY FORM The term "Life Annuity Form" means an annuity providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.15 ANNUITY VALUE The term "Annuity Value" with respect to a Participant's Guaranteed Interest Account means the amount in such Account pursuant to Section 2.02. SECTION 1.16 CASH VALUE With respect to a Participant for whom no cash value(s) of existing contract(s) issued by Equitable is (are) transferred to the Contract pursuant to Section 2.01, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account means an amount equal to the Annuity Value after either (i) the later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and six months, or (ii), the Participant's attainment of age 70 years and six months. Prior to such time, the Cash Value of such Participant's Guaranteed Interest Account will equal the greater of (a) 94% of the Annuity Value of such Account and (b) the Annuity Value of such Account minus an amount equal to the excess, if any, of (i) 9% of the total Contributions made on behalf of such Participant during the current Participation Year and the preceding nine completed Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Section 2.05. With respect to a Participant for whom cash value(s) of existing contract(s) issued by Equitable is (are) transferred to the Contract pursuant to Section 2.01, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account means an amount equal to the Annuity Value after such Participant attains age 59 years and six months. Prior to such time, the Cash Value of such Participant's Guaranteed Interest Account will equal the Annuity Value of such Account minus an amount equal to the lesser of (a) and (b) where: (a) is the sum of: (1) 2% of the excess, if any, of (i) the first $10,000 of Separate Account Transfers over (ii) the cumulative total of any previous withdrawals made pursuant to subsection (a) of the third paragraph of Section 2.05 and (2) 6% of the excess, if any, of (i) the Annuity Value over No. 11930 T Page 5 DEFINITIONS (continued) (ii) the total amount of Separate Account Transfers minus the cumulative total of any withdrawals made pursuant to Section 2.05 (but such amount shall not be less than zero). (b) is the excess, if any if of: (1) the sum of (i) 2% of the first $10,000 of Separate Account Transfers made during the current Participation Year and the preceding nine Participation Years and (ii) 9% of all other Contributions (excluding Separate Account Transfers) made on behalf of the Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any withdrawal charges made pursuant to Section 2.05. SECTION 1.17 CODE The term "Code" means the Internal Revenue Code of 1954, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.18 SEPARATE ACCOUNT TRANSFERS The term "Separate Account Transfers" with respect to a Participant means the amount of cash value(s) transferred to the Contract from separate investment account(s) maintained by Equitable, pursuant to Section 2.01. PART II - PARTICIPANT'S ACCOUNT SECTION 2.01 CONTRIBUTIONS The Employer is to make Contributions from time to time on such dates and in such amounts as determined by the Employer pursuant to the terms of the Plan or, if the Employer has no Plan, as determined by the Employer at its sole discretion. The Employer is to specify the Participant with respect to whom each such Contribution is being made. Each Contribution received by Equitable with respect to a Participant will, before its allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable, and by the amount of any applicable deduction in accordance with Section 2.08. A Participant may, with Equitable's agreement, transfer to the Contract any amount held with respect to such Participant under a contract meeting the requirements of Section 403(b) of the Code or under a Plan of an Employer described in clause (ii) of Section 1.01 ("Transferred Funds"). Any Transferred Funds from a contract not issued by Equitable will, before allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable. Equitable will issue to each Participant an individual certificate setting forth a statement in substance of the benefits to which such Participant is entitled under the Contract. SECTION 2.02 GUARANTEED INTEREST ACCOUNT Equitable maintains a Guaranteed Interest Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the Guaranteed Interest Account becomes part of the general assets of Equitable, which support the guarantees of the Contract and other contracts. The amount in a Guaranteed Interest Account at any time is equal to the sum of all amounts that have been allocated to such Guaranteed Interest Account pursuant to Section 2.01 and Section 2.03 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn pursuant to Section 2.05 and Section 2.06 from such Account and less the sum of any annual administrative charges accrued but not made. Equitable guarantees that the amount in a Guaranteed Interest Account at any time before the Retirement Date will not be less than the sum of all amounts allocated to such Account pursuant to Section 2.01 and less the sum of all amounts that have been withdrawn from such Account pursuant to Section 2.05, all accumulated at 3% interest, compounded annually. In any Participation Year in which no Contribution is allocated to the Guaranteed Interest Account, the amount in such Account at the end of the Participation Year shall not be less than the amount in such Account at the beginning of the Participation Year No. 11930 T Page 6 PARTICIPANT'S ACCOUNT (continued) less the sum of all amounts withdrawn from such Account pursuant to Section 2.05, all accumulated at 3% interest, compounded annually. A Guaranteed Interest Account for a Participant terminates on the earliest of (i) the Retirement Date, (ii) the death of the Participant, and (iii) termination of participation pursuant to Section 2.04. SECTION 2.03 ALLOCATION TO ACCOUNT Each Contribution made with respect to a Participant pursuant to Section 2.01, after deduction for any applicable taxes, will be allocated, as of the date by which Equitable has received such Contribution, to the Guaranteed Interest Account. Interest is allocated to the Guaranteed Interest Account at the end of each Participation Year, at the time of withdrawal pursuant to Sections 2.05 and 2.07, at the time of application of amounts in the Guaranteed Interest Account to provide Annuity Benefits, and upon termination of participation pursuant to Section 2.04. SECTION 2.04 TERMINATION OF PARTICIPATION Subject to any applicable restrictions under the terms of the Agreements or the Plan, whichever is applicable, on or before a Participant's Retirement Date, such Participant may elect by written notice to terminate participation under the Contract. Upon receipt of such notice, Equitable will determine the Cash Value, as of the date Equitable received such notice, of the Guaranteed Interest Account maintained for such Participant. The payment of such Cash Value to the Participant may be deferred by Equitable in accordance with the provisions of Section 4.08. Prior to a Participant's Retirement Date, Equitable reserves the right to withdraw the Annuity Value of the Participant's Guaranteed Interest Account, pay such Annuity Value and terminate such Participant's participation under the Contract. This right may be exercised with respect to the Participant only if both (i) no Contributions have been made under the Contract during the last three completed Participation Years, and (ii) such Annuity Value is $500 or less. Equitable reserves the right to terminate a Participant's participation under the Contract if at least 120 days have elapsed since the issue date shown on the certificate issued to such Participant under the Contract and no Contributions have been made under the Contract with respect to such Participant. Upon payment of such Cash Value or Annuity Value, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Cash Value or Annuity Value arose. SECTION 2.05 PARTIAL WITHDRAWALS Subject to any applicable restrictions under the terms of the Agreements or the Plan, whichever is applicable, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Guaranteed Interest Account maintained for such Participant before such Participant's Retirement Date. With respect to partial withdrawals requested by a Participant for whom no cash value(s) of existing contract(s) issued by Equitable is (are) transferred to the Contract, Equitable will withdraw from such Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the Annuity Value of such Account, provided the request for partial withdrawal is made after either (i) the later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and six months, or (ii) such Participant's attainment of age 70 years and six months. If a partial withdrawal with respect to such Participant is made prior to such time, Equitable will withdraw from such Account an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. Such withdrawal charge will equal the lesser of (a) 6% of the total amount to be withdrawn from the Account pursuant to this Section (including such charge) and (b) the excess, if any, of (i) 9% of the total Contributions made on behalf of such Participant during the current Participation Year and the preceding nine completed Participation Years over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. With respect to partial withdrawals requested by a Participant for whom cash value(s) of existing contract(s) issued by Equitable is (are) transferred to the Contract pursuant to Section 2.01, Equitable will withdraw from such Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the Annuity Value of such Account, provided the request for partial withdrawal is made after such Participant's attainment of age 59 years and six months. If a partial withdrawal with respect to No. 11930 T Page 7 PARTICIPANT'S ACCOUNT (continued) such Participant is made prior to such time, Equitable will withdraw from such Account an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. Such withdrawal charge will be an amount equal to the sum of the charges described in subsections (a) and (b) below; provided, however, that in no event will such withdrawal charge exceed an amount described in subsection (c) below: (a) With respect to any withdrawal made up to the excess, if any, of (1) the cumulative total of all Separate Account Transfers made on the Participant's behalf over (2) the cumulative total of prior withdrawals made to which the withdrawal charge described in the subsection was applied, an amount equal to the lesser of (i) 2% of the total amount to be withdrawn pursuant to this subsection (including such charge) and (ii) $200 minus the cumulative total of any prior withdrawal charges made pursuant to this subsection. (b) With respect to any withdrawal made to which the withdrawal charge described in subsection (a) does not apply, 6% of such amount to be withdrawn (including such charge). (c) is the excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Separate Account Transfers made during the current Participation Year and the preceding nine Participation Years and (ii) 9% of all other Contributions (excluding Separate Account Transfers) made on behalf of the Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any prior withdrawal charges made pursuant to this Section. Upon withdrawal pursuant to either of the preceding two paragraphs, Equitable will pay the lesser of the Cash Value of such Account or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by such Participant. Upon any payment to a Participant pursuant to this Section, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Payments to the Participant pursuant to this Section may be deferred by Equitable in accordance with the provisions of Section 4.08. Equitable is under no obligation to process any request for partial withdrawal of less than $300. If a withdrawal from the Account made pursuant to this Section would result in an Annuity Value of less than $200, Equitable will withdraw the Annuity Value of the Account, pay the Cash Value of the Account to the Participant, and will terminate such Participant's participation under the Contract. SECTION 2.06 ANNUAL ADMINSTRATIVE CHARGE As of the last day of each Participation Year before a Participant's Retirement Date, Equitable will withdraw from the Guaranteed Interest Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Value of the Guaranteed Interest Account at the end of the Participation Year and (ii) any withdrawals made from such Account pursuant to Section 2.05 during that Participation Year. As of Participant's Retirement Date and before application of the Annuity Value of such Participant's Account pursuant to Section 3.02, or upon termination of such Account pursuant to Section 2.04 or Section 2.07 during a Participation Year, Equitable will withdraw the administrative charge described in this Section for the applicable part of that Participation Year. SECTION 2.07 DEATH BENEFIT If the Employer reports to Equitable, or if Equitable otherwise ascertains, that a Participant has died while an Account for such Participant is maintained under the Contract and before such Participant's Retirement Date, Equitable, upon receipt of due proof of such death, will pay in a single sum to the beneficiary designated by such Participant to receive such payment the amount of death benefit payable with respect to such Participant. The amount of the death benefit with respect to a Participant at any time prior to the Retirement Date is equal to the greater of (i) the Annuity Value of the Guaranteed Interest Account maintained under the Contract for such Participant or (ii) the minimum death benefit with respect to such Participant. Such minimum death benefit is the sum of all Contributions made with respect to such Participant pursuant to Section 2.01 (before reduction pursuant to said Section) less an adjustment for any withdrawals made pursuant to Section 2.05 from the Account maintained under the Contract for such Participant. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same No. 11930 T Page 8 PARTICIPANT'S ACCOUNT (continued) proportion as the amount being withdrawn is to the Annuity Value then in the Guaranteed Interest Account maintained under the Contract for such Participant. If, in accordance with the provisions of Section 2.01, the cash value of an Annuity contract issued by Equitable, which provides for death benefit before retirement equal to the greater of the contract cash value or an alternative amount based on premiums paid or contributions made under the Annuity contract, is transferred to the Contract, such alternative amount as of the date of transfer will be included in the "sum of all Contributions" in lieu of the amount of cash value transferred, for purposes of the death benefit under the Contract. The amount of any death benefit payable with respect to a Participant will, to the extent such Account is sufficient therefor, be withdrawn from the Guaranteed Interest Account maintained with respect to such Participant under the Contract. Upon such payment, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Annuity Value arose. SECTION 2.08 CHANGE OF DEDUCTIONS FOR NEW PARTICIPANTS Equitable reserves the right to make deductions to the extent permitted by applicable law from Contributions made on behalf of new Participants at any time on or after the Contract Change Date, by at least 90 days advance written notice to the Contract Holder and by amendment to the Contract. Equitable will thereupon established a new Contract Change Date which shall be at least 5 years later. Equitable may lower the amount of the administrative charge described in Section 2.06 for new Participants at any time, by at least 15 days advance written notice to the Contract Holder. SECTION 2.09 CHANGE OF DEDUCTIONS AND CHARGES FOR EXISTING PARTICIPANTS Equitable may lower the amount of the administrative charge described in Section 2.06 for existing Participants at any time, by at least 15 days advance written notice to the Contract Holder and to such Participants. PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Value of such Participant's Guaranteed Interest Account shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of such Account in a single sum or (ii) to supply such Annuity Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.03, to provide an Annuity Benefit on any other annuity form offered by Equitable, as elected by the Participant, subject to Equitable's rules then in effect and any applicable requirements under the Code. Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate participation under the Contract pursuant to Section 2.04 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Value of such Participant's Guaranteed Interest Account. Equitable will have the right to require the Participant to furnish pertinent facts and determinations to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Section 3.03 and 3.04. Equitable may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form. No. 11930 T Page 9 ANNUITY BENEFITS (continued) SECTION 3.03 AMOUNT OF ANNUITY BENEFITS If a Participant elects pursuant to the first paragraph and third paragraph of Section 3.02 to receive an Annuity Benefit in lieu of the Cash Value of the Guaranteed Interest Account, the amount applied to provide the Annuity Benefit will be (i) the Annuity Value of such Account if the payments under the annuity form elected are contingent upon the survival of a person, or (ii) the Cash Value of such Account if the payments under the annuity form elected are not contingent upon the survival of a person. The amount applied to provide an Annuity Benefit shall be reduced by the amount, as determined by Equitable, of any applicable tax on annuity considerations. If such amount if applied on or after the completion of five Participation Years with respect to such Participant, or if such amount is applied on behalf of a Participant for whom cash value(s) of existing contract(s) issued by Equitable was(were) transferred to the Contract pursuant to Section 2.01, the balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. If the amount applied to provide an Annuity Benefit is applied before the completion of five Participation Years with respect to a Participant for whom no cash value(s) of existing contract(s) issued by Equitable was(were) transferred to the Contract, the balance, after any applicable tax on annuity consideration, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the Guaranteed Interest Account maintained for such Participant shall terminate. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (100% continuation). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, are based on 3 1/4% interest and the 1971 ELAS Mortality Table. Equitable may change the monthly income amounts contained in the Tables of Guaranteed Annuity Payments and the bases for determining such amounts, for new Participants, by at least 90 days advance notice to the Contract Holder and by an amendment to the Contract. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on 3 1/4% interest and the 1971 ELAS Mortality Table. SECTION 3.04 PAYMENT OF ANNUITY BENEFITS Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payable under the Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by Equitable will be charged against and underpayments will be added to any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may make the payments (in the case of a minor, at a rate not exceeding $50 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. No. 11930 T Page 10 ANNUITY BENEFITS (continued) If an annuity form made available by Equitable provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Upon election by a Participant pursuant to Section 3.02 of annuity form providing payments for a period certain, such Participant may designate (with the right to change such designation) a person or persons to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in single sum payment to such payee's executors or administrators in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, Equitable will pay in a single sum to such payee's executors or administrators the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.02. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. Equitable will require satisfactory evidence of the age of any person upon whose life an annuity form depends. TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM - 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Value)
- ------------------------------------------------------------------------------------------------------------------------------------ MALE FEMALE AGE - ------------------------------------------------------------------------------------------------------------------------------------ AGE 60 61 62 63 64 65 66 67 68 69 70 - ------------------------------------------------------------------------------------------------------------------------------------ 60 4.52 4.58 4.64 4.70 4.76 4.82 4.88 4.94 5.00 5.05 5.11 61 4.55 4.62 4.68 4.74 4.81 4.87 4.93 5.00 5.06 5.12 5.18 62 4.58 4.65 4.72 4.78 4.85 4.92 4.99 5.05 5.12 5.19 5.25 63 4.61 4.68 4.75 4.82 4.89 4.97 5.04 5.11 5.18 5.25 5.32 64 4.64 4.71 4.79 4.86 4.94 5.01 5.09 5.17 5.24 5.32 5.40 65 4.67 4.74 4.82 4.90 4.98 5.06 5.14 5.22 5.30 5.38 5.47 66 4.69 4.77 4.85 4.93 5.02 5.10 5.18 5.27 5.35 5.44 5.53 67 4.72 4.80 4.88 4.97 5.05 5.14 5.23 5.31 5.40 5.50 5.59 68 4.74 4.82 4.91 5.00 5.09 5.18 5.27 5.36 5.45 5.55 5.65 69 4.76 4.85 4.94 5.03 5.12 5.22 5.31 5.41 5.50 5.60 5.71 70 4.78 4.87 4.96 5.06 5.16 5.26 5.36 5.45 5.56 5.66 5.76 - ------------------------------------------------------------------------------------------------------------------------------------
FIXED ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) - -------------------------------------------------------------------------------- AGE MALES FEMALES - -------------------------------------------------------------------------------- 60 5.88 4.99 61 6.04 5.11 62 6.21 5.24 63 6.38 5.38 64 6.57 5.53 65 6.77 5.68 66 6.98 5.84 67 7.19 6.01 68 7.42 6.20 69 7.67 6.39 70 7.93 6.61 - -------------------------------------------------------------------------------- Any election, change, revocation or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a communication right under an Annuity Benefit is exercised, Equitable may defer payment in accordance with Section 4.08. No. 11930 T Page 11 PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT The Contract constitutes the entire Contract between the parties and the provisions of the Contract alone will govern with respect to the rights and obligations of Equitable. The provisions of the Contract will be applied separately with respect to each Participant. Nothing in the enrollment form referred to in Section 1.05, the Plan or trust agreement referred to in Section 4.01 nor any modification, amendment, or supplement to any such documents will in any way be construed to enlarge, change, vary or in any other way affect the obligations of Equitable as expressly provided in the Contract. The Contract may not be modified as to Equitable, nor may any of Equitable's rights or requirements be waived, except in writing and by an authorized officer of Equitable. The Contract may be changed by amendment or replacement upon agreement between the Contract Holder and Equitable without the consent of any other person provided that such change does not reduce any Annuity Benefit provided before such change and provided that no rights, privileges or benefits which have accrued to any Participant under the Contract may be reduced or forfeited except by the express consent of such Participant. SECTION 4.02 STATUTORY COMPLIANCE Equitable reserves the right to amend the Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the Contract and any certificate to reflect changes in the Code, or in regulations or published filings of the Internal Revenue Service, so that each such certificate will continue to be an Annuity. Any Annuity Benefit, Cash Value or death benefit available under a certificate issued pursuant to the Contract shall not be less than the minimum benefits required by any statute of the state in which the certificate is delivered. SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY The entire interest of any Participant under the Contract is nonforfeitable. No interest of a Participant under the Contract may be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than Equitable. No amount payable under the Contract may be assigned, commuted, or encumbered by the payee, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. SECTION 4.04 PARTICIPATION IN SURPLUS The Contract and all other contracts in the same class of contracts shall be combined for the purpose of ascertaining the annual surplus of Equitable to be apportioned to said contracts as a dividend, and the portion of any such dividend that is to be allocated to the Contract shall be determined by Equitable. The participation of this class of contracts in annual surplus is, however, expected to be minimal. Any amount so allocated to the Contract shall be payable as of January 1 of the calendar year in which a dividend is apportioned and will be payable in cash and shall be equitably allocated by Equitable to the Guaranteed Interest Accounts maintained hereunder for Participants. No Annuity Benefit will enter into the determination of any surplus to be apportioned to the Contract as a dividend. SECTION 4.05 BENEFICIARY Each Participant, as of such Participant's Participation Date is to provide Equitable with an initial designation of the beneficiary entitled to receive any death benefit payable with respect to such Participant pursuant to Section 2.07. The Participant may change such designation from time to time during such Participant's lifetime and while Accounts for such Participants are being maintained hereunder. Any such designation or change will be made by written notice in a form satisfactory to Equitable. A change will, upon receipt at a designated Equitable Office, take effect as of the time the written notice was signed, whether or not the Participant is living on the date of receipt, but without further liability as to any payment or other settlement made by Equitable before receipt of such change. Unless otherwise specified in the designation, if a Participant has designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive the Participant, and if more than one survive they will share equally. Any part of a death benefit payable with respect to a Participant pursuant to Section 2.07 for which there is no designated beneficiary living at the death of the No. 11930 T Page 12 GENERAL PROVISIONS (continued) Participant will be payable in a single sum to the children of the Participant who survive the Participant, in equal shares, or should none survive, then to the Participant's executors or administrators. If a Participant so elects in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by the Participant, with respect to the beneficiary, subject to Equitable's rules then in effect. If at the death of a Participant there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. SECTION 4.06 DISQUALIFICATION In the event that an annuity purchased hereunder with respect to a Participant fails to qualify as an Annuity as described in Section 1.03, Equitable shall have the right, upon receiving notice of such fact before the Retirement Date, to terminate participation with respect to such Participant under the Contract and pay to such Participant the amount in the Account maintained with respect to such Participant less a deduction for the appropriate part attributable to such Participant of any Federal income tax payable by Equitable which would not have been payable if such Participant had an Annuity under the Contract. SECTION 4.07 FUTURE PARTICIPANTS Equitable reserves the right at its sole discretion to curtail or prohibit further enrollment as Participants under the Contract of any individuals who are not currently participating under the Contract as of such date of curtailment or prohibition. SECTION 4.08 DEFERMENT Payments by Equitable from the Participant's Guaranteed Interest Account pursuant to the provisions of Section 2.04, Section 2.05 and Section 2.07, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.04, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.04. Interest at the current Guaranteed Interest Rate for such Participant's Guaranteed Interest Account will be allowed on any such payment deferred for 30 days or more. SECTION 4.09 ANNUAL NOTICE At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Guaranteed Interest Account, (2) the Cash Value of the Guaranteed Interest Account, and (3) the amount of death benefit payable with respect to the Participant. SECTION 4.10 CONTRACT HOLDER RESPONSIBILITY The sole responsibility of the Contract Holder is to serve as party to the Contract. The Contract Holder will have no responsibility for the administration of any Plan or Agreement, for payments to the Guaranteed Interest Account, or any payments or other distributions hereunder. Equitable will deal with the Contract Holder in accordance with the terms and conditions of the trust agreement pursuant to which the Contract Holder agreed to act as such and the Contract and in such manner as the Contract Holder and Equitable may agree, without the consent of any other person. Any Employer making Contributions under the Contract shall be deemed to have adopted and accepted the trust agreement as part of the Plan or Agreements with respect to which such Contributions are made. SECTION 4.11 AGE AND SEX If the Annuitant's age or sex has been misstated, any benefits will be those which would have been purchased at the correct age and sex. Any overpayments or underpayments made by Equitable will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. No. 11930 T Page 13 Attached to and made part of Group Annuity Contract No. 11930CT between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective August 15, 1981, said contract is amended as follows: 1. Contributions made to the contract, less applicable premium taxes, as determined by Equitable, may be allocated to the Guaranteed Interest Account or Stock Account maintained for the Participant, or in part to both, as directed by the Participant. 2. At the Retirement Date, if the Participant is then living, the amount in the Guaranteed Interest Account and Stock Account will be applied to provide the Participant with an Annuity Benefit or Cash Value Benefit. 3. ASSETS HELD IN CONNECTION WITH THE CONTRACT MAY BE HELD IN A SEPARATE ACCOUNT MAINTAINED BY EQUITABLE AND MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THE CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE SEPARATE ACCOUNT IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.20 IS 5% OR 3-1/2%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE OF 1.75% FOR INVESTMENT MANAGEMENT, FINANCIAL ACCOUNTING, THE ANNUITY RATE GUARANTEE AND MINIMUM DEATH BENEFIT, EXPENSES AND EXPENSE RISK, BUT AFTER ANY DEDUCTIONS TO PROVIDE FOR TAXES. THIS CONTRACT MAY NOT BE SUITABLE FOR A PARTICIPANT IF THE ONLY CONTRIBUTION TO BE MADE ON SUCH PARTICIPANT'S BEHALF IS A SUBSTANTIAL SINGLE SUM CONTRIBUTION. PF 14102CT PAGE 1 4. The following provisions are added to your Certificate: To Part I of your Certificate SECTION 1.05A EXISTING PARTICIPANT The term "Existing Participant" means a Participant for whom Cash Values of existing annuity contracts issued by Equitable is (are) eligible to be transferred to the Contract pursuant to Section 2.01. SECTION 1.05B NEW PARTICIPANT The term "New Participant" means a Participant who is not an Existing Participant. SECTION 1.14B ELIGIBLE ANNUITY CERTAIN The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by Equitable which extends beyond the Participant's attainment of age 59 years and six months and does not permit any prepayment of the unpaid principal prior to the participant's attainment of age 59 years and six months. SECTION 1.19 THE SEPARATE ACCOUNT The term "Separate Account" means Separate Account A, a separate investment account maintained by Equitable to which portions of its assets have been allocated for the Contract and certain other contracts. Equitable reserves the right to withdraw from the Separate Account and allocate to another separate account assets determined by Equitable to be associated with the class of contracts to which the Contract belongs. In any such event, to the extent practicable and permissible under applicable laws and regulations, the withdrawal shall be made by withdrawing the same percentage of each investment in the Separate Account, with appropriate adjustments to avoid lots and fractions. On and after the date of any such withdrawal the term "Separate Account" in the Contract shall mean such other separate account to which the withdrawn assets were allowed. It is contemplated that investments in the Separate Account will at most times, consist primarily of common stock and other equity-type investments. Equitable may, however, at its discretion invest the assets of the Separate Account in any investment permitted by applicable law. Equitable may rely conclusively on the opinion of counsel (including attorneys in its employ) as to what investments it is permitted by law to make. In lieu of making such investments directly, Equitable reserves the right to operate the Separate Account as a unit investment trust, or in any other form permitted by law, investing all or part of its assets in shares or units of a fund, the investment adviser of which may be Equitable or controlled by Equitable. The fund assets would be invested as provided above with respect to the Separate Account. Equitable reserves the right: (i) to cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such committee at any time; and (iii) restrict or eliminate any voting rights of participants or other persons who have voting rights as to the Separate Account. Assets of the Separate Account attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, consisting of .15% for investment management, .35% for financial accounting, .35% for the annuity rate guarantee and the minimum death benefit, and .90% for expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.20. The assets of the Separate Account are the property of Equitable; however, the portion of the assets of the Separate Account equal to the reserves and other contract liabilities with respect to such Account shall not be chargeable with liabilities arising out of any other business Equitable may conduct. Equitable reserves the right to transfer assets of the Separate Account in excess of such reserves and contract liabilities to the general account of Equitable. SECTION 1.20 DEFINITIONS RELATING TO THE SEPARATE ACCOUNT VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business day immediately preceding such PF 14102CT PAGE 2 business day will constitute a Valuation Period. A business day is any day on which there is a sufficient degree of trading in the portfolio securities of the Separate Account that the Accumulation Unit Value or Annuity Unit Value might be materially affected by changes in the value of the portfolio securities in the Separate Account, as determined by Equitable. NET INVESTMENT FACTOR: For the Separate Account the Net Investment Factor for a Valuation Period is (a) divided by (b), minus (c), where: (a) is (1) the value of the assets in the Separate Account at the close of business of the preceding Valuation Period plus (2) the investment income and the capital gains, realized or unrealized, credited to the assets of the Separate Account in the Valuation Period for which the Net Investment Factor is being determined; minus (3) the capital losses, realized or unrealized, charged against such assets in such Valuation Period, minus (4) any amount charged against the Separate Account in such Valuation Period for taxes or for amounts set aside by Equitable as a reserve for taxes attributable to the maintenance or operation of the Separate Account; (b) is the value of the assets in the Separate Account at the close of business of the preceding Valuation Period; and (c) is the daily charge, for each calendar day in such Valuation Period of .00004837 for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The value of the assets in the Separate Account, referred to above, shall be taken at their fair market value, or where there is no readily available market, their fair value, as determined in accordance with accepted accounting practices and applicable laws and regulations. ACCUMULATION UNIT: The Accumulation Unit is a unit used in determining the value of the interest of a Participant's Stock Account in the Separate Account on or before the Retirement Date. NEW ACCUMULATION UNIT VALUE: The initial New Accumulation Unit Value for the Separate Account has been established at $10.00 as of November 1, 1968. The New Accumulation Unit Value for each subsequent Valuation Period is the New Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such subsequent Valuation Period. ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable from the Separate Account under a Variable Annuity Benefit. NEW ANNUITY UNIT VALUE: The initial New Annuity Unit Value has been established at $1.00 on November 1, 1968. The New Annuity Unit Value for any subsequent Valuation Period is the New Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3 1/2%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE NEW ANNUITY UNIT VALUE: The Average New Annuity Unit value for a calendar month is equal to the average of the New Annuity Unit Values for the Valuation Periods ending in such month. To Part II of your Certificate SECTION 2.10 STOCK ACCOUNT Equitable maintains a Stock Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to a Stock Account becomes part of the Separate Account. Any amount withdrawn from a Stock Account will no longer be part of the Separate Account. On any date when an amount is allocated to or withdrawn from a Stock Account, the Stock Ac- PF 14102CT PAGE 3 count will be credited or charged, as the case may be, with a number of Accumulation Units determined by dividing said amount by the New Accumulation Unit Value for the Separate Account for the Valuation Period which includes that date. The number of Accumulation Units in a Stock Account on any date is equal to (i) the sum on any Accumulation Units that have been credited to the Stock Account minus (ii) the sum of any Accumulation Units that have been charged to the Stock Account. The amount in a Stock Account on any date is equal to the product of (i) the number of Accumulation Units in the Stock Account on that date and (ii) the Accumulation Unit Value for the Separate Account for the Valuation Period which includes that date. SECTION 2.11 TRANSFERS BETWEEN ACCOUNTS At any time before a Participant's Retirement Date, such Participant, upon written request, may transfer all or a part of the amounts from the Stock Account maintained for such Participant to the Guaranteed Interest Account maintained for such Participant, or may transfer all or a part of the amount in the Guaranteed Interest Account maintained for such Participant to the Stock Account maintained for such Participant. Such transfers will be made as of the later of (i) the date specified in such request and (ii) the date Equitable receives such request, and will be subject to Equitable's rules in effect at the time of transfer. To Part III of your Certificate SECTION 3.05 VARIABLE ANNUITY BENEFIT The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Separate Account. The amount of the first, second, and third payments under any Variable Annuity Benefit provided under the Contract with respect to a payee is the monthly amount provided with respect to the payee pursuant to Section 3.03. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average New Annuity Unit Value for the second calendar month immediately preceding the date of the payment. The fourth and subsequent annuity payments under a Variable Annuity Benefit will not be increased or decreased in amount because of mortality or expense experience. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the New Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. 5. The following sections of your Certificate are amended or modified as follows: A. Section 1.01, EMPLOYER, is amended to read as follows: SECTION 1.01 EMPLOYER The term "Employer" means (i) an educational organization employing a regular faculty which is a State, a political division of a State, or an agency or instrumentality of any one or more of the foregoing (within the meaning of Section 170(b)(1)(A)(ii) of the Code), and (ii) an organization described in Section 501(c)(3) of the Code which is exempt from Federal income tax under Section 501(c) of the Code. B. Section 1.02A, AGREEMENT, is amended by the addition of the following: The term "Agreement' shall also mean any program or arrangement (other than by use of agreements described above) pursuant to which an Employer makes contributions to the purchase of an annuity meeting the requirements of Section 403(b) of the Code. C. Section 1.15, ANNUITY VALUE, is amended to provide that the "Annuity Value" with respect to a Participant's Guaranteed Interest Account and Stock Account shall mean the amounts in such Accounts described in Section 2.02 and 2.10 D. Section 1.16, CASH VALUE, shall read as follows: PF 14102CT PAGE 4 SECTION 1.16 CASH VALUE - NEW PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to a New Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account and Stock Account means an amount equal to the Annuity Values of such Account after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and six months, or (ii) the Participant's attainment of age 70 years and six months, or (iii) the completion of 25 Participation Years with respect to such Participant, or (iv) if the Participant has attained age 55, completed five Participation Years, and the Cash Values are to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% of the sum of the Annuity Values of such Accounts. (b) is an amount equal to the excess, if any, of (i) 8% of the cumulative contributions made on behalf of such Participant over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.05 and 2.05A. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% of the excess of (i) the sum of the Annuity Values of such Accounts over (ii) the Free Corridor Amount defined in Section 2.05C. (b) is the excess, if any, of (i) 8% of the total contributions made on behalf of such Participant during the current Participation Year and the preceding nine Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.05 and 2.05A. The Cash Value of the Guaranteed Interest Account and the Cash Value of the Stock Account will be in the same proportion as are the Annuity Values of such Accounts. SECTION 1.16B CASH VALUE - EXISTING PARTICPANTS NO WITHDRAWAL CHARGE: With respect to an Existing Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account and Stock Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The Participant's attainment of age 59 years and six months, (ii) the completion of 20 Participation Years with respect to such Participant, or (iii) if the Participant has Attained age 55 and the Cash Values are to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a) and (b) below; provided, however, that such charge does not exceed the amount described in subsection (c) below where: (a) is an amount equal to 2% of any Preferred Withdrawable Amounts (defined in Section 2.05B) that have not previously been withdrawn pursuant to Section 2.05 and 2.05B. (b) is an amount equal to 6% of any Regular Withdrawable Amounts (defined in Sec- PF 14102CT PAGE 5 tion 2.05B) that have not previously been withdrawn pursuant to Section 2.05 and 2.05B. (c) is an amount equal to the sum of (a) above, and 6% of the excess, if any, of (i) the sum of the Annuity Values of such Accounts over (ii) the cumulative total of Equitable Transferred Funds made with respect to the Participant that have not previously been withdrawn pursuant to Section 2.05 and 2.05B WITHDRAWAL CAHRGE AFTER FIVE YEARS: After five Participation Years have been completed with respect to the Participant, Equitable (i) will first withdraw, pursuant to Section 2.05B, the Free Corridor Amount defined in Section 2.05C and (ii) next withdraw the remaining portion of the sum of the Annuity Values of such Accounts. A withdrawal charge will apply to the amount in (ii) above, and will equal the sum of the charges described in subsection (a) and (b) of the preceding subsection; provided, however, that such charge will not exceed an amount equal to the lesser of the charges defined in (d) and (e) below: (d) is an amount equal to the sum of (a) in the preceding subsection, and 6% of the excess, if any, of (i) the sum of the Annuity Values of such Accounts (after withdrawal of the Free Corridor Amount) over (ii) the cumulative total of Equitable Transferred Funds made on behalf of the Participant that have not previously been withdrawn pursuant to Section 2.05 and 2.05B. (e) is an amount equal to the excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other contributions (excluding Equitable Transferred Funds) made on behalf of such Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any withdrawal charges made pursuant to Sections 2.05 and 2.05B. The Cash Value of the Guaranteed Interest Account and the Cash Value of the Stock Account will be in the same proportion as are the Annuity Values of such Accounts. E. Section 1.18 SEPARATE ACCOUNT TRANSFERS, shall read as follows: SECTION 1.18 EQUITABLE TRANSFERRED FUNDS The term "Equitable Transferred Funds" with respect to a Participant means the amount of cash value(s) transferred to the Contract from a contract issued by Equitable, pursuant Section 2.01. F. The second paragraph of Section 2.02, GUARANTEED INTEREST ACCOUNT, is amended as follows: a. References to Section 2.05 are replaced by Sections 2.05, 2.05A and 2.05 B. b. The amount in the Guaranteed Interest Account at any time includes the amount transferred into the Account and does not include amounts withdrawn or transferred out of such Account. G. The Sections entitled TERMINATION OF PARTICIPATION (20.4), ANNUAL ADMINISTRATIVE CHARGE (2.06), DEATH BENEFIT (2.07), ELECTION AND COMMENCEMENT OF ANNUITY PAYMENTS (3.02), and CONTRACT HOLDER RESPONSIBILITY (4.10) are amended to change the term "Guaranteed Interest Account" wherever it appears to "Guaranteed Interest Account and Stock Account." H. Section 2.03, ALLOCATION TO ACCOUNT, shall read as follows: SECTION 2.03 ALLOCATION TO ACCOUNT Each Contribution made with respect to a Participant pursuant to Section 2.01, after deduction for any applicable taxes, will be allocated, as of the date by which Equitable has received both such Contribution and directions as to its allocation, to the Guaranteed Interest Ac- PF 14102CT PAGE 6 count, or Stock Account, or in part to each, at the sole direction of the Participant as specified to Equitable, provided that the percentage allocated to each Account is a whole number. Any amount that a Participant has directed to be transferred to the Guaranteed Interest Account or the Stock Account pursuant to Section 2.11 will be allocated as of the date of such transfer to the appropriate Account maintained for such Participant. Interest is allocated to the Guaranteed Interest Account at the end of each Participation Year, at the time of each transfer or withdrawal pursuant to Sections 2.05, 2.05A, 2.05B and 2.11 at the time of application of amounts in the Guaranteed Interest Account to provide Annuity Benefits, upon termination of participation pursuant to Section 2.04, and upon death of the Participant pursuant to Section 2.07. I. Section 2.05, PARTIAL WITHDRAWALS, shall read as follows: SECTION 2.05 PARTIAL WITHDRAWALS Subject to any applicable restrictions under the terms of the Plan, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Stock Account and the Guaranteed Interest Account maintained for such Participant before such Participant's Retirement Date. Upon withdrawal pursuant to Section 2.05, 2.05A or 2.05B, Equitable will pay the lesser of the sum of the Cash Values of such Account or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by such Participant. Unless instructed otherwise, the amount withdrawn (including the amount of any withdrawal charge) will be allocated between such Accounts in proportion to the Annuity Value of each such Account. Upon any payment to a Participant pursuant to Section 2.05, 2.05A or 2.05B, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Payments to the Participant pursuant to Section 2.05, 2.05A or 2.05B may be deferred by Equitable in accordance with the provisions of Section 4.08. Equitable is under no obligation to process any request for partial withdrawal of less than $300. If a withdrawal from the Accounts made pursuant to Sections 2.05, 2.05A or 2.05B would result in total Annuity Values of less than $200, Equitable will so advise the Participant and reserves the right to withdraw the Annuity Values of the Guaranteed Interest Account and Stock Account, pay the Annuity Values of such Accounts to the Participant, and terminate such Participant's participation under the Contract. If the Participant enrolled in this Contract on or after the effective date of this rider, the $200 amount stated above shall be $500. SECTION 2.05A PARTIAL WITHDRAWALS - NEW PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a New Participant, Equitable will withdraw from the Stock Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and six months, or (ii) such Participant's attainment of age 70 years and six months, or (iii) the completion of 25 Participation Years with respect to such Participant, or (iv) if the Participant has attained age 55, has completed five Participation Years, and the partial withdrawal is to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: If the Participant has not completed five Participation Years under the Con- PF 14102CT PAGE 7 tract, such withdrawal charge will equal the lesser of (a) or (b) where: (a) is an amount equal to 6% of the total amount to be withdrawn from the Accounts pursuant to this paragraph (including such charge) (b) is the excess, if any, of (i) 8% of the cumulative total of Contributions made on behalf of such Participant over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Participant, there will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.05C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% of the amount withdrawn pursuant to (ii) of the preceding sentence including such charge, and (b) is the excess, if any, of (i) 8% of the cumulative total of contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. SECTION 2.05B PARTIAL WITHDRAWAL - EXISTING PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by an Existing Participant, Equitable will withdraw from the Stock Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The Participant's attainment of age 59 years and six months, or (ii) the completion of 20 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55 and the partial withdrawal is to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. PREFERRED WITHDRAWABLE AMOUNT: This is an amount equal to the lesser of (a) the total of Equitable Transferred Funds made on behalf of the Participant or (b) $10,000. FREE WITHDRAWABLE AMOUNT: This is an amount equal to the excess, if any, of (a) the total Equitable Transferred Funds made on behalf of the Participant over (b) $10,000. REGULAR WITHDRAWABLE AMOUNT: This is the cumulative total of all Contributions, other than Equitable Transferred Funds, made on behalf of the Participant. ORDER OF WITHDRAWALS: In calculating the withdrawal charge, Equitable will assume that (a) any Preferred Withdrawable Amounts are first withdrawn, (b) any Free Withdrawable Amounts are next withdrawn, (c) any Regular Withdrawable Amounts are next withdrawn, and (d) lastly, any amounts other than the amounts described in (a), (b), and (c) above are withdrawn. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in sub-sections (a), (b), (c) and (d) below: PF 14102CT PAGE 8 (a) With respect to any withdrawals of Preferred Withdrawable Amounts, a charge of 2% of such withdrawals. (b) With respect to any withdrawals of Free Withdrawal Amounts, no charge. (c) With respect to any withdrawals of Regular Withdrawable Amounts, a charge of 6% of such withdrawals. (d) With respect to any withdrawals of amounts other than the amounts in (a), (b) and (c) above, no charge. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Participant, there will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.05C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (1) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (2) then withdraw from such Accounts an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will equal the sum of the charges described in (a), (b), (c), and (d) above; provided, however, that in no event will such charge exceed an amount equal to the following: The excess, in any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other Contributions (excluding Equitable Transferred Funds) made on behalf of the Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any prior withdrawal charges made pursuant to this Section. Whenever an amount is withdrawn from such Accounts that is not greater than the current Free Corridor Amount, such amount is considered to be (1) first, a withdrawal of Regular Withdrawable Amounts, (2) next, a withdrawal of Preferred Withdrawable Amounts, (3) next, a withdrawal of Free Withdrawable Amounts and (4) lastly, a withdrawal of amounts other than the amounts in (1), (2), or (3) above. However, no charge will be assessed with respect to the portion of the withdrawal up to the current Free Corridor Amount. SECTION 2.05C FREE CORRIDOR AMOUNT The term "Free Corridor Amount" with respect to a Participant who has completed five Participation Years means an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Values of the Stock Account and the Guaranteed Interest Account over (ii) cumulative prior withdrawals made pursuant to Section 2.05, 2.05A or 2.05B in the current Participation Year with respect to the Participant. J. The first paragraph of Section 2.06. ANNUAL ADMINISTRATIVE CHARGE, is amended by adding the following: The charge will be allocated between the Stock Account and the Guaranteed Interest Account in proportion to the Annuity Values of such Accounts at the end of the Participation Year. K. Section 2.08, Change of Deductions for New Participants, is deleted as of August 1, 1981 and Section 2.09, Change of Deductions and Charges for Existing Participants, shall not apply to Participants enrolled on or after August 1, 1981. L. With respect to Section 3.03, AMOUNT OF ANNUITY BENEFITS, a. Wherever the term "Guaranteed Interest Account" appears, it shall be changed to "Guaranteed Interest and Stock Account." b. The second and third sentences of paragraph 2 shall apply to a Participant who has completed five Participation Years and to an Existing Participant (as defined in Part I of this rider). c. Paragraph 3 shall apply to a New Participant (as defined in Part I of this rider) PF 14102CT PAGE 9 before the completion of five Participation Years. d. The last two paragraphs have been amended to provide that any Variable Annuity Benefit shall be calculated by Equitable on 1979 ELAS Mortality and an Assumed Base Rate of Net Investment Income Return of 5% or 3 1/2%, whichever applies pursuant to Section 1.20. M. Section 3.04, PAYMENT OF ANNUITY PAYMENTS, is amended by the addition of the following: VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVIOR LIFE ANNUITY FORM - 100% CONTINUATION-ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3 1/2% (Minimum Monthly Income per $1,000 of Annuity Value)
- ---------------------------------------------------------------------------------------------------------------------------------- MALE FEMALE AGE ----------------------------------------------------------------------------------------------------------------------- AGE 60 61 62 63 64 65 66 67 68 69 70 ----------------------------------------------------------------------------------------------------------------------- 60 4.31 4.35 4.39 4.43 4.47 4.51 4.55 4.59 4.63 4.67 4.71 61 4.35 4.39 4.43 4.48 4.52 4.56 4.61 4.65 4.69 4.73 4.78 62 4.39 4.43 4.48 4.52 4.57 4.61 4.66 4.71 4.75 4.80 4.85 63 4.42 4.47 4.52 4.57 4.62 4.67 4.72 4.77 4.82 4.87 4.92 64 4.46 4.51 4.57 4.62 4.67 4.72 4.77 4.83 4.88 4.94 4.99 65 4.50 4.56 4.61 4.66 4.72 4.78 4.83 4.89 4.95 5.01 5.07 66 4.54 4.60 4.65 4.71 4.77 4.83 4.89 4.95 5.01 5.08 5.14 67 4.58 4.64 4.70 4.76 4.82 4.88 4.95 5.01 5.08 5.15 5.22 68 4.62 4.68 4.77 4.81 4.87 4.95 5.01 5.08 5.15 5.22 5.29 69 4.65 4.72 4.78 4.85 4.92 4.99 5.06 5.14 5.22 5.29 5.37 70 4.69 4.76 4.83 4.90 4.97 5.05 5.12 5.20 5.28 5.36 5.45 - ----------------------------------------------------------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION--ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 5% (Minimum Monthly Income per $1,000 of Annuity Value)
- ---------------------------------------------------------------------------------------------------------------------------------- MALE FEMALE AGE ----------------------------------------------------------------------------------------------------------------------- AGE 60 61 62 63 64 65 66 67 68 69 70 ----------------------------------------------------------------------------------------------------------------------- 60 5.19 5.23 5.27 5.31 5.34 5.39 5.42 5.46 5.50 5.54 5.58 61 5.23 5.27 5.31 5.35 5.39 5.43 5.47 5.52 5.56 5.60 5.64 62 5.27 5.31 5.35 5.39 5.44 5.48 5.53 5.57 5.62 5.67 5.71 63 5.31 5.35 5.39 5.44 5.49 5.53 5.58 5.63 5.68 5.73 5.78 64 5.34 5.39 5.44 5.48 5.53 5.59 5.64 5.69 5.74 5.79 5.85 65 5.38 5.43 5.48 5.53 5.58 5.64 5.69 5.75 5.80 5.86 5.92 66 5.42 5.47 5.52 5.58 5.63 5.69 5.75 5.81 5.87 5.93 5.99 67 5.45 5.51 5.56 5.62 5.68 5.74 5.80 5.87 5.93 6.00 6.06 68 5.49 5.55 5.61 5.67 5.73 5.80 5.86 5.93 6.00 6.06 6.14 69 5.53 5.59 5.65 5.71 5.78 5.85 5.92 5.99 6.06 6.13 6.21 70 5.56 5.63 5.69 5.76 5.83 5.90 5.97 6.05 6.13 6.21 6.29 - ----------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) VARIABLE ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS 3 1/2% 5% ------ -- AGE MALES FEMALES MALES FEMALES --- ----- ------- ----- ------- 60 5.43 4.80 6.36 5.70 61 5.57 4.90 6.50 5.81 62 5.72 5.01 6.65 5.91 63 5.88 5.13 6.81 6.03 64 6.05 5.25 6.97 6.15 65 6.23 5.39 7.16 6.28 66 6.43 5.54 7.35 6.43 67 6.64 5.70 7.56 6.58 68 6.87 5.87 7.79 6.76 69 7.11 6.06 8.03 6.95 70 7.38 6.27 8.30 7.15 Equitable will notify the payee under a Variable Annuity Benefit of the number of Annuity Units and the Average New Annuity Unit Value used in determing the amount of each variable payment. N. Section 4.08, DEFERMENT, shall read as follows: SECTION 4.08 DEFERMENT Payments by Equitable from the Participant's Guaranteed Interest Account pursuant to the provisions of Setion 2.04, Sections 2.05, 2.05A and 2.05B, and Section 2.07, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.04, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due documentation for such commutation payment pursuant to Section 3.04. Interest at that current Guaranteed Interest Rate for such Participant's Guaranteed Interest Account will be allowed on any such payment deferred for 30 days or more. Except as provided in this Section, payments by Equitable from the Participant's Stock Account pursuant to the provisions of Section 2.04, Sections 2.05, 2.05A and 2.05B, and Section 2.07, or any commuted payments arising PF 14102CT PAGE 10 from a Variable Annuity Benefit pursuant to Section 3.04, will be made within seven days after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.04. During any period when (i) the sale of securities or the determination of the New Accumulation Unit Value or the New Annuity Unit Value is not reasonably practicable because an emergency, defined by the Securities and Exchange Commission, exists, or the New York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may by order permit postponement for the protection of persons having interests in the Separate Account, Equitable reserves the right: (a) to defer determination of Cash Values or Annuity Values and payment of Cash Values and Annuity Values, arising from an amount in a Participant's Stock Account; (b) to defer payment of any portion of the death benefit arising from an amount in a Participant's Stock Account; (c) to defer the payment of any Variable Annuity Benefit under the Contract or the application of any such Benefit to provide for any other payment called for by the Contract; or (d) in the event of (a) above, to defer application of such amounts to provide any Annuity Benefit permitted under the Contract. O. Section 4.09, ANNUAL NOTICE, shall read as follows: SECTION 4.09, ANNUAL NOTICE At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Guaranteed Interest Account, (2) the total number of Accumulation Units credited to the Stock Account, (3) the New Accumulation Unit Value, (4) the sum of the Cash Values of the Guaranteed Interest Account and the Stock Account and (5) the amount of death benefit payable with respect to the Participant. After the Retirement Date Equitable will notify the Participant of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK By ---------------------------- Title ------------------------- Dated ------------------------- At ----------------------------- FOR THE EQUITABLE By /s/ Coy Eklund ---------------------------------------------- President By /s/ Rodney L. Enochs ---------------------------------------------- Vice President and Secretary Date of Issue ----------------------------------- PF 14102CT PAGE 11 Attached to and made part of Group Annuity Contract No. 11930CT between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective January 1, 1982 said contract is amended by adding the following to the third paragraph of Section 1.10 (Guaranteed Interest Rate): For the period (not to exceed one year) next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent period (not to exceed one year) the Equitable may determine for each established Class of Participants a Guaranteed Interest Rate for such Class which exceeds the applicable Yearly Guaranteed Interest Rate. Equitable will notify each Participant in writing of the applicable Guaranteed Interest Rate and duration. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK By /s/ Alfred H. (signature illegible) ----------------------------------------------------------- Title Senior Vice President -------------------------------------------------------- Dated Dec. 22, 1981 --------------------------------------------------------- At New York, New York ----------------------------------------------------------- FOR THE EQUITABLE By /s/ Coy Eklund ------------------------------------------------------------- President By /s/ Rodney L. Enochs ------------------------------------------------------------ Vice President and Secretary Date of Issue Dec. 22, 1981 ------------------------------------------------ 14110 CT Attached to and made part of Group Annuity contract No. 11930CT between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective April 15, 1982, said contract and riders are amended as follows: o Contributions made to the Contract after deduction of any applicable taxes, will be allocated to the Stock Account, Money Market Account or the Guaranteed Interest Account maintained for the Participant, in accordance with Sections 2.02 and 2.03, or in part to any one, as directed by the Participant. o The amount in the Stock Account, Money Market Account and the Guaranteed Interest Account will be applied at the Retirement Date to provide the Participant with an Annuity Benefit or a Cash Value Benefit if the Participant is then living, and o The Participant will have other rights and benefits as described herein. ASSETS HELD IN CONNECTION WITH THE CONTRACT MAY BE HELD IN SEPARATE ACCOUNTS MAINTAINED BY EQUITABLE AND MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THE CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF SEPARATE ACCOUNT A. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN SEPARATE ACCOUNT A IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.16 IS 5% OR 3 1/2%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE OF 1.75% FOR INVESTMENT MANAGEMENT, FINANCIAL ACCOUNTING, THE ANNUITY RATE GUARANTEE AND MINIMUM DEATH BENEFIT, EXPENSES AND EXPENSE RISK, BUT AFTER ANY DEDUCTIONS TO PROVIDE FOR TAXES. Equitable will issue to each Participant an individual certificate setting forth a statement in substance of the benefits to which such Participant is entitled under the Contract. The provisions on the following pages are part of the Contract. PF 14112CT This page 2 reserved for information in connection with the issuance of certificates under this Contract. PAGE 2 This page 3 reserved for information in connection with the issuance of certificates under this Contract. PAGE 3 PART I - DEFINITIONS SECTION 1.01 EMPLOYER The term "Employer" means (i) an educational organization employing a regular faculty which is a State, a political division of a State, or an agency or instrumentality of any one or more of the foregoing (within the meaning of Section 170(b)(1)(A)(ii) of the Code), and (ii) an organization described in Section 501(c)(3) of the Code which is exempt from Federal income tax under Section 501(c) of the Code. SECTION 1.02A AGREEMENT The term "Agreement" means (i) an agreement between an Employer and an employee of the Employer, within the meaning of Section 1.403(b) - 1(b)(3) of the Federal income tax regulations, under which the employee agrees to accept a reduction in salary or to forego an increase in salary and to have such amounts applied under the contract for the employee's behalf and (ii) any program or arrangement (other than by use of agreements described above) pursuant to which an Employer makes Contributions to the purchase of an Annuity meeting the requirements of Section 403(b) of the Code. SECTION 1.02B PLAN The term "Plan" means a defined contribution pension plan established by an Employer described in clause (ii) of Section 1.01 which has been determined Page 4 PF14112CT DEFINITIONS (continued) by the Internal Revenue Service to meet the requirements for qualification under Section 401(a) of the Code and which permits or requires amounts contributed thereunder to be applied under the Contract on behalf of employees covered under the Plan. SECTION 1.03 ANNUITY The term "Annuity" means an annuity purchased in accordance with the terms of the Agreement or the Plan to the extent the Agreement and the annuity purchased pursuant thereto meet the requirements of Section 403(b) of the Code or the Plan meets the requirements of Section 401(a) of the Code, whichever is applicable. SECTION 1.04 ANNUITY BENEFIT The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Section 3.04 of the Contract. SECTION 1.05A PARTICIPANT The term "Participant" means a person who has been enrolled by Equitable under the Contract and for whom the Employer has purchased an Annuity under the Contract. A person shall become enrolled under the Contract upon receipt by Equitable of an enrollment form made available by Equitable and completed in a manner satisfactory to Equitable. An Annuity is purchased for a person enrolled under the Contract upon receipt by Equitable of an initial Contribution by the Employer. SECTION 1.05B EXISTING PARTICIPANT The term "Existing Participant" means a Participant for whom Cash Values of existing annuity contract(s) issued by Equitable were eligible to be transferred to the Contract pursuant to Section 2.01 and who was enrolled under the Contract on or prior to April 14, 1982. SECTION 1.05C NEW PARTICIPANT The term "New Participant" means a Participant who is not an Existing Participant. SECTION 1.06 CONTRIBUTION The term "Contribution" means a payment made to Equitable for a Participant with respect to an Annuity purchased for such Participant under the Contract. Equitable is under no obligation to accept any Contribution less than $20.00. SECTION 1.07 PARTICIPATION DATE The term "Participation Date" with respect to a Participant means the date as of which Equitable has enrolled such Participant under the terms of the Contract. SECTION 1.08 PARTICIPATION YEAR The term "Participation Year" with respect to a Participant means the twelve month period beginning on (i) the Participation Date, and (ii) each anniversary thereof, unless otherwise agreed to in writing by Equitable. SECTION 1.09 CLASS OF PARTICIPANTS Except as provided in Section 1.10, the term "Class of Participants" refers to all Participants whose Participation Date is in the same calendar year. SECTION 1.10 GUARANTEED INTEREST RATE For each Guaranteed Interest Account, the term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in such Account. Interest accrues daily. The Guaranteed Interest Rate will never be less than 3% per annum. Equitable will from time to time establish and make available for new Participants (i) an Initial Guaranteed Interest Rate, (ii) one or more Minimum Guaranteed Interest Rates and (iii) the applicable effective period(s) for such Rates. A new Class of Participants will be established effective with the effective date of the occurrence of (i), (ii) or (iii) above or any combination thereof. For the calendar year next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent calendar year thereafter, Equitable will determine for each established Class of Participants before the beginning of such calendar year a Yearly Guaranteed Interest Rate for such Class, which Yearly Guaranteed Interest Rate will not be lower than the effective Minimum Guaranteed Interest Rate applicable for such Class for such year. For any established Class of Participants, Equitable reserves the right to change the Minimum Guaranteed Interest Rate and the applicable period therefore provided that any such Minimum Guaranteed Interest Rate will not be lower than the Minimum Guaranteed Interest Rate that would have been in effect in the absence of such PF 14112CT Page 5 DEFINITIONS (continued) change. Equitable will notify each Participant in a Class in writing of the Yearly Guaranteed Interest Rate or of any change in the Minimum Guaranteed Interest Rate at least 15 days prior to its effective date. For the period (not to exceed one year) next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent period (not to exceed one year) the Equitable may determine for each established Class of Participants a Guaranteed Interest Rate for such Class which exceeds the applicable Yearly Guaranteed Interest Rate. Equitable will notify each Participant in writing of the applicable Guaranteed Interest Rate and duration. SECTION 1.11 RETIREMENT DATE The term "Retirement Date" means the date on which the Participant is to attain the retirement age specified in the Participant's enrollment form. Before the Retirement Date the Participant may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement date shall be earlier than the date of attainment of age 55 years. Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Home Office. SECTION 1.12 NORMAL FORM The "Normal Form" of an Annuity Benefit under the Contract means (i) if the Participant has a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (100% continuation), and (ii) if the Participant does not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.13 JOINT AND SURVIVOR LIFE ANNUITY FORM The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depends is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by the Participant. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.14A LIFE ANNUITY FORM The term "Life Annuity Form" means an annuity providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.14B ELIGIBLE ANNUITY CERTAIN The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by Equitable which extends beyond the Participant's attainment of age 59 years and six months and does not permit any prepayment of the unpaid principal prior to the participant's attainment of age 59 years and six months. SECTION 1.15 THE SEPARATE ACCOUNTS The term "Separate Accounts" means the following separate investment accounts maintained by Equitable to which portions of its assets have been allocated for the Contract and certain other contracts: Name Investments ---- ----------- Separate Account A Primarily common stock and other equity-type investments. Separate Account E Primarily short-term money market instruments PF 14112CT Page 6 DEFINITIONS (continued) Equitable reserves the right to withdraw from any Separate Account and allocate to another separate account assets determined by Equitable to be associated with the class of contracts to which the Contract belongs. In any such event, to the extent practicable and permissible under applicable laws and regulations, the withdrawal shall be made by withdrawing the same percentage of each investment in the Separate Account, with appropriate adjustments to avoid odd lots and fractions. On and after the date of any such withdrawal the reference in the Contract to such Separate Account shall mean such other separate account to which the withdrawn assets were allocated. It is contemplated that investments in the Separate Accounts will, at most times, consist primarily of the types of investments indicated above. Equitable may, however, at its discretion invest the assets of any Separate Account in any investment permitted by applicable law. Equitable may rely conclusively on the opinion of counsel (including attorneys in its employ) as to what investments it is permitted by law to make. In lieu of making such investments directly, Equitable reserves the right to operate any Separate Account as a unit investment trust, or in any other form permitted by law, investing all or part of its assets in shares or units of a fund, the investment adviser of which may be Equitable or controlled by Equitable. The fund assets would be invested as provided above with respect to the Separate Account. Equitable reserves the right: (i) to cause the registration or deregistration of any Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run any Separate Account under the direction of a committee, and to discharge such committee at any time; and (iii) restrict or eliminate any voting rights of participants or other persons who have voting rights as to the Separate Accounts. Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, consisting of .15% for investment management, .35% for financial accounting, .35% for the annuity rate guarantee and the minimum death benefit, and .90% for expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.16. The assets of Separate Accounts are the property of Equitable; however, the portion of the assets of each Separate Account equal to the reserves and other contract liabilities with respect to such Account shall not be chargeable with liabilities arising out of any other business Equitable may conduct. Equitable reserves the right to transfer assets of the Separate Accounts in excess of such reserves and contract liabilities to the general account of Equitable. SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business day immediately preceding such business day will constitute a Valuation Period. A business day is any day on which there is a sufficient degree of trading in the portfolio securities of a Separate Account that the New Accumulation Unit Value or New Annuity Unit Value might be materially affected by changes in the value of the portfolio securities in a Separate Account, as determined by the Separate Account Committee or, if there is no Committee, by Equitable. NET INVESTMENT FACTOR: For each Separate Account the Net Investment Factor for a Valuation Period is (a) divided by (b), minus (c), where (a) is (1) the value of the assets in the Separate Account at the close of business of the preceding Valuation Period plus (2) the investment income and the capital gains, realized or unrealized credited to the assets in the Separate in the Valuation Period for which the Net Investment Factor is being determined, minus (3) the capital losses, realized or unrealized, charged against such assets in such Valuation Period minus (4) any amount charged against the Separate Account in such Valuation period for taxes or for amounts set aside by Equitable as a reserve for taxes attributable to the maintenance or operation of the Separate Account; (b) is the value of he assets in the Separate Account at the close of business of the preceding Valuation Period; and PF 14112CT Page 7 DEFINITIONS (continued) (c) is the daily charge, for each calendar day in such Valuation Period of .00004837 for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The value of the assets in the Separate Accounts, referred to above, shall be taken at their fair market value, or where there is no readily available market, their fair value, as determined in accordance with accepted accounting practices and applicable laws and regulations. ACCUMULATION UNIT: The Accumulation Unit is a unit used in determining the value of the interest of a Participant's Stock Account or Money Market Account on or before the Retirement Date. NEW ACCUMULATION UNIT VALUE: The initial New Accumulation Unit Values for the Separate Accounts have been established as follows: Account Value Date ------- ----- ---- Separate Account A $10.00 As of November 1, 1968 Separate Account E $10.00 As of September 4, 1974 The new Accumulation Unit Value for each subsequent Valuation Period is the New Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such subsequent Valuation Period. ANNUITY UNITY: The Annuity Unit is a unit used in determining amounts payable from Separate Account A under a Variable Annuity Benefit. NEW ANNUITY UNIT VALUE: The initial New Annuity Unit Value for Separate Account A has been established at $1.00 as of November 1, 1968. The Annuity Unit Value for any subsequent Valuation Period is the New Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3 1/2%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE NEW ANNUITY UNIT VALUE: The Average Annuity Unit Value for Separate Account A for a calendar month is equal to the average of the New Annuity Unit Values for the Valuation Periods ending in such month. SECTION 1.17 ANNUITY VALUE The term "Annuity Value" with respect to a Participant's Guaranteed Interest Account, Stock Account and Money Market Account, means the amount in such Accounts pursuant to Sections 2.02 and 2.03. SECTION 1.18A CASH VALUE - NEW PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to a New Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and six months, or (ii) the Participant's attainment of age 70 years and six months, or (iii) the completion of 25 Participation Years with respect to such Participant, or (iv) if the Participant has attained age 55, completed five Participation Years, and the Cash Values are to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% of the sum of the Annuity Values of such Accounts. (b) is an amount equal to the excess, if any, of (i) 8% of the cumulative contributions made on behalf of such Participant over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. PF 14112CT Page 8 DEFINITIONS (continued) WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% of the excess of (i) the sum of the Annuity Values of such Accounts over (ii) the Free Corridor Amount defined in Section 2.07C. (b) is the excess, if any, of (i) 8% of the total contributions made on behalf of such Participant during the current Participation Year and the preceding nine Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. The Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. SECTION 1.18B CASH VALUE - EXISTING PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to an Existing Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The Participant's attainment of age 59 years and six months, (ii) the completion of 20 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55 and the Cash Values are to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a) and (b) below; provided, however, that such charge does not exceed the amount described in subsection (c) below where: (a) is an amount equal to 2% of any Preferred Withdrawable Amounts (defined in Section 2.07B) that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (b) is an amount equal to 6% of any Regular Withdrawable Amounts (defined in Section 2.07B) that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (c) is an amount equal to the sum of (a) above, and 6% of the excess, if any, of (i) the sum of the Annuity Values of such Accounts over (ii) the cumulative total of Equitable Transferred Funds made with respect to the Participant that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. WITHDRAWAL CHARGE AFTER FIVE YEARS: After five Participation Years have been completed with respect to the Participant, Equitable (i) will first withdraw, pursuant to Section 2.07B, the Free Corridor Amount defined in Section 2.07C and (ii) next withdraw the remaining portion of the sum of the Annuity Values of such Accounts. A withdrawal charge will apply to the amount in (ii) above, and will equal the sum of the charges described in subsections (a) and (b) of the preceding subsection; provided, however, that such charge will not exceed an amount equal to the lesser of the charge will not exceed an amount equal to the lesser of the charges defined in (d) and (e) below: (d) is an amount equal to the sum of (a) in the preceding subsection, and 6% of the excess, if any, of (i) the sum of the Annuity Values of such Accounts (after withdrawal of the Free Corridor Amount) over (ii) the cumulative total of Equitable Transferred Funds made on behalf of the Participant that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (e) is an amount equal to the excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other contributions (excluding Equitable Transferred Funds) made on behalf of such Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07B. The Cash Values of the Guaranteed Interest Account Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. PF 14112CT Page 9 DEFINITIONS (continued) SECTION 1.19 CODE The term "Code" means the Internal Revenue Code of 1954, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.20 EQUITABLE TRANSFERRED FUNDS The term "Equitable Transferred Funds" with respect to a Participant means the amount of cash value(s) transferred to the Contract from a contract issued by Equitable pursuant to Section 2.01. PART II - PARTICIPANT'S ACCOUNT SECTION 2.01 CONTRIBUTIONS The Employer is to make Contributions from time to time on such dates and in such amounts as determined by the Employer pursuant to the terms of the Plan or, if the Employer has no Plan, as determined by the Employer at its sole discretion. The Employer is to specify the Participant with respect to whom each such Contribution is being made and the amount to be allocated to the Stock Account, Money Market Account and the Guaranteed Interest Account. Each Contribution received by Equitable with respect to a Participant will, before its allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable. A Participant may, with Equitable's agreement, transfer to the Contract any amount held with respect to such Participant under a contract meeting the requirements of Section 403(b) of the Code or under a Plan of an Employer described in clause (ii) of Section 1.01 ("Transferred Funds"). Any Transferred Funds from a contract not issued by Equitable will, before allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable. Equitable will issue to each Participant an individual certificate setting forth a statement in substance of the benefits to which such Participant is entitled under the Contract. SECTION 2.02 STOCK AND MONEY MARKET ACCOUNTS Equitable maintains a Stock Account and Money Market Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the (i) Stock Account becomes part of Separate Account A, and (ii) Money Market Account becomes part of Separate Account E. Any amount withdrawn from an Account will no longer be part of the applicable Separate Account. On any date when an amount is allocated to or withdrawn from an Account, the Account will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the New Accumulation Value for the appropriate Separate Account for the Valuation Period which includes that date. The number of Units in an Account on any date is equal to (i) the sum of any Accumulation Units that have been credited to the Account minus (ii) the sum of any Accumulation Units that have been charged to that Account. The amount in the Stock Account or Money Market Account on any date is equal to the product of (i) the number of Accumulation Units in such Account on that date and (ii) the New Accumulation Unit Value for the appropriate Separate Account for the Valuation Period which includes that date. SECTION 2.03 GUARANTEED INTEREST ACCOUNT Equitable maintains a Guaranteed Interest Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the Guaranteed Interest Account becomes part of the general assets of Equitable, which support the guarantees of the Contract and other contracts. The amount in a Guaranteed Interest Account at any time is equal to the sum of all amounts that have been allocated to such Guaranteed Interest Account pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn pursuant to Sections 2.07, 2.07A, and 2.07B, and Section 2.08 from such Account, and transferred pursuant to Section 2.05 from such Guaranteed Interest Account, and less the sum of any annual administrative charges accrued but not made. Equitable guarantees that the amount in a Guaranteed Interest Account at any time before the Retirement Date will not be less than the sum of all PF 14112CT Page 10 PARTICIPANT'S ACCOUNT (continued) amounts allocated to such Account pursuant to Section 2.04 or transferred to such Account pursuant to Section 2.05 and less the sum of all amounts that have been withdrawn from such Account pursuant to Sections 2.07, 2.07A and 2.07B, and transferred form such Account pursuant to Section 2.05, all accumulated at 3% interest, compounded annually. In any Participation Year in which no Contribution is allocated to a Guaranteed Interest Account, the amount in such Account at the end of the Participation Year shall not be less than the amount in such Account at the beginning of the Participation Year plus the sum of all amounts transferred to such Account pursuant to Section 2.05 less the sum of all amounts withdrawn and transferred out of such Account pursuant to Sections 2.07, 2.07A and 2.07B, and Section 2.05, all accumulated at 3% interest, compounded annually. A Guaranteed Interest Account for a Participant terminates on the earliest of (i) the Retirement Date, (ii) the death of the Participant, and (iii) termination of participation pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO ACCOUNT Each Contribution made with respect to a Participant pursuant to Section 2.01, after deduction for any applicable taxes, will be allocated, as of the date by which Equitable has received both such Contribution and direction as to its allocation, to the Guaranteed Interest Account, Stock Account, or Money Market Account or in part to each, at the sole direction of the Participant as specified to Equitable, provided that the percentage allocated to each Account is a whole number. Any amount that a Participant has directed to be transferred to the Guaranteed Interest Account or Stock Account pursuant to Section 2.05 will be allocated as of the date of such transfer to the appropriate Account maintained for such Participant. Interest is allocated to the Guaranteed Interest Account at the end of each Participation Year, at the time of each transfer or withdrawal pursuant to Sections 2.05 and 2.07, 2.07A, and 2.07B, at the time of application of amounts in the Guaranteed Interest Account to provide Annuity Benefits, upon termination of participation pursuant to Section 2.06, and upon death of the Participant pursuant to Section 2.09. SECTION 2.05 TRANSFERS AMONG ACCOUNTS At any time before a Participant's Retirement Date, such Participant, upon written request, (i) may transfer all or a part of the amounts from the Stock Account or Money Market Account maintained for such Participant to the Guaranteed Interest Account maintained for such Participant, or (ii) may transfer all or a part of the amounts in the Guaranteed Interest Account or Money Market Account maintained for such Participant, to the Stock Account maintained for such Participant. Such transfers will be made as of the later of (i) the date specified in such request and (ii) the date Equitable receives such request, and will be subject to Equitable's rules in effect at the time of transfer. No transfers are permitted from the Guaranteed Interest Account or the Stock Account maintained for the Participant to the Money Market Account. SECTION 2.06 TERMINATION OF PARTICIPATION Subject to any applicable restrictions under the terms of the Agreement or the Plan, whichever is applicable, on or before a Participant's Retirement Date, such Participant may elect by written notice to terminate participation under the Contract. Upon receipt of such notice, Equitable will determine the Cash Value, as of the date Equitable received such notice, of the Guaranteed Interest Account, Stock Account, and Money Market Account maintained for such Participant. The payment of such Cash Value to the Participant may be deferred by Equitable in accordance with the provisions of Section 4.08. The payment of such Cash Value to the Participant may be deferred by Equitable in accordance with the provisions of Section 4.08. Prior to a Participant's Retirement Date, Equitable reserves the right to withdraw the Annuity Value of the Participant's Guaranteed Interest Account, Stock Account and Money Market Account, pay such Annuity Values and terminate such Participant's participation under the Contract. This right may be exercised with respect to the Participant only if both (i) no Contributions have been made under the Contract during the last three completed Participation Years and (ii) the sum of such Annuity Values is $500 or less. Equitable reserves the right to terminate a Participant's participation under the Contract if at least 120 days have elapsed since the issue date shown on the certificate issued to such Participant under the PF 14112CT Page 11 PARTICIPANT'S ACCOUNT (continued) Contract and no Contributions have been made under the Contract with respect to such Participant. Upon payment of such Cash Values or Annuity Values, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Cash Values or Annuity Values arose. SECTION 2.07 PARTIAL WITHDRAWALS Subject to any applicable restrictions under the terms of the Agreements, or the Plan, whichever is applicable, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Stock Account, Money Market Account, and the Guaranteed Interest Account maintained for such Participant before such Participant's Retirement Date. Upon withdrawal pursuant to Section 2.07, 2.07A or 2.07B, Equitable will pay the lesser of the sum of the Cash Values of such Accounts or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by such Participant. Unless instructed otherwise, the amount withdrawn (including the amount of any withdrawal charge) will be allocated between such Accounts in proportion to the Annuity Value of each such Account. Upon any payment to a Participant pursuant to Section 2.07, 207A or 2.07B, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Payments to the Participant pursuant to Section 2.07, 2.07A or 2.07B may be deferred by Equitable in accordance with the provisions of Section 4.08. Equitable is under no obligation to process any request for partial withdrawal of less than $300. If a withdrawal from the Accounts made pursuant to Sections 2.07, 2.07A or 2.07B would result in total Annuity Values of less than $500, Equitable will so advise the Participant and reserves the right to withdraw the Annuity Values of the Guaranteed Interest Account Stock Account and Money Market Account, pay the Annuity Values of such Accounts to the Participant, and terminate such Participant's participation under the Contract. If the Participant was enrolled in this Contract prior to August 15, 1981, the $500 amount stated above shall be $200. SECTION 2.07A PARTIAL WITHDRAWALS - NEW PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a New Participant, Equitable will withdraw from the Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and six months, or (ii) such Participant's attainment of age 70 years and six months, or (iii) the completion of 25 Participation Years with respect to such Participant, or (iv) if the Participant has attained age 55, has completed five Participation Years, and the partial withdrawal is to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: If the Participant has not completed five Participation Years under the Contract, such withdrawal charge will equal the lesser of (a) or (b) where: (a) is an amount equal to 6% of the total amount to be withdrawn from the Accounts (including such charge) pursuant to this paragraph. (b) is the excess, if any, of (i) 8% of the cumulative total of Contributions made on behalf of such Participant over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Participant, there will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount Equitable PF 14112CT Page 12 PARTICIPANT'S ACCOUNT (continued) will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% of the amount withdrawn (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the cumulative total of contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. SECTION 2.07B PARTIAL WITHDRAWAL - EXISTING PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by an Existing Participant, Equitable will withdraw from the Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to lesser of (a) the full amount of partial withdrawal requested or (b) the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The Participant's attainment of age 59 years and six months, or (ii) the completion of 20 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55 and the partial withdrawal is to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. PREFERRED WITHDRAWABLE AMOUNT: This is an amount equal to the lesser of (a) the total of Equitable Transferred Funds made on behalf of the Participant or (b) $10,000. FREE WITHDRAWABLE AMOUNT: This is an amount equal to the excess, if any, of (a) the total Equitable Transferred Funds made on behalf of the Participant over (b) $10,000. REGULAR WITHDRAWABLE AMOUNT: This is the cumulative total of all Contributions, other than Equitable Transferred Funds, made on behalf of the Participant. ORDER OF WITHDRAWALS: In calculating the withdrawal charge, Equitable will assume that (a) any Preferred Withdrawable Amounts are first withdrawn, (b) any Free Withdrawable Amounts are next withdrawn, (c) any Regular Withdrawable Amounts are next withdrawn, and (d) lastly, any amounts other than the amounts described in (a), (b), and (c) above are withdrawn. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a), (b), (c) and (d) below: (a) With respect to any withdrawals of Preferred Withdrawable Amounts, a charge of 2% of such withdrawals. (b) With respect to any withdrawals of Free Withdrawable Amounts, no charge. (c) With respect to any withdrawals of Regular Withdrawable Amounts, a charge of 6% of such withdrawals. (d) With respect to any withdrawals of amounts other than the amounts in (a), (b) and (c) above, no charge. WITHDRAWAL CHARGE AFTER FIVE YEARS: after the completion of five Participation Years with respect to the Participant, there will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (1) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (2) then withdraw from such Accounts an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will equal the sum of the charges described in (a), (b), (c), and (d) above; provided however, that in no event will such charge exceed an amount equal to the following: The excess, if any, of PF 14112CT Page 13 PARTICIPANT'S ACCOUNT (continued) (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other Contributions (excluding Equitable Transferred Funds) made on behalf of the Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any prior withdrawal charges made pursuant to this Section. Whenever an amount is withdrawn from such Accounts that is not greater than the current Free Corridor Amount, such amount is considered to be (1) first, a withdrawal of Regular Withdrawable Amounts, (2) next, a Withdrawal of Preferred Withdrawable Amounts, (3) next, a withdrawal of Free Withdrawable Amounts and (4) lastly, a withdrawal of amounts other than the amounts in (1), (2), or (3) above. However, no charge will be assessed with respect to the portion of the withdrawal up to the current Free Corridor Amount. SECTION 2.07C FREE CORRIDOR AMOUNT The term "Free Corridor Amount" with respect to a Participant who has completed five Participation Years means an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Values of the Stock Account, Money Market Account and the Guaranteed Interest Account over (ii) cumulative prior withdrawals made pursuant to Section 2.07, 2.07A or 2.07B in the current Participation Year with respect to the Participant. SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE As of the last day of each Participation Year before a Participant's Retirement Date, Equitable will withdraw from the Guaranteed Interest Account, Stock Account and Money Market Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Values of the Guaranteed Interest Account, Stock Account and Money Market Account at the end of that Participation Year and (ii) any withdrawals made from such Accounts Pursuant to Section 2.07, 2.07A and 2.07B during that Participation Year. The charge will be allocated between the Stock Account, Money Market Account and Guaranteed Interest Account in proportion to the Annuity Values of each such Account, at the end of the Participation Year. As of a Participant's Retirement Date and before application of the Annuity Values or Cash Values of such Participant's Account pursuant to Section 3.03, or upon termination of such Account pursuant to Section 2.06 or Section 2.09 during a Participation Year, Equitable will withdraw the administrative charge described in this Section for the applicable part of that Participation Year. SECTION 2.09 DEATH BENEFIT If the Employer reports to Equitable, or if Equitable otherwise ascertains, that a Participant has died while Accounts for such Participant are maintained under the Contract and before such Participant's Retirement Date, Equitable, upon receipt of due proof of such death, will pay in a single sum to the beneficiary designated by such Participant to receive such payment the amount of death benefit payable with respect to such Participant. The amount of the death benefit with respect to a Participant at any time prior to the Retirement Date is equal to the greater of (i) the sum of the Annuity Values of the Guaranteed Interest Account, Stock Account and Money Market Account maintained under the Contract for such Participant and (ii) the minimum death benefit with respect to such Participant. Such minimum death benefit is the sum of all Contributions made with respect to such Participant pursuant to Section 2.01 (before reduction of any applicable taxes) less an adjustment for any withdrawals made pursuant to Sections 2.07, 2.07A and 2.07B from the Accounts maintained under the Contract for such Participant. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount being withdrawn is to the Annuity Values then in the Guaranteed Interest Account, Stock Account and Money Market Account maintained under the Contract for such Participant. If, in accordance with the provisions of Section 2.01, the cash value of an Annuity contract issued by Equitable, which provides for a death benefit before retirement equal to the greater of the contract cash value or an alternative amount based on premiums paid or contributions made under the Annuity contract, is transferred to the Contract, such alternative amount as of the date of transfer will be included in the "sum of all Contributions" in lieu of the amount of cash value transferred, for purposes of the death benefit under the Contract. PF 14112CT Page 14 PARTICIPANT'S ACCOUNT (continued) The amount of any death benefit payable with respect to a Participant will, to the extent such Account is sufficient therefor, be withdrawn from the Guaranteed Interest Account, Stock Account and Money Market Account maintained with respect to such Participant under the Contract. Upon such payment, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Annuity Values arose. PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of Separate Account A. The amount of the first, second, and third payments under any Variable Annuity Benefit provided under the Contract with respect to a payee is the monthly amount provided with respect to the payee pursuant to Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average New Annuity Unit Value for the second calendar month immediately preceding the date of the payment. the fourth and subsequent annuity payments under a Variable Annuity Benefit will not be increased or decreased in amount because of mortality or expense experience. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the New Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Values of such Participant's Guaranteed Interest Account, Stock Account and Money Market Account shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of such Account in a single sum or (ii) to apply such Annuity Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by Equitable, as elected by the Participant, subject to Equitable's rules then in effect and any applicable requirements under the Code. Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Values of such Participant's Guaranteed Interest Account, Stock Account and Money Market Account Equitable will have the right to require the Participant to furnish pertinent facts and determinations to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. Equitable may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS If a Participant elects pursuant to the first paragraph or third paragraph of Section 3.03 to receive an Annuity Benefit in lieu of the Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account, the amount applied to provide the Annuity Benefit will be (i) the Annuity Values of such Accounts if the payments under the PF 14112CT Page 15 ANNUITY BENEFITS (continued) annuity form elected are contingent upon the survival of a person, or (ii) the Cash Values of such Account if the payments under the annuity form elected are not contingent upon the survival of a person. The amount applied to provide an Annuity Benefit shall be reduced by any applicable tax on annuity considerations, as determined by Equitable. If such amount is applied on or after the completion of five Participation Years with respect to such Participant, or if such amount is applied on behalf of an Existing Participant, the balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. If the amount applied to provide an Annuity Benefit is applied before the completion of five Participation Years with respect to a New Participant, the balance, after any applicable tax on annuity considerations, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the Guaranteed Interest Account, Stock Account and Money Market Account maintained for such Participant shall terminate. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (100% continuation). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, are based on 3 1/4% interest and the 1971 ELAS Mortality Table. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on 1979 ELAS mortality and an Assumed Base Rate of Net Investment Return of 3 1/2% or 5%, whichever applies pursuant to Section 1.16. Equitable may change the monthly income amounts contained in the Tables of Guaranteed Annuity Payments and the bases for determining such amounts, for new Participants, by at least 90 days advance notice to the Contract Holder and by an amendment to the Contract. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on 3 1/4% interest and the 1971 ELAS Mortality Table if such annuity form provides for a Fixed Annuity Benefit, and on 1979 ELAS Mortality and an Assumed Base Rate of Net Investment Income Return of 5% of 3 1/2%, whichever applies pursuant to Section 1.16, if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payable under the Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by Equitable will be charged against and underpayments will be added to any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian commit- PF 14112CT Page 16 ANNUITY BENEFITS (continued) tee, or other representative of the estate of such payee has been appointed, Equitable may make the payments (in the case of a minor, at a rate not exceeding $50 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If an annuity form made available by Equitable provides for payment for a period certain, such a 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Upon election by a Participant pursuant to Section 3.03 of an annuity form providing payments for a period certain, such Participant may designate (with the right to change such designation) a person or persons to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's executors or administrators accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, Equitable will pay in a single sum to such payee's executors or administrators the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. Equitable will require satisfactory evidence of the age of any person upon whose life and annuity form depends. PF 14112CT Page 17 ANNUITY BENEFITS (continued) TABLES OF GUARANTEED ANNUITY PAYMENTS (BASED ON AGE NEAREST BIRTHDAY ON DUE DATE OF FIRST PAYMENT) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Value)
- ---------------------------------------------------------------------------------------------------------------------------------- MALE FEMALE AGE ----------------------------------------------------------------------------------------------------------------------- AGE 60 61 62 63 64 65 66 67 68 69 70 ----------------------------------------------------------------------------------------------------------------------- 60 4.52 4.58 4.64 4.70 4.76 4.82 4.88 4.94 5.00 5.05 5.11 61 4.55 4.62 4.68 4.74 4.81 4.87 4.93 5.00 5.06 5.12 5.18 62 4.58 4.65 4.72 4.78 4.85 4.92 4.99 5.05 5.12 5.19 5.25 63 4.67 4.68 4.76 4.82 4.89 4.97 5.04 5.11 5.18 5.25 5.32 64 4.64 4.71 4.79 4.86 4.94 5.05 5.09 5.17 5.24 5.32 5.40 65 4.67 4.74 4.82 4.90 4.98 5.06 5.14 5.22 5.30 5.38 5.47 66 4.69 4.77 4.85 4.93 5.02 5.10 5.18 5.27 5.35 5.44 5.53 67 4.72 4.80 4.88 4.97 5.06 5.14 5.23 5.30 5.40 5.50 5.59 68 4.74 4.82 4.98 5.00 5.09 5.18 5.27 5.36 5.45 5.55 5.65 69 4.76 4.85 4.94 5.03 5.12 5.22 5.31 5.47 5.50 5.60 5.71 70 4.78 4.87 4.96 5.06 5.26 5.26 5.3? 5.45 5.56 5.66 5.76 - ----------------------------------------------------------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3 1/2% (Minimum Monthly Income per $1,000 of Annuity Value)
- ---------------------------------------------------------------------------------------------------------------------------------- MALE FEMALE AGE ----------------------------------------------------------------------------------------------------------------------- AGE 60 61 62 63 64 65 66 67 68 69 70 ----------------------------------------------------------------------------------------------------------------------- 60 4.30 4.35 4.39 4.43 4.47 4.50 4.55 4.59 4.63 4.67 4.71 61 4.35 4.39 4.43 4.48 4.52 4.56 4.64 4.65 4.69 4.73 4.78 62 4.39 4.43 4.48 4.52 4.57 4.67 4.66 4.71 4.75 4.80 4.85 63 4.42 4.47 4.52 4.57 4.62 4.67 4.72 4.77 4.82 4.87 4.92 64 4.46 4.51 4.57 4.62 4.67 4.72 4.77 4.83 4.88 4.94 4.99 65 4.50 4.56 4.61 4.66 4.73 4.76 4.83 4.89 4.95 5.01 5.07 66 4.54 4.60 4.65 4.71 4.77 4.83 4.89 4.95 5.01 5.08 5.14 67 4.58 4.64 4.70 4.76 4.82 4.88 4.95 5.01 5.08 5.15 5.22 68 4.62 4.68 4.77 4.81 4.87 4.95 5.01 5.08 5.15 5.22 5.29 69 4.65 4.72 4.78 4.85 4.92 4.99 5.06 5.14 5.22 5.29 5.37 70 4.69 4.76 4.83 4.90 4.97 5.05 5.12 5.20 5.28 5.36 5.45 - ----------------------------------------------------------------------------------------------------------------------------------
- ---------------------------------------------------------------------------------------------------------------------------------- MALE FEMALE AGE ----------------------------------------------------------------------------------------------------------------------- AGE 60 61 62 63 64 65 66 67 68 69 70 ----------------------------------------------------------------------------------------------------------------------- 60 5.19 5.23 5.27 5.31 5.34 5.39 5.42 5.46 5.50 5.54 5.58 61 5.23 5.27 5.31 5.35 5.39 5.43 5.47 5.52 5.56 5.60 5.64 62 5.27 5.31 5.35 5.39 5.44 5.48 5.53 5.57 5.62 5.67 5.71 63 5.31 5.35 5.39 5.44 5.49 5.53 5.58 5.63 5.68 5.73 5.78 64 5.34 5.39 5.44 5.48 5.53 5.59 5.64 5.69 5.74 5.79 5.85 65 5.38 5.43 5.48 5.53 5.58 5.64 5.69 5.75 5.80 5.86 5.92 66 5.42 5.47 5.52 5.58 5.63 5.69 5.75 5.81 5.87 5.93 5.99 67 5.45 5.51 5.56 5.62 5.68 5.74 5.80 5.87 5.93 6.00 6.06 68 5.49 5.55 5.61 5.67 5.73 5.80 5.86 5.93 6.00 6.06 6.00 69 5.53 5.59 5.65 5.71 5.78 5.85 5.92 5.99 6.06 6.13 6.20 70 5.56 5.63 5.69 5.76 5.83 5.90 5.97 6.05 6.13 6.21 6.29 - ----------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) VARIABLE ANNUITY BENEFIT IF ASSUMED FIXED ANNUITY BENEFIT BASE RATE OF NET INVESTMENT RETURN IS ---------------------- ------------------------------------- 3 1/2% 5% ------ -- AGE MALES FEMALES MALES FEMALES MALES FEMALES --- ----- ------- ----- ------- ----- ------- 60 5.88 4.99 5.43 4.80 6.36 5.70 61 6.04 5.11 5.57 4.90 6.50 5.81 62 6.21 5.24 5.72 5.02 6.65 5.91 63 6.38 5.38 5.88 5.13 6.81 6.03 64 6.57 5.53 6.05 5.25 6.97 6.75 65 6.77 5.68 6.23 5.39 7.16 6.28 66 6.98 5.84 6.43 5.54 7.35 6.43 67 7.19 6.01 6.64 5.70 7.56 6.58 68 7.42 6.20 6.87 5.87 7.79 6.76 69 7.67 6.39 7.11 6.06 8.03 6.96 70 7.93 6.61 7.38 6.27 8.30 7.15 Equitable will notify the payee under a Variable Annuity Benefit of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each variable payment. Any election, change, revocation or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a commutation right under an Annuity benefit is exercised, Equitable may defer payment in accordance with Section 4.08. PF 14112CT Page 18 PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT The Contract constitutes the entire Contract between the parties and the provisions of the Contract alone will govern with respect to the rights and obligations of Equitable. The provisions of the Contract will be applied separately with respect to each Participant. Nothing in the enrollment form referred to in Section 1.05, the Plan or trust agreement referred to in Section 4.10 nor any modification, amendment, or supplement to any such documents will in any way be construed to enlarge, change, vary or in any other way affect the obligations of Equitable as expressly provided in the Contract. The Contract may not be modified as to Equitable, nor may any of Equitable's rights or requirements be waived, except in writing and by an authorized officer of Equitable. The Contract may be changed by amendment or replacement upon agreement between the Contract Holder and Equitable without the consent of any other person provided that such change does not reduce any Annuity Benefit provided before such change and provided that no rights, privileges or benefits which have accrued to any Participant under the Contract may be reduced or forfeited except by the express consent of such Participant. SECTION 4.02 STATUTORY COMPLIANCE Equitable reserves the right to amend the Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the Contract and any certificate to reflect changes in the Code, or in regulations or published rulings of the Internal Revenue Service, so that each such certificate will continue to be an Annuity. Any Annuity Benefit, Cash Value or death benefit available under a certificate issued pursuant to the Contract shall not be less than the minimum benefits required by any statute of the state in which the certificate is delivered. SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY The entire interest of any Participant under the Contract is nonforfeitable. No interest of a Participant under the Contract may be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than Equitable. No amount payable under the Contract may be assigned, commuted, or encumbered by the payee, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. SECTION 4.04 PARTICIPATION IN SURPLUS The Contract and all other contracts in the same class of contracts shall be combined for the purpose of ascertaining the annual surplus of Equitable to be apportioned to said contracts as a dividend, and the portion of any such dividend that is to be allocated to the Contract shall be determined by Equitable. The participation of this class of contracts in annual surplus is, however, expected to be minimal. Any amount so allocated to the Contract shall be payable as of January 1 of the calendar year in which a dividend is apportioned and will be payable in cash and shall be equitably allocated by Equitable to the Guaranteed Interest Accounts maintained hereunder for Participants. No Annuity Benefit will enter into the determination of any surplus to be apportioned to the Contract as a dividend. SECTION 4.05 BENEFICIARY Each Participant, as of such Participant's Participation Date is to provide Equitable with an initial designation of the beneficiary entitled to receive any death benefit payable with respect to such Participant pursuant to Section 2.09. The Participants may change such designation form time to time during such Participant's lifetime and while Accounts for such Participants are being maintained hereunder. Any such designation or change will be made by written notice in a form satisfactory to Equitable. A change will, upon receipt at a designated Equitable Office, take effect as of the time the written notice was signed, whether or not the Participant is living on the date of receipt, but without further liability as to any payment or other settlement made by Equitable before receipt of such change. Unless otherwise specified in the designation, if a Participant has designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive the Participant and if more than one survive they will share equally. PF 14112CT Page 19 GENERAL PROVISIONS (continued) Any part of a death benefit payable with respect to a Participant pursuant to Section 2.09 for which there is no designated beneficiary living at the death of the Participant will be payable in a single sum to the children of the Participant who survive the Participant, in equal shares, or should none survive, then to the Participant's executors or administrators. If a Participant so elects in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by the Participant, with respect to the beneficiary, subject to Equitable's rules then in effect. If at the death of a Participant there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. SECTION 4.06 DISQUALIFICATION In the event that an annuity purchased hereunder with respect to a Participant fails to qualify as an Annuity as described in Section 1.03, Equitable shall have the right, upon receiving notice of such fact before the Retirement Date, to terminate participation with respect to such participant under the Contract and pay to such Participant the amount in the Account maintained with respect to such Participant less a deduction for the appropriate part attributable to such Participant of any Federal income tax payable by Equitable which would not have been payable if such Participant had an Annuity under the Contract. SECTION 4.07 FUTURE PARTICIPANTS Equitable reserves the right at its sole discretion to curtail or prohibit further enrollment as Participants under the contract of any individuals who are not currently participating under the Contract as of such date of curtailment or prohibition. SECTION 4.08 DEFERMENT Payments by Equitable from the Participant's Guaranteed Interest Account pursuant to the provisions of Section 2.06, Sections 2.07, 207A and 2.07B, and Section 2.09, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.05, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. Interest in the current Guaranteed Interest Rate for such Participant's Guaranteed Interest Account will be allowed on any such payment deferred for 30 days or more. Except as provided in this Section, payments by Equitable form the Participant's Stock Account or Money Market Account pursuant to the provisions of Section 2.06, Sections 2.07, 2.07A and 2.07B, and Section 2.09, or any commuted payments arising from a Variable Annuity Benefit pursuant to Section 3.05. will be made within seven days after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. During any period when (i) the sale of securities or the determination of the New Accumulation Unit Value or the Average New Annuity Unit Value is not reasonably practicable because any emergency, defined by the Securities and Exchange Commission, exists, or the New York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may by order permit postponement for the protection of persons having interests in the Separate Accounts, Equitable reserves the right: (a) to defer determination of Cash Values or Annuity Values and payment of Cash Values and Annuity Values, arising from an amount in a Participant's Stock Account or Money Market Account; (b) to defer payment of any portion of the death benefit arising from an amount in a Participant's Stock Account or Money Market Account; (c) to defer the payment of any Variable Annuity Benefit under the Contract or the application of any such Benefit to provide for any other payment called for by the Contract; or (d) in the event of (a) above, to defer application of such amounts to provide any Annuity Benefit permitted under the Contract. SECTION 4.09 ANNUAL NOTICE At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Guaranteed PF 14112CT Page 20 GENERAL PROVISIONS (continued) Interest Account, (2) the total number of Accumulation Units credited to the Stock Account and Money Market Account, (3) the New Accumulation Unit Values, (4) the sum of the Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account and (5) the amount of death benefit payable with respect to the Participant. After the Retirement Date Equitable will notify the Participant of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.10 CONTRACT HOLDER RESPONSIBILITY The sole responsibility of the Contract Holder is to serve as party to the Contract. The Contract Holder will have no responsibility for the administration of any Plan or Agreement, for payments to the Guaranteed Interest Account or Stock Account, or any payments or other distributions hereunder. Equitable will deal with the Contract Holder in accordance with the terms and conditions of the trust agreement pursuant to which the Contract Holder agreed to act as such and with the Contract and in such manner as the Contract Holder and Equitable may agree, without the consent of any other person. Any Employer making Contributions under the Contract shall be deemed to have adopted and accepted the trust agreement as part of the Plan or Agreement with respect to which such Contributions are made. SECTION 4.11 AGE AND SEX If the Annuitant's age or sex has been misstated, any benefits will be those which would have been purchased at the correct age and sex. Any overpayments or underpayments made by Equitable will be charged or credited with interest at the rate of 6% per year and such interest will be deducted from or added to benefits falling due thereafter. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK By /s/ (signature illegible) --------------------------------------- Title Senior Vice President ------------------------------------ Dated May 27, 1982 ------------------------------------ At New York, NY --------------------------------------- FOR THE EQUITABLE By /s/ Coy Eklund -------------------------------------- Chairman of the Board By /s/ Rodney L. Enochs -------------------------------------- Vice President and Secretary Date of Issue May 1, 1982 --------------------------- PF 14112CT Page 21 Attached to and made part of Group Annuity Contract No. 11930CT between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective August 26, 1983, said contract and riders are amended as follows: 1. with respect to Section 1.18A Cash Value -- New Participants a. the term "25 Participation Years" contained in the paragraph entitled "No Withdrawal Charge" is changed to "12 Participation Years," b. the paragraph entitled "Withdrawal Charge Within First Five Years" is replaced by the following: WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS: Within the first three Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% of the sum of the Annuity Values of such Accounts. (b) is an amount equal to the excess, if any, of (i) 8% of the cumulative contributions made on behalf of such Participant over (ii) the cumulative total of any withdrawal charges made pursuant to sections 2.07 and 2.07A. c. the paragraph entitled "Withdrawal Charge After Five Years" is replaced by the following: WITHDRAWAL CHARGE AFTER THREE YEARS: After the completion of three Participation Years with respect to the Participant, the withdrawal charge equal the lesser of (a) or (b) where: (a) equals 6% during Participation Years 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the excess of (i) the sum of the Annuity Values of such Accounts over (ii) the Free Corridor Amount defined in Section 2.07C. (b) is the excess, if any, of (i) 8% of the total contributions made on behalf of such Participant during the current Participation Year and the preceding nine Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. The Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account will be in the same proportion as are the Annuity values of such Accounts. PF 17002CT 2. with respect to Section 1.18B Cash Value -- Existing Participants a. the term "20 Participation Years" contained in the paragraph entitled "No Withdrawal Charge" is changed to "12 Participation Years," b. the paragraph entitled "Withdrawal Charge Within First Five Years" is replaced by the following: WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS: Within the first three Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a) and (b) below; provided, however, that such charge does not exceed the amount described in subsection (c) below where: (a) is an amount equal to 2% of any Preferred Withdrawable Amounts (defined in Section 2.07B) that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (b) is an amount equal to 6% during the first five Participation Years 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of any Regular Withdrawable Amounts (defined in Section 2.07B) that have not previously been withdrawn pursuant to Section 2.07 and 2.07B. (c) is an amount equal to the sum of (a) above, and 6% of the excess, if any, of (i) the sum of the Annuity Values of such Accounts over (ii) the cumulative total of Equitable Transferred Funds made with respect to the Participant that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. c. the paragraph entitled "Withdrawal Charge After Five Years" is replaced by the following: WITHDRAWAL CHARGE AFTER THREE YEARS: After three Participation Years have been completed with respect to the Participant, Equitable (i) will first withdraw, pursuant to Section 2.07B, the Free Corridor Amount defined in Section 2.07C and (ii) next withdraw the remaining portion of the sum of the Annuity Values of such Accounts. A withdrawal charge will apply to the amount in (ii) above, and will equal the sum of the charges described in subsections (a) and (b) of the preceding subsection; provided, however, that such charge will not exceed an amount equal to the lesser of the charges defined in (d) and (e) below: (d) is an amount equal to the sum of (a) in the preceding subsection, and 6% during Participation Years 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the excess, if any, of (i) the sum of the Annuity Values of such Accounts (after withdrawal of the Free Corridor Amount) over (ii) the cumulative total of Equitable Transferred Funds made on behalf of the Participant that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (e) is an amount equal to the excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other contributions (excluding Equitable Transferred Funds) made on behalf of such Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07B. The Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such accounts. 3. with respect to Section 2.07A Partial Withdrawals -- New Participants a. the term "25 Participation Years" contained in the provision entitled "No Withdrawal Charge" is changed to "12 Participation Years;" PF 17002CT b. the provision entitled "Withdrawal Charge Within First Five Years" is replaced by the following: WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS: If the Participant has not completed three Participation Years under the Contract, such withdrawal charge will equal the lesser of (a) or (b) where: (a) is an amount equal to 6% of the total amount to be withdrawn from the Accounts (including such charge) pursuant to this paragraph. (b) is the excess, if any, of (i) 8% of the cumulative total of Contributions made on behalf of such Participant over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. c. the provision entitled "Withdrawal Charge After Five Years" is replaced by the following: WITHDRAWAL CHARGE AFTER THREE YEARS: After the completion of three Participation Years with respect to the Participant, there will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Participation Years 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the amount withdrawn (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the cumulative total of contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. 4. with respect to Section 2.07B Partial Withdrawals -- Existing Participants a the term "20 Participation Years" contained in the provision entitled "No Withdrawal Charge" is changed to "12 Participation Years;" b. the provision entitled "Withdrawal Charge Within Fist Five Years" is replaced by the following: WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS: Within the first three Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a), (b), (c) and (d) below: (a) With respect to any withdrawals of Preferred Withdrawable Amounts, a charge of 2% of such withdrawals. (b) With respect to any withdrawals of Free Withdrawable Amounts, no charge. (c) With respect to any withdrawals of Regular Withdrawable Amounts, a charge of 6% of such withdrawals. (d) With respect to any withdrawals of amounts other than the amounts in (a), (b) and (c) above, no charge. c. the provision entitled "Withdrawal Charge After Five Years" is replaced by the following: WITHDRAWAL CHARGE AFTER THREE YEARS: After the completion of three Participation Years with respect to the Participant, there will be no withdrawal charge if the amount of the partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07C. PF17002CT If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (1) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (2) then withdraw from such Accounts an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will equal the sum of the charges described in (a), (b) and (d) above, plus with respect to any withdrawals of Regular Withdrawable Amounts, a charge of 6% during Participation Years 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter provided, however, that in no event will such charge exceed an amount equal to the following: The excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other Contributions (excluding Equitable Transferred Funds) made on behalf of the Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any prior withdrawal charges made pursuant to this Section. Whenever an amount is withdrawn from such Accounts that is not greater than the current Free Corridor Amount, such amount is considered to be (1) first, a withdrawal of Regular Withdrawable Amounts, (2) next, a withdrawal of Preferred Withdrawable Amounts, (3) next, a withdrawal of Free Withdrawable Amounts, and (4) lastly, a withdrawal of amounts other than the amounts in (1), (2), or (3) above. However, no charge will be assessed with respect to the portion of the withdrawal up to the current Free Corridor Amount. 5. with respect to Section 2.07C Free Corridor Amount, the term "five Participation Years" is changed to "three Participation Years." Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By /s/ William H. Schroeder By /s/ John B. Carter ------------------------------ ------------------------- President Title Vice President By /s/ Rodney L. Enochs ----------------------------- ------------------------- Vice President and Secretary Dated Aug 19, 1983 Date of Issue ----------------------------- ---------------- At New York, N. Y. -------------------------------- PF 17002CT This amendment was approved by the New York Insurance Department under an accelerated procedure to assist employers in complying with the United States Supreme Court decision in Arizona v. Norris. The Department has reserved the right to require changes in this amendment to comply with applicable New York law and regulations. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By /s/ William H. Schroeder By /s/ John B. Carter ------------------------ ------------------ President Title Vice President By /s/ Rodney L. Enochs -------------- -------------------- Vice President and Secretary Dated Dec 15 1983 Date of Issue ----------- --------------- At New York, N.Y. -------------- PF17007CT Attached to and made part of Group Annuity Contract No. 11930CT between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective December 12, 1983, said contract and riders are amended as follows: 1. all references in the contract to the Annuitant's sex are deleted. 2. the phrase "3 1/2% interest and the 1971 Equitable Annuity Mortality Table" and the phrase "1979 Equitable Annuity Mortality" appearing in Section 3.04 Amount of Annuity Benefits shall be changed to "3 1/2% interest and the 1983 Individual Annuity Mortality Table adjusted to a unisex basis based on a 50-50 split of males and females" and "the projected 1983 Basic Table adjusted to a unisex basis based on a 50-50 split of males and females," respectively, wherever they appear. 3. the Tables of Guaranteed Annuity Payments appearing in Section 3.05 Payment of Annuity Benefits, are replaced by the following Tables. TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Value)
Age Age 60 61 62 63 64 65 66 67 68 69 70 60 4.54 4.58 4.62 4.66 4.70 4.74 4.77 4.81 4.84 4.88 4.91 61 4.62 4.67 4.71 4.76 4.81 4.84 4.88 4.91 4.95 4.99 62 4.72 4.76 4.81 4.85 4.90 4.94 4.98 5.02 5.06 63 4.81 4.86 4.91 4.96 5.01 5.06 5.10 5.14 64 4.92 4.97 5.02 5.08 5.13 5.17 5.22 65 5.03 5.09 5.15 5.20 5.26 5.31 66 5.15 5.21 5.27 5.33 5.39 67 5.28 5.34 5.40 5.47 68 5.41 5.48 5.55 69 5.56 5.63 70 5.71
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3-1/2% (Minimum Monthly Income per $1,000 of Annuity Value)
Age Age 60 61 62 63 64 65 66 67 68 69 70 60 4.40 4.44 4.48 4.51 4.55 4.58 4.61 4.65 4.68 4.71 4.74 61 4.48 4.52 4.56 4.60 4.64 4.67 4.71 4.74 4.78 4.81 62 4.56 4.60 4.65 4.69 4.73 4.77 4.80 4.84 4.88 63 4.65 4.69 4.74 4.78 4.83 4.87 4.91 4.95 64 4.74 4.79 4.84 4.89 4.93 4.98 5.02 65 4.85 4.90 4.95 5.00 5.05 5.10 66 4.95 5.01 5.06 5.11 5.17 67 5.07 5.12 5.18 5.24 68 5.19 5.25 5.32 69 5.32 5.39 70 5.46
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 5% (Minimum Monthly Income per $1,000 of Annuity Value)
Age Age 60 61 62 63 64 65 66 67 68 69 70 60 5.27 5.30 5.34 5.37 5.41 5.44 5.47 5.51 5.54 5.57 5.59 61 5.34 5.38 5.42 5.46 5.49 5.53 5.57 5.60 5.63 5.66 62 5.42 5.46 5.50 5.54 5.58 5.62 5.65 5.69 5.73 63 5.50 5.55 5.59 5.63 5.67 5.71 5.75 5.79 64 5.59 5.64 5.69 5.73 5.78 5.82 5.86 65 5.69 5.74 5.79 5.84 5.89 5.93 66 5.79 5.85 5.90 5.95 6.00 67 5.90 5.96 6.02 6.08 68 6.02 6.08 6.15 69 6.15 6.22 70 6.24
PF17007CT ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) VARIABLE ANNUITY BENEFIT IF ASSUMED BASE FIXED ANNUITY BENEFIT RATE OF NET INVESTMENT RETURN IS --------------------- -------------------------------- Age 3 1/2% 5% - --- ------ -- 60 5.29 5.08 5.97 61 5.41 5.19 6.08 62 5.55 5.31 6.20 63 5.69 5.44 6.33 64 5.85 5.58 6.46 65 6.01 5.73 6.61 66 6.19 5.89 6.77 67 6.37 6.06 6.94 68 6.58 6.24 7.12 69 6.79 6.43 7.31 70 7.02 6.64 7.52 Attached to and made part of Group Annuity Contract No. 11930CT between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective May 1, 1984 said contract and riders are amended as follows: 1. The term "Stock Account" has been changed to "Stock Account, Balanced Account and Aggressive Stock Account" wherever it appears except as provided in items 4 and 5 of this rider. 2. The Section entitled "The Separate Accounts" is amended as follows: a. the following Accounts have been added: Name Investments ---- ----------- Separate Account J Primarily common stocks and other equity-type investments, publicly traded debt securities and short-term money market instruments. Separate Account K Primarily common stocks issued by high quality small and intermediate size companies with strong growth prospects. b. The sentences "Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, consisting of .15% for investment management, .35% for financial accounting, .35% for the annuity rate guarantee and the minimum death benefit, and .90% for expenses and expense risk. The charge shall be made in connection with (c) of the Net Investment factor provision in Section 1.16" are amended to read as follows: i. for Participants with a Participation Date prior to May 1, 1984 "Assets of Separate Account A and Separate Account E attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, consisting of .15% for investment management, .35% for financial accounting, .35% for the annuity rate guarantee and the minimum death benefit, and .90% for expenses and expense risk. Assets of Separate Account J and Separate Account K attributable to the Contract shall be subject to a charge at the rate 1.75% a year, for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The percentage allocation of the components of the charges for Separate Account J and Separate Account K are not necessarily allocated in the same amounts as for Separate Account A and Separate Account E. The charge shall be made in connection with (c) of the Net Investment Factor provision in Section 1.16" ii. for Participants with a Participation Date on or after May 1, 1984 "Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.16." PF 17014CT 3. The Section entitled "New Accumulation Unit Value" is amended by the addition of the following Accounts: Account Value Date ------- ----- ---- Separate Account J $10.00 As of May 1, 1984 Separate Account K $10.00 As of May 1, 1984 4. The title and the first two sentences of the Section entitled "Stock and Money Market Accounts" shall read as follows: STOCK, BALANCED, AGGRESSIVE STOCK AND MONEY MARKET ACCOUNTS Equitable maintains a Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the (1) Stock Account becomes part of Separate Account A, (2) Balanced Account becomes part of Separate Account J, (3) Aggressive Stock Account becomes part of Separate Account K, and (4) Money Market Account becomes part of Separate Account E. 5. The Section entitled "Transfers Among Accounts" is amended to read as follows: TRANSFERS AMONG ACCOUNTS At any time before a Participant's Retirement Date, such Participant, upon written request, may transfer all or part of the amounts maintained for the Participant to one or more of the other Accounts maintained for such Participant as follows: (1) amounts in the Guaranteed Interest Account, Stock Account, Balanced Account and Aggressive Stock Account may be transferred among such Accounts; (2) amounts in the Money Market Account may be transferred to the other Accounts. Such transfers will be made as of the date Equitable receives such request, and will be subject to Equitable's rules in effect at the time of transfer. No transfers are permitted from the Guaranteed Interest Account, Stock Account, Balanced Account or Aggressive Stock Account maintained for the Participant to the Money Market Account. Notwithstanding the above, transfers to the Balanced Account may be prohibited by Equitable upon 30 days written notice to the Participant. 6. The provision entitled "Retirement Date" is amended as follows: The sentence "No Retirement Date shall be earlier than the date of attainment of age 55 years" is changed to "No Retirement Date shall be earlier than the Participant's 55th birthday or later than the Participant's 75th birthday." 7. The provision entitled "Election and Commencement of Annuity Benefits" is amended by the addition of the following sentence to the end of the fifth paragraph: The Participant may only elect an annuity form pursuant to which either (i) the Annuity Value or Cash Value, whichever is applicable, will be paid to the Participant and the Participant's beneficiary over a period not exceeding the joint lives of the Participant and the Participant's spouse or (ii) more than 50% of the Annuity Value or Cash Value, whichever is applicable, will be paid to the Participant during the Participant's life. THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK By /s/ William H. Schroeder ---------------------------------------------- Title Vice President ------------------------------------------- Dated 06/27/84 ------------------------------------------- At N.Y., N.Y. ------------------------------------------- FOR THE EQUITABLE By /s/ John B. Carter ---------------------------------------------- President By /s/ Rodney L. Enochs ---------------------------------------------- Vice President and Secretary Date of Issue ------------------------------------ PF 17014CT Attached to and made part of Group Annuity Contract No. 11930CT between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective October 1, 1985, said contract and riders are amended as follows: Unless otherwise restricted by the Plan, the Participant may get a loan under the certificate before the Retirement Date. The Participant's total Annuity Value (including the loan reserve account as described below) will be the sole security for the loan. A loan is effected on the first day of the month following the date the Participant's loan agreement form is approved by the Equitable. The amount of the loan may not be more than (i) 80% of the total Annuity Value under the certificate, if such total Annuity Value is greater than or equal to $3,750 and less than $12,500, (ii) $10,000, if the total Annuity Value is greater than or equal to $12,500 and less than $20,000, and (iii) 50% of the total Annuity Value if the total Annuity Value is greater than $20,000, but in no event shall the loan amount exceed $50,000. The minimum loan permitted is $3,000. The total Annuity Value is the value as of the loan effective date. Only one outstanding loan is permitted at a time under a certificate and the Participant will not be permitted to get a new loan until 60 days has elapsed since the prior loan was repaid. As a condition for granting a loan, Equitable will require the Participant to represent that the loan amount requested, when aggregated with loans (principal plus interest) from all qualified plans of the Participant's Employer, does not exceed the greater of $10,000 or 50% of the value of the Participant's non-forfeitable accrued benefits, and in no event exceeds $50,000. Equitable may also require the Participant to elect out of federal income tax withholding with respect to any interest and/or loan principal that would otherwise be subject to withholding. The loan term will be either (i) 5 years or (ii) 10 years, if the Participant represents that the purpose of the loan is to acquire, build or substantially rehabilitate a dwelling unit which within a reasonable period of time is to be used by the Participant or a member of the Participant's family. In any event, the loan term may not extend beyond the earlier of (i) the Retirement Date, (ii) the date Equitable receives written notice to terminate the Participant's participation under the Contract pursuant to Section 2.06, (iii) the date Equitable pays a death benefit pursuant to Section 2.09, and (iv) any date provided for such loans by future federal tax rules. Future federal tax rules may also impose certain additional requirements to obtain the ten year loan period described above. These requirements may also apply to existing ten year loans. On the loan effective date, Equitable will transfer to a loan reserve account an amount equal to the sum of (i) the loan amount, which will earn interest at an effective annual rate of 4% during the loan term and (ii) 25% of the loan amount, which will earn interest at the Guaranteed Interest Rate, as defined in the certificate. The Participant may specify which Accounts these amounts are to be transferred from. In the absence of direction by the Participant, or if the Participant's directions cover only part of the amount required to be transferred to the loan reserve account, Equitable will transfer the required (or additional required) amounts from each Account based on the proportion that each Acccount's Annuity value bears to the total Annuity Values of all Accounts. On each loan anniversary (or first business day thereafter, if the loan anniversary is not a business day), interest earned at 4% during the prior year will be transferred to the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. Equitable will charge loan interest at an effective annual rate of 6% which is due on each loan anniversary. If annual loan interest (except interest due at the end of the loan term) is not received by Equitable's Processing office within 15 days after the due date, Equitable will deduct and treat as a partial withdrawal from the portion of the loan reserve account which earns interest at the Guaranteed Interest Rate an amount sufficient to pay the interest plus any applicable withdrawal charges and any required income tax withholding. The loan may be repaid in part on any loan anniversary, and may be repaid in full at any time on or after the first loan anniversary. However, any payments received will first be applied to interest due, with the balance applied towards repayment of the loan. Any partial loan repayment will result in a transfer of the amount repaid from (i) the portion of the loan reserve account that earns 4% to (ii) the portion of the loan reserve account that earns the Guaranteed Interest Rate. Sixty days after a partial repayment is made, the amount repaid will be transferred from the loan reserve account to the Guaranteed Interest Account and may be withdrawn, transferred, or annuitized as described in the certificate. No partial withdrawals or transfers from the loan reserve account may be made by the Participant. Upon full repayment of the loan by the Participant, Equitable will credit the Guaranteed Interest Rate to the full loan reserve account. Sixty days after the loan is fully repaid, any amounts remaining in the loan reserve account will be transferred to the Guaranteed Interest Account and may be withdrawn, transferred or annuitized as described in the certificate. If the remaining loan principal and accrued interest are not paid on or prior to the end of the loan terms, Equitable will deduct from the loan reserve account and treat as a partial withdrawal an amount sufficient repay the principal and accrued interest, plus any applicable withdrawal charges and required income tax withholding. Sixty days after the end of the loan term, any amounts remaining in the loan reserve account will be transferred to the Guaranteed Interest account and may be withdrawn, transferred or annuitized as described in the certificate. The Section entitled, "Free Corridor Amount", is amended to read as follows: The term "Free Corridor Amount" with respect to a Participant who has completed three Participation Years means an amount equal to the excess, if any, of (i) 10% of the sum of (a) the Annuity Values of the Stock Account, Money Market Account, Guaranteed Interest Account, Balanced Account, and Aggressive Stock Account and (b) the value of any loan reserve account, held with respect to the participant over (ii) cumulative prior withdrawals made pursuant to Section 2.07, 207A, or 2.07B or pursuant to the repayment of interest or principal on a loan, in the current Participation Year with respect to the Participant. The first sentence of Section 2.08, "Annual Administrative Charge" is replaced by the following: As of the last day of each Participation Year before a Participant's Retirement Date, Equitable will withdraw from the Guaranteed Interest Account, Stock Account, Money Market Account, Balanced Account, and Aggressive Stock Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) (a) the Annuity Values of the Guaranteed Interest Account, Stock Account, Money Market Account, Balanced Account and Aggressive Stock Account and (b) the amount of any loan reserve account held, at the end of that Participation Year and (ii) any withdrawals made from such Accounts pursuant to Section 2.07, 2.07A, or 2.07B and from any loan reserve account, during that Participation Year. The charge will be allocated between (i) the Stock Account, (ii) Money Market Account, (iii) Balanced Account, (iv) Aggressive Stock Account and (v) the Guaranteed Interest Account and loan reserve account, in proportion to the Annuity Values of (i), (ii), (iii), (iv) and (v), at the end of the Participation Year. The portion of the charge attributable to (v) above will be first withdrawn from the Guaranteed Interest Account and then, if the Annuity Value of the Guaranteed Interest Account is not sufficient, the remaining allocation will be withdrawn from the portion of the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. The Section entitled, "Death Benefit", is amended by adding the words "and from any loan reserve account" after word "Accounts" in the third sentence of that Section, and the words "and amounts in the loan reserve account" after the words "Money Market Account" in the fourth sentence of that section. This Endorsement shall not change any other provisions of the Contract. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK By _________________________________ Title ______________________________ Dated ______________________________ At _________________________________ FOR THE EQUITABLE By _________________________________ PRESIDENT By__________________________________ VICE PRESIDENT AND SECRETARY Date of Issue_______________________ Attached to and made part of Group Annuity Contract No. 11930CT between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective January 1, 1986, said contract and riders are amended as follows: 1. With respect to Section 1.18A CASH VALUE - NEW PARTICIPANTS, the provisions entitled "WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS" and "WITHDRAWAL CHARGE AFTER THREE YEARS" are replaced by the following: WITHDRAWAL CHARGE: The withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% during Participation Years 1, 2, 3, 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the excess of (i) the sum of the Annuity Values of such Accounts over (ii) the Free Corridor Amount defined in Section 2.07C. (b) is the excess, if any, of (i) 8% of the total contributions made on behalf of such Participants during the current Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. The Cash Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. 2. With respect to Section 2.07A PARTIAL WITHDRAWALS - NEW PARTICIPANTS, the provisions entitled "WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS" AND "WITHDRAWAL CHARGE AFTER THREE YEARS" are replaced by the following: WITHDRAWAL CHARGE: There will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Participantion Years 1,2,3,4 and 5 5% during Participation Years 6,7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the amount withdrawn (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the cumulative total of contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. 3. With respect to Section 2.07C FREE CORRIDOR AMOUNT: a. the term "who has completed three Participation Years" is changed to "who has completed three Participation Years or attained age 59-1 2" b. the following sentence is added: With respect to a Participant who has not completed three Participation Years or attained age 59-1/2, the Free Corridor Amount is zero. SPECIMEN VICE PRESIDENT AND SECRETARY SPECIMEN PRESIDENT PF 17016CT Attached to and made part of Group Annuity Contract No. 11930CT between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective January 1, 1986 for Participants with a Participation Date on or after January 1, 1986, said contract and riders are amended as follows: 1. With respect to the provision entitled NO WITHDRAWAL CHARGE, within the Section entitled CASH VALUE -- NEW PARTICIPANTS: the term "the Participant's attainment of age 70 years and six months, or (iii) the completion of 12 Participation Years with respect to such Participant, or (iv)" is changed to "the completion of 12 Participation Years with respect to such Participant, or (iii)" 2. With respect to the provision entitled NO WITHDRAWAL CHARGE within the Section entitled PARTIAL WITHDRAWAL -- NEW PARTICIPANTS: the term "such Participant's attainment of age 70 years and six months, or (iii) the completion of 12 Participation Years with respect to such Participant, or (iv)" is changed to "the completion of 12 Participation Years with respect to such Participant, or (iii)" Agreed to by: UNITED STATES TRUST COMPANY FOR THE EQUITABLE OF NEW YORK By By SPECIMEN ---------------------------------- --------------------------------- PRESIDENT Title By SPECIMEN ------------------------------- --------------------------------- VICE PRESIDENT AND SECRETARY Dated Date of Issue ------------------------------ ---------------------- At -------------------------------- PF 17020CT Attached to and part of Group Annuity Contract No. 11930CT between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective January 1, 1985, said contract and riders are amended as follows: 1. Section 1.02B entitle "Plan" is amended to read as follows: "The term "Plan" means a program established by an Employer described in clause (ii) of Section 1.01, for the purchase of Annuities on behalf of employees under the Contract, which program is not exempt under 29 CFR ss 2510.3-2(f) and is therefore an "employee pension benefit plan" subject to the requirements of Title I of the Employee Retirement Income Security Act of 1974 ("ERISA") as it may be amended from time to time." 2. Section 1.03 entitled "Annuity" is amended to read as follows: "The term "Annuity" means as annuity purchased in accordance with the terms of an Agreement, Plan, or program, which annuity meets the requirements of Section 403(b) of the Code." 3. In Section 1.11 entitled "Retirement Date" a new paragraph is added to read as follows: "If participation under the Contract is pursuant to the terms of a Plan, the designation of, and any election to change the Retirement Date under this Section 1.11 shall be made by the Participant in accordance with this Section 1.11 and the terms of the Plan." 4. Section 2.06 entitled "Termination of Participation" is amended by the addition of the following paragraph immediately after the end of the first paragraph: "In the event a Participant terminates participation under the Contract pursuant to this Section 2.06, the Cash Values payable to such Participant are not reduced by any withdrawal charges (as described in Section 1.18), and the Participant is not a Participant in a Plan or Program that restricts or imposes a penalty on such termination, then the Participant will not be permitted to resume making Contributions under the Contract for a period of twelve consecutive months following the date of termination. The Participant may resume making Contributions on the first day of the month coinciding with or next following the end of the twelve month period." 5. New Section 3.06 is added to read as follows: SECTION 3.06. SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS APPLICABLE TO PLANS. "If participation under the Contract is pursuant to the terms of a Plan, then the provisions of this Section 3.06 shall supersede any contrary provisions in the Contract and Certificate. "Unless a married Participant and the Participant's spouse elect otherwise in accordance with the terms of the Plan and as provided in this Section 3.06, as of Participant's Retirement Date, the Annuity Values of a Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Accounts shall be paid to the Participant in the form of a "Qualified Joint and Survivor Annuity." A "Qualified Joint and Survivor Annuity" is an Annuity Benefit for the life of the Participant with a survivor annuity for the life of the Participant's spouse which is not less than 50% and not more than 100% of the annuity which is payable during the joint lives of the Participant and the Participant's spouse. If the Participant is not married and does not elect otherwise, the Annuity Values shall be paid in the form of a life annuity." "In addition, unless an optional form of benefit is elected pursuant to the terms of the Plan and this Section 3.06, if a married Participant dies before pay- PF 17024CT ment of the Participant's Annuity Values or Cash Values have commenced, then the death benefit described in Section 2.09, shall be paid in the form of a life annuity for the Participant's spouse." "The Participant may elect, on a form acceptable to his Employer and Equitable, within the 90 consecutive day period before the date as of which payment of the Annuity Values is to commence, not to receive payment in the form of a Qualified Joint and Survivor Annuity, or, if the Participant is unmarried, a life annuity, in which case the Participant may elect to receive the Annuity Values or Cash Values, as the case may be, in any other form of payment available under the terms of the Plan and this Contract. The Participant may also elect, on a form acceptable to his Employer and Equitable, on the first day of the Plan year in which the Participant turns age 35 (or the date on which the Participant ceases to work for the employer if earlier) for a Beneficiary other than the Participant's spouse to receive the death benefit. An election under either of the two preceding sentences must be consented to by the Participant's spouse in writing before a notary or a representative of the Plan and must be limited to a benefit for a specific Beneficiary. However, no spousal consent will be required if the Participant can prove to the satisfaction of the Employer and Equitable, that the Participant has no spouse or else that the spouse cannot be located. Each election to designate a Beneficiary other than the Participant's spouse must be consented to by the spouse and any election made under this paragraph to waive the spouse's benefits may be revoked without the consent of the spouse at any time prior to the date as of which payments commence. Any consent to waive the spouse's benefits shall be valid only with regard to the spouse who signs it. Any new waiver or change of Beneficiary will require a new spousal consent." "The provision requiring spousal consent in this Section 3.06 shall also apply with regard to a Participant's election to terminate participation or make partial withdrawals pursuant to Section 2.06 and 2.07 and with regard to a Participant's taking a loan against the Cash Values of his Accounts spouse's written consent, witnessed by a representative of the Plan or notary, must be given on a form acceptable to the Employer and Equitable, within the 90 consecutive day period prior to such payment, withdrawal, or loan, unless the Participant can show that the Participant has no spouse or that the spouse cannot be located." "If the Annuity Values applied to provide the spousal benefits on the date payment is to commence are in the aggregate less than $3,500, Equitable may choose to make a payment in a single sum rather than in the form of a Qualified Joint and Survivor Annuity or life annuity as describe herein. Upon any payment made pursuant to this Section 3.06, Equitable will be released from any and all liability for payment with respect to the Contributions made for the Participant." Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK By________________________________ Title_____________________________ Dated_____________________________ At________________________________ FOR THE EQUITABLE By /s/ John B. Carter ---------------------------------------------- President By /s/ Rodney L. Enochs ---------------------------------------------- Vice President and Secretary Date of Issue_____________________ PF 17024CT Attached to and made part of Group Annuity Contract No. 11930CT between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES AND UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective July 1, 1986, said contract and riders are amended as follows: With respect to Section 2.08 ANNUAL ADMINISTRATIVE CHARGE, the first paragraph is replaced by the following paragraph: As of the last day of each Participation Year before a Participant's Retirement Date, Equitable will withdraw from the Guaranteed Interest Account, Stock Account, Money Market Account, Balanced Account and Aggressive Stock Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) (a) the Annuity Values of the Guaranteed Interest Account, Stock Account, Money Market Account, Balanced Account and Aggressive Stock Account and (b) the amount of any loan reserve account held, at the end of the Participation Year and (ii) any withdrawals made from such Accounts pursuant to Section 2.07, 2.07A or 2.07B and from any loan reserve account during that Participation Year. The charge will be allocated between (i) the Stock Account, (ii) Money Market Account, (iii) Balanced Account, (iv) Aggressive Stock Account and (v) the Guaranteed Interest Account and loan reserve account, in proportion to the Annuity Values of (i), (ii), (iii), (iv), and (v), at the end of the Participant Year. The portion of the charge attributable to (v) above will be first withdrawn from the Guaranteed Interest Account and then, if the Annuity Value of the Guaranteed Interest Account is not sufficient, the remaining allocation will be withdrawn from the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. Aggreed to by: UNITED STATES TRUST COMPANY OF NEW YORK By__________________________________________ Title_______________________________________ Dated_______________________________________ At__________________________________________ THE EQUITABLE LIFE ASSURANCE SOCIETY By /s/ John B. Carter ----------------------------------------- President By /s/ Rodney L. Enochs ----------------------------------------- Vice President and Secretary Date of Issue_______________________________ PF 17032CT Attached to and made part of Group Annuity Contract No. 11930CT between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective July 1, 1986, said contract and riders are amended as follows: 1. With respect to PART I - DEFINITIONS, the following section is added: SECTION 1.14C PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by Equitable which does not permit any prepayment of the unpaid principal. 2. With respect to SECTION 1.18 CASH VALUE, the following text replaces the paragraphs under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to a Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase Period Certain Annuity, defined I Section 1.14C, where the certain period of such Annuity is at least ten years. At all other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. 3. With respect to SECTION 2.07A PARTIAL WITHDRAWAL CHARGES, the following paragraph replaces the paragraph under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a Participant, Equitable will withdraw from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such Annuity is at least ten years. At all other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK By____________________________________ Title_________________________________ Dated_________________________________ At____________________________________ THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES By____________________________________ President By____________________________________ Vice President and Secretary Date of Issue_________________________ PF 17036CT Attached to and part of Group Annuity Contract No. 11930CT between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, with respect to Plans issued in conjunction with optional retirement programs or Plans adopted by universities, said Contract and riders are amended as follows: 1. With respect to PART I -- DEFINITIONS, SECTION 1.18 CASH VALUE is replaced by the following section: SECTION 1.18 CASH VALUE NO WITHDRAWAL CHARGE: With respect to a Participant, when withdrawals are permitted under Section 2.07, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such participant and (b) the Participant's attainment of age 59 1/2 years, or (ii) the completion of 12 Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form providing for the application of the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form providing for the application of the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such annuity is at least ten years. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less withdrawal charge. WITHDRAWAL CHARGE: When withdrawals are permitted under Section 2.07, the withdrawal charge equals the lesser of (a) or (b) where; (a) equals 6% during Participation Years 1, 2, 3, 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the excess of (i) the sum of the Annuity Values of such Accounts over (ii) the Free Corridor Amount defined in Section 2.07B. (b) is the excess, if any, of (i) 8% of the total Contributions made on behalf of such Participant during the current Participation Year and the preceding nine Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. The Cash Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. 2. With respect to PART II-- PARTICIPANT'S ACCOUNT, SECTION 2.07 PARTIAL WITHDRAWALS, the first paragraph is amended to read as follows: PF 17037CT-U SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under the terms of the Agreement or the Plan, whichever is applicable, or to applicable laws and regulations, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Guaranteed Interest Account maintained for such Participant before such Participant's Retirement Date. 3. With respect to PART II -- PARTICIPANT'S ACCOUNT, SECTION 2.07A PARTIAL WITHDRAWAL CHARGES is replaced by the following: NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a Participant, when and to the extent withdrawals are permitted under Section 2.07, Equitable will withdraw from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 1/2 years, or (ii) the completion of 12 Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form providing for the application of the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.4B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form providing for the application of the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such annuity is at least ten years. At all other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less the applicable withdrawal charge. 4. With respect to PART II -- PARTICIPANT'S ACCOUNT, SECTION 2.07A PARTIAL WITHDRAWAL CHARGES, the third paragraph is amended to read as follows: If the amount of the partial withdrawal requested is greater than the Free Corridor Amount, Equitable will, when and to the extent withdrawals are permitted under Section 2.07, (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Participation Years 1, 2, 3, 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the amount withdrawn (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the total Contributions made on behalf of such Participant during the current Participation Year and the preceding nine Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant this Section. 5. With respect to PART II -- PARTICIPANT'S ACCOUNT, SECTION 2.10 LOANS, the first sentence is amended to read as follows: The Participant is eligible for a loan under the Contract before the Retirement Date, if permitted by the Plan or Agreement and if not restricted by applicable laws and regulations. PF 17037CT-U With respect to PART III -- ANNUITY BENEFITS, SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS, the first, second and third paragraphs are amended to read as follows: SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Values of such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of such Accounts in a single sum, if such election is permitted by the Plan or Agreement, (ii) to receive not more than a specific percentage or dollar amount of the Cash Value of such Accounts in a single sum (if permitted by the Plan or Agreement) and to apply the remainder of the Cash Value to provide an Annuity Benefit on any annuity form offered by Equitable, as elected by the Participant, subject to Equitable's rules then in effect and any applicable requirements under the Code, if such election is permitted by the Plan or Agreement or (iii) to apply such Annuity Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by Equitable and permitted by the Plan or Agreement, as elected by the Participant, subject to Equitable's rules then in effect and any applicable requirements under the Code. A Participant can elect to divide the applicable value between a partial sum payment and an annuity form, if such election is in accordance with the Plan or Agreement. Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Value of such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, unless such election is restricted by the Plan. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK By________________________________ Title_____________________________ Dated_____________________________ At________________________________ THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES By________________________________ President By________________________________ Vice President and Secretary Date of Issue_____________________ PF 17037CT-U Attached to and made part of Group Annuity Contract No. 11930CT between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective January 1, 1987, said contract and riders are amended as follows: 1. SECTION 1.11 RETIREMENT DATE is replaced by the following: SECTION 1.11 RETIREMENT DATE. The term "Retirement Date" means the date on which the Participant attains the retirement age specified in the Participant's enrollment form, subject to the terms of the Plan or Agreement, if applicable. Before the Retirement Date, the Participant may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th or 31st of any month), subject to the terms of the Plan or Agreement, if applicable. Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Home Office. No Retirement Date shall be earlier than the Participant's 55th birthday or later than the date specified in the Code. 2. The new section, SECTION 1.11B REQUIRED DISTRIBUTIONS is added following SECTION 1.11A: SECTION 1.11B REQUIRED DISTRIBUTIONS. Notwithstanding any provisions to the contrary, distributions from the certificate must commence as of (i) the age specified by the Code, or (ii) for benefits accrued prior to January 1, 1987, no later than attainment of age 75. If payments have not begun prior to the first Participation Year following the Participant's attainment of age 70, the Participant will be notified regarding the minimum distribution required under the Code. 3. SECTION 1.19 CODE is replaced by the following: SECTION 1.19 CODE. The term "Code" means the Tax Reform Act of 1986, as nor or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. 4. SECTION 2.10 LOANS is replaced by the following: SECTION 2.10A LOANS ESTABLISHED PRIOR TO JANUARY 1, 1987. Unless otherwise restricted by the Plan, the Participant may get a loan under the certificate before the Retirement Date. The Participant's total Annuity Value (including the loan reserve account as described below) will be the sole security for the loan. A loan is effective on the first day of the month following the date the Participant's loan agreement form is approved by Equitable. The amount of the loan may not be more than (i) 80% of the total Annuity Value under the certificate, if such total Annuity Value is greater than or equal to $3,750 and less than $12,500, (ii) $10,000, if the total Annuity Value is greater than or equal to $12,500 and less than $20,000 and (iii) 50% of the total Annuity Value if the total Annuity Value is greater than or equal to $20,000, but in no event shall the loan amount exceed $50,000 less the highest outstanding loan balance under the certificate during the one year period ending the day before the effective date of the loan. The minimum loan permitted is $3,000. The total Annuity Value is the value as of the loan effective date. Only one outstanding loan is permitted at a time under a certificate and the Participant will not be permitted to get a new loan until sixty days have elapsed since the prior loan, including all interest due, was repaid. As a condition for granting a loan, Equitable will require the Participant to represent that the loan amount requested, when aggregated with loans (principal plus interest) from all qualified plans of the Participant's Employer, does not exceed the greater of $10,000 or 50% of the value of the Participant's non-forfeitable accrued benefits, and in no event exceeds $50,000. Equitable may also require the Participant to elect out of Federal income tax withholding with respect to any interest and/or loan principal that would otherwise be subject to withholding. The loan term will be either (i) 5 years or (ii) 10 years, if the Participant represents that the purpose of the loan is to acquire, build or substantially rehabilitate a dwelling unit which, within a reasonable period of time, is to be used by the Participant or a member of the Participant's family. In any event the loan term may not extend beyond the earlier of (i) the Retirement date, (ii) the date Equitable receives written notice to terminate the Participant's participation under the Contract pursuant to Section 2.06, (iii) the date Equitable pays a death benefit pursuant to Section 2.09, and (iv) any date provided for such loans by future Federal tax rules. Future Federal tax rules may also impose certain additional requirements to obtain the ten year loan period described above. These requirements may also apply to existing ten year loans. On the loan effective date, Equitable will transfer to a loan reserve account an amount equal to the sum of (i) the loan amount, which will earn interest at an effective annual rate of 4% during the loan term, and (ii) 25% of the loan amount, which will earn interest at the Guaranteed Interest Rate, as defined in the certificate. The Participant may specify which Accounts these amounts are to be transferred from. In the absence of direction by the Participant, or if the Participant's directions cover only part of the amount required to be transferred to the loan reserve account, Equitable will transfer the required (or additional required) amounts from each Account based on the proportion that each Account's Annuity Value bears to the total Annuity Value of all Accounts. On each loan anniversary (or first business day thereafter, if the loan anni- PF 17039CT Page 1 versary is not a business day), interest earned at 4% during the prior year will be transferred to the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. Equitable will charge loan interest at an effective annual rate of 6% which is due on each loan anniversary. If annual loan interest (except interest due at the end of the loan term)is not received by Equitable's Processing Office within fifteen days after the due date, Equitable will deduct and treat as a partial withdrawal from the portion of the loan reserve account which earns interest at the Guaranteed Interest Rate an amount sufficient to pay the interest plus any applicable withdrawal charges and any required income tax withholding. The loan may be repaid in part on any loan anniversary, and may be repaid in full at any time on or after the first loan anniversary. However, any payments received will first be applied to interest due, with the balance applied towards repayment of the loan. Any partial loan repayment will result in a transfer of the amount repaid from (i) the portion of the loan reserve account that earns 4% to (ii) the portion of the loan reserve account that earns the Guaranteed Interest Rate. Sixty days after a partial repayment is made, the amount repaid will be transferred from the loan reserve account to the Guaranteed Interest Account and may be withdrawn, transferred, or annuitized as described in the certificate. No partial withdrawals or transfers from the loan reserve account may be made by the Participant. Upon full repayment of the loan by the Participant, Equitable will credit the Guaranteed Interest Rate to the full loan reserve account. Sixty days after the loan is fully repaid, any amounts remaining in the loan reserve account will be transferred to the Guaranteed Interest Account and may be withdrawn, transferred or annuitized as described in the certificate. If the remaining loan principal and accrued interest are not paid on or prior to the end of the loan term, Equitable will deduct from the loan reserve account and treat as a partial withdrawal an amount sufficient to repay the principal and accrued interest, plus any applicable withdrawal charges and required income tax withholding. Sixty days after the end of the loan term, any amounts remaining in the loan reserve account will be transferred to the Guaranteed Interest Account and may be withdrawn, transferred or annuitized as described in the certificate. Upon annuitization prior to full repayment of the loan by the Participant, the Annuity Value of the Accounts maintained on behalf of such Participant will be reduced by the portion of the loan reserve account that earns interest at an effective annual rate of 4%. Upon termination of participation prior to full repayment of the loan by the Participant, Equitable will pay the Cash Value of the Accounts maintained on behalf of such Participant reduced by the portion of any loan reserve account that earns interest at an effective annual rate of 4%. 5. The new section, SECTION 2.10B LOANS ESTABLISHED JANUARY 1, 1987 OR LATER is added following SECTION 2.10A LOANS ESTABLISHED PRIOR TO JANUARY 1, 1987: SECTION 2.10B LOANS ESTABLISHED JANUARY 1, 1987 OR LATER. Unless otherwise restricted by the Plan, Agreement or the Code, the Participant may get a loan under the certificate before the Retirement Date. However, future restriction in the Code may require revision or withdrawal of the loan provisions as provided below. The Participant's total Annuity Value (including the loan reserve account as described below) will be the sole security for the loan. A loan is effective on the first day of the month following the date the Participant's loan agreement form is approved by Equitable. Beginning the first day of the third month following the effective date of the loan and quarterly on the first day of the month thereafter, loan repayments must be made to Equitable. Such payments will be equal to the sum of (a) and (b) where (a) is the loan interest, calculated at an effective annual rate of 6%, and (b) is an amortized portion of loan principal. By each due date, if the amount of the loan payment is less than the amount due or the loan payment is not received at Equitable's Processing Office, Equitable will deduct and treat as a partial withdrawal from the loan reserve account an amount equal to the interest and principal payments due plus any applicable withdrawal charges and any required income tax withholding. Specifically, an amount equal to the principal payment will be deducted from the portion of the loan reserve account which earns interest at 4%, and an amount equal to the interest payment plus any applicable withdrawal charges and required income tax withholding will be deducted from the portion of the loan reserve account which earns interest at the Guaranteed Interest Rate. Amounts deducted will be reportable to the IRS and other appropriate government authorities as taxable distributions. In addition, the Participant may be subject to a 10% penalty tax on the taxable portion of the amounts deducted. The amount of the loan may not be more than (i) 80% of the total Annuity Value under the certificate, if such total Annuity Value is greater than or equal to $3,750 and less than $12,500, (ii) $10,000, if the total Annuity Value is greater than or equal to $12,500 and less than $20,000 and (iii) 50% of the total Annuity Value if the total Annuity Value is greater than or equal to $20,000, but in no event shall the loan amount exceed $50,000 less the highest outstanding loan balance under the certificate during the one year period ending the day before the effective date of the loan. The minimum loan permitted is $3,000. The total Annuity Value is the value as of the loan effective date. Only one outstanding loan is permitted at a time under a certificate and the Participant will not be permitted to get a new loan until sixty days have elapsed since the prior loan was fully repaid, including all interest due. As a condition for granting a loan, Equitable will require the Participant to represent that the loan amount requested, when aggregated with loan (principal plus interest) from all qualified Plans of the Participant's Employer, does not exceed the greater of $10,000 or 50% of the value of the Participant's non-forfeitable accrued benefits, and in no event exceeds $50,000 less the highest outstanding balance of all loans from qualified Plans during the twelve month period ending on the day before the effective date of PF 17039CT Page 2 the loan. In addition, if participation under the certificate is pursuant to terms of a Plan established by the employer, the provision of the certificate requiring spousal consent in order to receive a loan will apply if the Participant is married. Equitable may also require the Participant to elect out of Federal income tax withholding will respect to any interest and/or loan principal that would otherwise be subject to withholding. The loan term will be either (i) 5 years or (ii) 10 years, if the Participant represents that the purpose of the loan is to acquire, build or substantially rehabilitate a dwelling unit which, within a reasonable period of time, is to be used as the principal residence of the Participant. In any event, the loan term may not extend beyond the earlier of (i) the Retirement date, (ii) the date Equitable receives written notice to terminate the Participant's participation under the Contract pursuant to Section 2.06, (iii) the date Equitable pays a death benefit pursuant to Section 2.09, and (iv) any date provided for such loans by future Federal tax rules including acceleration of the loan repayment in order that the operation of the loan provisions do not adversely affect the tax treatment of the Contract. Future Federal tax rules may also impose certain additional requirements to obtain the ten year loan period described above which may apply to existing ten year loans. On the loan effective date, Equitable will transfer to a loan reserve account an amount equal to the sum of (i) the loan amount, which will earn interest at an effective annual rate of 4% during the loan term, and (ii) 25% of the loan amount, which will earn interest at the Guaranteed Interest Rate, as defined in the certificate. The Participant may specify from which Accounts these amounts are to be transferred. In the absence of direction by the Participant, of if the Participant's directions cover only part of the amount required to be transferred to the loan reserve account, Equitable will transfer the required (or additional required) amounts from each Account based on the proportion that each Account's Annuity Value bears to the total Annuity Value of all Accounts. On the first day of the third month following the effective date of the loan and quarterly thereafter (or the first business day thereafter, if such day is not a business day), interest earned at the rate of 4% annually during the prior quarter will be transferred to the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. The loan must be repaid in part on each quarterly due date and may be repaid in full at any time on or after the first loan anniversary and must include the full interest due. Any payments received will first be applied to interest due, with the balance applied towards repayment of the loan. Any partial loan repayment will result in a transfer of an amount equal to the principal repaid from (i) the portion of the loan reserve account that earns 4% to (ii) the portion of the loan reserve account that earns the Guaranteed Interest Rate. Sixty days after a partial repayment is made, the principal amount repaid will be transferred from the loan reserve account to the Fixed Income Account and may be withdrawn, transferred or annuitized as described in the certificate. No partial withdrawals or transfer from the loan reserve account may be made by the Participant. Upon full repayment of the loan by the Participant, Equitable will credit the Guaranteed Interest Rate to the full loan reserve account. Sixty days after the loan is fully repaid, any amounts remaining in the loan reserve account will be transferred to the Fixed Income Account and may be withdrawn, transferred or annuitized as described in the certificate. Upon annuitization prior to full repayment of the loan by the Participant, the Annuity Value of the Accounts maintained on behalf of such Participant will be reduced by the portion of the loan reserve account that earns interest at an effective annual rate of 4%. Upon termination of participation prior to full repayment of the loan by the Participant, Equitable will pay the Cash Value of the Accounts maintained on behalf of such Participant reduced by the portion of any loan reserve account that earns interest at an effective annual rate of 4%. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK By ---------------------------------------------- Title ------------------------------------------- Dated ------------------------------------------ At ---------------------------------------------- THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES By SPECIMEN ---------------------------------------------- President By SPECIMEN --------------------------------------------- Vice President and Secretary Date of Issue ---------------------------------- PF 17039CT Page 3 Participant: Certificate Number: [LOGO] Issue Date: Retirement Date: The Equitable Life Assurance Society of The United States Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York, New York 10116 AGREES o To allocate the Contributions made to the Contract, after deduction of any applicable taxes, to the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account or the Guaranteed Interest Account maintained for the Participant, in accordance with Sections 2.02 and 2.03, or in part to any one, as directed by the Participant. o To apply the amount in the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Guaranteed Interest Account at the Retirement Date to provide the Participant with an Annuity Benefit or a Cash Value Benefit if the Participant is then living, and o To provide the Participant with the other rights and benefits of this certificate. These agreements are subject to the provisions of this certificate. TEN DAYS TO EXAMINE CERTIFICATE - The Participant may terminate participation under the Contract and cancel this certificate by returning it to Equitable within ten days after receipt of it. Upon such cancellation, Equitable will refund any contribution made to Equitable on behalf of a Participant under the Contract, plus or minus any investment gain or loss experienced in the Participant's Stock Account, Balanced Account, Aggressive Stock Account, or Money Market Account from the date such Contribution is allocated to such Account to the date of such Cancellation. Vice President and Secretary President /s/ Rodney L. Enochs /s/ John B. Carter ASSETS HELD IN CONNECTION WITH THE CONTRACT MAY BE HELD IN SEPARATE ACCOUNTS MAINTAINED BY EQUITABLE AND MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THE CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF SEPARATE ACCOUNT A. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN SEPARATE ACCOUNT A IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.16 IS 5% OR 3 1/2%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE OF 1.75% FOR INVESTMENT MANAGEMENT, FINANCIAL ACCOUNTING, THE ANNUITY RATE GUARANTEE AND MINIMUM DEATH BENEFIT, EXPENSES AND EXPENSE RISK. BUT AFTER ANY DEDUCTIONS TO PROVIDE FOR TAXES. THIS CONTRACT MAY NOT BE SUITABLE FOR A PARTICIPANT IF THE ONLY CONTRIBUTION TO BE MADE ON SUCH PARTICIPANT'S BEHALF IS A SUBSTANTIAL SINGLE SUM CONTRIBUTION. No. 19934T Amended by PF 17007T - PF 17011T - PF 17014T Rev. 6/85 - PF 17016T - PF 17020T Contents Part I - Definitions Page 2 Part II - Participant's Account Page 7 Part III - Annuity Benefits Page 10 Part IV - General Provisions Page 13 Equitable certifies that the Participant as named on page 3 is included under the Group Annuity Contract designated on page 3 ("the Contract"), all pertinent provisions of which are set forth below. As described in Section 1.10, Equitable will determine, before the beginning of each calendar year commencing after the period for which the Initial Guaranteed Interest Rate is effective, the Yearly Guaranteed Interest Rate for the calendar year for each Class of Participants, which shall not be lower than the Minimum Guaranteed Interest Rate then in effect. Equitable, from time to time, may declare a Guaranteed Interest Rate for a Class which exceeds the applicable Yearly Guaranteed Interest Rate and a period for which such rate applies. A Guaranteed Interest Rate is subject to annual administrative charges as described in Section 2.08. This certificate is valid only if participation under the Contract has not been terminated as described in the Contract and is subject to amendment as may be required pursuant to Section 4.02. EARLY WITHDRAWAL CHARGE. If a Participant terminates participation at any time after the earliest of the following occurrences: (i) The later of (a) the attainment of age 59 years and six months or (b) the completion of five Participation Years, or (ii) the completion of 12 Participation Years, the sum of the Cash Values of the Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account as provided in Section 1.18, will be equal to the sum of the Annuity Values of each such Account. AT other times, the sum of the Cash Values of such Account. At other times, the sum of the Cash Values of such Accounts may be less than the sum of the Annuity Values as provided in Section 1.18. The Contract is issued in consideration of the payment to Equitable of the Contributions made under the Contract. The provisions on the following pages are part of this certificate. PART 1 - DEFINITIONS SECTION 1.01 EMPLOYER. The term "Employer" means (i) an educational organization employing a regular faculty which is a State, a political division of a State, or an agency or instrumentality of any one or more of the foregoing (within the meaning of Section 170(b)(1)(A)(ii) of the Code, and (ii) an organization described in Section 501(c)(3) of the Code which is exempt from Federal income tax under Section 501(c) of the Code. SECTION 1.02A AGREEMENT. The Term "Agreement" means (i) an agreement between an Employer and an employee of the Employer, within the meaning of Section 1.403(b)-1(b)(3) of the Federal income tax regulations, under which the employee agrees to accept a reduction in salary or to forego an increase in salary and to have such amounts applied under the Contract for the employee's behalf and (ii) any program or arrangement (other than by use of agreements described above) pursuant to which an Employer makes Contributions to the purchase of an Annuity meeting the requirements of Section 403(b) of the Code. SECTION 1.02B PLAN. The term "Plan" means a defined contribution pension plan established by an Employer described in clause (ii) of Section 1.01 which has been determined by the Internal Revenue Service to meet the requirements for qualification under Section 401(a) of the Code and which permits or requires amounts contributed thereunder to be applied under the Contract on behalf of employees covered under the Plan. SECTION 1.03 ANNUITY. The term "Annuity" means an annuity purchased in accordance with the terms of the Agreement or the Plan to the extent the Agreement and the annuity purchased pursuant thereto meet the requirements of Section 403(b) of the Code or the Plan meets the requirements of Section 401(a) of the Code, whichever is applicable. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Section 3.04 of the Contract. No. 19934T Amended by PF 17007T - PF 17011T - PF 17014T Rev. 6/85 - PF 17016T - PF 17020T --------- Page Two Page Four --------- DEFINITIONS (Continued) SECTION 1.05 PARTICIPANT. The term "Participant" means a person who has been enrolled by Equitable under the Contract and for whom the Employer has purchased an Annuity under the Contract. A person shall become enrolled under the Contract upon receipt by Equitable of an enrollment form made available by Equitable and completed in a manner satisfactory to Equitable. An Annuity is purchased for a person enrolled under the Contract upon receipt by Equitable of an initial Contribution by the Employer. SECTION 1.06 CONTRIBUTION. The term "Contribution" means a payment made to Equitable for a Participant with respect to an Annuity purchased for such Participant under the Contract. Equitable is under no obligation to accept any Contribution less than $20.00. SECTION 1.07 PARTICIPATION DATE. The term "Participation Date" with respect to a Participant means the date as of which Equitable has enrolled such Participant under the terms of the Contract. SECTION 1.08 PARTICIPATION YEAR. The term "Participation Year" with respect to a Participant means the twelve month period beginning on (i) the Participation Date, and (ii) each anniversary thereof, unless otherwise agreed to in writing by Equitable. SECTION 1.09 CLASS OF PARTICIPANTS. Except as provided in Section 1.10, the term "Class of Participants" refers to all Participants whose Participation Date is in the same calendar year. SECTION 1.10. GUARANTEED INTEREST RATE. For each Guaranteed Interest Account, the term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in such Account. Interest accrues daily. The Guaranteed Interest Rate will never be less than 3% per annum. Equitable will from time to time establish and make available for new Participants (i) an Initial Guaranteed Interest Rate, (ii) one or more Minimum Guaranteed Interest Rates and (iii) the applicable effective period(s) for such Rates. A new Class of Participants will be established effective with the effective date of the occurrence of (i), (ii) or (iii) above or any combination thereof. For the calendar year next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent calendar year thereafter, Equitable will determine for each established Class of Participants before the beginning of such calendar year a Yearly Guaranteed Interest Rate for such Class, which Yearly Guaranteed Interest Rate will not be lower than the Effective Minimum Guaranteed Interest Rate applicable for such Class for such year. For any established Class of Participants, Equitable reserves the right to change the Minimum Guaranteed Interest Rate and the applicable period therefor, provided that any such Minimum Guaranteed Interest Rate will not be lower than the Minimum Guaranteed Interest Rate that would have been in effect in the absence of such change. Equitable will notify each Participant in a Class in writing of the Yearly Guaranteed Interest Rate or of any change in the Minimum Guaranteed Interest Rate at least 15 days prior to its effective date. For the period (not to exceed one year) next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent period (not to exceed one year) the Equitable may determine for each established Class of Participants a Guaranteed Interest Rate for such Class which exceeds the applicable Yearly Guaranteed Interest Rate. Equitable will notify each Participant in writing of the applicable Guaranteed Interest Rate and duration. SECTION 1.11 RETIREMENT DATE. The term "Retirement Date" means the date on which the Participant is to attain the retirement age specified in the Participant's enrollment form. Before the Retirement Date the Participant may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be earlier than the Participant's 55th birthday or later than the Participant's 75th birthday. Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Home Office. SECTION 1.12 NORMAL FORM. The "Normal Form" of an Annuity Benefit under the Contract means, (i) if the Participant has a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (100% continuation), and (ii) if the Participant does not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.13 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depends is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by the Participant. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.14A LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity providing fixed monthly payments during the lifetime of the person upon whose life such payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. No. 19934T Amended by PF 17007T - PF 17011T - PF 17014T Rev. 6/85 - PF 17016T - PF 17020T --------- Page Four Page Five --------- DEFINITIONS (Continued) SECTION 1.14B ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by Equitable which extends beyond the Participant's attainment of age 59 years and six months and does not permit any prepayment of the unpaid principal prior to the participant's attainment of age 59 years and six months. SECTION 1.15 THE SEPARATE ACCOUNTS. The term "Separate Accounts" means the following separate investment accounts maintained by Equitable to which portions of its assets have been allocated for the Contract and certain other contracts: Name Investments - ---- ----------- Separate Account A Primarily common stock and other equity-type investments. Separate Account E Primarily short-term money market instruments. Separate Account J Primarily common stocks and other equity-type investments, publicly traded debt securities and short-term money market instruments. Separate Account K Primarily common stocks issued by high quality small and intermediate size companies with strong growth prospects. Equitable reserves the right to withdraw from any Separate Account and allocate to another separate account assets determined by Equitable to be associated with the class of contracts to which the Contract belongs. In any such event, to the extent practicable and permissible under applicable laws and regulations, the withdrawal shall be made by withdrawing the same percentage of each investment in the Separate Account, with appropriate adjustments to avoid odd lots and fractions. On and after the date of any such withdrawal the reference in the Contract to such Separate Account shall mean such other separate account to which the withdrawn assets were allocated. It is contemplated that investments in the Separate Accounts will, at most times, consist primarily of the types of investments indicated above. Equitable may, however, at its discretion invest the assets of any Separate Account in any investment permitted by applicable law. Equitable may rely conclusively on the opinion of counsel (including attorneys in its employ) as to what investments it is permitted by law to make. In lieu of making such investments directly, Equitable reserves the right to operate any Separate Account as a unit investment trust, or in any other form permitted by law, investing all or a part of its assets in shares or units of a fund, the investment adviser of which may be Equitable or controlled by Equitable. The fund assets would be invested as provided above with respect to the Separate Account. Equitable reserves the right: (i) to cause the registration or deregistration of any Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run any Separate Account under direction of a committee, and to discharge such committee at any time; and (iii) restrict or eliminate any voting rights of participants or other persons who have voting rights as to the Separate Accounts. Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.16. The assets of Separate Accounts are the property of Equitable; however, the portion of the assets of each Separate Account equal to the reserves and other contract liabilities with respect to such Account shall not be chargeable with liabilities arising out of any other business Equitable may conduct. Equitable reserves the right to transfer assets of the Separate Accounts in excess of such reserves and, contract liabilities to the general account of Equitable. SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS. VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business day immediately preceding such business day will constitute a Valuation Period. A business day is a day on which there is a sufficient degree of trading in the portfolio securities of a Separate Account that the New Accumulation Unit Value or New Annuity Unit Value might be materially affected by changes in the value of the portfolio securities in a Separate Account, as determined by the Separate Account Committee or, if there is no Committee, by Equitable. NET INVESTMENT FACTOR: For each Separate Account the Net Investment Factor for a Valuation Period is (a) divided by (b), minus (c), where (a) is (1) the value of the assets in the Separate Account at the close of business of the preceding Valuation Period plus (2) the investment income and the capital gains, realized or unrealized, credited to the assets of the Separate Account in the Valuation Period for which the Net Investment Factor is being determined, minus (3) the capital losses, realized or unrealized, charged against such assets in such Valuation Period, minus (4) any amount charged against the Separate Account in such Valuation Period for taxes or for amounts set aside by Equitable as a reserve for taxes attributable to the maintenance or operation of the Separate Account; No. 19934T Amended by PF 17007T - PF 17011T - PF 17014T Rev. 6/85 - PF 17016T - PF 17020T --------- Page Five Page Six --------- DEFINITIONS (Continued) (b) is the value of the assets in the Separate Account at the close of business of the preceding Valuation Period; and (c) is the daily charge, for each calendar day in such Valuation Period of .00004837 for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The value of the assets in the Separate Accounts, referred to above, shall be taken at their fair market value, or where there is no readily available market, their fair value, as determined in accordance with accepted accounting practices and applicable laws and regulations. ACCUMULATION UNIT: The Accumulation Unit is a unit used in determining the value of the interest of a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account on or before the Retirement Date. NEW ACCUMULATION UNIT VALUE: The initial New Accumulation Unit Values for the Separate Accounts have been established as follows: Account Value Date - ------- ----- ---- Separate Account A $10.00 As of November 1, 1968 Separate Account E $10.00 As of September 4, 1974 Separate Account J $10.00 As of May 1, 1984 Separate Account K $10.00 As of May 1, 1984 The new Accumulation Unit Value for each subsequent Valuation Period is the New Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such subsequent Valuation Period. ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable from the Separate Account A under a Variable Annuity Benefit. NEW ANNUITY UNIT VALUE: The initial New Annuity Value for Separate Account A has been established at $1.00 as of November 1, 1968. The Annuity Value for any subsequent Valuation Period is the New Annuity Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3 1/2%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE NEW ANNUITY VALUE: The Average Annuity Unit Value for Separate Account A for a calendar month is equal to the average of the New Annuity Unit Values for the Valuation Periods ending in such month. SECTION 1.17 ANNUITY VALUE. The term "Annuity Value" with respect to a Participant's Guaranteed Interest Account, Stock Account, Balanced Account, means the amount in such Accounts pursuant to Sections 2.02 and 2.03. SECTION 1.18 CASH VALUE. NO WITHDRAWAL CHARGE: With respect to a Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and six months, or (ii) the completion of 12 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55, completed five Participation Years, and the Cash Values are to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, the sum of the Cash Values of such Accounts equal the sum of the Annuity Values of such Accounts, less a withdrawal charge. WITHDRAWAL CHARGE: The withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% during Participation Years 1, 2, 3, 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the excess of (i) the sum of the Annuity Values of such Accounts over (ii) the Free Corridor Amount defined in Section 2.07B. (b) is the excess, if any, of (i) 8% of the total contributions made on behalf of such Participants during the current Participation Year and the preceding nine Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. The Cash Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. SECTION 1.19 CODE. The term "Code" means the Internal Revenue Code of 1954, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. No. 19934T Amended by PF 17007T - PF 17011T - PF 17014T Rev. 6/85 - PF 17016T - PF 17020T -------- Page Six Page Seven ---------- PART II - PARTICIPANT'S ACCOUNT SECTION 2.01 CONTRIBUTIONS. The Employer is to make Contributions from time to time on such dates and in such amounts as determined by the Employer pursuant to the terms of the Plan or, if the Employer has no Plan, as determined by the Employer at its sole discretion. The Employer is to specify the Participant with respect to whom each such Contribution is being made and the amount to be allocated to the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Guaranteed Interest Account. Each Contribution received by Equitable with respect to Participant will, before its allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable. A Participant may, with Equitable's agreement, transfer to the Contract any amount held with respect to such Participant under a contract meeting the requirements of Section 403(b) of the Code or under a Plan of an Employer described in clause (ii) of Section 1.01 ("Transferred Funds"). Any Transferred Funds from a contract not issued by Equitable will, before allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable. Equitable will issue to each Participant an individual certificate setting forth a statement in substance of the benefits to which such Participant is entitled under the Contract. SECTION 2.02 STOCK, BALANCED, AGGRESSIVE STOCK AND MONEY MARKET ACCOUNTS. Equitable maintains a Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the (1) Stock Account becomes part of Separate Account A, (2) Balanced Account becomes part of Separate Account J, (3) Aggressive Stock Account becomes part of Separate Account K, and (4) Money Market becomes part of Separate Account E. Any amount withdrawn from an Account will no longer be part of the applicable Separate Account. On any date when an amount is allocated to or withdrawn from an Account, the Account will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the New Accumulation Value for the appropriate Separate Account for the Valuation Period which includes that date. The number of Units in an Account on any date is equal to (i) the sum of any Accumulation Units that have been credited to the Account minus (ii) the sum of any Accumulation Units that have been charged to that Account. The amount in the Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account on any date equal to the product of (i) the number of Accumulation Units in such Account on that date and (ii) the New Accumulation Unit Value for the appropriate Separate Account for the Valuation Period which includes that date. SECTION 2.03 GUARANTEED INTEREST ACCOUNT Equitable maintains a Guaranteed Interest Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the Guaranteed Interest Account becomes part of the general assets of Equitable, which support the guarantees of the Contract and other contracts. The amount in a Guaranteed Interest Account at any time is equal to the sum of all amounts that have been allocated to such Guaranteed Interest Account pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn pursuant to Sections 2.07, 2.07A, and Section 2.08 from such Account, and transferred pursuant to Section 2.05 from such Guaranteed Interest Account, and less the sum of any annual administrative charges accrued but not made. Equitable guarantees that the amount in a Guaranteed Interest Account at any time before the Retirement Date will not be less than the sum of all amounts allocated to such Account pursuant to Section 2.04 or transferred to such Account pursuant to Section 2.05 and less the sum of all amounts that have been withdrawn from such Account pursuant to Sections 2.07 and 2.07A, and transferred from such Account pursuant to Section 2.05, all accumulated at 3% interest, compounded annually. In any Participation Year in which no Contribution is allocated to a Guaranteed Interest Account, the amount in such Account at the end of the Participation Year shall not be less than the amount in such Account at the beginning of the Participation Year plus the sum of all amounts transferred to such Account pursuant to Section 2.05 less the sum of all amounts withdrawn and transferred out of such Account pursuant to Sections 2.07, 2.07A, and Section 2.05, all accumulated at 3% interest, compounded annually. A Guaranteed Interest Account for a Participant terminates on the earliest of (i) the Retirement Date, (ii) the death of the Participant, and (iii) termination of participation pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO ACCOUNT. Each Contribution made with respect to a Participant pursuant to Section 2.01, after deduction for any applicable taxes, will be allocated, as of the date by which Equitable has received both such Contribution and direction as to its allocation, to the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account or in part to each, at the sole direction of the Participant as specified to Equitable, provided that the percentage allocated to each Account is a whole number. Any amount that a Participant has directed to be transferred to the Guaranteed Interest Account, Stock Account, Balanced Account or Aggressive Stock Account pursuant to Section 2.05 will be allocated as of the date of such transfer to the appropriate Account maintained for such Participant. Interest is allocated to the Guaranteed Interest Account at the end of each Participation Year, at the time of each transfer or withdrawal pursuant to Sections 2.05 and 2.07 and 2.07A, at the time of application of amounts in the Guaranteed Interest Account to provide Annuity Benefits, upon termination of participation pursuant to Section 2.06, and upon death of the Participant pursuant to Section 2.09. No. 19934T Amended by PF 17007T - PF 17011T - PF 17014T Rev. 6/85 - PF 17016T - PF 17020T ---------- Page Seven Page Eight ---------- PARTICIPANT'S ACCOUNT (Continued) SECTION 2.05 TRANSFERS AMONG ACCOUNTS. At any time before a Participant's Retirement Date, such Participant, upon written request, may transfer all or part of the amounts maintained for the Participant to one or more of the other Accounts maintained for such Participant as follows: (1) amounts in the Guaranteed Interest Account, Stock Account, Balanced Account and Aggressive Stock Account may be transferred among such Accounts; (2) amounts in the Money Market Account may be transferred to the other Accounts. Such transfers will be made as of the date Equitable receives such request, and will be subject to Equitable's rules in effect at the time of transfer. No transfers are permitted from the Guaranteed Interest Account, Stock Account, Balanced Account and Aggressive Stock Account maintained for the Participant to the Money Market Account. Notwithstanding the above, transfers to the Balanced Account may be prohibited by Equitable upon 30 days written notice to the Participant. SECTION 2.06 TERMINATION OF PARTICIPATION. Subject to any applicable restrictions under the terms of the Agreement or the Plan, whichever is applicable, on or before a Participant's Retirement Date, such Participant may elect by written notice to terminate participation under the Contract. Upon receipt of such notice, Equitable will determine the Cash Value, as of the date Equitable received such notice, of the Guaranteed Interest Account, Stock Account, Balanced Account and Aggressive Stock Account and Money Market Account maintained for such Participant. The payment of such Cash Value to the Participant may be deferred by Equitable in accordance with the provisions of Section 4.08. Prior to a Participant's Retirement Date, Equitable reserves the right to withdraw the Annuity Value of the Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, pay such Annuity Values and terminate such Participant's participation under the Contract. This right may be exercised with respect to the Participant only if both (i) no Contributions have been made under the Contract during the last three completed Participation Years, and (ii) the sum of such Annuity Values is $500 or less. Equitable reserves the right to terminate a Participant's participation under the Contract if at least 120 days have elapsed since the issue date shown on the certificate issued to such Participant under the Contract and no Contributions have been made under the Contract with respect to such Participant. Upon payment of such Cash Values or Annuity Values, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Cash Values or Annuity Values arose. SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under the terms of the Agreements, or the Plan, whichever is applicable, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account, and the Guaranteed Interest Account maintained for such Participant before such Participant's Retirement Date. Upon withdrawal pursuant to Section 2.07 or 2.07A, Equitable will pay the lesser of the sum of the Cash Values of such Accounts or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by such Participant. Unless instructed otherwise, the amount withdrawn (including the amount of any withdrawal charge) will be allocated between such Accounts in proportion to the Annuity Value of each such Account. Upon any payment to a Participant pursuant to Section 2.07 or 2.07A, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Payments to the Participant pursuant to Section 2.07 or 2.07A may be deferred by Equitable in accordance with the provisions of Section 4.08. Equitable is under no obligation to process any request for partial withdrawal of less than $300. If a withdrawal from the Accounts made pursuant to Section 2.07 or 2.07A would result in total Annuity Values of less than $500, Equitable will so advise the Participant and reserves the right to withdraw the Annuity Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, pay the Annuity Values of such Accounts to the Participant, and terminate such Participant's participation under the contract. SECTION 2.O7A PARTIAL WITHDRAWAL CHARGES. NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a Participant, Equitable will withdraw from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested (b) the sum of the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and six months, or (ii) the completion of 12 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55, has completed five Participation Years, and the partial withdrawal is to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. WITHDRAWAL CHARGE: There will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07B. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will be equal to the lesser of (a) or (b) where: No. 19934T Amended by PF 17007T - PF 17011T - PF 17014T Rev. 6/85 - PF 17016T - PF 17020T ---------- Page Eight Page Nine --------- PARTICIPANT'S ACCOUNT (Continued) (a) is an amount equal to 6% during Participation Years 1, 2, 3, 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the amount withdrawn (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the cumulative total of contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. SECTION 2.07B FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" with respect to a Participant who has completed three Participation Years or attained age 59 1/2 means an amount equal to the excess, if any, of (i) 10% of the sum of (a) the Annuity Values of the Stock Account, Money Market Account, Guaranteed Interest Account, Balanced Account, and Aggressive Stock Account and (b) the value of any loan reserve account, held with respect to the Participant over (ii) cumulative prior withdrawals made pursuant to Section 2.07, 2.07A, or 2.07B or pursuant to the repayment of interest or principal on a loan, in the current Participation Year with respect to the Participant. With respect to a Participant who has not completed three Participation Years or attained age 59 1/2, the Free Corridor Amount is zero. SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Participation Year before a Participant's Retirement Date, Equitable will withdraw from the Guaranteed Interest Account, Stock Account, Money Market Account, Balanced Account and Aggressive Stock Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i)(a) the Annuity Values of the Guaranteed Interest Account, Stock Account, Money Market Account, Balanced Account and Aggressive Stock Account and (b) the amount of any loan reserve account held, at the end of that Participation Year and (ii) any withdrawals made from such Accounts pursuant to Section 2.07, 2.07A, or 2.07B and from any loan reserve account, during that Participation Year. The charge will be allocated between (i) the Stock Account, (ii) Money Market Account, (iii) Balanced Account, (iv) Aggressive Stock Account and (v) the Guaranteed Interest Account and loan reserve account, in proportion to the Annuity Values of (i), (ii), (iii), (iv) and (v), at the end of the Participation Year. The portion of the charge attributable to (v) above will be first withdrawn from the Guaranteed Interest Account and then, if the Annuity Value of the Guaranteed Interest Account is not sufficient, the remaining allocation will be withdrawn from the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. The charge will be allocated between the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Guaranteed Interest Account in proportion to the Annuity Values of each such Account, at the end of the Participation Year. As of a Participant's Retirement Date and before application of the Annuity Values or Cash Values of such Participant's Account pursuant to Section 3.03, or upon termination of such Account pursuant to Section 2.06 or Section 2.09 during a Participation Year, Equitable will withdraw the administrative charge described in this Section for the applicable part of that Participation Year. SECTION 2.09 DEATH BENEFIT. If the Employer reports to Equitable, or if Equitable otherwise ascertains, that a Participant has died while Accounts for such Participant are maintained under the Contract and before such Participant's Retirement Date, Equitable, upon receipt of due proof of such death, will pay in a single sum to the beneficiary designated by such Participant to receive such payment the amount of death benefit payable with respect to such Participant. The amount of the death benefit with respect to a Participant at any time prior to the Retirement Date is equal to the greater of (i) the sum of the Annuity Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract for such Participant and (ii) the minimum death benefit with respect to such Participant. Such minimum death benefit is the sum of all Contributions made with respect to such Participant pursuant to Section 2.01 (before reduction of any applicable taxes) less an adjustment for any withdrawals made pursuant to Sections 2.07 and 2.07A from the Accounts and from any loan reserve account maintained under the Contract for such Participant. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount being withdrawn is to the Annuity Values then in the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account and amounts in the loan reserve account maintained under the Contract for such Participant. If, in accordance with the provisions of Section 2.01, the cash value of an Annuity contract issued by Equitable, which provides for a death benefit before retirement equal to the greater of the contract cash value or an alternative amount based on premiums paid or contributions made under the Annuity contract, is transferred to the Contract, such alternative amount as of the date of transfer will be included in the "sum of all Contributions" in lieu of the amount of cash value transferred, for purposes of the death benefit under the Contract. The amount of any death benefit payable with respect to a Participant will, to the extent such Account is sufficient therefore, be withdrawn from the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained with respect to such Participant under the Contract. Upon such payment, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Annuity Value arose. SECTION 2.10 LOANS. Unless otherwise restricted by the Plan, the Participant may get a loan under the certificate before the Retirement Date. The Participant's total Annuity Value (including the loan reserve account as described below) will be the sole security for the loan. A loan is effective on the first day of the month following the date the Participant's loan agreement form is approved by the Equitable. No. 19934T Amended by PF 17007T - PF 17011T - PF 17014T Rev. 6/85 - PF 17016T - PF 17020T --------- Page Nine Page Ten -------- PARTICIPANT'S ACCOUNT (Continued) The amount of the loan may not be more than (i) 80% of the total Annuity Value under the certificate, if such total Annuity Value is greater than or equal to $3,750 and less than $12,500, (ii) $10,000, if the total Annuity Value is greater than or equal to $12,500 and less than $20,000, and (iii) 50% of the total Annuity Value if the total Annuity Value is greater than $20,000, but in no event shall the loan amount exceed $50,000. The minimum loan permitted is $3,000. The total Annuity Value is the value as of the loan effective date. Only one outstanding loan is permitted at a time under a certificate and the Participant will not be permitted to get a new loan until 60 days has elapsed since the prior loan was repaid. As a condition for granting a loan, Equitable will require the Participant to represent that the loan amount requested, when aggregated with loans (principal plus interest) from all qualified plans of the Participant's Employer, does not exceed the greater of $10,000 or 50% of the value of the Participant's non-forfeitable accrued benefits, and in no event exceeds $50,000. Equitable may also require the Participant to elect out of federal income tax withholding with respect to any interest and/or loan principal that would otherwise be subject to withholding. The loan term will be either (i) 5 years or (ii) 10 years, if the Participant represents that the purpose of the loan is to acquire, build or substantially rehabilitate a dwelling unit which within a reasonable period of time is to be used by the Participant or a member of the Participant's family. In any event, the loan term may not extend beyond the earlier of (i) the Retirement Date, (ii) the date Equitable receives written notice to terminate the Participant's participation under the Contract pursuant to Section 2.06, (iii) the date Equitable pays a death benefit pursuant to Section 2.09 and (iv) any date provided for such loans by future federal tax rules. Future federal tax rules may also impose certain additional requirements to obtain the ten year loan period described above. These requirements may also apply to existing ten year loans. On the loan effective date, Equitable will transfer to a loan reserve account an amount equal to the sum of (i) the loan amount, which will earn interest at an effective annual rate of 4% during the loan term and (ii) 25% of the loan amount, which will earn interest at the Guaranteed Interest Rate, as defined in the certificate. The Participant may specify which Accounts these amounts are to be transferred from. In the absence of direction by the Participant, or if the Participant's directions cover only part of the amount required to be transferred to the loan reserve account, Equitable will transfer the required (or additional required) amounts from each Account based on the proportion that each Account's Annuity Value bears to the total Annuity Values of all Accounts. On each loan anniversary (or first business day thereafter, if the loan anniversary is not a business day), interest earned at 4% during the prior year will be transferred to the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. Equitable will charge loan interest at an effective annual rate of 6% which is due on each loan anniversary. If annual loan interest (except interest due at the end of the loan term) is not received by Equitable's Processing Office within 15 days after the due date, Equitable will deduct and treat as a partial withdrawal from the portion of the loan reserve account which earns interest at the Guaranteed Interest Rate an amount sufficient to pay the interest plus any applicable withdrawal charges and any required income tax withholding. The loan may be repaid in part on any loan anniversary, and may be repaid in full at any time on or after the first loan anniversary. However, any payments received will first be applied to interest due, with the balance applied towards repayment of the loan. Any partial loan repayment will result in a transfer of the amount repaid from (i) the portion of the loan reserve account that earns 4% to (ii) the portion of the loan reserve account that earns the Guaranteed Interest Rate. Sixty days after a partial repayment is made, the amount repaid will be transferred from the loan reserve account to the Guaranteed Interest Account and may be withdrawn, transferred, or annuitized as described in the certificate. No partial withdrawals or transfers from the loan reserve account may be made by the Participant. Upon full repayment of the loan by Participant, Equitable will credit the Guaranteed Interest Rate to the full loan reserve account. Sixty days after the loan is fully repaid, any amounts remaining in the loan reserve account will be transferred to the Guaranteed Interest Account and may be withdrawn, transferred or annuitized as described in the certificate. If the remaining loan principal and accrued interest are not paid on or prior to the end of the loan term, Equitable will deduct from the loan reserve account and treat as a partial withdrawal an amount sufficient to repay the principal and accrued interest, plus any applicable withdrawal charges and required income tax withholding. Sixty days after the end of the loan term, any amounts remaining in the loan reserve account will be transferred to the Guaranteed Interest Account and may be withdrawn, transferred or annuitized as described in the certificate. PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of Separate Account A. The amount of the first, second, and third payments under any Variable Annuity Benefit provided under the Contract with respect to a payee is the monthly amount provided with respect to the payee pursuant to Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average New Annuity Unit Value for the second calendar month immediately preceding the date of the payment. The fourth No. 19934T Amended by PF 17007T - PF 17011T - PF 17014T Rev. 6/85 - PF 17016T - PF 17020T -------- Page Ten Page Eleven ----------- ANNUITY BENEFITS (Continued) and subsequent annuity payments under a Variable Annuity Benefit will not be increased or decreased in amount because of mortality or expense experience. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the New Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of Participant's Retirement Date, provided such Participant is then living, the Annuity Values of such Participant's Guaranteed Interest Accounts, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of such Account in a single sum or (ii) to apply such Annuity Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by Equitable, as elected by the Participant, subject to Equitable's rules then in effect and any applicable requirements under the Code. Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Values of such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account. Equitable will have the right to require the Participant to furnish pertinent facts and determinations to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. Equitable may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form. The Participant may only elect an annuity form pursuant to which either (i) the Annuity Value or Cash Value, whichever is applicable, will be paid to the Participant and the Participant's beneficiary over a period not exceeding the joint lives of the Participant and the Participant's spouse or (ii) more than 50% of the Annuity Value or Cash Value, whichever is applicable, will be paid to the Participant during the Participant's Life. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If a Participant elects pursuant to the first paragraph or third paragraph of Section 3.03 to receive an Annuity Benefit in lieu of the Cash Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, the amount applied to provide the Annuity Benefit will be (i) the Annuity Values of such Accounts if the payments under the annuity form elected are contingent upon the survival of a person, or (ii) the Cash Values of such Accounts if the payments under the annuity form elected are not contingent upon the survival of a person. The amount applied to provide an Annuity Benefit shall be reduced by any applicable tax on annuity considerations, as determined by Equitable. If such amount is applied on or after the completion of five Participation Years with respect to such Participant, the balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. If the amount applied to provide an Annuity Benefit is applied before the completion of five Participation Years with respect to a Participant, the balance, after any applicable tax on annuity considerations, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained for such Participant shall terminate. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (100% continuation). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, are based on 3 1/2% interest and the 1983 Individual Annuity Mortality Table adjusted to a unisex basis based on a 50-50 split of males and females. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on the projected 1983 Basic Table adjusted to a unisex basis based on a 50-50 split of males and females and an Assumed Base Rate of Net Investment Return of 3 1/2% or 5%, whichever applies pursuant to Section 1.16. The Assumed Base Rate of Net Investment Return is 5% for certificates issued for delivery in New York. Equitable may change the monthly income amounts contained in the Tables of Guaranteed Annuity Payments and the basis for determining such amounts, for new Participants, by at least 90 days advance notice to the Contract Holder and by an amendment to the Contract. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on 3 1/2% interest and the 1983 Individual Annuity Mortality Table adjusted to a unisex basis based on a 50-50 split of males and females if such annuity form provides for a Fixed Annuity Benefit, and on the projected 1983 Basic Table adjusted to a unisex basis based on a 50-50 split of males and females and an Assumed Base Rate of Net Investment Income Return of 5% or 3 1/2%, whichever applies pursuant to Section 1.16 if such annuity form provides for a Variable Annuity Benefit. No. 19934T Amended by PF 17007T - PF 17011T - PF 17014T Rev. 6/85 - PF 17016T - PF 17020T ----------- Page Eleven Page Twelve ----------- ANNUITY BENEFITS (CONTINUED) SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payable under the Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by Equitable will be charged against and underpayments will be added to any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may make the payments (in the case of a minor, at a rate not exceeding $50 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If an annuity form made available by Equitable provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Upon election by a Participant pursuant to Section 3.03 of an annuity form providing payments for a period certain, such Participant may designate (with the right to change such designation) a person or persons to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's executors or administrators in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, Equitable will pay in a single sum to such payee's executors or administrators the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. Equitable will require satisfactory evidence of the age of any person upon whose life an annuity form depends.
TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Value) - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ---------- Age 60 61 62 63 64 65 66 67 68 69 70 - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ---------- 60 4.54 4.58 4.62 4.66 4.70 4.74 4.77 4.81 4.84 4.88 4.91 61 4.62 4.67 4.71 4.76 4.81 4.84 4.88 4.91 4.95 4.99 62 4.72 4.67 4.81 4.85 4.90 4.94 4.98 5.02 5.06 63 4.81 4.86 4.91 4.96 5.01 5.06 5.10 5.14 64 4.92 4.97 5.02 5.08 5.13 5.17 5.22 65 5.03 5.09 5.15 5.20 5.26 5.31 66 5.15 5.21 5.27 5.33 5.39 67 5.28 5.34 5.40 5.47 68 5.41 5.48 5.55 69 5.56 5.63 70 5.71
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3 1/2 % (Minimum Monthly Income per $1,000 of Annuity Value) - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ---------- Age 60 61 62 63 64 65 66 67 68 69 70 - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ---------- 60 4.40 4.44 4.48 4.51 4.55 4.58 4.61 4.65 4.68 4.71 4.74 61 4.48 4.52 4.56 4.60 4.64 4.67 4.71 4.74 4.78 4.81 62 4.56 4.60 4.65 4.69 4.73 4.77 4.80 4.84 4.88 63 4.65 4.69 4.74 4.78 4.83 4.87 4.91 4.95 64 4.74 4.79 4.84 4.89 4.93 4.98 5.02 65 4.85 4.90 4.95 5.00 5.05 5.10 66 4.95 5.01 5.06 5.11 5.17 67 5.07 5.12 5.18 5.24 68 5.19 5.25 5.32 69 5.32 5.39 70 5.46
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3 1/2 % (Minimum Monthly Income per $1,000 of Annuity Value) - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ---------- Age 60 61 62 63 64 65 66 67 68 69 70 - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ---------- 60 5.27 5.30 5.34 5.37 5.41 5.44 5.47 5.51 5.54 5.57 5.59 61 5.34 5.38 5.42 5.46 5.49 5.53 5.57 5.60 5.63 5.66 62 5.42 5.46 5.50 5.54 5.58 5.62 5.65 5.69 5.73 63 5.50 5.55 5.59 5.63 5.67 5.71 5.75 5.79 64 5.59 5.64 5.69 5.73 5.78 5.82 5.86 65 5.69 5.74 5.79 5.84 5.89 5.93 66 5.79 5.85 5.90 5.95 6.00 67 5.90 5.96 6.02 6.08 68 6.02 6.08 6.15 69 6.15 6.22 70 6.29
No. 19934T Amended by PF 17007T - PF 17011T - PF 17014T Rev. 6/85 - PF 17016T - PF 17020T ----------- Page Twelve Page Thirteen ------------- ANNUITY BENEFITS (CONTINUED)
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) VARIABLE ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET AGE FIXED ANNUITY BENEFIT INVESTMENT RETURN IS - --- --------------------- ---------------------------- 3 1/2% 5% ------ -- 60 5.29 5.08 5.97 61 5.41 5.19 6.08 62 5.55 5.31 6.20 63 5.69 5.44 6.33 64 5.85 5.58 6.46 65 6.01 5.73 6.61 66 6.19 5.89 6.77 67 6.37 6.06 6.94 68 6.58 6.24 7.12 69 6.79 6.43 7.31 70 7.02 6.64 7.52
Equitable will notify the payee under a Variable Annuity Benefit of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each variable payment. Any election, change, revocation or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a commutation right under an Annuity Benefit is exercised, Equitable may defer payment in accordance with Section 4.08. PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT. The Contract constitutes the entire Contract between the parties and the provisions of the Contract alone will govern with respect to the rights and obligations of Equitable. The provisions of the Contract will be applied separately with respect to each Participant. Nothing in the enrollment form referred to in Section 1.05, the Plan or trust agreement referred to in Section 4.10 nor any modification, amendment, or supplement to any such documents will in any way be construed to enlarge, change, vary or in any other way affect the obligations of Equitable as expressly provided in the Contract. The Contract may not be modified as to Equitable, nor may any of Equitable's rights or requirements be waived, except in writing and by an authorized officer of Equitable. The Contract may be changed by amendment or replacement upon agreement between the Contract Holder and Equitable without the consent of any other person provided that such change does not reduce any Annuity Benefit provided before such change and provided that no rights, privileges or benefits which have accrued to any Participant under the Contract may be reduced or forfeited except by the express consent of such Participant. SECTION 4.02 STATUTORY COMPLIANCE. Equitable reserves the right to amend the Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the Contract and any certificate to reflect changes in the Code, or in regulations or published rulings of the Internal Revenue Service so that each such certificate will continue to be an Annuity. Any Annuity Benefit, Cash Value or death benefit available under a certificate issued pursuant to the Contract shall not be less than the minimum benefits required by any statute of the state in which the certificate is delivered. SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY. The entire interest of any Participant under the Contract is nonforfeitable. No interest of a Participant under the Contract may be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than Equitable. No amount payable under the Contract may be assigned, commuted, or encumbered by the payee, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. SECTION 4.04 PARTICIPATION IN SURPLUS. The Contract and all other contracts in the same class of contracts shall be combined for the purpose of ascertaining the annual surplus of Equitable to be apportioned to said contracts as a dividend and the portion of any such dividend that is to be allocated to the Contract shall be determined by Equitable. The participation of this class of contracts in annual surplus is, however, expected to be minimal. Any amount so allocated to the Contract shall be payable as of January 1 of the calendar year in which a dividend is apportioned and will be payable in cash and shall be equitably allocated by Equitable to the Guaranteed Interest Accounts maintained hereunder for Participants. No Annuity Benefit will enter into the determination of any surplus to be apportioned to the Contract as a dividend. SECTION 4.05 BENEFICIARY. Each Participant, as of such Participant's Participation Date, is to provide Equitable with an initial designation of the beneficiary entitled to receive any death benefit payable with respect to such Participant pursuant to Section 2.09. The Participant may change such designation from time to time during such Participant's lifetime and while Accounts for such Participants are being maintained hereunder. Any such designation or No. 19934T Amended by PF 17007T - PT 17011T - PF 17014T Rev. 6/85 - PF 17016T - PF 17020T Page Thirteen ------------- Page Fourteen ------------- GENERAL PROVISIONS (Continued) change will be made by written notice in a form satisfactory to Equitable. A change will, upon receipt at a designated Equitable Office, take effect as of the time the written notice was signed, whether or not the Participant is living on the date of receipt, but without further liability as to any payment or other settlement made by Equitable before receipt of such change. Unless otherwise specified in the designation, if a Participant has designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive the Participant, and if more than one survive they will share equally. Any part of a death benefit payable with respect to a Participant pursuant to Section 2.09 for which there is no designated beneficiary living at the death of the Participant will be payable in a single sum to the children of the Participant who survive the Participant, in equal shares, or should none survive, then to the Participant's executors or administrators. If a Participant so elects in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by the Participant, with respect to the beneficiary, subject to Equitable's rules then in effect. If at the death of a Participant there is to election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. SECTION 4.06 DISQUALIFICATION. In the event that an annuity purchased hereunder with respect to a Participant fails to qualify as an Annuity as described in Section 1.03, Equitable shall have the right, upon receiving notice of such fact before the Retirement Date, to terminate participation with respect to such Participant under the Contract and pay to such Participant the amount in the Account maintained with respect to such Participant less a deduction for the appropriate part attributable to such Participant of any Federal income tax payable by Equitable which would not have been payable if such Participant had an Annuity under the Contract. SECTION 4.07 FUTURE PARTICIPANTS. Equitable reserves the right at its sole discretion to curtail or prohibit further enrollment as Participants under the Contract of any individuals who are not currently participating under the Contract as of such date of curtailment or prohibition. SECTION 4.08 DEFERMENT. Payments by Equitable from the Participant's Guaranteed Interest Account pursuant to the provisions of Section 2.06, Sections 2.07 and 2.07A, and Section 2.09, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.05, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. Interest at the current Guaranteed Interest Rate for such Participant's Guaranteed Interest Account will be allowed on any such payment deferred for 30 days or more. Except as provided in this Section, payments by Equitable from the Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account pursuant to the provisions of Section 2.06, Sections 2.07 and 2.07A, and Section 2.09, or any commuted payments arising from a Variable Annuity Benefit pursuant to Section 3.05, will be made within seven days after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. During any period when (i) the sale of securities or the determination of the New Accumulation Unit Value or the Average New Annuity Unit Value is not reasonably practicable because an emergency, defined by the Securities and Exchange Commission, exists, or the New York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may by order permit postponement for the protection of persons having interests in the Separate Accounts, Equitable reserves the right: (a) to defer determination of Cash Values or Annuity Values and payment of Cash Values and Annuity Values, arising from an amount in a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (b) to defer payment of any portion of the death benefit arising from an amount in a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (c) to defer the payment of any Variable Annuity Benefit under the Contract or the application of any such Benefit to provide for any other payment called for by the Contract; or (d) in the event of (a) above, to defer application of such amounts to provide any Annuity Benefit permitted under the Contract. SECTION 4.09 ANNUAL NOTICE. At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Guaranteed Interest Account, (2) the total number of Accumulation Units credited to the Stock Account, Balanced Account, Aggressive Stock Account an Money Market Account, (3) the New Accumulation Unit Values, (4) the sum of the Cash Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account and (5) the amount of death benefit payable with respect to the Participant. After the Retirement Date Equitable will notify the Participant of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.10 CONTRACT HOLDER RESPONSIBILITY. The sole responsibility of the Contract Holder is to serve as party to the Contract. The Contract Holder will have no responsibility for the administration of any Plan or Agreement, for payments to the Guaranteed Interest Account, Stock Account, Balanced Account, No. 19934T Amended by PF 17007T - PF17011T - PF 17014T Rev. 6/85 - PF 17016T - PF 17020T ------------- Page Fourteen Page Fifteen ------------- GENERAL PROVISIONS (Continued) Aggressive Stock Account or Money Market Account, or any payments or other distributions hereunder. Equitable will deal with the Contract Holder in accordance with the terms and conditions of the trust agreement pursuant to which the Contract Holder agreed to act as such and with the Contract and in such manner as the Contract Holder and Equitable may agree, without the consent of any other person. Any Employer making Contributions under the Contract shall be deemed to have adopted and accepted the trust agreement as part of the Plan or Agreement with respect to which such Contributions are made. SECTION 4.11 AGE. If the Annuitant's age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by Equitable will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. This certificate was approved by the New York Insurance Department under an accelerated procedure to assist employers in complying with the United States Supreme Court decision in Arizona v. Norris. The Department has reserved the right to require changes to comply with applicable New York Law and regulations. No. 19934T Amended by PF 17007T - PF 17011T - PF 17014T Rev. 6/85 - PF 17016T - PF 17020T ------------- Page Fifteen THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective January 1, 1987, or your Participation Date, whichever is the later, your Certificate issued under Group Annuity Contract No. 11930CT is amended as follows: 1. SECTION 1.11 RETIREMENT DATE is replaced by the following: SECTION 1.11 RETIREMENT DATE. The term "Retirement Date" means the date on which the Participant attains the retirement age specified in the Participant's enrollment form, subject to the terms of the Plan or Agreement, if applicable. Before the Retirement Date, the Participant may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th or 31st day of any month), subject to the terms of the Plan or Agreement, if applicable. Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Home Office. No Retirement Date shall be earlier than the Participant's 55th birthday or later than the date specified in the Code. 2. The new section, SECTION 1.11B REQUIRED DISTRIBUTIONS is added following SECTION 1.11A: SECTION 1.11B REQUIRED DISTRIBUTIONS. Notwithstanding any provisions to the contrary, distributions from the certificate must commence as of (i) the age specified by the Code, or (ii) for benefits accrued prior to January 1, 1987, no later than attainment of age 75. If payments have not begun prior to the first Participation Year following the Participant's attainment of age 70, the Participant will be notified regarding the minimum distribution required under the Code. 3. SECTION 1.19 CODE is replaced by the following: SECTION 1.19 CODE. The term "Code" means the Tax Reform Act of 1986, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. 4. SECTION 2.10 LOANS is replaced by the following: SECTION 2.10A LOANS ESTABLISHED PRIOR TO JANUARY 1, 1987. Unless otherwise restricted by the Plan, the Participant may get a loan under the certificate before the Retirement Date. The Participant's total Annuity Value (including the loan reserve account as described below) will be the sole security for the loan. A loan is effective on the first day of the month following the date the Participant's loan agreement form is approved by Equitable. The amount of the loan may not be more than (i) 80% of the total Annuity Value under the certificate, if such total Annuity Value is greater than or equal to $3,750 and less than $12,500, (ii) $10,000, if the total Annuity Value is greater than or equal to $12,500 and less than $20,000 and (iii) 50% of the total Annuity Value if the total Annuity Value is greater than or equal to $20,000, but in no event shall the loan amount exceed $50,000 less the highest outstanding loan balance under the certificate during the one year period ending the day before the effective date of the loan. The minimum loan permitted is $3,000. The total Annuity Value is the value as of the loan effective date. Only one outstanding loan is permitted at a time under a certificate and the Participant will not be permitted to get a new loan until sixty days have elapsed since the prior loan, including all interest due, was repaid. As a condition for granting a loan, Equitable will require the Participant to represent that the loan amount requested, when aggregated with loans (principal plus interest) from all qualified plans of the Participant's Employer, does not exceed the greater of $10,000 or 50% of the value of the Participant's non-forfeitable accrued benefits, and in no event exceeds $50,000. Equitable may also require the Participant to elect out of Federal income tax withholding with respect to any interest and/or loan principal that would otherwise be subject to withholding. The loan term will be either (i) 5 years or (ii) 10 years, if the Participant represents that the purpose of the loan is to acquire, build or substantially rehabilitate a dwelling unit which, within a reasonable period of time, is to be used by the Participant or a member of the Participant's family. In any event, the loan term may not extend beyond the earlier of (i) the Retirement Date, (ii) the date Equitable receives written notice to terminate the Participant's participation under the Contract pursuant to Section 2.06, (iii) the date Equitable pays a death benefit pursuant to Section 2.09, and (iv) any date provided for such loans by future Federal tax rules. Future Federal tax rules may also impose certain additional requirements to obtain the ten year loan period described above. These requirements may also apply to existing ten year loans. On the loan effective date, Equitable will transfer to a loan reserve account an amount equal to the sum of (i) the loan amount, which will earn interest at an effective annual rate of 4% during the loan term, and (ii) 25% of the loan amount, which will earn interest at the Guaranteed Interest Rate, as defined in the certificate. The Participant may specify which Accounts these amounts are to be transferred from. In the absence of direction by the Participant, or if the Participant's directions cover only part of the amount required to be transferred to the loan reserve account, Equitable will transfer the required (or additional required) amounts from each Account based on the proportion that each Account's Annuity Value bears to the total Annuity Value of all Accounts. On each loan anniversary (or first business day thereafter, if the loan anniversary is not a business day), interest earned at 4% during the prior year will be transferred to the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. PF 17039T Page 1 Equitable will charge loan interest at an effective annual rate of 6% which is due on each loan anniversary. If annual loan interest (except interest due at the end of the loan term) is not received by Equitable's Processing Office within fifteen days after the due date, Equitable will deduct and treat as a partial withdrawal from the portion of the loan reserve account which earns interest at the Guaranteed Interest Rate an amount sufficient to pay the interest plus any applicable withdrawal charges and any required income tax withholding. The loan may be repaid in part on any loan anniversary, and may be repaid in full at any time on or after the first loan anniversary. However, any payments received will first be applied to interest due, with the balance applied towards repayment of the loan. Any partial loan repayment will result in a transfer of the amount repaid from (i) the portion of the loan reserve account that earns 4% to (ii) the portion of the loan reserve account that earns the Guaranteed Interest Rate. Sixty days after a partial repayment is made, the amount repaid will be transferred from the loan reserve account to the Guaranteed Interest Account and may be withdrawn, transferred, or annuitized as described in the certificate. No partial withdrawals or transfers from the loan reserve account may be made by the Participant. Upon full repayment of the loan by the Participant, Equitable will credit the Guaranteed Interest Rate to the full loan reserve account. Sixty days after the loan is fully repaid, any amounts remaining in the loan reserve account will be transferred to the Guaranteed Interest Account and may be withdrawn, transferred or annuitized as described in the certificate. If the remaining loan principal and accrued interest are not paid on or prior to the end of the loan term, Equitable will deduct from the loan reserve account and treat as a partial withdrawal an amount sufficient to repay the principal and accrued interest, plus any applicable withdrawal charges and required income tax withholding. Sixty days after the end of the loan term, any amounts remaining in the loan reserve account will be transferred to the Guaranteed Interest Account and may be withdrawn, transferred or annuitized as described in the certificate. Upon annuitization prior to full repayment of the loan by the Participant, the Annuity Value of the Accounts maintained on behalf of such Participant will be reduced by the portion of the loan reserve account that earns interest at an effective annual rate of 4%. Upon termination of participation prior to full repayment of the loan by the Participant, Equitable will pay the Cash Value of the Accounts maintained on behalf of such Participant reduced by the portion of any loan reserve account that earns interest at an effective annual rate of 4%. 5. The new section, SECTION 2.10B LOANS ESTABLISHED JANUARY 1, 1987 OR LATER is added following SECTION 2.10A LOANS ESTABLISHED PRIOR TO JANUARY 1, 1987: SECTION 2.10B LOANS ESTABLISHED JANUARY 1, 1987 OR LATER. Unless otherwise restricted by the Plan, Agreement or the Code, the Participant may get a loan under the certificate before the Retirement Date. However, future restrictions in the Code may require revision or withdrawal of the loan provisions as provided below. The Participant's total Annuity Value (including the loan reserve account as described below) will be the sole security for the loan. A loan is effective on the first day of the month following the date the Participant's loan agreement form is approved by Equitable. Beginning the first day of the third month following the effective date of the loan and quarterly on the first day of the month thereafter, loan payments must be made to Equitable. Such payments will be equal to the sum of (a) and (b) where (a) is the loan interest, calculated at an effective annual rate of 6%, and (b) is an amortized portion of loan principal. By each due date, if the amount of the loan payment is less than the amount due or the loan payment is not received at Equitable's Processing Office, Equitable will deduct and treat as a partial withdrawal from the loan reserve account an amount equal to the interest and principal payments due plus any applicable withdrawal charges and any required income tax withholding. Specifically, an amount equal to the principal payment will be deducted from the portion of the loan reserve account which earns interest at 4%, and an amount equal to the interest payment plus any applicable withdrawal charges and required income tax withholding will be deducted from the portion of the loan reserve account which earns interest at the Guaranteed Interest Rate. Amounts deducted will be reportable to the IRS and other appropriate government authorities as taxable distributions. In addition, the Participant may be subject to a 10% penalty tax on the taxable portion of the amounts deducted. The amount of the loan may not be more than (i) 80% of the total Annuity Value under the certificate, if such total Annuity Value is greater than or equal to $3,750 and less than $12,500, (ii) $10,000, if the total Annuity Value is greater than or equal to $12,500 and less than $20,000 and (iii) 50% of the total Annuity Value if the total Annuity Value is greater than or equal to $20,000, but in no event shall the loan amount exceed $50,000 less the highest outstanding loan balance under the certificate during the one year period ending the day before the effective date of the loan. The minimum loan permitted is $3,000. The total Annuity Value is the value as of the loan effective date. Only one outstanding loan is permitted at a time under a certificate and the Participant will not be permitted to get a new loan until sixty days have elapsed since the prior loan was fully repaid, including all interest due. As a condition for granting a loan, Equitable will require the Participant to represent that the loan amount requested, when aggregated with loans (principal plus interest) from all qualified Plans of the Participant's Employer, does not exceed the greater of $10,000 or 50% of the value of the Participant's non-forfeitable accrued benefits, and in no event exceeds $50,000 less the highest outstanding balance of all loans from qualified Plans during the twelve month period ending on the day before the effective date of the loan. In addition, if participation under the certificate is pursuant to terms of a Plan established by the PF 17039T Page 2 employer, the provisions of the certificate requiring spousal consent in order to receive a loan will apply if the Participant is married. Equitable may also require the Participant to elect out of Federal income tax withholding with respect to any interest and/or loan principal that would otherwise be subject to withholding. The loan term will be either (i) 5 years or (ii) 10 years, if the Participant represents that the purpose of the loan is to acquire, build or substantially rehabilitate a dwelling unit which, within a reasonable period of time, is to be used as the principal residence of the Participant. In any event, the loan term may not extend beyond the earlier of (i) the Retirement Date, (ii) the date Equitable receives written notice to terminate the Participant's participation under the Contract pursuant to Section 2.06, (iii) the date Equitable pays a death benefit pursuant to Section 2.09, and (iv) any date provided for such loans by future Federal tax rules including acceleration of the loan repayment in order that the operation of the loan provisions do not adversely affect the tax treatment of the Contract. Future Federal tax rules may also impose certain additional requirements to obtain the ten year loan period described above which may apply to existing ten year loans. On the loan effective date, Equitable will transfer to a loan reserve account an amount equal to the sum of (i) the loan amount, which will earn interest at an effective annual rate of 4% during the loan term and (ii) 25% of the loan amount, which will earn interest at the Guaranteed Interest Rate, as defined in the certificate. The Participant may specify from which Accounts these amounts are to be transferred. In the absence of direction by the Participant, or if the Participant's directions cover only part of the amount required to be transferred to the loan reserve account, Equitable will transfer the required (or additional required) amounts from each Account based on the proportion that each Account's Annuity Value bears to the total Annuity Value of all Accounts. On the first day of the third month following the effective date of the loan and quarterly thereafter (or the first business day thereafter, if such day is not a business day), interest earned at the rate of 4% annually during the prior quarter will be transferred to the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. The loan must be repaid in part on each quarterly due date and may be repaid in full at any time on or after the first loan anniversary and must include the full interest due. Any payments received will first be applied to interest due, with the balance applied towards repayment of the loan. Any partial loan repayment will result in a transfer of an amount equal to the principal repaid from (i) the portion of the loan reserve account that earns 4% to (ii) the portion of the loan reserve account that earns the Guaranteed Interest Rate. Sixty days after a partial repayment is made, the principal amount repaid will be transferred from the loan reserve account to the Fixed Income Account and may be withdrawn, transferred or annuitized as described in the certificate. No partial withdrawals or transfers from the loan reserve account may be made by the Participant. Upon full repayment of the loan by the Participant, Equitable will credit the Guaranteed Interest Rate to the full loan reserve account. Sixty days after the loan is fully repaid, any amounts remaining in the loan reserve account will be transferred to the Fixed Income Account and may be withdrawn, transferred or annuitized as described in the certificate. Upon annuitization prior to full repayment of the loan by the Participant, the Annuity Value of the Accounts maintained on behalf of such Participant will be reduced by the portion of the loan reserve account that earns interest at an effective annual rate of 4%. Upon termination of participation prior to full repayment of the loan by the Participant, Equitable will pay the Cash Value of the Accounts maintained on behalf of such Participant reduced by the portion of any loan reserve account that earns interest at an effective annual rate of 4%. VICE PRESIDENT SPECIMEN AND SECRETARY SPECIMEN PRESIDENT PF 17039T Page 3 THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES For Participants covered under Plans issued in conjunction with optional retirement programs or Plans adopted by universities effective on your Participation Date, we have amended your Certificate issued under Group Annuity Contract No. 11930CT as follows: 1. With respect to PART I-- DEFINITIONS, SECTION 1.18 CASH VALUE is replaced by the following section: SECTION 1.18 CASH VALUE. No Withdrawal Charge: With respect to a Participant, when withdrawals are permitted under Section 2.07, the term "Cash Value" means an amount equal to the Annuity Account Value less any outstanding loan after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 1/2 years, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase an Eligible Annuity Certain, defined in Section 1.14B or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such annuity is at least ten years. At other times, the Cash Value equals the Annuity Account Value less any outstanding loan and less a withdrawal charge. Withdrawal Charge: When withdrawals are permitted under Section 2.07, the withdrawal charge equals the lesser of (a) or (b) where; (a) equals 6% during Participation Years 1, 2, 3, 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the excess of (i) the sum of the Annuity Account Value over (ii) the Free Corridor Amount defined in Section 2.07. (b) in the excess, if any, of (i) 8% of the total Contributions made on behalf of such Participant during the current Participation Year and the preceding nine Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. 2. With respect to PART II -- PARTICIPANT'S ACCOUNT, SECTION 2.07 PARTIAL WITHDRAWALS, the first paragraph is amended to read as follows: SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under the terms of the Agreement or the Plan, which ever is applicable, or to applicable laws and regulations, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Divisions before such Participant's Retirement Date. 3. With respect to PART II -- PARTICIPANT'S ACCOUNT, SECTION 2.07A PARTIAL WITHDRAWAL CHARGES is replaced by the following: PF 17041T-U NO WITHDRAWAL CHARGE: When and to the extent withdrawals are permitted under Section 2.07, there will be no partial withdrawal charge if (a) the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07B or (b) the Cash Value is equal to the Annuity Account Value less any outstanding loan, pursuant to Section 1.18. WITHDRAWAL CHARGE: When and to the exert withdrawals are permitted under Section 2.07, if the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Divisions an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a partial withdrawal charge. Such partial withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Participation Years 1, 2, 3, 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the amount withdrawn in excess of the Free Corridor Amount (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the total Contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to this Section. 4. With respect to PART II -- PARTICIPANT'S ACCOUNT, SECTION 2.10A LOANS ESTABLISHED PRIOR TO JANUARY 1, 1987, the first sentence is amended to read as follows: The Participant is eligible for a loan under the Contract before the Retirement Date, if permitted by the Plan or Agreement and if not restricted by applicable laws and regulations. 5. With respect to PART II -- PARTICIPANT'S ACCOUNT, SECTION 2.10B LOANS ESTABLISHED JANUARY 1, 1987 OR LATER, the first sentence is amended to read as follows: The Participant is eligible for a loan under the Contract before the Retirement Date, if permitted by the Plan or Agreement and if not restricted by applicable laws and regulations. 6. With respect to PART III -- ANNUITY BENEFITS, SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS, the first, second and third paragraphs are amended to read as follows: SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Account Value less any outstanding loan shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of the certificate in a single sum, if such election is permitted by the Plan or Agreement, (ii) to receive not more than a specific percentage or dollar amount of the Cash Value of the certificate in a single sum (if permitted by the Plan or Agreement) and to apply the remainder of the Cash Value to provide an Annuity Benefit on any annuity form offered by Equitable, as elected by the Participant, subject to Equitable's rules then in effect and any applicable requirements under the Code, if such election is permitted by the Plan or Agreement or (iii) to apply such Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by Equitable and permitted by the Plan or Agreement, as elected by the Participant, subject to Equitable's rules then in effect and any other applicable requirements under the Code. A Participant can elect to divide the applicable value between a partial sum payment and an annuity form, if such election is in accordance with the Plan or Agreement. PF 17041T-U Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Value. VICE PRESIDENT SPECIMEN AND SECRETARY SPECIMEN PRESIDENT PF 17041T-U THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES For Participants covered under Plans issued in conjunction with optional retirement programs or Plans adopted by universities, effective on your Participation Date, we have amended your Certificate issued under Group Annuity Contract No. 11930CT as follows: 1. With respect to PART I - DEFINITIONS, SECTION 1.18 CASH VALUE is replaced by the following section: SECTION 1.18 CASH VALUE. NO WITHDRAWAL CHARGE: With respect to a Participant, when withdrawals are permitted under Section 2.07, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 1/2 years, or (ii) the completion of 12 Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form providing for the application of the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of properly completed settlement election form providing for the application of the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such annuity is at least ten years. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. WITHDRAWAL CHARGE: When withdrawals are permitted under Section 2.07, the withdrawal charge equals the lesser of (a) or (b) where; (a) equals 6% during Participation Years 1, 2, 3, 4 and 5 5% during Participation Years 6,7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the excess of (i) the sum of the Annuity Values of such Accounts over (ii) the Free Corridor Amount defined in Section 2.07B. (b) is the excess, if any, of (i) 8% of the total contributions made on behalf of such Participant during the current Participation Year and the preceding nine Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. The Cash Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. 2. With respect to PART II - PARTICIPANT'S ACCOUNT, SECTION 2.07 PARTIAL WITHDRAWALS, the first paragraph is amended to read as follows: SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under the terms of the Agreement or the Plan, whichever is applicable, or to applicable laws and regulations, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Guaranteed Interest Account maintained for such Participant before such Participant's Retirement Date. PF17037T-U 3. With respect to PART II - PARTICIPANT'S ACCOUNT, SECTION 2.07A PARTIAL WITHDRAWAL CHARGES is replaced by the following: NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a Participant, when and to the extent withdrawals are permitted under Section 2.07, Equitable will withdraw from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 1/2 years, or (ii) the completion of 12 Participation Years with respect to such Participant, or (iii) the Participant attainment of age 55, the completion of five Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form providing for the application of the Annuity Values to purchase and Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form providing for the application of the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such annuity is at least ten years. At all other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less the applicable withdrawal charge. 4. With respect to PART II - PARTICIPANT'S ACCOUNT, SECTION 2.07A PARTIAL WITHDRAWAL CHARGES, the third paragraph is amended to read as follows: If the amount of the partial withdrawal requested is greater than the Free Corridor Amount, Equitable will, when and to the extent withdrawals are permitted under Section 2.07, (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equals to 6% during Participation Years 1, 2, 3, 4 and 5 5% during Participation Years 6,7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the amount withdrawn (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the total Contributions made on behalf of such Participant during the current Participation Year and the preceding nine Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to this Section. 5. With respect to PART II - PARTICIPANT'S ACCOUNT, SECTION 2.10 LOANS, the first sentence is amended to read as follows: The Participant is eligible for a loan under the Contract before the Retirement Date, if permitted by the Plan or Agreement and if not restricted by applicable laws and regulations. 6. With respect to PART III - ANNUITY BENEFITS, SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS, the first, second and third paragraphs are amended to read as follows: PF 17037T-U SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Values of such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of such Accounts in a single sum, if such election is permitted by the Plan or Agreement, (ii) to receive not more than a specific percentage or dollar amount of the Cash Value of such Accounts in a single sum (if permitted by the Plan or Agreement) and to apply the remainder of the Cash Value to provide an Annuity Benefit on any annuity form offered by Equitable, as elected by the Participant, subject to Equitable's rules then in effect and any applicable requirements under the Code, if such election is permitted by the Plan or Agreement or (iii) to apply such Annuity Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by Equitable and permitted by the Plan or Agreement, as elected by the Participant, subject to Equitable's rules then in effect and any applicable requirements under the Code. A Participant can elect to divide the applicable value between a partial sum payment and an annuity form, if such election is in accordance with the Plan or Agreement. Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Value of such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, unless such election is restricted by the Plan. Vice President SPECIMEN and Secretary SPECIMEN President PF 17037T-U THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective July 1, 1986, or your Participation Date, whichever is the later, we have amended your Certificate issued under Group Annuity Contract No. 11930CT as follows: 1. With respect to PART 1 -- DEFINITIONS, the following section is added: SECTION 1.14C PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by Equitable which does not permit any prepayment of the unpaid principal. 2. With respect to SECTION 1.18 CASH VALUE, the following text replaces the paragraphs under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to a Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such Annuity is at least ten years. At all other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. 3. With respect to SECTION 2.07A PARTIAL WITHDRAWAL CHARGES, the following paragraph replaces the paragraph under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a Participant, Equitable will withdraw from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such Annuity is at least ten years. At all other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. Vice President SPECIMEN and Secretary SPECIMEN President PF 17036T The Equitable Life Assurance Society Of The United States Effective July 1, 1986, or your Participation Date, whichever is the later, your Certificate issued under Group Annuity Contract No. 11930CT is amended as follows: With respect to Section 2.08 ANNUAL ADMINISTRATIVE CHARGE, the first paragraph is replaced by the following paragraph: As of the last day of each Participation Year before a Participant's Retirement Date, Equitable will withdraw from the Guaranteed Interest Account, Stock Account, Money Market Account, Balanced Account and Aggressive Stock Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) (a) the Annuity Values of the Guaranteed Interest Account, Stock Account, Money Market Account, Balanced Account and Aggressive Stock Account and (b) the amount of any loan reserve account held, at the end of the Participation Year and (ii) any withdrawals made from such Accounts pursuant to Section 2.07, 2.07A or 2.07B and from any loan reserve account, during that Participation Year. The charge will be allocated between (i) the Stock Account, (ii) Money Market Account, (iii) Balanced Account, (iv) Aggressive Stock Account and (v) the Guaranteed Interest Account and loan reserve account, in proportion to the Annuity Values of (i), (ii), (iii), (iv), and (v), at the end of the Participation Year. The portion of the charge attributable to (v) above will be first withdrawn from the Guaranteed Interest Account and then, if the Annuity Value of the Guaranteed Interest Account is not sufficient, the remaining allocation will be withdrawn from the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. Vice President SPECIMEN and Secretary SPECIMEN President PF 17032T THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Your certificate issued under Group Annuity Contract No. 11930CT is amended as follows: With respect to the language on the front page, the following statement is deleted: "THIS CONTRACT MAY NOT BE SUITABLE FOR A PARTICIPANT IF THE ONLY CONTRIBUTION TO BE MADE ON SUCH PARTICIPANT'S BEHALF IS A SUBSTANTIAL SINGLE SUM CONTRIBUTION." VICE PRESIDENT SPECIMEN AND SECRETARY SPECIMEN PRESIDENT PF17029T THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective as of January 1, 1985 or your Participation Date, whichever is later, we have amended the Certificate issued under Group Annuity Contract 11930CT as follows: 1. Section 1.02B entitled "Plan" is amended to read as follows: "The term "Plan" means a program established by an Employer described in clause (ii) of Section 1.01, for the purchase of Annuities on behalf of employees under the Contract, which program is not exempt under 29 CFR 2510.3-2(f) and is therefore an "employee pension benefit plan" subject to the requirements of Title I of the Employee Retirement Income Security Act of 1974 ("ERISA") as it may be amended from time to time." 2. Section 1.03 entitled "Annuity" is amended to read as follows: "The term "Annuity" means an annuity purchased in accordance with the terms of an Agreement, Plan, or program, which annuity meets the requirements of Section 403(b) of the Code." 3. In Section 1.11 entitled "Retirement Date" a new paragraph is added to read as follows: "If participation under the Contract is pursuant to the terms of a Plan, the designation of, and any election to change the Retirement Date under this Section 1.11 shall be made by the Participant in accordance with this Section 1.11 and the terms of the Plan." 4. Section 2.06 entitled "Termination of Participation" is amended by the addition of the following paragraph immediately after the end of the first paragraph: "In the event a Participant terminates participation under the Contract pursuant to this Section 2.06, the Cash Values payable to such Participant are not reduced by any withdrawal charges (as described in Section 1.18), and the Participant is not a Participant in a Plan or Program that restricts or imposes a penalty on such termination, then the Participant will not be permitted to resume making Contributions under the Contract for a period of twelve consecutive months following the date of termination. The Participant may resume making Contributions on the first day of the month coinciding with or next following the end of the twelve month period." 5. New Section 3.06 is added to read as follows: SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS APPLICABLE TO PLANS. "If participation under the Contract is pursuant to the terms of a Plan, then the provisions of this Section 3.06 shall supersede any contrary provisions in the Contract and Certificate. "Unless a married Participant and the Participant's spouse elect otherwise in accordance with the terms of the Plan and as provided in this Section 3.06, as of a Participant's Retirement Date, the Annuity Values of a Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Accounts shall be paid to the Participant in the form of a `Qualified Joint and Survivor Annuity.' A `Qualified Joint and Survivor Annuity' is an Annuity Benefit for the life of the Participant with a survivor annuity for the life of the Participant's spouse which is not less than 50% and not more than 100% of the annuity which is payable during the joint lives of the Participant and the Participant's spouse. If the Participant is not married and does not elect otherwise, the Annuity Values shall be paid in the form of a life annuity. "In addition, unless an optional form of benefit is elected pursuant to the terms of the Plan and this Section 3.06, if a married Participant dies before payment of the Participant's Annuity Values or Cash Values have commenced, then the death benefit described in Section 2.09, shall be paid in the form of a life annuity for the Participant's spouse. PF 17024T "The Participant may elect, on a form acceptable to his Employer and Equitable, within the 90 consecutive day period before the date as of which payment of the Annuity Values is to commence, not to receive payment in the form of a Qualified Joint and Survivor Annuity, or, if the Participant is unmarried, a life annuity, in which case the Participant may elect to receive the Annuity Values or Cash Values, as the case may be, in any other form of payment available under the terms of the Plan and this Contract. The Participant may also elect, on a form acceptable to his Employer and Equitable, on the first day of the Plan year in which the Participant turns age 35 (or the date on which the Participant ceases to work for the employer if earlier) for a Beneficiary other than the Participant's spouse to receive the death benefit. An election under either of the two preceding sentences must be consented to by the Participant's spouse in writing before a notary or a representative of the Plan and must be limited to a benefit for a specific Beneficiary. However, no spousal consent will be required if the Participant can prove to the satisfaction of the Employer and Equitable, that the Participant has no spouse or else that the spouse cannot be located. Each election to designate a Beneficiary other than the Participant's spouse must be consented to by the spouse and any election made under this paragraph to waive the spouse's benefits may be revoked without the consent of the spouse at any time prior to the date as of which payments commence. Any consent to waive the spouse's benefits shall be valid only with regard to the spouse who signs it. Any new waiver or change of Beneficiary will require a new spousal consent. "The provisions requiring spousal consent in this Section 3.06 shall also apply with regard to a Participant's election to terminate participation or make partial withdrawals pursuant to Sections 2.06 and 2.07 and with regard to a Participant's taking a loan against the Cash Values of his Accounts. A spouse's written consent, witnessed by a representative of the Plan or notary, must be given on a form acceptable to the Employer and Equitable, within the 90 consecutive day period prior to such payment, withdrawal, or loan, unless the Participant can show that the Participant has no spouse or that the spouse cannot be located. "If the Annuity Values applied to provide the spousal benefits on the date payment is to commence are in the aggregate less than $3,500, Equitable may choose to make payment in a single sum rather than in the form of a Qualified Joint and Survivor Annuity or life annuity as described herein. Upon any payment made pursuant to this Section 3.06, Equitable will be released from any and all liability for payment with respect to the Contributions made for the Participant." Vice President SPECIMEN and Secretary SPECIMEN President PF 17024T [EQUITABLE LOGO] THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES 1285 AVENUE OF THE AMERICAS, NEW YORK, NEW YORK 10019 EQUI-PENSION-GV CONTRACT GROUP ANNUITY CONTRACT NO. 11931 CH CONTRACT HOLDER: UNITED STATES TRUST COMPANY OF NEW YORK CONTRACT CHANGE DATE: DECEMBER 31, 1984 The Initial Guaranteed Interest Rate is 10% and is effective until December 31, 1980. The Guaranteed Interest Rate after December 31, 1980 for a Class of Participants will be established before the beginning of each calendar year, but will not be less than the Minimum Guaranteed Interest Rate for such year and Class of Participants. This contract ("the Contract") is issued in consideration of the payment to Equitable of the contributions made under the Contract. Equitable will issue to each Participant an individual certificate setting forth a statement in substance of the benefits to which such Participant is entitled under the Contract. The provisions on the following pages are part of the Contract. FOR THE CONTRACT HOLDER: FOR THE EQUITABLE: By /s/ [Signature Unreadable] By /s/ Coy Eklund ............................... .................................. President Title Vice President By /s/ Rodney L. Enochs ............................... .................................. Vice President and Secretary Dated 3/7/80 Date of Issue March 7, 1980 ............................... ....................... At New York, New York .................................. (Head Office) No 11931 CH PARTICIPATING This page 2 reserved for information in connection with the issuance of certificates under this Contract. Page 2 This page 3 reserved for information in connection with the issuance of certificates under this Contract. Page 3 PART I - DEFINITIONS SECTION 1.01 EMPLOYER The term "Employer" means the sole proprietor or the partnership adopting the Plan, or any successor unincorporated trade or business that assumes in writing the obligations of the Plan. The Plan is adopted by the Employer's execution of the Adoption Statement which constitutes a part of the Plan and pursuant to which the Employer adopts the Plan. A sole proprietor is deemed to be his own Employer and a partnership is deemed to be the Employer of each partner. SECTION 1.02 PLAN The term "Plan" means the HR-10 Group Annuity/Profit Sharing Plan with Optional Life Insurance, a master profit sharing plan for self-employed individuals and their employees sponsored by Equitable which has been determined by the Internal Revenue Service to meet the requirements for qualification under Section 401(a) of the Code. SECTION 1.03 ANNUITY The term "Annuity" means an annuity purchased in accordance with the terms of the Plan if the Plan, as adopted by the Employer, meets the requirements for qualification under Section 401(a) of the Code. SECTION 1.04 ANNUITY BENEFIT The TERM "Annuity Benefit" means a benefit payable by Equitable pursuant to Section 3.03 of the contract. SECTION 1.05 PARTICIPANT The term "Participant" means a person who has been enrolled by Equitable under the Contract and for whom the Employer has purchased an Annuity under the Contract. A person shall become enrolled under the Contract upon receipt by Equitable of an enrollment form made available by Equitable and completed in a manner satisfactory to Equitable. An Annuity is purchased for a person enrolled under the Contract upon receipt by Equitable of an initial Contribution by the Employer. SECTION 1.06 CONTRIBUTION The term "Contribution" means a payment made to Equitable for a Participant with respect to an Annuity purchased for such Participant under the Contract. Equitable is under no obligation to accept any Contribution less than $20.00. SECTION 1.07 PARTICIPATION DATE The term "Participation Date" with respect to a Participant means the date as of which Equitable has enrolled such Participant under the terms of the Contract. SECTION 1.08 PARTICIPATION YEAR The term "Participation Year" with respect to a Participant means the twelve month period beginning on (i) the Participation Date, and (ii) each anniversary thereof, unless otherwise agreed to in writing by Equitable. SECTION 1.09 CLASS OF PARTICIPANTS Except as provided in Section 1.10, the term "Class of Participants" refers to all Participants whose Participation Date is in the same calendar year. SECTION 1.10 GUARANTEED INTEREST RATE For each Guaranteed Interest Account, the term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in such Account. Interest accrues daily. The Guaranteed Interest Rate will never be less than 3% per annum. Equitable will from time to time establish and make available for new Participants (i) an Initial Guaranteed Interest Rate, (ii) one or more Minimum Guaranteed Interest Rates and (iii) the applicable effective period(s) for such Rates. A new Class of Participants will be established effective with the effective date of the occurrance of (i), (ii) or (iii) above or any combination thereof. For the calendar year next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent calendar year thereafter, Equitable will determine for each established Class of Participants before the beginning of such calendar year a Yearly Guaranteed Interest Rate for such Class, which Yearly Guaranteed Interest Rate will not be lower than the effective Minimum Guaranteed Interest Rate applicable for such Class for such year. For any established Class of Participants, Equitable reserves the right to change the Minimum Guaranteed Interest Rate and the applicable period therefor, provided that any such Minimum Guaranteed Interest Rate will not be lower than the Minimum Guaranteed Interest Rate that would have been in effect in the absence of such change. Equitable will notify each Participant in a Class in writing of the Yearly Guaranteed Interest Rate or of any change in the Minimum Guaranteed Interest Rate at least 15 days prior to its effective date. Page 4 DEFINITIONS (continued) SECTION 1.11 RETIREMENT DATE The term "Retirement Date" means the date on which the Participant is to attain the retirement age specified in the Participant's enrollment form. Before the Retirement Date the Participant may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be earlier than the date of attainment of age 59 years and six months nor shall be later than the date of attainment of age 70 years and six months. Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Home Office. SECTION 1.12 NORMAL FORM The "Normal Form" of an Annuity Benefit under the Contract means, (i) if the Participant has a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (100% continuation), and (ii) if the Participant does not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.13 JOINT AND SURVIVOR LIFE ANNUITY FORM The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depends is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by the Participant. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.14 LIFE ANNUITY FORM The term "Life Annuity Form" means an annuity providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.15 ANNUITY VALUE The term "Annuity Value" with respect to a Participant's Guaranteed Interest Account means the amount in such Account pursuant to Section 2.02. SECTION 1.16 CASH VALUE With respect to a Participant for whom no cash value(s) of existing contract(s) issued by Equitable is (are) transferred to the Contract pursuant to Section 2.01, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account means an amount equal to the Annuity Value after either (i) the later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and six months, or (ii) the Participant's attainment of age 70 years and six months. Prior to such time, the Cash Value of such Participant's Guaranteed Interest Account will equal the greater of (a) 94% of the Annuity Value of such Account and (b) the Annuity Value of such Account minus an amount equal to the excess, if any, of (i) 9% of the total Contributions made on behalf of such Participant during the current Participation Year and the preceding nine completed Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Section 2.05. With respect to a Participant for whom cash value(s) of existing contract(s) issued by Equitable is (are) transferred to the Contract pursuant to Section 2.01, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account means an amount equal to the Annuity Value after such Participant attains age 59 years and six months. Prior to such time, the Cash Value of such Participant's Guaranteed Interest Account will equal the Annuity Value of such Account minus an amount equal to the lesser of (a) and (b) where: (a) is the sum of: (1) 2% of the excess, if any, of (i) the first $10,000 of Separate Account Transfers over (ii) the cumulative total of any previous withdrawals made pursuant to subsection (a) of the third paragraph of Section 2.05 and (2) 6% of the excess, if any, of (i) the Annuity Value over (ii) the total amount of Separate Account Transfers minus the cumulative total of any withdrawals made pursuant to Section 2.05 (but such amount shall not be less than zero). (b) is the excess, if any, of: (1) the sum of (i) 2% of the first $10,000 of Separate Account Transfers made during the current Participation Year and the preceding nine Participation Years and (ii) 9% of all other Contributions (excluding Separate Account Transfers) made on behalf of the Participant during the current Participation Page 5 DEFINITIONS (continued) Year and the preceding nine completed Participation Years over (2) the cumulative total of any withdrawal charges made pursuant to Section 2.05. SECTION 1.17 CODE The term "Code" means the Internal Revenue Code of 1954, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.18 SEPARATE ACCOUNT TRANSFERS The term "Separate Account Transfers" with respect to a Participant means the amount of cash value(s) transferred to the Contract from separate investment account(s) maintained by Equitable, pursuant to Section 2.01. PART II - PARTICIPANT'S ACCOUNT SECTION 2.01 CONTRIBUTIONS The Employer is to make Contributions from time to time on such dates and in such amounts as determined by the Employer pursuant to the terms of the Plan. The Employer is to specify the Participant with respect to whom each such Contribution is being made. Each Contribution received by Equitable with respect to a Participant will, before its allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable, and by the amount of any applicable deduction in accordance with Section 2.08. A Participant may, with Equitable's agreement, transfer to the Contract any amount held with respect to such Participant under a plan covering self-employed individuals which has been determined by the Internal Revenue Service to meet the requirements for qualification under Section 401(a) of the Code, as modified by Section 401(d) of the Code ("Transferred Funds"). Any Transferred Funds from a contract not issued by Equitable will, before allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable. Equitable will issue to each Participant an individual certificate setting forth a statement in substance of the benefits to which such Participant is entitled under the Contract. SECTION 2.02 GUARANTEED INTEREST ACCOUNT Equitable maintains a Guaranteed Interest Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the Guaranteed Interest Account becomes part of the general assets of Equitable, which support the guarantees of the Contract and other contracts. The amount in a Guaranteed Interest Account at any time is equal to the sum of all amounts that have been allocated to such Guaranteed Interest Account pursuant to Section 2.01 and Section 2.03 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn pursuant to Section 2.05 and Section 2.06 from such Account and less the sum of any annual administrative charges accrued but not made. Equitable guarantees that the amount in a Guaranteed Interest Account at any time before the Retirement Date will not be less than the sum of all amounts allocated to such Account pursuant to Section 2.01 and less the sum of all amounts that have been withdrawn form such Account pursuant to Section 2.05, all accumulated at 3% interest, compounded annually. In any Participation Year in which no Contribution is allocated to the Guaranteed Interest Account, the amount in such Account at the end of the Participation Year shall not be less than the amount in such Account at the beginning of the Participation Year less the sum of all amounts withdrawn from such Account pursuant to Section 2.05, all accumulated at 3% interest, compounded annually. A Guaranteed Interest Account for a Participant terminates on the earliest of (i) the Retirement Date, (ii) the death of the Participant, and (iii) termination of participation pursuant to Section 2.04. No. 11931 H Page 6 PARTICIPANT'S ACCOUNT (continued) SECTION 2.03 ALLOCATION TO ACCOUNT Such Contribution made with respect to a Participant pursuant to Section 2.01, after deduction for any applicable taxes, will be allocated, as of the date by which Equitable has received such Contribution, to the Guaranteed Interest Account. Interest is allocated to the Guaranteed Interest Account at the end of each Participation Year, at the time of withdrawal pursuant to Sections 2.05 and 2.07, at the time of application of amounts in the Guaranteed Interest Account to provide Annuity Benefits, and upon termination of participation pursuant to Section 2.04. SECTION 2.04 TERMINATION OF PARTICIPATION Subject to any applicable restrictions under the terms of the Plan, on or before a Participant's Retirement Date, such Participant may elect by written notice to terminate participation under the Contract. Upon receipt of such notice, Equitable will determine the Cash Value, as of the date Equitable received such notice, of the Guaranteed Interest Account maintained for such Participant. The payment of such Cash Value to the Participant may be deferred by Equitable in accordance with the provisions of Section 4.08. Prior to a Participant's Retirement Date, Equitable reserves the right to withdraw the Annuity Value of the Participant's Guaranteed Interest Account, pay such Annuity Value and terminate such Participant's participation under the Contract. This right may be exercised with respect to the Participant only if both (i) no Contributions have been made under the Contract during the last three completed Participation Years, and (ii) such Annuity Value is $500 or less. Equitable reserves the right to terminate a Participant's participation under the Contract if at least 120 days have elapsed since the issue date shown on the certificate issued to such Participant under the Contract and no Contributions have been made under the Contract with respect to such Participant. Upon payment of such Cash Value or Annuity Value, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Cash Value or Annuity Value arose. SECTION 2.05 PARTIAL WITHDRAWALS Subject to any applicable restrictions under the terms of the Plan, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Guaranteed Interest Account maintained for such Participant before such Participant's Retirement Date. With respected to partial withdrawals requested by a Participant for whom no cash value(s) of existing contract(s) issued by Equitable is (are) transferred to the Contract, Equitable will withdraw from such Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the Annuity Value of such Account, provided the request for partial withdrawal is made after either (i) the later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and six months, or (ii) such Participant's attainment of age 70 years and six months. If a partial withdrawal with respect to such Participant is made prior to such time, Equitable will withdraw from such Account an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. Such withdrawal charge will equal the lesser of (a) 6% of the total amount to be withdrawn from the Account pursuant to this Section (including such charge) and (b) the excess, if any, of (i) 9% of the total Contributions made on behalf of such Participant during the current Participation Year and the preceding nine completed Participation Years over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. With respect to partial withdrawals requested by a Participant for whom cash value(s) of existing contract(s) issued by Equitable is (are) transferred to the Contract pursuant to Section 2.01, Equitable will withdraw from such Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the Annuity Value of such Account, provided the request for partial withdrawal is made after such Participant's attainment of age 59 years and six months. If a partial withdrawal with respect to such Participant is made prior to such time, Equitable will withdraw from such Account an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. Such withdrawal charge will be an amount equal to the sum of the charges described in subsections (a) and (b) below; provided, however, that in no event will such withdrawal charge exceed an amount described in subsection (c) below: (a) With respect to the amount of any withdrawal made up to the excess, if any, of (1) the cumulative total of all Separate Account Transfers made on the Participant's behalf over Page 7 PARTICIPANT'S ACCOUNT (continued) (2) the cumulative total of prior withdrawals made to which the withdrawal charge described in this subsection was applied, an amount equal to the lesser of (i) 2% of the total amount to be withdrawn pursuant to this subsection (including such charge) and (ii) $200 minus the cumulative total of any prior withdrawal charges made pursuant to this subsection. (b) With respect to any withdrawal made to which the withdrawal charge described in subsection (a) does not apply, 6% of such amount to be withdrawn (including such charge). (c) is the excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Separate Account Transfers made during the current Participation Year and the preceding nine Participation Years and (ii) 9% of all other Contributions (excluding Separate Account Transfers) made on behalf of the Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any prior withdrawal charges made pursuant to this Section. Upon withdrawal pursuant to either of the preceding two paragraphs, Equitable will pay the lesser of the Cash Value of such Account or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by such Participant. Upon any payment to a Participant pursuant to this Section, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Payments to the Participant pursuant to this Section may be deferred by Equitable in accordance with the provisions of Section 4.08. Equitable is under no obligation to process any request for partial withdrawal of less than $300. If a withdrawal from the Account made pursuant to this Section would result in an Annuity Value of less than $200, Equitable will withdraw the Annuity Value of the Account, pay the Cash Value of the Account to the Participant, and will terminate such Participant's participation under the contract. SECTION 2.06 ANNUAL ADMINISTRATIVE CHARGE As of the last day of each Participation Year before a Participant's Retirement Date, Equitable will withdraw from the Guaranteed Interest Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, an annual administrative charge equal to the lesser of $30 and 2% of the sum of (i) the Annuity Value of the Guaranteed Interest Account at the end of that Participation Year and (ii) any withdrawals made from such Account pursuant to Section 2.05 during that Participation Year. As of a Participant's Retirement Date and before application of the Annuity Value of such Participant's Account pursuant to Section 3.02, or upon termination of such Account pursuant to Section 2.04 or Section 2.07 during a Participation Year, Equitable will withdraw the administrative charge described in this Section for the applicable part of that Participation Year. SECTION 2.07 DEATH BENEFIT If the Employer reports to Equitable, or if Equitable otherwise ascertains, that a Participant has died while an Account for such Participant is maintained under the Contract and before such Participant's Retirement Date, Equitable, upon receipt of due proof of such death, will pay in a single sum to the beneficiary designated by such Participant to receive such payment the amount of death benefit payable with respect to such Participant. The amount of the death benefit with respect to a Participant at any time prior to the Retirement Date is equal to the greater of (i) the Annuity Value of the Guaranteed Interest Account maintained under the Contract for such Participant and (ii) the minimum death benefit with respect to such Participant. Such minimum death benefit is the sum of all Contributions made with respect to such Participant pursuant to Section 2.01 (before reduction pursuant to said Section) less an adjustment for any withdrawals made pursuant to Section 2.05 from the Account maintained under the Contract for such Participant. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount being withdrawn is to the Annuity Value then in the Guaranteed Interest Account maintained under the Contract for such Participant. If, in accordance with the provisions of Section 2.01, the cash value of an Annuity contract issued by Equitable, which provides for a death benefit before retirement equal to the greater of the contract cash value or an alternative amount based on premiums paid or contributions made under the Annuity contract, is transferred to the Contract, such alternative amount as of the date of transfer will be included in the "sum of all Contributions" in lieu of the amount Page 8 PARTICIPANT'S ACCOUNT (continued) of cash value transferred, for purposes of the death benefit under the Contract. The amount of any death benefit payable with respect to a Participant will, to the extent such Account is sufficient therefor, be withdrawn from the Guaranteed Interest Account maintained with respect to such Participant under the Contract. Upon such payment, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Annuity Value arose. SECTION 2.08 CHANGE OF DEDUCTIONS FOR NEW PARTICIPANTS Equitable reserves the right to make deductions to the extent permitted by applicable law from Contributions made on behalf of new Participants at any time on or after the Contract Change Date, by as least 90 days advance written notice to the Contract Holder and by amendment to the Contract. Equitable will thereupon establish a new Contract Change Date which shall be at least 5 years later. Equitable may lower the amount of the administrative charge described in Section 2.06 for new Participants at any time, by at least 15 days advance written notice to the Contract Holder. SECTION 2.09 CHANGE OF DEDUCTIONS AND CHARGES FOR EXISTING PARTICIPANTS Equitable may lower the amount of the administrative charge described in Section 2.06 for existing Participants at any time, by at 15 days advance written notice to the Contract Holder and to such Participants. PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the Contract with respect to a payee is the amount provided with respect to a payee pursuant to Section 3.03. SECTION 3.02 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Value of such Participant's Guaranteed Interest Account shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects(i) to receive the Cash Value of such Account in a single sum or (ii) to apply such Annuity Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.03, to provide an Annuity Benefit on any other annuity form offered by Equitable, as elected by the Participant, subject to Equitable's rules then in effect and any applicable requirements under the Code. Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate participation under the Contract pursuant to Section 2.04 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Value of such Participant's Guaranteed Interest Account. Equitable will have the right to require the Participant to furnish pertinent facts and determinations to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.03 and 3.04. Equitable may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form. SECTION 3.03 AMOUNT OF ANNUITY BENEFIT If a Participant elects pursuant to the first paragraph or third paragraph of Section 3.02 to receive an Annuity Benefit in lieu of the Cash Value of the Guaranteed Interest Account, the amount applied to provide the Annuity Benefit will be (i) the Annuity Value of such Account if the payments under the annuity form elected are contingent upon the survival of a person, or (ii) the Cash Value of such Account if the payments under the annuity form elected are not contingent upon the survival of a person. Page 9 ANNUITY BENEFITS (continued) The amount applied to provide an Annuity Benefit shall be reduced by the amount, as determined by Equitable, of any applicable tax on annuity considerations. If such amount is applied on or after the completion of five Participation Years with respect to such Participant, or if such amount is applied on behalf of a Participant for whom cash value(s) of existing contract(s) issued by Equitable was (were) transferred to the Contract pursuant to Section 2.01, the balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. If the amount applied to provide an Annuity Benefit is applied before the completion of five Participation Years with respect to a Participant for whom no cash value(s) of existing contract(s) issued by Equitable was (were) transferred to the Contract, the balance, after any applicable tax on annuity considerations, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the Guaranteed Interest Account maintained for such Participant shall terminate. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (100% continuation). The amounts of income provided under Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, are based on 3 1/4% interest and the 1971 ELAS Mortality Table. Equitable may change the monthly income amounts contained in the Tables of Guaranteed Annuity Payments and the bases for determining such amounts, for new Participants, by at least 90 days advance notice to the Contract Holder and by an amendment to the Contract. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on 3 1/4 % interest and the 1971 ELAS Mortality Table. SECTION 3.04 PAYMENT OF ANNUITY BENEFITS Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payable under the Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by Equitable will be charged against and underpayments will be added to any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may make the payments (in the case of a minor, at a rate not exceeding $50 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If an annuity form made available by Equitable provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of a least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Upon election by a Participant pursuant to Section 3.02 of an annuity form providing payments for a period certain, such Participant may designate (with the right to change such designation) a person or persons to receive any payments that may become due Page 10 ANNUITY BENEFITS (continued) after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's executors or administrators in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, Equitable will pay in a single sum to such payee's executors or administrators the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.02. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. Equitable will require satisfactory evidence of the age of any person upon whose life an annuity form depends. TABLE OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Value)
- ------------------------------------------------------------------------------------------------------------------------------------ Male Female Age Age 60 61 62 63 64 65 66 67 68 69 70 - ------------------------------------------------------------------------------------------------------------------------------------ 60 4.52 4.58 4.64 4.70 4.76 4.82 4.88 4.94 5.00 5.05 5.11 61 4.55 4.62 4.68 4.74 4.81 4.87 4.93 5.00 5.06 5.12 5.18 62 4.58 4.65 4.72 4.78 4.85 4.92 4.99 5.05 5.12 5.19 5.25 63 4.61 4.68 4.75 4.82 4.89 4.97 5.04 5.11 5.18 5.25 5.32 64 4.64 4.71 4.79 4.86 4.94 5.01 5.09 5.17 5.24 5.32 5.40 65 4.67 4.74 4.82 4.90 4.98 5.06 5.14 5.22 5.30 5.38 5.47 66 4.69 4.77 4.85 4.93 5.02 5.10 5.18 5.27 5.35 5.44 5.53 67 4.72 4.80 4.88 4.97 5.05 5.14 5.23 5.31 5.40 5.50 5.59 68 4.74 4.82 4.91 5.00 5.09 5.18 5.27 5.36 5.45 5.55 5.65 69 4.76 4.85 4.94 5.03 5.12 5.22 5.31 5.41 5.50 5.60 5.71 70 4.78 4.87 4.96 5.06 5.16 5.26 5.36 5.45 5.56 5.66 5.76 - ------------------------------------------------------------------------------------------------------------------------------------
FIXED ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) - -------------------------------------------------------------------------------- Age Males Females - -------------------------------------------------------------------------------- 60 5.88 4.99 61 6.04 5.11 62 6.21 5.24 63 6.38 5.38 64 6.57 5.53 65 6.77 5.68 66 6.98 5.84 67 7.19 6.01 68 7.42 6.20 69 7.67 6.39 70 7.93 6.61 - -------------------------------------------------------------------------------- Any election, change, revocation or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a commutation right under an Annuity Benefit is exercised, Equitable may defer payment in accordance with Section 4.08. PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT The Contract constitutes the entire Contract between the parties and the provisions of the Contract alone will govern with respect to the rights and obligations of Equitable. The Provisions of the Contract will be applied separately with respect to each Participant. Nothing in the enrollment form referred to in Section 1.05, the Plan or trust agreement referred to in Section 4.10 nor any modification, amendment, or supplement to any such documents will in any way be construed to enlarge, change, vary or in any other way affect the obligations of Equitable as expressly provided in the Contract. Page 11 GENERAL PROVISION (continued) The Contract may not be modified as to Equitable, nor may any of Equitable's rights or requirements be waived, except in writing and by an authorized officer of Equitable. The Contract may be changed by amendment or replacement upon agreement between the Contract Holder and Equitable without the consent of any other person provided that such change does not reduce any Annuity Benefit provided before such change and provided that no rights, privileges or benefits which have accrued to any Participant under the Contract may be reduced or forfeited except by the express consent of such Participant. SECTION 4.02 STATUTORY COMPLIANCE Equitable reserves the right to amend the Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the Contract and any certificate to reflect changes in the Code, or in regulations or published rulings of the Internal Revenue Service, so that each such certificate will continue to be an Annuity. Any Annuity Benefit, Cash Value or death benefit available under a certificate issued pursuant to the Contract shall not be less than the minimum benefits required by any statute of the state in which the certificate is delivered. SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY The entire interest of any Participant under the Contract is nonforfeitable. No interest of a Participant under the Contract may be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than Equitable. No amount payable under the Contract may be assigned, commuted, or encumbered by the payee, and, to the extent permitted by law no such amount will in any way be subject to any claim against such payee. SECTION 4.04 PARTICIPATION IN SURPLUS The Contract and all other contracts in the same class of contracts shall be combined for the purpose of ascertaining the annual surplus of Equitable to be apportioned to said contracts as a dividend, and the portion of any such dividend that is to be allocated to the Contract shall be determined by Equitable. The participation of this class of contracts in annual surplus is, however, expected to be minimal. Any amount so allocated to the Contract shall be payable as of January 1 of the calendar year in which a dividend is apportioned and will be payable in cash and shall be equitably allocated by Equitable to the Guaranteed Interest Accounts maintained hereunder for Participants. No Annuity Benefit will enter into the determination of any surplus to be apportioned to the Contract as a dividend. SECTION 4.05 BENEFICIARY Each participant, as of such Participant's Participation Date is to provide Equitable with an initial designation of the beneficiary entitled to receive any death benefit payable with respect to such Participant pursuant to Section 2.07. The Participant may change such designation from time to time during such Participant's lifetime and while Accounts for such Participants are being maintained hereunder. Any such designation or change will be made by written notice in a form satisfactory to Equitable. A change will, upon receipt at a designated Equitable Office, take effect as of the time the written notice was signed, whether or not the Participant is living on the date of receipt, but without further liability as to any payment or other settlement made by Equitable before receipt of such change. Unless otherwise specified in the designation, if a Participant has designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive the Participant, and if more than one survive they will share equally. Any part of a death benefit payable with respect to a Participant pursuant to Section 2.07 for which there is no designated beneficiary living at the death of the Participant will be payable in a single sum to the children of the Participant who survive the Participant, in equal shares, or should none survive, then to the Participant's executors or administrators. If a Participant so elects in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by the Participant, with respect to the beneficiary, subject to Equitable's rules then in effect. If at the death of a Participant there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. Page 12 GENERAL PROVISIONS (continued) SECTION 4.06 DISQUALIFICATION In the event that an annuity purchased hereunder with respect to a Participant fails to qualify as an Annuity as described in Section 1.03, Equitable shall have the right, upon receiving notice of such fact before the Retirement Date, to terminate participation with respect to such Participant under the Contract and pay to such Participant the amount in the Account maintained with respect to such Participant less a deduction for the appropriate part attributable to such Participant of any Federal income tax payable by Equitable which would not have been payable if such Participant had an Annuity under the Contract. SECTION 4.07 FUTURE PARTICIPANTS Equitable reserves the right at its sole discretion to curtail or prohibit further enrollment as Participants under the Contract of any individuals who are not currently participating under the Contract as of such date of curtailment or prohibition. SECTION 4.08 DEFERMENT Payments by Equitable from the Participant's Guaranteed Interest Account pursuant to the provisions of Section 2.04, Section 2.05 and Section 2.07, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.04, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.04. Interest at the current Guaranteed Interest Rate for such Participant's Guaranteed Interest Account will be allowed on any such payment deferred for 30 days or more. SECTION 4.09 ANNUAL NOTICE At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Guaranteed Interest Account, (2) the Cash Value of the Guaranteed Interest Account, and (3) the amount of death benefit payable with respect to the Participant. SECTION 4.10 CONTRACT HOLDER RESPONSIBILITY The sole responsibility of the Contract Holder is to serve as party to the Contract. The Contract Holder will have no responsibility for the administration of any Plan, for payments to the Guaranteed Interest Account, or any payments or other distributions hereunder. Equitable will deal with the Contract Holder in accordance with the terms and conditions of the trust agreement pursuant to which the Contract Holder agreed to act as such and the Contract and in such manner as the Contract Holder and Equitable may agree, without the consent of any other person. Any Employer making Contributions under the Contract shall be deemed to have adopted and accepted the trust agreement as part of the Plan with respect to which such Contributions are made. SECTION 4.11 AGE AND SEX If the Annuitant's age or sex has been misstated, any benefits will be those which would have been purchased at the correct age and sex. Any overpayments or underpayments made by Equitable will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. Page 13 Attached to and made part of Group Annuity Contract No. 11931CH between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective August 15, 1981, said contract is amended as follows: 1. Contributions made to the contract, less applicable premium taxes, as determined by Equitable, may be allocated to the Guaranteed Interest Account or Stock Account maintained for the Participant, or in part to both, as directed by the Participant. 2. At the Retirement Date, if the Participant is then living, the amount in the Guaranteed Interest Account and Stock Account will be applied to provide the Participant with an Annuity Benefit or Cash Value Benefit. 3. ASSETS HELD IN CONNECTION WITH THE CONTRACT MAY BE HELD IN A SEPARATE ACCOUNT MAINTAINED BY EQUITABLE AND MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THE CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE SEPARATE ACCOUNT IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.20 IS 5% OR 3 1/2%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE OF 1.75% FOR INVESTMENT MANAGEMENT, FINANCIAL ACCOUNTING, THE ANNUITY RATE GUARANTEE AND MINIMUM DEATH BENEFIT, EXPENSES AND EXPENSE RISK, BUT AFTER ANY DEDUCTIONS TO PROVIDE FOR TAXES. THIS CONTRACT MAY NOT BE SUITABLE FOR A PARTICIPANT IF THE ONLY CONTRIBUTION TO BE MADE ON SUCH PARTICIPANT'S BEHALF IS A SUBSTANTIAL SINGLE SUM CONTRIBUTION. PF 14103CH Page 1 4. The following provisions are added to your Certificate. To Part 1 of your Certificate SECTION 1.05A EXISTING PARTICIPANT The term "Existing Participant" means a Participant for whom Cash Values of existing annuity contract(s) issued by Equitable is (are) eligible to be transferred to the Contract pursuant to Section 2.01. SECTION 1.05B NEW PARTICIPANT The term "New Participant" means a Participant who is not an Existing Participant. SECTION 1.14B ELIGIBLE ANNUITY CERTAIN The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by Equitable which extends beyond the Participant's attainment of age 59 years and six months and does not permit any prepayment of the unpaid principal prior to the participant's attainment of age 59 years and six months. SECTION 1.19 THE SEPARATE ACCOUNT The Term "Separate Account" means Separate Account A, a separate investment account maintained by Equitable to which portions of its assets have been allocated for the Contract and certain other contracts. Equitable reserves the right to withdraw from the Separate Account and allocate to another separate account assets determined by Equitable to be associated with the class of contracts to which the Contract belongs. In any such event, to the extent practicable and permissible under applicable laws and regulations, the withdrawal shall be made by withdrawing the same percentage of each investment in the Separate Account, with appropriate adjustments to avoid odd lots and fractions. On and after the date of any such withdrawal the term "Separate Account" in the Contract shall mean such other separate account to which the withdrawn assets were allocated. It is contemplated that investments in the Separate Account will, at most times, consist primarily of common stock and other equity-type investments. Equitable may, however, at its discretion invest the assets of the Separate Account in any investment permitted by applicable law. Equitable may rely conclusively on the opinion of counsel (including attorneys in its employ) as to what investments it is permitted by law to make. In lieu of making such investments directly, Equitable reserves the right to operate the Separate Account as a unit investment trust, or in any other form permitted by law, investing all or part of its assets in shares or units of a fund, the investment adviser of which may be Equitable or controlled by Equitable. The fund assets would be invested as provided above with respect to the Separate Account. Equitable reserves the right: (i) to cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such committee at any time; and (iii) restrict or eliminate any voting rights of participants or other persons who have voting rights as to the Separate Account. Assets of the Separate Account attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, consisting of .15% for investment management, .35% for financial accounting, .35% for the annuity rate guarantee and the minimum death benefit, and .90% for expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.20. The assets of the Separate Account are the property of Equitable; however, the portion of the assets of the Separate Account equal to the reserves and other contract liabilities with respect to such Account shall not be chargeable with liabilities arising out of any other business Equitable may conduct. Equitable reserves the right to transfer assets of the Separate Account in excess of such reserves and contract liabilities to the general account of Equitable. SECTION 1.20 DEFINITIONS RELATING TO THE SEPARATE ACCOUNT VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business day immediately preceding such business day will constitute a Valuation Period. A PF 14103CH Page 2 business day is any day on which there is a sufficient degree of trading in the portfolio securities of the Separate Account that the Accumulation Unit Value or Annuity Unit Value might be materially affected by changes in the value of the portfolio securities in the Separate Account, as determined by Equitable. NET INVESTMENT FACTOR: For the Separate Account the Net Investment Factor for a Valuation Period is (a) divided by (b), minus (c), where (a) is (1) the value of the assets in the Separate Account at the close of business of the preceding Valuation Period plus (2) the investment income and the capital gains, realized or unrealized, credited to the assets of the Separate Account in the Valuation Period for which the Net Investment Factor is being determined, minus (3) the capital losses, realized or unrealized, charged against such assets in such Valuation Period, minus (4) any amount charged against the Separate Account in such Valuation Period for taxes or for amounts set aside by Equitable as a reserve for taxes attributable to the maintenance or operation of the Separate Account; (b) is the value of the assets in the Separate Account at the close of business of the preceding Valuation Period; and (c) is the daily charge, for each calendar day in such Valuation Period of .00004837 for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The value of the assets in the Separate Account, referred to above, shall be taken at their fair market value, or where there is no readily available market, their fair value, as determined in accordance with accepted accounting practices and applicable laws and regulations. ACCUMULATION UNIT: The Accumulation Unit is a unit used in determining the value of the interest of a Participant's Stock Account in the Separate Account on or before the Retirement Date. NEW ACCUMULATION UNIT VALUE: The initial New Accumulation Unit Value for the Separate Account has been established at $10.00 as of November 1, 1968. The New Accumulation Unit Value for each subsequent Valuation Period is the New Accumulation Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such subsequent Valuation Period. ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable from the Separate Account under a Variable Annuity Benefit. NEW ANNUITY UNIT VALUE: The initial New Annuity Unit Value has been established at $1.00 on November 1, 1968. The New Annuity Unit Value for any subsequent Valuation Period is the New Annuity Unit Value for the immediately Preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3 1/2%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE NEW ANNUITY UNIT VALUE: The Average New Annuity Unit Value for a calendar month is equal to the average of the New Annuity Unit Values for the Valuation Periods ending in such month. To Part II of your Certificate SECOND 2.10 STOCK ACCOUNT Equitable maintains a Stock Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to a Stock Account becomes part of the Separate Account. Any amount withdrawn from a Stock Account will no longer be part of the Separate Account. On any date when an amount is allocated to or withdrawn from a Stock Account, the Stock Ac- PF 14103CH Page 3 count will be credited or charged, as the case may be, with a number of Accumulation Units determined by dividing said amount by the New Accumulation Unit Value for the Separate Account for the Valuation Period which includes that date. The number of Accumulation Units in a Stock Account on any date is equal to (i) the sum of any Accumulation Units that have been credited to the Stock Account minus (ii) the sum of any Accumulation Units that have been charged to the Stock Account. The amount in a Stock Account on any date is equal to the product of (i) the number of Accumulation Units in the Stock Account on that date and (ii) the Accumulation Unit Value for the Separate Account for the Valuation Period which includes that date. SECTION 2.11 TRANSFERS BETWEEN ACCOUNTS At any time before a Participant's Retirement Date, such Participant, upon written request, may transfer all or a part of the amounts from the Stock Account maintained for such Participant to the Guaranteed Interest Account maintained for such Participant, or may transfer all or a part of the amounts in the Guaranteed Interest Account maintained for such Participant to the Stock Account maintained for such Participant. Such transfers will be made as of the later of (i) the date specified in such request and (ii) the date Equitable receives such request, and will be subject to Equitable's rules in effect at the time of transfer. To Part III of your Certificate SECTION 3.04 VARIABLE ANNUITY BENEFIT The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Separate Account. The amount of the first, second, and third payments under any Variable Annuity Benefit provided under the Contract with respect to a payee is the monthly amount provided with respect to the payee pursuant to Section 3.03. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average New Annuity Unit Value for the second calendar month immediately preceding the date of the payment. The fourth and subsequent annuity payments under a Variable Annuity Benefit will not be increased or decreased in amount because of mortality or expense experience. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the New Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. 5. The following sections of your Certificate are amended or modified as follows: A. Section 1.15, ANNUITY VALUE, is amended to provide that the "Annuity Value" with respect to a Participant's Guaranteed Interest Account and Stock Account shall mean the amounts in such Accounts described in Section 2.02 and 2.10. B. Section 1.16, CASH VALUE, shall read as follows: SECTION 1.16 CASH VALUE - NEW PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to a New Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account and Stock Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and six months, or (ii) the Participant's attainment of age 70 years and six months, or (iii) the completion of 25 Participation Years with respect to such Participant, or (iv) if the Participant has attained age 55, completed five Participation Years, and the Cash Values are to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. PF 14103CH Page 4 WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% of the sum of the Annuity Values of such Accounts. (b) is an amount equal to the excess, if any, of (i) 8% of the cumulative contributions made on behalf of such Participant over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.05 and 2.05A. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% of the excess of (i) the sum of the Annuity Values of such Accounts over (ii) the Free Corridor Amount defined in Section 2.05C. (b) is the excess, if any, of (i) 8% of the total contributions made on behalf of such Participant during the current Participation Year and the preceding nine Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.05 and 2.05A. The Cash Value of the Guaranteed Interest Account and the Cash Value of the Stock Account will be in the same proportion as are the Annuity Values of such Accounts. SECTION 1.16B CASH VALUE - EXISTING PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to an Existing Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account and Stock Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The Participant's attainment of age 59 years and six months, (ii) the completion of 20 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55 and the Cash Values are to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a) and (b) below; provided, however, that such charge does not exceed the amount described in subsection (c) below where: (a) is an amount equal to 2% of any Preferred Withdrawable Amounts (defined in Section 2.05B) that have not previously been withdrawn pursuant to Section 2.05 and 2.05B. (b) is an amount equal to 6% of any Regular Withdrawable Amounts (defined in Section 2.05B) that have not previously been withdrawn pursuant to Section 2.05 and 2.05B. (c) is an amount equal to the sum of (a) above, and 6% of the excess, if any, of (i) the sum of the Annuity Values of such Accounts over (ii) the cumulative total of Equitable Transferred Funds made with respect to the Participant that have not previously been withdrawn pursuant to Section 2.05 and 2.05B. WITHDRAWAL CHARGE AFTER FIVE YEARS: After five Participation Years have been completed with respect to the Participant, Equitable (i) will first withdraw, pursuant to Section 2.05B, the Free Corridor Amount defined in Section 2.05C and (ii) next withdraw the remaining portion of the sum of the Annuity Values of such Accounts. A withdrawal charge will apply to the amount in (ii) above, and will equal the sum of the PF 14103CH Page 5 charges described in subsection (a) and (b) of the preceding subsection; provided, however, that such charge will not exceed an amount equal to the lesser of the charges defined in (d) and (e) below: (d) is an amount equal to the sum of (a) in the preceding subsection, and 6% of the excess, if any, of (i) the sum of the Annuity Values of such Accounts (after withdrawal of the Free Corridor Amount) over (ii) the cumulative total of Equitable Transferred Funds made on behalf of the Participant that have not previously been withdrawn pursuant to Sections 2.05 and 2.05B. (e) is an amount equal to the excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other contributions (excluding Equitable Transferred Funds) made on behalf of such Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any withdrawal charges made pursuant to Section 2.05 and 2.05B. The Cash Value of the Guaranteed Interest Account and the Cash Value of the Stock Account will be in the same proportion as are the Annuity Values of such Accounts. C. Section 1.18, SEPARATE ACCOUNT TRANSFERS, shall read as follows: SECTION 1.18 EQUITABLE TRANSFERRED FUNDS The Term "Equitable Transferred Funds" with respect to a Participant means the amount of cash value(s) transferred to the Contract from a contract issued by Equitable, pursuant to Section 2.01. D. The second paragraph of Section 2.02, GUARANTEED INTEREST ACCOUNT, is amended as follows: a. References to Section 2.05 are replaced by Sections 2.05, 2.05A and 2.05B. b. The amount in the Guaranteed Interest Account at any time includes the amount transferred into the Account and does not include amounts withdrawn or transferred out of such Account. E. The Sections entitled TERMINATION OF PARTICIPATION (2.04), ANNUAL ADMINISTRATIVE CHARGE (2.06), DEATH BENEFIT (2.07), ELECTION AND COMMENCEMENT OF ANNUITY PAYMENTS (3.02), and CONTRACT HOLDER RESPONSIBILITY (4.10) are amended to change the term "Guaranteed Interest Account" wherever it appears to "Guaranteed Interest Account and Stock Account." F. Section 2.03, ALLOCATION TO ACCOUNT, shall read as follows: SECTION 2.03 ALLOCATION TO ACCOUNT Each Contribution made with respect to a Participant pursuant to Section 2.01, after deduction for any applicable taxes, will be allocated, as of the date by which Equitable has received both such Contribution and direction as to its allocation, to the Guaranteed Interest Account, or Stock Account, or in part to each, at the sole direction of the Participant as specified to Equitable, provided that the percentage allocated to each Account is a whole number. Any amount that a Participant has directed to be transferred to the Guaranteed Interest Account or the Stock Account pursuant to Section 2.11 will be allocated as of the date of such transfer to the appropriate Account maintained for such Participant. Interest is allocated to the Guaranteed Interest Account at the end of each Participation Year, at the time of each transfer or withdrawal pursuant to Sections 2.05, 2.05A, 2.05B and 2.11 at the time of application of amounts in the Guaranteed Interest Account to provide Annuity Benefits, upon termination of participation pursuant to Section 2.04, and upon death of the Participation pursuant to Section 2.07. PF 14103CH Page 6 G. Section 2.05, PARTIAL WITHDRAWALS, shall read as follows: SECTION 2.05 PARTIAL WITHDRAWALS Subject to any applicable restrictions under the terms of the Plan, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Stock Account and the Guaranteed Interest Account maintained for such Participant before such Participant's Retirement Date. Upon withdrawal pursuant to Section 2.05, 2.05A or 2.05B, Equitable will pay the lesser of the sum of the Cash Values of such Accounts or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by such Participant. Unless instructed otherwise, the amount withdrawn, (including the amount of any withdrawal charge) will be allocated between such Accounts in proportion to the Annuity Value of each such Account. Upon any payment to a Participant pursuant to Section 2.05, 2.05A or 2.05B, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Payments to the Participant pursuant to Section 2.05, 2.05A or 2.05B may be deferred by Equitable in accordance with the provisions of Section 4.08. Equitable is under no obligation to process any request for partial withdrawal of less than $300. If a withdrawal from the Accounts made pursuant to Sections 2.05, 2.05A or 2.05B would result in total Annuity Values of less than $200, Equitable will so advise the Participant and reserves the right to withdraw the Annuity Values of the Guaranteed Interest Account and Stock Account, pay the Annuity Values of such Accounts to the Participant, and terminate such Participant's participation under the Contract. If the Participant enrolled in this Contract on or after the effective date of this rider, the $200 amount stated above shall be $500. SECTION 2.05A PARTIAL WITHDRAWALS - NEW PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a New Participant, Equitable will withdraw from the Stock Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and six months, or (ii) such Participant's attainment of age 70 years and six months, or (iii) the completion of 25 Participation Years with respect to such Participant, or (iv) if the Participant has attained age 55, has completed five Participation Years, and the partial withdrawal is to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: If the Participant has not completed five Participation Years under the Contract, such withdrawal charge will equal the lesser of (a) or (b) where: (a) is an amount equal to 6% of the total amount to be withdrawn from the Accounts pursuant to this paragraph (including such charge) (b) is the excess, if any, of (i) 8% of the cumulative total of Contributions made on behalf of such Participant over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participant Years with respect to the Participant, there will be no withdrawal charge if the PF 14103CH Page 7 amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.05C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% of the amount withdrawn pursuant to (ii) of the preceding sentence including such charge, and (b) is the excess, if any, of (i) 8% of the cumulative total of contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. SECTION 2.05B PARTIAL WITHDRAWAL - EXISTING PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by an Existing Participant, Equitable will withdraw from the Stock Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The Participant's attainment of age 59 years and six months, or (ii) the completion of 20 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55 and the partial withdrawal is to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. PREFERRED WITHDRAWABLE AMOUNT: This is an amount equal to the lesser of (a) the total of Equitable Transferred Funds made on behalf of the Participant or (b) $10,000. FREE WITHDRAWABLE AMOUNT: This is an amount equal to the excess, if any, of (a) the total of Equitable Transferred Funds made on behalf of the Participant over (b) $10,000. REGULAR WITHDRAWAL AMOUNT: This is the cumulative total of all Contributions, other than Equitable Transferred Funds, made on behalf of the Participant. ORDER OF WITHDRAWALS: In calculating the withdrawal charge, Equitable will assume that (a) any Preferred Withdrawable Amounts are first withdrawn, (b) any Free Withdrawable Amounts are next withdrawn, (c) any Regular Withdrawable Amounts are next withdrawn, and (d) lastly, any amounts other than the amounts described in (a), (b), and (c) above are withdrawn. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in sub-sections (a), (b), (c) and (d) below: (a) With respect to any withdrawals of Preferred Withdrawable Amounts, a charge of 2% of such withdrawals. (b) With respect to any withdrawals of Free Withdrawable Amounts, no charge. (c) With respect to any withdrawals of Regular Withdrawable Amounts, a charge of 6% of such withdrawals. (d) With respect to any withdrawals of amounts other than the amounts in (a), (b) and (c) above, no charge. WITHDRAWABLE CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Partici- PF 14103CH Page 8 pant, there will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.05C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (1) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (2) then withdraw from such Accounts an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will equal the sum of the charges described in (a), (b), (c), and (d) above; provided, however, that in no event will such charge exceed an amount equal to the following: The excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and (ii) 8% of all other Contributions (excluding Equitable Transferred Funds) made on behalf of the Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any prior withdrawal charges made pursuant to this Section. Whenever an amount is withdrawn from such Accounts that is not greater than the current Free Corridor Amount, such amount is considered to be (1) first, a withdrawal of Regular Withdrawal Amounts, (2) next, a withdrawal of Preferred Withdrawable Amounts, (3) next, a withdrawal of Free Withdrawable Amounts and (4) lastly, a withdrawal of amounts other than the amounts in (1), (2), or (3) above. However, no charge will be assessed with respect to the portion of the withdrawal up to the current Free Corridor Amount. SECTION 2.05C FREE CORRIDOR AMOUNT The term "Free Corridor Amount" with respect to a Participant who has completed five Participation Years means an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Values of the Stock Account and the Guaranteed Interest Account over (ii) cumulative prior withdrawals made pursuant to Section 2.05, 2.05A or 2.05B in the current Participation Year with respect to the Participant. H. The first paragraph of Section 2.06, ANNUAL ADMINISTRATIVE CHARGE, is amended by adding the following: The charge will be allocated between the Stock Account and the Guaranteed Interest Account in proportion to the Annuity Values of such Accounts at the end of the Participation Year. I. Section 2.08, Change of Deductions for New Participants, is deleted as of August 1, 1981 and Section 2.09, Change of Deductions and Charges for Existing Participants, shall not apply to Participants enrolled on or after August 1, 1981. J. With respect to Section 3.03, AMOUNT OF ANNUITY BENEFITS, a. Wherever the term "Guaranteed Interest Account" appears, it shall be changed to "Guaranteed Interest and Stock Account." b. The second and third sentences of paragraph 2 shall apply to a Participant who has completed five Participation Years and to an Existing Participant (as defined in Part I of this rider). c. Paragraph 3 shall apply to a New Participant (as defined in Part I of this rider) before the completion of five Participation Years. d. The last two paragraphs have been amended to provide that any Variable Annuity Benefit shall be calculated by Equitable on 1979 ELAS Mortality and an Assumed Base Rate of Net Investment Income Return of 5% or 3 1/2%, whichever applies pursuant to Section 1.20. PF 14103CH Page 9 K. Section 3.04 PAYMENT OF ANNUITY PAYMENTS, is amended by the addition of the following: VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3 1/2% (Minimum Monthly Income per $1,000 of Annuity Value)
- ---------------------------------------------------------------------------------------------------------------------------------- FEMALE AGE MALE ----------------------------------------------------------------------------------------------------------------------- AGE 60 61 62 63 64 65 66 67 68 69 70 ----------------------------------------------------------------------------------------------------------------------- 60 4.31 4.35 4.39 4.43 4.47 4.51 4.55 4.59 4.63 4.67 4.71 61 4.35 4.39 4.43 4.48 4.52 4.56 4.61 4.65 4.69 4.73 4.78 62 4.39 4.43 4.48 4.52 4.57 4.61 4.66 4.71 4.75 4.80 4.85 63 4.42 4.47 4.52 4.57 4.62 4.67 4.72 4.77 4.82 4.87 4.92 64 4.46 4.51 4.57 4.62 4.67 4.72 4.77 4.83 4.88 4.94 4.99 65 4.50 4.56 4.61 4.66 4.72 4.78 4.83 4.89 4.95 5.01 5.07 66 4.54 4.60 4.65 4.71 4.77 4.83 4.89 4.95 5.01 5.08 5.14 67 4.58 4.64 4.70 4.76 4.82 4.88 4.95 5.01 5.08 5.15 5.22 68 4.62 4.68 4.77 4.81 4.87 4.95 5.01 5.08 5.15 5.22 5.29 69 4.65 4.72 4.78 4.85 4.92 4.99 5.06 5.14 5.22 5.29 5.37 70 4.69 4.76 4.83 4.90 4.97 5.05 5.12 5.20 5.28 5.36 5.45 - ----------------------------------------------------------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 5% (Minimum Monthly Income per $1,000 of Annuity Value)
- ---------------------------------------------------------------------------------------------------------------------------------- FEMALE AGE MALE ----------------------------------------------------------------------------------------------------------------------- AGE 60 61 62 63 64 65 66 67 68 69 70 ----------------------------------------------------------------------------------------------------------------------- 60 5.19 5.23 5.27 5.31 5.34 5.39 5.42 5.46 5.50 5.54 5.58 61 5.23 5.27 5.31 5.35 5.39 5.43 5.47 5.52 5.56 5.60 5.64 62 5.27 5.31 5.35 5.39 5.44 5.48 5.53 5.57 5.62 5.67 5.71 63 5.31 5.35 5.39 5.44 5.49 5.53 5.58 5.63 5.68 5.73 5.78 64 5.34 5.39 5.44 5.48 5.53 5.59 5.64 5.69 5.74 5.79 5.85 65 5.38 5.43 5.48 5.53 5.58 5.64 5.69 5.75 5.80 5.86 5.92 66 5.42 5.47 5.52 5.58 5.63 5.69 5.75 5.81 5.87 5.93 5.99 67 5.45 5.51 5.56 5.62 5.68 5.74 5.80 5.87 5.93 6.00 6.06 68 5.49 5.55 5.61 5.67 5.73 5.80 5.86 5.93 6.00 6.06 6.14 69 5.53 5.59 5.65 5.71 5.78 5.85 5.92 5.99 6.06 6.13 6.21 70 5.56 5.63 5.69 5.76 5.83 5.90 5.97 6.05 6.13 6.21 6.29 - ----------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) VARIABLE ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS ------------------------------------------------------------------------ 3 1/2% 5% ------ -- AGE MALES FEMALES MALES FEMALES - --- ----- ------- ----- ------- 60 5.43 4.80 6.36 5.70 61 5.57 4.90 6.50 5.81 62 5.72 5.01 6.65 5.91 63 5.88 5.13 6.81 6.03 64 6.05 5.25 6.97 6.15 65 6.23 5.39 7.16 6.28 66 6.43 5.54 7.35 6.43 67 6.64 5.70 7.56 6.58 68 6.87 5.87 7.79 6.76 69 7.11 6.06 8.03 6.95 70 7.38 6.27 8.30 7.15 Equitable will notify the payee under a Variable Annuity Benefit of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each variable payment. L. Section 4.08 DEFERMENT, shall read as follows: SECTION 4.08 DEFERMENT Payments by Equitable from the Participant's Guaranteed Interest Account pursuant to the provisions of Section 2.04, Sections 2.05, 2.05A and 2.05B, and Section 2.07, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.04, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.04. Interest at the current Guaranteed Interest Account will be allowed on any such payment deferred for 30 days or more. Except as provided in this Section, payments by Equitable from the Participant's Stock Account pursuant to the provisions of Section 2.04, Sections 2.05, 2.05A and 2.05B, and Section 2.07, or any commuted payments arising from a Variable Annuity Benefit pursuant to Section 3.04, will be made within seven days after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.04. During any period when (i) the sale of securities or the determination of the New Accumulation Unit Value or the New Annuity Unit Value is not reasonably practicable because an emergency, defined by the Securities and Exchange Commission, exists, or the New York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may by order permit postponement for the protection of persons having interests in the Separate Account, Equitable reserves the right: PF 14103CH Page 10 (a) to defer determination of Cash Values or Annuity Values and payment of Cash Values and Annuity Values, arising from an amount in a Participant's Stock Account; (b) to defer payment of any portion of the death benefit arising from an amount in a Participant's Stock Account; (c) to defer the payment of any variable Annuity Benefit under the Contract or the application of any such Benefit to provide for any other payment called for by the Contract; or (d) in the event of (a) above, to defer application of such amounts to provide any Annuity Benefit permitted under the Contract. M. Section 4.09, ANNUAL NOTICE, shall read as follows: SECTION 4.09 ANNUAL NOTICE At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Guaranteed Interest Account, (2) the total number of Accumulation Units credited to the Stock Account, (3) the New Accumulation Unit Value, (4) the sum of the Cash Values of the Guaranteed Interest Account and the Stock Account and (5) the amount of death benefit payable with respect to the Participant. After the Retirement Date Equitable will notify the Participant of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By /s/ Signature Unreadable By /s/ Coy Eklund ----------------------------------- -------------------------------- President Title S/V/P By /s/ Rodney L. Enochs ------------------------------- -------------------------------- Vice President and Secretary Dated 8/12/81 Date of Issuance Aug 12 1981 ------------------------------- ------------------ At N.Y., N.Y. ----------------------------------- PF 14103CH Page 11 Attached to and made part of Group Annuity Contract No. 11931CH between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective April 15, 1982, said contract and riders are amended as follows: o Contributions made to the Contract after deduction of any applicable taxes, will be allocated to the Stock Account, Money Market Account or the Guaranteed Interest Account maintained for the Participant, in accordance with Sections 2.02 and 2.03, or in part to any one, as directed by the Participant. o The amount in the Stock Account, Money Market Account and the Guaranteed Interest Account will be applied at the Retirement Date to provide the Participant with an Annuity Benefit or a Cash Value Benefit if the Participant is then living, and o The Participant will have other rights and benefits as described herein. ASSETS HELD IN CONNECTION WITH THE CONTRACT MAY BE HELD IN SEPARATE ACCOUNTS MAINTAINED BY EQUITABLE AND MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THE CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF SEPARATE ACCOUNT A. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN SEPARATE ACCOUNT A IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.16 IS 5% OR 3 1/2%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE OF 1.75% FOR INVESTMENT MANAGEMENT, FINANCIAL ACCOUNTING, THE ANNUITY RATE GUARANTEE AND MINIMUM DEATH BENEFIT; EXPENSES AND EXPENSE RISK, BUT AFTER ANY DEDUCTIONS TO PROVIDE FOR TAXES. Equitable will issue to each Participant an individual certificate setting forth a statement in substance of the benefits to which such Participant is entitled under the Contract. The provisions on the following pages are part of the Contract. PF 14113CH This page 2 reserved for information in connection with the issuance of certificates under this Contract. PAGE 2 This page 3 reserved for information in connection with the issuance of certificates under this Contract. PAGE 3 PART 1 - DEFINITIONS SECTION 1.01 EMPLOYER The term "Employer" means the sole proprietor or the partnership adopting the Plan, or any successor unincorporated trade or business that assumes in writing the obligations of the Plan. The Plan is adopted by the Employer's execution of the Adoption Statement which constitutes a part of the Plan and pursuant to which the Employer adopts the Plan. A sole proprietor is deemed to be his own Employer and a partnership is deemed to be the Employer of each partner. SECTION 1.02 PLAN The term "Plan" means the HR-10 Group Annuity Pension Plan with Optional Life Insurance, a master pension plan for self-employed individuals and their employees sponsored by Equitable which has been determined by the Internal Revenue Service to meet the requirements for qualification under Section 401(a) of the Code. SECTION 1.03 ANNUITY The term "Annuity" means an annuity purchased in accordance with the terms of the Plan if the Plan, as adopted by the Employer, meets the requirements for qualification under Section 401(a) of the Code. SECTION 1.04 ANNUITY BENEFIT The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Section 3.04 of the Contract. PF 14113CH Page 4 DEFINITIONS (continued) SECTION 1.05A PARTICIPANT The term "Participant" means a person who has been enrolled by Equitable under the Contract and for whom the Employer has purchased an Annuity under the Contract. A person shall become enrolled under the Contract upon receipt by Equitable of an enrollment form made available by Equitable and completed in a manner satisfactory to Equitable. An Annuity is purchased for a person enrolled under the Contract upon receipt by Equitable of an initial Contribution by the Employer. SECTION 1.05B EXISTING PARTICIPANT The term "Existing Participant" means a Participant for whom Cash Values of existing annuity contract(s) issued by Equitable were eligible to be transferred to the Contract pursuant to Section 2.01 and who was enrolled under the Contract on or prior to April 14, 1982. SECTION 1.05C NEW PARTICIPANT The term "New Participant" means a Participant who is not an Existing Participant. SECTION 1.06 CONTRIBUTION The term "Contribution" means a payment made to Equitable for a Participant with respect to an Annuity purchased for such Participant under the Contract. Equitable is under no obligation to accept any Contribution less than $20.00. SECTION 1.07 PARTICIPATION DATE The term "Participation Date" with respect to a Participant means the date as of which Equitable has enrolled such Participant under the terms of the Contract. SECTION 1.08 PARTICIPATION YEAR The term "Participation Year" with respect to a Participant means the twelve month period beginning on (i) the Participation Date, and (ii) each anniversary thereof, unless otherwise agreed to in writing by Equitable. SECTION 1.09 CLASS OF PARTICIPANTS Except as provided in Section 1.10, the term "Class of Participants" refers to all Participants whose Participation Date is in the same calendar year. SECTION 1.10 GUARANTEED INTEREST RATE For each Guaranteed Interest Account, the term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in such Account. Interest accrues daily. The Guaranteed Interest Rate will never be less than 3% per annum. Equitable will from time to time establish and make available for new Participants (i) an Initial Guaranteed Interest Rate, (ii) one or more Minimum Guaranteed Interest Rates and (iii) the applicable effective period(s) for such Rates. A new Class of Participants will be established effective with the effective date of the occurrence of (i), (ii) or (iii) above or any combination thereof. For the calendar year next succeeding the end of the period for which an established Initial Guaranteed interest Rate is effective and for each subsequent calendar year thereafter, Equitable will determine for each established Class of Participants before the beginning of such calendar year a Yearly Guaranteed interest Rate for such Class, which Yearly Guaranteed Interest Rate will not be lower than the effective Minimum Guaranteed Interest Rate applicable for such Class for such year. For any established Class of Participants, Equitable reserves the right to change the Minimum Guaranteed Interest Rate and the applicable period therefor, provided that any such Minimum Guaranteed Interest Rate will not be lower than the Minimum Guaranteed Interest Rate that would have been in effect in the absence of such change. Equitable will notify each Participant in a Class in writing of the Yearly Guaranteed Interest Rate or of any change in the Minimum Guaranteed Interest Rate at least 15 days prior to its effective date. For the period (not to exceed one year) next succeeding the end of the period for which an established PF 14113CH Page 5 DEFINITIONS (continued) Initial Guaranteed Interest Rate is effective and for each subsequent period (not to exceed one year) the Equitable may determine for each established Class of Participants a Guaranteed Interest Rate for such Class which exceeds the applicable Yearly Guaranteed Interest Rate. Equitable will notify each Participant in writing of the applicable Guaranteed Interest Rate and duration. SECTION 1.11 RETIREMENT DATE The term "Retirement Date" means the date on which the Participant is to attain the retirement age specified in the Participant's enrollment form. Before the Retirement Date the Participant may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be earlier than the date of attainment of age 59 years and six months nor shall be later than the date of attainment of age 70 years and six months. Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Home Office. SECTION 1.12 NORMAL FORM The "Normal Form" of an Annuity Benefit under the Contract means, (i) if the Participant has a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (100% continuation), and (ii) if the Participant does not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.13 JOINT AND SURVIVOR LIFE ANNUITY FORM The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depends is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by the Participant. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.14A LIFE ANNUITY FORM The term "Life Annuity Form" means an annuity providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.14B ELIGIBLE ANNUITY CERTAIN The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by Equitable which extends beyond the Participant's attainment of age 59 years and six months and does not permit any prepayment of the unpaid principal prior to the participant's attainment of age 59 years and six months. SECTION 1.15 THE SEPARATE ACCOUNTS The term "Separate Accounts" means the following separate investment accounts maintained by Equitable to which portions of its assets have been allocated for the Contract and certain other contracts: Name Investments ---- ----------- Separate Account A Primarily common stock and other equity-type investments. Separate Account E Primarily short-term money market instruments. Equitable reserves the right to withdraw from any Separate Account and allocate to another separate account assets determined by Equitable to be associated with the class of contracts to which the Contract belongs. In any such event, to the extent practicable and permissible under applicable laws and regulations, the withdrawal shall be made by withdrawing the same percentage of each investment in the Separate Account, with appropriate adjustments to avoid odd lots and fractions. On and after the date of any such withdrawal the reference in the Contract to such Separate Account shall mean such other separate account to which the withdrawn assets were allocated. It is contemplated that investments in the Separate Accounts will, at most times, consist primarily of the types of investments indicated above. Equitable may, PF 14113CH Page 6 DEFINITIONS (continued) however, at its discretion invest the assets of any Separate Account in any investment permitted by applicable law. Equitable may rely conclusively on the opinion of counsel (including attorneys in its employ) as to what investments it is permitted by law to make. In lieu of making such investments directly, Equitable reserves the right to operate any Separate Account as a unit investment trust, or in any other form permitted by law, investing all or part of its assets in shares or units of a fund, the investment adviser of which may be Equitable or controlled by Equitable. The fund assets would be invested as provided above with respect to the Separate Account. Equitable reserves the right: (i) to cause the registration or deregistration of any Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run any Separate Account under the direction of a committee, and to discharge such committee at any time; and (iii) restrict or eliminate any voting rights of participants or other person who have voting rights as to the Separate Accounts. Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the Rate of 1.75% a year, consisting of .15% for investment management, .35% for financial accounting, .35% for the annuity rate guarantee and the minimum death benefit, and .90% for expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.16. The assets of Separate Accounts are the property of Equitable; however, the portion of the assets of each Separate Account equal to the reserves and other contract liabilities with respect to such Account shall not be chargeable with liabilities arising out of any other business Equitable may conduct. Equitable reserves the right to transfer assets of the Separate Accounts in excess of such reserves and contract liabilities to the general account of Equitable. SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS EVALUATION PERIOD: Each business day together with any non-business day or consecutive non-busniess day immediately preceding such business day will constitute a Valuation Period. A business day is any day on which there is a sufficient degree of trading in the portfolio securities of a Separate Account that the New Accumulation Unit Value or New Annuity Unit Value might be materially affected by changes in the value of the portfolio securities in a Separate Account, as determined by the Separate Account Committee or, if there is no Committee, by Equitable. NET INVESTMENT FACTOR: For each Separate Account the Net Investment Factor for a Valuation Period is (a) divided by (b), minus (c), where (a) is (1) the value of the assets in the Separate Account at the close of business of the preceding Valuation Period plus (2) the investment income and the capital gains, realized or unrealized, credited to the assets of the Separate Account in the Valuation Period for which the Net Investment Factor is being determined, minus (3) the capital losses, realized or unrealized, charged against such assets in such Valuation Period, minus (4) any amount charged against the Separate Account in such Valuation Period for taxes or for amounts set aside by Equitable as a reserve for taxes attributable to the maintenance or operation of the Separate Account: (b) is the value of the assets in the Separate Account at the close of business of the preceding Valuation Period; and (c) is the daily charge, for each calendar day in such Valuation Period of .00004837 for investment management, financial account, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The value of the assets in the Separate Accounts, referred to above, shall be taken at their fair market value, or where there is no readily available market, their fair value, as determined in accordance with accepted accounting practices and applicable laws and regulations. ACCUMULATION UNIT: The Accumulation Unit is a unit used in determining the value of the interest of a Participant's Stock Account or Money Market Account on or before the Retirement Date. PF 14113CH Page 7 DEFINITIONS (continued) NEW ACCUMULATION UNIT VALUE: The initial New Accumulation Unit Values for the Separate Accounts have been established as follows: Account Value Date ------- ----- ---- Separate Account A $ 10.00 As of November 1, 1968 Separate Account E $ 10.00 As of September 4, 1974 The new Accumulation Unit Value for each subsequent Valuation Period is the New Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such subsequent Valuation Period. ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable from Separate Account A under a Variable Annuity Benefit. NEW ANNUITY UNIT VALUE: The initial New Annuity Unit Value for Separate Account A has been established at $1.00 as of November 1, 1968. The Annuity Unit Value for any subsequent Valuation Period is the New Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3 1/2%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE NEW ANNUITY UNIT VALUE: The Average Annuity Unit Value for Separate Account A for a calendar month is equal to the average of the New Annuity Unit Values of the Valuation Periods ending in such month. SECTION 1.17 ANNUITY VALUE The term "Annuity Value" with respect to a Participant's Guaranteed Interest Account, Stock Account and Money Market Account, means the amount in such Accounts pursuant to Sections 2.02 and 2.03. SECTION 1.18A CASH VALUE -- NEW PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to a New Participant, the term "Cash Value" with respect to a new Participant's Guaranteed Interest Account, Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and six months, or (ii) the Participant's attainment of age 70 years and six months, or (iii) the completion of 25 Participation Years with respect to such Participant, or (iv) if the Participant has attained age 55, completed five Participation Years, and the Cash Values are to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% of the sum of the Annuity Values of such Accounts. (b) is an amount equal to the excess, if any, of (i) 8% of the cumulative contributions made on behalf of such Participant over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% of the excess of (i) the sum of the Annuity Values of such Accounts over (ii) the Free Corridor Amount defined in Section 2.07C. (b) is the excess, if any, of (i) 8% of the total contributions made on behalf of such Participant during the current Participation Year and the preceding nine Participation Year over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.97 and 2.07A. PF 14113CH Page 8 DEFINITIONS (continued) The Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. SECTION 1.18B CASH VALUE -- EXISTING PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to an Existing Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The Participant's attainment of age 59 years and six months, (ii) the completion of 20 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55 and the Cash Values are to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a) and (b) below; provided, however, that such charge does not exceed the amount described in subsection (c) below where: (a) is an amount equal to 2% of any Preferred Withdrawable Amounts (defined in Section 2.07B) that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (b) is an amount equal to 6% of any Regular Withdrawable Amounts (defined in Section 2.07B) that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (c) is an amount equal to the sum of (a) above, and 6% of the excess, if any, of (i) the sum of the Annuity Values of such Accounts over (ii) the cumulative total of Equitable Transferred Funds made with respect to the Participant that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. WITHDRAWAL CHARGE AFTER FIVE YEARS: After five Participation Years have been completed with respect to the Participant, Equitable (i) will first withdraw, pursuant to Section 2.07B, the Free Corridor Amount defined in Section 2.07C and (ii) next withdraw the remaining portion of the sum of the Annuity Values of such Accounts. A withdrawal charge will apply to the amount in (ii) above, and will equal the sum of the charges described in subsections (a) and (b) of the preceding subsection; provided, however, that such charge will not exceed an amount equal to the lesser of the charges defined in (d) and (e) below: (d) is an amount equal to the sum of (a) in the preceding subsection, and 6% of the excess, if any, of (i) the sum of the Annuity Values of such Accounts (after withdrawal of the Free Corridor Amount) over (ii) the cumulative total of Equitable Transferred Funds made on behalf of the Participant that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (e) is an amount equal to the excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other contributions (excluding Equitable Transferred Funds) made on behalf of such Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07B. The Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. SECTION 1.19 CODE The term "Code" means the Internal Revenue Code of 1954, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.20 EQUITABLE TRANSFERRED FUNDS The term "Equitable Transferred Funds" with respect to a Participant means the amount of cash value(s) transferred to the Contract from a contract issued by Equitable pursuant to Section 2.01. PF 14113CH Page 9 PART II -- PARTICIPANT'S ACCOUNT SECTION 2.01 CONTRIBUTIONS The Employer is to make Contributions from time to time on such dates and in such amounts as determined by the Employer pursuant to the terms of the Plan. The Employer is to specify the Participant with respect to whom each such Contribution is being made and the amount to be allocated to the Stock Account, Money Market Account and the Guaranteed Interest Account. Each Contribution received by Equitable with respect to a Participant will, before its allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable. A Participant may, with Equitable's agreement, transfer to the Contract any amount held with respect to such Participant under a plan covering self-employed individuals which has been determined by the Internal Revenue Service to meet the requirements for qualification under Section 401(a) of the Code, as modified by Section 401(d) of the Code ("Transferred Funds"). Any Transferred Funds from a contract not issued by Equitable will, before allocation under the Contract, be reduced by the amount of any applicable taxes, as determined be Equitable. Equitable will issue to each Participant an individual certificate setting forth a statement in substance of the benefits which such Participant is entitled under the Contract. SECTION 2.02 STOCK AND MONEY MARKET ACCOUNTS Equitable maintains a Stock Account and Money Market Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the (i) Stock Account becomes part of Separate Account A, and (ii) Money Market Account becomes part of Separate Account E. Any amount withdrawn from an Account will no longer be part of the applicable Separate Account. On any date when an amount is allocated to or withdrawn from an Account, the Account will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the New Accumulation Value for the appropriate Separate Account for the Valuation Period which includes that date. The number of Units in an Account on any date is equal to (i) the sum of any Accumulation Units that have been credited to the Account minus (ii) the sum of any Accumulation Units that have been charged to that Account. The amount in the Stock Account or Money Market Account on any date is equal to the product of (i) the number of Accumulation Units in such Account on that date and (ii) the New Accumulation Unit Value for the appropriate Separate Account for the Valuation Period which includes that date. SECTION 2.03 GUARANTEED INTEREST ACCOUNT Equitable maintains a Guaranteed Interest Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the Guaranteed Interest Account becomes part of the general assets of Equitable, which support the guarantees of the Contract and other contracts. The amount in a Guaranteed Interest Account at any time is equal to the sum of all amounts that have been allocated to such Guaranteed Interest Account pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn pursuant to Sections 2.07, 2.07A, and 2.07B, and Section 2.08 from such Account, and transferred pursuant to Section 2.05 from such Guaranteed Interest Account, and less the sum of any annual administrative charges accrued but not made. Equitable guarantees that the amount in a Guaranteed Interest Account, at any time before the Retirement Date will not be less than the sum of all amounts allocated to such Account pursuant to Section 2.04 or transferred to such Account pursuant to Section 2.05 and less the sum of all amounts that have been withdrawn from such Account pursuant to Sections 2.07, 2.07A and 2.07B, and transferred from such Account pursuant to Section 2.05, all accumulated at 3% interest, compounded annually. In any Participation Year in which no Contribution is allocated to a Guaranteed Interest Account , the amount in such Account at the end of the Participation Year shall not be less than the amount in such Account at the beginning of the Participation Year plus the sum of all amounts transferred to such Account pursuant to Section 2.05 less the sum of all amounts withdrawn and transferred out of such Account pursuant to Sections 2.07, 2.07A and 2.07B, and Section 2.05, all accumulated at 3% interest, compounded annually. PF 14113CH Page 10 PART II -- PARTICIPANT'S ACCOUNT (continued) A Guaranteed Interest Account for a Participant terminated on the earliest of (i) the Retirement Date, (ii) the death of the Participant, and (iii) termination of participation pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO ACCOUNT Each Contribution made with respect to a Participant pursuant to Section 2.01, after deduction for any applicable taxes, will be allocated, as of the date by which Equitable has received both such Contribution and direction as to its allocation, to the Guaranteed Interest Account, Stock Account, or Money Market Account or in part to each, at the sole direction of the Participant as specified to Equitable, provided that the percentage allocated to each Account is a whole number. Any amount that a Participant has directed to be transferred to the Guaranteed Interest Account or Stock Account pursuant to Section 2.05 will be allocated as of the date of such transfer to the appropriate Account maintained for such Participant. Interest is allocated to the Guaranteed Interest Account at the end of each Participation Year, at the time of each transfer or withdrawal pursuant to Sections 2.05 and 2.07, 2.07A, and 2.07B at the time of application of amounts in the Guaranteed Interest Account to provide Annuity Benefits, upon termination of participation pursuant to Section 2.06, and upon death of the Participant pursuant to Section 2.09. SECTION 2.05 TRANSFERS AMONG ACCOUNTS At any time before a Participant's Retirement Date, such Participant, upon written request, (i) may transfer all or a part of the amounts from the Stock Account or Money Market Account maintained for such Participant to the Guaranteed Interest Account maintained for such Participant, or (ii) may transfer all or a part of the amounts in the Guaranteed Interest Account or Money Market Account maintained for such Participant to the Stock Account maintained for such Participant. Such transfers will be made as of the later of (i) the date specified in such request, and (ii) the date Equitable receives such request, and will be subject to Equitable's rules in effect at the time of transfer. No transfers are permitted from the Guaranteed Interest Account or the Stock Account maintained for the Participant to the Money Market Account. SECTION 2.06 TERMINATION OF PARTICIPATION Subject to any applicable restrictions under the terms of the Plan, on or before a Participant's Retirement Date, such Participant may elect by written notice to terminate participation under the Contract. Upon receipt of such notice, Equitable will determine the Cash Value, as of the date Equitable received such notice, of the Guaranteed Interest Account, Stock Account and Money Market Account maintained for such Participant. The payment of such Cash Value to the Participant may be deferred by Equitable in accordance with the provisions of Section 4.08. Prior to a Participant's Retirement Date, Equitable reserves the right to withdraw the Annuity Value of the Participant's Guaranteed interest Account, Stock Account and Money Market Account, pay such Annuity Values and terminate such Participant's participation under the Contract. This right may be exercised with respect to the Participant only if both (i) no Contributions have been made under the Contract during the last three completed Participation Years, and (ii) the sum of such Annuity Values is $500 or less. Equitable reserves the right to terminate a Participant's participation under the Contract if at least 120 days have elapsed since the issue date shown on the certificate issued to such Participant under the Contract and no Contributions have been made under the Contract with respect to such Participant. Upon payment of such Cash Values or Annuity Values, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Cash Values or Annuity Values arose. SECTION 2.07 PARTIAL WITHDRAWALS Subject to any applicable restrictions under the terms of the Plan, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Stock Account, Money Market Account and the Guaranteed Interest Account maintained for such Participant before such Participant's Retirement Date. Upon withdrawal pursuant to Section 2.07, 2.07A or 2.07B, Equitable will pay the lesser of the sum of the Cash Values of such Accounts or the amount of partial withdrawal requested to the person entitled to PF 14113CH Page 11 PARTICIPANT'S ACCOUNT (continued) such payment as designated in writing by such Participant. Unless instructed otherwise, the amount withdrawn (including the amount of any withdrawal charge) will be allocated between such Accounts in proportion to the Annuity Value of each such Account. Upon any payment to a Participant pursuant to Section 2.07, 207A, or 2.07B, equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Payments to the Participant pursuant to Section 2.07, 207A or 2.07B may be deferred by Equitable in accordance with the provisions of Section 4.08. Equitable is under no obligation to process any request for partial withdrawal of less than $300. If a withdrawal from the Accounts made pursuant to Sections 2.07, 207A or 2.07B would result in total Annuity Values of less than $500, Equitable will so advise the Participant and reserves the right to withdraw the Annuity Values of the Guaranteed Interest Account, Stock Account and Money Market Account, pay the Annuity Values of such Accounts to the Participant, and terminate such Participant's participation under the Contract. If the Participant was enrolled in this Contract prior to August 15, 1981, the $500 amount stated above shall be $200. SECTION 2.07A PARTIAL WITHDRAWALS -- NEW PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a New Participant, Equitable will withdraw from the Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and six months, or (ii) such Participant's attainment of age 70 years and six months, or (iii) the completion of 25 Participation Years with respect to such Participant, or (iv) if the Participant has attained age 55, has completed five Participation Years, and the partial withdrawal is to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: If the participant has not completed five Participation Years under the Contract, such withdrawal charge will equal the lesser of (a) or (b) where: (a) is an amount equal to 6% of the total amount to be withdrawn from the Accounts (including such charge) pursuant to this paragraph. (b) is the excess, if any, of (i) 8% of the cumulative total of Contributions made on behalf of such Participant over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Participant, there will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% of the amount withdrawn (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the cumulative total of contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (iii) the cumulative total of any prior withdrawal charges made pursuant to this Section. SECTION 2.07B PARTIAL WITHDRAWAL -- EXISTING PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by an Existing Participant, Equitable will withdraw from the Stock Account, PF 14113CH Page 12 PARTICIPANT'S ACCOUNT (continued) Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The Participant's attainment of age 59 years and six months, or (ii) the completion of 20 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55 and the partial withdrawal is to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. PREFERRED WITHDRAWABLE AMOUNT: This is an amount equal to the lesser of (a) the total of Equitable Transferred Funds made on behalf of the Participant or (b) $10,000. FREE WITHDRAWABLE AMOUNT: This is an amount equal to the excess, if any, of (a) the total Equitable Transferred Funds made on behalf of the Participant over (b) $10,000. REGULAR WITHDRAWABLE AMOUNT: This is the cumulative total of all Contributions, other than Equitable Transferred Funds, made on behalf of the Participant. ORDER OF WITHDRAWALS: In calculating the withdrawal charge, Equitable will assume that (a) any Preferred Withdrawable Amounts are first withdrawn, (b) any Free Withdrawable Amounts are next withdrawn, (c) any Regular Withdrawable Amounts are next withdrawn, and (d) lastly, any amounts other than the amounts described in (a), (b) and (c) above are withdrawn. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a), (b), (c) and (d) below: (a) With respect to any withdrawals of Preferred Withdrawable Amounts, a charge of 2% of such withdrawals. (b) With respect to any withdrawals of Free Withdrawable Amounts, no charge. (c) With respect to any withdrawals of Regular Withdrawable Amounts, a charge of 6% of such withdrawals. (d) With respect to any withdrawals of amounts other than the amounts in (a), (b) and (c) above, no charge. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Participant, there will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (1) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (2) then withdraw from such Accounts an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will equal the sum of the charges described in (a), (b) (c), and (d) above; provided, however, that in no event will such charge exceed an amount equal to the following: The excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other Contributions (excluding Equitable Transferred Funds) made on behalf of the Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any prior withdrawal charges made pursuant to this Section. Whenever an amount is withdrawn from such Accounts that is not greater than the current Free Corridor Amount, such amount is considered to be (1) first, a withdrawal of Regular Withdrawable Amounts, (2) next, a withdrawal of Preferred Withdrawable Amounts, (3) next, a withdrawal of Free Withdrawable Amounts and (4) lastly, a withdrawal of amounts other than the amounts in (1), (2), or (3) above. However, no charge will be assessed with respect to the portion of the withdrawal up to the current Free Corridor Amount. SECTION 2.07C FREE CORRIDOR AMOUNT The term "Free Corridor Amount" with respect to a Participant who has completed five Participation PF 14113CH Page 13 PARTICIPANT'S ACCOUNT (continued) Years means an amount equal to the excess, if any of (i) 10% of the sum of the Annuity Values of the Stock Account, Money Market Account and the Guaranteed Interest Account over (ii) cumulative prior withdrawals made pursuant to Section 2.07, 2.07A or 2.07B in the current Participation Year with respect to the Participant. SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE As of the last day of each Participation Year before a Participant's Retirement Date, Equitable will withdraw from the Guaranteed Interest Account, Stock Account and Money Market Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, and annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Values of the Guaranteed Interest Account, Stock Account and Money Market Account at the end of that Participation Year and (iii) any withdrawals made from such Accounts pursuant to Section 2.07, 2.07A and 2.07B during that Participation Year. The charge will be allocated between the Stock Account, Money Market Account and Guaranteed Interest Account in proportion to the Annuity Values of each such Account, at the end of the Participation Year. As of a Participant's Retirement Date and before application of the Annuity Values or Cash Values of such Participant's Account pursuant to Section 3.03, or upon termination of such Account pursuant to Section 2.06 or Section 2.09 during a Participation Year, Equitable will withdraw the administrative charge described in this Section for the applicable part of that Participation Year. SECTION 2.09 DEATH BENEFIT If the Employer reports to Equitable, or if Equitable otherwise ascertain, that a Participant has died while Accounts for such Participant are maintained under the Contract and before such Participant's Retirement Date, Equitable , upon receipt of due proof of such death, will pay in a single sum to the beneficiary designated by such Participant to receive such payment the amount of death benefit payable with respect to such Participant. The amount of the death benefit with respect to a Participant at any time prior to the Retirement Date is equal to the greater of (i) the sum of the Annuity Values of the Guaranteed Interest Account, Stock Account and Money Market Account maintained under the Contract for such Participant or (ii) the minimum death benefit with respect to such Participant. Such minimum death benefit is the sum of all Contributions made with respect to such Participant pursuant to Section 2.01 (before reduction of any applicable taxes) less an adjustment for any withdrawals made pursuant to Sections 2.07, 2.07A and 2.07B from the Accounts maintained under the Contract for such Participant. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount being withdrawn is to the Annuity Values then in the Guaranteed Interest Account, Stock Account and Money Market Account maintained under the Contract for such Participant. If, in accordance with the provisions of Section 2.01, the cash value of the Annuity contract issued by Equitable, which provides for a death benefit before retirement equal to the greater of the contract cash value or an alternative amount based on premiums paid or contributions made under the Annuity contract, is transferred to the Contract, such alternative amount as of the date of transfer will be included in the "sum of all Contributions" in lieu of the amount of cash value transferred, for purposes of the death benefit under the Contract. The amount of any death benefit payable with respect to a Participant will, to the extent such Account is sufficient therefor, be withdrawn from the Guaranteed Interest Account, Stock Account and Money Market Account maintained with respect to such Participant under the Contract. Upon such payment, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Annuity Values arose. PF 14113CH Page 14 PART III -- ANNUITY BENEFITS SECTION ___ ___ANNUITY BENEFIT The term fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to ___ payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity provided under the Contract with respect to pay___ the amount provided with respect to pay__ pursuant to Section 3.03. SECTION VARIABLE ANNUITY BENEFIT The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payment with respect to a payee may increase or decrease depending on the investment experience of a separate Account A. The amount of the second, and third payments under any Variable Annuity Benefit provided under the Contract with respect to a payee is the monthly amount provided with respect to the payee pursuant to Section 3.04. Amount of the fourth and each subsequent payable under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to __ benefit, multiplied by the Average ___ Unit Value for the second calendar month immediately preceding the date of the payment. The __ and subsequent annuity payments under __-able Annuity Benefit will not be increased or decreased in amount because of mortality ______. The number of Annuity Units with respect to benefit is the number determined by ___ amount of the first monthly payment ___ ___ by the New Annuity Unit Value for ___ Period which includes the due date ___ monthly payment. SECTION ___ ____ AND COMMENCEMENT OF ANNUITY BENEFITS As of a ____ retirement Date, provided such Participant _____, the Annuity Values of such Participation Guaranteed Interest Account, Stock Account and Money Market Account shall be applied to provide ___ of Annuity Benefit, unless such P_____ to receive the Cash Value of such A____ ___ sum or (ii) to apply such Annuity ___ ___, whichever is applicable pursuant _____ paragraph of Section 3.04 to provide _____ Benefit on any other annuity form offered _____ as elected by the Participant, subject to Equitable's rules then in effect and any applicable requirements under the Code. Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Values of such Participant's Guaranteed Interest Account, Stock Account and Money Market Account. Equitable will have the right to require the Participant to furnish pertinent facts and determinations to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Section 3.04 and 3.05. Equitable may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS If a Participant elects pursuant to the first paragraph or third paragraph of Section 3.03 to receive an Annuity Benefit in lieu of the Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account, the amount applied to provide the Annuity benefit will be (i) the Annuity Values of such Accounts if the payments under the annuity form elected are contingent upon the survival of a person, or (ii) the Cash Values of such Account if the payments under the annuity form elected are not contingent upon the survival of a person. The amount applied to provide an Annuity Benefit shall be reduced by any applicable tax on annuity considerations, as determined by Equitable. If such amount is applied on or after the completion of five Participation Years with respect to such Participant, or if such amount is applied on behalf of an Existing Participant, the balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. PF 14113CH Page 15 ANNUITY BENEFITS (continued) If the amount applied to provide an Annuity Benefit is applied before the completion of five Participation Years with respect to a New Participant, the balance, after any applicable tax on annuity considerations, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the Guaranteed Interest Account, Stock Account and Money Market Account maintained for such Participant shall terminate. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (100% continuation). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, are based on 3 1/4% interest and the 1971 ELAS Mortality Table. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on 1979 ELAS mortality and an Assumed Base Rate of Net Investment Return of 3 1/2% or 5%, whichever applies pursuant to Section 1.16. Equitable may change the monthly income amounts contained in the Tables of Guaranteed Annuity Payments and the bases for determining such amounts, for new Participants, by at least 90 days advance notice to the Contract Holder and by an amendment to the Contract. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on 3 1/4% interest and the 1971 ELAS Mortality Table if such annuity form provides for a Fixed Annuity Benefit, and on 1979 ELAS Mortality and an Assumed Base Rate of Net Investment Income Return of 5% or 3 1/2%, whichever applies pursuant to Section 1.16, if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payable under the Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by Equitable will be charged against and underpayments will be added to any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may make the payments (in the case of a minor, at a rate not exceeding $50 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If an annuity form made available by Equitable provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Upon election by a Participant pursuant to Section 3.03 of an annuity form providing payments for a period certain, such Participant may designate (with the right to change such designation) a person or persons to receive any payments that may become due PF 14113CH Page 16 ANNUITY BENEFITS (continued) After the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's executors or administrators in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, Equitable will pay in a single sum to such payees executors or administrators the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. Equitable will require satisfactory evidence of the age of any person upon whose life an annuity form depends. TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Value)
- ----------------------------------------------------------------------------------------------------------- MALE FEMALE AGE AGE 60 61 62 63 64 65 66 67 68 69 70 - ----------------------------------------------------------------------------------------------------------- 60 4.52 4.58 4.64 ` 4.70 4.76 4.82 4.88 4.94 5.00 5.05 5.11 61 4.55 4.62 4.68 4.74 4.81 4.87 4.93 5.00 5.06 5.12 5.18 62 4.58 4.65 4.72 4.78 4.85 4.92 4.99 5.05 5.12 5.19 5.25 63 4.61 4.68 4.75 4.82 4.89 4.97 5.04 5.11 5.18 5.25 5.32 64 4.64 4.71 4.79 4.86 4.94 5.01 5.09 5.17 5.24 5.32 5.40 65 4.67 4.74 4.82 4.90 4.98 5.06 5.14 5.22 5.30 5.38 5.47 66 4.69 4.77 4.85 4.93 5.02 5.10 5.18 5.27 5.35 5.44 5.53 67 4.72 4.80 4.88 4.97 5.05 5.14 5.23 5.31 5.40 5.50 5.59 68 4.74 4.82 4.91 5.00 5.09 5.18 5.27 5.36 5.45 5.55 5.65 69 4.76 4.85 4.94 5.03 5.12 5.22 5.31 5.41 5.50 5.60 5.71 70 4.78 4.87 4.96 5.06 5.16 5.26 5.36 5.45 5.56 5.66 5.76 - -----------------------------------------------------------------------------------------------------------
PF 14113CH Page 17 ANNUITY BENEFITS (continued) VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3 1/2% (Minimum Monthly Income per $1,000 of Annuity Value)
- ----------------------------------------------------------------------------------------------------------- MALE FEMALE AGE AGE 60 61 62 63 64 65 66 67 68 69 70 - ----------------------------------------------------------------------------------------------------------- 60 4.31 4.35 4.39 4.43 4.47 4.51 4.55 4.59 4.63 4.67 4.71 61 4.35 4.39 4.43 4.48 4.52 4.56 4.61 4.65 4.69 4.73 4.78 62 4.39 4.43 4.48 4.52 4.57 4.61 4.66 4.71 4.75 4.80 4.85 63 4.42 4.47 4.52 4.57 4.62 4.67 4.72 4.77 4.82 4.87 4.92 64 4.46 4.51 4.57 4.62 4.67 4.72 4.77 4.83 4.88 4.94 4.99 65 4.50 4.56 4.61 4.66 4.72 4.78 4.83 4.89 4.95 5.01 5.07 66 4.54 4.60 4.65 4.71 4.77 4.83 4.89 4.95 5.01 5.08 5.14 67 4.58 4.64 4.70 4.76 4.82 4.88 4.95 5.01 5.08 5.15 5.22 68 4.62 4.68 4.77 4.81 4.87 4.95 5.01 5.08 5.15 5.22 5.29 69 4.65 4.72 4.78 4.85 4.92 4.99 5.06 5.14 5.22 5.29 5.37 70 4.69 4.76 4.83 4.90 4.97 5.05 5.12 5.20 5.28 5.36 5.45 - -----------------------------------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 5% (Minimum Monthly Income per $1,000 of Annuity Value)
- ----------------------------------------------------------------------------------------------------------- MALE FEMALE AGE AGE 60 61 62 63 64 65 66 67 68 69 70 - ----------------------------------------------------------------------------------------------------------- 60 5.19 5.23 5.27 5.31 5.34 5.39 5.42 5.46 5.50 5.54 5.58 61 5.23 5.27 5.31 5.35 5.39 5.43 5.47 5.52 5.56 5.60 5.64 62 5.27 5.31 5.35 5.39 5.44 5.48 5.53 5.57 5.62 5.67 5.71 63 5.31 5.35 5.39 5.44 5.49 5.53 5.58 5.63 5.68 5.73 5.78 64 5.34 5.39 5.44 5.48 5.53 5.59 5.64 5.69 5.74 5.79 5.85 65 5.38 5.43 5.48 5.53 5.58 5.64 5.69 5.75 5.80 5.86 5.92 66 5.42 5.47 5.52 5.58 5.63 5.69 5.75 5.81 5.87 5.93 5.99 67 5.45 5.51 5.56 5.62 5.68 5.74 5.80 5.87 5.93 6.00 6.06 68 5.49 5.55 5.61 5.67 5.73 5.80 5.86 5.93 6.00 6.06 6.14 69 5.53 5.59 5.65 5.71 5.78 5.85 5.92 5.99 6.06 6.13 6.21 70 5.56 5.63 5.69 5.76 5.83 5.90 5.97 6.05 6.13 6.21 6.29 - -----------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value)
VARIABLE ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET FIXED ANNUITY BENEFIT INVESTMENT RETURN IS --------------------- -------------------- 3 1/2% 5% ------ ---- AGE MALES FEMALES MALES FEMALES MALES FEMALES --- ----- ------- ----- ------- ----- ------- 60 5.88 4.99 5.43 4.80 6.36 5.70 61 6.04 5.11 5.57 4.90 6.50 5.81 62 6.21 5.24 5.72 5.01 6.65 5.91 63 6.38 5.38 5.88 5.13 6.81 6.03 64 6.57 5.53 6.05 5.25 6.97 6.15 65 6.77 5.68 6.23 5.39 7.16 6.28 66 6.98 5.84 6.43 5.54 7.35 6.43 67 7.19 6.01 6.64 5.70 7.56 6.58 68 7.42 6.20 6.87 5.87 7.79 6.76 69 7.67 6.39 7.11 6.06 8.03 6.95 70 7.93 6.61 7.38 6.27 8.30 7.15
Equitable will notify the payee under a Variable Annuity Benefit of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each variable payment. Any election, change, revocation or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a commutation right under an Annuity Benefit is exercised, Equitable may defer payment in accordance with Section 4.08. PART IV -- GENERAL PROVISIONS SECTION 4.01 CONTRACT The Contract constitutes the entire Contract between the parties and the provisions of the Contract alone will govern with respect to the rights and obligations of Equitable. The provisions of the Contract will be applied separately with respect to each Participant. Nothing in the enrollment form referred to in Section 1.05, the Plan or trust agreement referred to in Section 4.10 nor any modification, amendment, or supplement to any such documents will in any way be construed to enlarge, change, vary or in any other way affect the obligations of Equitable as expressly provided in the Contract. The Contract may not be modified as to Equitable, nor may any of Equitable's rights or requirements be waived, except in writing and by an authorized officer of Equitable. The Contract may be changed by amendment or replacement upon agreement between the Contract Holder and Equitable without the consent of any other person provided that such change does not reduce any Annuity Benefit provided before such change and provided that no rights, privileges or benefits which have accrued to any Participant under the Contract may be reduced or forfeited except by the express consent of such Participant. SECTION 4.02 STATUTORY COMPLIANCE Equitable reserves the right to amend the Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to PF 14113CH Page 18 GENERAL PROVISIONS (continued) conform the contract and any certificate to reflect changes in the Code, or in regulations or published rulings of the Internal Revenue Service, so that each such certificate will continue to be an Annuity. Any Annuity Benefit, Cash Value or death benefit available __ a certificate issued pursuant to the Contract ___ not be less than the minimum benefits required ___ statute of the state in which the certificate is ____. SECTION ___ ASSIGNMENTS AND NONTRANSFERABILITY The en___ ___ of any Participant under the Contract is _____able. No inter____ Participant under the Contract may be sold, ___ discounted, or pledged as collateral for a ____ security for the performance of an obligation ___ any other purpose to any person other than ___able. No amount payable under the Contract may be assigned, ____, or encumbered by the payee, and , to ____ permitted by law, no such amount will in ___ be subject to any claim against such payee. SECTION ______ PARTICIPATION IN SURPLUS The ___ all other contracts in the same class of con___ shall be combined for the purpose of ascertain ____ annual surplus of Equitable to be apportioned _____ contracts as a dividend, and the portion dividend that is to be allocated to the Contract __ shall be determined by Equitable. The participant __ this class of contracts in annual surplus ___ ever, expected to be minimal. Any amount ___ to the Contract shall be payable as of ___ of the calendar year in which a dividend is ____ and will be payable in cash and shall be ___ allocated by Equitable to the Guaranteed Interest Accounts maintained hereunder for Part____. No Annuity Benefit will enter into the determination of any ___ to be apportioned to the Contract as a dividend. SECTION ____ BENEFICIARY Each Participant as of such Participant's Participation Date is to provide Equitable with an initial designation beneficiary entitled to receive any death benefit payable with respect to such Participant pursuant to Section 2.09. The Participant may change such designation from time to time during such Participant's lifetime and while Accounts for such Participants are being maintained hereunder. Any such designation or change will be made by written notice in a form satisfactory to Equitable. A change will, upon receipt at a designated Equitable Office, take effect as of the time the written notice was signed, whether or not the Participant is living on the date receipt, but without further liability as to any payment or other settlement made by Equitable before receipt of such change. Unless otherwise specified in the designation, if a Participant has designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive the Participant, and if more than one survive they will share equally. Any part of a death benefit payable with respect to a Participant pursuant to Section 2.09 for which there is no designated beneficiary living at the death of the Participant will be payable in a single sum to the children of the Participant who survive the Participant, in equal shares, or should none survive, then to the Participant's executors or administrators. If a Participant so elects in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by the Participant, with respect to the beneficiary, subject to Equitable's rules then in effect. If at the death of a Participant there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. SECTION 4.06 DISQUALIFICATION In the event that an annuity purchased hereunder with respect to a Participant fails to qualify as an Annuity as described in Section 1.03, Equitable shall have the right, upon receiving notice of such fact before the Retirement Date, to terminate participation with respect to such Participant under the Contract and pay to such Participant the amount in the Account maintained with respect to such Participant less a deduction for the appropriate part attributable to such Participant of any Federal income tax payable if such Participant had an Annuity under the Contract. PF 14113CH Page 19 GENERAL PROVISIONS (continued) SECTION 4.07 FUTURE PARTICIPANTS Equitable reserves the right at its sole discretion to curtail or prohibit further enrollment as Participants under the Contract of any individuals who are not currently participating under the Contract as of such date of curtailment or prohibition. SECTION 4.08 DEFERMENT Payment by Equitable from the Participant's Guaranteed Interest Account pursuant to the Provisions of Section __, Sections 2.07, 2.07A and 2.07B, and Section 2.__ any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.05, may be deferred for up to six months after receipt of a ?? request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such ?? mutation payment pursuant to Section 3.05. ?? at the current Guaranteed Interest Rate for such Participant's Guaranteed Interest Account will be ?? on any such payment deferred for 30 days or more. Except as provided in this Section, payments by Equitable from the Participant's Stock Account or Money Market Account pursuant to the provisions of Section 2.06, Sections 2.07, 2.07A and 2.07B, and Section 2.09, or commutation payments arising from a Variable Annuity benefit pursuant to Section 3.05, will be made within seven days after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, receipt of due documentation for such commutation payment pursuant to Section 3.05. During any ??? when (i) the sale of securities or the determination of the New Accumulation Unit Value or the ?? New Annuity Unit Value is not reasonably ??? because an emergency, defined by the Securities and Exchange Commission, exists, or the New York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may by order permit pose ?? for the protection of persons having interests in the Separate Accounts, Equitable reserves the right (a) to defer determination of Cash Values or Annuity values and payment of Cash Values and Annuity Values, arising from an amount in a Participant's Stock Account or Money Market Account; (b) to defer payment of any portion of the death benefit arising from an amount in a Participant's Stock Account or Money Market Account; (c) to defer the payment of any Variable Annuity Benefit under the Contract or the application of any such Benefit to provide for any other payment called for by the Contract; or (d) in the event of (a) above, to defer application of such amounts to provide any Annuity Benefit permitted under the Contract. SECTION 4.09 ANNUAL NOTICE At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Guaranteed Interest Account, (2) the total number of Accumulation Units credited to the Stock Account and Money Market Account, (3) the New Accumulation Unit Values, (4) the sum of the Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account and (5) the amount of death benefit payable with respect to the Participant. After the Retirement Date Equitable will notify the Participant of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.10 CONTRACT HOLDER RESPONSIBILITY The sole responsibility of the Contract Holder is to serve as party to the Contract. The Contract Holder will have no responsibility for the administration of any Plan, for payments to the Guaranteed Interest Account, Stock Account or Money Market Account, or any payments or other distributions hereunder. Equitable will deal with the Contract Holder in accordance with the terms and conditions of the trust agreement pursuant to which the Contract Holder agreed to act as such and with the Contract and in such manner as the Contract Holder and Equitable may agree, without the consent of any other person. Any Employer making Contributions under the Contract shall be deemed to have adopted and accepted the trust agreement as part of the Plan with respect to which such Contributions are made. SECTION 4.11 AGE AND SEX If the Annuitant's age or sex has been misstated, any benefits will be those which would have been purchased at the correct age and sex. Any overpayments or underpayments made by Equitable will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. PF 14113CH Page 20 Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By /s/ Signature Unreadable By /s/ Coy Eklund ----------------------------------- -------------------------------- Chairman of the Board Title Senior Vice President By /s/ Rodney L. Enochs ------------------------------- -------------------------------- Vice President and Secretary Dated May 27, 1982 Date of Issue MAY 1 1982 ------------------------------- ------------------ At New York, N.Y. ----------------------------------- PF 14113CH Page 21 Attached to and made part of Group Annuity Contract No. 11931CH between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective January 1, 1982 said contract is amended by adding the following to the third paragraph of Section 1.10 (Guaranteed Interest Rate): For the period (not to exceed one year) next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent period (not to exceed one year) the Equitable may determine for each established Class of Participants a Guaranteed Interest Rate for such Class which exceeds the applicable Yearly Guaranteed Interest Rate. Equitable will notify each Participant in writing of the applicable Guaranteed Interest Rate and duration. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By Sinature not legible By /s/ Coy Eklund --------------------------------- ------------------------------- President Title Senior Vice President By /s/ Rodney L. Enochs ------------------------------ ------------------------------- Vice President and Secretary Dated DEC 22 1981 Date of Issue DEC 22 1981 ----------------------------- -------------------- At New York, New York -------------------------------- PF 14107CH Attached to and made part of Group Annuity Contract No. 11931CH between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective August 26, 1983, said contract and riders are amended as follows: 1. with respect to Section 1.18A Cash Value -- New Participants a. the term "25 Participation Years" contained in the paragraph entitled "No Withdrawal Charge" is changed to "12 Participation Years," b. the paragraph entitled "Withdrawal Charge Within First Five Years" is replaced by the following: WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS: Within the first three Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% of the sum of the Annuity Values of such Accounts. (b) is an amount equal to the excess, if any, of (i) 8% of the cumulative contributions made on behalf of such Participant over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. c. the paragraph entitled "Withdrawal Charge After Five Years" is replaced by the following: WITHDRAWAL CHARGE AFTER THREE YEARS: After the completion of three Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% during Participation Years 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the excess of (i) the sum of the Annuity Values of such Accounts over (ii) the Free Corridor Amount defined in Section 2.07C. (b) is the excess, if any, of (i) 8% of the total contributions made on behalf of such Participant during the current Participation Year and the preceding nine Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. The Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. PF 17003CH 2. with respect to Section 1.18B Cash Value -- Existing Participants a. the term "20 Participation Years" contained in the paragraph entitled "No Withdrawal Charge" is changed to "12 Participation Years," b. the paragraph entitled "Withdrawal Charge Within First Five Years" is replaced by the following: WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS: Within the first three Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a) and (b) below; provided, however, that such charge does not exceed the amount described in subsection (c) below where: (a) is an amount equal to 2% of any Preferred Withdrawable Amounts (defined in Section 2.07B) that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (b) is an amount equal to 6% during the first five Participation Years 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of any Regular Withdrawable Amounts (defined in Section 2.07B) that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (c) is an amount equal to the sum of (a) above, and 6% of the excess, if any, if (i) the sum of the Annuity Values of such Accounts over (ii) the cumulative total of Equitable Transferred Funds made with respect to the Participant that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. c. the paragraph entitled "Withdrawal Charge After Five Years" is replaced by the following: WITHDRAWAL CHARGE AFTER THREE YEARS: After three Participation Years have been completed with respect to the Participant, Equitable (i) will first withdraw, pursuant to Section 2.07B, the Free Corridor Amount defined in Section 2.07C and (ii) next withdraw the remaining portion of the sum of the Annuity Values of such Accounts. A withdrawal charge will apply to the amount in (ii) above, and will equal the sum of the charges described in subsections (a) and (b) of the preceding subsection; provided, however, that such charge will not exceed an amount equal to the lesser of the charges defined in (d) and (e) below: (d) is an amount equal to the sum of (a) in the preceding subsection, and 6% during Participation Years 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the excess, if any, of (i) the sum of the Annuity Values of such Accounts (after withdrawal of the Free Corridor Amount) over (ii) the cumulative total of Equitable Transferred Funds made on behalf of the Participant that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (e) is an amount equal to the excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other contributions (excluding Equitable Transferred Funds) made on behalf of such Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07B. The Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. 3. with respect to Sections 2.07A Partial Withdrawals -- New Participants a. the term "25 Participation Years" contained in the provision entitled "No Withdrawal Charge" is changed to "12 Participation Years;" PF 17003CH b. the provision entitled "Withdrawal Charge Within First Five Years" is replaced by the following: WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS: If the Participant has not completed three Participation Years under the Contract, such withdrawal charge will equal the lesser of (a) or (b) where: (a) is an amount equal to 6% of the total amount to be withdrawn from the Accounts (including such charge) pursuant to this paragraph. (b) is the excess, if any, of (i) 8% of the cumulative total of Contributions made on behalf of such Participant over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. c. the provision entitled "Withdrawal Charge After Five Years" is replaced by the following: WITHDRAWAL CHARGE AFTER THREE YEARS: After the completion of three Participation Years with respect to the Participant, there will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Participation Years 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the amount withdrawn (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the cumulative total of contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. 4. with respect to Section 2.07B Partial Withdrawals -- Existing Participants a. the term "20 Participation Years" contained in the provision entitled "No Withdrawal Charge" is changed to "12 Participation Years;" b. the provision entitled "Withdrawal Charge Within First Five Years" is replaced by the following: WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS: Within the first three Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a), (b), (c) and (d) below: (a) With respect to any withdrawals of Preferred Withdrawable Amounts, a charge of 2% of such withdrawals. (b) With respect to any withdrawals of Free Withdrawable Amounts, no charge. (c) With respect to any withdrawals of Regular Withdrawable Amounts, a charge of 6% of such withdrawals. (d) With respect to any withdrawals of amounts other than the amounts in (a), (b) and (c) above, no charge. c. the provision entitled "Withdrawal Charge After Five Years" is replaced by the following: WITHDRAWAL CHARGE AFTER THREE YEARS: After the completion of three Participation Years with respect to the Participant, there will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07C. PF 17003CH If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (1) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (2) then withdraw from such Accounts an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will equal the sum of the charges described in (a), (b) and (d) above plus with respect to any withdrawals of Regular Withdrawable Amounts, a charge of 6% during Participation Years 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter provided, however, that in no event will such charge exceed an amount equal to the following: The excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other Contributions (excluding Equitable Transferred Funds) made on behalf of the Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any prior withdrawal charges made pursuant to this Section. Whenever an amount is withdrawn from such Accounts that is not greater than the current Free Corridor Amount, such amount is considered to be (1) first, a withdrawal of Regular Withdrawable Amounts, (2) next, a withdrawal of Preferred Withdrawable Amounts, (3) next, a withdrawal of Free Withdrawable Amounts, and (4) lastly, a withdrawal of amounts other than the amounts in (1), (2), or (3) above. However, no charge will be assesed with respect to the portion of the withdrawal up to the current Free Corridor Amount. 5. with respect to Section 2.07C Free Corridor Amount, the term "five Participation Years" is changed to "three Participation Years." Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By /s/ [Signature Unreadable] By /s/ John B. Carter ............................... .................................. President Title Vice President By /s/ Rodney L. Enochs ............................... .................................. Vice President and Secretary Dated August 19, 1983 Date of Issue ............................... ....................... At New York, New York .................................. PF 17003CH Attached to and made part of Group Annuity Contract No. 11931CH between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective December 12, 1983, said contract and riders are amended as follows: 1. all references in the contract to the Annuitant's sex are deleted. 2. the phrase "3 1/4% interest and the 1971 ELAS Mortality Table" and the phrase "1979 ELAS Mortality" appearing in Section 3.04 Amount of Annuity Benefits shall be changed to "3 1/2% interest and the 1983 Individual Annuity Mortality Table adjusted to a unisex basis based on a 50-50 split of males and females" and "the projected 1983 Basic Table adjusted to a unisex basis based on a 50-50 split of males and females," respectively, wherever they appear. 3. the Tables of Guaranteed Annuity Payments appearing in Section 3.05 Payment of Annuity Benefits, are replaced by the following Tables. TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Value) AGE
AGE 60 61 62 63 64 65 66 67 68 69 70 60 4.54 4.58 4.62 4.66 4.70 4.74 4.77 4.81 4.84 4.86 4.91 61 4.62 4.67 4.71 4.76 4.81 4.84 4.88 4.91 4.95 4.99 62 4.72 4.76 4.81 4.85 4.90 4.94 4.98 5.02 5.06 63 4.81 4.86 4.91 4.96 5.01 5.06 5.10 5.14 64 4.92 4.97 5.02 5.08 5.13 5.17 5.22 65 5.03 5.09 5.15 5.20 5.26 5.31 66 5.15 5.21 5.27 5.33 5.39 67 5.28 5.34 5.40 5.47 68 5.41 5.48 5.55 69 5.56 5.63 70 5.71
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3 1/2% (Minimum Monthly Income per $1,000 of Annuity Value) AGE
AGE 60 61 62 63 64 65 66 67 68 69 70 60 4.40 4.44 4.48 4.51 4.55 4.58 4.61 4.65 4.68 4.71 4.74 61 4.48 4.52 4.56 4.60 4.64 4.67 4.71 4.74 4.78 4.81 62 4.56 4.60 4.65 4.69 4.73 4.77 4.80 4.84 4.86 63 4.65 4.69 4.74 4.78 4.83 4.87 4.91 4.95 64 4.74 4.79 4.84 4.89 4.93 4.98 5.02 65 4.85 4.90 4.95 5.00 5.05 5.10 66 4.95 5.01 5.06 5.11 5.17 67 5.07 5.12 5.18 5.24 68 5.19 5.25 5.32 69 5.32 5.39 70 5.46
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 5% (Minimum Monthly Income per $1,000 of Annuity Value) AGE
AGE 60 61 62 63 64 65 66 67 68 69 70 60 5.27 5.30 5.34 5.37 5.41 5.44 5.47 5.51 5.54 5.57 5.59 61 5.34 5.38 5.42 5.46 5.49 5.53 5.57 5.60 5.63 5.66 62 5.42 5.46 5.50 5.54 5.58 5.62 5.65 5.69 5.73 63 5.50 5.55 5.59 5.63 5.67 5.71 5.75 5.79 64 5.59 5.64 5.69 5.73 5.78 5.82 5.86 65 5.69 5.74 5.79 5.84 5.89 5.93 66 5.79 5.85 5.90 5.95 6.00 67 5.90 5.96 6.02 6.08 68 6.02 6.08 6.15 69 6.15 6.22 70 6.29
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value)
VARIABLE ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET FIXED ANNUITY BENEFIT INVESTMENT RETURN IS ------------------------- ------------------------------------------- AGE 3 1/2% 5% - --------- -------- -------- 60 5.29 5.08 5.97 61 5.41 5.19 6.08 62 5.55 5.31 6.20 63 5.69 5.44 6.33 64 5.85 5.58 6.46 65 6.01 5.73 6.61 66 6.19 5.89 6.77 67 6.37 6.06 6.94 68 6.58 6.24 7.12 69 6.79 6.43 7.31 70 7.02 6.64 7.52
PF17008CH This amendment was approved by the New York Insurance Department under an accelerated procedure to assist employers in complying with the United States Supreme Court decision in Arizona v. Norris. The Department has reserved the right to require changes in this amendment to comply with applicable New York law and regulations. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By /s/ William H. Schroeder By /s/ John B. Carter ------------------------------- ----------------------------------- President Title Vice President By /s/ Rodney L. Enochs ---------------------------- ----------------------------------- Vice President and Secretary Dated DEC. 15 1983 Date of Issue ---------------------------- ---------------------- At New York, N.Y. ---------------------------- PF17008CH Attached to and made part of Group Annuity Contract No. 11931CH between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective May 1, 1984, said contract and riders are amended as follows: 1. The term "Stock Account" has been changed to "Stock Account, Balanced Account and Aggressive Stock Account" wherever it appears except as provided in items 4 and 5 of this rider. 2. The Section entitled "The Separate Accounts" is amended as follows: a. the following Accounts have been added:
Name Investments ---- ----------- Separate Account J Primarily common stocks and other equity-type investments, publicly traded debt securities and short-term money market instruments. Separate Account K Primarily common stocks issued by high quality small and intermediate size companies with strong growth prospects.
b. The sentences "Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, consisting of .15% for investment management, .35% for financial accounting, .35% for the annuity rate guarantee and the minimum death benefit, and .90% for expenses and expense risk. The charge shall be made in connection with (c) of the Net Investment Factor provision in Section 1.16" are amended to read as follows: i. for Participants with a Participation Date prior to May 1, 1984 "Assets of Separate Account A and Separate Account E attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, consisting of .15% for investment management, .35% for financial accounting, .35% for the annuity rate guarantee and the minimum death benefit, and .90% for expenses and expense risk. Assets of separate Account J and Separate Account K attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The percentage allocation of the components of the charges for Separate Account J and Separate Account K are not necessarily allocated in the same amounts as for Separate Account A and Separate Account E. The charge shall be made in connection with (c) of the Net Investment Factor provision in Section 1.16" ii. for Participants with a Participation Date on or after May 1, 1984 "Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.16" PF 17012CH 3. The Section entitled "New Accumulation Unit Value" is amended by the addition of the following Accounts: Account Value Date ------- ----- ---- Separate Account J $10.00 As of May 1, 1984 Separate Account K $10.00 As of May 1, 1984 4. The title and the first two sentences of the Section entitled "Stock and Money Market Accounts" shall read as follows: STOCK, BALANCED, AGGRESSIVE STOCK AND MONEY MARKET ACCOUNTS Equitable maintains a Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the (1) Stock Account becomes part of Separate Account A, (2) Balanced Account becomes part of Separate Account J, (3) Aggressive Stock Account becomes part of Separate Account K, and (4) Money Market Account becomes part of Separate Account E. 5. The Section entitled "Transfers Among Accounts" is amended to read as follows: TRANSFERS AMONG ACCOUNTS At any time before a Participant's Retirement Date, such Participant, upon written request, may transfer all or part of the amounts maintained for the Participant to one or more of the other Accounts maintained for such Participant as follows: (1) amounts in the Guaranteed Interest Account, Stock Account, Balanced Account and Aggressive Stock Account may be transferred among such Accounts; (2) amounts in the Money Market Account may be transferred to the other Accounts. Such transfers will be made as of the date Equitable receives such request, and will be subject to Equitable rules in effect at the time of transfer. No transfers are permitted from the Guaranteed Interest Account, Stock Account, Balanced Account or Aggressive Stock Account maintained for the Participant to the Money Market Account. Notwithstanding the above, transfers to the Balanced Account may be prohibited by Equitable upon 30 days written notice to the Participant. THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By /s/ William H. Schroeder By /s/ John B. Carter ------------------------ -------------------------------- President Title Vice President By /s/ Rodney L. Enochs ---------------------- -------------------------------- Dated 06/27/84 Date of Issue ---------------------- ----------------------- At N.Y. N.Y. ------------------------- PF 17012CH Attached to and made part of Group Annuity Contract No. 11931CH between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective July 1, 1986, said contract and riders are amended as follows: 1. With respect to PART I - DEFINITIONS, the following section is added: SECTION 1.14C PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by Equitable which does not permit any prepayment of the unpaid principal. 2. With respect to SECTION 1.18 CASH VALUE, the following text replaces the paragraphs under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to a Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such Annuity is at least ten years. At all other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. 3. With respect to SECTION 2.07A PARTIAL WITHDRAWAL CHARGES, the following paragraph replaces the paragraph under NO WIHTDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a Participant, Equitable will withdraw from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such Annuity is at least ten years. At all other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES By________________________________ By_______________________________ President Title_____________________________ By_______________________________ Vice President and Secretary Dated_____________________________ Date of Issue____________________ At________________________________ PF 17035CH Participant: Certificate Number: [LOGO] Issue Date: Retirement Date: THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York, New York 10116 AGREES o To allocate the Contributions made to the Contract, after deduction of any applicable taxes, to the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account or the Guaranteed Interest Account maintained for the Participant, in accordance with Sections 2.02 and 2.03, or in part to any one, as directed by the Participant. o To apply the amount in the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Guaranteed Interest Account at the Retirement Date to provide the Participant with an Annuity Benefit or a Cash Value Benefit if the Participant is then living, and o To provide the Participant with the other rights and benefits of this certificate. These agreements are subject to the provisions of this certificate. TEN DAYS TO EXAMINE CERTIFICATE -- The Participant may terminate participation under the Contract and cancel this certificate by returning it to Equitable within ten days after receipt of it. Upon such cancellation, Equitable will refund any Contribution made to Equitable on behalf of a Participant under the Contract, plus or minus any investment gain or loss experienced in the Participant's Stock Account, Balanced Account, Aggressive Stock Account, or Money Market Account from the date such Contribution is allocated to such Account to the date of such Cancellation. /s/ Rodney L. Enochs Vice President /s/ John B. Carter President and Secretary ASSETS HELD IN CONNECTION WITH THE CONTRACT MAY BE HELD IN SEPARATE ACCOUNTS MAINTAINED BY EQUITABLE AND MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THE CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF SEPARATE ACCOUNT A. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN SEPARATE ACCOUNT A IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.16 IS 5% OR 3 1/2%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE OF 1.75% FOR INVESTMENT MANAGEMENT, FINANCIAL ACCOUNTING, THE ANNUITY RATE GUARANTEE AND MINIMUM DEATH BENEFIT, EXPENSES AND EXPENSE RISK, BUT AFTER ANY DEDUCTIONS TO PROVIDE FOR TAXES. THIS CONTRACT MAY NOT BE SUITABLE FOR A PARTICIPANT IF THE ONLY CONTRIBUTION TO BE MADE ON SUCH PARTICIPANT'S BEHALF IS A SUBSTANTIAL SINGLE SUM CONTRIBUTION. NO. 11935H AMENDED BY PF 17008H - PF 17012H - PF 17017H - PF 17021H CONTENTS Part I - Definitions Page 2 Part II - Participant's Account Page 6 Part III - Annuity Benefits Page 9 Part IV - General Provisions Page 12 Equitable certifies that the Participant as named on page 3 is included under the Group Annuity Contract designated on page 3 ("the Contract"), all pertinent provisions of which are set forth below. As described in Section 1.10, Equitable will determine, before the beginning of each calendar year commencing after the period for which the Initial Guaranteed Interest Rate is effective, the Yearly Guaranteed Interest Rate for the calendar year for each Class of Participants, which shall not be lower than the Minimum Guaranteed Interest Rate then in effect. Equitable, from time to time, may declare a Guaranteed Interest Rate for a Class which exceeds the applicable Yearly Guaranteed Interest Rate and a period for which such rate applies. A Guaranteed Interest Rate is subject to annual administrative charges described in Section 2.08. This certificate is valid only if participation under the Contract has not been terminated as described in the Contract and is subject to amendment as may be required pursuant to Section 4.02. EARLY WITHDRAWAL CHARGE. If a Participant terminates participation at any time after the earliest of the following occurrences: (i) The later of (a) the attainment of age 59 years and six months or (b) the completion of five Participation Years, or (ii) the completion of 12 Participation Years, the sum of the Cash Values of the Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account as provided in Section 1.18, will be equal to the sum of the Annuity Values of each such Account. At other times, the sum of the Cash Values of such Accounts may be less than the sum of the Annuity Values as provided in Section 1.18. The Contract is issued in consideration of the payment to Equitable of the Contributions made under the Contract. The provisions on the following pages are part of this certificate. PART I - DEFINITIONS SECTION 1.10 EMPLOYER. The term "Employer" means the sole proprietor or the partnership adopting the Plan, or any successor unincorporated trade or business that assumes in writing the obligations of the Plan. The Plan is adopted by the Employer's execution of the Adoption Statement which constitutes a part of the Plan and pursuant to which the Employer adopts the Plan. A sole proprietor is deemed to be his own Employer and a partnership is deemed to be the Employer of each partner. SECTION 1.02 PLAN. The term "Plan" means the HR-10 Group Annuity/Pension Plan with Optional Life Insurance, a master pension plan for self-employed individuals and their employees sponsored by Equitable which has been determined by the Internal Revenue Service to meet the requirements for qualification under Section 401(a) of the Code. SECTION 1.03 ANNUITY. The term "Annuity" means an annuity purchased in accordance with the terms of the Plan if the Plan, as adopted by the Employer, meets the requirements for qualification under Section 401(a) of the Code. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Section 3.04 of the Contract. SECTION 1.05 PARTICIPANT. The term "Participant" means a person who has been enrolled by Equitable under the Contract and for whom the Employer has purchased an Annuity under the Contract. A person shall become enrolled under the Contract upon receipt by Equitable of an enrollment form made available by Equitable and completed in a manner satisfactory to Equitable. An Annuity is purchased for a person enrolled under the Contract upon receipt by Equitable of an initial Contribution by the Employer. SECTION 1.06 CONTRIBUTION. The term "Contribution" means a payment made to Equitable for a Participant with respect to an Annuity purchased for such Participant under the Contract. Equitable is under no obligation to accept any Contribution less than $20.00 NO. 11935H AMENDED BY PF 17008H - PF 17012H - PF 17017H - PF 17021H -------- Page Two Page Four --------- DEFINITIONS (CONTINUED) SECTION 1.07 PARTICIPATION DATE. The Term "Participation Date" with respect to a Participant means the date as of which Equitable has enrolled such Participant under the terms of the Contract. SECTION 1.08 PARTICIPATION YEAR. The term "Participation Year" with respect to the Participant means the twelve month period beginning on (i) the Participation Date, and (ii) each anniversary thereof, unless otherwise agreed to in writing by Equitable. SECTION 1.09 CLASS OF PARTICIPANTS. Except as provided in Section 1.10, the term "Class of Participants" refers to all Participants whose Participation Date is in the same calendar year. SECTION 1.10 GUARANTEED INTEREST RATE. For each Guaranteed Interest Account, the term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in such Account. Interest accrues daily. The Guaranteed Interest Rate will never be less than 3% per annum. Equitable will from time to time establish and make available for new Participants (i) an Initial Guaranteed Interest Rate, (ii) one or more Minimum Guaranteed Interest Rates and (iii) the applicable effective period(s) for such Rates. A new Class of Participants will be established effective with the effective date of the occurrence of (i), (ii) or (iii) above or any combination thereof. For the calendar year next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent calendar year thereafter, Equitable will determine for each established Class of Participants before the beginning of such calendar year a Yearly Guaranteed Interest Rate for such Class, which Yearly Guaranteed Interest Rate will not be lower than the effective Minimum Guaranteed Interest Rate applicable for such Class for such year. For any established Class of Participants, Equitable reserves the right to change the Minimum Guaranteed Interest Rate and the applicable period therefor, provided that any such Minimum Guaranteed Interest Rate will not be lower than the Minimum Guaranteed Interest Rate that would have been in effect in the absence of such change. Equitable will notify each Participant in a Class in writing of the Yearly Guaranteed Interest Rate or of any change in the Minimum Guaranteed Interest Rate at least 15 days prior to its effective date. For the period (not to exceed one year)next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent period (not to exceed one year) the Equitable may determine for each established Class of Participants a Guaranteed Interest Rate for such Class which exceeds the applicable Yearly Guaranteed Interest Rate. Equitable will notify each Participant in writing of the applicable Guaranteed Interest Rate and duration. SECTION 1.11 RETIREMENT DATE. The term "Retirement Date" means the date on which the Participant is to attain the retirement age specified in the Participant's enrollment form. Before the Retirement Date the Participant may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be earlier than the date of attainment of age 59 years and six months nor shall be later than the date of attainment of age 70 years and six months. Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Home Office. SECTION 1.12 NORMAL FORM. The "Normal Form" of an Annuity Benefit under the Contract means, (i) if the Participant has a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (100% continuation), and (ii) if the Participant does not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.13 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depends is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by the Participant. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.14A LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.14B ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by Equitable which extends beyond the Participant's attainment of age 59 years and six months and does not permit any prepayment of the unpaid principal prior to the participant's attainment of age 59 years and six months. SECTION 1.15 THE SEPARATE ACCOUNTS. The term "Separate Accounts" means the following separate investment accounts maintained by Equitable to which portions of its assets have been allocated for the Contract and certain other contracts: NO. 11935H AMENDED BY PF 17008H - PF 17012H - PF 17017H - PF 17021H --------- Page Four Page Five --------- DEFINITIONS (CONTINUED) Name Investments - ---- ----------- Separate Account A Primarily common stock and other equity-type investments. Separate Account E Primarily short-term money market instruments. Separate Account J Primarily common stocks and other equity-type investments, publicly traded debt securities and short-term money market instruments. Separate Account K Primarily common stocks issued by high quality small and intermediate size companies with strong growth prospects. Equitable reserves the right to withdraw from any Separate Account and allocate to another separate account assets determined by Equitable to be associated with the class of contracts to which the Contract belongs. In any such event, to the extent practicable and permissible under applicable laws and regulations, the withdrawal shall be made by withdrawing the same percentage of each investment in the Separate Account, with appropriate adjustments to avoid odd lots and fractions. On and after the date of any such withdrawal the reference in the Contract to such Separate Account shall mean such other separate account to which the withdrawn assets were allocated. It is contemplated that investments in the Separate Accounts will, at most times, consist primarily of the types of investments indicated above. Equitable may, however, at its discretion invest the assets of any Separate Account in any investment permitted by applicable law. Equitable may rely conclusively on the opinion of counsel (including attorneys in its employ) as to what investments it is permitted by law to make. In lieu of making such investments directly, Equitable reserves the right to operate any Separate Account as a unit investment trust, or in any other form permitted by law, investing all or a part of its assets in shares or units of a fund, the investment adviser of which may be Equitable or controlled by Equitable. The fund assets would be invested as provided above with respect to the Separate Account. Equitable reserves the right: (i) to cause the registration or deregistration of any Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run any Separate Account under direction of a committee, and to discharge such committee at any time; and (iii) restrict or eliminate any voting rights of participants or other persons who have voting rights as to the Separate Accounts. Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.16. The assets of Separate Accounts are the property of Equitable; however, the portion of the assets of each Separate Account equal to the reserves and other contract liabilities with respect to such Account shall not be chargeable with liabilities arising out of any other business Equitable may conduct. Equitable reserves the right to transfer assets of the Separate Accounts in excess of such reserves and contract liabilities to the general account of Equitable. SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS. VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business day immediately preceding such business day will constitute a Valuation Period. A business day is any day on which there is a sufficient degree of trading in the portfolio securities of a Separate Account that the New Accumulation Unit Value or New Annuity Unit Value might be materially affected by changes in the value of the portfolio securities in a Separate Account, as determined by the Separate Account Committee or, if there is no Committee, by Equitable. NET INVESTMENT FACTOR: For each Separate Account the Net Investment Factor for a Valuation Period is (a) divided by (b), minus (c), where (a) is (1) the value of the assets in the Separate Account at the close of business of the preceding Valuation Period plus(2) the investment income and the capital gains, realized or unrealized, credited to the assets of the Separate Account in the Valuation Period for which the Net Investment Factor is being determined, minus (3) the capital losses, realized or unrealized, charged against such assets in such Valuation Period, minus (4) any amount charges against the Separate Account in such Valuation Period for taxes or for amounts set aside by Equitable as a reserve for taxes attributable to the maintenance or operation of the Separate Account; (b) is the value of the assets in the Separate Account at the close of business of the preceding Valuation Period; and (c) is the daily charge, for each calendar day in such Valuation Period of .00004837 for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The value of the assets in the Separate Account, referred to above, shall be taken at their fair market value, or where there is no readily available market, their fair value, as determined in accordance with accepted accounting practices and applicable laws and regulations. NO. 11935H AMENDED BY PF 17008H - --------- PF 17012H - PF 17017H - PF 17021H Page Five Page Six -------- DEFINITIONS (CONTINUED) ACCUMULATION UNIT: The Accumulation Unit is a unit used in determining the value of the interest of a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account on or before the Retirement Date. NEW ACCUMULATION UNIT VALUE: The initial New Accumulation Unit Values for the Separate Accounts have been established as follows: Account Value Date ------- ----- ---- Separate Account A $10.00 As of November 1, 1968 Separate Account E $10.00 As of September 4, 1974 Separate Account J $10.00 As of May 1, 1984 Separate Account K $10.00 As of May 1, 1984 The new Accumulation Unit Value for each subsequent Valuation Period is the New Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such subsequent Valuation Period. ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable from the Separate Account A Variable Annuity Benefit. NEW ANNUITY UNIT VALUE: The initial New Annuity Unit Value for Separate Account A has been established at $1.00 as of November 1, 1968. The Annuity Unit Value for any subsequent Valuation Period is the New Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i).00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3 1/2%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE NEW ANNUITY UNIT VALUE: The Average Annuity Unit Value for Separate Account A for a calendar month is equal to the average of the New Annuity Unit Values for the Valuation Periods ending in such month. SECTION 1.17 ANNUITY VALUE. The term "Annuity Value" with respect to a Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, means the amount in such Accounts pursuant to Sections 2.02 and 2.03. SECTION 1.18 CASH VALUE. NO WITHDRAWAL CHARGE: With respect to a Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account, and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and six months, or (ii) the completion of 12 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55, completed five Participation Years, and the Cash Values are to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. WITHDRAWAL CHARGE: The withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% during Participation Years 1, 2, 3, 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the excess of (i) the sum of the Annuity Values of such Accounts over (ii) the Free Corridor Amount defined in Section 2.07B. (b) is the excess, if any, of (i) 8% of the total contributions made on behalf of such Participants during the current Participation Year and the preceding nine Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. The Cash Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. SECTION 1.19 CODE. The term "Code" means the Internal Revenue Code of 1954, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. PART II - PARTICIPANT'S ACCOUNT SECTION 2.01 CONTRIBUTIONS. The Employer is to make Contributions from time to time on such dates and in such amounts as determined by the Employer pursuant to the terms of the Plan. The Employer is to specify the Participant with respect to whom each such Contribution is being made and the amount to be allocated to the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Guaranteed Interest Account. Each Contribution received by Equitable with respect to a Participant will, before its allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable. NO. 11935H AMENDED BY PF 17008H - -------- PF 17012H - PF 17017H - PF 17021H Page Six Page Seven ---------- PARTICIPANT'S ACCOUNT (CONTINUED) Participant may, with Equitable's agreement, transfer to the Contract any amount held with respect to such Participant under a plan covering self-employed individuals which has been determined by the Internal Revenue Service to meet the requirements for qualification under Section 401 (a) of the Code, as modified by Section 401(d) of the Code ("Transferred Funds"). Any Transferred Funds from a contract not issued by Equitable will, before allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable. Equitable will issue to each Participant an individual certificates setting forth a statement in substance of the benefits to which such Participant is entitled under the Contract. SECTION 2.02 STOCK, BALANCED, AGGRESSIVE STOCK AND MONEY MARKET ACCOUNTS. Equitable maintains a Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the (1) Stock Account becomes part of Separate Account A, (2) Balanced Account becomes part of Separate Account J, (3) Aggressive Stock Account becomes part of Separate Account K, and (4) Money Market Account becomes part of Separate Account E. Any amount withdrawn from an Account will no longer be part of the applicable Separate Account. On any date when an amount is allocated to or withdrawn from an Account, the Account will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the New Accumulation Value for the appropriate Separate Account for the Valuation Period which includes that date. The number of Units in an Account on any date is equal to (i) the sum of any Accumulation Units that have been credited to the Account minus (ii) the sum of any Accumulation Units that have been charged to that Account. The amount in the Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account on any date is equal to the product of (i) the number of Accumulation Units in such Account on that date and (ii) the New Accumulation Unit Value for the appropriate Separate Account for the Valuation Period which includes that date. SECTION 2.03 GUARANTEED INTEREST ACCOUNT. Equitable maintains a Guaranteed Interest Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the Guaranteed Interest Account becomes part of the general assets of Equitable, which support the guarantees of the Contract and other contracts. The amount in a Guaranteed Interest Account at any time is equal to the sum of all amounts that have been allocated to such Guaranteed Interest Account pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn pursuant to Sections 2.07, 2.07A, and Section 2.08 from such Account, and transferred pursuant to Section 2.05 from such Guaranteed Interest Account, and less the sum of any annual administrative charges accrued but not made. Equitable guarantees that the amount in a Guaranteed Interest Account at any time before the Retirement Date will not be less than the sum of all amounts allocated to such Account pursuant to Section 2.04 or transferred to such Account pursuant to Section 2.05 and less the sum of all amounts that have been withdrawn from such Account pursuant to Sections 2.07 and 2.07A, and transferred from such Account pursuant to Section 2.05, all accumulated at 3% interest, compounded annually. In any Participation Year in which no Contribution is allocated to a Guaranteed Interest Account, the amount in such Account at the end of the Participation Year shall not be less than the amount in such Account at the beginning of the Participation Year plus the sum of all amounts transferred to such Account pursuant to Section 2.05 less the sum of all amounts withdrawn and transferred out of such Account pursuant to Sections 2.07, 2.07A, and Section 2.05, all accumulated at 3% interest, compounded annually. A Guaranteed Interest Account for a Participant terminates on the earliest of (i) the Retirement Date, (ii) the death of the Participant, and (iii) termination of participation pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO ACCOUNT. Each Contribution made with respect to a Participant pursuant to Section 2.01, after deduction for any applicable taxes, will be allocated, as of the date by which Equitable has received both such Contribution and direction as to its allocation, to the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account or in part to each, at the sole direction of the Participant as specified to Equitable, provided that the percentage allocated to each Account is a whole number. Any amount that a Participant has directed to be transferred to the Guaranteed Interest Account, Stock Account, Balanced Account or Aggressive Stock Account pursuant to Section 2.05 will be allocated as of the date of such transfer to the appropriate Account maintained for such Participant. Interest is allocated to the Guaranteed Interest Account at the end of each Participation Year, at the time of each transfer or withdrawal pursuant to Sections 2.05 and 2.07 and 2.07A, at the time of application of amounts in the Guaranteed Interest Account to provide Annuity Benefits, upon termination of participation pursuant to Section 2.06, and upon death of the Participant pursuant to Section 2.09. SECTION 2.05 TRANSFERS AMONG ACCOUNTS. At any time before a Participant's Retirement Date, such Participant, upon written request, may transfer all or part of the amounts maintained for the Participant to one or more of the other Accounts maintained for such Participant as follows: (1) amounts in the Guaranteed Interest Account, Stock Account, Balanced Account and Aggressive Stock Account may be transferred among such Accounts; (2) amounts in the Money Market Account may be transferred to the other accounts. Such transfers will be made as of the date Equitable receives such request, and will be subject to Equitable's rules in effect at the time of transfer. No transfers are permitted from the Guaranteed Interest Account, Stock Account, Balanced Account or Aggressive Stock Account maintained for the Participant to the Money Market Account. Notwithstanding the above, transfers to the Balanced Account may be prohibited by Equitable upon 30 days written notice to the Participant. NO. 11935H AMENDED BY PF 17008H - ---------- PF 17012H - PF 17017H - PF 17021H Page Seven Page Eight ---------- PARTICIPANT'S ACCOUNT (CONTINUED) SECTION 2.06 TERMINATION OF PARTICIPATION. Subject to any applicable restrictions under the terms of the Plan, on or before a Participant's Retirement Date, such Participant may elect by written notice to terminate participation under the Contract. Upon receipt of such notice, Equitable will determine the Cash Value, as of the date Equitable received such notice, of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained for such Participant. The payment of such Cash Value to the Participant may be deferred by Equitable in accordance with the provisions of Section 4.08. Prior to a Participant's Retirement Date, Equitable reserves the right to withdraw the Annuity Value of the Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, pay such Annuity Values and terminate such Participant's participation under the Contract. This right may be exercised with respect to the Participant only if both (i) no Contributions have been made under the Contract during the last three completed Participation Years, and (ii) the sum of such Annuity Values is $500 or less. Equitable reserves the right to terminate a Participant's participation under the Contract if at least 120 days have elapsed since the issue date shown on the certificate issued to such Participant under the Contract and no Contributions have been made under the Contract with respect to such Participant. Upon payment of such Cash Values or Annuity Values, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Cash Values or Annuity Values arose. SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under the terms of the Plan, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Guaranteed Interest Account maintained for such Participant before such Participant's Retirement Date. Upon withdrawal pursuant to Section 2.07 or 2.07A, Equitable will pay the lesser of the sum of the Cash Values of such Accounts or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by such Participant. Unless instructed otherwise, the amount withdrawn (including the amount of any withdrawal charge) will be allocated between such Accounts in proportion to the Annuity Value of each such Account. Upon any payment to a Participant pursuant to Section 2.07 or 2.07A, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Payments to the Participant pursuant to Section 2.07 or 2.07A may be deferred by Equitable in accordance with the provisions of Section 4.08. Equitable is under no obligation to process any request for partial withdrawal of less than $300. If a withdrawal from the Accounts made pursuant to Sections 2.07 or 2.07A would result in total Annuity Values of less than $500, Equitable will so advise the Participant and reserves the right to withdraw the Annuity Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, pay the Annuity Values of such Accounts to the Participant, and terminate such Participant's participation under the contract. SECTION 2.07A PARTIAL WITHDRAWAL CHARGES. NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a Participant, Equitable will withdraw from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and six months, or (ii) the completion of 12 Participation Years with respect to such participant, or (iii) if the Participant has attained age 55, has completed five Participation Years, and the partial withdrawal is to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. WITHDRAWAL CHARGE: There will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07B. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Participation Years 1, 2, 3, 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the amount withdrawn (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the cumulative total of contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. NO. 11935H AMENDED BY PF 17008H - ---------- PF 17012H - PF 17017H - PF 17021H Page Eight Page Nine --------- PARTICIPANT'S ACCOUNT (CONTINUED) SECTION 2.07B FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" with respect to a Participant who has completed three Participation Years or attained age 59 1/2 means an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Values of the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Guaranteed Interest Account over (ii) cumulative prior withdrawals made pursuant to Section 2.07 or 2.07A in the current Participation Year with respect to the Participant. With respect to a Participant who has not completed three Participation Years or attained age 59 1/2, the Free Corridor Amount is zero. SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Participation Year before a Participant's Retirement Date, if the sum of the Annuity Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account on that date is less than $10,000.00, Equitable will withdraw from the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account at the end of that Participation Year and (ii) any withdrawals made from such Accounts pursuant to Section 2.07 and 2.07A during that Participation Year. The charge will be allocated between the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Guaranteed Interest Account in proportion to the Annuity Values of each such Account, at the end of the Participation Year. As of a Participant's Retirement Date and before application of the Annuity Values or Cash Values of such Participant's Account Pursuant to Section 3.03, or upon termination of such Account pursuant to Section 2.06 or Section 2.09 during a Participation Year, if the sum of the Annuity Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account, and Money Market Account at that date is less than $10,000, Equitable will withdraw the administrative charge described in this Section for the applicable part of that Participation Year. SECTION 2.09 DEATH BENEFIT. If the Employer reports to Equitable, or if Equitable otherwise ascertains, that a Participant has died while Accounts for such Participant are maintained under the Contract and before such Participant's Retirement Date, Equitable, upon receipt of due proof of such death, will pay in a single sum to the beneficiary designated by such Participant to receive such payment the amount of death benefit payable with respect to such Participant. The amount of the death benefit with respect to a Participant at any time prior to the Retirement Date is equal to the greater of (i) the sum of the Annuity Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract for such Participant and (ii) the minimum death benefit with respect to such Participant. Such minimum death benefit is the sum of all Contributions made with respect to such Participant pursuant to Section 2.01 (before reduction of any applicable taxes) less an adjustment for any withdrawals made pursuant to Sections 2.07 and 2.07A from the Accounts maintained under the Contract for such Participant. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount being withdrawn is to the Annuity Values then in the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract for such Participant. If, in accordance with the provisions of Section 2.01, the cash value of an Annuity contract issued by Equitable, which provides for a death benefit before retirement equal to the greater of the contract cash value or an alternative amount based on premiums paid or contributions made under the Annuity contract, is transferred to the Contract, such alternative amount as of the date of transfer will be included in the "sum of all Contributions" in lieu of the amount of cash value transferred, for purposes of the death benefit under the Contract. The amount of any death benefit payable with respect to a Participant will, to the extent such Account is sufficient therefore, be withdrawn from the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained with respect to such Participant under the Contract. Upon such payment, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Annuity Values arose. PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of Separate Account A. The amount of the first, second, and third payments under any Variable Annuity Benefit provided under the Contract with respect to a payee is the monthly amount provided with respect to the payee pursuant to Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average New Annuity Unit Value for the second calendar NO. 11935H AMENDED BY PF 17008H - --------- PF 17012H - PF 17017H - PF 17021H Page Nine Page Ten -------- ANNUITY BENEFITS (CONTINUED) month immediately preceding the date of the payment. The fourth and subsequent annuity payments under a Variable Annuity Benefit will not be increased or decreased in amount because of mortality or expense experience. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the New Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Values of such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of such Account in a single sum or (ii) to apply such Annuity Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by Equitable, as elected by the Participant, subject to Equitable's rules then in effect and any applicable requirements under the Code. Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Values of such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account. Equitable will have the right to require the Participant to furnish pertinent facts and determinations to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. Equitable may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If a Participant elects pursuant to the first paragraph or third paragraph of Section 3.03 to receive an Annuity Benefit in lieu of the Cash Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, the amount applied to provide the Annuity Benefit will be (i) the Annuity Values of such Accounts if the payments under the annuity form elected are contingent upon the survival of a person, or (ii) the Cash Values of such Accounts if the payments under the annuity form elected are not contingent upon the survival of a person. The amount applied to provide an Annuity Benefit shall be reduced by any applicable tax on annuity considerations, as determined by Equitable. If such amount is applied on or after the completion of five Participation Years with respect to such Participant, the balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. If the amount applied to provide an Annuity Benefit is applied before the completion of five Participation Years with respect to a Participant, the balance, after any applicable tax on annuity considerations, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained for such Participant shall terminate. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (100% continuation). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on 3 1/2% interest and the 1983 Individual Annuity Mortality Table adjusted to a unisex basis based on a 50-50 split of males and females and an Assumed Base Rate of Net Investment Return of 3 1/2% or 5%, whichever applies pursuant to Section 1.16. The Assumed Base Rate of Net Investment Return is 5% for certificates issued for delivery in New York. Equitable may change the monthly income amounts contained in the Tables of Guaranteed Annuity Payments and the basis for determining such amounts, for new Participants, by at least 90 days advance notice to the Contract Holder and by an amendment to the Contract. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on 3 1/2% interest and the 1983 Individual Annuity Mortality Table adjusted to a unisex basis based on a 50-50 split of males and females if such annuity form provides for a Fixed Annuity Benefit, and on the projected 1983 Basic Table adjusted to a unisex basis based on a 50-50 split of males and females and an Assumed Base Rate of Net Investment Income Return of 5% or 3 1/2%, whichever applies pursuant to Section 1.16 if such annuity form provides for a Variable Annuity Benefit. NO. 11935H AMENDED BY PF 17008H - -------- PF 17012H - PF 17017H - PF 17021H Page Ten Page Eleven ----------- ANNUITY BENEFITS (CONTINUED) SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payable under the Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by Equitable will be charged against and underpayments will be added to any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may make the payments (in the case of a minor, at a rate not exceeding $50 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If an annuity form made available by Equitable provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Upon election by a Participant pursuant to Section 3.03 of an annuity form providing payments for a period certain, such Participant may designate (with the right to change such designation) a person or persons to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's executors or administrators in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, Equitable will pay in a single sum to such payee's executors or administrators the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. Equitable will require satisfactory evidence of the age of any person upon whose life an annuity form depends.
TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Value) - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ---------- Age 60 61 62 63 64 65 66 67 68 69 70 - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ---------- 60 4.54 4.58 4.62 4.66 4.70 4.74 4.77 4.81 4.84 4.88 4.91 61 4.62 4.67 4.71 4.76 4.81 4.84 4.88 4.91 4.95 4.99 62 4.72 4.76 4.81 4.85 4.90 4.94 4.98 5.02 5.06 63 4.81 4.86 4.91 4.96 5.01 5.06 5.10 5.14 64 4.92 4.97 5.02 5.08 5.13 5.17 5.22 65 5.03 5.09 5.15 5.20 5.26 5.31 66 5.15 5.21 5.27 5.33 5.39 67 5.28 5.34 5.40 5.47 68 5.41 5.48 5.55 69 5.56 5.63 70 5.71
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3-1/2% (Minimum Monthly Income per $1,000 of Annuity Value) - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ---------- Age 60 61 62 63 64 65 66 67 68 69 70 - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ---------- 60 4.40 4.44 4.48 4.51 4.55 4.58 4.61 4.65 4.68 4.71 4.74 61 4.48 4.52 4.56 4.60 4.64 4.67 4.71 4.74 4.78 4.81 62 4.56 4.60 4.65 4.69 4.73 4.77 4.80 4.84 4.88 63 4.65 4.69 4.74 4.78 4.83 4.87 4.91 4.95 64 4.74 4.79 4.84 4.89 4.93 4.98 5.02 65 4.85 4.90 4.95 5.00 5.05 5.10 66 4.95 5.01 5.06 5.11 5.17 67 5.07 5.12 5.18 5.24 68 5.19 5.25 5.32 69 5.32 5.39 70 5.46
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 5% (Minimum Monthly Income per $1,000 of Annuity Value) - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ---------- Age 60 61 62 63 64 65 66 67 68 69 70 - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ---------- 60 5.27 5.30 5.34 5.37 5.41 5.44 5.47 5.51 5.54 5.57 5.59 61 5.34 5.38 5.42 5.46 5.49 5.53 5.57 5.60 5.63 5.66 62 5.42 5.46 5.50 5.54 5.58 5.62 5.65 5.69 5.73 63 5.50 5.55 5.59 5.63 5.67 5.71 5.75 5.79 64 5.59 5.64 5.69 5.73 5.78 5.82 5.86 65 5.69 5.74 5.79 5.84 5.89 5.93 66 5.79 5.85 5.90 5.95 6.00 67 5.90 5.96 6.02 6.08 68 6.02 6.08 6.15 69 6.15 6.22 70 6.29
NO. 11935H AMENDED BY PF 17008H - ----------- PF 171012H - PF 17017H - PF 17021H Page Eleven Page Twelve ----------- ANNUITY BENEFITS (CONTINUED) ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) VARIABLE ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET AGE FIXED ANNUITY BENEFIT INVESTMENT RETURN IS - --- --------------------- --------------------------- 3 1/2% 5% ------ -- 60 5.29 5.08 5.97 61 5.41 5.19 6.08 62 5.55 5.31 6.20 63 5.69 5.44 6.33 64 5.85 5.58 6.46 65 6.01 5.73 6.61 66 6.19 5.89 6.77 67 6.37 6.06 6.94 68 6.58 6.24 7.12 69 6.79 6.43 7.31 70 7.02 6.64 7.52 Equitable will notify the payee under a Variable Annuity Benefit of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each variable payment. Any election, change, revocation or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a commutation right under an Annuity Benefit is exercised, Equitable may defer payment in accordance with Section 4.08. PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT. The Contract constitutes the entire Contract between the parties and the provisions of the Contract alone will govern with respect to the rights and obligations of Equitable. The provisions of the Contract will be applied separately with respect to each Participant. Nothing in the enrollment form referred to in Section 1.05, the Plan or trust agreement referred to in Section 4.10 nor any modification, amendment, or supplement to any such documents will in any way be construed to enlarge, change, vary or in any other way affect the obligations of Equitable as expressly provided in the Contract. The Contract may not be modified as to Equitable, nor may any of Equitable's rights or requirements be waived, except in writing and by an authorized officer of Equitable. The Contract may be changed by amendment or replacement upon agreement between the Contract Holder and Equitable without the consent of any other person provided that such change does not reduce any Annuity Benefit provided before such change and provided that no rights, privileges or benefits which have accrued to any Participant under the Contract may be reduced or forfeited except by the express consent of such Participant. SECTION 4.02 STATUTORY COMPLIANCE. Equitable reserves the right to amend the Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the Contract and any certificate to reflect changes in the Code, or in regulations or published rulings of the Internal Revenue Service so that each such certificate will continue to be an Annuity. Any Annuity Benefit, Cash Value or death benefit available under a certificate issued pursuant to the Contract shall not be less than the minimum benefits required by any statute of the state in which the certificate is delivered. SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY. The entire interest of any Participant under the Contract is nonforfeitable. No interest of a Participant under the Contract may be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than Equitable. No amount payable under the Contract may be assigned, commuted, or encumbered by the payee, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. SECTION 4.04 PARTICIPATION IN SURPLUS. The Contract and all other contracts in the same class of contracts shall be combined for the purpose of ascertaining the annual surplus of Equitable to be apportioned to said contracts as a dividend and the portion of any such dividend that is to be allocated to the Contract shall be determined by Equitable. The participation of this class of contracts in annual surplus is, however, expected to be minimal. Any amount so allocated to the Contract shall be payable as of January 1 of the calendar year in which a dividend is apportioned and will be payable in cash and shall be equitably allocated by Equitable to the Guaranteed Interest Accounts maintained hereunder for Participants. No Annuity Benefit will enter into the determination of any surplus to be apportioned to the Contract as a dividend. SECTION 4.05 BENEFICIARY. Each Participant, as of such Participant's Participation Date, is to provide Equitable with an initial designation of the beneficiary entitled to receive any death benefit payable with respect to such Participant pursuant to Section 2.09. The Participant may change such designation from time to time during such Participant's lifetime and while Accounts for such Participants are being maintained hereunder. Any such designation or NO. 11935H AMENDED BY PF 17008H - ----------- PF 17012H - PF 17017H - PF 17021H Page Twelve Page Thirteen ------------- GENERAL PROVISIONS (Continued) change will be made by written notice in a form satisfactory to Equitable. A change will, upon receipt at a designated Equitable Office, take effect as of the time the written notice was signed, whether or not the Participant is living on the date of receipt, but without further liability as to any payment or other settlement made by Equitable before receipt of such change. Unless otherwise specified in the designation, if a Participant has designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive the Participant, and if more than one survive they will share equally. Any part of a death benefit payable with respect to a Participant pursuant to Section 2.09 for which there is no designated beneficiary living at the death of the Participant will be payable in a single sum to the children of the Participant who survive the Participant, in equal shares, or should none survive, then to the Participant's executors or administrators. If a Participant so elects in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by the Participant, with respect to the beneficiary, subject to Equitable's rules then in effect. If at the death of a Participant there is to election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. SECTION 4.06 DISQUALIFICATION. In the event that an annuity purchased hereunder with respect to a Participant fails to qualify as an Annuity as described in Section 1.03, Equitable shall have the right, upon receiving notice of such fact before the Retirement Date, to terminate participation with respect to such Participant under the Contract and pay to such Participant the amount in the Account maintained with respect to such Participant less a deduction for the appropriate part attributable to such Participant of any Federal income tax payable by Equitable which would not have been payable if such Participant had an Annuity under the Contract. SECTION 4.07 FUTURE PARTICIPANTS. Equitable reserves the right at its sole discretion to curtail or prohibit further enrollment as Participants under the Contract of any individuals who are not currently participating under the Contract as of such date of curtailment or prohibition. SECTION 4.08 DEFERMENT. Payments by Equitable from the Participant's Guaranteed Interest Account pursuant to the provisions of Section 2.06, Sections 2.07 and 2.07A, and Section 2.09, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.05, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. Interest at the current Guaranteed Interest Rate for such Participant's Guaranteed Interest Account will be allowed on any such payment deferred for 30 days or more. Except as provided in this Section, payments by Equitable from the Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account pursuant to the provisions of Section 2.06, Sections 2.07 and 2.07A, and Section 2.09, or any commuted payments arising from a Variable Annuity Benefit pursuant to Section 3.05, will be made within seven days after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. During any period when (i) the sale of securities or the determination of the New Accumulation Unit Value or the Average New Annuity Unit Value is not reasonably practicable because an emergency, defined by the Securities and Exchange Commission, exists, or the New York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may by order permit postponement for the protection of persons having interests in the Separate Accounts, Equitable reserves the right: (a) to defer determination of Cash Values or Annuity Values and payment of Cash Values and Annuity Values, arising from an amount in a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (b) to defer payment of any portion of the death benefit arising from an amount in a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (c) to defer the payment of any Variable Annuity Benefit under the Contract or the application of any such Benefit to provide for any other payment called for by the Contract; or (d) in the event of (a) above, to defer application of such amounts to provide any Annuity Benefit permitted under the Contract. SECTION 4.09 ANNUAL NOTICE. At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Guaranteed Interest Account, (2) the total number of Accumulation Units credited to the Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, (3) the New Accumulation Unit Values, (4) the sum of the Cash Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account and (5) the amount of death benefit payable with respect to the Participant. After the Retirement Date Equitable will notify the Participant of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.10 CONTRACT HOLDER RESPONSIBILITY. The sole responsibility of the Contract Holder is to serve as party to the Contract. The Contract Holder will have no responsibility for the administration of any Plan, for payments to the Guaranteed NO. 11935H AMENDED BY PF 17008H - ------------- PF 17012H - PF 17017H - PF 17021H Page Thirteen Page Fourteen ------------- GENERAL PROVISIONS (CONTINUED) Interest Account, Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account, or any payments or other distributions hereunder. Equitable will deal with the Contract Holder in accordance with the terms and conditions of the trust agreement pursuant to which the Contract Holder agreed to act as such and with the Contract and in such manner as the Contract Holder and Equitable may agree, without the consent of any other person. Any Employer making Contributions under the Contract shall be deemed to have adopted and accepted the trust agreement as part of the Plan with respect to which such Contributions are made. SECTION 4.11 AGE. If the Annuitant's age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by Equitable will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. This certificate was approved by the New York Insurance Department under an accelerated procedure to assist employers in complying with the United States Supreme Court decision in Arizona v. Norris. The Department has reserved the right to require changes to comply with applicable New York law and regulations. NO. 11935H AMENDED BY PF 17008H - ------------- PF 17012H - PF 17017H - PF 17021H Page Fourteen THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective July 1, 1986, or your Participation Date, whichever is the later, we have amended your Certificate issued under Group Annuity Contract No. 11931CH as follows: 1. With respect to PART I - DEFINITIONS, the following section is added: SECTION 1.14C PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by Equitable which does not permit any prepayment of the unpaid principal. 2. With respect to SECTION 1.18 CASH VALUE, the following text replaces the paragraphs under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to a Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such Annuity is at least ten years. At all other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. 3. With respect to SECTON 2.07A PARTIAL WITHDRAWAL CHARGES, the following paragraph replaces the paragraph under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a Participant, Equitable will withdraw from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values of such Accounts provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such Annuity is at least ten years. At all other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. SPECIMEN VICE PRESIDENT SPECIMEN PRESIDENT AND SECRETARY PF 17035H THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES 1285 AVENUE OF THE AMERCAS, NEW YORK, NEW YORK 10019 [EQUITABLE LOGO] EQUI-PENSION-GV CONTRACT GROUP ANNUITY CONTRACT NO. 11932 CP CONTRACT HOLDER: UNITED STATES TRUST COMPANY OF NEW YORK CONTRACT CHANGE DATE: DECEMBER 31, 1984 The Initial Guaranteed Interest Rate is 10% and is effective until December 31, 1980. The Guaranteed Interest Rate after December 31, 1980 for a Class of Participants will be established before the beginning of each calendar year, but will not be less than the Minimum Guaranteed Interest Rate for such year and Class of Participants. This contract ("the Contract") is issued in consideration of the payment to Equitable of the contributions made under the Contract. Equitable will issue to each Participant an individual certificate setting forth a statement in substance of the benefits to which such Participant is entitled under the Contract. The provisions on the following pages are part of the Contract. FOR THE CONTRACT HOLDER: FOR THE EQUITABLE: By /s/ Alfred H. Antigrolo By /s/ Coy Eklund --------------------------- --------------------------------- President Title Vice President By /s/ Rodney L. Enochs ------------------------ --------------------------------- Vice President and Secretary Dated 3/7/80 Date of Issue MAR 7, 1980 ------------------------ ---------------------- At New York, New York --------------------------- (Head Office) PARTICIPATING NO. 11932 CP This page 2 reserved for information in connection with the issuance of certificates under this Contract. PAGE 2 This Page 3 reserved for information in connection with the issuance of certificates under this Contract. PAGE 3 PART I - DEFINITIONS SECTION 1.01 EMPLOYER The term "Employer" means (i) a State, political subdivision of a State, or an agency or instrumentality of a State or political subdivision of a State which has adopted a Plan, or (ii) a rural electric cooperative, as defined in Section 457(d)(9)(B) of the Code, which has adopted a Plan. SECTION 1.02 PLAN The term "Plan" means a program constituting an "Eligible State Deferred Compensation Plan" meeting the requirements of Section 457(b) of the Code which is established and maintained by an Employer for the benefit of persons performing services for the Employer and their beneficiaries. SECTION 1.03 ANNUITY The term "Annuity" means an annuity purchased in accordance with the terms of the Plan. SECTION 1.04 ANNUITY BENEFIT The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Section 3.03 of the Contract. SECTION 1.05 PARTICIPANT The term "Participant" means a person who has been enrolled by Equitable under the Contract and for whom the Employer has purchased an Annuity under the Contract. A person shall become enrolled under the Contract upon receipt by Equitable of an enrollment form made available by Equitable and completed in a manner satisfactory to Equitable. An Annuity is purchased for a person enrolled under the Contract upon receipt by Equitable of an initial Contribution by the Employer. SECTION 1.06 CONTRIBUTION The term "Contribution" means a payment made to Equitable for a Participant with respect to an Annuity purchased for such Participant under the Contract. Equitable is under no obligation to accept any Contribution less than $20.00. SECTION 1.07 PARTICIPATION DATE The term "Participation Date" with respect to a Participant means the date as of which Equitable has enrolled such Participant under the terms of the Contract. SECTION 1.08 PARTICIPATION YEAR The term "Participation Year" with respect to a Participant means the twelve month period beginning on (i) the Participation Date, and (ii) each anniversary thereof, unless otherwise agreed to in writing by Equitable. SECTION 1.09 CLASS OF PARTICIPANTS Except as provided in Section 1.10, the term "Class of Participants" refers to all Participants whose Participation Date is in the same calendar year. SECTION 1.10 GUARANTEED INTEREST RATE For each Guaranteed Interest Account, the term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in such Account. Interest accrues daily. The Guaranteed Interest Rate will never be less than 3% per annum. Equitable will from time to time establish and make available for new Participants (i) an Initial Guaranteed Interest Rate, (ii) one or more Minimum Guaranteed Interest Rates and (iii) the applicable effective period(s) for such Rates. A new Class of Participants will be established effective with the effective date of the occurrence of (i), (ii) or (iii) above or any combination thereof. For the calendar year next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent calendar year thereafter , Equitable will determine for each established Class of Participants before the beginning of such calendar year a Yearly Guaranteed Interest Rate for such Class, which Yearly Guaranteed Interest Rate will not be lower than the effective Minimum Guaranteed Interest Rate applicable for such Class for such year. For any established Class of Participants, Equitable reserves the right to change the Minimum Guaranteed Interest Rate and the applicable period therefor, provided that any such Minimum Guaranteed Interest Rate will not be lower than the Minimum Guaranteed Interest Rate that would have been in effect in the absence of such change. Equitable will notify each Participant in a Class in writing of the Yearly Guaranteed Interest Rate or of any change in he Minimum Guaranteed Interest Rate at least 15 days prior to its effective date. SECTION 1.11 RETIREMENT DATE The term "Retirement Date" means the date on which the Participant is to attain the retirement age specified in the Participant's enrollment form. Before the Retirement Date the Participant may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election Page 4 DEFINITIONS (continued) (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be earlier than the Retirement Date provided under the Plan. Any election for such change must have the consent of the Employer and must be made in writing by the Participant. Such election shall not take effect until received by Equitable at its Home Office. SECTION 1.12 NORMAL FORM The "Normal Form" of an Annuity Benefit under the Contract means, (i) if the Participant has a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (100% continuation), and (ii) if the Participant does not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.13 JOINT AND SURVIVOR LIFE ANNUITY FORM The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depends is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by the Participant. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.14 LIFE ANNUITY FORM The term "Life Annuity Form" means an annuity providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.15 ANNUITY VALUE The term "Annuity Value" with respect to a Participant's Guaranteed Interest Account means the amount in such Account pursuant to Section 2.02. SECTION 1.16 CASH VALUE With respect to a Participant for whom no cash value(s) of existing contract(s) issued by Equitable is(are) transferred to the Contract pursuant to Section 2.01, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account means an amount equal to the Annuity Value after either (i) the later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and six months, or (ii) the Participant's attainment of age 70 years and six months. Prior to such time, the Cash Value of such Participant's Guaranteed Interest Account will equal the greater of (a) 94% of the Annuity Value of such Account and (b) the Annuity Value of such Account minus an amount equal to the excess, if any, of (i) 9% of the total Contributions made on behalf of such Participant during the current Participation Year and the preceding nine completed Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Section 2.05. With respect to a Participant for whom cash value(s) of existing contract(s) issued by Equitable is(are) transferred to the Contract pursuant to Section 2.01, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account means an amount equal to the Annuity Value after such Participant attains age 59 years and six months. Prior to such time, the Cash Value of such Participant's Guaranteed Interest Account will equal the Annuity Value of such Account minus an amount equal to the lesser of (a) and (b) where: (a) is the sum of: (1) 2% of the excess, if any, of (i) the first $10,000 of Separate Account Transfers over (ii) the cumulative total of any previous withdrawals made pursuant to subsection (a) of the third paragraph of Section 2.05 and (2) 6% of the excess, if any, of (i) the Annuity Value over (ii) the total amount of Separate Account Transfers minus the cumulative total of any withdrawals made pursuant to Section 2.05 (but such amount shall not be less than zero). (b) is the excess, if any, of: (1) the sum of (i) 2% of the first $10,000 of Separate Account Transfers made during the current Participation Year and the preceding nine Participation Years and (ii) 9% of all other Contributions (excluding Separate Account Transfers) made on behalf of the Participant during the current Participation Year and the preceding nine completion Participation Years over (2) the cumulative total of any withdrawal charges made pursuant to Section 2.05. Page 5 DEFINITIONS (continued) SECTION 1.17 CODE The term "Code" means the Internal Revenue Code of 1954, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.18 SEPARATE ACCOUNT TRANSFERS The term "Separate Account Transfers" with respect to a Participant means the amount of cash value(s) transferred to the Contract from separate investment account(s) maintained by Equitable, pursuant to Section 2.01. PART II - PARTICIPANT'S ACCOUNT SECTION 2.01 CONTRIBUTIONS The Employer is to make Contributions from time to time on such dates and in such amounts as determined by the Employer pursuant to the terms of the Plan or, if the Employer has no Plan, as determined by the Employer at its sole discretion. The Employer is to specify the Participant with respect to whom each such Contribution is being made. Each Contribution received by Equitable with respect to a Participant will, before its allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable, and by the amount of any applicable deduction in accordance with Section 2.08. A Participant may, with Equitable's agreement, transfer to the Contract any amount held with respect to such Participant under a Plan of the Employer or under an "Eligible State Deferred Compensation Plan" meeting the requirements of Section 457(b) of the code established and maintained by any other employer ("Transferred Funds"). Any Transferred Funds from a contract not issued by Equitable will, before allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable. Equitable will issue to each Participant an individual certificate setting forth a statement in substance of the benefits to which such Participant is entitled under the Contract. SECTION 2.02 GUARANTEED INTEREST ACCOUNT Equitable maintains a Guaranteed Interest Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the Guaranteed Interest Account becomes part of the general assets of Equitable, which supports the guarantees of the Contract and other contracts. The amount in a Guaranteed Interest Account at any time is equal to the sum of all amounts that have been allocated to such Guaranteed Interest Account pursuant to Section 2.01 and Section 2.03 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn pursuant to Section 2.05 and Section 2.06 from such Account and less the sum of any annual administrative charges accrued but not made. Equitable guarantees that the amount in a Guaranteed Interest Account at any time before the Retirement Date will not be less than the sum of all amounts allocated to such Account pursuant to Section 2.01 and less the sum of all amounts that have been withdrawn from such Account pursuant to Section 2.05, all accumulated at 3% interest, compounded annually. In any Participation Year in which no Contribution is allocated to the Guaranteed Interest Account, the amount in such Account at the end of the Participation Year shall not be less than the amount in such Account at the beginning of the Participation Year less the sum of all amounts withdrawn from such Account pursuant to Section 2.05, all accumulated at 3% interest, compounded annually. A Guaranteed Interest Account for a Participant terminates on the earliest of (i) the Retirement Date, (ii) the death of the Participant, and (iii) termination of participation pursuant to Section 2.04. Section 2.03 ALLOCATION TO ACCOUNT Each Contribution made with respect to a Participant pursuant to Section 2.01, after deduction for any applicable taxes, will be allocated, as of the date by which Equitable has received such Contribution, to the Guaranteed Interest Account. Page 6 PARTICIPANT'S ACCOUNT (continued) Interest is allocated to the Guaranteed Interest Account at the end of each Participation Year, at the time of withdrawal pursuant to Sections 2.05 and 2.07, at the time of application of amounts in the Guaranteed Interest Account to provide Annuity Benefits, and upon termination of participation pursuant to Section 2.04. SECTION 2.04 TERMINATION OF PARTICIPATION Subject to any applicable restrictions under the terms of the Plan, on or before a Participant's Retirement Date, such Participant may elect by written notice to terminate participation under the Contract. Upon receipt of such notice, Equitable will determine the Cash Value, as of the date Equitable received such notice, of the Guaranteed Interest Account maintained for such Participant. The payment of such Cash Value to the Participant may be deferred by Equitable in accordance with the provisions of Section 4.08. Prior to a Participant's Retirement Date, Equitable reserves the right to withdraw the Annuity Value of the Participant's Guaranteed Interest Account, pay such Annuity Value and terminates such Participant's participation under the Contract. This right may be exercised with respect to the Participant only if both (i) no Contributions have been made under the Contract during the last three completed Participation Years, and (ii) such Annuity Value is $500 or less. Equitable reserves the right to terminate a Participant's participation under the Contract if at least 120 days have elapsed since the issued date sown on the certificate issued to such Participant under the Contract and no Contributions have been made under the Contract with respect to such Participant. Upon payment of such Cash Value or Annuity Value, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Cash Value or Annuity Value arose. SECTION 2.05 PARTIAL WITHDRAWALS Subject to any applicable restrictions under the terms of the Plan, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Guaranteed Interest Account maintained for such Participant before such Participant's Retirement Date. With respect to partial withdrawals requested by a Participant for whom no cash value(s) of existing contract(s) issued by Equitable is (are) transferred to the Contract, Equitable will withdraw from such Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the Annuity Value of such Account, provided the request for partial withdrawal is made after either (i) the later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and six months, or (ii) such Participant's attainment of age 70 years and six months. If a partial withdrawal with respect to such Participant is made prior to such time, Equitable will withdraw from such Account an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. Such withdrawal charge will equal the lesser of (a) 6% of the total amount to be withdrawn from the Account pursuant to this Section (including such charge) and (b) the excess, if any, of (i) 9% of the total Contributions made on behalf of such Participant during the current Participation Year and the preceding nine completed Participation Years over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. With respect to partial withdrawals requested by a Participant for whom cash value(s) of existing contract(s) issued by Equitable is (are) transferred to the Contract pursuant to Section 2.01. Equitable will withdraw from such Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the Annuity Value of such Account, provided the request for partial withdrawal is made after such Participant's attainment of age 50 years and six months. If a partial withdrawal with respect to such Participant is made prior to such time, Equitable will withdraw from such Account an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. Such withdrawal charge will be an amount equal to the sum of the charges described in subsections (a) and (b) below; provided, however, that in no event will such withdrawal charge exceed an amount described in subsection (c) below: (a) With respect to the amount of any withdrawal made up to the excess, if any, of (1) the cumulative total of all Separate Account Transfers made on the Participant's behalf over (2) the cumulative total of prior withdrawals made to which the withdrawal charge described in this subsection was applied, an amount equal to the lesser of (i) 2% of the total amount to be Page 7 PARTICIPANT'S ACCOUNT (continued) withdrawn pursuant to this subsection (including such charge) and (ii) $200 minus the cumulative total of any prior withdrawal charges made pursuant to this subsection. (b) With respect to any withdrawal made to which the withdrawal charge described in subsection (a) does not apply, 6% of such amount to be withdrawn (including such charge). (c) is the excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Separate Account Transfers made during the current Participation Year and the preceding nine Participation Years and (ii) 9% of all other Contributions (excluding Separate Account Transfers) made on behalf of the Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any prior withdrawal charges made pursuant to this Section. Upon withdrawal pursuant to either of the preceding two paragraphs, Equitable will pay the lesser of the Cash Value of such Account or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by such Participant. Upon any payment to a Participant pursuant to this Section, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Payments to the Participant pursuant to this Section may be deferred by Equitable in accordance with the provisions of Section 4.08. Equitable is under no obligation to process any request for partial withdrawal of less than $300. If a withdrawal from the Account made pursuant to this Section would result in an Annuity Value of less than $200, Equitable will withdraw the Annuity Value of the Account, pay the Cash Value of the Account to the Participant, and will terminate such Participant's participation under the Contract. SECTION 2.06 ANNUAL ADMINISTRATIVE CHARGE As of the last day of each Participation Year before a Participant's Retirement Date, Equitable will withdraw from the Guaranteed Interest Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, an annual administrative charge equal to the lesser of $30 and 2% of the sum of (i) the Annuity Value of the Guaranteed Interest Account at the end of that Participation Year and (ii) any withdrawals made from such Account pursuant to Section 2.05 during that Participation Year. As of a Participant's Retirement Date and before application of the Annuity Value of such Participant's Account pursuant to Section 3.02, or upon termination of such Account pursuant to Section 2.04 or Section 2.07 during a Participation Year, Equitable will withdraw the administrative charge described in this Section for the applicable part of that Participation Year. SECTION 2.07 DEATH BENEFIT If the Employer reports to Equitable, or if Equitable otherwise ascertains, that a Participant has died while an Account for such Participant is maintained under the Contract and before such Participant's Retirement Date, Equitable, upon receipt of due proof of such death, will pay in a single sum to the beneficiary designated by such Participant to receive such payment the amount of death benefit payable with respect to such Participant. The amount of the death benefit with respect to a Participant at any time prior to the Retirement Date is equal to the greater of (i) the Annuity Value of the Guaranteed Interest Account maintained under the Contract for such Participant and (ii) the minimum death benefit with respect to such Participant. Such minimum death benefit is the sum of all Contributions made with respect to such Participant pursuant to Section 2.01 (before reduction pursuant to said Section) less an adjustment for any withdrawals made pursuant to Section 2.05 from the Account maintained under the Contract for such Participant. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount being withdrawn is to the Annuity Value then in the Guaranteed Interest Account maintained under the Contract for such Participant. If, in accordance with the provisions of Section 2.01, the cash value of an Annuity contract issued by Equitable, which provides for a death benefit before retirement equal to the greater of the contract cash value or an alternative amount based on premiums paid or contributions made under the Annuity contract, is transferred to the Contract, such alternative amount as of the date of transfer will be included in the "sum of all Contributions" in lieu of the amount of cash value transferred, for purposes of the death benefit under the Contract. Page 8 PARTICIPANT'S ACCOUNT (continued) The amount of any death benefit payable with respect to a Participant will, to the extent such Account is sufficient therefor, be withdrawn from the Guaranteed Interest Account maintained with respect to such Participant under the Contract. Upon such payment, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Annuity Value arose. SECTION 2.08 CHANGE OF DEDUCTIONS FOR NEW PARTICIPANTS Equitable reserves the right to make deductions to the extent permitted by applicable law from Contributions made on behalf of new Participants at any time on or after the Contract Change Date, by at least 90 days advance written notice to the Contract Holder and by amendment to the Contract. Equitable will thereupon established a new Contract Change Date which shall be at least 5 years later. Equitable may lower the amount of the administrative charge described in Section 2.06 for new Participants at any time, by at least 15 days advance written notice to the Contract Holder. SECTION 2.09 CHANGE OF DEDUCTIONS AND CHARGES FOR EXISTING PARTICIPANTS Equitable may lower the amount of the administrative charge described in Section 2.06 for existing Participants at any time, by at least 15 days advance written notice to the Contract Holder and to such Participants. PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Value of such Participant's Guaranteed Interest Account shall be applied to provide the Normal Form of Annuity Benefit, unless, subject to any applicable limitations under the Plan, such Participant elects (i) to receive the Cash Value of such Account in a single sum or (ii) to apply such Annuity Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.03, to provide an Annuity Benefit on any other annuity form offered by Equitable, as elected by the Participant, subject to Equitable's rules then in effect and any applicable requirements under the Code. Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate participation under the Contract pursuant to Section 2.04 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Value of such Participant's Guaranteed Interest Account. Equitable will have the right to require the Participant to furnish pertinent facts and determinations to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.03 and 3.04. Equitable may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form. SECTION 3.03 AMOUNT OF ANNUITY BENEFITS If a Participant elects pursuant to the first paragraph or third paragraph of Section 3.02 to receive an Annuity Benefit in lieu of the Cash Value of the Guaranteed Interest Account, the amount applied to provide the Annuity Benefit will be (i) the Annuity Value of such Account if the payments under the annuity form elected are contingent upon the survival of a person, or (ii) the Cash Value of such Account if the payments under the annuity form elected are not contingent upon the survival of a person. The amount applied to provide an Annuity Benefit shall be reduced by the amount, as determined by Page 9 ANNUITY BENEFITS (continued) Equitable, of any applicable tax on annuity considerations. If such amount is applied on or after the completion of five Participation Years with respect to such Participant, or if such amount is applied on behalf of a Participant for whom cash value(s) of existing contract(s) issued by Equitable was (were) transferred to the Contract pursuant to Section 2.01, the balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. If the amount applied to provide an Annuity Benefit is applied before the completion of five Participation Years with respect to a Participant for whom no cash value(s) of existing contract(s) issued by Equitable was (were) transferred to the Contract, the balance, after any applicable tax on annuity considerations, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the Guaranteed Interest Account maintained for such Participant shall terminate. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (100% continuation). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, are based on 3 1/4% interest and the 1971 ELAS Mortality Table. Equitable may change the monthly income amounts contained in the Tables of Guaranteed Annuity Payments and the bases for determining such amounts, for new Participants, by at least 90 days advance notice to the Contract Holder and by an amendment to the Contract. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on 3 1/4% interest and the 1971 ELAS Mortality Table. SECTION 3.04 PAYMENT OF ANNUITY BENEFITS Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payable under the Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by Equitable will be charged against and underpayments will be added to any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may make the payments (in the case of a minor, at a rate not exceeding $50 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If an annuity form made available by Equitable provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Upon election by a Participant pursuant to Section 3.02 of an annuity form providing payments for a period certain, such Participant may designate (with the right to change such designation) a person or per- Page 10 ANNUITY BENEFITS (continued) sons to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's executors or administrators in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, Equitable will pay in a single sum to such payee's executors or administrators the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.02. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. Equitable will require satisfactory evidence of the age of any person upon whose life an annuity form depends. TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM - 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Value)
- ------------------------------------------------------------------------------------------------------------------------------------ Male Female Age Age 60 61 62 63 64 65 66 67 68 69 70 - ------------------------------------------------------------------------------------------------------------------------------------ 60 4.52 4.58 4.64 4.70 4.76 4.82 4.88 4.94 5.00 5.05 5.11 61 4.55 4.62 4.68 4.74 4.81 4.87 4.93 5.00 5.06 5.12 5.18 62 4.58 4.65 4.72 4.78 4.85 4.92 4.99 5.05 5.12 5.19 5.25 63 4.61 4.68 4.75 4.82 4.89 4.97 5.04 5.11 5.18 5.25 5.32 64 4.64 4.71 4.79 4.86 4.94 5.01 5.09 5.17 5.24 5.32 5.40 65 4.67 4.74 4.82 4.90 4.98 5.06 5.14 5.22 5.30 5.36 5.47 66 4.69 4.77 4.85 4.93 5.02 5.10 5.18 5.27 5.35 5.44 5.53 67 4.72 4.80 4.88 4.97 5.05 5.14 5.23 5.31 5.40 5.50 5.59 68 4.74 4.82 4.91 5.00 5.09 5.18 5.27 5.36 5.45 5.55 5.65 69 4.76 4.85 4.94 5.03 5.12 5.22 5.31 5.41 5.50 5.60 5.71 70 4.78 4.87 4.96 5.06 5.16 5.26 5.36 5.45 5.56 5.65 5.76 - ------------------------------------------------------------------------------------------------------------------------------------
FIXED ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) Age Males Females --- ----- ------- 60 5.88 4.99 61 6.04 5.11 62 6.21 5.24 63 6.38 5.38 64 6.57 5.53 65 6.77 5.68 66 6.98 5.84 67 7.19 6.01 68 7.42 6.20 69 7.67 6.39 70 7.93 6.61 Any election, change, revocation or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a commutation right under an Annuity Benefit is exercised, Equitable may defer payment in accordance with Section 4.08. PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT The Contract constitutes the entire Contract between the parties and the provisions of the Contract alone will govern with respect to the rights and obligations of Equitable. The provisions of the Contract will be applied separately with respect to each Participant. Nothing in the enrollment form referred to in Section 1.05, the Plan or trust agreement referred to in Section 4.10, nor any modification, amendment, or supplement to any such documents will in any way be construed to enlarge, change, vary or in any other way affect the obligations of Equitable as expressly provided in the Contract. The Contract may not be modified as to Equitable, nor may any of Equitable's rights or requirements be PAGE 11 GENERAL PROVISIONS (continued) waived, except in writing and by an authorized officer of Equitable. The Contract may be changed by amendment or replacement upon agreement between the Contract Holder and Equitable without the consent of any other person provided that such change does not reduce any Annuity Benefit provided before such change and provided that no rights, privileges or benefits which have accrued to any Participant under the Contract may be reduced or forfeited except by the express consent of such Participant. SECTION 4.02 STATUTORY COMPLIANCE Equitable reserves the right to amend the Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the Contract and any certificate to reflect changes in the Code, or in regulations or published rulings of the Internal Revenue Service, so that each such certificate will continue to be an Annuity. Any Annuity Benefit, Cash Value or death benefit available under a certificate issued pursuant to the Contract shall not be less than the minimum benefits required by any statute of the state in which the certificate is delivered. SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY The entire interest of any Participant under the Contract is nonforfeitable. No interest of a Participant under the Contract may be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation for any other purpose to any person other than Equitable. No amount payable under the Contract may be assigned, commuted, or encumbered by the payee, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. SECTION 4.04 PARTICIPATION IN SURPLUS The Contract and all other contracts in the same class of contracts shall be combined for the purpose of ascertaining the annual surplus of Equitable to be apportioned to said contracts as a dividend, and the portion of any such dividend that is to be allocated to the Contract shall be determined by Equitable. The participation of this class of contracts in annual surplus is, however, expected to be minimal. Any amount so allocated to the Contract shall be payable as of January 1 of the calendar year in which a dividend is apportioned and will be payable in cash and shall be equitably allocated by Equitable to the Guaranteed Interest Accounts maintained hereunder for Participants. No Annuity Benefit will enter into the determination of any surplus to be apportioned to the Contract as a dividend. SECTION 4.05 BENEFICIARY Each Participant, as of such Participant's Participation Date is to provide Equitable with an initial designation of the beneficiary entitled to receive any death benefit payable with respect to such Participant pursuant to Section 2.07. The Participant may change such designation from time to time during such Participant's lifetime and while Accounts for such Participants are being maintained hereunder. Any such designation or change will be made by written notice in a form satisfactory to Equitable. A change will, upon receipt at a designated Equitable Office, take effect as of the time the written notice was signed, whether or not the Participant is living on the date of receipt, but without further liability as to any payment or other settlement made by Equitable before receipt of such change. Unless otherwise specified in the designation, if a Participant has designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive the Participant, and if more than one survive they will share equally. Any part of a death benefit payable with respect to a Participant pursuant to Section 2.07 for which there is no designated beneficiary living at the death of the Participant will be payable in a single sum to the children of the Participant who survive the Participant, in equal shares, or should none survive, then to the Participant's executors or administrators. If a Participant so elects in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by the Participant, with respect to the beneficiary, subject to Equitable's rules then in effect. If at the death of a Participant there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. SECTION 4.06 DISQUALIFICATION In the event that an annuity purchased hereunder PAGE 12 GENERAL PROVISIONS (continued) with respect to a Participant fails to qualify as an Annuity as described in Section 1.03, Equitable shall have the right, upon receiving notice of such fact before the Retirement Date, to terminate participation with respect to such Participant under the Contract and pay to such Participant the amount in the Account maintained with respect to such Participant less a deduction for the appropriate part attributable to such Participant of any Federal income tax payable by Equitable which would not have been payable if such Participant had an Annuity under the Contract. SECTION 4.07 FUTURE PARTICIPANTS Equitable reserves the right at its sole discretion to curtail or prohibit further enrollment as Participants under the Contract of any individuals who are not currently participating under the Contract as of such date of curtailment or prohibition. SECTION 4.08 DEFERMENT Payments by Equitable from the Participant's Guaranteed Interest Account pursuant to the provisions of Section 2.04, Section 2.05 and Section 2.07, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.04, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.04. Interest at the current Guaranteed Interest Rate for such Participant's Guaranteed Interest Account will be allowed on any such payment deferred for 30 days or more. SECTION 4.09 ANNUAL NOTICE At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Guaranteed Interest Account, (2) the Cash Value of the Guaranteed Interest Account, and (3) the amount of death benefit payable with respect to the Participant. SECTION 4.10 CONTRACT HOLDER RESPONSIBILITY The sole responsibility of the Contract Holder is to serve as party to the Contract. The Contract Holder will have no responsibility for the administration of any Plan, for payments to the Guaranteed Interest Account, or any payments or other distributions hereunder. Equitable will deal with the Contract Holder in accordance with the terms and conditions of the trust agreement pursuant to which the Contract Holder agreed to act as such and the Contract and in such manner as the Contract Holder and Equitable may agree, without the consent of any other person. Any Employer making Contributions under the Contract shall be deemed to have adopted and accepted the trust agreement as part of the Plan with respect to which such Contributions are made. SECTION 4.11 AGE AND SEX If the Annuitant's age or sex has been misstated, any benefits will be those which would have been purchased at the correct age and sex. Any overpayments or underpayments made by Equitable will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. SECTION 4.12 RIGHT OF EMPLOYER Notwithstanding any other provision of the Contract, except with respect to amounts attributable to Contributions made by a Participant, if any, as permitted under the terms of the Plan, the value of the Guaranteed Interest Account maintained for each Participant shall, until distributed to the Participant or his beneficiaries in accordance with the terms of the Plan and the Contract, remain solely the property and rights of the Employer (without being restricted to the provision of benefits under the Plan) subject only to claims of the Employer's general creditors. This Section shall be construed and administered in accordance with Section 457(b)(6) of the Code and the regulations thereunder. PAGE 13 Attached to and made part of Group Annuity Contract No. 11932CP between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective August 15, 1981, said contract is amended as follows: 1. Contributions made to the contract, less applicable premium taxes, as determined by Equitable, may be allocated to the Guaranteed Interest Account or Stock Account maintained for the Participant, or in part to both, as directed by the Participant. 2. At the Retirement Date, if the Participant is then living, the amount in the Guaranteed Interest Account and Stock Account will be applied to provide the Participant with an Annuity Benefit or Cash Value Benefit. 3. ASSETS HELD IN CONNECTION WITH THE CONTRACT MAY BE HELD IN A SEPARATE ACCOUNT MAINTAINED BY EQUITABLE AND MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THE CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE SEPARATE ACCOUNT IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.20 IS 5% OR 3 1/2%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE OF 1.75% FOR INVESTMENT MANAGEMENT, FINANCIAL ACCOUNTING, THE ANNUITY RATE GUARANTEE AND MINIMUM DEATH BENEFIT, EXPENSES AND EXPENSE RISK, BUT AFTER ANY DEDUCTIONS TO PROVIDE FOR TAXES. THIS CONTRACT MAY NOT BE SUITABLE FOR A PARTICIPANT IF THE ONLY CONTRIBUTION TO BE MADE ON SUCH PARTICIPANT'S BEHALF IS A SUBSTANTIAL SINGLE SUM CONTRIBUTION. PF 14104CP Page 1 4. The following provisions are added to your Certificate: To Part I of your Certificate SECTION 1.05A EXISTING PARTICIPANT The term "Existing Participant" means a Participant for whom Cash Values of existing annuity contract(s) issued by Equitable is (are) eligible to be transferred to the Contract pursuant to Section 2.01. SECTION 1.05B NEW PARTICIPANT The term "New Participant" means a Participant who is not an Existing Participant. SECTION 1.14B ELIGIBLE ANNUITY CERTAIN The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by Equitable which extends beyond the Participant's attainment of age 59 years and six months and does not permit any prepayment of the unpaid principal prior to the participant's attainment of age 59 years and six months. SECTION 1.19 THE SEPARATE ACCOUNT The term "Separate Account" means Separate Account A, a separate investment account maintained by Equitable to which portions of its assets have been allocated for the Contract and certain other contracts. Equitable reserves the right to withdraw from the Separate Account and allocate to another separate account assets determined by Equitable to be associated with the class of contracts to which the Contract belongs. In any such event, to the extent practicable and permissible under applicable laws and regulations, the withdrawal shall be made by withdrawing the same percentage of each investment in the Separate Account, with appropriate adjustments to avoid odd lots and fractions. On and after the date of any such withdrawal the term "Separate Account" in the Contract shall mean such other separate account to which the withdrawn assets were allocated. It is contemplated that investments in the Separate Account will, at most times, consist primarily of common stock and other equity-type investments. Equitable may, however, at its discretion invest the assets of the Separate Account in any investment permitted by applicable law. Equitable may rely conclusively on the opinion of counsel (including attorneys in its employ) as to what investments it is permitted by law to make. In lieu of making such investments directly, Equitable reserves the right to operate the Separate Account as a unit investment trust, or in any other form permitted by law, investing all or part of its assets in shares or units of a fund, the investment adviser of which may be Equitable or controlled by Equitable. The fund assets would be invested as provided above with respect to the Separate Account. Equitable reserves the right: (i) to cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such committee at any time; and (iii) restrict or eliminate any voting rights of participants or other persons who have voting rights as to the Separate Account. Assets of the Separate Account attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, consisting of .15% for investment management, .35% for financial accounting, .35% for the annuity rate guarantee and the minimum death benefit, and .90% for expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provisions in Section 1.20. The assets of the Separate Account are the property of Equitable; however, the portion of the assets of the Separate Account equal to the reserves and other contract liabilities with respect to such Account shall not be chargeable with liabilities arising out of any other business Equitable may conduct. Equitable reserves the right to transfer assets of the Separate Account in excess of such reserves and contract liabilities to the general account of Equitable. SECTION 1.20 DEFINITIONS RELATING TO THE SEPARATE ACCOUNT VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business day immediately preceding such business day will constitute a Valuation Period. A PF 14104CP Page 2 business day is any day on which there is a sufficient degree of trading in the portfolio securities of the Separate Account that the Accumulation Unit Value or Annuity Unit Value might be materially affected by changes in the value of the portfolio securities in the Separate Account, as determined by Equitable. NET INVESTMENT FACTOR: For the Separate Account the Net Investment Factor for a Valuation Period is (a) divided by (b), minus (c), where (a) is (1) the value of the assets in the Separate Account at the close of business of the preceding Valuation Period plus (2) the investment income and the capital gains, realized or unrealized, credited to the assets of the Separate Account in the Valuation Period for which the Net Investment Factor is being determined, minus (3) the capital losses, realized or unrealized, charged against such assets in such Valuation Period, minus (4) any amount charged against the Separate Account in such Valuation Period for taxes or for amounts set aside by Equitable as a reserve for taxes attributable to the maintenance or operation of the Separate Account; (b) is the value of the assets in the Separate Account at the close of business of the preceding Valuation Period; and (c) is the daily charge, for each calendar day in such Valuation Period of .00004837 for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The value of the assets in the Separate Account, referred to above, shall be taken at their fair market value, or where there is no readily available market, their fair value, as determined in accordance with accepted accounting practices and applicable laws and regulations. ACCUMULATION UNIT: The Accumulation Unit is a unit used in determining the value of the interest of a Participant's Stock Account in the Separate Account on or before the Retirement Date. NEW ACCUMULATION UNIT VALUE: The initial New Accumulation Unit Value for the Separate Account has been established at $10.00 as of November 1, 1968. The New Accumulation Unit Value for each subsequent Valuation Period is the New Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such subsequent Valuation Period. ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable from the Separate Account under a Variable Annuity Benefit. NEW ANNUITY UNIT VALUE: The initial New Annuity Value has been established at $1.00 on November 1, 1968. The New Annuity Unit Value for any subsequent Valuation Period is the New Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3 1/2%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE NEW ANNUITY UNIT VALUE: The Average New Annuity Unit Value for a calendar month is equal to the average of the New Annuity Unit Values for the Valuation Periods ending in such month. To Part II of your Certificate SECTION 2.10 STOCK ACCOUNT Equitable maintains a Stock Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to a Stock Account becomes part of the Separate Account. Any amount withdrawn from a Stock Account will no longer be part of the Separate Account. On any date when an amount is allocated to or withdrawn from a Stock Account, the Stock Ac- PF 14104CP Page 3 count will be credited or charged, as the case may be, with a number of Accumulation Units determined by dividing said amount by the New Accumulation Unit Value for the Separate Account for the Valuation Period which includes that date. The number of Accumulation Units in a Stock Account on any date is equal to (i) the sum of any Accumulation Units that have been credited to the Stock Account minus (ii) the sum of any Accumulation Units that have been charged to the Stock Account. The amount in a Stock Account on any date is equal to the product of (i) the number of Accumulation Units in the Stock Account on that date and (ii) the Accumulation Unit Value for the Separate Account for the Valuation Period which includes that date. SECTION 2.11 TRANSFERS BETWEEN ACCOUNTS At any time before a Participant's Retirement Date, such Participant, upon written request, may transfer all or a part of the amounts from the Stock Account maintained for such Participant to the Guaranteed Interest Account maintained for such Participant, or may transfer all or a part of the amounts in the Guaranteed Interest Account maintained for such Participant to the Stock Account maintained for such Participant. Such transfers will be made as of the later of (i) the date specified in such request and (ii) the date Equitable receives such request, and will be subject to Equitable's rules in effect at the time of transfer. To Part III of your Certificate SECTION 3.05 VARIABLE ANNUITY BENEFIT The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Separate Account. The amount of the first, second, and third payments under any Variable Annuity Benefit provided under the Contract with respect to a payee is the monthly amount provided with respect to the payee pursuant to Section 3.03. The amount of the forth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average New Annuity Unit Value for the second calendar month immediately preceding the date of the payment. The fourth and subsequent annuity payments under a Variable Annuity Benefit will not be increased or decreased in amount because of mortality or expense experience. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the New Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. 5. The following sections of your Certificate are amended or modified as follows: A. Section 1.15, ANNUITY VALUE, is amended to provide that the "Annuity Value" with respect to a Participant's Guaranteed Interest Account and Stock Account shall mean the amounts in such Accounts described in Section 2.02 and 2.10. B. Section 1.16, CASH VALUE, shall read as follows: SECTION 1.16 CASH VALUE -- NEW PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to a New Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account and Stock Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and six months, or (ii) the Participant's attainment of age 70 years and six months, or (iii) the completion of 25 Participation Years with respect to such Participant, or (iv) if the Participant has attained age 55, completed five Participation Years, and the Cash Values are to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. PF 14104CP Page 4 WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% of the sum of the Annuity Values of such Accounts. (b) is an amount equal to the excess, if any, of (i) 8% of the cumulative contributions made on behalf of such Participant over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.05 and 2.05A. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Participant, the withdrawal charge equals the lesser or (a) or (b) where: (a) equals 6% of the excess of (i) the sum of the Annuity Values of such Accounts over (ii) the Free Corridor Amount defined in Section 2.05C. (b) is the excess, if any, of (i) 8% of the total contributions made on behalf of such Participant during the current Participation Year and the preceding nine Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.05 and 2.05A. The Cash Value of the Guaranteed Interest Account and the Cash Value of the Stock Account will be in the same proportion as are the Annuity Values of such Accounts. SECTION 1.16B CASH VALUE -- EXISTING PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to an Existing Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account and Stock Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The Participant's attainment of age 59 years and six months, (ii) the completion of 20 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55 and the Cash Values are to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a) and (b) below; provided, however, that such charge does not exceed the amount described in subsection (c) below where: (a) is an amount equal to 2% of any Preferred Withdrawable Amounts (defined in Section 2.05B) that have not previously been withdrawn pursuant to Section 2.05 and 2.05B. (b) is an amount equal to 6% of any Regular Withdrawable Amounts (defined in Section 2.05B) that have not previously been withdrawn pursuant to Section 2.05 and 2.05B. (c) is an amount equal to the sum of (a) above, and 6% of the excess, if any, of (i) the sum of the Annuity Values of such Accounts over (ii) the cumulative total of Equitable Transferred Funds made with respect to the Participant that have not previously been withdrawn pursuant to Section 2.05 and 2.05B. WITHDRAWAL CHARGE AFTER FIVE YEARS: After five Participation Years have been completed with respect to the Participant, Equitable (i) will first withdraw, pursuant to Section 2.05B, the Free Corridor Amount defined in Section 2.05C and (ii) next withdraw the remaining portion of the sum of the Annuity Values of such Accounts. A withdrawal charge will apply to the amount in (ii) above, and will equal the sum of the PF 14104CP Page 5 charges described in subsection (a) and (b) of the preceding subsection; provided, however, that such charge will not exceed an amount equal to the lesser of the charges defined in (d) and (e) below: (d) is an amount equal to the sum of (a) in the preceding subsection, and 6% of the excess, if any, of (i) the sum of the Annuity Values of such Accounts (after withdrawal of the Free Corridor Amount) over (ii) the cumulative total of Equitable Transferred Funds made on behalf of the Participant that have not previously been withdrawn pursuant to Section 2.05 and 2.05B. (e) is an amount equal to the excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other contributions (excluding Equitable Transferred Funds) made on behalf of such Participant during the current Participation Year over (2) the cumulative total of any withdrawal charges made pursuant to Sections 2.05 and 2.05B. The Cash Value of the Guaranteed Interest Account and the Cash Value of the Stock Account will be in the same proportion as are the Annuity Values of such Accounts. C. Section 1.18, SEPARATE ACCOUNT TRANSFERS, shall read as follows: SECTION 1.18 EQUITABLE TRANSFERRED FUNDS The term "Equitable Transferred Funds" with respect to a Participant means the amount of cash value(s) transferred to the Contract from a contract issued by Equitable, pursuant to Section 2.01. D. The second paragraph of Section 2.02, GUARANTEED INTEREST ACCOUNT, is amended as follows: a. References to Section 2.05 are replaced by Sections 2.05, 2.05A and 2.05B. b. The amount in the Guaranteed Interest Account at any time includes the amount transferred into the Account and does not include amounts withdrawn or transferred out of such Account. E. The Sections entitled TERMINATION OF PARTICIPATION (2.04), ANNUAL ADMINISTRATIVE CHARGE (2.06), DEATH BENEFIT (2.07), ELECTION AND COMMENCEMENT OF ANNUITY PAYMENTS (3.02), CONTRACT HOLDER RESPONSIBILITY (4.10) and RIGHT OF EMPLOYER (4.12) are amended to change the term "Guaranteed Interest Account" wherever it appears to "Guaranteed Interest Account and Stock Account." F. Section 2.03, ALLOCATION TO ACCOUNT, shall read as follows: SECTION 2.03 ALLOCATION TO ACCOUNT Each Contribution made with respect to a Participant pursuant to Section 2.01, after deduction for any applicable taxes, will be allocated, as of the date by which Equitable has received both such Contribution and direction as to its allocation, to the Guaranteed Interest Account, or Stock Account, or in part to each, at the sole direction of the Participant as specified to Equitable, provided that the percentage allocated to each Account is a whole number. Any amount that a Participant has directed to be transferred to the Guaranteed Interest Account or the Stock Account pursuant to Section 2.11 will be allocated as of the date of such transfer to the appropriate Account maintained for such Participant. Interest is allocated to the Guaranteed Interest Account at the end of each Participation Year, at the time of each transfer or withdrawal pursuant to Sections 2.05, 2.05A, 2.05B and 2.11 at the time of application of amounts in the Guaranteed Interest Account to provide Annuity Benefits, upon termination of participation pursuant to Section 2.04, and upon death of the Participation pursuant to Section 2.07. PF 14104CP Page 6 G. Section 2.05, PARTIAL WITHDRAWALS, shall read as follows: SECTION 2.05 PARTIAL WITHDRAWALS Subject to any applicable restrictions under the terms of the Plan, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Stock Account and the Guaranteed Interest Account maintained for such Participant before such Participant's Retirement Date. Upon withdrawal pursuant to Section 2.05, 2.05A or 2.05B, Equitable will pay the lesser of the sum of the Cash Values of such Accounts or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by such Participant. Unless instructed otherwise, the amount withdrawn (including the amount of any withdrawal charge) will be allocated between such Accounts in proportion to the Annuity Value of each such Account. Upon any payment to a Participant pursuant to Section 2.05, 2.05A or 2.05B, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Payments to the Participant pursuant to Section 2.05, 2.05A or 2.05B may be deferred by Equitable in accordance with the provisions of Section 4.08. Equitable is under no obligation to process any request for partial withdrawal of less than $300. If a withdrawal from the Accounts made pursuant to Sections 2.05, 2.05A or 2.05B would result in total Annuity Values of less than $200, Equitable will so advise the Participant and reserves the right to withdraw the Annuity Values of the Guaranteed Interest Account and Stock Account, pay the Annuity Values of such Accounts to the Participant, and terminate such Participant's participation under the Contract. If the Participant enrolled in this Contract on or after the effective date of this rider, the $200 amount stated above shall be $500. SECTION 2.05A PARTIAL WITHDRAWALS -- NEW PARTICIPANT NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a New Participant, Equitable will withdraw from the Stock Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and six months, or (ii) such Participant's attainment of age 70 years and six months, or (iii) the completion of 25 Participation Years with respect to such Participant, or (iv) if the Participant has attained age 55, has completed five Participation Years, and the partial withdrawal is to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: If the Participant has not completed five Participation Years under the Contract, such withdrawal charge will equal the lesser of (a) or (b) where: (a) is a amount equal to 6% of the total amount to be withdrawn from the Accounts pursuant to this paragraph (including such charge) (b) is the excess, if any, of (i) 8% of the cumulative total of Contributions made on behalf of such Participant over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Participant, there will be no withdrawal charge if the PF 14104CP Page 7 amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.05C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% of the amount withdrawn pursuant to (ii) of the preceding sentence including such charge, and (b) is the excess, if any, of (i) 8% of the cumulative total of contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. SECTION 2.05B PARTIAL WITHDRAWAL -- EXISTING PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by an Existing Participant, Equitable will withdraw from the Stock Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The Participant's attainment of age 59 years and six months, or (ii) the completion of 20 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55 and the partial withdrawal is to be applied to the purchase of an Eligible Annuity Certain defined in Section 1.14B. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. PREFERRED WITHDRAWABLE AMOUNT: This is an amount equal to the lesser of (a) the total of Equitable Transferred Funds made on behalf of the Participant or (b) $10,000. FREE WITHDRAWABLE AMOUNT: This is an amount equal to the excess, if any, of (a) the total Equitable Transferred Funds made on behalf of the Participant over (b) $10,000. REGULAR WITHDRAWABLE AMOUNT: This is the cumulative total of all Contributions, other than Equitable Transferred Funds, made on behalf of the Participant. ORDER OF WITHDRAWALS: In calculating the withdrawal charge, Equitable will assume that (a) any Preferred Withdrawable Amounts are first withdrawn, (b) any Free Withdrawable Amounts are next withdrawn, (c) any Regular Withdrawable Amounts are next withdrawn, and (d) lastly, any amounts other than the amounts described in (a), (b), and (c) above are withdrawn. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in sub-sections (a), (b), (c) and (d) below: (a) With respect to any withdrawals of Preferred Withdrawable Amounts, a charge of 2% of such withdrawals. (b) With respect to any withdrawals of Free Withdrawable Amounts, no charge. (c) With respect to any withdrawals of Regular Withdrawable Amounts, a charge of 6% of such withdrawals. (d) With respect to any withdrawals of amounts other than the amounts in (a), (b) and (c) above, no charge. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Partici- PF 14104CP Page 8 pant, there will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.05C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (1) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (2) then withdraw from such Accounts an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will equal the sum of the charges described in (a), (b), (c), and (d) above; provided, however, that in no event, will such charge exceed an amount equal to the following: The excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other Contributions (excluding Equitable Transferred Funds) made on behalf of the Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any prior withdrawal charges made pursuant to this Section. Whenever an amount is withdrawn from such Accounts that is not greater than the current Free Corridor Amount; such amount is considered to be (1) first, a withdrawal of Regular Withdrawable Amounts, (2) next, a withdrawal of Preferred Withdrawable Amounts, (3) next, a withdrawal of Free Withdrawable Amounts and (4) lastly, a withdrawal of amounts other than the amounts in (1), (2), or (3) above. However, no charge will be assessed with respect to the portion of the withdrawal up to the current Free Corridor Amount. SECTION 2.05C FREE CORRIDOR AMOUNT The term "Free Corridor Amount" with respect to a Participant who has completed five Participation Years means an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Values of the Stock Account and the Guaranteed Interest Account over (ii) cumulative prior withdrawals made pursuant to Section 2.05, 2.05A or 2.05B in the current Participation Year with respect to the Participant. H. The first paragraph of Section 2.06, ANNUAL ADMINISTRATIVE CHARGE, is amended by adding the following: The charge will be allocated between the Stock Account and the Guaranteed Interest Account in proportion to the Annuity Values of such Accounts at the end of the Participation Year. I. Section 2.08, Change of Deductions for New Participants, is deleted as of August 1, 1981 and Section 2.09, Change of Deductions and Charges for Existing Participants, shall not apply to Participants enrolled on or after August 1, 1981. J. With respect to Section 3.03, AMOUNT OF ANNUITY BENEFITS, a. Wherever the term "Guaranteed Interest Account" appears, it shall be changed to "Guaranteed Interest and Stock Account." b. The second and third sentences of paragraph 2 shall apply to a Participant who has completed five Participation Years and to an Existing Participant (as defined in Part I of this rider). c. Paragraph 3 shall apply to a New Participant (as defined in Part I of this rider) before the completion of five Participation Years. d. The last two paragraphs have been amended to provide that any Variable Annuity Benefit shall be calculated by Equitable on 1979 ELAS Mortality and an Assumed Base Rate of Net Investment Income Return of 5% or 3 1/2%, whichever applies pursuant to Section 1.20. PF 14104CP Page 9 K. Section 3.04, PAYMENT OF ANNUITY PAYMENTS, is amended by the addition of the following: VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3 1/2% (MINIMUM MONTHLY INCOME PER $1,000 OF ANNUITY VALUE)
- --------------------------------------------------------------------------------------------------------------------------------- FEMALE AGE MALE --------------------------------------------------------------------------------------------------------------------- AGE 60 61 62 63 64 65 66 67 68 69 70 --------------------------------------------------------------------------------------------------------------------- 60 4.31 4.35 4.39 4.43 4.47 4.51 4.55 4.59 4.63 4.67 4.71 61 4.35 4.39 4.43 4.48 4.52 4.56 4.61 4.65 4.69 4.73 4.78 62 4.39 4.43 4.48 4.52 4.57 4.61 4.66 4.71 4.75 4.80 4.85 63 4.42 4.47 4.52 4.57 4.62 4.67 4.72 4.77 4.82 4.87 4.92 64 4.46 4.51 4.57 4.62 4.67 4.72 4.77 4.83 4.88 4.94 4.99 65 4.50 4.56 4.61 4.66 4.72 4.78 4.83 4.89 4.95 5.01 5.07 66 4.54 4.60 4.65 4.71 4.77 4.83 4.89 4.95 5.01 5.08 5.14 67 4.58 4.64 4.70 4.76 4.82 4.88 4.95 5.01 5.08 5.15 5.22 68 4.62 4.68 4.77 4.81 4.87 4.95 5.01 5.08 5.15 5.22 5.29 69 4.65 4.72 4.78 4.85 4.92 4.99 5.06 5.14 5.22 5.29 5.37 70 4.69 4.76 4.83 4.90 4.97 5.05 5.12 5.20 5.28 5.36 5.45 - ---------------------------------------------------------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 5% (MINIMUM MONTHLY INCOME PER $1,000 OF ANNUITY VALUE)
- --------------------------------------------------------------------------------------------------------------------------------- FEMALE AGE MALE --------------------------------------------------------------------------------------------------------------------- AGE 60 61 62 63 64 65 66 67 68 69 70 --------------------------------------------------------------------------------------------------------------------- 60 5.19 5.23 5.27 5.31 5.34 5.39 5.42 5.46 5.50 5.54 5.58 61 5.23 5.27 5.31 5.35 5.39 5.43 5.47 5.52 5.56 5.60 5.64 62 5.27 5.31 5.35 5.39 5.44 5.48 5.53 5.57 5.62 5.67 5.71 63 5.31 5.35 5.39 5.44 5.49 5.53 5.58 5.63 5.68 5.73 5.78 64 5.34 5.39 5.44 5.48 5.53 5.59 5.64 5.69 5.74 5.79 5.85 65 5.38 5.43 5.48 5.53 5.58 5.64 5.69 5.75 5.80 5.86 5.92 66 5.42 5.47 5.52 5.58 5.63 5.69 5.75 5.81 5.87 5.93 5.99 67 5.45 5.51 5.56 5.62 5.68 5.74 5.80 5.87 5.93 6.00 6.06 68 5.49 5.55 5.61 5.67 5.73 5.80 5.86 5.93 6.00 6.06 6.14 69 5.53 5.59 5.65 5.71 5.78 5.85 5.92 5.99 6.06 6.13 6.21 70 5.56 5.63 5.69 5.76 5.83 5.90 5.97 6.05 6.13 6.21 6.29 - ---------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (MINIMUM MONTHLY INCOME PER $1,000 OF ANNUITY VALUE)
VARIABLE ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS -------------------------------- 3 1/2% 5% ---------- ---------- AGE MALES FEMALES MALES FEMALES - ----------- --------- ---------- ---------- ---------- 60 5.43 4.80 6.36 5.70 61 5.57 4.90 6.50 5.81 62 5.72 5.01 6.65 5.91 63 5.88 5.13 6.81 6.03 64 6.05 5.25 6.97 6.15 65 6.23 5.39 7.16 6.28 66 6.43 5.54 7.35 6.43 67 6.64 5.70 7.56 6.58 68 6.87 5.87 7.79 6.76 69 7.11 6.06 8.03 6.95 70 7.38 6.27 8.30 7.15
Equitable will notify the payee under a Variable Annuity Benefit of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each variable payment. L. Section 4.08, DEFERMENT, shall read as follows: SECTION 4.08 DEFERMENT Payments by Equitable from the Participant's Guaranteed Interest Account pursuant to the provisions of Section 2.04, Sections 2.05, 2.05A and 2.05B, and Section 2.07, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.04, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.04. Interest at the current Guaranteed Interest Rate for such Participant's Guaranteed Interest Account will be allowed on any such payment deferred for 30 days or more. Except as provided in this Section, payments by Equitable from the Participant's Stock Account pursuant to the provisions of Section 2.04, Sections 2.05, 2.05A and 2.05B, and Section 2.07, or any commuted payments arising from a Variable Annuity Benefit pursuant to Section 3.04, will be made within seven days after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.04. During any period when (i) the sale of securities or the determination of the New Accumulation Unit Value or the New Annuity Unit Value is not reasonably practicable because an emergency, defined by the Securities and Exchange Commission, exists, or the New York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may by order permit postponement for the protection of persons having interests in the Separate Account, Equitable reserves the right: PF 14104CP Page 10 (a) to defer determination of Cash Values or Annuity Values and payment of Cash Values and Annuity Values, arising from an amount in a Participant's Stock Account; (b) to defer payment of any portion of the death benefit arising from an amount in a Participant's Stock Account; (c) to defer the payment of any Variable Annuity Benefit under the Contract or the application of any such Benefit to provide for any other payment called for by the Contract; or (d) in the event of (a) above, to defer application of such amounts to provide any Annuity Benefit permitted under the Contract. M. Section 4.09, ANNUAL NOTICE, shall read as follows: SECTION 4.09 ANNUAL NOTICE At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Guaranteed Interest Account, (2) the total number of Accumulation Units credited to the Stock Account, (3) the New Accumulation Unit Value, (4) the sum of the Cash Values of the Guaranteed Interest Account and the Stock Account and (5) the amount of death benefit payable with respect to the Participant. After the Retirement Date Equitable will notify the Participant of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By /s/ Signature Unreadable By /s/ Coy Eklund ---------------------------------- --------------------------------------- President Title S/V/P By /s/ Rodney L. Enochs ------------------------------ --------------------------------------- Vice President and Secretary Dated 8/12/81 Date of Issuance AUG 12 1981 ------------------------------ ------------------------- At N.Y. N.Y. --------------------------------- PF 14104CP Page 11 Attached to and made part of Group Annuity Contract No. 11932CP between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective January 1, 1982 said contract is amended by adding the following to the third paragraph of Section 1.10 (Guaranteed Interest Rate): For the period (not to exceed one year) next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent period (not to exceed one year) the Equitable may determine for each established Class of Participants a Guaranteed Interest Rate for such Class which exceeds the applicable Yearly Guaranteed Interest Rate. Equitable will notify each Participant in writing of the applicable Guaranteed Interest Rate and duration.
Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By /s/ Signature Unreadable By /s/ Coy Eklund ---------------------------------------------- ---------------------------------------------- President Title Senior Vice President By /s/ Rodney L. Enochs ------------------------------------------ ---------------------------------------------- Vice President and Secretary Dated DEC 22 1981 Date of Issuance DEC 22 1981 ------------------------------------------ -------------------------------- At New York, New York ---------------------------------------------
PF 14109CP Attached to and made part of Group Annuity Contract No. 11932CP between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective April 15, 1982, said contract and riders are amended as follows: o Contributions made to the Contract after deduction of any applicable taxes, will be allocated to the Stock Account, Money Market Account or the Guaranteed Interest Account maintained for the Participant, in accordance with Sections 2.02 and 2.03, or in part to any one, as directed by the Participant. o The amount in the Stock Account, Money Market Account and the Guaranteed Interest Account will be applied at the Retirement Date to provide the Participant with an Annuity Benefit or a Cash Value Benefit if the Participant is then living, and o The Participant will have other rights and benefits as described herein. ASSETS HELD IN CONNECTION WITH THE CONTRACT MAY BE HELD IN SEPARATE ACCOUNTS MAINTAINED BY EQUITABLE AND MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THE CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF SEPARATE ACCOUNT A. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN SEPARATE ACCOUNT A IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.16 IS 5% OR 3 1/2%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE OF 1.75% FOR INVESTMENT MANAGEMENT, FINANCIAL ACCOUNTING, THE ANNUITY RATE GUARANTEE AND MINIMUM DEATH BENEFIT, EXPENSES AND EXPENSE RISK, BUT AFTER ANY DEDUCTIONS TO PROVIDE FOR TAXES. Equitable will issue to each Participant an individual certificate setting forth a statement in substance of the benefits to which such Participant is entitled under the Contract. The provisions on the following pages are part of the Contract. PF 14114CP This page 2 reserved for information in connection with the issuance of certificates under this Contract. PAGE 2 This page 3 reserved for information in connection with the issuance of certificates under this Contract. PAGE 3 DEFINITIONS (continued) change. Equitable will notify each Participant in a Class in writing of the Yearly Guaranteed Interest Rate or of any change in the Minimum Guaranteed Interest Rate at least 15 days prior to its effective date. For the period (not to exceed one year) next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent period (not to exceed one year) the Equitable may determine for each established Class of Participants a Guaranteed Interest Rate for such Class which exceeds the applicable Yearly Guaranteed Interest Rate. Equitable will notify each Participant in writing of the applicable Guaranteed Interest Rate and duration. SECTION 1.11 RETIREMENT DATE The term "Retirement Date" means the date on which the Participant is to attain the retirement age specified in the Participant's enrollment form. Before the Retirement Date the Participant may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be earlier than the Retirement Date provided under the Plan. Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Home Office. SECTION 1.12 NORMAL FORM The "Normal Form" of an Annuity Benefit under the Contract means, (i) if the Participant has a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (100% continuation), and (ii) if the Participant does not have a living spouse at the Retirement Date, the Fixed Annuity Benefit Payable on the Life Annuity Form. SECTION 1.13 JOINT AND SURVIVOR LIFE ANNUITY FORM The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depends is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by the Participant. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.14A LIFE ANNUITY FORM The term "Life Annuity Form" means an annuity providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.14B ELIGIBLE ANNUITY CERTAIN The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by Equitable which extends beyond the Participant's attainment of age 59 years and six months and does not permit any prepayment of the unpaid principal prior to the participant's attainment of age 59 years and six months. SECTION 1.15 THE SEPARATE ACCOUNTS The term "Separate Accounts" means the following separate investment accounts maintained by Equitable to which portions of its assets have been allocated for the Contract and certain other contracts: Name Investments ---- ----------- Separate Account A Primarily common stock and other equity-type investments. Separate Account E Primarily short-term money market instruments. Equitable reserves the right to withdraw from any Separate Account and allocate to another separate account assets determined by Equitable to be associated with the class of contracts to which the Contract belongs. In any such event, to the extent practicable and permissible under applicable laws and regulations, the withdrawal shall be made by withdrawing the same percentage of each investment in the Separate Account, with appropriate adjustments to avoid odd lots and fractions. On and after the date of PF 14114CP Page 6 DEFINITIONS (continued) any such withdrawal the reference in the Contract to such Separate Account shall mean such other separate account to which the withdrawn assets were allocated. It is contemplated that investments in the Separate Accounts will, at most times, consist primarily of the types of investments indicated above. Equitable may, however, at its discretion invest the assets of any Separate Account in any investment permitted by applicable law. Equitable may rely conclusively on the opinion of counsel (including attorneys in its employ) as to what investments it is permitted by law to make. In lieu of making such investments directly, Equitable reserves the right to operate any Separate Account as a unit investment trust, or in any other form permitted by law, investing all or part of its assets in shares or units of a fund, the investment adviser of which may be Equitable or controlled by Equitable. The fund assets would be invested as provided above with respect to the Separate Account. Equitable reserves the right: (i) to cause the registration or deregistration of any Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run any Separate Account under the direction of a committee, and to discharge such committee at any time; and (iii) restrict or eliminate any voting rights of participants or other persons who have voting rights as to the Separate Accounts. Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, consisting of .15% for investment management, .35% for financial accounting, .35% for the annuity rate guarantee and the minimum death benefit, and .90% for expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.16. The assets of Separate Accounts are the property of Equitable; however, the portion of the assets of each Separate Account equal to the reserves and other contract liabilities with respect to such Account shall not be chargeable with liabilities arising out of any other business Equitable may conduct. Equitable reserves the right to transfer assets of the Separate Accounts in excess of such reserves and contract liabilities to the general account of Equitable. SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business day immediately preceding such business day will constitute a Valuation Period. A business day is any day on which there is a sufficient degree of trading in the portfolio securities of a Separate Account that the New Accumulation Unit Value or New Annuity Unit Value might be materially affected by changes in the value of the portfolio securities in a Separate Account, as determined by the Separate Account Committee or, if there is no Committee, by Equitable. NET INVESTMENT FACTOR: For each Separate Account the Net Investment Factor for a Valuation Period is (a) divided by (b), minus (c), where (a) is (1) the value of the assets in the Separate Account at the close of business of the preceding Valuation Period plus (2) the investment income and the capital gains, realized or unrealized, credited to the assets of the Separate Account in the Valuation Period for which the Net Investment Factor is being determined, minus (3) the capital losses, realized or unrealized, charged against such assets in such Valuation Period, minus (4) any amount charged against the Separate Account in such Valuation Period for taxes or for amounts set aside by Equitable as a reserve for taxes attributable to the maintenance or operation of the Separate Account; (b) is the value of the assets in the Separate Account at the close of business of the preceding Valuation Period; and (c) is the daily charge, for each calendar day in such Valuation Period of .00004837 for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The value of the assets in the Separate Accounts, referred to above, shall be taken at their fair market value, or where there is no readily available market. PF 14114CP Page 7 DEFINITIONS (continued) their fair value, as determined in accordance with accepted accounting practices and applicable laws and regulations. ACCUMULATION UNIT: The accumulation Unit is a unit used in determining the value of the interest of a Participant's Stock Account or Money Market Account on or before the Retirement Date. NEW ACCUMULATION UNIT VALUE: The initial New Accumulation Unit Values for the Separate Accounts have been established as follows: Account Value Date ------- ----- ---- Separate Account A $10.00 As of November 1, 1968 Separate Account E $10.00 As of September 4, 1974 The new Accumulation Unit Value for each subsequent Valuation Period is the New Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such subsequent Valuation Period. ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable from Separate Account A under a Variable Annuity Benefit. NEW ANNUITY UNIT VALUE: The initial New Annuity Unit Value for Separate Account A has been established at $1.00 as of November 1, 1968. The Annuity Unit Value for any subsequent Valuation Period is the New Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3 1/2%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE NEW ANNUITY UNIT VALUE: The Average Annuity Unit Value for Separate Account A for a calendar month is equal to the average of the New Annuity Unit Values for the Valuation Periods ending in such month. SECTION 1.17 ANNUITY VALUE The term "Annuity Value" with respect to a Participant's Guaranteed Interest Account, Stock Account and Money Market Account, means the amount in such Accounts pursuant to Sections 2.02 and 2.03. SECTION 1.18A CASH VALUE - NEW PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to a New Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and six months, of (ii) the Participant's attainment of age 70 years and six months, or (iii) the completion of 25 Participation Years with respect to such Participant, or (iv) if the Participant has attained age 55, completed five Participation Years, and the Cash Values are to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% of the sum of the Annuity Values of such Accounts. (b) is an amount equal to the excess, if any, of (i) 8% of the cumulative contributions made on behalf of such Participant over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: PF 14114CP Page 8 DEFINITIONS (continued) (a) equals 6% of the excess of (i) the sum of the Annuity Values of such Accounts over (ii) the Free Corridor Amount defined in Section 2.07C. (b) is the excess, if any, of (i) 8% of the total contributions made on behalf of such Participant during the current Participation Year and the preceding nine Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. The Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. SECTION 1.18B CASH VALUE - EXISTING PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to an Existing Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The Participant's attainment of age 59 years and six months, (ii) the completion of 20 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55 and the Cash Values are to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a) and (b) below; provided, however, that such charge does not exceed the amount described in subsection (c) below where: (a) is an amount equal to 2% of any Preferred Withdrawable Amounts (defined in Section 2.07B) that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (b) is an amount equal to 6% of any Regular Withdrawable Amounts (defined in Section 2.07B) that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (c) is an amount equal to the sum of (a) above, and 6% of the excess, if any, of (i) the sum of the Annuity Values of such Accounts over (ii) the cumulative total of Equitable Transferred Funds made with respect to the Participant that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. WITHDRAWAL CHARGE AFTER FIVE YEARS: After five Participation Years have been completed with respect to the Participant, Equitable (i) will first withdraw, pursuant to Section 2.07B, the Free Corridor Amount defined in Section 2.07C and (ii) next withdraw the remaining portion of the sum of the Annuity Values of such Accounts. A withdrawal charge will apply to the amount in (ii) above, and will equal the sum of the charges described in subsections (a) and (b) of the preceding subsection; provided, however, that such charge will not exceed an amount equal to the lesser of the charges defined in (d) and (e) below: (d) is an amount equal to the sum of (a) in the preceding subsection, and 6% of the excess, if any, of (i) the sum of the Annuity Values of such Accounts (after withdrawal of the Free Corridor Amount) over (ii) the cumulative total of Equitable Transferred Funds made on behalf of the Participant that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (e) is an amount equal to the excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other contributions (excluding Equitable Transferred Funds) made on behalf of such Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07B. The Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. PF 14114CP Page 9 DEFINITIONS (continued) SECTION 1.19 CODE The term "Code" means the Internal Revenue Code of 1954, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.20 EQUITABLE TRANSFERRED FUNDS The term "Equitable Transferred Funds" with respect to a Participant means the amount of cash value(s) transferred to the Contract from a contract issued by Equitable, pursuant to Section 2.01. PART II - PARTICIPANT'S ACCOUNT SECTION 2.01 CONTRIBUTIONS The Employer is to make Contributions from time to time on such dates and in such amounts as determined by the Employer pursuant to the terms of the Plan or, if the Employer has no Plan, as determined by the Employer at its sole discretion. The Employer is to specify the Participant with respect to whom each such Contribution is being made and the amount to be allocated to the Stock Account, Money Market Account and the Guaranteed Interest Account. Each Contribution received by Equitable with respect to a Participant will, before its allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable. A Participant may, with Equitable's agreement, transfer to the Contract any amount held with respect to such Participant under a Plan of the Employer or under an "Eligible State Deferred Compensation Plan" meeting the requirements of Section 457(b) of the Code established and maintained by an other employer ("Transferred Funds"). Any Transferred Funds from a contract not issued by Equitable will, before allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable. Equitable will issue to each Participant an individual certificate setting forth a statement in substance of the benefits to which such Participant is entitled under the Contract. SECTION 2.02 STOCK AND MONEY MARKET ACCOUNTS Equitable maintains a Stock Account and Money Market Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the (i) Stock Account becomes part of Separate Account A, and (ii) Money Market Account becomes part of Separate Account E. Any amount withdrawn from an Account will no longer be part of the applicable Separate Account. On any date when an amount is allocated to or withdrawn from an Account, the Account will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the New Accumulation Value for the appropriate Separate Account for the Valuation Period which includes that date. The number of Units in an Account on any date is equal to (i) the sum of any Accumulation Units that have been credited to the Account minus (ii) the sum of any Accumulation Units that have been charged to that Account. The amount in the Stock Account or Money Market Account on any date is equal to the product of (i) the number of Accumulation Units in such Account on that date and (ii) the New Accumulation Unit Value for the appropriate Separate Account for the Valuation Period which includes that date. SECTION 2.03 GUARANTEED INTEREST ACCOUNT Equitable maintains a Guaranteed Interest Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the Guaranteed Interest Account becomes part of the general assets of Equitable, which support the guarantees of the Contract and other contracts. The amount in a Guaranteed Interest Account at any time is equal to the sum of all amounts that have been allocated to such Guaranteed Interest Account pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn pursuant to Sections 2.07, 2.07A, and 2.07B, and Section 2.08 from such Ac- PF 14114CP Page 10 PARTICIPANT'S ACCOUNT (continued) count, and transferred pursuant to Section 2.05 from such Guaranteed Interest Account, and less the sum of any annual administrative charges accrued but not made. Equitable guarantees that the amount in a Guaranteed Interest Account at any time before the Retirement Date will not be less than the sum of all amounts allocated to such Account pursuant to Section 2.04 or transferred to such Account pursuant to Section 2.05 and less the sum of all amounts that have been withdrawn from such Account pursuant to Sections 2.07, 2.07A and 2.07B, and transferred from such Account pursuant to Section 2.05, all accumulated at 3% interest, compounded annually. In any Participation Year in which no Contribution is allocated to a Guaranteed Interest Account, the amount in such Account at the end of the Participation Year shall not be less than the amount in such Account at the beginning of the Participation Year plus the sum of all amounts transferred to such Account pursuant to Section 2.05 less the sum of all amounts withdrawn and transferred out of such Account pursuant to Sections 2.07, 2.07A and 2.07B, and Section 2.05, all accumulated at 3% interest, compounded annually. A Guaranteed Interest Account for a Participant terminates on the earliest of (i) the Retirement Date, (ii) the death of the Participant, and (iii) termination of participation pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO ACCOUNT Each Contribution made with respect to a Participant pursuant to Section 2.01, after deduction for any applicable taxes, will be allocated, as of the date by which Equitable has received both such Contribution and direction as to its allocation, to the Guaranteed Interest Account, Stock Account, or Money Market Account or in part to each, at the sole direction of the Participant as specified to Equitable, provided that the percentage allocated to each Account is a whole number. Any amount that a Participant has directed to be transferred to the Guaranteed Interest Account or Stock Account pursuant to Section 2.05 will be allocated as of the date of such transfer to the appropriate Account maintained for such Participant. Interest is allocated to the Guaranteed Interest Account at the end of each Participation Year, at the time of each transfer or withdrawal pursuant to Sections 2.05 and 2.07, 2.07A, and 2.07B, at the time of application of amounts in the Guaranteed Interest Account to provide Annuity Benefits, upon termination of participation pursuant to Section 2.06, and upon death of the Participant pursuant to Section 2.09. SECTION 2.05 TRANSFERS AMONG ACCOUNTS At any time before a Participant's Retirement Date, such Participant, upon written request, (i) may transfer all or a part of the amounts from the Stock Account or Money Market Account maintained for such Participant to the Guaranteed Interest Account maintained for such Participant, or (ii) may transfer all or a part of the amounts in the Guaranteed Interest Account or Money Market Account maintained for such Participant to the Stock Account maintained for such Participant. Such transfers will be made as of the later of (i) the date specified in such request and (ii) the date Equitable receives such request, and will be subject to Equitable's rules in effect at the time of transfer. No transfers are permitted from the Guaranteed Interest Account or the Stock Account maintained for the Participant to the Money Market Account. SECTION 2.06 TERMINATION OF PARTICIPATION Subject to any applicable restrictions under the terms of the Plan, on or before a Participant's Retirement Date, such Participant may elect by written notice to terminate participation under the Contract. Upon receipt of such notice, Equitable will determine the Cash Value, as of the date Equitable received such notice, of the Guaranteed Interest Account, Stock Account and Money Market Account maintained for such Participant. The payment of such Cash Value to the Participant may be deferred by Equitable in accordance with the provisions of Section 4.08. Prior to a Participant's Retirement Date, Equitable reserves the right to withdraw the Annuity Value of the Participant's Guaranteed Interest Account, Stock Account and Money Market Account, pay such Annuity Values and terminate such Participant's participation under the Contract. This right may be exercised with respect to the Participant only if both (i) no PF 14114CP Page 11 PARTICIPANT'S ACCOUNT (continued) Contributions have been made under the Contract during the last three completed Participation Years, and (ii) the sum of such Annuity Values is $500 or less. Equitable reserves the right to terminate a Participant's participation under the Contract if at least 120 days have elapsed since the issue date shown on the certificate issued to such Participant under the Contract and no Contributions have been made under the Contract with respect to such Participant. Upon payment of such Cash Values or Annuity Values, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Cash Values or Annuity Values arose. SECTION 2.07 PARTIAL WITHDRAWALS Subject to any applicable restrictions under the terms of the Plan, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Stock Account, Money Market Account and the Guaranteed Interest Account maintained for such Participant before such Participant's Retirement Date. Upon withdrawal pursuant to Section 2.07, 2.07A or 2.07B, Equitable will pay the lesser of the sum of the Cash Values of such Accounts or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by such Participant. Unless instructed otherwise, the amount withdrawn (including the amount of any withdrawal charge) will be allocated between such Accounts in proportion to the Annuity Value of each such Account. Upon any payment to a Participant pursuant to Section 2.07, 2.07A or 2.07B, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Payments to the Participant pursuant to Section 2.07, 2.07A or 2.07B may be deferred by Equitable in accordance with the provisions of Section 4.08. Equitable is under no obligation to process any request for partial withdrawal of less than $300. If a withdrawal from the Accounts made pursuant to Sections 2.07, 2.07A or 2.07B would result in total Annuity Values of less than $500, Equitable will so advise the Participant and reserves the right to withdraw the Annuity Values of the Guaranteed Interest Account, Stock Account and Money Market Account, pay the Annuity Values of such Accounts to the Participant, and terminate such Participant's participation under the Contract. If the Participant was enrolled in this Contract prior to August 15, 1981, the $500 amount stated above shall be $200. SECTION 2.07A PARTIAL WITHDRAWALS -- NEW PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a New Participant, Equitable will withdraw from the Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and six months, or (ii) such Participant's attainment of age 70 years and six months, or (iii) the completion of 25 Participation Years with respect to such Participant, or (iv) if the Participant has attained age 55, has completed five Participation Years, and the partial withdrawal is to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: If the Participant has not completed five Participation Years under the Contract, such withdrawal charge will equal the lesser of (a) or (b) where: (a) is an amount equal to 6% of the total amount to be withdrawn from the Accounts (including such charge) pursuant to this paragraph. (b) is the excess, if any, of (i) 8% of the cumulative total of Contributions made on behalf of such Participant over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Participant, there will be no withdrawal charge if the amount of partial withdrawal requested PF 14114CP Page 12 PARTICIPANT'S ACCOUNT (continued) is not greater than the Free Corridor Amount defined in Section 2.07C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% of the amount withdrawn (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the cumulative total of contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (ii) the cumulative tota of any prior withdrawal charges made pursuant to this Section. SECTION 2.07B PARTIAL WITHDRAWAL -- EXISTING PARTICIPANTS NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by an Existing Participant, Equitable will withdraw from the Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The Participant's attainment of age 59 years and six months, or (ii) the completion of 20 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55 and the partial withdrawal is to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. PREFERRED WITHDRAWABLE AMOUNT: This is an amount equal to the lesser of (a) the total of Equitable Transferred Funds made on behalf of the Participant or (b) $10,000. FREE WITHDRAWABLE AMOUNT: This is an amount equal to the excess, if any, of (a) the total Equitable Transferred Funds made on behalf of the Participant over (b) $10,000. REGULAR WITHDRAWABLE AMOUNT: This is the cumulative total of all Contributions, other than Equitable Transferred Funds, made on behalf of the Participant. ORDER OF WITHDRAWALS: In calculating the withdrawal charge, Equitable will assume that (a) any Preferred Withdrawable Amounts are first withdrawn, (b) any Free Withdrawable Amounts are next withdrawn, (c) any Regular Withdrawable Amounts are next withdrawn, and (d) lastly, any amounts other than the amounts described in (a), (b), and (c) above are withdrawn. WITHDRAWAL CHARGE WITHIN FIRST FIVE YEARS: Within the first five Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a), (b), (c) and (d) below: (a) With respect to any withdrawals of Preferred Withdrawable Amounts, a charge of 2% of such withdrawals. (b) With respect to any withdrawals of Free Withdrawable Amounts, no charge. (c) With respect to any withdrawals of Regular Withdrawable Amounts, a charge of 6% of such withdrawals. (d) With respect to any withdrawals of amounts other than the amounts in (a), (b) and (c) above, no charge. WITHDRAWAL CHARGE AFTER FIVE YEARS: After the completion of five Participation Years with respect to the Participant, there will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (1) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (2) then withdraw from such Accounts an amount equal to the excess of the amount requested over the Free Cor- PF 14114CP Page 13 PARTICIPANT'S ACCOUNT (continued) ridor Amount, plus a withdrawal charge. Such withdrawal charge will equal the sum of the charges described in (a), (b), (c), and (d) above; provided, however, that in no event will such charge exceed an amount equal to the following: The excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other Contributions (excluding Equitable Transferred Funds) made on behalf of the Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any prior withdrawal charges made pursuant to this Section. Whenever an amount is withdrawn from such Accounts that is not greater than the current Free Corridor Amount, such amount is considered to be (1) first, a withdrawal of Regular Withdrawable Amounts, (2) next, a withdrawal of Preferred Withdrawable Amounts, (3) next, a withdrawal of Free Withdrawable Amounts and (4) lastly, a withdrawal of amounts other than the amounts in (1), (2) or (3) above. However, no charge will be assessed with respect to the portion of the withdrawal up to the current Free Corridor Amount. SECTION 2.07C FREE CORRIDOR AMOUNT The term "Free Corridor Amount" with respect to a Participant who has completed five Participation Years means an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Values of the Stock Account, Money Market Account and the Guaranteed Interest Account over (ii) cumulative prior withdrawals made pursuant to Section 2.07, 2.07A or 2.07B in the current Participation Year with respect to the Participant. SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE As of the last day of each Participation Year before a Participant's Retirement Date, Equitable will withdraw from the Guaranteed Interest Account, Stock Account and Money Market Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Values of the Guaranteed Interest Account, Stock Account and Money Market Account at the end of that Participation Year and (ii) any withdrawals made from such Accounts pursuant to Section 2.07, 2.07A and 2.07B during that Participation Year. The charge will be allocated between the Stock Account, Money Market Account and Guaranteed Interest Account in proportion to the Annuity Values of each such Account, at the end of the Participation Year. As of a Participant's Retirement Date and before application of the Annuity Values or Cash Values of such Participant's Account pursuant to Section 3.03, or upon termination of such Account pursuant to Section 2.06 or Section 2.09 during a Participation Year, Equitable will withdraw the administrative charge described in this Section for the applicable part of that Participation Year. SECTION 2.09 DEATH BENEFIT If the Employer reports to Equitable, or if Equitable otherwise ascertains, that a Participant has died while Accounts for such Participant are maintained under the Contract and before such Participant's Retirement Date, Equitable, upon receipt of due proof of such death, will pay in a single sum to the beneficiary designated by such Participant to receive such payment the amount of death benefit payable with respect to such Participant. The amount of the death benefit with respect to a Participant at any time prior to the Retirement Date is equal to the greater of (i) the sum of the Annuity Values of the Guaranteed Interest Account, Stock Account and Money Market Account maintained under the Contract for such Participant and (ii) the minimum death benefit with respect to such Participant. Such minimum death benefit is the sum of all Contributions made with respect to such Participant pursuant to Section 2.01 (before reduction of any applicable taxes) less an adjustment for any withdrawals made pursuant to Sections 2.07, 2.07A and 2.07B from the Accounts maintained under the Contract for such Participant. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount being withdrawn is to the Annuity Values then in the Guaranteed Interest Account, Stock Account and Money Market Account maintained under the Contract for such Participant. If, in accordance with the provisions of Section 2.01, the cash value of an Annuity contract issued by Equitable, which provides for a death benefit before retirement equal to the greater of the contract cash value or an alternative amount based on premiums paid or contributions PF 14114CP Page 14 PARTICIPANT'S ACCOUNT (continued) made under the Annuity contract, is transferred to the Contract, such alternative amount as of the date of transfer will be included in the "sum of all Contributions" in lieu of the amount of cash value transferred, for purposes of the death benefit under the Contract. The amount of any death benefit payable with respect to a Participant will, to the extent such Account is sufficient therefore, be withdrawn from the Guaranteed Interest Account, Stock Account and Money Market Account maintained with respect to such Participation under the Contract. Upon such payment, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Annuity Values arose. PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of Separate Account A. The amount of the first, second and third payments under any Variable Annuity Benefit provided under the Contract with respect to a payee is the monthly amount provided with respect to the payee pursuant to Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average New Annuity Unit Value for the second calendar month immediately preceding the date of the payment. The fourth and subsequent annuity payments under a Variable Annuity Benefit will not be increased or decreased in amount because of mortality or expense experience. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the New Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Values of such Participant's Guaranteed Interest Account, Stock Account and Money Market Account shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of such Account in a single sum or (ii) to apply such Annuity Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by Equitable, as elected by the Participant, subject to Equitable's rules then in effect and any applicable requirements under the Code. Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Values of such Participant's Guaranteed Interest Account, Stock Account and Money Market Account. Equitable will have the right to require the Participant to furnish pertinent facts and determinations to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. Equitable may offer annuity forms other than the Life Annuity Form or Joint Survivor Life Annuity Form. PF 14114CP Page 15 ANNUITY BENEFITS (continued) SECTION 3.04 AMOUNT OF ANNUITY BENEFITS If a Participant elects pursuant to the first paragraph or third paragraph of Section 3.03 to receive an Annuity Benefit in lieu of the Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account, the amount applied to provide the Annuity Benefit will be (i) the Annuity Values of such Accounts if the payments under the annuity form elected are contingent upon the survival of a person, or (ii) the Cash Values of such Account if the payments under the annuity form elected are not contingent upon the survival of a person. The amount applied to provide an Annuity Benefit shall be reduced by any applicable tax on annuity considerations, as determined by Equitable. If such amount is applied on or after the completion of five Participation Years with respect to such Participant, or if such amount is applied on behalf of an Existing Participant, the balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. If the amount applied to provide an Annuity Benefit is applied before the completion of five Participation Years with respect to a New Participant, the balance, after any applicable tax on annuity considerations, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the Guaranteed Interest Account, Stock Account and Money Market Account maintained for such Participant shall terminate. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (100% continuation). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, are based on 3 1/4% interest and the 1971 ELAS Mortality Table. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on 1979 ELAS mortality and an Assumed Base Rate of Net Investment Return of 3 1/2% or 5%, whichever applies pursuant to Section 1.16. Equitable may change the monthly income amounts contained in the Tables of Guaranteed Annuity Payments and the bases for determining such amounts, for new Participants, by at least 90 days advance notice to the Contract Holder and by an amendment to the Contract. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on 3 1/4% interest and the 1971 ELAS Mortality Table if such annuity form provides for a Fixed Annuity Benefit, and on 1979 ELAS Mortality and an Assumed Base Rate of Net Investment Income Return of 5% or 3 1/2%, whichever applies pursuant to Section 1.16, if such annuity form pro- vides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payable under the Contract was based on information that is subsequently found to be incor- PF 14114CP Page 16 ANNUITY BENEFITS (continued) rect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by Equitable will be charged against and underpayments will be added to any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may make the payments (in the case of a minor, at a rate not exceeding $50 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If an annuity form made available by Equitable provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Upon election by a Participant pursuant to Section 3.03 of an annuity form providing payments for a period certain, such Participant may designate (with the right to change such designation) a person or persons to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment of such payee's executors or administrators in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, Equitable will pay in a single sum to such payee's executors or administrators the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. Equitable will require satisfactory evidence of the age of any person upon whose life an annuity form depends. PF 14114CP Page 17
ANNUITY BENEFITS (continued) TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM - 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Value) ------------------------------------------------------------------------------------------------------------------------- MALE FEMALE AGE AGE 60 61 62 63 64 65 66 67 68 69 70 -------------------------------------------------------------------------------------------------------------------------- 60 4.52 4.58 4.64 4.70 4.76 4.82 4.88 4.94 5.00 5.05 5.11 61 4.55 4.62 4.68 4.74 4.81 4.87 4.93 5.00 5.06 5.12 5.18 62 4.58 4.65 4.72 4.78 4.85 4.92 4.99 5.05 5.12 5.19 5.25 63 4.61 4.68 4.75 4.82 4.89 4.97 5.04 5.11 5.18 5.25 5.32 64 4.64 4.71 4.79 4.86 4.94 5.01 5.09 5.17 5.24 5.32 5.40 65 4.67 4.74 4.82 4.90 4.98 5.06 5.14 5.22 5.30 5.38 5.47 66 4.69 4.77 4.85 4.93 5.02 5.10 5.18 5.27 5.35 5.44 5.53 67 4.72 4.80 4.88 4.97 5.05 5.14 5.23 5.31 5.40 5.50 5.59 68 4.74 4.82 4.91 5.00 5.09 5.18 5.27 5.36 5.45 5.55 5.65 69 4.76 4.85 4.94 5.03 5.12 5.22 5.31 5.41 5.50 5.60 5.71 70 4.78 4.87 4.96 5.06 5.16 5.26 5.36 5.45 5.56 5.66 5.76 - ----------------------------------------------------------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM - 100% CONTINUATION - ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3 1/2% (Minimum Monthly Income per $1,000 of Annuity Value) ------------------------------------------------------------------------------------------------------------------------- MALE FEMALE AGE AGE 60 61 62 63 64 65 66 67 68 69 70 ------------------------------------------------------------------------------------------------------------------------- 60 4.31 4.35 4.39 4.43 4.47 4.51 4.55 4.59 4.63 4.67 4.71 61 4.35 4.39 4.43 4.48 4.52 4.56 4.61 4.65 4.69 4.73 4.78 62 4.39 4.43 4.48 4.52 4.57 4.61 4.66 4.71 4.75 4.80 4.85 63 4.42 4.47 4.52 4.57 4.62 4.67 4.72 4.77 4.82 4.87 4.92 64 4.46 4.51 4.57 4.62 4.67 4.72 4.77 4.83 4.88 4.94 4.99 65 4.50 4.56 4.61 4.66 4.72 4.78 4.83 4.89 4.95 5.01 5.07 66 4.54 4.60 4.65 4.71 4.77 4.83 4.89 4.95 5.01 5.08 5.14 67 4.58 4.64 4.70 4.76 4.82 4.88 4.95 5.01 5.08 5.15 5.22 68 4.62 4.68 4.77 4.81 4.87 4.95 5.01 5.08 5.15 5.22 5.29 69 4.65 4.72 4.78 4.85 4.92 4.99 5.06 5.14 5.22 5.29 5.37 70 4.69 4.76 4.83 4.90 4.97 5.05 5.12 5.20 5.28 5.36 5.45 - ----------------------------------------------------------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM - 100% CONTINUATION - ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 5% (Minimum Monthly Income per $1,000 of Annuity Value) ------------------------------------------------------------------------------------------------------------------------- MALE FEMALE AGE AGE 60 61 62 63 64 65 66 67 68 69 70 ------------------------------------------------------------------------------------------------------------------------- 60 5.19 5.23 5.27 5.31 5.34 5.39 5.42 5.46 5.50 5.54 5.58 61 5.23 5.27 5.31 5.35 5.39 5.43 5.47 5.52 5.56 5.60 5.64 62 5.27 5.31 5.35 5.39 5.44 5.48 5.53 5.57 5.62 5.67 5.71 63 5.31 5.35 5.39 5.44 5.49 5.53 5.58 5.63 5.68 5.73 5.78 64 5.34 5.39 5.44 5.48 5.53 5.59 5.64 5.69 5.74 5.79 5.85 65 5.38 5.43 5.48 5.53 5.58 5.64 5.69 5.75 5.80 5.86 5.92 66 5.42 5.47 5.52 5.58 5.63 5.69 5.75 5.81 5.87 5.93 5.99 67 5.45 5.51 5.56 5.62 5.68 5.74 5.80 5.87 5.93 6.00 6.06 68 5.49 5.55 5.61 5.67 5.73 5.80 5.86 5.93 6.00 6.06 6.14 69 5.53 5.59 5.65 5.71 5.78 5.85 5.92 5.99 6.06 6.13 6.21 70 5.56 5.63 5.69 5.76 5.83 5.90 5.97 6.05 6.13 6.21 6.29 - ----------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) VARIABLE ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET FIXED ANNUITY BENEFIT INVESTMENT RETURN IS --------------------- --------------------------- 3 1/2% 5% ------ --- Age Males Females Males Females Males Females --- ----- ------- ----- ------- ----- ------- 60 5.88 4.99 5.43 4.80 6.36 5.70 61 6.04 5.11 5.57 4.90 6.50 5.81 62 6.21 5.24 5.72 5.01 6.65 5.91 63 6.38 5.38 5.88 5.13 6.81 6.03 64 6.57 5.53 6.05 5.25 6.97 6.15 65 6.77 5.68 6.23 5.39 7.16 6.28 66 6.98 5.84 6.43 5.54 7.35 6.43 67 7.19 6.01 6.64 5.70 7.56 6.58 68 7.42 6.20 6.87 5.87 7.79 6.76 69 7.67 6.39 7.11 6.06 8.03 6.95 70 7.93 6.61 7.38 6.27 8.30 7.15
Equitable will notify the payee under a Variable Annuity Benefit of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each variable payment. Any election, change, revocation or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a commutation right under an Annuity Benefit is exercised, Equitable may defer payment in accordance with Section 4.08. PF 14114CP Page 18 PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT The Contract constitutes the entire Contract between the parties and the provisions of the Contract alone will govern with respect to the rights and obligations of Equitable. The provisions of the Contract will be applied separately with respect to each Participant. Nothing in the enrollment form referred to in Section 1.05, the Plan or trust agreement referred to in Section 4.10 nor any modification, amendment, or supplement to any such documents will in any way be construed to enlarge, change, vary or in any other way affect the obligations of Equitable as expressly provided in the Contract. The Contract may not be modified as to Equitable, nor may any of Equitable's rights or requirements be waived, except in writing and by an authorized officer of Equitable. The Contract may be changed by amendment or replacement upon agreement between the Contract Holder and Equitable without the consent of any other person provided that such change does not reduce any Annuity Benefit provided before such change and provided that no rights, privileges or benefits which have accrued to any Participant under the Contract may be reduced or forfeited except by the express consent of such Participant. SECTION 4.02 STATUTORY COMPLIANCE Equitable reserves the right to amend the Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the Contract and any certificate to reflect changes in the Code, or in regulations or published rulings of the Internal Revenue Service, so that each such certificate will continue to be an Annuity. Any Annuity Benefit, Cash Value or death benefit available under a certificate issued pursuant to the Contract shall not be less than the minimum benefits required by any statute of the state in which the certificate is delivered. SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY The entire interest of any Participant under the Contract is nonforfeitable. No interest of a Participant under the Contract may be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than Equitable. No amount payable under the Contract may be assigned, commuted, or encumbered by the payee, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. SECTION 4.04 PARTICIPATION IN SURPLUS The Contract and all other contracts in the same class of contracts shall be combined for the purpose of ascertaining the annual surplus of Equitable to be apportioned to said contracts as a dividend, and the portion of any such dividend that is to be allocated to the Contract shall be determined by Equitable. The participation of this class of contracts in annual surplus is, however, expected to be minimal. Any amount so allocated to the Contract shall be payable as of January 1 of the calendar year in which a dividend is apportioned and will be payable in cash and shall be equitably allocated by Equitable to the Guaranteed Interest Accounts maintained hereunder for Participants. No Annuity Benefit will enter into the determination of any surplus to be apportioned to the Contract as a dividend. SECTION 4.05 BENEFICIARY Each Participant, as of such Participant's Participation Date is to provide Equitable with an initial designation of the beneficiary entitled to receive any death benefit payable with respect to such Participant pursuant to Section 2.09. The Participant may change such designation from time to time during such Participant's lifetime and while Accounts for such Participants are being maintained hereunder. Any such designation or change will be made by written notice in a form satisfactory to Equitable. A change will, upon receipt at a designated Equitable Office, take effect as of the time the written notice was signed, whether or not the Participant is living on the date of receipt, but without further liability as to any payment or other settlement made by Equitable before receipt of such change. Unless otherwise specified in the designation, if a Participant has designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive the Participant, and if more than one survive they will share equally. PF 14114CP Page 19 GENERAL PROVISIONS (continued) Any part of a death benefit payable with respect to a Participant pursuant to Section 2.09 for which there is no designated beneficiary living at the death of the Participant will be payable in a single sum to the children of the Participant who survive the Participant, in equal shares, or should none survive, then to the Participant's executors or administrators. If a Participant so elects in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by the Participant, with respect to the beneficiary, subject to Equitable's rules then in effect. If at the death of a Participant there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. SECTION 4.06 DISQUALIFICATION In the event that an annuity purchased hereunder with respect to a Participant fails to qualify as an Annuity as described in Section 1.03, Equitable shall have the right, upon receiving notice of such fact before the Retirement Date, to terminate participation with respect to such Participant under the Contract and pay to such Participant the amount in the Account maintained with respect to such Participant less a deduction for the appropriate part attributable to such Participant of any Federal income tax payable by Equitable which would not have been payable if such Participant had an Annuity under the Contract. SECTION 4.07 FUTURE PARTICIPANTS Equitable reserves the right at its sole discretion to curtail or prohibit further enrollment as Participants under the Contract of any individuals who are not currently participating under the Contract as of such date of curtailment or prohibition. SECTION 4.08 DEFERMENT Payments by Equitable from the Participant's Guaranteed Interest Account pursuant to the provisions of Section 2.06, Sections 2.07, 2.07A and 2.07B, and Section 2.09, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.05, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. Interest at the current Guaranteed Interest Rate for such Participant's Guaranteed Interest Account will be allowed on any such payment deferred for 30 days or more. Except as provided in the Section, payments by Equitable from the Participant's Stock Account or Money Market Account pursuant to the provisions of Section 2.06, Sections 2.07, 2.07A and 2.07B, and Section 2.09, or any commuted payments arising from a Variable Annuity Benefit pursuant to Section 3.05, will be made within seven days after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. During any period when (i) the sale of securities or the determination of the New Accumulation Unit Value or the Average New Annuity Unit Value is not reasonably practicable because an emergency, defined by the Securities and Exchange Commission, exists, or the New York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may by order permit postponement for the protection of persons having interests in the Separate Accounts, Equitable reserves the right: (a) to defer determination of Cash Values or Annuity Values and payment of Cash Values and Annuity Values, arising from an amount in a Participant's Stock Account or Money Market Account; (b) to defer payment of any portion of the death benefit arising from an amount in a Participant's Stock Account or Money Market Account; (c) to defer the payment of any Variable Annuity Benefit under the Contract or the application of any such Benefit to provide for any other payment called for by the Contract; or (d) in the event of (a) above, to defer application of such amounts to provide any Annuity Benefit permitted under the Contract. SECTION 4.09 ANNUAL NOTICE At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish PF 14114CP Page 20 GENERAL PROVISIONS (continued) the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Guaranteed Interest Account, (2) the total number of Accumulation Units credited to the Stock Account and Money Market Account, (3) the New Accumulation Unit Values, (4) the sum of the Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account and (5) the amount of death benefit payable with respect to the Participant. After the Retirement Date Equitable will notify the Participant of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.10 CONTRACT HOLDER RESPONSIBILITY The sole responsibility of the Contract Holder is to serve as party to the Contract. The Contract Holder will have no responsibility for the administration of any Plan, for payments to the Guaranteed Interest Account, Stock Account or Money Market Account, or any payments or other distributions hereunder. Equitable will deal with the Contract Holder in accordance with the terms and conditions of the custodial agreement pursuant to which the Contract Holder agreed to act as such and with the Contract and in such manner as the Contract Holder and Equitable may agree, without the consent of any other person. Any Employer making Contributions under the Contract shall be deemed to have adopted and accepted the custodial agreement as part of the Plan with respect to which such Contributions are made. SECTION 4.11 AGE AND SEX If the Annuitant's age or sex has been misstated, any benefits will be those which would have been purchased at the correct age and sex. Any overpayments or underpayments made by Equitable will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. SECTION 4.12 RIGHT OF EMPLOYER Notwithstanding any other provision of the Contract, except with respect to amounts attributable to Contributions made by a Participant, if any, as permitted under the terms of the Plan, the value of the Accounts maintained for each Participant shall, until distributed to the Participant or his beneficiaries in accordance with the terms of the Contract, remain solely the property and rights of the Employer (without being restricted to the provision of the benefits under the Plan) subject only to claims of the Employer's general creditors. This Section shall be construed and administered in accordance with Section 457(b)(6) of the Code and the regulations thereunder. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By /s/ [Signature unreadable] By /s/ Coy Eklund --------------------------- ------------------------------ Chairman of the Board Title Senior Vice President By /s/ Rodney L. Enochs ------------------------- ------------------------------ Vice President and Secretary Dated May 27, 1982 Date of Issue May 1, 1982 ------------------------- ---------------- At New York, NY ------------------------- PF 14114CP Page 21 Attached to and made part of Group Annuity Contract No. 11932CP between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective August 26, 1983, said contract and riders are amended as follows: 1. with respect to Section 1.18A Cash Value - New Participants a. the term "25 Participation Years" contained in the paragraph entitled "No Withdrawal Charge" is changed to "12 Participation Years," b. the paragraph entitled "Withdrawal Charge Within First Five Years" is replaced by the following: WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS: Within the first three Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% of the sum of the Annuity Values of such Accounts. (b) is an amount equal to the excess, if any, of (i) 8% of the cumulative contributions made on behalf of such Participant over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. c. the paragraph entitled "Withdrawal Charge After Five Years" is replaced by the following: WITHDRAWAL CHARGE AFTER THREE YEARS: After the completion of three Participation Years with respect to the Participant, the withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% during Participation Years 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the excess of (i) the sum of the Annuity Values of such Accounts over (ii) the Free Corridor Amount defined in Section 2.07C. (b) is the excess, if any, of (i) 8% of the total contributions made on behalf of such Participant during the current Participation Year and the preceding nine Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. The Cash Values of the Guaranteed Interest Account, Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. PF 17004CP 2. with respect to Section 1.18B Cash Value-Existing Participants a. the term "20 Participation Years" contained in the paragraph entitled "No Withdrawal Charge" is changed to "12 Participation Years," b. the paragraph entitled "Withdrawal Charge Within First Five Years" is replaced by the following: WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS: Within the first three Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a) and (b) below; provided, however, that such charge does not exceed the amount described in subsection (c) below where: (a) is an amount equal to 2% of any Preferred Withdrawable Amounts (defined in Section 2.07B) that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (b) is an amount equal to 6% during the first five Participation Years 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of any Regular Withdrawable Amounts (defined in Section 2.07B) that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (c) is an amount equal to the sum of (a) above, and 6% of the excess, if any, of (i) the sum of the Annuity Values of such Accounts over (ii) the cumulative total of Equitable Transferred Funds made with respect to the Participant that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. c. the paragraph entitled "Withdrawal Charge After Five Years" is replaced by the following: WITHDRAWAL CHARGE AFTER THREE YEARS: After three Participation Years have been completed with respect to the Participant, Equitable (i) will first withdraw, pursuant to Section 2.07B, the Free Corridor Amount defined in Section 2.07C and (ii) next withdraw the remaining portion of the sum of the Annuity Values of such Accounts. A withdrawal charge will apply to the amount in (ii) above, and will equal the sum of the charges described in subsections (a) and (b) of the preceding subsection: provided, however, that such charge will not exceed an amount equal to the lesser of the charges defined in (d) and (e) below: (d) is an amount equal to the sum of (a) in the preceding subsection and 6% during Participation Years 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the excess, if any, of (i) the sum of the Annuity Values of such Accounts (after withdrawal of the Free Corridor Amount) over (ii) the cumulative total of Equitable Transferred Funds made on behalf of the Participant that have not previously been withdrawn pursuant to Sections 2.07 and 2.07B. (e) is an amount equal to the excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other contributions (excluding Equitable Transferred Funds) made on behalf of such Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07B. The Cash Values of the Guaranteed Interest Account, Stock and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. 3. with respect to Section 2.07A Partial Withdrawals - New Participants a. the term "25 Participation Years" contained in the provision entitled "No Withdrawal Charge" is changed to "12 Participation Years;" PF 17004CP b. the provision entitled "Withdrawal Charge Within First Five Years" is replaced by the following: WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS: If the Participant has not completed three Participation Years under the Contract, such withdrawal charge will equal the lesser of (a) or (b) where: (a) is an amount equal to 6% of the total amount to be withdrawn from the Accounts (including such charge) pursuant to this paragraph. (b) is the excess, if any, of (i) 8% of the cumulative total of Contributions made on behalf of such Participant over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. c. the provision entitled "Withdrawal Charge After Five Years" is replaced by the following: WITHDRAWAL CHARGE AFTER THREE YEARS: After the completion of three Participation Years with respect to the Participant, there will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07C. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and(ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Participation Years 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the amount withdrawn (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the cumulative total of contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. 4. with respect to Section 2.07B Partial Withdrawals - Existing Participants a. the term "20 Participation Years" contained in the provision entitled "No Withdrawal Charge" is changed to "12 Participation Years;" b. the provision entitled "Withdrawal Charge Within First Five Years" is replaced by the following: WITHDRAWAL CHARGE WITHIN FIRST THREE YEARS: Within the first three Participation Years with respect to the Participant, the withdrawal charge equals the sum of the charges described in subsections (a), (b), (c) and (d) below: (a) With respect to any withdrawals of Preferred Withdrawable Amounts, a charge of 2% of such withdrawals. (b) With respect to any withdrawals of Free Withdrawable Amounts, no charge. (c) With respect to any withdrawals of Regular Withdrawable Amounts, a charge of 6% of such withdrawals. (d) With respect to any withdrawals of amounts other than the amounts in (a), (b) and (c) above, no charge. c. the provision entitled "Withdrawal Charge After Five Years" is replaced by the following: WITHDRAWAL CHARGE AFTER THREE YEARS: After the completion of three Participation Years with respect to the Participant, there will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07C. PF 17004CP If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (1) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (2) then withdraw from such Accounts an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will equal the sum of the charges described in (a),(b) and (d) above plus with respect to any withdrawals of Regular Withdrawable Amounts, a charge of 6% during Participation Years 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter provided, however, that in no event will such charge exceed an amount equal to the following: The excess, if any, of (1) the sum of (i) 2% of the first $10,000 of Equitable Transferred Funds made during the current Participation Year and the preceding nine Participation Years and (ii) 8% of all other Contributions (excluding Equitable Transferred Funds) made on behalf of the Participant during the current Participation Year and the preceding nine completed Participation Years over (2) the cumulative total of any prior withdrawal charges made pursuant to this Section. Whenever an amount is withdrawn from such Accounts that is not greater than the current Free Corridor Amount, such amount is considered to be (1) first, a withdrawal of Regular Withdrawable Amounts, (2) next, a withdrawal of Preferred Withdrawable Amounts, (3) next, a withdrawal of Free Withdrawable Amounts, and (4) lastly, a withdrawal of amounts other than the amounts in (1), (2), or (3) above. However, no charge will be assessed with respect to the portion of the withdrawal up to the current Free Corridor Amount. 5. with respect to Section 2.07C Free Corridor Amount, the term "five Participation years" is changed to "three Participation Years." Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By /s/ [Signature Unreadable] By /s/ John B. Carb ---------------------------------- ------------------------------------- President Title Vice President By /s/ Rodney L. Enochs ------------------------------ ------------------------------------- Vice President and Secretary Dated Aug. 19, 1983 Date of Issue ------------------------------ -------------------------- At New York, N.Y. --------------------------------- PF 17004CP Attached to and made part of Group Annuity Contract No. 11932CP between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective December 12, 1983, said contract and riders are amended as follows: 1. all references in the contract to the Annuitant's sex are deleted. 2. the phrase "3 1/4% interest and the 1971 ELAS Mortality Table" and the phrase "1979 ELAS Mortality" appearing in Section 3.04 Amount of Annuity Benefits shall be changed to "3 1/2% interest and the 1983 Individual Annuity Mortality Table adjusted to a unisex basis based on a 50-50 split of males and females" and "the projected 1983 Basic Table adjusted to a unisex basis based on a 50-50 split of males and females," respectively, wherever they appear. 3. the Tables of Guaranteed Annuity Payments appearing in Section 3.05 Payment of Annuity Benefits, are replaced by the following Tables. TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Value)
Age Age 60 61 62 63 64 65 66 67 68 69 70 60 4.54 4.58 4.62 4.66 4.70 4.74 4.77 4.81 4.84 4.88 4.91 61 4.62 4.67 4.71 4.76 4.81 4.84 4.88 4.91 4.95 4.99 62 4.72 4.76 4.81 4.85 4.90 4.94 4.98 5.02 5.06 63 4.81 4.86 4.91 4.96 5.01 5.06 5.10 5.14 64 4.92 4.97 5.02 5.06 5.13 5.17 5.22 65 5.03 5.09 5.15 5.20 5.26 5.31 66 5.15 5.21 5.27 5.33 5.39 67 5.28 5.34 5.40 5.47 68 5.41 5.48 5.55 69 5.56 5.63 70 5.71
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3 1/2% (Minimum Monthly Income per $1,000 of Annuity Value)
Age Age 60 61 62 63 64 65 66 67 68 69 70 60 4.40 4.44 4.48 4.51 4.55 4.58 4.61 4.65 4.68 4.71 4.74 61 4.48 4.52 4.56 4.60 4.64 4.67 4.71 4.74 4.78 4.81 62 4.56 4.60 4.65 4.69 4.73 4.77 4.80 4.84 4.88 63 4.65 4.69 4.74 4.78 4.83 4.87 4.91 4.95 64 4.74 4.79 4.84 4.89 4.93 4.98 5.02 65 4.85 4.90 4.95 5.00 5.05 5.10 66 4.95 5.01 5.06 5.11 5.17 67 5.07 5.12 5.18 5.24 68 5.19 5.25 5.32 69 5.32 5.39 70 5.46
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 5% (Minimum Monthly Income per $1,000 of Annuity Value)
Age Age 60 61 62 63 64 65 66 67 68 69 70 60 5.27 5.30 5.34 5.37 5.41 5.44 5.47 5.51 5.54 5.57 5.59 61 5.34 5.38 5.42 5.46 5.49 5.53 5.57 5.60 5.63 5.66 62 5.42 5.46 5.50 5.54 5.58 5.62 5.65 5.69 5.73 63 5.50 5.55 5.59 5.63 5.67 5.71 5.75 5.79 64 5.59 5.64 5.69 5.73 5.78 5.82 5.86 65 5.69 5.74 5.79 5.84 5.89 5.93 66 5.79 5.85 5.90 5.95 6.00 67 5.90 5.96 6.02 6.08 68 6.02 6.08 6.15 69 6.15 6.22 70 6.29 ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) VARIABLE ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET FIXED ANNUITY BENEFIT INVESTMENT RETURN IS ------------------------------------ ---------------------------------------- Age 3 1/2% 5% - ----------- ----------------- ----------------- 60 5.29 5.08 5.97 61 5.41 5.19 6.08 62 5.55 5.31 6.20 63 5.69 5.44 6.33 64 5.85 5.58 6.46 65 6.01 5.73 6.61 66 6.19 5.89 6.77 67 6.37 6.06 6.94 68 6.58 6.24 7.12 69 6.79 6.43 7.31 70 7.02 6.64 7.52
PF17009CP This amendment was approved by the New York Insurance Department under an accelerated procedure to assist employers in complying with the United States Supreme Court decision in Arizona v. Norris. The Department has reserved the right to require changes in this amendment to comply with applicable New York law and regulations. Agreed to by: UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By /s/ William H. Schroeder By /s/ John B. Carter ------------------------------- ---------------------------------- Title Vice President By /s/ Rodney L. Enochs ---------------------------- ----------------------------------- Vice President and Secretary Dated 12/15/83 Date of Issue -------------------------- ----------------------- At New York, N.Y. ------------------------------ PF17009CP Attached to and made part of Group Annuity Contract No. 11932CP between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective May 1, 1984, said contract and riders are amended as follows: 1. The term "Stock Account" has been changed to "Stock Account, Balanced Account and Aggressive Stock Account" wherever it appears except as provided in items 4 and 5 of this rider. 2. The Section entitled "The Separate Accounts" is amended as follows: a. the following Accounts have been added: Name Investments ---- ----------- Separate Account J Primarily common stocks and other equity-type investments, publicly traded debt securities and short-term money market instruments. Separate Account K Primarily common stocks issued by high quality small and intermediate size companies with strong growth prospects. b. The sentences "Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, consisting of .15% for investment management, .35% for financial accounting, .35% for the annuity rate guarantee and the minimum death benefit, and .90% for expenses and expense risk. The charge shall be made in connection with (c) of the Net Investment Factor provision in Section 1.16" are amended to read as follows: i. for Participants with a Participation Date prior to May 1, 1984 "Assets of Separate Account A and Separate Account E attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, consisting of .15% for investment management, .35% for financial accounting, .35% for the annuity rate guarantee and the minimum death benefit, and .90% for expenses and expense risk. Assets of Separate Account J and Separate Account K attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The percentage allocation of the components of the charges for Separate Account J and Separate Account K are not necessarily allocated in the same amounts as for Separate Account A and Separate Account E. The charge shall be made in connection with (c) of the Net Investment Factor provision in Section 1.16." ii. for Participants with a Participation Date on or after May 1, 1984 "Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.16." 3. The Section entitled "New Accumulation Unit Value" is amended by the addition of the following Accounts: Account Value Date ------- ----- ---- Separate Account J $10.00 As of May 1, 1984 Separate Account K $10.00 As of May 1, 1984 4. The title and the first two sentences of the Section entitled "Stock and Money Market Accounts" shall read as follows: STOCK, BALANCED, AGGRESSIVE STOCK AND MONEY MARKET ACCOUNTS Equitable maintains a Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the (1) Stock Account becomes part of Separate Account A, (2) Balanced Account becomes part of Separate Account J, (3) Aggressive Stock Account becomes part of Separate Account K, and (4) Money Market Account becomes part of Separate Account E. 5. The Section entitled "Transfers Among Accounts" is amended to read as follows: TRANSFERS AMONG ACCOUNTS At any time before a Participant's Retirement Date, such Participant, upon written request, may transfer all or part of the amounts maintained for the Participant to one or more of the other Accounts maintained for such Participant as follows: (1) amounts in the Guaranteed Interest Account, Stock Account, Balanced Account and Aggressive Stock Account may be transferred among such Accounts; (2) amounts in the Money Market Account may be transferred to the other Accounts. Such transfers will be made as of the date Equitable receives such request, and will be subject to Equitable's rules in effect at the time of transfer. No transfers are permitted from the Guaranteed Interest Account, Stock Account, Balanced Account or Aggressive Stock Account maintained for the Participant to the Money Market Account. Notwithstanding the above, transfers to the Balanced Account may be prohibited by Equitable upon 30 days written notice to the Participant. THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Agreed to by UNITED STATES TRUST COMPANY OF NEW YORK FOR THE EQUITABLE By /s/ William H. Schroeder By /s/ John B. Carter ------------------------------ ----------------------------------- Vice President President Title By /s/ Rodney L. Enochs ----------------------------- ----------------------------------- Vice President and Secretary Dated 06/27/84 Date of Issue ----------------------------- ----------------------- At NY, NY --------------------------------- PF17013CP Attached to and made part of Group Annuity Contract No. 11932CP between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective July 1, 1986, said contract and riders are amended as follows: 1. With respect to PART I -- DEFINITIONS, the following section is added: SECTION 1.14C PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by Equitable which does not permit any prepayment of the unpaid principal. 2. With respect to SECTION 1.18 CASH VALUE, the following text replaces the paragraphs under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to a Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant or (iii) the Participant's attainment of age 55, the completion of five Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such Annuity is at least ten years. At all other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. 3. With respect to SECTION 2.07A PARTIAL WITHDRAWAL CHARGES, the following paragraph replaces the paragraph under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a Participant, Equitable will withdraw from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such Annuity is at least ten years. At all other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. Agreed to by: UNTIED STATES TRUST COMPANY THE EQUITABLE LIFE ASSURANCE OF NEW YORK SOCIETY OF THE UNITED STATES By By --------------------------------- --------------------------------- President Title By ------------------------------ --------------------------------- Vice President and Secretary Dated Date of Issue ------------------------------ ---------------------- At -------------------------------- PF 17033CP Attached to and made part of Group Annuity Contract No. 11932CP between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, with respect to Certificates issued under the Contract in the state of New York effective January 1, 1987, said Contract and riders are amended as follows: 1. With respect to the front page, the third paragraph is replaced by the following: THE ANNUITY BENEFITS PAYABLE UNDER THE CONTRACT ARE FIXED ANNUITY BENEFITS. 2. With respect to PART I - DEFINITIONS, SECTION 1.12 NORMAL FORM is amended to read as follows: PART 1 - DEFINITIONS, SECTION 1.12 NORMAL FORM. The "Normal Form" of an Annuity Benefit under the Contract means a Period Certain Annuity. 3. With respect to PART I - DEFINITIONS, SECTION 1.13 JOINT AND SURVIVOR LIFE ANNUITY FORM is deleted. 4. With respect to PART I - DEFINITIONS, SECTION 1.14A LIFE ANNUITY FORM is deleted. 5. With respect to PART I - DEFINITIONS, SECTION 1.14C PERIOD CERTAIN ANNUITY is amended to read as follows: SECTION 1.14C PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by Equitable that does not permit any prepayment of the unpaid principal. Any installment payments shall be made over a period which does not exceed the remaining life expectancy of the Participant. 6. With respect to PART I - DEFINITIONS, SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS, the first paragraph is replaced by the following: VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business day immediately preceding such business day will constitute a Valuation Period. A business day is any day on which there is a sufficient degree of trading in the portfolio securities of a Separate Account that the New Accumulation Unit Value might be materially affected by changes in the value of the portfolio securities in a Separate Account, as determined by the Separate Account Committee or, if there is no Committee, by Equitable. 7. With respect to PART I - DEFINITIONS, SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS, the last three paragraphs are deleted. 8. With respect to PART I - DEFINITIONS, SECTION 1.18 CASH VALUE, the following text replaces the paragraphs under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to a participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation PF 17062CP Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period certain Annuity, defined in Section 1.14C, where the certain period of such annuity is at least 10 years, or (v) the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such annuity is at least 15 years. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. 9. With respect to PART II - PARTICIPANT'S ACCOUNT, SECTION 2.07A PARTIAL WITHDRAWAL CHARGES, the following paragraph replaces the paragraph under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to a Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such annuity is at least 10 years, or (v) the receipt by Equitable of a properly completed settlement election from in order to apply the Annuity is at least 10 years, or (v) the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such annuity is at least 15 years. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. 10. With respect to PART III - ANNUITY BENEFITS, SECTION 3.02 VARIABLE ANNUITY BENEFIT is deleted. 11. With respect to PART III - ANNUITY BENEFITS, SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS, is amended to read as follows: SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Values of such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects to receive the Cash Value of such Account in a single sum subject to Equitable's rules then in effect and any applicable requirements under the Code. Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Values of such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock and Money Market Account. Equitable will have the right to require the Participant to furnish pertinent facts and determinations to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. 12. With respect to PART III - ANNUITY BENEFITS, SECTION 3.04 AMOUNT OF ANNUITY BENEFITS is amended to read as follows: PF 17062CP SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If a Participant elects pursuant to the first paragraph or third paragraph of Section 3.03 to receive an Annuity Benefit in lieu of the Cash Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, the amount applied to provide the Annuity Benefit will be the Cash Values of such Accounts. The amount applied to provide an Annuity Benefit shall be reduced by any applicable tax on annuity considerations, as determined by Equitable. If such amount is applied with respect to such Participant, the balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained for such Participant shall terminate. The Table of Guaranteed Annuity Payments sets forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract, as indicated, as a Period Certain Annuity. The amounts of income provided under the Fixed Annuity Benefit payable on the Period Certain Annuity are based on 3 1/2% interest. Equitable may change the monthly income amounts contained in the Table of Guaranteed Annuity Payments and the basis for determining such amounts, for new Participants, by at least 90 days advance notice to the Contract Holder and by an amendment to the Contract. Amounts required for periods certain not shown in the Table will be calculated by Equitable on 3 1/2% interest. 13. With respect to PART III - ANNUITY BENEFITS, SECTION 3.05 PAYMENT OF ANNUITY BENEFITS is amended to read as follows: SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payable under the Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by Equitable will be charged against and underpayments will be added to any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may make the payments (in the case of a minor, at a rate not exceeding $50 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. Upon election by a Participant pursuant to Section 3.03 of a Period Certain Annuity, such Participant may designate (with the right to change such designation) a person or persons to receive any payments that become due after the death of the Participant. The payee may designate (with the right to change such designation and without the concurrence for any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's executors or administrators in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, Equitable will pay in a single sum to such payee's executors or administrators the commuted value of any remaining payments or installments. PF 17062CP The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis. If the amount to be applied hereunder is less than $2,000 or would result in an initial payment of less than $20, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. TABLE OF GUARANTEED ANNUITY PAYMENTS FIXED ANNUITY BENEFIT PAYABLE ON THE PERIOD CERTAIN ANNUITY (Minimum Monthly Income per $1,000 of Annuity Value)
PERIOD CERTAIN PERIOD CERTAIN (IN YEARS) MONTHLY INCOME (IN YEARS) MONTHLY INCOME - ------------------------- ------------------------ ----------------------- ----------------------- 1 $84.65 11 $ 9.09 2 $43.06 12 $ 8.46 3 $29.19 13 $ 7.94 4 $22.27 14 $ 7.49 5 $18.12 15 $ 7.10 6 $15.35 16 $ 6.76 7 $13.38 17 $ 6.47 8 $11.90 18 $ 6.20 9 $10.75 19 $ 5.97 10 $ 9.83 20 $ 5.75
Any ? change, revocation, or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a commutation right under an Annuity Benefit is exercised, Equitable may defer payment in accordance with Section 4.08. 14. With respect to PART IV - GENERAL PROVISIONS, SECTION 4.01 CONTRACT, a fourth paragraph is added as follows: ? ? subject to the rules and regulations of the Deferred Compensation Board of the State of New York, ? regulations are made a part of such Contract. 15. With respect to PART IV - GENERAL PROVISIONS, SECTION 4.08 DEFERMENT is replaced by the following: SECTION 4.08 DEFERMENT. Payments by Equitable from the Participant's Guaranteed Interest Account pursuant to the provisions of Section 2.06, Sections 2.07 and 2.07A, and Section 2.09, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.05, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due ? for such commutation payments pursuant to Section 3.05. Interest at the current Guaranteed Interest Rate for such Participant's Guaranteed Interest Account will be allowed on any such payment deferred for 30 days or more. Except as provided in this Section, payments by Equitable from the Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account pursuant to the provisions of Section 2.06, Sections 2.07 and 2.07A and Section 2.09 will be made within seven days after receipt of a written request for such surrender or withdrawal upon receipt of proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. During the period when (i) the sale of securities or the determination of the New Accumulation Unit Value is not reasonably practicable because an emergency, defined by the Securities and Exchange Commission, exists, or the New PF 17062CP York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may by order permit postponement for the protection of persons having interests in the Separate Accounts, Equitable reserves the right: (a) to defer determination of Cash Values or Annuity Values and payment of Cash Values and Annuity Values arising from an amount in a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (b) to defer payment of any portion of the death benefit arising from an amount in a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (c) in the event of (a) above, to defer application of such amounts to provide any Annuity Benefit permitted under the Contract. 16. With respect to PART IV - GENERAL PROVISIONS, SECTION 4.09 ANNUAL NOTICE is amended to read as follows: SECTION 4.09 ANNUAL NOTICE. At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Guaranteed Interest Account, (2) the total number of Accumulation Units credited to the Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, (3) the New Accumulation Unit Values, (4) the sum of the Cash Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account and (5) the amount of death benefit payable with respect to the Participant. 17. With respect to PART IV - GENERAL PROVISIONS, the following section is added: SECTION 4.09A QUARTERLY NOTICE. At least once during each calendar quarter up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing the Annuity Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account. Agreed to by: UNITED STATES TRUST COMPANY THE EQUITABLE LIFE ASSURANCE OF NEW YORK SOCIETY OF THE UNITED STATES By By SPECIMEN ---------------------------------- --------------------------------- President Title By SPECIMEN ------------------------------- ---------------------------------- Vice President and Secretary Dated Date of Issue ------------------------------- ----------------------- At ---------------------------------- PF 17062CP Participant: Certificate Number: THE EQUITABLE [LOGO] Issue Date: Participation Date: Retirement Date: THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York, New York 10116 AGREES o To allocate the Contributions made to the Contract, after deduction of any applicable taxes, to the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account or the Guaranteed Interest Account maintained for the Participant, in accordance with Sections 2.02 and 2.03, or in part to any one, as directed by the Participant. o To apply the amount in the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Guaranteed Interest Account at the Retirement Date to provide the Participant with an Annuity Benefit or a Cash Value Benefit if the Participant is then living, and o To provide the Participant with the other rights and benefits of this certificate. These agreements are subject to the provisions of this certificate. TEN DAYS TO EXAMINE CERTIFICATE - The Participant may terminate participation under the Contract and cancel this certificate by returning it to Equitable within ten days after receipt of it. Upon such cancellation, Equitable will refund any Contribution made to Equitable on behalf of a Participant under the Contract, plus or minus any investment gain or loss experienced in the Participant's Stock Account, Balanced Account, Aggressive Stock Account, or Money Market Account from the date such Contribution is allocated to such Account to the date of such Cancellation. /s/ Rodney L. Enochs /s/ John B. Carter Vice President President and Secretary ASSETS HELD IN CONNECTION WITH THE CONTRACT MAY BE HELD IN SEPARATE ACCOUNTS MAINTAINED BY EQUITABLE AND MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THE CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF SEPARATE ACCOUNT A. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN SEPARATE ACCOUNT A IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT REFERRED TO IN SECTION 1.16 IS 5% OR 3 1/2%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE OF 1.75% FOR INVESTMENT MANAGEMENT, FINANCIAL ACCOUNTING, THE ANNUITY RATE GUARANTEE AND MINIMUM DEATH BENEFIT, EXPENSES AND EXPENSE RISK, BUT AFTER ANY DEDUCTIONS TO PROVIDE FOR TAXES. THIS CONTRACT MAY NOT BE SUITABLE FOR A PARTICIPANT IF THE ONLY CONTRIBUTION TO BE MADE ON SUCH PARTICIPANT'S BEHALF IS A SUBSTANTIAL SINGLE SUM CONTRIBUTION. NO. 11936P AMENDED BY PF 17009P - PF 17013P - PF 17018P - PF 17022P CONTENTS Part I - Definitions Page 2 Part II - Participant's Account Page 6 Part III - Annuity Benefits Page 9 Part IV - General Provisions Page 12 Equitable certifies that the Participant as named on page 3 is included under the Group Annuity Contract designated on page 3 ("the Contract"), all pertinent provisions of which are set forth below. As described in Section 1.10, Equitable will determine, before the beginning of each calendar year commencing after the period for which the Initial Guaranteed Interest Rate is effective, the Yearly Guaranteed Interest Rate for the calendar year for each Class of Participants, which shall not be lower than the Minimum Guaranteed Interest Rate then in effect. Equitable, from time to time, may declare a Guaranteed Interest Rate for a Class which exceeds the applicable Yearly Guaranteed Interest Rate and a period for which such rate applies. A Guaranteed Interest Rate is subject to annual administrative charges as described in Section 2.08. This certificate is valid only if participation under the Contract has not been terminated as described in the Contract and is subject to amendment as may be required pursuant to Section 4.02. EARLY WITHDRAWAL CHARGE. If a Participant terminates participation at any time after the earliest of the following occurrences: (i) The later of (a) the attainment of age 59 years and six months or (b) the completion of five Participation Years, or (ii) the completion of 12 Participation Years, the sum of the Cash Values of the Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account as provided in Section 1.18, will be equal to the sum of the Annuity Values of each such Account. At other times, the sum of the Cash Values of such Accounts may be less than the sum of the Annuity Values as provided in Section 1.18. The Contract is issued in consideration of the payment to Equitable of the Contributions made under the Contract. The provisions on the following pages are part of this certificate. PART I - DEFINITIONS SECTION 1.01 EMPLOYER. The term "Employer" means (i) a State, political subdivision of a State, or an agency or instrumentality of a State or political subdivision of a State which has adopted a Plan, or (ii) a rural electric cooperative, as defined in Section 457(d)(9)(B) of the Code, which has adopted a Plan. SECTION 1.02 PLAN. The term "Plan" means a program constituting an "Eligible State Deferred Compensation Plan" meeting the requirements of Section 457(b) of the Code which is established and maintained by an Employer for the benefit of persons performing services for the Employer and their beneficiaries. SECTION 1.03 ANNUITY. The term "Annuity" means an annuity purchased in accordance with the terms of the Plan. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Section 3.04 of the Contract. SECTION 1.05 PARTICIPANT. The term "Participant" means a person who has been enrolled by Equitable under the Contract and for whom the Employer has purchased an Annuity under the Contract. A person shall become enrolled under the Contract upon receipt by Equitable of an enrollment form made available by Equitable and completed in a manner satisfactory to Equitable. An Annuity is purchased for a person enrolled under the Contract upon receipt by Equitable of an initial Contribution by the Employer. SECTION 1.06 CONTRIBUTION. The term "Contribution" means a payment made to Equitable for a Participant with respect to an Annuity purchased for such Participant under the Contract. Equitable is under no obligation to accept any Contribution less than $20.00 NO. 11936P AMENDED BY PF 17009P - -------- PF 17013P - PF 17018P - PF 17022P Page Two Page Four --------- DEFINITIONS (CONTINUED) SECTION 1.07 PARTICIPATION DATE. The term "Participation Date" with respect to a Participant means the date as of which Equitable has enrolled such Participant under the terms of the Contract. SECTION 1.08 PARTICIPATION YEAR. The term "Participation Year" with respect to a Participant means the twelve month period beginning on (i) the Participant Date, and (ii) each anniversary thereof, unless otherwise agreed to in writing by Equitable. SECTION 1.09 CLASS OF PARTICIPANTS. Except as provided in Section 1.10, the term "Class of Participants" refers to all Participants whose Participation Date is in the same calendar year. SECTION 1.10 GUARANTEED INTEREST RATE. For each Guaranteed Interest Account, the term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in such Account. Interest accrues daily. The Guaranteed Interest Rate will never be less than 3% per annum. Equitable will from time to time establish and make available for new Participants (i) an Initial Guaranteed Interest Rate, (ii) one or more Minimum Guaranteed Interest Rates and (iii) the applicable effective period(s) for such Rates. A new Class of Participants will be established effective with the effective date of the occurrence of (i), (ii) or (iii) above or any combination thereof. For the calendar year next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent calendar year thereafter, Equitable will determine for each established Class of Participants before the beginning of such calendar year a Yearly Guaranteed Interest Rate for such Class, which Yearly Guaranteed Interest Rate will not be lower than the effective Minimum Guaranteed Interest Rate applicable for such Class for such year. For any established Class of participants, Equitable reserves the right to change the Minimum Guaranteed Interest Rate and the applicable period therefor, provided that any such Minimum Guaranteed Interest Rate will not be lower than the Minimum Guaranteed Interest Rate that would have been in effect in the absence of such change. Equitable will notify each Participant in a Class in writing of the Yearly Guaranteed Interest Rate or of any change in the Minimum Guaranteed Interest Rate at least 15 days prior to its effective date. For the period (not to exceed one year) next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent period (not to exceed one year) the Equitable may determine for each established Class of Participants a Guaranteed Interest Rate for such Class which exceeds the applicable Yearly Guaranteed Interest Rate. Equitable will notify each Participant in writing of the applicable Guaranteed Interest Rate and duration. SECTION 1.11 RETIREMENT DATE. The term "Retirement Date" means the date on which the Participant is to attain the retirement age specified in the Participant's enrollment form. Before the Retirement Date the Participant may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be earlier than the Retirement Date provided under the Plan. Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Home Office. SECTION 1.12 NORMAL FORM. The "Normal Form" of an Annuity Benefit under the Contract means, (i) if the Participant has a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (100% continuation), and (ii) if the Participant does not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.13 JOINT AND SURVIVOR LIFE AND ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depends is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by the Participant. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.14A LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.14B ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by Equitable which extends beyond the Participant's attainment of age 59 years and six months and does not permit any prepayment of the unpaid principal prior to the participant's attainment of age 59 years and six months. SECTION 1.15 THE SEPARATE ACCOUNTS. The term "Separate Account" means the following separate investment accounts maintained by Equitable to which portions of its assets have been allocated for the Contract and certain other contracts: NO. 11936P AMENDED BY PF 17009P - --------- PF 17013P - PF 17018P - PF 17022P Page Four Page Five --------- DEFINITIONS (CONTINUED) Name Investments - ---- ----------- Separate Account A Primarily common stock and other equity-type investments. Separate Account E Primarily short-term money market instruments. Separate Account J Primarily common stocks and other equity-type investments, publicly traded debt securities and short-term money market instruments. Separate Account K Primarily common stocks issued by high quality small and intermediate size companies with strong growth prospects. Equitable reserves the right to withdraw from any Separate Account and allocate to another separate account assets determined by Equitable to be associated with the class of contracts to which the Contract belongs. In any such event, to the extent practicable and permissible under applicable laws and regulations, the withdrawal shall be made by withdrawing the same percentage of each investment in the Separate Account, with appropriate adjustments to avoid odd lots and fractions. On and after the date of any such withdrawal the reference in the Contract to such Separate Account shall mean such other separate account to which the withdrawn assets were allocated. It is contemplated that investments in the Separate Accounts will, at most times, consist primarily of the types of investments indicated above. Equitable may, however, at its discretion invest the assets of any Separate Account in any investment permitted by applicable law. Equitable may rely conclusively on the opinion of counsel (including attorneys in its employ) as to what investments it is permitted by law to make. In lieu of making such investments directly, Equitable reserves the right to operate any Separate Account as a unit investment trust, or in any other form permitted by law, investing all or a part of its assets in shares or units of a fund, the investment adviser of which may be Equitable or controlled by Equitable. The fund assets would be invested as provided above with respect to the Separate Account. Equitable reserves the right: (i) to cause the registration or deregistration of any Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run any Separate Account under direction of a committee, and to discharge such committee at any time; and (iii) restrict or eliminate any voting rights participants or other persons who have voting rights as to the Separate Accounts. Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.16. The assets of Separate Accounts are the property of Equitable; however, the portion of the assets of each Separate Account equal to the reserves and other contract liabilities with respect to such Account shall not be chargeable with liabilities arising out of any other business Equitable may conduct. Equitable reserves the right to transfer assets of the Separate Accounts in excess of such reserves and contract liabilities to the general account of Equitable. SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS. VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business day immediately preceding such business day will constitute a Valuation Period. A business day is any day on which there is a sufficient degree of trading in the portfolio securities of a Separate Account that the New Accumulation Unit Value or New Annuity Unit Value might be materially affected by changes in the value of the portfolio securities in a Separate Account, as determined by the Separate Account Committee or, if there is no Committee, by Equitable. NET INVESTMENT FACTOR: For each Separate Account the Net Investment Factor for a Valuation Period is (a) divided by (b), minus (c), where (a) is (1) the value of the assets in the Separate Account at the close of business of the preceding Valuation Period plus (2) the investment income and the capital gains, realized or unrealized, credited to the assets of the Separate Account in the Valuation Period for which the Net Investment Factor is being determined, minus (3) the capital losses, realized or unrealized, charged against such assets in such Valuation Period, minus (4) any amount charged against the Separate Account in such Valuation Period for taxes or for amounts set aside by Equitable as a reserve for taxes attributable to the maintenance or operation of the Separate Account; (b) is the value of the assets in the Separate Account at the close of business of the preceding Valuation Period; and (c) is the daily charge, for each calendar day in such Valuation Period of .00004837 for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The value of the assets in the Separate Accounts, referred to above, shall be taken at their fair market value, or where there is no readily available market, their fair value, as determined in accordance with accepted accounting practices and applicable laws and regulations. NO. 11936P AMENDED BY PF 17009P - -------- PF 17013P - PF 17018P - PF 17022P Page Five Page Six -------- DEFINITIONS (CONTINUED) ACCUMULATION UNIT: The Accumulation Unit is a unit used in determining the value of the interest of a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account on or before the Retirement Date. NEW ACCUMULATION UNIT VALUE: The initial New Accumulation Unit Values for the Separate Accounts have been established as follows: Account Value Date ------- ----- ---- Separate Account A $10.00 As of November 1, 1968 Separate Account E $10.00 As of September 4, 1974 Separate Account J $10.00 As of May 1, 1984 Separate Account K $10.00 As of May 1, 1984 The New Accumulation Unit Value for each subsequent Valuation Period is the New Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such subsequent Valuation Period. ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable from the Separate Account A under A Variable Annuity Benefit. NEW ANNUITY UNIT VALUE: The initial New Annuity Unit Value for Separate Account A has been established at $1.00 as of November 1, 1968. The Annuity Unit Value for any subsequent Valuation Period is the New Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3 1/2%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE NEW ANNUITY UNIT VALUE: The Average Annuity Unit Value for Separate Account A for a calendar month is equal to the average of the New Annuity Unit Values for the Valuation Period s ending in such month. SECTION 1.17 ANNUITY VALUE. The term "Annuity Value" with respect to a Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, means the amount in such Accounts pursuant to Sections 2.02 and 2.03. SECTION 1.18 CASH VALUE. NO WITHDRAWAL CHARGE: With respect to a Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and six months, or (ii) the completion of 12 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55, completed five Participation Years, and the Cash Values are to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, the sum of the Cash Values of such Accounts equal the sum of the Annuity Values of such Accounts, less a withdrawal charge. WITHDRAWAL CHARGE: The withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% during Participation Years 1, 2, 3, 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the excess of (i) the sum of the Annuity Values of such Accounts over (ii)the Free Corridor Amount defined in Section 2.07B. (b) is the excess, if any, of (i) 8% of the total contributions made on behalf of such Participants during the current Participation Year and the preceding nine Participation Years over (ii) the cumulative total of any withdrawal charges made pursuant to Sections 2.07 and 2.07A. The Cash Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account will be in the same proportion as are the Annuity Values of such Accounts. SECTION 1.19 CODE. The term "Code" means the Internal Revenue Code of 1954, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. PART II - PARTICIPANT'S ACCOUNT SECTION 2.01 CONTRIBUTIONS. The Employer is to make Contributions from time to time on such dates and in such amounts as determined by the Employer pursuant to the terms of the Plan or, if the Employer has no Plan, as determined by the Employer at its sole discretion. The Employer is to specify the Participant with respect to whom each such Contribution is being made and the amount to be allocated to the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Guaranteed Interest Account. Each Contribution received by Equitable with respect to a Participant will, before its allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable. NO. 11936P AMENDED BY PF 17009P - -------- PF 17013P - PF 17018P - PF 17022P Page Six Page Seven ---------- PARTICIPANT'S ACCOUNT (CONTINUED) Participant may, with Equitable's agreement, transfer to the Contract any amount held with respect to such Participant under a Plan of the Employer or under an "Eligible State Deferred Compensation Plan" meeting the requirements of Section 457(b) of the Code established and maintained by another employer ("Transferred Funds"). Any Transferred Funds from a contract not issued by Equitable will, before allocation under the Contract, be reduced by the amount of any applicable taxes, as determined by Equitable. Equitable will issue to each Participant an individual certificate setting forth a statement in substance of the benefits to which such Participant is entitled under the Contract. SECTION 2.02 STOCK, BALANCED, AGGRESSIVE STOCK AND MONEY MARKET ACCOUNTS. Equitable maintains a Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the (1) Stock Account becomes part of Separate Account A, (2) Balanced Account becomes part of Separate Account J, (3) Aggressive Stock Account becomes part of Separate Account K, and (4) Money Market Account becomes part of Separate Account E. Any amount withdrawn from an Account will no longer be part of the applicable Separate Account. On any date when an amount is allocated to or withdrawn from an Account, the Account will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the New Accumulation Value for the appropriate Separate Account for the Valuation Period which includes that date. The number of Units in an Account on any date is equal to (i) the sum of any Accumulation Units that have been credited to the Account minus (ii) the sum of any Accumulation Units that have been charged to that Account. The amount in the Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account on any date is equal to the product of (i) the number of Accumulation Units in such Account on that date and (ii) the New Accumulation Unit Value for the appropriate Separate Account for the Valuation Period which includes that date. SECTION 2.03 GUARANTEED INTEREST ACCOUNT. Equitable maintains a Guaranteed Interest Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the Guaranteed Interest Account becomes part of the general assets of Equitable, which support the guarantees of the Contract and other contracts. The amount in a Guaranteed Interest Account at any time is equal to the sum of all amounts that have been allocated to such Guaranteed Interest Account pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn pursuant to Sections 2.07, 2.07A, and Section 2.08 from such Account, and transferred pursuant to Section 2.05 from such Guaranteed Interest Account, and less the sum of any annual administrative charges accrued but not made. Equitable guarantees that the amount in a Guaranteed Interest Account at any time before the Retirement Date will not be less than the sum of all amounts allocated to such Account pursuant to Section 2.04 or transferred to such Account pursuant to Section 2.05 and less the sum of all amounts that have been withdrawn from such Account pursuant to Sections 2.07 and 2.07A, and transferred from such Account pursuant to Section 2.05, all accumulated at 3% interest, compounded annually. In any Participation Year in which no Contribution is allocated to a Guaranteed Interest Account, the amount in such Account at the end of the Participation Year shall not be less than the amount in such Account at the beginning of the Participation Year plus the sum of all amounts transferred to such Account pursuant to Section 2.05 less the sum of all amounts withdrawn and transferred out of such Account pursuant to Sections 2.07, 2.07A, and Section 2.05, all accumulated at 3% interest, compounded annually. A Guaranteed Interest Account for a Participant terminates on the earliest of (i) the Retirement Date, (ii) the death of the Participant, and (iii) termination of participation pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO ACCOUNT. Each Contribution made with respect to a Participant pursuant to Section 2.01, after deduction for any applicable taxes, will be allocated, as of the date by which Equitable has received both such Contribution and direction as to its allocation, to the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account or in part to each, at the sole direction of the Participant as specified to Equitable, provided that the percentage allocated to each Account is a whole number. Any amount that a Participant has directed to be transferred to the Guaranteed Interest Account, Stock Account, Balanced Account or Aggressive Stock Account pursuant to Section 2.05 will be allocated as of the date of such transfer to the appropriate Account maintained for such Participant. Interest is allocated to the Guaranteed Interest Account at the end of each Participation Year, at the time of each transfer or withdrawal pursuant to Sections 2.05 and 2.07 and 2.07A, at the time of application of amounts in the Guaranteed Interest Account to provide Annuity Benefits, upon termination of participation pursuant to Section 2.06, and upon death of the Participant pursuant to Section 2.09. SECTION 2.05 TRANSFERS AMONG ACCOUNTS. At any time before a Participant's Retirement Date, such Participant, upon written request, may transfer all or part of the amounts maintained for the Participant to one or more of the other Accounts maintained for such Participant as follows: (1) amounts in the Guaranteed Interest Account, Stock Account, Balanced Account and Aggressive Stock Account may be transferred among such Accounts; (2) amounts in the Money Market Account may be transferred to the other Accounts. Such transfers will be made as of the date Equitable receives such request, and will be subject to Equitable's rules in effect at the time of transfer. No transfers are permitted from the Guaranteed Interest Account, Stock Account, Balanced Account or Aggressive Stock Account maintained for the Participant to the Money Market Account. Notwithstanding the above, transfers to the Balanced Account may be prohibited by Equitable upon 30 days written notice to the Participant. NO. 11936P AMENDED BY PF 17009P - ---------- PF 17013P - PF 17018P - PF 17022P Page Seven Page Eight ---------- PARTICIPANT'S ACCOUNT (CONTINUED) SECTION 2.06 TERMINATION OF PARTICIPATION. Subject to any applicable restrictions under the terms of the Plan, on or before a Participant's Retirement Date, such Participant may elect by written notice to terminate participation under the Contract. Upon receipt of such notice, Equitable will determine the Cash Value, as of the date Equitable received such notice, of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained for such Participant. The payment of such Cash Value to the Participant may be deferred by Equitable in accordance with the provisions of Section 4.08. Prior to a Participant's Retirement Date, Equitable reserves the right to withdraw the Annuity Value of the Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, pay such Annuity Values and terminate such Participant's participation under the Contract. This right may be exercised with respect to the Participant only if both (i) no Contributions have been made under the Contract during the last three completed Participation Years, and (ii) the sum of such Annuity Values is $500 or less. Equitable reserves the right to terminate a Participant's participation under the Contract if at least 120 days have elapsed since the issue date shown on the certificate issued to such Participant under the Contract and no Contributions have been made under the Contract with respect to such Participant. Upon payment of such Cash Values or Annuity Values, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Cash Values or Annuity Values arose. SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under the terms of the Plan, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Guaranteed Interest Account maintained for such Participant before such Participant's Retirement Date. Upon withdrawal pursuant to Section 2.07 or 2.07A, Equitable will pay the lesser of the sum of the Cash Values of such Accounts or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by such Participant. Unless instructed otherwise, the amount withdrawn (including the amount of any withdrawal charge) will be allocated between such Accounts in proportion to the Annuity Value of each such Account. Upon any payment to a Participant pursuant to Section 2.07 or 2.07A, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Payments to the Participant pursuant to Section 2.07 or 2.07A may be deferred by Equitable in accordance with the provisions of Section 4.08. Equitable is under no obligation to process any request for partial withdrawal of less than $300. If a withdrawal from the Accounts made pursuant to Sections 2.07 or 2.07A would result in total Annuity Values of less than $500, Equitable will so advise the Participant and reserves the right to withdraw the Annuity Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, pay the Annuity Values of such Accounts to the Participant, and terminate such Participant's participation under the contract. SECTION 2.07A PARTIAL WITHDRAWAL CHARGES. NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a Participant, Equitable will withdraw from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values of such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and six months, or (ii) the completion of 12 Participation Years with respect to such Participant, or (iii) if the Participant has attained age 55, has completed five Participation Years, and the partial withdrawal is to be applied to purchase an Eligible Annuity Certain defined in Section 1.14B. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. WITHDRAWAL CHARGE: There will be no withdrawal charge if the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07B. If the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge. Such withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Participation Years 1, 2, 3, 4 and 5 5% during Participation Years 6, 7 and 8 4% during Participation Year 9 3% during Participation Year 10 2% during Participation Year 11 1% during Participation Year 12 0% thereafter of the amount withdrawn (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the cumulative total of contributions made on behalf of such Participant during the current Participation Year and the nine preceding Participation Years over (ii) the cumulative total of any prior withdrawal charges made pursuant to this Section. NO. 11936P AMENDED BY PF 17009P - ---------- PF 17013P - PF 17018P - PF 17022P Page Eight Page Nine --------- PARTICIPANT'S ACCOUNT (CONTINUED) SECTION 2.07B FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" with respect to a Participant who has completed three Participation Years or attained age 59 1/2 means an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Values of the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Guaranteed Interest Account over (ii) cumulative prior withdrawals made pursuant to Section 2.07 or 2.07A in the current Participation Year with respect to the Participant. With respect to a Participant who has not completed three Participation Years or attained age 59 1/2, the Free Corridor Amount is zero. SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Participation Year before a Participant's Retirement Date, Equitable will withdraw from the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account at the end of that Participation Year and (ii) any withdrawals made from such Accounts pursuant to Section 2.07 and 2.07A during that Participation Year. The charge will be allocated between the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Guaranteed Interest Account in proportion to the Annuity Value of each such Account, at the end of the Participation Year. As of a Participant's Retirement Date and before application of the Annuity Values or Cash Values of such Participant's Account pursuant to Section 3.03, or upon termination of such Account pursuant to Section 2.06 or Section 2.09 during a Participation Year, Equitable will withdraw the administrative charge described in this Section for the applicable part of that Participation Year. SECTION 2.09 DEATH BENEFIT. If the Employer reports to Equitable, or if Equitable otherwise ascertains, that a Participant has died while Accounts for such Participant are maintained under the Contract and before such Participant's Retirement Date, Equitable, upon receipt of due proof of such death, will pay in a single sum to the beneficiary designated by such Participant to receive such payment the amount of death benefit payable with respect to such Participant. The amount of the death benefit with respect to a Participant at any time prior to the Retirement Date is equal to the greater of (i) the sum of the Annuity Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract for such Participant and (ii) the minimum death benefit with respect to such Participant. Such minimum death benefit is the sum of all Contributions made with respect to such Participant pursuant to Section 2.01 (before reduction of any applicable taxes) less an adjustment for any withdrawals made pursuant to Sections 2.07 and 2.07A from the Accounts maintained under the Contract for such Participant. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount being withdrawn is to the Annuity Values then in the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract for such Participant. If, in accordance with the provisions of Section 2.01, the cash value of an Annuity contract issued by Equitable, which provides for a death benefit before retirement equal to the greater of the contract cash value or an alternative amount based on premiums paid or contributions made under the Annuity contract, is transferred to the Contract, such alternative amount as of the date of transfer will be included in the "sum of all Contributions" in lieu of the amount of cash value transferred, for purposes of the death benefit under the Contract. The amount of any death benefit payable with respect to a Participant will, to the extent such Account is sufficient therefore, be withdrawn from the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained with respect to such Participant under the Contract. Upon such payment, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Annuity Values arose. PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of Separate Account A. The amount of the first, second, and third payments under any Variable Annuity Benefit provided under the Contract with respect to a payee is the monthly amount provided with respect to the payee pursuant to Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average New Annuity Unit Value for the second calendar NO. 11936P AMENDED BY PF 17009P - --------- PF 17013P - PF 17018P - PF 17022P Page Nine Page Ten -------- ANNUITY BENEFITS (CONTINUED) month immediately preceding the date of the payment. The fourth and subsequent annuity payments under a Variable Annuity Benefit will not be increased or decreased in amount because of mortality or expense experience. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the New Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Values of such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of such Account in a single sum or (ii) to apply such Annuity Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by Equitable, as elected by the Participant, subject to Equitable's rules then in effect and any applicable requirements under the Code. Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Values of such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account. Equitable will have the right to require the Participant to furnish pertinent facts and determinations to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. Equitable may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If a Participant elects pursuant to the first paragraph or third paragraph of Section 3.03 to receive an Annuity Benefit in lieu of the Cash Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, the amount applied to provide the Annuity Benefit will be (i) the Annuity Values of such Accounts if the payments under the annuity form elected are contingent upon the survival of a person, or (ii) the Cash Values of such Accounts if the payments under the annuity form elected are not contingent upon the survival of a person. The amount applied to provide an Annuity Benefit shall be reduced by any applicable tax on annuity considerations, as determined by Equitable. If such amount is applied on or after the completion of five Participation Years with respect to such Participant, the balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. If the amount applied to provide an Annuity Benefit is applied before the completion of five Participation Years with respect to a Participant, the balance, after any applicable tax on annuity considerations, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained for such Participant shall terminate. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (100% continuation). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, are based on 3 1/2% interest and the 1983 Individual Annuity Mortality Table adjusted to a unisex basis based on a 50-50 split of males and females. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on the projected 1983 Basic Table adjusted to a unisex basis based on a 50-50 split of males and females and an Assumed Base Rate of Net Investment Return of 3 1/2% or 5%, whichever applies pursuant to Section 1.16. The Assumed Base Rate of Net Investment Return is 5% for certificates issued for delivery in New York. Equitable may change the monthly income amounts contained in the Tables of Guaranteed Annuity Payments and the basis for determining such amounts, for new Participants, by at least 90 days advance notice to the Contract Holder and by an amendment to the Contract. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on 3 1/2% interest and the 1983 Individual Annuity Mortality Table adjusted to a unisex basis based on a 50-50 split of males and females if such annuity form provides for a Fixed Annuity Benefit, and on the projected 1983 Basic Table adjusted to a unisex basis based on a 50-50 split of males and females and an Assumed Base Rate of Net Investment Income Return of 5% or 3 1/2%, whichever applies pursuant to Section 1.16, if such annuity form provides for a Variable Annuity Benefit. NO. 11936P AMENDED BY PF 17009P - --------- PF 17013P - PF 17018P - PF 17022P Page Ten Page Eleven ----------- ANNUITY BENEFITS (CONTINUED) SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payable under the Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by Equitable will be charged against and underpayments will be added to any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may make the payments (in the case of a minor, at a rate not exceeding $50 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If an annuity form made available by Equitable provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Upon election by a Participant pursuant to Section 3.03 of an annuity form providing payments for a period certain, such Participant may designate (with the right to change such designation) a person or persons to receive any payments that may become due after death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's executors or administrators in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, Equitable will pay in a single sum to such payee's executors or administrators the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. Equitable will require satisfactory evidence of the age of any person upon whose life an annuity form depends.
TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM - 100% CONTINUATION (Minimum Monthly Income Per $1,000 of Annuity Value) - ------- ------- ------ ------- ------ ------- -------- ------ ------- ------- ------ ------- Age 60 61 62 63 64 65 66 67 68 69 70 - ------- ------- ------ ------- ------ ------- -------- ------ ------- ------- ------ ------- 60 4.54 4.58 4.62 4.66 4.70 4.74 4.77 4.81 4.84 4.88 4.91 61 4.62 4.67 4.71 4.76 4.81 4.84 4.88 4.91 4.95 4.99 62 4.72 4.76 4.81 4.85 4.90 4.94 4.98 5.02 5.06 63 4.81 4.86 4.91 4.96 5.01 5.06 5.10 5.14 64 4.92 4.97 5.02 5.08 5.13 5.17 5.22 65 5.03 5.09 5.15 5.20 5.26 5.31 66 5.15 5.21 5.27 5.33 5.39 67 5.28 5.34 5.40 5.47 68 5.41 5.48 5.55 69 5.56 5.63 70 5.71 - ------- ------- ------ ------- ------ ------- -------- ------ ------- ------- ------ -------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM-100% CONTINUATION-ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3 1/2% (Minimum Monthly Income Per $1,000 of Annuity Value) - ------- ------- ------ ------- ------ ------- -------- ------ ------- ------- ------ ------- Age 60 61 62 63 64 65 66 67 68 69 70 - ------- ------- ------ ------- ------ ------- -------- ------ ------- ------- ------ ------- 60 4.40 4.44 4.48 4.51 4.55 4.58 4.61 4.65 4.68 4.71 4.74 61 4.48 4.52 4.56 4.60 4.64 4.67 4.71 4.74 4.78 4.81 62 4.56 4.60 4.65 4.69 4.73 4.77 4.80 4.84 4.88 63 4.65 4.69 4.74 4.78 4.83 4.87 4.91 4.95 64 4.74 4.79 4.84 4.89 4.93 4.98 5.02 65 4.85 4.90 4.95 5.00 5.05 5.10 66 4.95 5.01 5.06 5.11 5.17 67 5.07 5.12 5.18 5.24 68 5.19 5.25 5.32 69 5.32 5.39 70 5.46 - ------- ------- ------ ------- ------ ------- -------- ------ ------- ------- ------ -------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM-100% CONTINUATION-ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 5% (Minimum Monthly Income Per $1,000 of Annuity Value) - ------- ------- ------ ------- ------ ------- -------- ------ ------- ------- ------ ------- Age 60 61 62 63 64 65 66 67 68 69 70 - ------- ------- ------ ------- ------ ------- -------- ------ ------- ------- ------ ------- 60 5.27 5.30 5.34 5.37 5.41 5.44 5.47 5.51 5.54 5.57 5.59 61 5.34 5.38 5.42 5.46 5.49 5.53 5.57 5.60 5.63 5.66 62 5.42 5.46 5.50 5.54 5.58 5.62 5.65 5.69 5.73 63 5.50 5.55 5.59 5.63 5.67 5.71 5.75 5.79 64 5.59 5.64 5.69 5.73 5.78 5.82 5.86 65 5.69 5.74 5.79 5.84 5.89 5.93 66 5.79 5.85 5.90 5.95 6.00 67 5.90 5.96 6.02 6.08 68 6.02 6.08 6.15 69 5.56 5.63 70 6.29 - ------- ------- ------ ------- ------ ------- -------- ------ ------- ------- ------ -------
NO. 11936P AMENDED BY PF 17009P - ----------- PF 17013P - PF 17018P - PF 17022P Page Eleven Page Twelve ----------- ANNUITY BENEFITS (CONTINUED) ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) VARIABLE ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET Age Fixed Annuity Benefit INVESTMENT RETURN IS --- --------------------- --------------------------- 3 1/2% 5% ------ -- 60 5.29 5.08 5.97 61 5.41 5.19 6.08 62 5.55 5.31 6.20 63 5.69 5.44 6.33 64 5.85 5.58 6.46 65 6.01 5.73 6.61 66 6.19 5.89 6.77 67 6.37 6.06 6.94 68 6.58 6.24 7.12 69 6.79 6.43 7.31 70 7.02 6.64 7.52 Equitable will notify the payee under a Variable Annuity Benefit of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each variable payment. Any election, change, revocation or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a commutation right under an Annuity Benefit is exercised, Equitable may defer payment in accordance with Section 4.08. PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT. The Contract constitutes the entire Contract between the parties and provisions of the Contract alone will govern with respect to the rights and obligations of Equitable. The provisions of the Contract will be applied separately with respect to each Participant. Nothing in the enrollment form referred to in Section 1.05, the Plan or trust agreement referred to in Section 4.10 nor any modification, amendment, or supplement to any such documents will in any way be construed to enlarge, change, vary or in any other way affect the obligations of Equitable as expressly provided in the Contract. The Contract may not be modified as to Equitable, nor may any of Equitable's rights or requirements be waived, except in writing and by an authorized officer of Equitable. The Contract may be changed by amendment or replacement upon agreement between the Contract Holder and Equitable without the consent of any other person provided that such change does not reduce any Annuity Benefit provided before such change and provided that no rights, privileges or benefits which have accrued to any Participant under the Contract may be reduced or forfeited except by the express consent of such Participant. SECTION 4.02 STATUTORY COMPLIANCE. Equitable reserves the right to amend the Contract without the consent of any other person in order to comply with applicable laws and regulations. Such rights shall include, but not be limited to, the right to conform the Contract and any certificate to reflect changes in the Code, or in regulations or published rulings of the Internal Revenue Service so that each such certificate will continue to be an Annuity. Any Annuity Benefit, Cash Value or death benefit available under a certificate issued pursuant to the Contract shall not be less than the minimum benefits required by any statute of the state in which the certificate is delivered. SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY. The entire interest of any Participant under the Contract is nonforfeitable. No interest of a Participant under the Contract may be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than Equitable. No amount payable under the Contract may be assigned, commuted, or encumbered by the payee, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. SECTION 4.04 PARTICIPATION IN SURPLUS. The Contract and all other contracts in the same class of contracts shall be combined for the purpose of ascertaining the annual surplus of Equitable to be apportioned to said contracts as a dividend and the portion of any such dividend that is to be allocated to the Contract shall be determined by Equitable. The participation of this class of contracts in annual surplus is, however, expected to be minimal. Any amount so allocated to the Contract shall be payable as of January 1 of the calendar year in which a dividend is apportioned and will be payable in cash and shall be equitably allocated by Equitable to the Guaranteed Interest Accounts maintained hereunder for Participants. No Annuity Benefit will enter into the determination of any surplus to be apportioned to the Contract as a dividend. SECTION 4.05 BENEFICIARY. Each Participant, as of such Participant's Participation Date, is to provide Equitable with an initial designation of the beneficiary entitled to receive any death benefit payable with respect to such Participant pursuant to Section 2.09. The Participant may change such designation from time to time during such Participant's lifetime and while Accounts for such Participants are being maintained hereunder. Any such designation or NO. 11936P AMENDED BY PF 17009P - ----------- PF 17013P - PF 17018P - PF 17022P Page Twelve Page Thirteen ------------- GENERAL PROVISIONS (CONTINUED) change will be made by written notice in a form satisfactory to Equitable. A change will, upon receipt at a designated Equitable Office, take effect as of the time the written notice was signed, whether or not the Participant is living on the date of receipt, but without further liability as to any payment or other settlement made by Equitable before receipt of such change. Unless otherwise specified in the designation, if a Participant has designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive the Participant, and if more than one survive they will share equally. Any part of a death benefit payable with respect to a Participant pursuant to Section 2.09 for which there is no designated beneficiary living at the death of the Participant will be payable in a single sum to the children of the Participant who survive the Participant, in equal shares, or should none survive, then to the Participant's executors or administrators. If a Participant so elects in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by the Participant, with respect to the beneficiary, subject to Equitable's rules then in effect. If at the death of a Participant there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. SECTION 4.06 DISQUALIFICATION. In the event that an annuity purchased hereunder with respect to a Participant fails to qualify as an Annuity as described in Section 1.03, Equitable shall have the right, upon receiving notice of such fact before the Retirement Date, to terminate participation with respect to such Participant under the Contract and pay to such Participant the amount in the Account maintained with respect to such Participant less a deduction for the appropriate part attributable to such Participant of any Federal income tax payable by Equitable which would not have been payable if such Participant had an Annuity under the Contract SECTION 4.07 FUTURE PARTICIPANTS. Equitable reserves the right at its sole discretion to curtail or prohibit further enrollment as Participants under the Contract of any individuals who are not currently participating under the Contract as of such date of curtailment or prohibition. SECTION 4.08 DEFERMENT. Payments by Equitable from the Participant's Guaranteed Interest Account pursuant to the provisions of Section 2.06, Sections 2.07 and 2.07A, and Section 2.09, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.05, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. Interest at the current Guaranteed Interest Rate for such Participant's Guaranteed Interest Account will be allowed on any such payment deferred for 30 days or more. Except as provided in this Section, payments by Equitable from the Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account pursuant to the provisions of Section 2.06, Sections 2.07 and 2.07A, and Section 2.09, or any commuted payments arising from a Variable Annuity Benefit pursuant to Section 3.05, will be made within seven days after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. During any period when (i) the sale of securities or the determination of the New Accumulation Unit Value or the Average New Annuity Unit Value is not reasonably practicable because an emergency, defined by the Securities and Exchange Commission, exists, or the New York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may by order permit postponement for the protection of persons having interests in the Separate Accounts, Equitable reserves the right: (a) to defer determination of Cash Values or Annuity Values and payment of Cash Values and Annuity Values, arising from an amount in a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (b) to defer payment of any portion of the death benefit arising from an amount in a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (c) to defer the payment of any Variable Annuity Benefit under the Contract or the application of any such Benefit to provide for any other payment called for by the Contract; or (d) in the event of (a) above, to defer application of such amounts to provide any Annuity Benefit permitted under the Contract. SECTION 4.09 ANNUAL NOTICE. At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Guaranteed Interest Account, (2) the total number of Accumulation Units credited to the Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, (3) the New Accumulation Unit Values, (4) the sum of the Cash Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account and (5) the amount of death benefit payable with respect to the Participant. After the Retirement Date Equitable will notify the Participant of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.10 CONTRACT HOLDER RESPONSIBILITY. The sole responsibility of the Contract Holder is to serve as party to the Contract. The Contract Holder will have no responsibility for the administration of any Plan, for payments to the Guaranteed NO. 11936P AMENDED BY PF 17009P - ------------- PF 17013P - PF 17018P - PF 17022P Page Thirteen Page Fourteen ------------- GENERAL PROVISIONS (CONTINUED) Interest Account, Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account, or any payments or other distributions hereunder. Equitable will deal with the Contract Holder in accordance with the terms and conditions of the custodial agreement pursuant to which the Contract Holder agreed to act as such and with the Contract and in such manner as the Contract Holder and Equitable may agree, without the consent of any other person. Any Employer making Contributions under the Contract shall be deemed to have adopted and accepted the custodial agreement as part of the Plan with respect to which such Contributions are made. SECTION 4.11 AGE. If the Annuitant's age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by Equitable will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. SECTION 4.12 RIGHT OF EMPLOYER. Notwithstanding any other provision of the Contract, except with respect to amounts attributable to Contributions made by a Participant, if any, as permitted under the terms of the Plan, the value of the Accounts maintained for each Participant shall, until distributed to the Participant or his beneficiaries in accordance with the terms of the Plan and the Contract, remain solely the property and rights of the Employer (without being restricted to the provision of benefits under the Plan) subject only to claims of the Employer's general creditors. This Section shall be construed and administered in accordance with Section 457(b)(6) of the Code and the regulations thereunder. This certificate was approved by the New York Insurance Department under an accelerated procedure to assist employers in complying with the United States Supreme Court decision in Arizona v. Norris. The Department has reserved the right to require changes to comply with applicable New York law and regulations. NO. 11936P AMENDED BY PF 17009P - ------------- PF 17013P - PF 17018P - PF 17022P Page Fourteen THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES For Participants in the State of New York, effective on your Participation Date, we have amended your Certificate issued under Group Annuity Contract No. 11932CP as follows: 1. With respect to the front page, the last paragraph is replaced by the following: THE ANNUITY BENEFITS PAYABLE UNDER THE CONTRACT ARE FIXED ANNUITY BENEFITS. 2. With respect to Page Three, the TABLE OF GUARANTEED VALUES, the Guaranteed Paid-Up Monthly Annuity at Age 65 Values for the Fixed Benefit Life Annuity Form With 10 Years of Payments Guaranteed is deleted. 3. With respect to PART I -- DEFINITIONS, SECTION 1.12 NORMAL FORM is amended to read as follows: PART I -- DEFINITIONS, SECTION 1.12 NORMAL FORM. The "Normal Form" of an Annuity Benefit under the Contract means a Period Certain Annuity. 4. With respect to PART I -- DEFINITIONS, SECTION 1.13 JOINT AND SURVIVOR LIFE ANNUITY FORM is deleted. 5. With respect to PART I -- DEFINITIONS, SECTION 1.14A LIFE ANNUITY FORM is deleted. 6. With respect to PART I -- DEFINITIONS, SECTION 1.14C PERIOD CERTAIN ANNUITY is amended to read as follows: SECTION 1.14C PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by Equitable that does not permit any prepayment of the unpaid principal. Any installment payments shall be made over a period which does not exceed the remaining life expectancy of the Participant. 7. With respect to PART I -- DEFINITIONS, SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS, the first paragraph is replaced by the following: VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business day immediately preceding such business day will constitute a Valuation Period. 8. With respect to PART I -- DEFINITIONS, SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS, the last three paragraphs are deleted. 9. With respect to PART I -- DEFINITIONS, SECTION 1.18 CASH VALUE, the following text replaces the paragraphs under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to a Participant, the term "Cash Value" means an amount equal to the Annuity Account Value after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Account Value to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of properly completed settlement election form in order to apply the Annuity Account Value to purchase a Period Certain Annuity, defined in Section 1.14C, where the PF 17040P certain period of such annuity is at least 10 years, or (v) the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Account Value to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such annuity is at least 15 years. At other times, the Cash Value equals the Annuity Account Value and less a withdrawal charge. 10. With respect to PART II -- PARTICIPANTS ACCOUNT, SECTION 2.07A PARTIAL WITHDRAWAL CHARGES, the following paragraph replaces the paragraph under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07B or (b) the Cash Value is equal to the Annuity Account Value, pursuant to Section 1.18. 11. With respect to PART III -- ANNUITY BENEFITS, SECTION 3.02 VARIABLE ANNUITY BENEFIT is deleted. 12. With respect to PART III -- ANNUITY BENEFITS, SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS, is amended to read as follows: SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects to receive the Cash Value of the certificate in a single sum, subject to Equitable's rules then in effect and any applicable requirements under the Code. Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate Participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Value. Equitable will have the right to require the Participant to furnish pertinent facts and determinations to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. 13. With respect to PART III -- ANNUITY BENEFITS, SECTION 3.04 AMOUNT OF ANNUITY BENEFITS is amended to read as follows: SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If a Participant elects pursuant to the first paragraph or third paragraph of Section 3.03 to receive an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be the Cash Value. The amount applied to provide an Annuity Benefit shall be reduced by any applicable tax on annuity considerations, as determined by Equitable. If such amount is applied with respect to such Participant, the balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the amounts the Participant has in the Divisions and the Annuity Account Value shall be zero. The Table of Guaranteed Annuity Payments sets forth the minimum amount of monthly income that $1,000 of Annuity PF 17040P Account Value will provide under the Contract, as indicated, as a Period Certain Amount. The amounts of income provided under the Fixed Annuity Benefit payable on the Period Certain Annuity are based on 3 1/2% interest. Equitable may change the monthly income amounts contained in the Table of Guaranteed Annuity Payments and the basis for determining such amounts, for new Participants, by at least 90 days advance notice to the Contract Holder and by an amendment to the Contract. Amounts required for periods certain not shown in the Table will be calculated by Equitable on 3 1/2% interest. 14. With respect to PART III -- ANNUITY BENEFITS, SECTION 3.05 PAYMENT OF ANNUITY BENEFITS, is amended to read as follows: SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payable under the Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Over payments by Equitable will be charged against and underpayments will be added to any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may make the payments (in the case of a minor, at a rate not exceeding $50 a month) to such the person or institution, and will thereupon be fully discharged from all liability with respect thereto. Upon election by a Participant pursuant to Section 3.03 of a Period Certain Annuity, such Participant may designate (with the right to change such designation) a person or persons to receive any payments that may become due after the death of the Participant. The payee may designate (with the right to change such designation and without the concurrence for any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's executors or administrators in accordance with the following paragraph. If at the death of a payee there is no designated person living entitled to receive any remaining payments or installments, Equitable will pay in a single sum to such payee's executors or administrators the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis. If the amount to be applied hereunder is less than $2,00 or would result in an initial payment of less than $20, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. PF 17040P TABLE OF GUARANTEED ANNUITY PAYMENTS FIXED ANNUITY BENEFIT PAYABLE ON THE PERIOD CERTAIN ANNUITY (Minimum Monthly Income per $1,000 of Annuity Account Value) PERIOD CERTAIN PERIOD CERTAIN (IN YEARS) MONTHLY INCOME (IN YEARS) MONTHLY INCOME ---------- -------------- ---------- -------------- 1 $84.65 11 $ 9.09 2 $43.06 12 $ 8.46 3 $29.19 13 $ 7.94 4 $22.27 14 $ 7.49 5 $18.12 15 $ 7.10 6 $15.35 16 $ 6.76 7 $13.38 17 $ 6.47 8 $11.90 18 $ 6.20 9 $10.75 19 $ 5.97 10 $ 9.83 20 $ 5.75 Any election, change, revocation, or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a commutation right under an Annuity Benefit is exercised, Equitable may defer payment in accordance with Section 4.08. 15. With respect to PART IV-- GENERAL PROVISIONS, SECTION 4.01 CONTRACT, a fourth paragraph is added as follows: The Contract is subject to the rules and regulations of the Deferred Compensation Board of the State of New York, and said rules and regulations are made a part thereof. 16. With respect to PART IV-- GENERAL PROVISIONS, SECTION 4.08 DEFERMENT is replaced by the following: SECTION 4.08 DEFERMENT. Payments by Equitable from the Participant's Guaranteed Interest Division pursuant to the provisions of Section 2.06, Sections 2.07, 207A and Section 2.09, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.05, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payments pursuant to Section 3.05. Interest at the current Guaranteed Interest Rate will be allowed on any such payment deferred for 30 days or more. Except as provided in this Section, payments by Equitable from the amounts the Participant has in the Separate Account Investment Division, pursuant to the provisions of Section 2.06, Sections 2.07, 2.07A and Section 2.09, will be made within seven days after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. During any period when (i) the sale of securities or the determination of the New Accumulation Unit Value is not reasonably practicable because an emergency, defined by the Securities and Exchange Commission, exists, or the New York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may, by order, permit postponement for the protection of persons having interests in the Separate Account, Equitable reserves the right: (a) to defer determination of Cash Value or Annuity Account Value and payment of Cash Value and Annuity Account Value, arising from an Investment Division of the Separate Account; (b) to defer payment of any portion of the death benefit arising from an Investment Division of the separate Account; or (c) in the event of (a) above, to defer application of such amounts to provide any Annuity Benefit permitted under the Contract. 17. With respect to PART IV -- GENERAL PROVISIONS, SECTION 4.09 ANNUAL NOTICE is amended to read as follows: SECTION 4.09 ANNUAL NOTICE. At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date (1) the amount the Participant has in the Guaranteed Interest Division, (2) the total number of Accumulation Units the Participant has in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Values, (4) the amount the Participant has in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the Cash Value and (6) the amount of death benefit payable with respect to the Participant. 18. With respect to PART IV -- GENERAL PROVISIONS, the following section is added: SECTION 4.09A QUARTERLY NOTICE. At least once during each calendar quarter up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing the Annuity Value in the Guaranteed Interest Division, Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division. Vice President SPECIMEN and Secretary SPECIMEN President PF 17040P THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES For Participants in the State of New York, effective January 1, 1987, or your Participation Date, whichever is the later, we have amended your Certificate issued under Group Annuity Contract No. 11932CP as follows: 1. With respect to the front page, the last paragraph is replaced by the following: THE ANNUITY BENEFITS PAYABLE UNDER THE CONTRACT ARE FIXED ANNUITY BENEFITS. 2. With respect to Page Three, the TABLE OF GUARANTEED VALUES, the Guaranteed Paid-Up Monthly Annuity at Age 65 Values for the Fixed Benefit Life Annuity Form With 10 Years of Payments Guaranteed is deleted. 3. With respect to PART I -- DEFINITIONS, SECTION 1.12 NORMAL FORM is amended to read as follows: PART 1 -- DEFINITIONS, SECTION 1.12 NORMAL FORM. The "Normal Form" of an Annuity Benefit under the Contract means a Period Certain Annuity. 4. With respect to PART I -- DEFINITIONS, SECTION 1.13 JOINT AND SURVIVOR LIFE ANNUITY FORM is deleted. 5. With respect to PART I -- DEFINITIONS, SECTION 1.14A LIFE ANNUITY FORM is deleted. 6. With respect to PART I -- DEFINITIONS, SECTION 1.14C PERIOD CERTAIN ANNUITY is amended to read as follows: SECTION 1.14C PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by Equitable that does not permit any prepayment of the unpaid principal. Any installment payments shall be made over a period which does not exceed the remaining life expectancy of the Participant. 7. With respect to PART I -- DEFINITIONS, SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS, the first paragraph is replaced by the following: VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business day immediately preceding such business day will constitute a Valuation Period. A business day is any day on which there is a sufficient degree of trading in the portfolio securities of a Separate Account that the New Accumulation Unit Value might be materially affected by changes in the value of the portfolio securities in a Separate Account, as determined by the Separate Account Committee or, if there is no Committee, by Equitable. 8. With respect to PART I -- DEFINITIONS, SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS, the last three paragraphs are deleted. 9. With respect to PART I -- DEFINITIONS, SECTION 1.18 CASH VALUE, the following text replaces the paragraphs with NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to a participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such annuity is at least 10 years, or (v) the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such annuity is at least 15 years. At other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. 10. With respect to PART II -- PARTICIPANT'S ACCOUNT, SECTION 2.07A PARTIAL WITHDRAWAL CHARGES, the following paragraph replaces the paragraph under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to a participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such annuity is at least 10 years, or (v) the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such annuity is at least 15 years. At other times, Equitable will withdraw from such Accounts an amount equal to the amount of partial withdrawal requested plus a withdrawal charge. 11. With respect to PART III -- ANNUITY BENEFITS, SECTION 3.02 VARIABLE ANNUITY BENEFIT is deleted. 12. With respect to PART III -- ANNUITY BENEFITS, SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS, is amended to read as follows: SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Values of such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects to receive the Cash Value of such Account in a single sum subject to Equitable's rules then in effect and any applicable requirements under the Code. Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Values of such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock and Money Market Account. Equitable will have the right to require the Participant to furnish pertinent facts and determinations to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. 13. With respect to PART III -- ANNUITY BENEFITS, SECTION 3.04 AMOUNT OF ANNUITY BENEFITS is amended to read as follows: SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If a Participant elects pursuant to the first paragraph or third paragraph of Section 3.03 to receive an Annuity Benefit in lieu of the Cash Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, the amount applied to provide the Annuity Benefit will be the Cash Values of such Accounts. The amount applied to provide an Annuity Benefit shall be reduced by any applicable tax on annuity considerations, as determined by Equitable. If such amount is applied with respect to such Participant, the balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained for such Participant shall terminate. The Table of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract, as indicated, as a Period Certain Annuity. The amounts of income provided under the Fixed Annuity Benefit payable on the Period Certain Annuity are based on 3 1/2% interest. Equitable may change the monthly income amounts contained in the Table of Guaranteed Annuity Payments and the basis for determining such amounts, for new Participants, by at least 90 days advance notice to the Contract Holder and by an amendment to the Contract. Amounts required for periods certain not shown in the Table will be calculated by Equitable on 3 1/2% interest. 14. With respect to PART III -- ANNUITY BENEFITS, SECTION 3.05 PAYMENT OF ANNUITY BENEFITS, is amended to read as follows: SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payable under the Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by Equitable will be charged against and underpayments will be added to any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may make the payments (in the case of a minor, at a rate not exceeding $50 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. Upon election by a Participant pursuant to Section 3.03 of a Period Certain Annuity, such Participant may designate (with the right to change such designation) a person or persons to receive any payments that may become due after the death of the Participant. The payee may designate (with the right to change such designation and without the concurrence for any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's executors or administrators in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, Equitable will pay in a single sum to such payee's executors or administrators the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis. If the amount to be applied hereunder is less than $2,000 or would result in an initial payment of less than $20, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. TABLE OF GUARANTEED ANNUITY PAYMENTS FIXED ANNUITY BENEFIT PAYABLE ON THE PERIOD CERTAIN ANNUITY (Minimum Monthly Income per $1,000 of Annuity Value)
PERIOD CERTAIN PERIOD CERTAIN (IN YEARS) MONTHLY INCOME (IN YEARS) MONTHLY INCOME -------------- -------------- -------------- -------------- 1 $84.65 11 $9.09 2 $43.06 12 $8.46 3 $29.19 13 $7.94 4 $22.27 14 $7.49 5 $18.12 15 $7.10 6 $15.35 16 $6.76 7 $13.38 17 $6.47 8 $11.90 18 $6.20 9 $10.75 19 $5.97 10 $ 9.83 20 $5.75
Any election, change, revocation, or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a commutation right under an Annuity Benefit is exercised, Equitable may defer payment in accordance with Section 4.08. 15. With respect to PART IV -- GENERAL PROVISIONS, SECTION 4.01 CONTRACT, a fourth paragraph is added as follows: The Contract is subject to the rules and regulations of the Deferred Compensation Board of the State of New York, and said rules and regulations are made a part thereof. 16. With respect to PART IV -- GENERAL PROVISIONS, SECTION 4.08 DEFERMENT is replaced by the following: SECTION 4.08 DEFERMENT. Payments by Equitable from the Participant's Guaranteed Interest Account pursuant to the provisions of Section 2.06, Sections 2.07 and 2.07A, and Section 2.09, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.05, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payments pursuant to Section 3.05. Interest at the current Guaranteed Interest Rate for such Participant's Guaranteed Interest Account will be allowed on any such payment deferred for 30 days or more. Except as provided in this Section, payments by Equitable from the Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account pursuant to the provisions of Section 2.06, Sections 2.07 and 2.07A and Section 2.09 will be made within seven days after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. During any period when (i) the sale of securities or the determination of the New Accumulation Unit Value is not reasonably practicable because an emergency, defined by the Securities and Exchange Commission, exists, or the New York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may by order permit postponement for the protection of persons having interests in the Separate Accounts, Equitable reserves the right: (a) to defer determination of Cash Values or Annuity Values and payment of Cash Values and Annuity Values, arising from an amount in a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (b) to defer payment of any portion of the death benefit arising from an amount in a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (c) in the event of (a) above, to defer application of such amounts to provide any Annuity Benefit permitted under the Contract. 17. With respect to PART IV -- GENERAL PROVISIONS, SECTION 4.09 ANNUAL NOTICE is amended to read as follows: SECTION 4.09 ANNUAL NOTICE. At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Guaranteed Interest Account, (2) the total number of Accumulation Units credited to the Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, (3) the New Accumulation Unit Values, (4) the sum of the Cash Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account and (5) the amount of death benefit payable with respect to the Participant. 18. With respect to PART IV -- GENERAL PROVISIONS, the following section is added: SECTION 4.09A QUARTERLY NOTICE. At least once during each calendar quarter up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing the Annuity Values of the Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account. VICE PRESIDENT SPECIMEN AND SECRETARY SPECIMEN PRESIDENT Attached to and made part of Group Annuity Contract No. 11932CP between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, effective July 1, 1986, said contract and riders are amended as follows: 1. With respect to PART I -- DEFINITIONS, the following section is added: SECTION 1.14C PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by Equitable which does not permit any prepayment of the unpaid principal. 2. With respect to SECTION 1.18 CASH VALUE, the following text replaces the paragraphs under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to a Participant, the term "Cash Value" with respect to such Participant's Guaranteed Interest Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account means an amount equal to the Annuity Values of such Accounts after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) the Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such Annuity is at least ten years. At all other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. 3. With respect to SECTION 2.07A PARTIAL WITHDRAWAL CHARGES, the following paragraph replaces the paragraph under NO WITHDRAWAL CHARGE: NO WITHDRAWAL CHARGE: With respect to partial withdrawals requested by a Participant, Equitable will withdraw from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Guaranteed Interest Account an amount equal to the lesser of (a) the full amount of partial withdrawal requested or (b) the sum of the Annuity Values for such Accounts, provided the request for partial withdrawal is made after the earliest of the following occurrences: (i) The later of (a) the completion of five Participation Years with respect to such Participant and (b) such Participant's attainment of age 59 years and 6 months, or (ii) the completion of twelve Participation Years with respect to such Participant, or (iii) the Participant's attainment of age 55, the completion of five Participation years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase an Eligible Annuity Certain, defined in Section 1.14B, or (iv) the completion of three Participation Years with respect to such Participant and the receipt by Equitable of a properly completed settlement election form in order to apply the Annuity Values to purchase a Period Certain Annuity, defined in Section 1.14C, where the certain period of such Annuity is at least ten years. At all other times, the sum of the Cash Values of such Accounts equals the sum of the Annuity Values of such Accounts, less a withdrawal charge. Agreed to by: UNITED STATES TRUST COMPANY THE EQUITABLE LIFE ASSURANCE OF NEW YORK SOCIETY OF THE UNITED STATES By ________________________________ By ______________________________ President Title _____________________________ By ______________________________ Vice President and Secretary Dated _____________________________ Date of Issue ___________________ At ________________________________ PF 17033CP THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective July 1, 1986, or your Participation Date, whichever is the later, we have amended your Certificate issued under Group Annuity Contract No. 11932CP as follows: 1. With respect to PART I - Definitions, the following section is added: SECTION 1.14C PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies providing a fixed sum payable for a fixed period. The payments commence on the date as of which the Period Certain Annuity is purchased and terminate with the last payment at the end of such period. 2. With respect to SECTION 1.18 CASH VALUES: The term "an Eligible Annuity Certain defined in Section 1.14B" is replaced by "an Eligible Annuity Certain defined in Section 1.14B, or (iv) the completion of 3 Participation Years with respect to such Participant, and the partial withdrawal is to be applied to purchase a Period Certain Annuity, payable for not less than 10 years, as defined in Section 1.14C". 3. With respect to SECTION 2.07A PARTIAL WITHDRAWAL CHARGES: The term "an Eligible Annuity Certain Defined in Section 1.14B" is replaced by "an Eligible Annuity Certain defined in Section 1.14B, or (iv) the completion of 3 Participation Years with respect to such Participant, and the partial withdrawal is to be applied to purchase a Period Certain Annuity, payable for not less than 10 years, as defined in Section 1.14C". Vice President SPECIMEN and Secretary SPECIMEN President PF 17033P THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Your certificate issued under Group Annuity Contract No. 11932CP is amended as follows: With respect to the language on the front page, the following statement is deleted: "THIS CONTRACT MAY NOT BE SUITABLE FOR A PARTICIPANT IF THE ONLY CONTRIBUTION TO BE MADE ON SUCH PARTICIPANT'S BEHALF IS A SUBSTANTIAL SINGLE SUM CONTRIBUTION." Vice President SPECIMEN and Secretary SPECIMEN President PF17031P THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York, New York 10016 Group Annuity Contract Between The Equitable Life Assurance Society of the United States and United States Trust Company of New York THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES AGREES o TO ALLOCATE the Contributions made to the Contract to the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account or the Fixed Income Account maintained for the Participant, in accordance with Sections 2.02 and 2.03, or in part to any one, as directed by the Owner, o TO APPLY the amount in the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Fixed Income Account at the Retirement Date to provide the Participant with an Annuity Benefit or a Cash Value benefit if the Participant is then living, and o TO PROVIDE the Owner with the other rights and benefits of this certificate. The agreements are subject to the provisions of this certificate. TEN DAYS TO EXAMINE CERTIFICATE - The Owner may terminate participation under the Contract and cancel this certificate by returning it to Equitable within ten days after receipt of it. Upon such cancellation, Equitable will refund any Contribution made to Equitable on behalf of a Participant under the Contract, plus or minus any investment gain or loss experienced in the Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account from the date such Contribution is allocated to such Account to the date of such cancellation. SPECIMEN Vice President SPECIMEN President and Secretary ASSETS HELD IN CONNECTION WITH THE CONTRACT MAY BE HELD IN SEPARATE ACCOUNTS MAINTAINED BY EQUITABLE AND MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THE CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF SEPARATE ACCOUNT A. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN SEPARATE ACCOUNT A IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.16 IS 5% OR 3 1/2%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE OF 1.75% FOR INVESTMENT MANAGEMENT, FINANCIAL ACCOUNTING, THE ANNUITY RATE GUARANTEE AND MINIMUM DEATH BENEFIT, EXPENSES AND EXPENSE RISK, BUT AFTER ANY DEDUCTIONS TO PROVIDE FOR TAXES. NO. 11938C-C CONTENTS Part I - Definitions Page 2 Part II - Participant's Account Page 5 Part III - Annuity Benefits Page 8 Part IV - General Provisions Page 11 Equitable certifies that the Participant as named on Page 3 of the Certificate is included under the Group Annuity Contract ("the Contract") designated on Page 3 of the certificate, all pertinent provisions of which are set forth below. The Contact is issued in consideration of the payment to Equitable of the Contributions made under the Contract. The provisions on the following pages are part of this certificate. PART I - DEFINITIONS SECTION 1.01 EMPLOYER. The term "Employer" means the employer adopting the Plan, or any employer that assumes in writing the obligation of the Plan. A sole proprietor is deemed to be his or her own Employer and a partnership is deemed to be the Employer of each partner. SECTION 1.02 PLAN. The term "Plan" means a defined contribution plan adopted by the Employer that is intended to meet the requirements for qualification under Section 401(a) of the Code. SECTION 1.02A TRUSTEED PLAN. The term "Trusteed Plan" means a Plan under which there is maintained a trust forming a part of the Plan (other than the trust agreement described in Section 4.10 of this Contract). SECTION 1.02B TRUSTEE. The term "Trustee" means the person or persons named as trustee under a Trusteed Plan and such Trustee's successors. SECTION 1.03 ANNUITY. The term "Annuity" means an annuity purchased in accordance with the terms of the Plan and which is intended to meet the requirements for qualification under Section 401(a) of the Code. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Section 3.04. SECTION 1.05 PARTICIPANT. The term "Participant" means a person who has been enrolled by Equitable under the Contract and for whom the Employer has purchased an Annuity under the Contract. A person shall become enrolled under the Contract upon receipt by Equitable of an enrollment form made available by Equitable and completed in a manner satisfactory to Equitable. SECTION 1.05A OWNER. The term "Owner" means the Owner of a certificate issued under the Contract is as stated in the enrollment form, or later changed. Notwithstanding any provisions in the certificate to the contrary, only the Owner can exercise all the rights under the certificate while the Participant is living. The Owner does not need the consent of anyone who has only a conditional or future ownership interest in a certificate. While the Participant is living, an Owner of a certificate issued on behalf of the Participant may change the Owner by written notice satisfactory to Equitable. The change will take effect on the date the Owner signs the notice, except it will not apply to any payment Equitable makes or other actions Equitable takes before Equitable receives the notice. SECTION 1.06 CONTRIBUTION. The term "Contribution" means a payment made to Equitable for a Participant with respect to an Annuity purchased for such Participant under the Contract. Equitable is under no obligation to accept any Contribution less than $20.00. SECTION 1.07 PARTICIPATION DATE. The term "Participation Date" with respect to a Participant means the date as of which Equitable has enrolled such Participant under the terms of the Contract as shown on Page 3 of the certificate. SECTION 1.08 PARTICIPATION YEAR. The term "Participation Year" with respect to the Participant means the twelve month period beginning on (i) the Participation Date and (ii) each anniversary thereof, unless otherwise agreed to in writing by Equitable. SECTION 1.09 CLASS OF PARTICIPANTS. The term "Class of Participants" refers to all Participants whose Participation Date is in the same calendar year. 11938C-C -------- Page Two Page Three ---------- DEFINITIONS (CONTINUED) SECTION 1.10 GUARANTEED INTEREST RATE. With regard to a Fixed Income Account, the term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amounts in such Account. Interest accrues daily. The Guaranteed Interest Rate will never be less than 4% per annum. For each Class of Participants, Equitable will from time to time establish and make available for new Participants (i) an Initial Guaranteed Interest Rate, (ii) one or more minimum Guaranteed Interest Rates and (iii) the applicable effective period(s) for such Rates. A new Class of Participants will be established effective with the effective date of the occurrence of (i), (ii) or (iii) above or any combination thereof. For the period (not to exceed one year) next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent period (not to exceed one year) Equitable may determine for each established Class of Participants a Guaranteed Interest Rate and duration which exceeds the applicable minimum Guaranteed Interest Rate. Equitable will notify each Participant in writing of the applicable Guaranteed Interest Rate and duration. Equitable reserves the right to combine one or more Classes of Participants into a single Class of Participants, provided such Classes were initially established during a continuous period of time. SECTION 1.11 RETIREMENT DATE. The term "Retirement Date" means the date on which the Participant attains the retirement age specified in the Participant's enrollment form pursuant to the terms of the Plan. Before the Retirement Date, the Participant may elect to change the Retirement Date to any other Retirement Date permitted under the Plan, which may be any date after the filing of the election other than the 29th, 30th, or 31st day of any month. Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Processing Office. SECTION 1.12 NORMAL FORM. The "Normal Form" of an Annuity Benefit under the Contract means the Fixed Annuity Benefit payable on the Life Annuity Form as defined in Sections 3.01 and 1.14, with 10 years of payments guaranteed. SECTION 1.13 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depends is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by the Owner. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.14 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.14A ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by Equitable, which annuity may not provide for payments beyond the life expectancy of the Participant or the joint and last survivor life expectancy of the Participant and the Participant's designated beneficiary. Such annuity shall extend beyond the Participant's attainment of 59 years and six months and shall not permit any prepayment of principal prior to the Participant's attainment of age 59 years and six months. Life expectancy and joint and last survivor life expectancy are computed by the use of the return multiples contained in section 1.72-9 of the regulations under the Code. If the Participant's spouse is not the designated beneficiary, at least 50 percent of the present value of the amount available for distribution under an Eligible Annuity Certain must be paid within the life expectancy of the Participant. SECTION 1.14B PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by Equitable that does not permit any prepayment of the unpaid principal. SECTION 1.15 THE SEPARATE ACCOUNTS. The terms "Separate Accounts" means the following separate investment accounts maintained by Equitable to which portions of its assets have been allocated for the Contract and certain other contracts: Name Investments ---- ----------- Separate Account A Primarily common stock and other equity-type investments Separate Account E Primarily short-term money market instruments. Separate Account J Primarily common stocks and other equity-type investments, publicly traded debt securities and short-term money market instruments. Separate Account K Primarily common stocks issued by high quality small and intermediate size companies with strong growth prospects. Equitable reserves the right to withdraw from any Separate Account and allocate to another Separate Account assets determined by Equitable to be associated with the class of contracts to which the Contract belongs. In any such event, to the extent practicable and permissible under applicable laws and regulations, the withdrawal shall be made by withdrawing the same percentage of each investment in the Separate Account, with appropriate adjustments to avoid odd lots and fractions. On and after the date of any such withdrawal the reference in the Contract to such Separate Account shall mean such other Separate Account to which the withdrawal assets were allocated. 11938C-C ---------- Page Three Page Four --------- DEFINITIONS (CONTINUED) It is contemplated that investments in the Separate Accounts will, at most times, consist primarily of the types of investments indicated above. Equitable may, however, at its discretion invest the assets of any Separate Account in any investment permitted by applicable law. Equitable may rely conclusively on the opinion of counsel (including attorneys in its employ) as to what investments it is permitted by law to make. In lieu of making such investments directly, Equitable reserves the right to operate any Separate Account as a unit investment trust, or in any other form permitted by law, investing all or a part of its assets in shares or units of a fund, the investment adviser of which may be Equitable or controlled by Equitable. The fund assets would be invested as provided above with respect to the Separate Account. Equitable reserves the right: (i) to cause the registration or deregistration of any Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run any Separate Account under direction of a committee, and to discharge such committee at any time; and (iii) restrict or eliminate any voting rights of participants or other persons who have voting rights as to the Separate Accounts. Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.16. The assets of the Separate Accounts are the property of Equitable; however, the portion of the assets of each Separate Account equal to the reserves and other contract liabilities with respect to such Account shall not be chargeable with liabilities arising out of any other business Equitable may conduct. Equitable reserves the right to transfer assets of a Separate Account in excess of such reserves and contract liabilities to another Separate Account or to the general account of Equitable. SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS. VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business day immediately preceding such business day will constitute a Valuation Period. A business day is any day on which there is a sufficient degree of trading in the portfolio securities of a Separate Account that the New Accumulation Unit Value or New Annuity Value might be materially affected by changes in the value of the portfolio securities in a Separate Account, as determined by the Separate Account Committee or, if there is no committee, by Equitable. NET INVESTMENT FACTOR: For each Separate Account the Net Investment Factor for a Valuation Period is (a) divided by (b), minus (c), where (a) is (1) the value of the assets in the Separate Account at the close of business of the preceding Valuation Period plus (2) the investment income and the capital gains, realized or unrealized, credited to the assets of the Separate Account in the Valuation Period for which the Net Investment Factor is being determined, minus (3) the capital losses, realized or unrealized, charged against such assets in such Valuation Period, minus (4) any amount charged against the Separate Account in such Valuation Period for taxes or for amounts set aside by Equitable as a reserve for taxes attributable to the maintenance or operation of the Separate Account; (b) is the value of the assets in the Separate Account at the close of business of the preceding Valuation Period; and (c) is the daily charge, for each calendar day in such Valuation Period of .00004837 for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The value of the assets in the Separate Accounts, referred to above, shall be taken at their fair market value, or where there is no readily available market, their fair value, as determined in accordance with accepted accounting practices and applicable laws and regulations. ACCUMULATION UNIT: The Accumulation Unit is a unit used in determining the value of a Participant's interest in the Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account on or before the Retirement Date. NEW ACCUMULATION UNIT VALUE: The initial New Accumulation Unit Values for the Separate Accounts have been established as follows: Account Value Date ------- ----- ---- Separate Account A $10.00 As of November 1, 1968 Separate Account E $10.00 As of September 4, 1974 Separate Account J $10.00 As of May 1, 1984 Separate Account K $10.00 As of May 1, 1984 The New Accumulation Unit Value for each subsequent Valuation Period is the New Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such subsequent Valuation Period. ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable from Separate Account A under a Variable Annuity Benefit. NEW ANNUITY UNIT VALUE: The initial New Annuity Unit Value for Separate Account A has been established at $1.00 as of November 1, 1968. The Annuity Unit Value for any subsequent Valuation NO. 11938C-C --------- Page Four Page Five --------- DEFINITIONS (CONTINUED) Period is the New Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3 1/2%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE NEW ANNUITY UNIT VALUE: The Average New Annuity Unit Value for Separate Account A for a calendar month is equal to the average of the New Annuity Unit Values for the Valuation Periods ending in such month. SECTION 1.17 ANNUITY VALUE. The term "Annuity Value" with respect to a Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, means the amount in such Accounts pursuant to Sections 2.02 and 2.03. SECTION 1.18 CASH VALUE. With respect to the Participant, the term "Cash Value" with respect to such Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account, and Money Market Account means an amount equal to the greater of (i) or (ii) below: (i) the Annuity Value of such Accounts less 6% of the Contributions made during the current and five prior Participation Years, which had not been previously withdrawn pursuant to Section 2.07A. (ii) the sum of (a) the Free Corridor Amount as defined in Section 2.07B and (b) 94% of (the Annuity Value of such Accounts less the Free Corridor Amount). SECTION 1.18A CODE. The term "Code" means the Internal Revenue Code of 1954, as now or hereafter amended. PART II - PARTICIPANT'S ACCOUNT SECTION 2.01 CONTRIBUTIONS. The Employer or the Trustee is to make Contributions from time to time on such dates and in such amounts as determined by the Employer or the Trustee pursuant to the terms of the Plan. The Employer or the Trustee is to specify the Participant with respect to whom each such Contribution is being made and the amount to be allocated to the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Fixed Income Account. If the Plan provides, and subject to any Code restrictions, the Owner may, with Equitable's agreement, transfer to the Contract any amount held with respect to such Participant under a plan which is intended to meet the requirements for qualification under Section 401(a) of the Code ("Transferred Funds"). Equitable will issue for each Participant an individual certificate setting forth a statement in substance of the benefits to which such Participant is entitled under the Contract. SECTION 2.02 STOCK, BALANCED, AGGRESSIVE STOCK AND MONEY MARKET ACCOUNTS. Equitable maintains a Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the (1) Stock Account becomes part of Separate Account A, (2) Balanced Account becomes part of Separate Account J, (3) Aggressive Stock Account becomes part of Separate Account K and (4) Money Market Account becomes part of Separate Account E. Any amount withdrawn from an Account will no longer be part of the applicable Separate Account. On any date when an amount is allocated to or withdrawn from an Account, the Account will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the New Accumulation Unit Value for the appropriate Separate Account for the Valuation Period which includes that date. The number of Units in an Account on any date is equal to (i) the sum of any Accumulation Units that have been allocated to the Account minus (ii) the sum of any Accumulation Units that have been withdrawn from that Account. The amount in the Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account on any date is equal to the product of (i) the number of Accumulation Units in such Account on that date and (ii) the New Accumulation Unit Value for the appropriate Account for the Valuation Period which includes that date. SECTION 2.03 FIXED INCOME ACCOUNT. Equitable maintains a Fixed Income Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the Fixed Income Account becomes part of the general assets of Equitable, which supports the guarantees of the Contract and other contracts. The amounts in the Fixed Income Account at any time is equal to the sum of all amounts that have been allocated to such Fixed Income Account pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn pursuant to Sections 2.07, 2.07A, and Section 2.08 from such Account, and transferred pursuant to Section 2.05 from the Fixed Income Account, and less the sum of any annual administrative charges accrued but not made. Equitable 11938C-C --------- Page Five Page Six -------- PARTICIPANT'S ACCOUNT (CONTINUED) guarantees that the amount in the Fixed Income Account at any time before the Retirement Date will not be less than the sum of all amounts allocated to such Account pursuant to Section 2.04 or transferred to such Account pursuant to Section 2.05 and less the sum of all amounts that have been withdrawn from such Account pursuant to Sections 2.07 and 2.07A, and transferred from such Account pursuant to Section 2.05, all accumulated at 4% interest, compounded annually. In any Participation Year in which no Contribution is allocated to the Fixed Income Account, the amount in such Account at the end of the Participation Year shall not be less than the amount in such Account at the beginning of the Participation Year plus the sum of all amounts transferred to such Account pursuant to Section 2.05 less the sum of all amounts withdrawn and transferred out of such Account pursuant to Sections 2.07, 2.07A, and Section 2.05, all accumulated at 4% interest, compounded annually. The Fixed Income Account for a Participant terminates on the earliest of (i) the Retirement Date, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO ACCOUNT. Each Contribution made with respect to a Participant pursuant to Section 2.01 will be allocated, as of the date by which Equitable has received both such Contribution and direction as to its allocation, to the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account or in part to each, at the sole direction of the Owner as specified to Equitable, unless the Owner transfers to the Participant the right to allocate Contributions to such Accounts maintained for such Participant, provided that the percentage allocated to each Account is a whole number. Any amount that the Owner has directed to be transferred to the Fixed Income Account, Stock Account, Balanced Account or Aggressive Stock Account pursuant to Section 2.05 will be allocated as of the date of such transfer to the appropriate Account maintained for such Participant. Interest is allocated to the Fixed Income Account at the end of each Participation Year, at the time of each transfer or withdrawal pursuant to Sections 2.05 and 2.07, at the time of application of amounts in the Fixed Income Account to provide Annuity Benefits, upon termination of participation pursuant to Section 2.06, and upon death of the Participant pursuant to Section 2.09. SECTION 2.05 TRANSFERS AMONG ACCOUNTS. At any time before a Participant's Retirement Date, the Owner, unless the Owner transfers to the Participant the right to transfer all or part of the amounts maintained for the Participant to one or more of the other Accounts maintained for such Participant, upon written request, may transfer all or part of the amounts maintained for the Participant to one or more of the other Accounts maintained for such Participant as follows: (1) amounts in the Fixed Income Account, Stock Account, Balanced Account and Aggressive Stock Account may be transferred among such Accounts; (2) amounts in the Money Market Account may be transferred to the other Accounts. Such transfers will be made as of the date Equitable receives such request, and will be subject to Equitable's rules in effect at the time of transfer. No transfers are permitted from the Fixed Income Account, Stock Account, Balanced Account or Aggressive Stock Account maintained for the Participant to the Money Market Account. Notwithstanding the above, transfers to the Balanced Account may be prohibited by Equitable upon 30 days written notice to the Owner. SECTION 2.06 TERMINATION OF PARTICIPATION. Subject to any applicable restrictions under the terms of the Plan, on or before a Participant's Retirement Date, the Owner may elect by written notice to terminate participation under the Contract. Upon receipt of such notice, Equitable will determine the Cash Value, as of the date Equitable received such notice, of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained for such Participant. The payment of such Cash Value to the Owner may be deferred by Equitable in accordance with the provisions of Section 4.08. Prior to a Participant's Retirement Date, Equitable reserves the right to withdraw the Annuity Value of the Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, pay to the Owner such Annuity Values and terminate such Participant's participation under the Contract. This right may be exercised with respect to the Participant only if both (i) no Contributions have been made under the Contract during the last three Participation Years, and (ii) the sum of the Annuity Values is $500 or less. Equitable reserves the right to terminate a Participant's participation under the Contract if at least 120 days have elapsed since the issue date shown on the certificate issued to such Participant under the Contract and no Contributions have been made under the Contract with respect to such Participant. Upon payment of such Cash Values or Annuity Values, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Cash Values or Annuity Values arose. SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under the terms of the Plan, the Owner may elect by written notice to Equitable to make a partial withdrawal from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Fixed Income Account maintained for such Participant before such Participant's Retirement Date. Upon withdrawal pursuant to Section 2.07, Equitable will pay the lesser of the sum of the Cash Values of such Accounts or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by the Owner. Unless instructed otherwise, the amount withdrawn (including the amount of any withdrawal charge) will be allocated between such Accounts in proportion to the Annuity Value of each such Account. Upon any payment made at the direction of the Owner pursuant to Section 2.07, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. 11938C-C -------- Page Six Page Seven ---------- PARTICIPANT'S ACCOUNT (CONTINUED) Payments made at the direction of the Owner pursuant to Section 2.07 may be deferred by Equitable in accordance with the provisions of Section 4.06. Equitable is under no obligation to process any request for partial withdrawal of less than $300. SECTION 2.07A PARTIAL WITHDRAWAL CHARGES. With respect to partial withdrawals requested by the Owner, there will be no withdrawal charge if the amount of the partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07B. In that case, Equitable will withdraw from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account, and Fixed Income Account and pay, at the direction of the Owner, an amount equal to the partial withdrawal requested. However, if the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge, if applicable. Such withdrawal charge will be calculated in the following manner: (a) Withdrawals of Contributions made on behalf of the Participant during the current and five prior Participation Years will be subject to a charge of 6% of the amount withdrawn (including such charge). (b) Withdrawals of other amounts will not be subject to any withdrawal charges. Equitable will pay, at the direction of the Owner, the lesser of a) the amount requested or b) the sum of Cash Values of the Accounts maintained on the Participant's behalf. For purposes of determining withdrawal charges described in this Section, amounts withdrawn up to the Free Corridor Amount will not be considered a withdrawal of any Contributions. Any excess withdrawals, i.e. those pursuant to item (ii) above, shall be considered withdrawals of Contributions in the order received, with the older Contributions first. SECTION 2.07B FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" with respect to the Owner means an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Values of the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Fixed Income Account over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the current Participation Year with respect to the Participant. SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Participation Year before a Participant's Retirement Date, Equitable will withdraw from the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account at the end of that Participation Year and (ii) any withdrawals made from such Accounts pursuant to Section 2.07 during that Participation Year. The charge will be allocated among the Stock Account, Aggressive Stock Account, Money Market Account and Fixed Income Account in proportion to the Annuity Values of each such Account, at the end of the Participation Year. As of a Participant's Retirement Date and before application of the Annuity Values or Cash Values of such Participant's account pursuant to Section 3.03, or upon termination of such Account pursuant to Section 2.06 or Section 2.09 during a Participation Year, Equitable will withdraw the administrative charge described in this Section for the applicable part of that Participation Year. SECTION 2.09 DEATH BENEFIT. If a Participant dies while Accounts for such Participant are maintained under the Contract, Equitable, upon receipt of due proof of such death, will pay to the beneficiary the death benefit payable with respect to such Participant. If the beneficiary under the certificate is the Trustee, the Trustee may, subject to the terms of the Plan, change the beneficiary within 31 days after the Equitable receives due proof of the Participant's death. The change shall be made in the same manner and subject to the same provisions as apply to a change of beneficiary during the Participant's lifetime. If the Trustee changes the beneficiary of the certificate after the death of the Participant according to the terms of the Plan, the Trustee may elect an Annuity Benefit on any annuity form offered by Equitable, subject to Equitable's rules then in effect, for the benefit of the beneficiary. The beneficiary may not revoke or change any election made by the Trustee. If the Trustee does not make an election, the beneficiary may make such election for the beneficiary's own benefit. If the beneficiary under the certificate is not the Trustee, and the Participant is married at the time of death of such Participant, Equitable will pay the death benefit under the certificate to the spouse of the Participant in the form of a Life Annuity, unless the spouse of the Participant makes an election for a single sum payment or for an Annuity Benefit on any other annuity form offered by the Equitable, subject to Equitable's rules then in effect. If the Equitable determines that the Participant is married at the time of death, the beneficiary under the certificate is not the spouse of such Participant and the spouse of such Participant has not given written consent to the designation of another beneficiary, Equitable shall have the right to pay the death benefit to the spouse of such Participant instead of the named beneficiary, if such action is required to comply with Federal law. The amount of the death benefit with respect to a Participant at any time prior to the Retirement Date is equal to the greater of (i) the sum of the Annuity Values of the Fixed Income Account, Stock 11938C-C ---------- Page Seven Page Eight --------- PARTICIPANT'S ACCOUNT (CONTINUED) Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract for such Participant and (ii) the minimum death benefit with respect to such Participant. Such minimum death benefit is the sum of all Contributions made with respect to such Participant pursuant to Section 2.01 less an adjustment for any withdrawals made pursuant to Section 2.07 from the Accounts maintained under the Contract for such Participant. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount being withdrawn is to the Annuity Values then in the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract for such Participant. The amount of any death benefit payable with respect to a Participant, to the extent such Account is sufficient therefore, will be withdrawn from the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained with respect to such Participant under the Contract. Upon such payment, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Annuity Values arose. PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of Separate Account A. The amount of the first, second and third payments under any Variable Annuity Benefit provided under the Contract with respect to a payee is the monthly amount provided with respect to the payee pursuant to Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average New Annuity Unit Value for the second calendar month immediately preceding the date of the payment. The fourth and subsequent annuity payments under a Variable Annuity Benefit will not be increased or decreased in amount because of mortality or expense experience. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the New Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Values of such Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock and Money Market Account shall be applied to provide the Normal Form of Annuity Benefit, unless the owner on behalf of the Participant and, if applicable, the Participant's spouse elects (i) to receive the Cash Value of such Accounts in a single sum or (ii) to apply such Annuity Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by Equitable, subject to Equitable's rules then in effect, the terms of the Plan, and any applicable requirements under the Code. Equitable will provide notice and election forms to the Owner not more than six months before the Participant's Retirement Date. If the Owner elects to terminate a Participant's participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Values of such Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account. Equitable has the right to require the Owner to furnish pertinent information to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. Equitable may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If the Owner elects to receive an Annuity Benefit in lieu of the Cash Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, the amount applied to provide the Annuity Benefit will be (i) the Annuity Values of such Accounts, if the payments under the annuity form elected are contingent upon the survival of a person, or (ii) the Cash Values of such Accounts if the payments under the annuity form elected are not contingent upon the survival of a person. If such amount is applied on or after the completion of five Participation Years with respect to such Participant: (1) the balance, less any Contribution made on behalf of the Participant during the current and five prior Participation Years, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown herein or (ii) Equitable's current individual annuity rates for payment of 11938C-C ---------- Page Eight Page Nine --------- ANNUITY BENEFITS (CONTINUED) proceeds whichever rates would provide a larger benefit with respect to payee; (2) any Contributions made on behalf of the Participant during the current and five prior Participation Years shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity payments shown herein or (ii) Equitable's current individual rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. If the amount applied to provide an Annuity Benefit is applied before the completion of five Participation Years with respect to a Participant, the balance, after any applicable tax on annuity considerations, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown herein or (ii) Equitable's current individual annuity rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained for such Participant shall terminate. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (100% continuation). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on 3 1/2% interest and the 1983 Individual Annuity Mortality Table adjusted to a unisex basis based on a 50-50 split of males and females. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on the projected 1983 Basic Table adjusted to a unisex basis based on a 50-50 split of males and females and an Assumed Based Rate of Net Investment Return of 3 1/2% or 5%, whichever applies pursuant to Section 1.16. The Assumed Base Rate of Net Investment Return is 5% for certificates issued for delivery in New York. Equitable may change the monthly income amounts contained in the Tables of Guaranteed Annuity Payments and the basis for determining such amounts, for new Participants, by at least 90 days advance notice to the Contract Holder and by an amendment to the Contract. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on 3 1/2% interest and the 1983 Individual Annuity Mortality Table adjusted to a unisex basis based on a 50-50 split of males and females if such annuity form provides for a Fixed Annuity Benefit, and on the projected 1983 Basic Table adjusted to a unisex basis based on a 50-50 split of males and females and an Assumed Base Rate of Net Investment Income Return of 5% or 3 1/2%, whichever applies pursuant to Section 1.16, if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payable under the Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. The amount of the overpayments by Equitable will be charged against, and the amount of the underpayments will be added to, any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, or (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may, unless the Plan to provide to the contrary, make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If an annuity form made available by Equitable provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Upon election by the Owner on behalf of the Participant and, if applicable, the Participant's spouse, pursuant to Section 3.03 of an annuity form providing payments for a period certain, such Owner may designate (with the right to change such designation, in accordance with the terms of the Plan) a person or persons to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person, unless the Plan provides to the contrary) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's executors or administrators in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, Equitable 11938C-C --------- Page Nine Page Ten -------- ANNUITY BENEFITS (CONTINUED) will pay in a single sum to such payee's executors or administrators the commuted value of any remaining payments or installments. The commuted value of any such remaining payments or installments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis. If the amount to be applied hereunder is less than $3,500, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later Equitable will require satisfactory evidence of the age of any person upon whose life an annuity form depends.
TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM - 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Value) ------ -------- -------- -------- ------- -------- -------- -------- -------- --------- --------- -------- Age 60 61 62 63 64 65 66 67 68 69 70 ------ -------- -------- -------- ------- -------- -------- -------- -------- --------- --------- -------- 60 4.54 4.58 4.62 4.66 4.70 4.74 4.77 4.81 4.84 4.88 4.91 61 4.62 4.67 4.71 4.76 4.81 4.84 4.88 4.91 4.95 4.99 62 4.72 4.76 4.81 4.85 4.90 4.94 4.98 5.08 5.06 63 4.81 4.86 4.91 4.96 5.01 5.06 5.10 5.14 64 4.92 4.97 5.02 5.08 5.13 5.17 5.22 65 5.03 5.09 5.15 5.20 5.26 5.31 66 5.15 5.21 5.27 5.33 5.39 67 5.28 5.34 5.40 5.47 68 5.41 5.48 5.55 69 5.56 5.63 70 5.71 ------ -------- -------- -------- ------- -------- -------- -------- -------- --------- --------- --------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM-100% CONTINUATION - ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3 1/2% (Minimum Monthly Income per $1,000 of Annuity Value) ------ -------- -------- -------- ------- -------- -------- -------- -------- --------- --------- -------- Age 60 61 62 63 64 65 66 67 68 69 70 ------ -------- -------- -------- ------- -------- -------- -------- -------- --------- --------- -------- 60 4.40 4.44 4.58 4.51 4.55 4.58 4.61 4.65 4.68 4.71 4.74 61 4.48 4.52 4.56 4.60 4.64 4.67 4.71 4.74 4.78 4.81 62 4.56 4.60 4.65 4.69 4.73 4.77 4.80 4.84 4.85 63 4.65 4.69 4.74 4.78 4.83 4.87 4.91 4.95 64 4.74 4.79 4.84 4.89 4.93 4.98 5.02 65 4.85 4.90 4.95 5.00 5.05 5.10 66 4.95 5.01 5.06 5.11 5.17 67 5.07 5.12 5.18 5.24 68 5.19 5.25 5.32 69 5.32 5.39 70 5.46 ------ -------- -------- -------- ------- -------- -------- -------- -------- --------- --------- --------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM-100% CONTINUATION - ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 5% (Minimum Monthly Income per $1,000 of Annuity Value) ------ -------- -------- -------- ------- -------- -------- -------- -------- --------- --------- -------- Age 60 61 62 63 64 65 66 67 68 69 70 ------ -------- -------- -------- ------- -------- -------- -------- -------- --------- --------- -------- 60 5.27 5.30 5.34 5.37 5.41 5.44 5.47 5.51 5.54 5.57 5.59 61 5.34 5.38 5.42 5.46 5.49 5.53 5.57 5.60 5.63 5.66 62 5.42 5.46 5.50 5.54 5.58 5.62 5.65 5.69 5.73 63 5.50 5.55 5.59 5.63 5.67 5.71 5.75 5.79 64 5.59 5.64 5.69 5.73 5.78 5.82 5.86 65 5.69 5.74 5.79 5.84 5.89 5.93 66 5.79 5.85 5.90 5.95 6.00 67 5.90 5.96 6.02 6.08 68 6.02 6.08 6.15 69 6.15 6.22 70 6.29 ------ -------- -------- -------- ------- -------- -------- -------- -------- --------- --------- --------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) VARIABLE ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET Age FIXED ANNUITY BENEFIT INVESTMENT RETURN IS --- --------------------- --------------------------- 3 1/2% 5% ----- ---- 60 5.29 5.08 5.97 61 5.41 5.19 6.08 62 5.55 5.31 6.20 63 5.69 5.44 6.33 64 5.85 5.58 6.46 65 6.01 5.73 6.61 66 6.19 5.89 6.77 67 6.37 6.06 6.94 68 6.58 6.24 7.12 69 6.79 6.43 7.31 70 7.02 6.64 7.52 Equitable will notify the payee under a Variable Annuity Benefit of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each variable payment. Any election, change, revocation or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a commutation right under an Annuity Benefit is exercised, Equitable may defer payment in accordance with Section 4.08. 11938C-C -------- Page Ten Page Eleven ----------- PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT. The Contract constitutes the entire agreement between the parties and the provisions of the Contract alone will govern with respect to the rights and obligations of Equitable. The provisions of the Contract will be applied separately with respect to each Participant. Nothing in the enrollment form referred to in Section 1.05, the Plan or trust agreement referred to in Section 4.10 nor any modification, amendment, or supplement to any such documents will in any way be construed to enlarge, change, vary or in any other way affect the obligations of Equitable as expressly provided in the Contract. The Contract may not be modified by Equitable, nor many any of Equitable's rights or requirements be waived, except in writing and by an authorized officer of Equitable. The Contract may be changed by amendment or replacement upon agreement between the Contract Holder and Equitable without the consent of any other person provided that such change does not reduce any Annuity Benefit provided before such change and provided that no rights, privileges or benefits which have accrued to any Participant under the Contract may be reduced or forfeited except by the express consent of such Participant. SECTION 4.02 STATUTORY COMPLIANCE. Equitable reserves the right to amend the Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the Contract and any certificate to reflect changes in the Code, or in regulations or published rulings of the Internal Revenue Service so that each such certificate will continue to be an Annuity. Any Annuity Benefit, Cash Value or death benefit available under a certificate issued pursuant to the Contract shall not be less than the minimum benefits required by any statute of the state in which the certificate is delivered. SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY. The entire interest of any Participant under the Contract is nonforfeitable. If the Owner is the Trustee, the Trustee may assign the interest of a Participant under the Contract. However, while the Contract is part of a plan that is intended to meet the requirements for qualification under Section 401(a) of the Code, the Trustee may assign the interest of a Participant under the Contract only if permitted by that plan. Equitable will not be bound by such an assignment unless the assignment is written and received by Equitable. The rights of the Participant, the Owner, the Trustee and the Employer will be subject to such an assignment. Equitable assumes no responsibility for the validity of any assignment. If the Owner is other than the Trustee, no interest of a Participant under the Contract may be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than Equitable. No amount payable under the Contract may be assigned, commuted, or encumbered by the payee, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. Notwithstanding the foregoing, the provisions of this Section 4.03 shall not be construed so as to prevent compliance with a "qualified domestic relations order" (as that term is defined in Section 414(p) of the Code). SECTION 4.04 PARTICIPATION IN SURPLUS. The Contract and all other contracts in the same class of contracts shall be combined for the purpose of ascertaining the annual surplus of Equitable to be apportioned to said contracts as a dividend and the portion of any such dividend that is to be allocated to the Contract shall be determined by Equitable. The participation of this class of contracts in annual surplus is, however, expected to be minimal. Any amount so allocated to the Contract shall be payable as of January 1 of the calendar year in which a dividend is apportioned and will be payable in cash and shall be equitably allocated by Equitable to the Fixed Income Accounts maintained hereunder for each Participant. No Annuity Benefit will enter into the determination of any surplus to be apportioned to the Contract as a dividend. SECTION 4.05 BENEFICIARY. The Owner, as of the Participant's Participation Date, is to provide Equitable with an initial designation of the beneficiary entitled to receive any death benefit payable with respect to such Participation pursuant to Section 2.09. The Owner may change such designation from time to time during the Participant's lifetime and while Accounts for such Participant are being maintained hereunder. If the beneficiary is the Trustee, the Trustee will have the right within 31 days of the day Equitable receives due proof of death of such Participant and pursuant to the provisions of the Plan, to change the beneficiary entitled to receive the death benefit with respect to the Participant. If the Trustee is not the beneficiary, the beneficiary will be the spouse of the Participant for any married Participant, unless the spouse has given written and witnessed consent to the designation of another beneficiary, or the Participant can establish that the spouse cannot be located in accordance with the Plan and the requirements of the Code. Such spousal consent must be on file with the Trustee while the certificate is owned by the Trustee. If the Trustee is not the Owner, such spousal consent must be presented to Equitable with the change of beneficiary request or with proof of the death of the Participant and the election for an Annuity Benefit. SECTION 4.06 DISQUALIFICATION. In the event that an annuity purchased hereunder with respect to the Participant fails to qualify as an Annuity as described in Section 1.03, Equitable shall have the right, upon receiving notice of such fact before the Retirement Date, to terminate participation with respect to such Participant under the Contract and pay at the direction of the Owner the amount in the Account maintained with respect to such Participant 11938C-C ----------- Page Eleven Page Twelve ----------- GENERAL PROVISIONS (CONTINUED) less a deduction for the appropriate part attributable to the Owner for any Federal income tax payable by Equitable which would not have been payable if the Owner had an Annuity under the Contract. SECTION 4.07 FUTURE PARTICIPANTS. Equitable reserves the right at its sole discretion to curtail or prohibit further enrollment as Participants under the Contract of any individuals who are not currently participating under the Contract as of such date of curtailment or prohibition. SECTION 4.08 DEFERMENT. Payments by Equitable from the Participant's Fixed Income Account pursuant to the provisions of Sections 2.06, 2.07, 2.07A and 2.09, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.05, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. Interest at the current Guaranteed Interest Rate for such Participant's Fixed Income Account will be allowed on any such payment deferred for 30 days or more. Except as provided in this Section, payments by Equitable from the Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account pursuant to the provisions of Sections 2.06, 2.07, 2.07A and 2.09, or any commuted payments arising from a Variable Annuity Benefit pursuant to Section 3.05, will be made within seven days after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. During any period when (i) the sale of securities or the determination of the New Accumulation Unit Value or the Average New Annuity Unit Value is not reasonably practicable because an emergency, defined by the Securities and Exchange Commission, exists, or the New York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may by order permit postponement for the protection of persons having interests in the Separate Accounts, Equitable reserves the right: (a) to defer determination of Cash Values or Annuity Values and payment of Cash Values and Annuity Values, arising from an amount in a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (b) to defer payment of any portion of the death benefit arising from an amount in a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (c) to defer the payment of any Variable Annuity Benefit under the Contract or the application of any such Variable Annuity Benefit to provide for any other payment called for by the Contract; or (d) in the event of (a) above, to defer application of such amount to provide any Annuity Benefit permitted under the Contract. SECTION 4.09 ANNUAL NOTICE. At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Owner with a notice showing as of a specified recent date (1) the Annuity Value of the Fixed Income Account, (2) the total number of Accumulation Units credited to the Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, (3) the New Accumulation Unit Values, (4) the sum of the Cash Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account and (5) the amount of death benefit payable with respect to the Participant. After the Retirement Date, Equitable will notify the Participant of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.10 CONTRACT HOLDER RESPONSIBILITY. The sole responsibility of the Contract Holder is to serve as party to the Contract. The Contract Holder will have no responsibility for the administration of any Plan, for payments to the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account, or any payments or other distributions hereunder. Equitable will deal with the Contract Holder in accordance with the terms and conditions of the trust agreement pursuant to which the Contract Holder agreed to act as such and with the Contract and in such manner as the Contract Holder and Equitable may agree, without the consent of any other person. Any Employer or Trustee making Contributions under the Contract shall be deemed to have adopted and accepted the trust agreement as part of the Plan with respect to which such Contributions are made. SECTION 4.10A TRUSTEE'S RESPONSIBILITY. The Trustee shall hold this certificate on behalf of the Participant and the Participant's beneficiaries as an asset of the trust, unless the Contract is distributed to the Participant pursuant to the terms of the Plan. The Trustee shall be responsible for transferring all payments made under this certificate to the Participant and the Participant's beneficiaries in accordance with the terms of the Plan and the applicable provisions of the Code. Equitable shall make no payment hereunder without written instructions from the Trustee, and Equitable shall be fully discharged of any liability therefor to the extent such payments are made to and at the direction of the Trustee. SECTION 4.11 AGE. If the Participant's age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by Equitable will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. 11938C-C ----------- Page Twelve Attached to and made part of Group Annuity Contract No. 11938C-C between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and UNITED STATES TRUST COMPANY OF NEW YORK IT IS HEREBY AGREED that, with respect to HR-10 Plans, said contract and riders are amended as follows: With respect to PART II - PARTICIPANT'S ACCOUNTS, SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE is amended to read as follows: SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Participation Year before a Participant's Retirement Date, if the sum of the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account on that date is less than $10,000.00, Equitable will withdraw from the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account at the end of that Participation Year and (ii) any withdrawals made from such Account pursuant to Section 2.07 and 2.07A during that Participation Year. The charge will be allocated among the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Fixed Income Account in proportion to the Annuity Values of each such Account, at the end of the Participation Year. As of a Participant's Retirement Date and before application of the Annuity Values or Cash Values of such Participant's Account pursuant to Section 3.03 or upon termination of such Account pursuant to Section 2.06 or Section 2.09 during a Participation Year, if the sum of the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account, and Money Market Account at that date is less than $10,000.00, Equitable will withdraw the administrative charge described in this Section for the applicable part of that Participation Year.
Agreed to by: THE EQUITABLE LIFE ASSURANCE UNITED STATES TRUST COMPANY SOCIETY OF THE UNITED STATES OF NEW YORK By By -------------------------------------------- --------------------------------------------- President Title By ----------------------------------------- --------------------------------------------- Vice President and Secretary Dated Date of Issue ----------------------------------------- ---------------------------------- At --------------------------------------------
PF 17054C-C PARTICIPANT: CERTIFICATE NUMBER: [THE EQUITABLE LOGO] ISSUE DATE: PARTICIPATION DATE: RETIREMENT DATE: THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York, New York 10116 AGREES o TO ALLOCATE the Contributions made to the Contract to the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account or the Fixed Income Account maintained for the Participant, in accordance with Sections 2.02 and 2.03, or in part to any one, as directed by the Owner, o TO APPLY the amount in the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Fixed Income Account at the Retirement Date to provide the Participant with an Annuity Benefit or a Cash Value benefit if the Participant is then living, and o TO PROVIDE the Owner with the other rights and benefits of this certificate. The agreements are subject to the provisions of this certificate. TEN DAYS TO EXAMINE CERTIFICATE - The Owner may terminate participation under the Contract and cancel this certificate by returning it to Equitable within ten days after receipt of it. Upon such cancellation, Equitable will refund any Contribution made to Equitable on behalf of a Participant under the Contract, plus or minus any investment gain or loss experienced in the Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account from the date such Contribution is allocated to such Account to the date of such cancellation. VICE PRESIDENT SPECIMEN AND SECRETARY SPECIMEN PRESIDENT ASSETS HELD IN CONNECTION WITH THE CONTRACT MAY BE HELD IN SEPARATE ACCOUNTS MAINTAINED BY EQUITABLE AND MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THE CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF SEPARATE ACCOUNT A. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN SEPARATE ACCOUNT A IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.16 IS 5% OR 3 1/2%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE OF 1.75% FOR INVESTMENT MANAGEMENT, FINANCIAL ACCOUNTING, THE ANNUITY RATE GUARANTEE AND MINIMUM DEATH BENEFIT, EXPENSES AND EXPENSE RISK, BUT AFTER ANY DEDUCTIONS TO PROVIDE FOR TAXES. No. 11938C CONTENTS Part I - Definitions Page 2 Part II - Participant's Account Page 6 Part III - Annuity Benefits Page 9 Part IV - General Provision Page 12 Equitable certifies that the Participant as named on page 3 is included under the Group Annuity Contract designated on page 3 ("the Contract"), all pertinent provisions of which are set forth below. The Contract is issued in consideration of the payment to Equitable of the Contributions made under the Contract. The provisions on the following pages are part of this certificate. PART I - DEFINITIONS SECTION 1.01 EMPLOYER. The term "Employer" means the employer adopting the plan, or any employer that assumes in writing the obligations of the Plan. A sole proprietor is deemed to be his or her own Employer and a partnership is deemed to be the Employer of each partner. SECTION 1.02 PLAN. The term "Plan" means a defined contribution plan adopted by the Employer that is intended to meet the requirements for qualification under Section 401(a) of the Code. SECTION 1.02A TRUSTEED PLAN. The term "Trusteed Plan" means a Plan under which there is maintained a trust forming a part of the Plan (other than the trust agreement described in Section 4.10 of this Contract). SECTION 1.02B TRUSTEE. The term "Trustee" means the person or persons named as trustee under a Trusteed Plan and such trustee's successors. SECTION 1.03 ANNUITY. The term "Annuity" means an annuity purchased in accordance with the terms of the Plan and which is intended to meet the requirements for qualification under Section 401(a) of the Code. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Section 3.04. SECTION 1.05 PARTICIPANT. The term "Participant" means a person who has been enrolled by Equitable under the Contract and for whom the Employer has purchased an Annuity under the Contract. A person shall become enrolled under the Contract upon receipt by Equitable of an enrollment form made available by Equitable and completed in a manner satisfactory to Equitable. SECTION 1.05A OWNER. The Owner of a certificate issued under the Contract is as stated in the enrollment form, or later changed. Notwithstanding any provisions in the certificate to the contrary, only the Owner can exercise all the rights under the certificate while the Participant is living. The Owner does not need the consent of anyone who has only a conditional or future ownership interest in a certificate. While the Participant is living, an Owner of a certificate issued on behalf of the Participant may change the Owner by written notice satisfactory to Equitable. The change will take effect on the date the Owner signs the notice, except it will not apply to any payment Equitable makes or other actions Equitable takes before Equitable receives the notice. SECTION 1.06 CONTRIBUTION. The term "Contribution" means a payment made to Equitable for a Participant with respect to an Annuity purchased for such Participant under the Contract. Equitable is under no obligation to accept any Contribution less than $20.00. SECTION 1.07 PARTICIPATION DATE. The term "Participation Date" with respect to a Participant means the date as of which Equitable has enrolled such Participant under the Contract as shown on Page 3 of this certificate. SECTION 1.08 PARTICIPATION YEAR. The term "Participation Year" with respect to the Participant means the twelve month period beginning on (i) the Participation Date and (ii) each anniversary thereof, unless otherwise agreed to in writing by Equitable. SECTION 1.09 CLASS OF PARTICIPANTS. The term "Class of Participants" refers to all Participants whose Participation Date is in the same calendar year. ---------- Page Three Page Four --------- DEFINITIONS (CONTINUED) SECTION 1.10 GUARANTEED INTEREST RATE. With regard to a Fixed Income Account, the term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amounts in such Account. Interest accrues daily. The Guaranteed Interest Rate will never be less than 4% per annum. For each Class of Participants, Equitable will from time to time establish and make available for new Participants (i) an Initial Guaranteed Interest Rate, (ii) one or more minimum Guaranteed Interest Rates and (iii) the applicable effective period(s) for such Rates. A new Class of Participants will be established effective with the effective date of the occurrence of (i), (ii) or (iii) above or any combination thereof. For the period (not to exceed one year) next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent period (not to exceed one year) Equitable may determine for each established Class of Participants a Guaranteed Interest Rate and duration which exceeds the applicable minimum Guaranteed Interest Rate. Equitable will notify each Participant in writing of the applicable Guaranteed Interest Rate and duration. Equitable reserves the right to combine one or more Classes of Participants into a single Class of Participants, provided such Classes were initially established during a continuous period of time. SECTION 1.11 RETIREMENT DATE. The term "Retirement Date" means the date on which the Participant attains the retirement age specified in the Participant's enrollment form pursuant to the terms of the Plan. Before the Retirement Date, the Participant may elect to change the Retirement Date to any other Retirement Date permitted under the Plan, which may be any date after the filing of the election other than the 29th, 30th, or 31st day of any month. Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Processing Office. SECTION 1.12 NORMAL FORM. The "Normal Form" of an annuity Benefit under the Contract means the Fixed Annuity Benefit payable on the Life Annuity Form as defined in Sections 3.01 and 1.14, with 10 years of payments guaranteed. SECTION 1.13 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depends is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by the Owner. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.14 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.14A ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by Equitable, which annuity may not provide for payments beyond the life expectancy of the Participant or the joint and last survivor life expectancy of the Participant and the Participant's designated beneficiary. Such annuity shall extend beyond the Participant's attainment of 59 years and six months and shall not permit any prepayment of principal prior to the Participant's attainment of age 59 years and six months. Life expectancy and joint and last survivor life expectancy are computed by the use of the return multiples contained in section 1.72-9 of the regulations under the Code. If the Participant's spouse is not the designated beneficiary, at least 50 percent of the present value of the amount available for distribution under an Eligible Annuity Certain must be paid within the life expectancy of the Participant. SECTION 1.14B PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by Equitable that does not permit any prepayment of the unpaid principal. SECTION 1.15 THE SEPARATE ACCOUNTS. The term "Separate Accounts" means the following separate investment accounts maintained by Equitable to which portions of its assets have been allocated for the Contract and certain other contracts: Name Investments ---- ----------- Separate Account A Primarily common stock and other equity-type investments. Separate Account E Primarily short-term money market instruments. Separate Account J Primarily common stocks and other equity-type investments, publicly traded debt securities and short-term money market instruments. Separate Account K Primarily common stocks issued by high quality small and intermediate size companies with strong growth prospects. Equitable reserves the right to withdraw from any Separate Account and allocate to another Separate Account assets determined by Equitable to be associated with the class of contracts to which the Contract belongs. In any such event, to the extent practicable and permissible under applicable laws and regulations, the withdrawal shall be made by withdrawing the same percentage of each investment in the Separate Account, with appropriate adjustments to avoid odd lots and fractions. On and after the date of any such withdrawal --------- Page Four Page Five --------- DEFINITIONS (CONTINUED) the reference in the Contract to such Separate Account shall mean such other Separate Account to which the withdrawal assets were allocated. It is contemplated that investments in the Separate Accounts will, at most times, consist primarily of the types of investments indicated above. Equitable may, however, at its discretion invest the assets of any Separate Account in any investment permitted by applicable law. Equitable may relay conclusively on the opinion of counsel (including attorneys in its employ) as to what investments it is permitted by law to make. In lieu of making such investments directly, Equitable reserves the right to operate any Separate Account as a unit investment trust, or in any other form permitted by law, investing all or a part of its assets in shares or units of a fund, the investment adviser of which may be Equitable or controlled by Equitable. The fund assets would be invested as provided above with respect to the Separate Account. Equitable reserves the right: (i) to cause the registration or deregistration of any Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run any Separate Account under direction of a committee, and to discharge such committee at any time; and (iii) restrict or eliminate any voting rights of participants or other persons who have voting rights as to the Separate Accounts. Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.16. The assets of the Separate Accounts are the property of Equitable; however, the portion of the assets of each Separate Account equal to the reserves and other contract liabilities with respect to such Account shall not be chargeable with liabilities arising out of any other business Equitable may conduct. Equitable reserves the right to transfer assets of a Separate Account in excess of such reserves and contract liabilities to another Separate account or to the general account of Equitable. SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS. VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business day immediately preceding such business day will constitute a Valuation Period. A business day is any day on which there is a sufficient degree of trading in the portfolio securities of a Separate Account that the New Accumulation Unit Value or New Annuity Value might be materially affected by changes in the value of the portfolio securities in a Separate Account, as determined by the Separate Account Committee or, if there is no committee, by Equitable. NET INVESTMENT FACTOR: For each Separate Account the Net Investment Factor for a Valuation Period is (a) divided by (b), minus (c), where (a) is (1) the value of the assets in the Separate Account at the close of business of the preceding Valuation Period plus (2) the investment income and the capital gains, realized or unrealized, credited to the assets of the Separate Account in the Valuation Period for which the Net Investment Factor is being determined, minus (3) the capital losses, realized or unrealized, charged against such assets in such Valuation Period, minus (4) any amount charged against the Separate Account in such Valuation Period for taxes or for amounts set aside by Equitable as a reserve for taxes attributable to the maintenance or operation of the Separate Account; (b) is the value of the assets in the Separate Account at the close of business of the preceding Valuation Period; and (c) is the daily charge, for each calendar day in such Valuation Period of .00004837 for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The value of the assets in the Separate Accounts, referred to above, shall be taken at their fair market value, or where there is no readily available market, their fair value, as determined in accordance with accepted accounting practices and applicable laws and regulations. ACCUMULATION UNIT: The Accumulation Unit is a unit used in determining the value of a Participant's interest in the Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account on or before the Retirement Date. NEW ACCUMULATION UNIT VALUE: The initial New Accumulation Unit Values for the Separate Accounts have been established as follows: Account Value Date ------ ----- ---- Separate Account A $10.00 As of November 1, 1968 Separate Account E $10.00 As of September 4, 1974 Separate Account J $10.00 as of May 1, 1984 Separate Account K $10.00 As of May 1, 1984 The New Accumulation Unit Value for each subsequent Valuation Period is the New Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such subsequent Valuation Period. ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable from Separate Account A under a Variable Annuity Benefit. NEW ANNUITY UNIT VALUE: The initial New Annuity Unit Value for Separate Account A has been established at $1.00 as of November 1, 1968. The Annuity Unit Value for any subsequent Valuation --------- No. 11938C Page Five -------- Page Six DEFINITIONS (CONTINUED) Period is the New Annuity Unit value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3 1/2%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE NEW ANNUITY UNIT VALUE: The Average New Annuity Unit Value for Separate Account A for a calendar month is equal to the average of the New Annuity Unit Values for the Valuation Periods ending in such month. SECTION 1.17 ANNUITY VALUE. The term "Annuity Value" with respect to a Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, means the amount in such Accounts pursuant to `Sections 2.02 and 2.03. SECTION 1.18 CASH VALUE With respect to the Participant, the term "Cash Value" with respect to such Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account, and Money Market Account means an amount equal to the greater of (i) or (ii) below: (i) the Annuity Value of such Accounts less 6% of the Contributions made during the current and five prior Participation Years, which had not been previously withdrawn pursuant to Section 2.07A. (ii) the sum of (a) the Free Corridor Amount as defined in Section 2.07B and (b) 94% of (the Annuity Value of such Accounts less the Free Corridor Amount). SECTION 1.18A CODE. The term "Code" means the Internal Revenue Code of 1954, as now or hereafter amended. PART II -- PARTICIPANT'S ACCOUNT SECTION 2.01 CONTRIBUTIONS. The Employer or the Trustee is to make Contributions from time to time on such dates and in such amounts as determined by the Employer or the Trustee pursuant to the terms of the Plan. The Employer or the Trustee is to specify the Participant with respect to whom each such Contribution is being made and the amount to be allocated to the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Fixed Income Account. If the Plan provides, and subject to any Code restriction, the Owner may, with Equitable's agreement, transfer to the Contract any amount held with respect to such Participant under a plan which is intended to meet the requirements for qualification under Section 401(a) of the Code ("Transferred Funds"). Equitable will issue for each Participant an individual certificate setting forth a statement in substance of the benefits to which such Participant is entitled under the Contract. SECTION 2.02 STOCK, BALANCED, AGGRESSIVE STOCK AND MONEY MARKET ACCOUNTS. Equitable maintains a Stock Account, Balanced Account, Aggressive Stock Account and Money market Account under the Contract for each participant with respect to who Contributions are made. Any amount allocated to the (1) Stock Account becomes part of Separate Account A, (2) Balanced Account becomes part of Separate Account J, (3) Aggressive Stock Account becomes part of Separate Account K, and (4) Money Market Account becomes part of Separate Account E. Any amount withdrawn from an Account will no longer be part of the applicable Separate Account. On any date when an amount is allocated to or withdrawn from an Account, the Account will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the New Accumulation Unit Value for the appropriate Account for the Valuation Period which includes that date. The number of Units in an Account on any date is equal to (i) the sum of any Accumulation Units that have been allocated to the Account minus (ii) the sum of any Accumulation Units that have been withdrawn from that Account. The amount in the Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account on any date is equal to the product of (i) the number of Accumulation Units in such Account on that date and (ii) the New Accumulation Unit Value for the appropriate Account for the Valuation Period which includes that date. SECTION 2.03 FIXED INCOME ACCOUNT. Equitable maintains a Fixed Income Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the Fixed Income Account becomes part of the general assets of Equitable, which supports the guarantees of the Contract and other contracts. The amount in the Fixed Income Account at any time is equal to the sum of all amounts that have been allocated to such Fixed Income Account pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn pursuant to Sections 2.07, 2.07A, and Section 2.08 from such Account, and transferred pursuant to Section 2.05 from the Fixed Income Account, and less the sum of any annual administrative charges accrued but not made. Equitable -------- Page Six ---------- Page Seven PARTICIPANT'S ACCOUNT (CONTINUED) guarantees that the amount in the Fixed Income Account at any time before the Retirement Date will not be less than the sum of all amounts allocated to such Account pursuant to Section 2.04 or transferred to such Account pursuant to Section 2.05 and less the sum of all amounts that have been withdrawn from such Account pursuant to Sections 2.07 and 2.07A, and transferred from such Account pursuant to Section 2.05, all accumulated at 4% interest, compounded annually. In any Participation Year in which no Contribution is allocated to the Fixed Income Account, the amount in such Account at the end of the Participation Year shall not be less than the amount in such Account at the beginning of the Participation Year plus the sum of all amounts transferred to such Account pursuant to Section 2.05 less the sum of all amounts withdrawn and transferred out of such Account pursuant to Sections 2.07, 2.07A, and Section 2.05, all accumulated at 4% interest, compounded annually. The Fixed Income Account for a participant terminates on the earliest of (i) the Retirement Date, (ii) the death of the Participant and (iii)termination of participation pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO ACCOUNT. Each Contribution made with respect to a Participant pursuant to Section 2.01 will be allocated, as of the date by which Equitable has received both such Contribution and direction as to its allocation, to the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account or in part to each, at the sole direction of the Owner as specified to Equitable, unless the Owner transfers to the Participant the right to allocate contributions to such Accounts maintained for such Participant, provided that the percentage allocated to each Account is a whole number. Any amount that the Owner has directed to be transferred to the Fixed Income Account, Stock Account, Balanced Account or Aggressive Stock Account pursuant to Section 2.05 will be allocated as of the date of such transfer to the appropriate Account maintained for such Participant. Interest is allocated to the Fixed Income Account at the end of each Participation Year, at the time of each transfer or withdrawal pursuant to Sections 2.05 and 2.07, at the time of application of amounts in the Fixed Income Account to provide Annuity Benefits, upon termination of participation pursuant to Section 2.06, and upon death of the Participant pursuant to Section 2.09. SECTION 2.05 TRANSFERS AMONG ACCOUNTS. At any time before a Participant's Retirement Date, the Owner, unless the Owner transfers to the Participant the right to transfer all or part of the amounts maintained for the Participant to one or more of the other Accounts maintained for such Participant, upon written request, may transfer all or part of the amounts maintained for the Participant to one or more of the other Accounts maintained for such Participant as follows: (1) amounts in the Fixed Income Account, Stock Account, Balanced Account and Aggressive Stock Account may be transferred among such Accounts; (2) amounts in the Money Market Account may be transferred to the other Accounts. Such transfers will be made as of the date Equitable receives such request, and will be subject to Equitable's rules in effect at the time of transfer. No transfers are permitted from the Fixed Income Account, Stock Account, Balanced Account or Aggressive Stock Account maintained for the Participant to the Money Market Account. Notwithstanding the above, transfers to the Balanced Account may be prohibited by Equitable upon 30 days written notice to the Owner. SECTION 2.06 TERMINATION OF PARTICIPATION. Subject to any applicable restrictions under the terms of the Plan, on or before a Participant's Retirement Date, the Owner may elect by written notice to terminate participation under the Contract. Upon receipt of such notice, Equitable will determine the Cash Value, as of the date Equitable received such notice, of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained for such Participant. The payment of such Cash Value to the Owner may be deferred by Equitable in accordance with the provisions of Section 4.08. Prior to a Participant's Retirement Date, Equitable reserves the right to withdraw the Annuity Value of the Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, pay to the Owner such Annuity Values and terminate such Participant's participation under the Contract. This right may be exercised with respect to the Participant only if both (i) no Contributions have been made under the Contract during the last three Participation Years, and (ii) the sum of the Annuity Values is $500 or less. Equitable reserves the right to terminate a Participant's participation under the Contract if at least 120 days have elapsed since the issue date shown on the certificate issued to such Participant under the Contract and no Contributions have been made under the Contract with respect to such Participant. Upon payment of such Cash Values or Annuity Values, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Cash Values or Annuity Values arose. SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under the terms of the Plan, the Owner may elect by written notice to Equitable to make a partial withdrawal from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Fixed Income Account maintained for such Participant before such Participant's Retirement Date. Upon withdrawal pursuant to Section 2.07, Equitable will pay the lesser of the sum of the Cash Values of such Accounts or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by the Owner. Unless instructed otherwise, the amount withdrawn (including the amount of any withdrawal charge) will be allocated between such Accounts in proportion to the Annuity Value of each such Account. Upon any payment made at the direction of the Owner pursuant to Section 2.07, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. ----------- Page Seven Page Eight ---------- PARTICIPANT'S ACCOUNT (CONTINUED) Payments made at the direction of the Owner pursuant to Section 2.07 may be deferred by Equitable in accordance with the provisions of Section 4.06. Equitable is under no obligation to process any request for partial withdrawal of less than $300. SECTION 2.07A PARTIAL WITHDRAWAL CHARGES. With respect to partial withdrawals requested by the Owner, there will be no withdrawal charge if the amount of the partial withdrawal requested is not greater than the Free Corridor Amount define in Section 2.07B. In that case, Equitable will withdraw from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account, and Fixed Income Account and pay at the direction of the Owner an amount equal to the partial withdrawal requested. However, if the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge, if applicable. Such withdrawal charge will be calculated in the following manner: (a) Withdrawals of Contributions made on behalf of the Participant during the current and five prior Participation Years will be subject to a charge of 6% of the amount withdrawn (including such charge). (b) Withdrawals of other amounts will not be subject to any withdrawal charges. Equitable will pay at the direction of the Owner the lesser of a) the amount requested or b) the sum of Cash Values of the Accounts maintained on the Participant's behalf. For purposes of determining withdrawal charges described in this Section, amounts withdrawn up to the Free Corridor Amount will not be considered a withdrawal of any Contributions. Any excess withdrawals, i.e., those pursuant to item (ii) above, shall be considered withdrawals of Contributions in the order received, with the older Contributions first. SECTION 2.07B FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" with respect to the Owner means an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Values of the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Fixed Income Account over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the current Participation Year with respect to the Participant. SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Participation Year before a Participant's Retirement Date, Equitable will withdraw from the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account at the end of that Participation Year and (ii) any withdrawals made from such Accounts pursuant to Section 2.07 during that Participation Year. The charge will be allocated among the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Fixed Income Account in proportion to the Annuity Values of each such Account, at the end of the Participation Year. As of a Participant's Retirement Date and before application of the Annuity Values or Cash Values of such Participant's account pursuant to Section 3.03, or upon termination of such account pursuant to Section 2.06 or Section 2.09 during a Participation Year, Equitable will withdraw the administrative charge described in this Section for the applicable part of that Participation Year. SECTION 2.09 DEATH BENEFIT. If a Participant dies while Accounts for such Participant are maintained under the Contract, Equitable, upon receipt of due proof of such death, will pay to the beneficiary the death benefit payable with respect to such Participant. If the beneficiary under the certificate is the Trustee, the Trustee may, subject to the terms of the Plan, change the beneficiary within 31 days after Equitable receives due proof of the Participant's death. The change shall be made in the same manner and subject to the same provisions as apply to a change of beneficiary during the Participant's lifetime. If the Trustee changes the beneficiary of the certificate after the death of the Participant according to the terms of the Plan, the Trustee may elect an Annuity Benefit on any annuity form offered by Equitable, subject to Equitable's rules then in effect, for the benefit of the beneficiary. The beneficiary may not revoke or change any election made by the Trustee. If the Trustee does not make an election, the beneficiary may make such election for the beneficiary's own benefit. If the beneficiary under the certificate is not the Trustee, and the Participant is married at the time of death of such Participant, Equitable will pay the death benefit under the certificate to the spouse of the Participant in the form of a Life Annuity, unless the spouse of the Participant makes an election for a single sum payment or for an Annuity Benefit on any other annuity form offered by the Equitable, subject to Equitable's rules then in effect. If the Equitable determines that the Participant is married at the time of death, the beneficiary under the certificate is not the spouse of such Participant and the spouse of such Participant has not given written consent to the designation of another beneficiary, Equitable shall have the right to pay the death benefit to the spouse of such Participant instead of the named beneficiary, if such action is required to comply with Federal law. The amount of the death benefit with respect to a Participant at any time prior to the Retirement Date is equal to the greater of (i) the ---------- Page Eight Page Nine --------- PARTICIPANT'S ACCOUNT (CONTINUED) sum of the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract for such Participant and (ii) the minimum death benefit with respect to such Participant. Such minimum death benefit is the sum of all Contributions made with respect to such Participant pursuant to Section 2.01 less an adjustment for any withdrawals made pursuant to Section 2.07 from the Accounts maintained under the Contract for such Participant. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount being withdrawn is to the Annuity Values then in the Fixed Income Account, Stick Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract for such Participant. The amount of any death benefit payable with respect to a Participant, to the extent such Account is sufficient therefore, will be withdrawn from the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained with respect to such Participant under the Contract. Upon such payment, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Annuity Values arose. PART III -- ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of Separate Account A. The amount of the first, second and third payments under any Variable Annuity Benefit provided under the Contract with respect to a payee is the monthly amount provided with respect to the payee pursuant to Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such Benefit, multiplied by the Average New Annuity Unit Value for the second calendar month immediately preceding the date of the payment. The fourth and subsequent annuity payments under a Variable Annuity Benefit will not be increased or decreased in amount because of mortality or expense experience. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the New Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Values of such Participant's Fixed Income Account, Stock Account Balanced Account, Aggressive Stock Account and Money Market Account shall be applied to provide the Normal Form of Annuity Benefit, unless the Owner on behalf of the Participant and, if applicable, the Participant's spouse elects (i) to receive the Cash Value of such Accounts in a single sum or (ii) to apply such Annuity Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity benefit on any other annuity form offered by Equitable, subject to Equitable's rules then in effect, the terms of the Plan, and any applicable requirements under the Code. Equitable will provide notice and election forms to the Owner not more than six months before the Participant's Retirement Date. If the Owner elects to terminate a Participant's participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Values of such Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account. Equitable has the right to require the Owner to furnish pertinent information to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. Equitable may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If the Owner elects to receive an Annuity Benefit in lieu of the Cash Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money market Account, the amount applied to provide the Annuity Benefit will be (i) the Annuity Values of such Accounts, if the payments under the annuity form elected are contingent upon the survival of a person, or (ii) the Cash Values of such Accounts if the payments under the annuity form elected are not contingent upon the survival of a person. If such amount is applied on or after the completion of five Participation Years with respect to such Participant: (1) the balance, less any Contribution made on behalf of the Participant during the current and five prior Participation Years, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown herein or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee; (2) any Contributions made on behalf of the Participant --------- Page Nine Page Ten -------- ANNUITY BENEFITS (CONTINUED) during the current and five prior Participation Years shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed annuity payments shown herein or (ii) Equitable's current individual rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. If the amount applied to provide an Annuity Benefit is applied before the completion of five Participation Years with respect to a Participant, the balance, after any applicable tax on annuity considerations, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown herein or (ii) Equitable's current individual annuity rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained for such Participant shall terminate. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (100% continuation). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, are based on 3 1/2% interest and the 1983 Individual Annuity Mortality Table adjusted to a unisex basis based on a 50-50 split of males and females. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on the projected 1983 Basic Table adjusted to a unisex basis based on a 50-50 split of males and females and an Assumed Base Rate of Net Investment Return of 3 1//2% or 5%, whichever applies pursuant to Section 1.16. The Assumed Base Rate of Net Investment Return is 5% for certificates issued for delivery in New York. Equitable may change the monthly income amounts contained in the Tables of Guaranteed Annuity Payments and the basis for determining such amounts, for new Participants, by at least 90 days advance notice to the Contract Holder and by an amendment to the Contract. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on 3 1/2% interest and the 1983 Individual Annuity Mortality Table adjusted to a unisex basis based on 50-50 split of males and females if such annuity form provides for a Fixed Annuity Benefit, and on the projected 1983 Basic Table adjusted to a unisex basis based on a 50-50 split of males and females and an Assumed Base Rate of Net Investment Income Return of 5% or 3 1/2%, whichever applies pursuant to Section 1.16, if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payable under the Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. The amount of the overpayments by Equitable will be charged against and the amount of the underpayments will be added to any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, or (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may, unless the Plan provides to the contrary, make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If an annuity form made available by Equitable provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Upon election by the Owner on behalf of the Participant and, if applicable, the Participant's spouse, pursuant to Section 3.03 of an annuity form providing payments for a period certain, such Owner may designate (with the right to change such designation, in accordance with the terms of the Plan) a person or persons to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person, unless the Plan provides to the contrary) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's executors or administrators in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, Equitable will pay in a single sum to such payee's executors or administrators the commuted value of any remaining payments or installments. Page Ten -------- Page Eleven ----------- ANNUITY BENEFITS (CONTINUED) The commuted value of any such remaining payments or installments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis. If the amount to be applied hereunder is less than $3,500, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. Equitable will require satisfactory evidence of the age of any person upon whose life an annuity form depends. TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Value)
- ----------------------------------------------------------------------------------------------------------------------------- Age 60 61 62 63 64 65 66 67 68 69 70 - ----------------------------------------------------------------------------------------------------------------------------- 60 4.54 4.58 4.62 4.66 4.70 4.74 4.77 4.81 4.84 4.88 4.91 61 4.62 4.67 4.71 4.76 4.81 4.84 4.88 4.91 4.95 4.99 62 4.72 4.76 4.81 4.85 4.90 4.94 4.98 5.02 5.06 63 4.81 4.86 4.91 4.96 5.01 5.06 5.10 5.14 64 4.92 4.97 5.02 5.08 5.13 5.17 5.22 65 5.03 5.09 5.15 5.20 5.26 5.31 66 5.15 5.21 5.27 5.33 5.39 67 5.28 5.34 5.40 5.47 68 5.41 5.48 5.55 69 5.56 5.63 70 5.71 - -----------------------------------------------------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3 1/2% (Minimum Monthly Income per $1,000 of Annuity Value)
- ----------------------------------------------------------------------------------------------------------------------------- Age 60 61 62 63 64 65 66 67 68 69 70 - ----------------------------------------------------------------------------------------------------------------------------- 60 4.40 4.44 4.58 4.51 4.55 4.58 4.61 4.65 4.68 4.71 4.74 61 4.48 4.52 4.56 4.60 4.64 4.67 4.71 4.74 4.78 4.81 62 4.56 4.60 4.65 4.69 4.73 4.77 4.80 4.84 4.85 63 4.65 4.69 4.74 4.78 4.83 4.87 4.91 4.95 64 4.74 4.79 4.84 4.89 4.93 4.98 5.02 65 4.85 4.90 4.95 5.00 5.05 5.10 66 4.95 5.01 5.06 5.11 5.17 67 5.07 5.12 5.18 5.24 68 5.19 5.25 5.32 69 5.32 5.39 70 5.46 - -----------------------------------------------------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% CONTINUATION -- ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 5% (Minimum Monthly Income per $1,000 of Annuity Value)
- ------------------------------------------------------------------------------------------------------------------------------- Age 60 61 62 63 64 65 66 67 68 69 70 - ------------------------------------------------------------------------------------------------------------------------------- 60 5.27 5.30 5.34 5.37 5.41 5.44 5.47 5.51 5.54 5.57 5.59 61 5.34 5.38 5.42 5.46 5.49 5.53 5.57 5.60 5.63 5.66 62 5.42 5.46 5.50 5.54 5.58 5.62 5.65 5.69 5.73 63 5.50 5.55 5.59 5.63 5.67 5.71 5.75 5.79 64 5.59 5.64 5.69 5.73 5.78 5.82 5.86 65 5.69 5.74 5.79 5.84 5.89 5.93 66 5.79 5.85 5.90 5.95 6.00 67 5.90 5.96 6.02 6.08 68 6.02 6.08 6.15 69 6.15 6.22 70 6.29 - -------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) VARIABLE ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET AGE FIXED ANNUITY BENEFIT INVESTMENT RETURN IS --- -------------------- --------------------------- 3 1/2% 5% ------ --- 60 5.29 5.08 5.97 61 5.41 5.19 6.08 62 5.55 5.31 6.20 63 5.69 5.44 6.33 64 5.85 5.58 6.46 65 6.01 5.73 6.61 66 6.19 5.89 6.77 67 6.37 6.06 6.94 68 6.58 6.24 7.12 69 6.79 6.43 7.31 70 7.02 6.64 7.52 Equitable will notify the payee under a Variable Annuity Benefit of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each variable payment. Any election, change, revocation or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a commutation right under an Annuity Benefit is exercised, Equitable may defer payment in accordance with Section 4.08. ----------- Page Eleven Page Twelve ----------- PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT. The Contract constitutes the entire agreement between the parties and the provisions of the Contract alone will govern with respect to the rights and obligations of Equitable. The provisions of the Contract will be applied separately with respect to each Participant. Nothing in the enrollment form referred to in Section 1.05, the Plan or trust agreement referred to in Section 4.10 nor any modification, amendment, or supplement to any such documents will in any way be construed to enlarge, change, vary or in any other way affect the obligations of Equitable as expressly provided in the Contract. The Contract may not be modified by Equitable, nor may any of Equitable's rights or requirements be waived, except in writing and by an authorized officer of Equitable. The Contract may be changed by amendment or replacement upon agreement between the Contract Holder and Equitable without the consent of any other person provided that such change does not reduce any Annuity Benefit provided before such change and provided that no rights, privileges or benefits which have accrued to any Participant under the Contract may be reduced or forfeited except by the express consent of such Participant. SECTION 4.02 STATUTORY COMPLIANCE. Equitable reserves the right to amend the Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the Contract and any certificate to reflect changes in the Code, or in regulations or published rulings of the Internal Revenue Service. Any Annuity Benefit, Cash Value or death benefit available under a certificate issued pursuant to the Contract shall not be less than the minimum benefits required by any statute of the state in which the certificate is delivered. SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY. The entire interest of any Participant under the Contract is nonforfeitable. If the Owner is the Trustee, the Trustee may assign the interest of a Participant under the Contract. However, while the Contract is part of a plan that is intended to meet the requirements for qualification under Section 401(a) of the Code, the Trustee may assign the interest of a Participant under the Contract only if permitted by that plan. Equitable will not be bound by such an assignment unless the assignment is written and received by Equitable. The rights of the Participant, the Owner, the Trustee and the Employer will be subject to such an assignment. Equitable assumes no responsibility for the validity of any assignment. If the Owner is other than the Trustee, no interest of a Participant under the Contract may be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than Equitable. No amount payable under the Contract may be assigned, commuted, or encumbered by the payee, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. Notwithstanding the foregoing, the provisions of this Section 4.03 shall not be construed so as to prevent compliance with a "qualified domestic relations order" (as that term is defined in Section 414(p) of the Code). SECTION 4.04 PARTICIPATION IN SURPLUS. The Contract and all other contracts in the same class of contracts shall be combined for the purpose of ascertaining the annual surplus of Equitable to be apportioned to said contracts as a dividend and the portion of any such dividend that is to be allocated to the Contract shall be determined by Equitable. The participation of this class of contracts in annual surplus is, however, expected to be minimal. Any amount so allocated to the Contract shall be payable as of January 1 of the calendar year in which a dividend is apportioned and will be payable in cash and shall be equitably allocated by Equitable to the Fixed Income Accounts maintained hereunder for each Participant. No Annuity Benefit will enter into the determination of any surplus to be apportioned to the Contract as a dividend. SECTION 4.05 BENEFICIARY. The Owner, as of the Participant's Participation Date, is to provide Equitable with an initial designation of the beneficiary entitled to receive any death benefit payable with respect to such Participant pursuant to Section 2.09. The Owner may change such designation from time to time during the Participant's lifetime and while Accounts for such Participant are maintained hereunder. If the Beneficiary is the Trustee, the Trustee will have the right within 31 days of the day Equitable receives due proof of death of such Participant and pursuant to the provisions of the Plan, to change the beneficiary entitled to receive the death benefits with respect to the Participant. If the Trustee is not the beneficiary, the beneficiary will be the spouse of the Participant for any married Participant, unless the spouse has given written and witnessed consent to the designation of another beneficiary, or the Participant can establish that the spouse cannot be located in accordance with the Plan and the requirements of the Code. Such spousal consent must be on file with the Trustee while the certificate is owned by the Trustee. If the Trustee is not the Owner, such spousal consent must be presented to Equitable with the change of beneficiary request or with proof of the death of the Participant and the election for an Annuity Benefit. SECTION 4.06 DISQUALIFICATION. In the event that an annuity purchased hereunder with respect to a Participant fails to qualify as an Annuity as described in Section 1.03, Equitable shall have the right, upon receiving notice of such fact before the Retirement Date, to terminate participation with respect to such Participant under the Contract and pay at the direction of the Owner the amount in the Account maintained with respect to such Participant less a deduction for the appropriate part attributable to the Owner of any Federal income tax payable by Equitable which would not have been payable if the Owner had an Annuity under the Contract. ----------- No. 11938C Page Twelve Page Thirteen ------------- GENERAL PROVISIONS (CONTINUED) SECTION 4.07 FUTURE PARTICIPANTS. Equitable reserves the right at its sole discretion to curtail or prohibit further enrollment as Participants under the Contract of any individuals who are not currently participating under the Contract as of such date of curtailment or prohibition. SECTION 4.08 DEFERMENT. Payments by Equitable from the Participant's Fixed Income Account pursuant to the provisions of Sections 2.06, 2.07, 207A and 2.09, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.05, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. Interest at the current Guaranteed Interest Rate for such Participant's Fixed Income Account will be allowed on any such payment deferred for 30 days or more. Except as provided in this Section, payments by Equitable from the Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account pursuant to the provisions of Sections 2.06, 2.07A and 2.09, or any commuted payments arising from a Variable Annuity Benefit pursuant to Section 3.05, will be made within seven days after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. During any period when (i) the sale of securities or the determination of the New Accumulation Unit Value or the Average New Annuity Unit Value is not reasonably practicable because an emergency, defined by the Securities and Exchange Commission, exists, or the New York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may by order permit postponement for the protection of persons having interests in the Separate Accounts, Equitable reserves the right: (a) to defer determination of Cash Values or Annuity Values and payment of Cash Values and Annuity Values, arising from an amount in a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (b) to defer payment of any portion of the death benefit arising from an amount in a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (c) to defer the payment of any Variable Annuity Benefit under the Contract or the application of any such Variable Annuity Benefit to provide for any other payment called for by the Contract; or (d) in the event of (a) above, to defer application of such amount to provide any Annuity Benefit permitted under the Contract. SECTION 4.09 ANNUAL NOTICE. At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Owner with a notice showing as of a specified recent date (1) the Annuity Value of the Fixed Income Account, (2) the total number of Accumulation Units credited to the Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, (3) the new Accumulation Unit Values, (4) the sum of the Cash Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account and (5) the amount of death benefit payable with respect to the Participant. After the Retirement Date, Equitable will notify the Participant of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.10 CONTRACT HOLDER RESPONSIBILITY. The sole responsibility of the Contract Holder is to serve as party to the Contract. The Contract Holder will have no responsibility for the administration of any Plan, for payments to the Fixed Income Account, Stock Account, Balanced Account, Agggressive Stock Account or Money Market Account, or any payments or other distributions hereunder. Equitable will deal with the Contract Holder in accordance with the terms and conditions of the trust agreement pursuant to which the Contract Holder agreed to act as such and with the Contract and in such manner as the Contract Holder and Equitable may agree, without the consent of any other person. Any Employer or Trustee making Contributions under the Contract shall be deemed to have adopted and accepted the trust agreement as part of the Plan with respect to which such Contributions are made. SECTION 4.10A TRUSTEE'S RESPONSIBILITY. The Trustee shall hold this certificate on behalf of the Participant and the Participant's beneficiaries as an asset of the trust, unless the Contract is distributed to the Participant pursuant to the terms of the Plan. The Trustee shall be responsible for transferring all payments made under this certificate to the Participant and the Participant's beneficiaries in accordance with the terms of the Plan and the applicable provisions of the Code. Equitable shall make no payment hereunder without written instructions from the Trustee, and Equitable shall be fully discharged of any liability therefor to the extent such payments are made to and at the direction of the Trustee. SECTION 4.11 AGE. If the Participant's age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by Equitable will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. No. 11938C Page Thirteen THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES For Participants in HR-10 Plans, effective on your Participation Date, we have amended your Certificate issued under Group Annuity Contract No. 11938C-C as follows: With respect to PART II - PARTICIPANT'S ACCOUNTS, SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE is amended to read as follows: SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Participation Year before a Participant's Retirement Date, if the sum of the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account on that date is less than $10,000.00, Equitable will withdraw from the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account at the end of that Participation Year and (ii) any withdrawals made from such Accounts pursuant to Section 2.07 and 2.07A during that Participation Year. The charge will be allocated among the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Fixed Income Account in proportion to the Annuity Values of each such Account, at the end of the Participation Year. As of a Participant's Retirement Date and before application of the Annuity Values or Cash Values of such Participant's Account pursuant to Section 3.03 or upon termination of such Account pursuant to Section 2.06 or Section 2.09 during a Participation Year, if the sum of the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account, and Money Market Account at that date is less than $10,000.00, Equitable will withdraw the administrative charge described in this Section for the applicable part of that Participation Year. Vice President SPECIMEN and Secretary SPECIMEN President PF 17051C THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York, New York 10116 Group Annuity Contract Between The Equitable Life Assurance Society of the United States and Rhode Island Hospital Trust THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES AGREES O To allocate the Contributions made to the Contract to the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account or the Fixed Income Account maintained for the Participant, in accordance with Sections 2.02 and 2.03, or in part to any one, as directed by the Participant. o To apply the amount in the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Fixed Income Account at the Retirement Date to provide the Participant with an Annuity Benefit or a Cash Value Benefit if the Participant is then living, and o To provide the Participant with the other rights and benefits of this certificate. These agreements are subject to the provisions of this certificate. TEN DAYS TO EXAMINE CERTIFICATE - The Participant may terminate participation under the Contract and cancel this certificate by returning it to Equitable within ten days after receipt of it. Upon such cancellation, Equitable will refund any Contribution made to Equitable on behalf of a Participant under the Contract, plus or minus any investment gain or loss experienced in the Participant's Stock Account, Balanced Account, Aggressive Stock Account, or Money Market Account from the date such Contribution is allocated to such Account to the date of such Cancellation. /s/John B. Carter President /s/Rodney L. Enochs Vice President and Secretary ASSETS HELD IN CONNECTION WITH THE CONTRACT MAY BE HELD IN SEPARATE ACCOUNTS MAINTAINED BY EQUITABLE AND MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THE CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF SEPARATE ACCOUNT A. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN SEPARATE ACCOUNT A IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.15 IS 5% OR 3 1/2%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE OF 1.75% FOR INVESTMENT MANAGEMENT, FINANCIAL ACCOUNTING, THE ANNUITY RATE GUARANTEE AND MINIMUM DEATH BENEFIT, EXPENSES AND EXPENSE RISK, BUT AFTER ANY DEDUCTIONS TO PROVIDE FOR TAXES. NO. 11937C NQ CONTENTS Part I - Definitions Page 2 Part II - Participant's Account Page 5 Part III - Annuity Benefits Page 8 Part IV - General Provisions Page 11 Equitable certifies that the Participant as named on Page 3 is included under the Group Annuity Contract designated on Page 3 ("the Contract"), all pertinent provisions of which are set forth below. The Contract is issued in consideration of the payment to Equitable of the Contributions made under the Contract. The provisions on the following pages are part of this certificate. PART I - DEFINITIONS SECTION 1.01 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Part III of the Contract. SECTION 1.02 PARTICIPANT. The term "Participant" means a person who has been enrolled by Equitable under the Contract. A person shall become enrolled under the Contract upon receipt by Equitable of an enrollment form made available by Equitable and completed in a manner satisfactory to Equitable. SECTION 1.03 OWNER. The Owner of a certificate issued under the Contract is the Participant unless otherwise stated in the enrollment form, or later changed. Notwithstanding any provisions in the certificate to the contrary, only the Owner can exercise all the rights under the certificate while the Participant is living. The Owner does not need the consent of anyone who has only a conditional or future ownership interest in a certificate. While the Participant is living, an Owner of a certificate issued on behalf of the Participant may change the Owner by written notice satisfactory to Equitable. The change will take effect on the date the Owner signs the notice, except it will not apply to any payment Equitable makes or other actions Equitable takes before Equitable receives the notice. SECTION 1.04 ASSIGNMENTS. A certificate issued under the Contract may not be assigned as collateral or security for a loan. Otherwise, the Participant may assign this certificate before the Retirement Date but Equitable will not be bound by an assignment unless it is in writing and Equitable has received it. The Participant's rights and those of any of persons referred to in the certificate will be subject to the assignment. Equitable assumes no responsibility for the validity of any assignment. No amounts payable under a certificate to a payee other than the Owner may be assigned by that payee, nor will they be subject to the claims of creditors or to legal process, except to the extent permitted by law. SECTION 1.05 CONTRIBUTION. The term "Contribution" means a payment made to Equitable for a Participant with respect to an annuity purchased for such Participant under the Contract Equitable is under no obligation to accept any Contribution less than $50.00. SECTION 1.06 PARTICIPATION DATE. The term "Participation Date" with respect to a Participant means the date as of which Equitable has enrolled such Participant under the terms of the Contract, as shown on Page 3 of the certificate. SECTION 1.07 PARTICIPATION YEAR. The term "Participation Year" with respect to a Participant means the twelve month period beginning on (i) the Participation Date, and (ii) each anniversary thereof, unless otherwise agreed to in writing by Equitable. SECTION 1.08 CLASS OF PARTICIPANTS. Except as provided in Section 1.09, the term "Class of Participants" refers to all Participants whose Participation Date is in the same calendar year. SECTION 1.09 GUARANTEED INTEREST RATE. In regard to a Fixed Income Account, the term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in such Account. Interest accrues daily. The Guaranteed Interest Rate will never be less than 4% per annum. Equitable will from time to time establish and make available to new Participants (i) an Initial Guaranteed Interest Rate, (ii) one or more Minimum Guaranteed Interest Rates and (iii) the applicable effective period(s) for such Rates. A new Class of Participants will -------- No. 11937C NQ Page Two Page Three ---------- DEFINITIONS (CONTINUED) be established effective with the effective date of the occurrence of (ii) or (iii) above or any combination thereof. For the period (not to exceed one year) next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent period (not to exceed one year) the Equitable may determine for each established Class of Participants a Guaranteed Interest Rate and duration for such Class which exceeds the applicable Minimum Guaranteed Interest Rate. Equitable will notify each Participant in writing of the applicable Guaranteed Interest Rate and duration. Equitable reserves the right to combine one or more Classes of Participants into a single Class of Participants, provided such Classes were initially established during a continuous period of time. SECTION 1.10 RETIREMENT DATE. The term "Retirement Date" means the date on which the Participant is to attain the retirement age specified in the Participant's enrollment form. Before the Retirement Date the Participant may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be later than the date the Participant attains age 85. Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Processing Office. SECTION 1.11 NORMAL FORM. The "Normal Form" of an Annuity Benefit under the Contract means the Fixed Annuity Benefit payable on the Life Annuity Form, as defined in Sections 3.01 and 1.12, with 10 years of payments guaranteed. SECTION 1.12 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.13 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by the Participant. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.14 THE SEPARATE ACCOUNTS. The term "Separate Accounts" means the following separate investment accounts maintained by Equitable to which portions of its assets have been allocated for the Contract and certain other contracts: Name Investments ---- ----------- Separate Account A Primarily common stock and other equity-type investments. Separate Account E Primarily short-term money market instruments. Separate Account J Primarily common stocks and other equity-type investments, publicly traded debt securities and short-term money market instruments. Separate Account K Primarily common stocks issued by high quality small and intermediate size companies with strong growth prospects. Equitable reserves the right to withdraw from any Separate Account and allocate to another separate account assets determined by Equitable to be associated with the class of contracts to which the Contract belongs. In any such event, to the extent practicable and permissible under applicable laws and regulations, the withdrawal shall be made by withdrawing the same percentage of each investment in the Separate Account, with appropriate adjustments to avoid odd lots and fractions. On and after the date of any such withdrawal the reference in the Contract to such Separate Account shall mean such other separate account to which the withdrawn assets were allocated. It is contemplated that investments in the Separate Accounts will, at most times, consist primarily of the types of investments indicated above. Equitable may, however, at its discretion invest the assets of any Separate Account in any investment permitted by applicable law. Equitable may rely conclusively on the opinion of counsel (including attorneys in its employ) as to what investments it is permitted by law to make. ---------- No. 11937C NQ Page Three Page Four --------- DEFINITIONS (CONTINUED) In lieu of making such investments directly, Equitable reserves the right to operate any Separate Account as a unit investment trust, or in any other form permitted by law, investing all or part of its assets in shares or units of a fund, the investment adviser of which may be Equitable or controlled by Equitable. The fund assets would be invested as provided above with respect to the Separate Account. Equitable reserves the right: (i) to cause the registration or deregistration of any Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run any Separate Account under direction of a committee, and to discharge such committee at any time; and (iii) restrict or eliminate any voting rights of participants or other persons who have voting rights as to the Separate Accounts. Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.15. The assets of Separate Accounts are the property of Equitable; however, the portion of the assets of each Separate Account equal to the reserves and other contract liabilities with respect to such Account shall not be chargeable with liabilities arising our of any other business Equitable may conduct. Equitable reserves the right to transfer assets of the Separate Accounts in excess of such reserves and contract liabilities to the general account of Equitable. SECTION 1.15 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS. VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business days immediately preceding such business day will constitute a Valuation Period. A business day is any day on which the New York Stock Exchange is open. NET INVESTMENT FACTOR: For each Separate Account the Net Investment Factor for a Valuation Period is (a) divided by (b), minus (c), where (a) is (1) the value of assets in the Separate Account at the close of business of the preceding Valuation Period plus (2) the investment income and the capital gains, realized or unrealized, credited to the assets of the Separate Account in the Valuation Period for which the Net Investment Factor is being determined, minus (3) the capital losses, realized or unrealized, charged against such assets in such Valuation Period, minus (4) any amount charged against the Separate Account in such Valuation Period for taxes or for amounts set aside by Equitable as a reserve for taxes attributable to the maintenance or operation of the Separate Account. (b) is the value of the assets in the Separate Account at the close of business of the preceding Valuation Period; and (c) is the daily charge, for each calendar day in such Valuation Period, of .00004837 for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The value of the assets in the Separate Accounts, referred to above, shall be taken at their fair market value, or where there is no readily available market, their fair value, as determined in accordance with accepted accounting practices and applicable laws and regulations. ACCUMULATION UNIT: The Accumulation Unit is a unit used in determining the value of the interest of a Participant's Stock Account. Balanced Account, Aggressive Stock Account or Money Market Account on or before the Retirement Date. NEW ACCUMULATION UNIT VALUE: The initial New Accumulation Unit Values for the Separate Accounts have been established as follows: Account Value Date ------- ----- ---- Separate Account A $10.00 As of November 1, 1968 Separate Account E $10.00 As of September 4, 1974 Separate Account J $10.00 As of May 1, 1984 Separate Account K $10.00 As of May 1, 1984 The New Accumulation Unit Value for each subsequent Valuation Period is the New Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such subsequent Valuation Period. ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable from Separate Account A under a Variable Annuity Benefit. NEW ANNUITY UNIT VALUE: The initial New Annuity Unit Value for Separate Account A has been established at $1.00 as of November 1, 1968. The Annuity Unit Value for any subsequent Valuation Period is the New Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment --------- No. 11937C NQ Page Four Page Five --------- DEFINITIONS (CONTINUED) Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3 1/2%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE NEW ANNUITY UNIT VALUE: The Average New Annuity Unit Value for Separate Account A for a calendar month is equal to the average of the New Annuity Unit Values for the Valuation Periods ending in such month. SECTION 1.16 ANNUITY VALUE. The term "Annuity Value" with respect to a Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, means the amount in such Accounts pursuant to Sections 2.02 and 2.03. SECTION 1.17 CASH VALUE. With respect to a Participant, the term "Cash Value" with respect to such Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account, and Money Market Account means an amount equal to the greater of (i) or (ii) below: (i) the Annuity Value of such Accounts less 6% of the Contributions made during the current and five prior Participation Years which had not been previously withdrawn pursuant to Section 2.07A. (ii) the sum of (a) the Free Corridor Amount as defined in Section 2.07B and (b) 94% of (the Annuity Value of such Accounts less the Free Corridor Amount). SECTION 1.18 CODE. The term "Code" means the Internal Revenue Code of 1954, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. PART II - PARTICIPANT'S ACCOUNTS SECTION 2.01 CONTRIBUTIONS. Contributions may be made with respect to a Participant on whichever basis, as described under subsections A and B below, is specified upon the Participant's enrollment under the Contract. If Contributions are made by or on behalf of a Participant under more than one such basis, Equitable will accept such Contributions if the Participant is separately enrolled under the Contract under each basis, and in such case separate certificates will be issued under the Contract for the Participant reflecting amounts accumulated on the Participant's behalf attributable to Contributions made under each Contribution basis. A. Post-August 13, 1982 Basis Contributions are to be made from time to time at the Participant's discretion. With each Contribution, the Participant with respect to whom such Contribution is being made and the amounts to be allocated to the Stock Account, Money Market Account, Fixed Income Account, Balanced Account and Aggressive Stock Account shall be specified. A Participant may transfer to the Contract under this basis any amount held with respect to such Participant under a deferred annuity contract, where such transferred amount represents amounts invested in or credited to investments in annuity contracts after August 13, 1982. B. Pre-August 14, 1982 Basis A Participant may transfer to the Contract under this basis any amount held with respect to such Participant under a deferred annuity contract where such transferred amount represents amounts invested in or credited to investments in annuity contracts prior to August 14, 1982. New Contributions cannot be made under this basis. SECTION 2.02 STOCK, BALANCED, AGGRESSIVE STOCK AND MONEY MARKET ACCOUNTS. Equitable maintains a Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the (1) Stock Account becomes part of Separate Account A. (2) Balanced Account becomes part of Separate Account J. (3) Aggressive Stock Account becomes part of Separate Account K. and (4) Money Market Account becomes part of Separate Account E. Any amount withdrawn from an Account will no longer be part of the applicable Separate Account. On any date when an amount is allocated to or withdrawn from an Account, the Account will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the New Accumulation Unit Value for the appropriate Separate Account for the Valuation Period which includes that date. The number of Units in an Account on any date is equal to (i) the sum of any Accumulation Units that have been credited to the Account minus (ii) the sum of any Accumulation Units that have been charged to that Account. The amount in the Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account on any date is equal to the product of (i) the number of Accumulation Units in such Account on that date and (ii) the New Accumulation Unit Value for the appropriate Separate Account for the Valuation Period which includes that date, less any administrative charge accrued but not made. SECTION 2.03 FIXED INCOME ACCOUNT. Equitable maintains a Fixed Income Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the Fixed Income Account becomes part of the general assets of Equitable, which support the guarantees of the Contract and other contracts. --------- No. 11937C NQ Page Five Page Six -------- PARTICIPANT'S ACCOUNT (CONTINUED) The amount in a Fixed Income Account at any time is equal to the sum of all amounts that have been allocated to such Fixed Income Account pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn pursuant to Sections 2.07, 2.07A, and Section 2.08 from such Account, and transferred pursuant to Section 2.05 from such Fixed Income Account, and less any annual administrative charges accrued but not made. Equitable guarantees that the amount in a Fixed Income Account at any time before the Retirement Date will not be less than the sum of all amounts allocated to such Account pursuant to Section 2.04 or transferred to such Account pursuant to Section 2.05 and less the sum of all amounts that have been withdrawn from such Account pursuant to Sections 2.07, 2.07A and 2.08 all accumulated at 4% interest, compounded annually. In any Participation Year in which no Contribution is allocated to a Fixed Income Account, the amount in such Account at the end of the Participation Year shall in no event be less than the amount in such Account at the beginning of the Participation Year plus the sum of all amounts transferred to such Account pursuant to Section 2.05 less the sum of all amounts withdrawn and transferred out of such Account pursuant to Sections 2.07, 2.07A, and Section 2.05, all accumulated at 3% interest, compounded annually. A Fixed Income Account for a Participant terminates on the earliest of (i) the Retirement Date, (ii) the death of the Participant, and (iii) termination of participation pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO ACCOUNT. Each Contribution made with respect to a Participant pursuant to Section 2.01, will be allocated, as of the date by which Equitable has received at its Processing Office both such Contribution and direction as to its allocation, to the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account or in part to each, at the sole direction of the Participant as specified to Equitable, provided that the percentage allocated to each Account is a whole number. Any amount that a Participant has directed to be transferred to the Fixed Income Account, Stock Account, Balanced Account or Aggressive Stock Account pursuant to Section 2.05 will be allocated as of the date of such transfer to the appropriate Account maintained for such Participant. Interest is allocated to the Fixed Income Account at the end of each Participation Year, at the time of each transfer or withdrawal pursuant to Sections 2.05 and 2.07 and 2.07A, at the time of application of amounts in the Fixed Income Account to provide Annuity Benefits, upon termination of participation pursuant to Section 2.06, and upon death of the Participant pursuant to Section 2.09. SECTION 2.05 TRANSFERS AMONG ACCOUNTS. At any time before a Participant's Retirement Date, such Participant may transfer all or part of the amounts maintained for the Participant to one or more of the other Accounts maintained for such Participant as follows: (1) amounts in the Fixed Income Account, Stock Account, Balanced Account and Aggressive Stock Account may be transferred among such Accounts; (2) amounts in the Money Market Account may be transferred to the other Accounts. Such transfers will be made as of the date Equitable receives such request at its Processing Office and will be subject to Equitable's rules in effect at the time of transfer. No transfers are permitted from the Fixed Income Account, Stock Account, Balanced Account or Aggressive Stock Account maintained for the Participant to the Money Market Account. Notwithstanding the above, transfers to the Balanced Account may be prohibited by Equitable upon 30 days written notice to the Participant. SECTION 2.06 TERMINATION OF PARTICIPATION. On or before a Participant's Retirement Date, such Participant may elect by written notice to terminate participation under the Contract. Upon receipt of such notice at its Processing Office, Equitable will determine the Cash Value, as of the date Equitable received such notice, of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained for such Participant. The payment of such Cash Value to the Participant may be deferred by Equitable in accordance with the provisions of Section 4.06. Prior to a Participant's Retirement Date, Equitable reserves the right to withdraw the Cash Value of the Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, pay such Cash Values and terminate such Participant's participation under the Contract. This right may be exercised with respect to the Participant only if either (i) no Contributions have been made under the Contract on the Participant's behalf during the last two completed Participation Years, and the sum of such Annuity Values is $1,000 or less, or (ii) the Participant has completed at least three Participation Years and the sum of such Annuity Values is $1,000 or less. Equitable reserves the right to terminate a Participant's participation under the Contract if at least 120 days have elapsed since the issue date shown on the certificate issued to such Participant under the Contract and no Contributions have been made under the Contract with respect to such Participant. Upon payment of such Cash Values, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Cash Value arose. SECTION 2.07 PARTIAL WITHDRAWALS. A Participant may elect by written notice to Equitable to make a partial withdrawal from the Stock Account, Balanced Account, Aggressive Stock Account, -------- No. 11937C NQ Page Six Page Seven ---------- PARTICIPANT'S ACCOUNT (CONTINUED) Money Market Account and the Fixed Income Account maintained for such Participant before such Participant's Retirement Date. Upon withdrawal pursuant to Section 2.07 or 2.07A, Equitable will pay the lesser of the sum of the Cash Values of such Accounts or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by such Participant. Unless instructed otherwise, the amount withdrawn (including the amount of any withdrawal charge) will be allocated between such Accounts in proportion to the Annuity Value of each such Account. Upon any payment on behalf of a Participant pursuant to Section 2.07 or 2.07A, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Payments on behalf of the Participant pursuant to Section 2.07 or 2.07A may be deferred by Equitable in accordance with the provisions of Section 4.06. Equitable is under no obligation to process any request for partial withdrawal of less than $300. SECTION 2.07A PARTIAL WITHDRAWAL CHARGES. With respect to partial withdrawals requested by a Participant, there will be no withdrawal charge if the amount of the partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07B. Equitable will withdraw from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account, and Fixed Income Account and pay to the Participant an amount equal to the partial withdrawal requested. However, if the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge, if applicable. Such withdrawal charge will be calculated in the following manner: (a) Withdrawals of Contributions made on behalf of the Participant during the current and five prior Participation Years will be subject to a charge of 6% of the amount withdrawn (including such charge). (b) Withdrawals of other amounts will not be subject to any withdrawal charges. Equitable will pay the Participant the lesser of a) the amount requested or b)the sum of the Cash Values of the Accounts maintained on the Participant's behalf. For purposes of determining withdrawal charges described in this Section, amounts withdrawn up to the Free Corridor Amount will not be considered a withdrawal of any Contributions. Any excess withdrawals, i.e. those pursuant to item (ii) above, shall be considered withdrawals of older contributions first and more recent contributions next. SECTION 2.07B FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" with respect to a Participant means an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Values of the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Fixed Income Account over (ii) cumulative prior withdrawals made pursuant to Section 2.07 or 2.07A in the current Participation Year with respect to the Participant. SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Participation Year before a Participant's Retirement Date, Equitable will withdraw from the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract as to the Contributions remitted with respect to such Participant an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account at the end of that Participation Year and (ii) any withdrawals made from such Accounts pursuant to Section 2.07 and 2.07A during that Participation Year. The charge will be allocated between the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Fixed Income Account in proportion to the Annuity Values of each such Account, at the end of the Participation year. As of a Participant's Retirement Date and before application of the Annuity Values or Cash Values of such Participant's Account pursuant to Section 3.03, or upon termination of such Account pursuant to Section 2.06 or Section 2.09 during a Participation Year, Equitable will withdraw the administrative charge described in this Section for the applicable part of that Participation Year. SECTION 2.09 DEATH BENEFIT. If Equitable ascertains that a Participant has died while Accounts for such Participant are maintained under the Contract and before such Participant's Retirement Date, Equitable, upon receipt of due proof of such death, will pay in a single sum to the beneficiary designated by such Participant to receive such payment the amount of death benefit payable with respect to such Participant. The amount of the death benefit with respect to a Participant at any time prior to the Retirement Date is equal to the greater of (i) the sum of the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the ---------- No. 11937C NQ Page Seven Page Eight ---------- PARTICIPANT'S ACCOUNT (CONTINUED) Contract for such Participant and (ii) the minimum death benefit with respect to such Participant. Such minimum death benefit is the sum of all Contributions made with respect to such Participant pursuant to Section 2.01 less an adjustment for any withdrawals made pursuant to Sections 2.07 and 2.07A from the Accounts maintained under the Contract for such Participant. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount being withdrawn is to the Annuity Values then in the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract for such Participant. The amount of any death benefit payable with respect to a Participant will, to the extent such Account is sufficient therefore, be withdrawn from the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained with respect to such Participant under the Contract. Upon such payment, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Annuity Values arose. SECTION 2.10 OWNER DEATH DISTRIBUTION RULES. Upon the death of a certificate Owner before a Participant's Retirement Date: (i) If the Owner is the Participant, Equitable will pay the death benefit in accordance with Section 2.09. (ii) If the Owner is not the Participant, the designated beneficiary will succeed as Owner, notwithstanding the existence of any co-owner. The entire interest in the Accounts maintained for such Participant - subject to any applicable withdrawal charges as described in the certificate - must be distributed either: a) within 5 years after the Owner's death, or b) within 1 year after the Owner's death as a life annuity or installment option, for a period of not longer than the life expenctancy of the designated beneficiary. However, if the designated beneficiary is the Owner's spouse, the entire interest in the Accounts maintained for such Participant must then be distributed not later than 5 years after the spouse's death. If payments under an Annuity Benefit had commenced prior to the Owner's death, such payments will continue to be made over a period not longer than the period provided for under the Annuity Benefit elected. If the Participant dies before the entire interest in the Accounts maintained for such Participant under the Contract is distributed, Equitable will pay the death benefit in Section 2.09. The designated beneficiary is the same as the beneficiary who is entitled to the death benefit upon the Participant's death. Where more than one Owner is named, the date of death of the Owner will be deemed to be the date of death of the first Owner to die. SECTION 2.11 CONTRIBUTION LIMIT. Equitable may refuse to accept a Contribution made with respect to a Participant if the total prior Contributions made with respect to the Participant exceed (or if acceptance of such Contribution would cause the total Contributions to exceed) the following: (i) $500,000, if the Participant's current age last birthday is 75 or less. (ii) $250,000, if the Participant's current age last birthday is 76 - 79. Equitable may refuse to accept any Contribution made with respect to a Participant if such Participant's current age last birthday is 80 or greater. PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of Separate Account A. The amount of the first, second, and third payments under any variable Annuity Benefit provided under the Contract with respect to a payee is the monthly amount provided with respect to the payee pursuant to Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average New Annuity Unit Value for the second calendar month immediately preceding the date of the payment. The fourth and subsequent annuity payments under a Variable Annuity Benefit will not be increased or decreased in amount because of mortality or expense experience. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the New Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Values of such Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account shall ---------- No. 11937C NQ Page Eight Page Nine --------- ANNUITY BENEFITS (CONTINUED) be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of such Account in a single sum or (ii) to apply such Annuity Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by Equitable, as elected by the Participant, subject to Equitable's rules then in effect. Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit lieu of the Cash Values of such Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account. Equitable will have the right to require the Participant to furnish pertinent facts and determinations to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If a Participant elects to receive an Annuity Benefit in lieu of the Cash Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, the amount applied to provide the Annuity Benefit will be (i) the Annuity Values of such Accounts if the payments under the annuity form elected are contingent upon the survival of a person, or (ii) the Cash Values of such Accounts if the payments under the annuity form elected are not contingent upon the survival of a person. The amount applied to provide an Annuity Benefit shall be reduced by any applicable tax on annuity considerations, as determined by Equitable. If such amount is applied on or after the completion of five Participation Years with respect to such Participant: (1) The balance, less any Contribution made on behalf of the Participant during the current and five prior Participation Years, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown herein or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. (2) Any Contributions made on behalf of the Participant during the current and five prior Participation Years shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity payments shown herein or (ii) Equitable's current individual rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. If the amount applied to provide an Annuity Benefit is applied before the completion of five Participation Years with respect to a Participant, the balance, after any applicable tax on annuity considerations, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown herein or (ii) Equitable's current individual annuity rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained for such Participant shall terminate. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract, as indicated, on either the Life Annuity Form with 10 years of payments guaranteed or the Joint and Survivor Life Annuity Form (100% continuation). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form with 10 years of payments guaranteed and Joint and Survivor Life Annuity Form are based on 3 1/2% interest and the 1971 Equitable Annuity Mortality Table. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on the 1979 Equitable Annuitant Mortality Table and an Assumed Base Rate of Net Investment Return of 3 1/2% or 5%, whichever applies pursuant to Section 1.15. Equitable may change the monthly income amounts contained in the Tables of Guaranteed Annuity Payments and the basis for determining such amounts, for new Participants, by at least 90 days advance notice to the Contract Holder and by an amendment to the Contract. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on 3 1/2% interest and the 1971 Equitable Annuity Mortality Table if such annuity form provides for a Fixed Annuity Benefit, and on the 1979 Equitable Annuitant Mortality Table and an Assumed Base Rate of Net Investment Return of 5% or 3 1/2%, whichever applies pursuant to Section 1.15, if such annuity form provides for a Variable Annuity Benefit. ---------- No. 11937C NQ Page Nine Page Ten --------- ANNUITY BENEFITS (CONTINUED) SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payable under the Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by Equitable will be charged against and underpayments will be added to any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may make the payments (in the case of a minor, at a rate not exceeding $50 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. Upon election by a Participant pursuant to Section 3.03 of an annuity form providing payments for a period certain, such Participant may designate (with the right to change such designation) a person or persons to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's executors or administrators in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, Equitable will pay in a single sum to such payee's executors or administrators the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis originally used to determine such payments. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. Equitable will require satisfactory evidence of the age of any person upon whose life an annuity form depends.
TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM WITH 10 YEARS OF PAYMENTS GUARANTEED - 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Value) ------------------------------------------------------------------------------------------------------------------------------ FEMALE AGE MALE ----------------------------------------------------------------------------------------------------------------------- AGE 60 61 62 63 64 65 66 67 68 69 70 ------------------------------------------------------------------------------------------------------------------------------ 60 4.65 4.71 4.77 4.83 4.89 4.94 5.00 5.06 5.11 5.17 5.22 61 4.68 4.74 4.81 4.87 4.93 4.99 5.05 5.11 5.17 5.23 5.29 62 4.71 4.78 4.84 4.91 4.97 5.04 5.10 5.17 5.23 5.29 5.35 63 4.74 4.81 4.88 4.94 5.01 5.08 5.15 5.22 5.29 5.36 5.42 64 4.77 4.84 4.91 4.98 5.05 5.13 5.20 5.27 5.35 5.42 5.49 65 4.79 4.87 4.94 5.02 5.09 5.17 5.25 5.33 5.40 5.48 5.56 66 4.82 4.89 4.97 5.05 5.13 5.21 5.29 5.38 5.46 5.54 5.62 67 4.84 4.92 5.00 5.08 5.17 5.25 5.34 5.42 5.51 5.60 5.69 68 4.86 4.94 5.03 5.11 5.20 5.29 5.38 5.47 5.56 5.66 5.75 69 4.88 4.97 5.05 5.14 5.23 5.32 5.42 5.52 5.61 5.71 5.81 70 4.90 4.99 5.08 5.17 5.26 5.36 5.46 5.56 5.66 5.76 5.87 ------------------------------------------------------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM - 100% CONTINUATION - ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3 1/2% (Minimum Monthly Income per $1,000 of Annuity Value) - ---------------------------------------------------------------------------------------------------------------------------------- FEMALE AGE MALE ----------------------------------------------------------------------------------------------------------------------- AGE 60 61 62 63 64 65 66 67 68 69 70 - ---------------------------------------------------------------------------------------------------------------------------------- 60 4.31 4.35 4.39 4.43 4.47 4.51 4.55 4.59 4.63 4.67 4.71 61 4.35 4.39 4.43 4.48 4.52 4.56 4.61 4.65 4.69 4.73 4.78 62 4.39 4.43 4.48 4.52 4.57 4.61 4.66 4.71 4.75 4.80 4.85 63 4.42 4.47 4.52 4.57 4.62 4.67 4.72 4.77 4.82 4.87 4.92 64 4.46 4.51 4.57 4.62 4.67 4.72 4.77 4.83 4.88 4.94 4.99 65 4.50 4.56 4.61 4.66 4.72 4.78 4.83 4.89 4.95 5.01 5.07 66 4.54 4.60 4.65 4.71 4.77 4.83 4.89 4.95 5.01 5.08 5.14 67 4.58 4.64 4.70 4.76 4.82 4.88 4.95 5.01 5.08 5.15 5.22 68 4.62 4.68 4.77 4.81 4.87 4.95 5.01 5.08 5.15 5.22 5.29 69 4.65 4.72 4.78 4.85 4.92 4.99 5.06 5.14 5.22 5.29 5.37 70 4.69 4.76 4.83 4.90 4.97 5.05 5.12 5.20 5.28 5.36 5.45 - ----------------------------------------------------------------------------------------------------------------------------------
-------- No. 11937C NQ Page Ten Page Eleven ----------- ANNUITY BENEFITS (CONTINUED)
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM - 100% CONTINUATION - ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 5% (Minimum Monthly Income per $1,000 of Annuity Value) - ---------------------------------------------------------------------------------------------------------------------------------- FEMALE AGE MALE ----------------------------------------------------------------------------------------------------------------------- AGE 60 61 62 63 64 65 66 67 68 69 70 - ---------------------------------------------------------------------------------------------------------------------------------- 60 5.19 5.23 5.27 5.31 5.34 5.39 5.42 5.46 5.50 5.54 5.58 61 5.23 5.27 5.31 5.35 5.39 5.43 5.47 5.52 5.56 5.60 5.64 62 5.27 5.31 5.35 5.39 5.44 5.48 5.53 5.57 5.62 5.67 5.71 63 5.31 5.35 5.39 5.44 5.49 5.53 5.58 5.63 5.68 5.73 5.78 64 5.34 5.39 5.44 5.48 5.53 5.59 5.64 5.69 5.74 5.79 5.85 65 5.38 5.43 5.48 5.53 5.58 5.64 5.69 5.75 5.80 5.86 5.92 66 5.42 5.47 5.52 5.58 5.63 5.69 5.75 5.81 5.87 5.93 5.99 67 5.45 5.51 5.56 5.62 5.68 5.74 5.80 5.87 5.93 6.00 6.06 68 5.49 5.55 5.61 5.67 5.73 5.80 5.86 5.93 6.00 6.06 6.14 69 5.53 5.59 5.65 5.71 5.78 5.85 5.92 5.99 6.06 6.13 6.21 70 5.56 5.63 5.69 5.76 5.83 5.90 5.97 6.05 6.13 6.21 6.29 - ----------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) VARIABLE ANNUITY BENEFIT FIXED ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET WITH 10 YEARS OF PAYMENTS INVESTMENT RETURN IS GUARANTEED 3 1/2% 5% -------------------------- ------ -- AGE MALES FEMALES MALES FEMALES MALES FEMALES --- ----- ------- ----- ------- ----- ------- 60 5.77 5.06 5.43 4.80 6.36 5.70 61 5.89 5.16 5.57 4.90 6.50 5.81 62 6.02 5.28 5.72 5.01 6.65 5.91 63 6.16 5.40 5.88 5.13 6.81 6.03 64 6.29 5.52 6.05 5.25 6.97 6.15 65 6.44 5.66 6.23 5.39 7.16 6.28 66 6.59 5.80 6.43 5.54 7.35 6.43 67 6.74 5.94 6.64 5.70 7.56 6.58 68 6.90 6.10 6.87 5.87 7.79 6.76 69 7.06 6.26 7.11 6.06 8.03 6.95 70 7.23 6.43 7.38 6.27 8.30 7.15
Equitable will notify the payee under a Variable Annuity Benefit of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each variable payment. Any election, change, revocation or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a commutation right under an Annuity Benefit is exercised, Equitable may defer payment in accordance with Section 4.06. PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT. The Contract constitutes the entire Contract between the parties and the provisions of the Contract alone will govern with respect to the rights and obligations of Equitable. The provisions of the Contract will be applied separately with respect to each Participant. Nothing in the enrollment form referred to in Section 1.02 nor any modification, amendment, or supplement to any such document will in any way be construed to enlarge, change, vary or in any other way affect the obligations of Equitable as expressly provided in the Contract. The Contract may not be modified as to Equitable, nor may any of Equitable's rights or requirements be waived, except in writing and by an authorized officer of Equitable. The Contract may be changed by amendment or replacement upon agreement between the Contract Holder and Equitable without the consent of any other person provided that such change does not reduce any Annuity Benefit provided before such change and provided that no rights, privileges or benefits which have accrued to any Participant under the Contract may be reduced or forfeited except by the expressed consent of such Participant. SECTION 4.02 STATUTORY COMPLIANCE. Equitable reserves the right to amend the Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the Contract and any certificate to reflect changes in the Code, or in regulations or published rulings of the Internal Revenue Service so that each such certificate will continue to be an "annuity" as defined in Section 72 of the Code. Any Annuity Benefit, Cash Value or death benefit available under a certificate issued pursuant to the Contract shall not be less than the minimum benefits required by any statute of the state in which the certificate is delivered. SECTION 4.03 PARTICIPATION IN SURPLUS. The Contract and all other contracts in the same class of contracts shall be combined for the purpose of ascertaining the annual surplus of Equitable to be apportioned to said contracts as a dividend and the portion of any such dividend that is to be allocated to the Contract shall be determined by Equitable. The participation of this class of contracts in annual surplus is, however, expected to be minimal. Any amount so allocated to the Contract shall be payable as of January 1 of the calendar year in which a dividend is apportioned and will be payable in cash and shall be equitably allocated by Equitable to the Fixed Income Accounts maintained hereunder for Participants. No Annuity Benefit will enter into the determination of any surplus to be apportioned to the Contract as a dividend. SECTION 4.04 BENEFICIARY. Each Participant, as of the Participant's Participation Date, is to name a beneficiary entitled to receive any death benefit payable with respect to such Participant pursuant to Section 2.09. The Participant may change such beneficiary from time to time while Accounts for the Participant are being maintained hereunder. Any such change will be made by ----------- No. 11937C NQ Page Eleven Page Twelve ----------- GENERAL PROVISIONS (CONTINUED) written notice in a form satisfactory to Equitable. A change will, upon receipt at a designated Equitable Office, take effect as of the time the written notice was signed, whether or not the Participant is living on the date of receipt, but without further liability as to any payment or other settlement made by Equitable before receipt of such change. Unless otherwise specified in the enrollment form, if a Participant has named two or more persons as beneficiary, the beneficiary will be the named person or persons who survive the Participant, and if more than one survive they will share equally. Any part of a death benefit payable with respect to a Participant pursuant to Section 2.09 for which there is no named beneficiary living at the death of the Participant will be payable in a single sum to the children of the Participant who survive the Participant, in equal shares, or should none survive, then to the Participant's executors or administrators. If a Participant so elects in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by the Participant, with respect to the beneficiary, subject to Equitable's rules then in effect. If at the death of a Participant there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. SECTION 4.05 FUTURE PARTICIPANTS AND CONTRIBUTIONS. Equitable reserves the right at its sole discretion to (i) curtail or prohibit further enrollment as Participants under the Contract of any individuals who are not currently participating under the Contract as of such date of curtailment or prohibition, and (ii) prohibit future Contributions under the Contract upon written notice to existing Participants. SECTION 4.06 DEFERMENT. Payments by Equitable from the Participant's Fixed Income Account pursuant to the provisions of Section 2.06, Sections 2.07 and 2.07A, and Section 2.09, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.05, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due documentation for such commutation payment pursuant to Section 3.05. Interest at the current Guaranteed Interest Rate for such Participant's Fixed Income Account will be allowed on any such payment deferred for 30 days or more. Except as provided in this Section, payments by Equitable from the Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account pursuant to the provisions of Section 2.06, Sections 2.07 and 2.07A, and Section 2.09, or any commuted payments arising from a Variable Annuity Benefit pursuant to Section 3.05, will be made within seven days after receipt, at Equitable's Processing Office, of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. During any period when (i) the sale of securities or the documentation of the New Accumulation Unit Value or the Average New Annuity Unit Value is not reasonably practicable because an emergency, defined by the Securities and Exchange Commission, exists, or the New York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may by order permit postponement for the protection of persons having interests in the Separate Accounts, Equitable reserves the right: (a) to defer determination of Cash Values or Annuity Values and payment of Cash Values and Annuity Values, arising from an amount in a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (b) to defer payment of any portion of the death benefit arising from an amount in a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (c) to defer the payment of any Variable Annuity Benefit under the Contract or the application of any such Benefit to provide for any other payment called for by the Contract; or (d) in the event of (a) above, to defer application of such amounts to provide any Annuity Benefit permitted under the Contract. SECTION 4.07 ANNUAL NOTICE. At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Fixed Income Account, (2) the total number of Accumulation Units credited to the Stock Account, Balanced Account, Aggressive Stock Account and Money market Account, (3) the New Accumulation Unit Values, (4) the sum of the Cash Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account and (5) the amount of death benefit payable with respect to the Participant. After the Retirement Date Equitable will notify the Participant of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.08 CONTRACT HOLDER RESPONSIBILITY. The sole responsibility of the Contract Holder is to serve as party to the Contract. The Contract Holder will have no responsibility for the administration of any Plan or Agreement, for payments to ----------- No. 11937C NQ Page Twelve Page Thirteen ------------- GENERAL PROVISIONS (CONTINUED) the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account, or any payments or other distributions hereunder. Equitable will deal with the Contract Holder in accordance with the terms and conditions of the trust agreement pursuant to which the Contract Holder agreed to act as such and with the Contract and in such manner as the Contract Holder and Equitable may agree, without the consent of any other person. SECTION 4.09 AGE AND SEX. If the age or sex of any person upon whose life an Annuity Benefit depends has been misstated, any benefits will be those which would have been purchased at the correct age and sex. Any overpayments or underpayments made by Equitable will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. ------------- No. 11937C NQ Page Thirteen Attached to and made part of Group Annuity Contract No. 11937CNQ between THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES and RHODE ISLAND HOSPITAL TRUST IT IS HEREBY AGREED that, effective July 1, 1986 said contract is amended as follows: With respect to Section 2.07 PARTIAL WITHDRAWALS, the following sentence is added: For New Participants whose Participation Date is on or after July 1, 1986: If a withdrawal from the Accounts made pursuant to Sections 2.07 or 2.07A would result in total Annuity values of less than $500, Equitable will so advise the Participant and reserves the right to withdraw the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, pay the Annuity Values of such Accounts to the Participant, and terminate such Participant's participation under the contract. Agreed to by: RHODE ISLAND HOSPITAL TRUST FOR THE EQUITABLE By __________________________________ By /s/ John B. Carter ---------------------------------- President Title _______________________________ By /s/ Rodney L. Enochs ---------------------------------- Vice President and Secretary Dated________________________________ Date of Issue ______________________ At __________________________________ PF17026CNQ OWNER: PARTICIPANT: CERTIFICATE NUMBER: [EQUITABLE LOGO] ISSUE DATE: PARTICIPATION DATE: RETIREMENT DATE: THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York, New York 10116 SPECIMEN AGREES o TO ALLOCATE the Contributions made to the Contract to the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account or the Fixed Income Account maintained for the Participant, in accordance with Sections 2.02 and 2.03, or in part to any one, as directed by the Participant. o TO APPLY the amount in the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Fixed Income Account at the Retirement Date to provide the Participant with an Annuity Benefit or a Cash Value Benefit if the Participant is then living, and o TO PROVIDE the Participant with the other rights and benefits of this certificate. These agreements are subject to the provisions of this certificate. TEN DAYS TO EXAMINE CERTIFICATE - The Participant may terminate participation under the Contract and cancel this certificate by returning it to Equitable within ten days after receipt of it. Upon such cancellation, Equitable will refund any Contribution made to Equitable on behalf of a Participant under the Contract, plus or minus any investment gain or loss experienced in the Participant's Stock Account, Balanced Account, Aggressive Stock Account, or Money Market Account from the date such Contribution is allocated to such Account to the date of such Cancellation. /s/ John B. Carter President /s/ Rodney L. Enochs Vice President and Secretary ASSETS HELD IN CONNECTION WITH THE CONTRACT MAY BE HELD IN SEPARATE ACCOUNTS MAINTAINED BY EQUITABLE AND MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THE CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF SEPARATE ACCOUNT A. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN SEPARATE ACCOUNT A IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.15 IS 5% OR 3 1/2%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE OF 1.75% FOR INVESTMENT MANAGEMENT, FINANCIAL ACCOUNTING, THE ANNUITY RATE GUARANTEE AND MINIMUM DEATH BENEFIT, EXPENSES AND EXPENSE RISK, BUT AFTER ANY DEDUCTIONS TO PROVIDE FOR TAXES. No. 11937 NQ CONTENTS Part I - Definitions Page 2 Part II - Participant's Account Page 6 Part III - Annuity Benefits Page 9 Part IV - General Provisions Page 12 Equitable certifies that the Participant as named on Page 3 is included under the Group Annuity Contract designated on Page 3 ("the Contract"), all pertinent provisions of which are set forth below. The Contract is issued in consideration of the payment to Equitable of the Contributions made under the Contract. The provisions on the following pages are part of this certificate. PART I - DEFINITIONS SECTION 1.01 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Part III of the Contract. SECTION 1.02 PARTICIPANT. The term "Participant" means a person who has been enrolled by Equitable under the Contract. A person shall become enrolled under the Contract upon receipt by Equitable of an enrollment form made available by Equitable and completed in a manner satisfactory to Equitable. SECTION 1.03 OWNER. The Owner of a certificate issued under the Contract is the Participant unless otherwise stated in the enrollment form, or later changed. Notwithstanding any provisions in the certificate to the contrary, only the Owner can exercise all the rights under the certificate while the Participant is living. The Owner does not need the consent of anyone who has only a conditional or future ownership interest in a certificate. While the Participant is living, an Owner of a certificate issued on behalf of the Participant may change the Owner by written notice satisfactory to Equitable. The change will take effect on the date the Owner signs the notice, except it will not apply to any payment Equitable makes or other actions Equitable takes before Equitable receives the notice. SECTION 1.04 ASSIGNMENTS. A certificate issued under the Contract may not be assigned as collateral or security for a loan. Otherwise, the Participant may assign this certificate before the Retirement Date but Equitable will not be bound by an assignment unless it is in writing and Equitable has received it. The Participant's rights and those of any of persons referred to in the certificate will be subject to the assignment. Equitable assumes no responsibility for the validity of any assignment. No amounts payable under a certificate to a payee other than the Owner may be assigned by that payee, nor will they be subject to the claims of creditors or to legal process, except to the extent permitted by law. SECTION 1.05 CONTRIBUTION. The term "Contribution" means a payment made to Equitable for a Participant with respect to an annuity purchased for such Participant under the Contract. Equitable is under no obligation to accept any Contribution less than $50.00. SECTION 1.06 PARTICIPATION DATE. The term "Participation Date" with respect to a Participant means the date as of which Equitable has enrolled such Participant under the terms of the Contract, as shown on Page 3 of the certificate. SECTION 1.07 PARTICIPATION YEAR. The term "Participation Year" with respect to a Participant means the twelve month period beginning on (i) the Participation Date, and (ii) each anniversary thereof, unless otherwise agreed to in writing by Equitable. SECTION 1.08 CLASS OF PARTICIPANTS. Except as provided in Section 1.09, the term "Class of Participants" refers to all Participants whose Participation Date is in the same calendar year. SECTION 1.09 GUARANTEED INTEREST RATE. In regards to a Fixed Income Account, the term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in such Account. Interest accrues daily. The Guaranteed Interest Rate will never be less than 4% per annum. Equitable will from time to time establish and make available for new Participants (i) an Initial Guaranteed Interest Rate, (ii) one or more Minimum Guaranteed Interest Rates and (iii) the applicable effective period(s) for such Rates. A new Class of Participants will -------- No. 11937 NQ Page Two Page Four --------- DEFINITIONS (CONTINUED) be established effective with the effective date of the occurrence of (i), (ii) or (iii) above or any combination thereof. For the period (not to exceed one year) next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent period (not to exceed one year) the Equitable may determine for each established Class of Participants a Guaranteed Interest Rate and duration for such Class which exceeds the applicable Minimum Guaranteed Interest Rate. Equitable will notify each Participant in writing of the applicable Guaranteed Interest Rate and duration. Equitable reserves the right to combine one or more Classes of Participants into a single Class of Participants, provided such Classes were initially established during a continuous period of time. SECTION 1.10 RETIREMENT DATE. The term "Retirement Date" means the date on which the Participant is to attain the retirement age specified in the Participant's enrollment form. Before the Retirement Date the Participant may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be later than the date the Participant attains age 85. Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Processing Office. SECTION 1.11 NORMAL FORM. The "Normal Form" of an Annuity Benefit under the Contract means the Fixed Annuity Benefit payable on the Life Annuity Form, as defined in Sections 3.01 and 1.12, with 10 years of payments guaranteed. SECTION 1.12 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.13 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by the Participant. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.14 THE SEPARATE ACCOUNTS. The term "Separate Accounts" means the following separate investment accounts maintained by Equitable to which portions of its assets have been allocated for the Contract and certain other contracts: Name Investments ---- ----------- Separate Account A Primarily common stock and other equity-type investments. Separate Account E Primarily short-term money market instruments. Separate Account J Primarily common stocks and other equity-type investments, publicly traded debt securities and short-term money market instruments. Separate Account K Primarily common stocks issued by high quality small and intermediate size companies with strong growth prospects. Equitable reserves the right to withdraw from any Separate Account and allocate to another separate account assets determined by Equitable to be associated with the class of contracts to which the Contract belongs. In any such event, to the extent practicable and permissible under applicable laws and regulations, the withdrawal shall be made by withdrawing the same percentage of each investment in the Separate Account, with appropriate adjustments to avoid odd lots and fractions. On and after the date of any such withdrawal the reference in the Contract to such Separate Account shall mean such other separate account to which the withdrawn assets were allocated. It is contemplated that investments in the Separate Accounts will, at most times, consist primarily of the types of investments indicated above. Equitable may, however, at its discretion invest the assets of any Separate Account in any investment permitted by applicable law. Equitable may rely conclusively on the opinion of counsel (including attorneys in its employ) as to what investments it is permitted by law to make. --------- No. 11937 NQ Page Four Page Five --------- DEFINITIONS (CONTINUED) In lieu of making such investments directly, Equitable reserves the right to operate any Separate Account as a unit investment trust, or in any other form permitted by law, investing all or a part of its assets in shares or units of a fund, the investment adviser of which may be Equitable or controlled by Equitable. The fund assets would be invested as provided above with respect to the Separate Account. Equitable reserves the right: (i) to cause the registration or deregistration of any Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run any Separate Account under direction of a committee, and to discharge such committee at any time; and (iii) restrict or eliminate any voting rights of participants or other persons who have voting rights as to the Separate Accounts. Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.15. The assets of Separate Accounts are the property of Equitable; however, the portion of the assets of each Separate Account equal to the reserves and other contract liabilities with respect to such Account shall not be chargeable with liabilities arising out of any other business Equitable may conduct. Equitable reserves the right to transfer assets of the Separate Accounts in excess of such reserves and contract liabilities to the general account of Equitable. SECTION 1.15 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS. VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business days immediately preceding such business day will constitute a Valuation Period. A business day is any day on which the New York Stock Exchange is open. NET INVESTMENT FACTOR: For each Separate Account the Net Investment Factor for a Valuation Period is (a) divided by (b), minus (c), where (a) is (1) the value of the assets in the Separate Account at the close of business of the preceding Valuation Period plus (2) the investment income and the capital gains, realized or unrealized, credited to the assets of the Separate Account in the Valuation Period for which the Net Investment Factor is being determined, minus (3) the capital losses, realized or unrealized, charged against such assets in such Valuation Period, minus (4) any amount charged against the Separate Account in such Valuation Period for taxes or for amounts set aside by Equitable as a reserve for taxes attributable to the maintenance or operation of the Separate Account; (b) is the value of the assets in the Separate Account at the close of business of the preceding Valuation Period; and (c) is the daily charge, for each calendar day in such Valuation Period, of .00004837 for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The value of the assets in the Separate Accounts, referred to above, shall be taken at their fair market value, or where there is no readily available market, their fair value, as determined in accordance with accepted accounting practices and applicable laws and regulations. ACCUMULATION UNIT: The Accumulation Unit is a unit used in determining the value of the interest of a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account on or before the Retirement Date. NEW ACCUMULATION UNIT VALUE: The initial New Accumulation Unit Values for the Separate Accounts have been established as follows: Account Value Date ------- ----- ---- Separate Account A $10.00 As of November 1, 1968 Separate Account E $10.00 As of September 4, 1974 Separate Account J $10.00 As of May 1, 1984 Separate Account K $10.00 As of May 1, 1984 The New Accumulation Unit Value for each subsequent Valuation Period is the New Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such subsequent Valuation Period. ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable from Separate Account A under a Variable Annuity Benefit. NEW ANNUITY UNIT VALUE: The initial New Annuity Unit Value for Separate Account A has been established at $1.00 as of November 1, 1968. The Annuity Unit Value for any subsequent Valuation Period is the New Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment --------- No. 11937 NQ Page Five Page Six -------- DEFINITIONS (CONTINUED) Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3 1/2%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE NEW ANNUITY UNIT VALUE: The Average Annuity Unit Value for Separate Account A for a calendar month is equal to the average of the New Annuity Unit Values for the Valuation Periods ending in such month. SECTION 1.16 ANNUITY VALUE. The term "Annuity Value" with respect to a Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, means the amount in such Accounts pursuant to Sections 2.02 and 2.03. SECTION 1.17 CASH VALUE. With respect to a Participant, the term "Cash Value" with respect to such Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account, and Money Market Account means an amount equal to the greater of (i) or (ii) below: (i) the Annuity Value of such Accounts less 6% of the Contributions made during the current and five prior Participation Years, which had not been previously withdrawn pursuant to Section 2.07A. (ii) the sum of (a) the Free Corridor Amount as defined in Section 2.07B and (b) 94% of (the Annuity Value of such Accounts less the Free Corridor Amount). SECTION 1.18 CODE. The term "Code" means the Internal Revenue Code of 1954, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. PART II - PARTICIPANT'S ACCOUNTS SECTION 2.01 CONTRIBUTIONS. Contributions may be made with respect to a Participant on whichever basis, as described under subsections A and B below, is specified upon the Participant's enrollment under the Contract. If Contributions are made by or on behalf of a Participant under more than one such basis, Equitable will accept such Contributions if the Participant is separately enrolled under the Contract under each basis, and in such case separate certificates will be issued under the Contract for the Participant reflecting amounts accumulated on the Participant's behalf attributable to Contributions made under each Contribution basis. A. Post-August 13, 1982 Basis Contributions are to be made from time to time at the Participant's discretion. With each Contribution, the Participant with respect to whom such Contribution is being made and the amounts to be allocated to the Stock Account, Money Market Account, Fixed Income Account, Balanced Account and Aggressive Stock Account shall be specified. A Participant may transfer to the Contract under this basis any amount held with respect to such Participant under a deferred annuity contract, where such transferred amount represents amounts invested in or credited to investments in annuity contracts after August 13, 1982. B. Pre-August 14, 1982 Basis A Participant may transfer to the Contract under this basis any amount held with respect to such Participant under a deferred annuity contract where such transferred amount represents amounts invested in or credited to investments in annuity contracts prior to August 14, 1982. New Contributions cannot be made under this basis SECTION 2.02 STOCK, BALANCED, AGGRESSIVE STOCK AND MONEY MARKET ACCOUNTS. Equitable maintains a Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the (1) Stock Account becomes part of Separate Account A, (2) Balanced Account becomes part of Separate Account J, (3) Aggressive Stock Account becomes part of Separate Account K, and (4) Money Market Account becomes part of Separate Account E. Any amount withdrawn from an Account will no longer be part of the applicable Separate Account. On any date when an amount is allocated to or withdrawn from an Account, the Account will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the New Accumulation Unit Value for the appropriate Separate Account for the Valuation Period which includes that date. The number of Units in an Account on any date is equal to (i) the sum of any Accumulation Units that have been credited to the Account minus (ii) the sum of any Accumulation Units that have been charged to that Account. The amount in the Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account on any date is equal to the product of (i) the number of Accumulation Units in such Account on that date and (ii) the New Accumulation Unit Value for the appropriate Separate Account for the Valuation Period which includes that date, less any administrative charge accrued but not made. SECTION 2.03 FIXED INCOME ACCOUNT. Equitable maintains a Fixed Income Account under the Contract for each Participant with respect to whom Contributions are made. Any amount allocated to the Fixed Income Account becomes part of the general assets of Equitable, which support the guarantees of the Contract and other contracts. -------- No. 11937 NQ Page Six Page Seven ---------- PARTICIPANT'S ACCOUNT (CONTINUED) The amount in a Fixed Income Account at any time is equal to the sum of all amounts that have been allocated to such Fixed Income Account pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn pursuant to Sections 2.07, 2.07A, and Section 2.08 from such Account, and transferred pursuant to Section 2.05 from such Fixed Income Account, and less any annual administrative charges accrued but not made. Equitable guarantees that the amount in a Fixed Income Account at any time before the Retirement Date will not be less than the sum of all amounts allocated to such Account pursuant to Section 2.04 or transferred to such Account pursuant to Section 2.05 and less the sum of all amounts that have been withdrawn from such Account pursuant to Sections 2.07, 2.07A and 2.08, and transferred from such Account pursuant to Section 2.05, all accumulated at 4% interest, compounded annually. In any Participation Year in which no Contribution is allocated to a Fixed Income Account, the amount in such Account at the end of the Participation Year shall in no event be less than the amount in such Account at the beginning of the Participation Year plus the sum of all amounts transferred to such Account pursuant to Section 2.05 less the sum of all amounts withdrawn and transferred out of such Account pursuant to Sections 2.07, 2.07A, and Section 2.05, all accumulated at 3% interest, compounded annually. A Fixed Income Account for a Participant terminates on the earliest of (i) the Retirement Date, (ii) the death of the Participant, and (iii) termination of participation pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO ACCOUNT. Each Contribution made with respect to a Participant pursuant to Section 2.01, will be allocated, as of the date by which Equitable has received at its Processing Office both such Contribution and direction as to its location, to the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account or in part to each, at the sole direction of the Participant as specified to Equitable, provided that the percentage allocated to each Account is a whole number. Any amount that a Participant has directed to be transferred to the Fixed Income Account, Stock Account, Balanced Account or Aggressive Stock Account pursuant to Section 2.05 will be allocated as of the date of such transfer to the appropriate Account maintained for such Participant. Interest is allocated to the Fixed Income Account at the end of each Participation Year, at the time of each transfer or withdrawal pursuant to Sections 2.05 and 2.07 and 2.07A, at the time of application of amounts in the Fixed Income Account to provide Annuity Benefits, upon termination of participation pursuant to Section 2.06, and upon death of the Participant pursuant to Section 2.09. SECTION 2.05 TRANSFERS AMONG ACCOUNTS. At any time before a Participant's Retirement Date, such Participant may transfer all or part of the amounts maintained for the Participant to one or more of the other Accounts maintained for such Participant as follows: (1) amounts in the Fixed Income Account, Stock Account, Balanced Account and Aggressive Stock Account may be transferred among such Accounts; (2) amounts in the Money Market Account may be transferred to the other Accounts. Such transfers will be made as of the date Equitable receives such request at its Processing Office and will be subject to Equitable's rules in effect at the time of transfer. No transfers are permitted from the Fixed Income Account, Stock Account, Balanced Account or Aggressive Stock Account maintained for the Participant to the Money Market Account. Notwithstanding the above, transfers to the Balanced Account may be prohibited by Equitable upon 30 days written notice to the Participant. SECTION 2.06 TERMINATION OF PARTICIPATION. On or before a Participant's Retirement Date, such Participant may elect by written notice to terminate participation under the Contract. Upon receipt of such notice at its Processing Office, Equitable will determine the Cash Value, as of the date Equitable received such notice, of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained for such Participant. The payment of such Cash Value to the Participant may be deferred by Equitable in accordance with the provisions of Section 4.06. Prior to a Participant's Retirement Date, Equitable reserves the right to withdraw the Cash Value of the Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, pay such Cash Values and terminate such Participant's participation under the Contract. This right may be exercised with respect to the Participant only if either (i) no Contributions have been made under the Contract on the Participant's behalf during the last two completed Participation Years, and the sum of such Annuity Values is $1,000 or less, or (ii) the Participant has completed at least three Participation Years and the sum of such Annuity Values is $1,000 or less. Equitable reserves the right to terminate a Participant's participation under the Contract if at least 120 days have elapsed since the issue date shown on the certificate issued to such Participant under the Contract and no Contributions have been made under the Contract with respect to such Participant. Upon payment of such Cash Values, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Cash Values arose. SECTION 2.07 PARTIAL WITHDRAWLS. A Participant may elect by written notice to Equitable to make a partial withdrawal from the Stock Account, Balanced Account, Aggressive Stock Account, ---------- No. 11937 NQ Page Seven Page Eight ---------- PARTICIPANT'S ACCOUNT (CONTINUED) Money Market Account and the Fixed Income Account maintained for such Participant before such Participant's Retirement Date. Upon withdrawal pursuant to Section 2.07 or 2.07A, Equitable will pay the lesser of the sum of the Cash Values of such Accounts or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by such Participant. Unless instructed otherwise, the amount withdrawn (including the amount of any withdrawal charge) will be allocated between such Accounts on proportion to the Annuity Value of each such Account. Upon any payment on behalf of a Participant pursuant to Section 2.07 or 2.07A, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Payments on behalf of the Participant pursuant to Section 2.07 or 2.07A may be deferred by Equitable in accordance with the provisions of Section 4.06. Equitable is under no obligation to process any request for partial withdrawal of less than $300. SECTION 2.07A PARTIAL WITHDRAWAL CHARGES. With respect to partial withdrawals requested by a Participant, there will be no withdrawal charge if the amount of the partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07B. Equitable will withdraw from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account, and Fixed Income Account and pay to the Participant an amount equal to the partial withdrawal requested. However, if the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge, if applicable. Such withdrawal charge will be calculated in the following manner: (a) Withdrawals of Contributions made on behalf of the Participant during the current and five prior Participation Years will be subject to a charge of 6% of the amount withdrawn (including such charge). (b) Withdrawals of other amounts will not be subject to any withdrawal charges. Equitable will pay the Participant the lesser of a) the amount requested or b) the sum of the Cash Values of the Accounts maintained on the Participant's behalf. For purposes of determining withdrawal charges described in this Section, amounts withdrawn up to the Free Corridor Amount will not be considered a withdrawal of any Contributions. Any excess withdrawals, i.e. those pursuant to item (ii) above, shall be considered withdrawals of older contributions first and more recent contributions next. SECTION 2.07B FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" with respect to a Participant means an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Values of the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Fixed Income Account over (ii) cumulative prior withdrawals made pursuant to Section 2.07 or 2.07A in the current Participation Year with respect to the Participant. SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Participation Year before a Participant's Retirement Date, Equitable will withdraw from the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract, as to the Contributions remitted with respect to such Participant, an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account at the end of that Participation Year and (ii) any withdrawals made from such Accounts pursuant to Section 2.07 and 2.07A during that Participation Year. The charge will be allocated between the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Fixed Income Account in proportion to the Annuity Values of each such Account, at the end of the Participation Year. As of a Participant's Retirement Date and before application of the Annuity Values or Cash Values of such Participant's Account pursuant to Section 3.03, or upon termination of such Account pursuant to Section 2.06 or Section 2.09 during a Participation Year, Equitable will withdraw the administrative charge described in this Section for the applicable part of that Participation Year. SECTION 2.09 DEATH BENEFIT. If Equitable ascertains that a Participant has died while Accounts for such Participant are maintained under the Contract and before such Participant's Retirement Date, Equitable, upon receipt of due proof of such death, will pay in a single sum to the beneficiary designated by such Participant to receive such payment the amount of death benefit payable with respect to such Participant. The amount of the death benefit with respect to a Participant at any time prior to the Retirement Date is equal to the greater of (i) the sum of the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the ---------- No. 11937 NQ Page Eight Page Nine --------- PARTICIPANT'S ACCOUNT (CONTINUED) Contract for such Participant and (ii) the minimum death benefit with respect to such Participant. Such minimum death benefit is the sum of all Contributions made with respect to such Participant pursuant to Section 2.01 less an adjustment for any withdrawals made pursuant to Sections 2.07 and 2.07A from the Accounts maintained under the Contract for such Participant. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount being withdrawn is to the Annuity Values then in the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract for such Participant. The amount of any death benefit payable with respect to a Participant will, to the extent such Account is sufficient therefore, be withdrawn from the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained with respect to such Participant under the Contract. Upon such payment, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Annuity Values arose. SECTION 2.10 OWNER DEATH DISTRIBUTION RULES. Upon the death of a certificate Owner before a Participant's Retirement Date: (i) If the Owner is the Participant, Equitable will pay the death benefit in accordance with Section 2.09. (ii) If the Owner is not the Participant, the designated beneficiary will succeed as Owner, notwithstanding the existence of any co-owner. The entire interest in the Accounts maintained for such Participant--subject to any applicable withdrawal charges as described in the certificate--must be distributed either: a) within 5 years after the Owner's death, or b) within 1 year after the Owner's death as a life annuity or installment option, for a period of not longer than the life expectancy of the designated beneficiary. However, if the designated beneficiary is the Owner's spouse, the entire interest in the Accounts maintained for such Participant must then be distributed no later than 5 years after the spouse's death. If payments under an Annuity Benefit had commenced prior to the Owner's death, such payments will continue to be made over a period not longer than the period provided for under the Annuity Benefit elected. If the Participant dies before the entire interest in the Accounts maintained for such Participant under the Contract is distributed, Equitable will pay the death benefit in Section 2.09. The designated beneficiary is the same as the beneficiary who is entitled to the death benefit upon the Participant's death. Where more than one Owner is named, the date of death of the Owner will be deemed to be the date of death of the first Owner to die. SECTION 2.11 CONTRIBUTION LIMIT. Equitable may refuse to accept a Contribution made with respect to a Participant if the total prior Contributions made with respect to the Participant exceed (or if acceptance of such Contribution would cause the total Contributions to exceed) the following: (i) $500,000, if the Participant's current age last birthday is 75 or less. (ii) $250,000, if the Participant's current age last birthday is 76-79. Equitable may refuse to accept any Contribution made with respect to a Participant if such Participant's current age last birthday is 80 or greater. PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of Separate Account A. The amount of the first, second, and third payments under any Variable Annuity Benefit provided under the Contract with respect to a payee is the monthly amount provided with respect to the payee pursuant to Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average New Annuity Unit Value for the second calendar month immediately preceding the date of the payment. The fourth and subsequent annuity payments under a Variable Annuity Benefit will not be increased or decreased in amount because of mortality or expense experience. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the New Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Values of such Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account shall --------- No. 11937 NQ Page Nine Page Ten -------- ANNUITY BENEFITS (CONTINUED) be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of such Account in a single sum or (ii) to apply such Annuity Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by Equitable, as elected by the Participant, subject to Equitable's rules then in effect. Equitable will provide notice and election forms to a Participant not more than six months before such Participant's Retirement Date. If a Participant elects to terminate participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Values of such Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account. Equitable will have the right to require the Participant to furnish pertinent facts and determinations to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If a Participant elects to receive an Annuity Benefit in lieu of the Cash Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, the amount applied to provide the Annuity Benefit will be (i) the Annuity Values of such Accounts if the payments under the annuity form elected are contingent upon the survival of a person, or (ii) the Cash Values of such Accounts if the payments under the annuity form elected are not contingent upon the survival of a person. The amount applied to provide an Annuity Benefit shall be reduced by any applicable tax on annuity considerations, as determined by Equitable. If such amount is applied on or after the completion of five Participation Years with respect to such Participant: (1) The balance, less any Contribution made on behalf of the Participant during the current and five prior Participation Years, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown herein or (ii) Equitable's current individual annuity rates for payments of proceeds, whichever rates would provide a larger benefit with respect to the payee, (2) Any Contributions made on behalf of the Participant during the current and five prior Participation Years shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown herein or (ii) Equitable's current individual rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. If the amount applied to provide an Annuity Benefit is applied before the completion of five Participation Years with respect to a Participant, the balance, after any applicable tax on annuity considerations, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown herein or (ii) Equitable's current individual annuity rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained for such Participant shall terminate. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract, as indicated, on either the Life Annuity Form with 10 years of payments guaranteed or the Joint and Survivor Life Annuity Form (100% continuation). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form with 10 years of payments guaranteed and Joint and Survivor Life Annuity Form are based on 3 1/2% interest and the 1971 Equitable Annuity Mortality Table. The amounts of income initally provided under the Variable Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on the 1979 Equitable Annuitant Mortality Table and an Assumed Base Rate of Net Investment Return of 3 1/2% or 5%, whichever applies pursuant to Section 1.15. Equitable may change the monthly income amounts contained in the Tables of Guaranteed Annuity Payments and the basis for determining such amounts, for new Participants, by at least 90 days advance notice to the Contract Holder and by an amendment to the Contract. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on 3 1/2% interest and the 1971 Equitable Annuity Mortality Table if such annuity form provides for a Fixed Annuity Benefit, and on the 1979 Equitable Annuitant Mortality Table and an Assumed Base Rate of Net Investment Return of 5% or 3 1/2%, whichever applies pursuant to Section 1.15, if such annuity form provides for a Variable Annuity Benefit. -------- No. 11937 NQ Page Ten Page Eleven ----------- ANNUITY BENEFITS (CONTINUED) SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payable under the Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by Equitable will be charged against and underpayments will be added to any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may make the payments (in the case of a minor, at a rate not exceeding $50 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. Upon election by a Participant pursuant to Section 3.03 of an annuity form providing payments for a period certain, such Participant may designate (with the right to change such designation) a person or persons to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's executors or administrators in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, Equitable will pay in a single sum to such payee's executors or administrators the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis originally used to determine such payments. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. Equitable will require satisfactory evidence of the age of any person upon whose life an annuity form depends. TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM WITH 10 YEARS OF PAYMENTS GUARANTEED -- 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Value)
- ---------------------------------------------------------------------------------------------------------- MALE FEMALE AGE ------------------------------------------------------------------------------------------------ AGE 60 61 62 63 64 65 66 67 68 69 70 - ---------------------------------------------------------------------------------------------------------- 60 4.65 4.71 4.77 4.83 4.89 4.94 5.00 5.06 5.11 5.17 5.22 61 4.68 4.74 4.81 4.87 4.93 4.99 5.05 5.11 5.17 5.23 5.29 62 4.71 4.78 4.84 4.91 4.97 5.04 5.10 5.17 5.23 5.29 5.35 63 4.74 4.81 4.88 4.94 5.01 5.08 5.15 5.22 5.29 5.36 5.42 64 4.77 4.84 4.91 4.98 5.05 5.13 5.20 5.27 5.35 5.42 5.49 65 4.79 4.87 4.94 5.02 5.09 5.17 5.25 5.33 5.40 5.48 5.56 66 4.82 4.89 4.97 5.05 5.13 5.21 5.29 5.38 5.46 5.54 5.62 67 4.84 4.92 5.00 5.08 5.17 5.25 5.34 5.42 5.51 5.60 5.69 68 4.86 4.94 5.03 5.11 5.20 5.29 5.38 5.47 5.56 5.66 5.75 69 4.88 4.97 5.05 5.14 5.23 5.32 5.42 5.52 5.61 5.71 5.81 70 4.90 4.99 5.08 5.17 5.26 5.36 5.46 5.56 5.66 5.76 5.87 - ----------------------------------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM--100% CONTINUATION--ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3 1/2% (Minimum Monthly Income per $1,000 of Annuity Value)
- ---------------------------------------------------------------------------------------------------------- MALE FEMALE AGE ------------------------------------------------------------------------------------------------ AGE 60 61 62 63 64 65 66 67 68 69 70 - ---------------------------------------------------------------------------------------------------------- 60 4.31 4.35 4.39 4.43 4.47 4.51 4.55 4.59 4.63 4.67 4.71 61 4.35 4.39 4.43 4.48 4.52 4.56 4.61 4.65 4.69 4.73 4.78 62 4.39 4.43 4.48 4.52 4.57 4.61 4.66 4.71 4.75 4.80 4.85 63 4.42 4.47 4.52 4.57 4.62 4.67 4.72 4.77 4.82 4.87 4.92 64 4.46 4.51 4.57 4.62 4.67 4.72 4.77 4.83 4.88 4.94 4.99 65 4.50 4.56 4.61 4.66 4.72 4.78 4.83 4.89 4.95 5.01 5.07 66 4.54 4.60 4.65 4.71 4.77 4.83 4.89 4.95 5.01 5.08 5.14 67 4.58 4.64 4.70 4.76 4.82 4.88 4.95 5.01 5.08 5.15 5.22 68 4.62 4.68 4.77 4.81 4.87 4.95 5.01 5.08 5.15 5.22 5.29 69 4.65 4.72 4.78 4.85 4.92 4.99 5.06 5.14 5.22 5.29 5.37 70 4.69 4.76 4.83 4.90 4.97 5.05 5.12 5.20 5.28 5.36 5.45 - ----------------------------------------------------------------------------------------------------------
----------- No. 11937 NQ Page Eleven Page Twelve ----------- ANNUITY BENEFITS (CONTINUED) VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM--100% CONTINUATION--ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 5% (Minimum Monthly Income per $1,000 of Annuity Value)
- ---------------------------------------------------------------------------------------------------------- MALE FEMALE AGE ------------------------------------------------------------------------------------------------ AGE 60 61 62 63 64 65 66 67 68 69 70 ------------------------------------------------------------------------------------------------ 60 5.19 5.23 5.27 5.31 5.34 5.39 5.42 5.46 5.50 5.54 5.58 61 5.23 5.27 5.31 5.35 5.39 5.43 5.47 5.52 5.56 5.60 5.64 62 5.27 5.31 5.35 5.39 5.44 5.48 5.53 5.57 5.62 5.67 5.71 63 5.31 5.35 5.39 5.44 5.49 5.53 5.58 5.63 5.68 5.73 5.78 64 5.34 5.39 5.44 5.48 5.53 5.59 5.64 5.69 5.74 5.79 5.85 65 5.38 5.43 5.48 5.53 5.58 5.64 5.69 5.75 5.80 5.86 5.92 66 5.42 5.47 5.52 5.58 5.63 5.69 5.75 5.81 5.87 5.93 5.99 67 5.45 5.51 5.56 5.62 5.68 5.74 5.80 5.87 5.93 6.00 6.06 68 5.49 5.55 5.61 5.67 5.73 5.80 5.86 5.93 6.00 6.06 6.14 69 5.53 5.59 5.65 5.71 5.78 5.85 5.92 5.99 6.06 6.13 6.21 70 5.56 5.63 5.69 5.76 5.83 5.90 5.97 6.05 6.13 6.21 6.29 - ----------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value)
FIXED ANNUITY BENEFIT VARIABLE ANNUITY BENEFIT WITH 10 YEARS OF IF ASSUMED BASE RATE OF NET PAYMENTS INVESTMENT RETURN IS GUARANTEED ------------------------------------------- ------------------------- 3 1/2% 5% ------ -- MALES FEMALES MALES FEMALES MALES FEMALES ----- ------- ----- ------- ----- ------- 60 5.77 5.06 5.43 4.80 6.36 5.70 61 5.89 5.16 5.57 4.90 6.50 5.81 62 6.02 5.28 5.72 5.01 6.65 5.91 63 6.16 5.40 5.88 5.13 6.81 6.03 64 6.29 5.52 6.05 5.25 6.97 6.15 65 6.44 5.66 6.23 5.39 7.16 6.28 66 6.59 5.80 6.43 5.54 7.35 6.43 67 6.74 5.94 6.64 5.70 7.56 6.58 68 6.90 6.10 6.87 5.87 7.79 6.76 69 7.06 6.26 7.11 6.06 8.03 6.95 70 7.23 6.43 7.38 6.27 8.30 7.15
Equitable will notify the payee under a Variable Annuity Benefit of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each variable payment. Any election, change, revocation or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a commutation right under an Annuity Benefit is exercised, Equitable may defer payment in accordance with Section 4.06. PART IV - GENERAL PROVISIONS. SECTION 4.01 CONTRACT. The Contract constitutes the entire Contract between the parties and the provisions of the Contract alone will govern with respect to the rights and obligations of Equitable. The provisions of the Contract will be applied separately with respect to each Participant. Nothing in the enrollment form referred to in Section 1.02 nor any modification, amendment, or supplement to any such document will in any way be construed to enlarge, change, vary or in any other way affect the obligations of Equitable as expressly provided in the Contract. The Contract may not be modified as to Equitable, nor may any of Equitable's rights or requirements be waived, except in writing and by an authorized officer of Equitable. The Contract may be changed by amendment or replacement upon agreement between the Contract Holder and Equitable without the consent of any other person provided that such change does not reduce any Annuity Benefit provided before such change and provided that no rights, privileges or benefits which have accrued to any Participant under the Contract may be reduced or forfeited except by the expressed consent of such Participant. SECTION 4.02 STATUTORY COMPLIANCE. Equitable reserves the right to amend the Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the Contract and any certificate to reflect changes in the Code, or in regulations or published rulings of the Internal Revenue Service so that such certificate will continue to be an "annuity" as defined in Section 72 of the Code. Any Annuity Benefit, Cash Value or death benefit available under a certificate issued pursuant to the Contract shall not be less than the minimum benefits required by any statute of the state in which the certificate is delivered. SECTION 4.03 PARTICIPATION IN SURPLUS. The Contract and all other contracts in the same class of contracts shall be combined for the purpose of ascertaining the annual surplus of Equitable to be apportioned to said contracts as a dividend and the portion of any such dividend that is to be allocated to the Contract shall be determined by Equitable. The participation of this class of contracts in annual surplus is, however, expected to be minimal. Any amount so allocated to the Contract shall be payable as of January 1 of the calendar year in which a dividend is apportioned and will be payable in cash and shall be equitably allocated by Equitable to the Fixed Income Accounts maintained hereunder for Participants. No Annuity Benefit will enter into the determination of any surplus to be apportioned to the Contract as a dividend. SECTION 4.04 BENEFICIARY. Each Participant, as of the Participant's Participation Date, is to name a beneficiary entitled to receive any death benefit payable with respect to such Participant pursuant to Section 2.09. The Participant may change such beneficiary from time to time while Accounts for the Participant are being maintained hereunder. Any such change will be made by ----------- No. 11937 NQ Page Twelve Page Thirteen ------------- GENERAL PROVISIONS (CONTINUED) written notice in a form satisfactory to Equitable. A change will, upon receipt at a designated Equitable Office, take effect as of the time the written notice was signed, whether or not the Participant is living on the date of receipt, but without further liability as to any payment or other settlement made by Equitable before receipt of such change. Unless otherwise specified in the enrollment form, if a Participant has named two or more persons as beneficiary, the beneficiary will be the named person or persons who survive the Participant, and if more than one survive they will share equally. Any part of a death benefit payable with respect to a Participant pursuant to Section 2.09 for which there is no named beneficiary living at the death of the Participant will be payable in a single sum to the children of the Participant who survive the Participant, in equal shares, or should none survive, then to the Participant's executors or administrators. If a Participant so elects in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by the Participant, with respect to the beneficiary, subject to Equitable's rules then in effect. If at the death of a Participant there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. SECTION 4.05 FUTURE PARTICIPANTS AND CONTRIBUTIONS. Equitable reserves the right at its sole discretion to (i) curtail or prohibit further enrollment as Participants under the Contract of any individuals who are not currently participating under the Contract as of such date of curtailment or prohibition, and (ii) prohibit future Contributions under the Contract upon written notice to existing Participants. SECTION 4.06 DEFERMENT. Payments by Equitable from the Participant's Fixed Income Account pursuant to the provisions of Section 2.06, Sections 2.07 and 2.07A, and Section 2.09, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.05, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. Interest at the current Guaranteed Interest Rate for such Participant's Fixed Income Account will be allowed on any such payment deferred for 30 days or more. Except as provided in this Section, payments by Equitable from the Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account pursuant to the provisions of Section 2.06, Sections 2.07 or 2.07A, and Section 2.09, or any commuted payments arising from a Variable Annuity Benefit pursuant to Section 3.05, will be made within seven days after receipt, at Equitable's Processing Office, of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. During any period when (i) the sale of securities or the determination of the New Accumulation Unit Value or the Average New Annuity Unit Value is not reasonably practicable because an emergency, defined by the Securities and Exchange Commission, exists, or the New York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may by order permit postponement for the protection of persons having interests in the Separate Accounts, Equitable reserves the right: (a) to defer determination of Cash Values or Annuity Values and payment of Cash Values and Annuity Values, arising from an amount in the Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (b) to defer payment of any portion of the death benefit arising from an amount in a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (c) to defer the payment of any Variable Annuity Benefit under the Contract or the application of any such Benefit to provide for any other payment called for by the Contract; or (d) in the event of (a) above, to defer application of such amounts to provide any Annuity Benefit permitted under the Contract. SECTION 4.07 ANNUAL NOTICE. At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Fixed Income Account, (2) the total number of Accumulation Units credited to the Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, (3) the New Accumulation Unit Values, (4) the sum of the Cash Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account and (5) the amount of death benefit payable with respect to the Participant. After the Retirement date Equitable will notify the Participant of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.08 CONTRACT HOLDER RESPONSIBILITY. The sole responsibility of the Contract Holder is to serve as party to the Contract. The Contract Holder will have no responsibility for the administration of any Plan or Agreement, for payments to ------------- No. 11937 NQ Page Thirteen Page Fourteen ------------- GENERAL PROVISIONS (CONTINUED) the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account, or any payments or other distributions hereunder. Equitable will deal with the Contract Holder in accordance with the terms and conditions of the trust agreement pursuant to which the Contract Holder agreed to act as such and with the Contract and in such manner as the Contract Holder and Equitable may agree, without the consent of any other person. SECTION 4.09 AGE AND SEX. If the age or sex of any person upon whose life an Annuity Benefit depends has been misstated, any benefits will be those which would have been purchased at the correct age and sex. Any overpayments or underpayments made by Equitable will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. ------------- No. 11937 NQ Page Fourteen THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Section 2.07 is modified by adding the following after the last sentence: If a withdrawal from the Accounts made pursuant to Sections 2.07 or 2.07A would result in total Annuity Values of less than $500, Equitable will so advise the Participant and reserves the right to withdraw the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, pay the Annuity values of such Accounts to the Participant, and terminate such Participant's participation under the contract. Vice President SPECIMEN and Secretary SPECIMEN President PF17026 NQ OWNER: PARTICIPANT: CONTRACT NUMBER: [THE EQUITABLE LOGO] ISSUE DATE: PARTICIPATION DATE: RETIREMENT DATE: THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York, New York 10116 AGREES O To allocate the Contributions made to this Contract to the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account or the Fixed Income Account maintained for the Participant, in accordance with Sections 2.02 and 2.03, or in part to any one, as directed by the Participant. O To apply the amount in the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Fixed Income Account at the Retirement Date to provide the Participant with an Annuity Benefit or a Cash Value Benefit if the Participant is then living, and O To provide the Participant with the other rights and benefits of this Contract. These agreements are subject to the provisions of this Contract. TEN DAYS TO EXAMINE CONTRACT - The Participant may terminate participation under the Contract and cancel this Contract by returning it to Equitable within ten days after receipt of it. Upon such cancellation, Equitable will refund any Contribution made to Equitable on behalf of the Participant under the Contract, plus or minus any investment gain or loss experienced in the Participant's Stock Account, Balanced Account, Aggressive Stock Account, or Money Market Account from the date such Contribution is allocated to such Account to the date of such Cancellation. VICE PRESIDENT AND SECRETARY PRESIDENT ASSETS HELD IN CONNECTION WITH THE CONTRACT MAY BE HELD IN SEPARATE ACCOUNTS MAINTAINED BY EQUITABLE AND MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THE CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF SEPARATE ACCOUNT A. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN SEPARATE ACCOUNT A IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.15 IS 5% OR 3 1/2%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE OF 1.75% FOR INVESTMENT MANAGEMENT, FINANCIAL ACCOUNTING, THE ANNUITY RATE GUARANTEE AND MINIMUM DEATH BENEFIT, EXPENSES AND EXPENSE RISK, BUT AFTER ANY DEDUCTIONS TO PROVIDE FOR TAXES. NO. 11939C NQ-I INDIVIDUAL DEFERRED ANNUITY CONTRACT CONTENTS Part I - Definitions Page 2 Part II - Participant's Accounts Page 6 Part III - Annuity Benefits Page 9 Part IV - General Provisions Page 12 Equitable certifies that the Participant is as named on Page 3 of this Individual Annuity Contract, all pertinent provisions of which are set forth below. The Contract is issued in consideration of the payment to Equitable of the Contributions made under the Contract. The provisions on the following pages are part of this Contract. A copy of the application is incorporated in and made part of this Contract. PART I - DEFINITIONS SECTION 1.01 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Part III of the Contract. SECTION 1.02 PARTICIPANT. The term "Participant" means a person who is the annuitant under the Contract. A person shall become the Participant under the Contract upon receipt by Equitable of an application made available by Equitable and completed in a manner satisfactory to Equitable. SECTION 1.03 OWNER. The Owner of the Contract is the Participant unless otherwise stated in the application, or later changed. Notwithstanding any provisions in the Contract to the contrary, only the Owner can exercise all the rights under the Contract while the Participant is living. The Owner does not need the consent of anyone who has only a conditional or future ownership interest in the Contract. While the Participant is living, the Owner of the Contract issued on behalf of the Participant may change the Owner by written notice satisfactory to Equitable. The change will take effect on the date the Owner signs the notice, except it will not apply to any payment Equitable makes or other actions Equitable takes before Equitable receives the notice. SECTION 1.04 ASSIGNMENTS. This Contract may not be assigned as collateral or security for a loan. Otherwise, the Participant may assign this Contract before the Retirement Date but Equitable will not be bound by an assignment unless it is in writing and Equitable has received it. The Participant's rights and those of any persons referred to in the Contract will be subject to the assignment. Equitable assumes no responsibility for the validity of any assignment. No amounts payable under the Contract to a payee other than the Owner may be assigned by that payee, nor will they be subject to the claims of creditors or to legal process, except to the extent permitted by law. SECTION 1.05 CONTRIBUTION. The term "Contribution" means a payment made to Equitable for the Participant with respect to this annuity Contract purchased for the Participant. Equitable is under no obligation to accept any Contribution less than $50.00. SECTION 1.06 PARTICIPATION DATE. The term "Participation Date" with respect to the Participant means the date as of which Equitable has accepted the Participant under the terms of this Contract, as shown on Page 3 of this Contract. SECTION 1.07 PARTICIPATION YEAR. The term "Participation Year" with respect to the Participant means the twelve month period beginning on (i) the Participation Date, and (ii) each anniversary thereof, unless otherwise agreed to in writing by Equitable. SECTION 1.09 GUARANTEED INTEREST RATE. In regard to the Fixed Income Account, the term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in such Account. Interest accrues daily. The Guaranteed Interest Rate will never be less than 4% per annum. Equitable will from time to time establish and make available for the Participant (i) an Initial Guaranteed Interest Rate, (ii) one or more Minimum Guaranteed Interest Rates and (iii) the applicable effective period(s) for such Rates. NO. 11939C NQ-I -------- Page Two Page Four --------- DEFINITIONS (CONTINUED) For the period (not to exceed one year) next succeeding the end of the period for which an established Initial Guaranteed Interest Rate is effective and for each subsequent period (not to exceed one year) the Equitable may determine a Guaranteed Interest Rate and duration which exceeds the applicable Minimum Guaranteed Interest Rate. Equitable will notify the Participant in writing of the applicable Guaranteed Interest Rate and duration. SECTION 1.10 RETIREMENT DATE. The term "Retirement Date" means the date on which the Participant is to attain the retirement age specified in the Participant's application. Before the Retirement Date the Participant may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be later than the date the Participant attains age 85. Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Processing Office. SECTION 1.11 NORMAL FORM. The "Normal Form" of an Annuity Benefit under this Contract means the Fixed Annuity Benefit payable on the Life Annuity Form, as defined in Sections 3.01 and 1.12, with 10 years of payments guaranteed. SECTION 1.12 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person or the end of a chosen certain period, whichever is later. SECTION 1.13 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by the Participant. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.14 THE SEPARATE ACCOUNTS. The term "Separate Accounts" means the following separate investment accounts maintained by Equitable to which portions of its assets have been allocated for this Contract and certain other contracts: NAME INVESTMENTS ---- ----------- Separate Account A Primarily common stock and other equity-type investments. Separate Account E Primarily short-term money market instruments. Separate Account J Primarily common stocks and other equity-type investments, publicly traded debt securities and short-term money market instruments. Separate Account K Primarily common stocks issued by high quality small and intermediate size companies with strong growth prospects. Equitable reserves the right to withdraw from any Separate Account and allocate to another Separate Account assets determined by Equitable to be associated with the class of contracts to which this Contract belongs. In any such event, to the extent practicable and permissible under applicable laws and regulations, the withdrawal shall be made by withdrawing the same percentage of each investment in the Separate Account, with appropriate adjustments to avoid odd lots and fractions. On and after the date of any such withdrawal the reference in this Contract to such Separate Account shall mean such other Separate Account to which the withdrawn assets were allocated. It is contemplated that investments in the Separate Accounts will, at most times, consist primarily of the types of investments indicated above. Equitable may, however, at its discretion invest the assets of any Separate Account in any investment permitted by applicable law. Equitable may rely conclusively on the opinion of counsel (including attorneys in its employ) as to what investments it is permitted by law to make. In lieu of making such investments directly, Equitable reserves the right to operate any Separate Account as a unit investment trust, or in any other form permitted by law, investing all or a part of its assets in shares or units of a fund, the investment adviser of which may be Equitable or controlled by Equitable. The fund assets would be invested as provided above with respect to the Separate Account. Equitable reserves the right: (i) to cause the registration or deregistration of any Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) to run any Separate NO. 11939C NQ-I --------- Page Four Page Five --------- DEFINITIONS (CONTINUED) Account under direction of a committee, and to discharge such committee at any time; and (iii) to restrict or eliminate any voting rights of participants or other persons who have voting rights as to the Separate Accounts. Assets of the Separate Accounts attributable to the Contract shall be subject to a charge at the rate of 1.75% a year, for investment management, financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.15. The assets of Separate Accounts are the property of Equitable; however, the portion of the assets of each Separate Account equal to the reserves and other contract liabilities with respect to such Account shall not be chargeable with liabilities arising out of any other business Equitable may conduct. Equitable reserves the right to transfer assets of the Separate Accounts in excess of such reserves and contract liabilities to the general account of Equitable. SECTION 1.15 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS. VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business days immediately preceding such business day will constitute a Valuation Period. A business day is any day on which the New York Stock Exchange is open. NET INVESTMENT FACTOR: For each Separate Account, the Net Investment Factor for a Valuation Period is (a) divided by (b), minus (c), where (a) is (1) the value of assets in the Separate Account at the close of business of the preceding Valuation Period plus (2) the investment income and the capital gains, realized or unrealized, credited to the assets of the Separate Account in the Valuation Period for which the Net Investment Factor is being determined, minus (3) the capital losses, realized or unrealized, charged against such assets in such Valuation Period, minus (4) any amount charged against the Separate Account in such Valuation Period for taxes or for amounts set aside by Equitable as a reserve for taxes attributable to the maintenance or operation of the Separate Account; (b) is the value of the assets in the Separate Account at the close of business of the preceding Valuation Period; and (c) is the daily charge, for each calendar day in such Valuation Period, of .00004837 for investment management financial accounting, the annuity rate guarantee and the minimum death benefit, and expenses and expense risk. The value of the assets in the Separate Accounts, referred to above, shall be taken at their fair value, or where there is no readily available market, their fair value, as determined in accordance with accepted accounting practices and applicable laws and regulations. ACCUMULATION UNIT: The Accumulation Unit is a unit used in determining the value of the interest of a Participant's Stock Account, Balanced Account, Aggressive Account or Money Market Account on or before the Retirement Date. NEW ACCUMULATION UNIT VALUE: The initial New Accumulation Unit Values for the Separate Accounts have been established as follows: Account Value Date ------- ----- ---- Separate Account A $10.00 As of November 1, 1968 Separate Account E $10.00 As of September 4, 1974 Separate Account J $10.00 As of May 1, 1984 Separate Account K $10.00 As of May 1, 1984 The New Accumulation Unit Value for each subsequent Valuation Period is the New Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such subsequent Valuation Period. ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable from Separate Account A under a Variable Annuity Benefit. NEW ANNUITY UNIT VALUE: The initial New Annuity Unit Value for Separate Account A has been established at $1.00 as of November 1, 1968. The Annuity Unit Value for any subsequent Valuation Period is the New Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3 1/2%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE NEW ANNUITY UNIT VALUE: The Average Annuity Unit Value for Separate Account A for a calendar month is equal to the average of the New Annuity Unit Values for the Valuation Periods ending in such month. NO. 11939C NQ-I --------- Page Five Page Six -------- DEFINITIONS (CONTINUED) SECTION 1.16 ANNUITY VALUE. The term "Annuity Value" with respect to the Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, means the amount in such Accounts pursuant to Sections 2.02 and 2.03. SECTION 1.17 CASH VALUE. With respect to the Participant, the term "Cash Value" with respect to the Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account, and Money Market Account, means an amount equal to the greater of (i) or (ii) below: (i) the Annuity Value of such Accounts less 6% of the Contributions made during the current and five prior Participation Years, which had not been previously withdrawn pursuant to Section 2.07A. (ii) the sum of (a) the Free Corridor Amount as defined in Section 2.07B and (b) 94% of (the Annuity Value of such Accounts less the Free Corridor Amount). SECTION 1.18 CODE. The term "Code" means the Internal Revenue Code of 1954, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. PART II - PARTICIPANT'S ACCOUNTS SECTION 2.01 CONTRIBUTIONS. Contributions may be made with respect to the Participant on whichever basis, as described under subsections A and B below, is specified upon the Participant's acceptance under the Contract. If Contributions are made by or on behalf of the Participant under more than one such basis, Equitable will accept such Contributions if the Participant has been issued a separate Contract under each basis, and in such case separate Contracts for the Participant will reflect amounts accumulated on the Participant's behalf attributable to Contributions made under each Contribution basis. A. Post-August 13, 1982 Basis Contributions are to be made from time to time at the Participant's discretion. With each Contribution, the amounts to be allocated to the Stock Account, Money Market Account, Fixed Income Account, Balanced Account and Aggressive Stock Account shall be specified. The Participant may transfer to the Contract under this basis any amount held with respect to the Participant under a deferred annuity contract, where such transferred amount represents amounts invested in or credited to investments in annuity contracts after August 13, 1982. B. Pre-August 14, 1982 Basis The Participant may transfer to the Contract under this basis any amount held with respect to the Participant under a deferred annuity contract where such transferred amount represents amounts invested in or credited to investments in annuity contracts prior to August 14, 1982. New contributions cannot be made under this basis. SECTION 2.02 STOCK, BALANCED, AGGRESSIVE STOCK AND MONEY MARKET ACCOUNTS. Equitable maintains a Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account under the Contract for the Participant. Any amount allocated to the (1) Stock Account becomes part of Separate Account A, (2) Balanced Account becomes part of Separate Account J, (3) Aggressive Stock Account becomes part of Separate Account K, and (4) Money Market Account becomes part of Separate Account E. Any amount withdrawn from an Account will no longer be part of the applicable Separate Account. On any date when an amount is allocated to or withdrawn from an Account, the Account will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the New Accumulation Unit value for the appropriate Separate Account for the Valuation Period which includes that date. The number of Units in an Account on any date is equal to (i) the sum of any Accumulation Units that have been credited to the Account minus (ii) the sum of any Accumulation Units that have been charged to that Account. The amount in the Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account on any date is equal to the product of (i) the number of Accumulation Units in such Account on that date and (ii) the New Accumulation Unit Value for the appropriate Separate Account for the Valuation Period which includes that date, less any administrative charge accrued but not made. SECTION 2.03 FIXED INCOME ACCOUNT. Equitable maintains a Fixed Income Account under the Contract for the Participant with respect to whom Contributions are made. Any amount allocated to the Fixed Income Account becomes part of the general assets of Equitable, which support the guarantees of this contract and other contracts. The amount in a Fixed Income Account at any time is equal to the sum of all amounts that have been allocated to such Fixed Income Account pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn pursuant to Sections 2.07, 2.07A, and Section 2.08 from such Account, and transferred pursuant to Section 2.05 from such Fixed Income Account, and less any annual administrative charges accrued but not made. Equitable guarantees that the amount in a Fixed No. 11939C NQ-I --------- Page Six Page Seven ---------- PARTICIPANT'S ACCOUNTS (CONTINUED) Income Account at any time before the Retirement Date will not be less than the sum of all amounts allocated to such Account pursuant to Section 2.04 or transferred to such Account pursuant to Section 2.05 and less the sum of all amounts that have been withdrawn from such Account pursuant to Sections 2.07, 2.07A and 2.08, and transferred from such Account pursuant to Section 2.05, all accumulated at 4% interest, compounded annually. In any Participation Year in which no Contribution is allocated to a Fixed Income Account, the amount in such Account at the end of the Participation Year shall in no event be less than the amount in such Account at the beginning of the Participation Year plus the sum of all amounts transferred to such Account pursuant to Section 2.05 less the sum of all amounts withdrawn and transferred out of such Account pursuant to Sections 2.07, 2.07A, and Section 2.05, all accumulated at 4% interest, compounded annually. A Fixed Income Account for the Participant terminates on the earliest of (i) the Retirement Date, (ii) the death of the Participant, and (iii) termination of participation pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO ACCOUNT. Each Contribution made with respect to the Participant pursuant to Section 2.01, will be allocated, as of the date by which Equitable has received at its Processing Office both such Contribution and direction as to its allocation, to the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account or in part to each, at the sole direction of the Participant as specified to Equitable, provided that the percentage allocated to each Account is a whole number. Any amount that the Participant has directed to be transferred to the Fixed Income Account, Stock Account, Balanced Account or Aggressive Stock Account pursuant to Section 2.05 will be allocated as of the date of such transfer to the appropriate Account maintained for the Participant. Interest is allocated to the Fixed Income Account at the end of each Participation Year, at the time of each transfer or withdrawal pursuant to Sections 2.05 and 2.07 and 2.07A, at the time of application of amounts in the Fixed Income Account to provide Annuity Benefits, upon termination of participation pursuant to Section 2.06, and upon death of the Participant pursuant to Section 2.09. SECTION 2.05 TRANSFERS AMONG ACCOUNTS. At any time before the Participant's Retirement Date, the Participant may transfer all or part of the amounts maintained for the Participant to one or more of the other Accounts maintained for the Participant as follows: (1) amounts in the Fixed Income Account, Stock Account, Balanced Account and Aggressive Stock Account may be transferred among such Accounts; (2) amounts in the Money Market Account may be transferred to the other Accounts. Such transfers will be made as of the date Equitable receives such request at its Processing Office and will be subject to Equitable's rules in effect at the time of transfer. No transfers are permitted from the Fixed Income Account, Stock Account, Balanced Account or Aggressive Stock Account maintained for the Participant to the Money Market Account. Notwithstanding the above, transfers to the Balanced Account may be prohibited by Equitable upon 30 days written notice to the Participant. SECTION 2.06 TERMINATION OF PARTICIPATION. On or before the Participant's Retirement Date, the Owner may elect by written notice to terminate this Contract. Upon receipt of such notice at its Processing Office, Equitable will determine the Cash Value, as of the date Equitable received such notice of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained for the Participant. The payment of such Cash Value to the Participant may be deferred by Equitable in accordance with the provisions of Section 4.06. Prior to the Participant's Retirement Date, Equitable reserves the right to withdraw the Cash Value of the Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, pay such Cash Values and terminate the Contract. This right may be exercised with respect to the Participant only if no Contributions have been made to the Contract on the Participant's behalf during the last three completed Participation Years, and the sum of such Annuity Values is $500 or less. Equitable reserves the right to terminate this Contract if at least 120 days have elapsed since the issue date shown on Page 3 of the Contract and no Contributions have been made to the Contract by or on behalf of the Participant. Upon payment of the Cash Values, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Cash Values arose. SECTION 2.07 PARTIAL WITHDRAWALS. The Owner may elect by written notice to Equitable to make a partial withdrawal from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Fixed Income Account maintained for the Participant before such Participant's Retirement Date. Upon withdrawal pursuant to Section 2.07 or 2.07A Equitable will pay the lesser of the sum of the Cash Values of the Accounts or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by the Participant. Unless instructed otherwise, the amount withdrawn (including the amount of any withdrawal charge) will be allocated between such Accounts in proportion to the Annuity Value of each such Account. Upon any payment on behalf of the Participant pursuant to Section 2.07 or 2.07A, Equitable will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. No. 11939C NQ-I ---------- Page Seven Page Eight ---------- PARTICIPANT'S ACCOUNTS (CONTINUED) Payments on behalf of the Participant pursuant to Section 2.07 or 2.07A may be deferred by Equitable in accordance with the provisions of Section 4.06. Equitable is under no obligation to process any request for partial withdrawal of less than $300. If a withdrawal from the Accounts made pursuant to Section 2.07 would result in total Annuity Values of less than $500 and no Contributions have been made to the Contract for the three prior Participation Years, Equitable will so advise the Participant and reserves the right to withdraw the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, pay the Annuity Values of such Accounts to the Participant, and terminate this Contract. SECTION 2.07A PARTIAL WITHDRAWAL CHARGES. With respect to partial withdrawals requested by the Participant, there will be no withdrawal charge if the amount of the partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.07B. Equitable will withdraw from the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account, and Fixed Income Account and pay to the Participant an amount equal to the partial withdrawal requested. However, if the amount of partial withdrawal requested is greater than the Free Corridor Amount, Equitable will (i) first withdraw from such Accounts an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge, if applicable. Such withdrawal charge will be calculated in the following manner: (a) Withdrawals of Contributions made on behalf of the Participant during the current and five prior Participation Years will be subject to a charge of 6% of the amount withdrawn (including such charge). (b) Withdrawals of other amounts will not be subject to any withdrawal charges. Equitable will pay the Participant the lesser of (a) the amount requested or (b) the sum of the Cash Values of the Accounts maintained on the Participant's behalf. For purposes of determining withdrawal charges described in this Section, amounts withdrawn up to the Free Corridor Amount will not be considered a withdrawal of any Contributions. Any excess withdrawals, i.e. those pursuant to item (ii) above, shall be considered withdrawals of older contributions first and more recent contributions next. SECTION 2.07B FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" with respect to the Participant means an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Values of the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and the Fixed Income Account over (ii) cumulative prior withdrawals made pursuant to Section 2.07 or 2.07A in the current Participation Year with respect to the Participant. SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Participation Year before the Participant's Retirement Date, if the sum of the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account on that date is less than $10,000, Equitable will withdraw from the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract, as to the Contributions remitted with respect to the Participant, an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account at the end of that Participation Year and (ii) any withdrawals made from such Accounts pursuant to Section 2.07 or 2.07A during that Participation Year. The charge will be allocated between the Stock Account, Balanced Account, Aggressive Stock Account, Money Market Account and Fixed Income Account in proportion to the Annuity Values of each such Account, at the end of the Participation Year. As of the Participant's Retirement Date and before application of the Annuity Values or Cash Values of the Participant's Account pursuant to Section 3.03, or upon termination of such Account pursuant to Section 2.06 or Section 2.09 during a Participation Year, if the sum of the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account, and Money Market Account at that date is less than $10,000, Equitable will withdraw the administrative charge described in this Section for the applicable part of that Participation Year. SECTION 2.09 DEATH BENEFIT. If Equitable ascertains that the Participant has died while Accounts for the Participant are maintained under the Contract and before the Participant's Retirement Date, Equitable, upon receipt of due proof of such death, will pay in a single sum to the beneficiary designated by the Participant to receive such payment the amount of death benefit payable with respect to the Participant. The amount of the death benefit with respect to the Participant at any time prior to the Retirement Date is equal to the greater of (i) the sum of the Annuity Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the No. 11939C NQ-I ---------- Page Eight Page Nine --------- PARTICIPANT'S ACCOUNT (CONTINUED) Contract for the Participant and (ii) the minimum death benefit with respect to the Participant. Such minimum death benefit is the sum of all Contributions made with respect to the Participant pursuant to Section 2.01 less an adjustment for any withdrawals made pursuant to Section 2.07 or 2.07A from the Accounts maintained under the Contract for the Participant. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount being withdrawn is to the Annuity Values then in the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained under the Contract for the Participant. The amount of any death benefit payable with respect to the Participant will, to the extent such Account is sufficient therefore, be withdrawn from the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained with respect to the Participant under the Contract. Upon such payment, Equitable will be released from any and all liability for payments with respect to the Contributions from which the Annuity Values arose. SECTION 2.10 OWNER DEATH DISTRIBUTION RULES. Upon the death of the Contract Owner before the Participant's Retirement Date: (i) If the Owner is the Participant, Equitable will pay the death benefit in accordance with Section 2.09. (ii) If the Owner is not the Participant, the designated beneficiary will succeed as Owner, notwithstanding the existence of any co-owner. The entire interest in the Accounts maintained for the Participant - subject to any applicable withdrawal charges as described in the Contract - must be distributed either: (a) within 5 years after the Owner's death, or (b) within 1 year after the Owner's death as a life annuity or installment option, for a period of not longer than the life expectancy of the designated beneficiary. However, if the designated beneficiary is the Owner's spouse, the entire interest in the Accounts maintained for the Participant must then be distributed no later than 5 years after the spouse's death. If payments under an Annuity Benefit had commenced prior to the Owner's death, such payments will continue to be made over a period not longer than the period provided for under the Annuity Benefit elected. If the Participant dies before the entire interest in the Accounts maintained for the Participant under the Contract is distributed, Equitable will pay the death benefit in Section 2.09. The designated beneficiary is the same as the beneficiary who is entitled to the death benefit upon the Participant's death. Where more than one Owner is named, the date of death of the Owner will be deemed to be the date of death of the first Owner to die. SECTION 2.11 CONTRIBUTION LIMIT. Equitable may refuse to accept a Contribution made with respect to the Participant if the total prior Contributions made with respect to the Participant exceed (or if acceptance of such Contribution would cause the total Contributions to exceed) the following: (i) $500,000, if the Participant's current age last birthday is 75 or less. (ii) $250,000, if the Participant's current age last birthday is 76-79. Equitable may refuse to accept any Contribution made with respect to the Participant if the Participant's current age last birthday is 80 or greater. PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of Separate Account A. The amount of the first, second, and third payments under any Variable Annuity Benefit provided under the Contract with respect to a payee is the monthly amount provided with respect to the payee pursuant to Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average New Annuity Unit Value for the second calendar month immediately preceding the date of the payment. The fourth and subsequent annuity payments under a Variable Annuity Benefit will not be increased or decreased in amount because of mortality or expense experience. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the New Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of the Participant's Retirement Date, provided the Participant is then living, the Annuity Values of the Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account shall be No. 11939C NQ-I ---------- Page Nine Page Ten -------- ANNUITY BENEFITS (CONTINUED) applied to provide the Normal Form of Annuity Benefit, unless the Participant elects (i) to receive the Cash Value of such Account in a single sum or (ii) to apply such Annuity Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by Equitable, as elected by the Participant, subject to Equitable's rules then in effect. Equitable will provide notice and election forms to the Participant not more than six months before the Participant's Retirement Date. If the Participant elects to terminate participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Values of the Participant's Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account. Equitable will have the right to require the Participant to furnish pertinent facts and determinations to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If the Participant elects to receive an Annuity Benefit in lieu of the Cash Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, the amount applied to provide the Annuity Benefit will be (i) the Annuity Values of such Accounts if the payments under the annuity form elected are contingent upon the survival of a person, or (ii) the Cash Values of such Accounts if the payments under the annuity form elected are not contingent upon the survival of a person. The amount applied to provide an Annuity Benefit shall be reduced by any applicable tax on annuity considerations, as determined by Equitable. If such amount is applied on or after the completion of five Participation Years: (1) The balance, less any Contribution made on behalf of the Participant during the current and five prior Participation Years, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown herein or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. (2) Any Contributions made on behalf of the Participant during the current and five prior Participation Years shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity payments shown herein or (ii) Equitable's current individual rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, this Contract will be replaced by an Equitable supplementary contract. If the amount applied to provide an Annuity Benefit is applied before the completion of five Participation Years with respect to the Participant, the balance, after any applicable tax annuity considerations, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown herein or (ii) Equitable's current individual annuity rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, this Contract will be replaced by an Equitable supplementary contract. After such application of an amount to provide an Annuity Benefit pursuant to either of the preceding two paragraphs, the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account maintained for the Participant shall terminate. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract, as indicated, on either the Life Annuity Form with 10 years of payments guaranteed or the Joint and Survivor Life Annuity Form (100% continuation). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form with 10 years of payments guaranteed and Joint and Survivor Life Annuity Form are based on 3 1/2% interest and the 1971 Equitable Annuity Mortality Table. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on the 1979 Equitable Annuitant Mortality Table and an Assumed Base Rate of Net Investment Return of 3 1/2% or 5%, whichever applies pursuant to Section 1.15. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on 3 1/2% interest and the 1971 Equitable Annuity Mortality Table if such annuity form provides for a Fixed Annuity Benefit, and on the 1979 Equitable Annuitant Mortality Table and an Assumed Base Rate of Net Investment Return of 5% or 3 1/2%, whichever applies pursuant to Section 1.15, if such annuity form provides for a Variable Annuity Benefit. No. 11939C NQ-I --------- Page Ten Page Eleven ----------- ANNUITY BENEFITS (CONTINUED) SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Evidence of each payee's survival must be furnished to Equitable either by personal endorsement of the check drawn for payment or by other means satisfactory to Equitable. If a benefit payable under the Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by Equitable will be charged against and underpayments will be added to any payments thereafter falling due under the Contract with respect to the payee. The liability of Equitable with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the Contract. If Equitable receives evidence satisfactory to it that (i) a payee entitled to receive any payment under the Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. Upon election by the Participant pursuant to Section 3.03 of an annuity form providing payments for a period certain, the Participant may designate (with the right to change such designation) a person or persons to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's executors or administrators in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, Equitable will pay in a single sum to such payee's executors or administrators the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis originally used to determine such payments. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. Equitable will require satisfactory evidence of the age of any person upon whose life an annuity form depends.
TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM WITH 10 YEARS OF PAYMENTS GUARANTEED - 100% CONTINUATION (Minimum Monthly Income per $1,000 of Annuity Value) - ---------- ---------------------------------------------------------------------------------------------------------------------- FEMALE AGE MALE ---------------------------------------------------------------------------------------------------------------------- AGE 60 61 62 63 64 65 66 67 68 69 70 - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ---------- 60 4.65 4.71 4.77 4.83 4.89 4.94 5.00 5.06 5.11 5.17 5.22 61 4.68 4.74 4.81 4.87 4.93 4.99 5.05 5.11 5.17 5.23 5.29 62 4.71 4.78 4.84 4.91 4.97 5.04 5.10 5.17 5.23 5.29 5.35 63 4.74 4.81 4.88 4.94 5.01 5.08 5.15 5.22 5.29 5.36 5.42 64 4.77 4.84 4.91 4.98 5.05 5.13 5.20 5.27 5.35 5.42 5.49 65 4.79 4.87 4.94 5.02 5.09 5.17 5.25 5.33 5.40 5.48 5.56 66 4.82 4.89 4.97 5.05 5.13 5.21 5.29 5.38 5.46 5.54 5.62 67 4.84 4.92 5.00 5.08 5.17 5.25 5.34 5.42 5.51 5.60 5.69 68 4.86 4.94 5.03 5.11 5.20 5.29 5.38 5.47 5.56 5.66 5.75 69 4.88 4.97 5.05 5.14 5.23 5.32 5.42 5.52 5.61 5.71 5.81 70 4.90 4.99 5.08 5.17 5.26 5.36 5.46 5.56 5.66 5.76 5.87 - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ----------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM--100% CONTINUATION--ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 3 1/2% (Minimum Monthly Income per $1,000 of Annuity Value) - ---------- ---------------------------------------------------------------------------------------------------------------------- MALE FEMALE AGE ---------------------------------------------------------------------------------------------------------------------- AGE 60 61 62 63 64 65 66 67 68 69 70 - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ---------- 60 4.31 4.35 4.39 4.43 4.47 4.51 4.55 4.59 4.63 4.67 4.71 61 4.35 4.39 4.43 4.48 4.52 4.56 4.61 4.65 4.69 4.73 4.78 62 4.39 4.43 4.48 4.52 4.57 4.61 4.66 4.71 4.75 4.80 4.85 63 4.42 4.47 4.52 4.57 4.62 4.67 4.72 4.77 4.82 4.87 4.92 64 4.46 4.51 4.57 4.62 4.67 4.72 4.77 4.83 4.88 4.94 4.99 65 4.50 4.56 4.61 4.66 4.72 4.78 4.83 4.89 4.95 5.01 5.07 66 4.54 4.60 4.65 4.71 4.77 4.83 4.89 4.95 5.01 5.08 5.14 67 4.58 4.64 4.70 4.76 4.82 4.88 4.95 5.01 5.08 5.15 5.22 68 4.62 4.68 4.77 4.81 4.87 4.95 5.01 5.08 5.15 5.22 5.29 69 4.65 4.72 4.78 4.85 4.92 4.99 5.06 5.14 5.22 5.29 5.37 70 4.69 4.76 4.83 4.90 4.97 5.05 5.12 5.20 5.28 5.36 5.45 - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ----------
No. 11939C NQ-I ----------- Page Eleven Page Twelve ----------- ANNUITY BENEFITS (CONTINUED)
VARIABLE ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM--100% CONTINUATION--ASSUMED BASE RATE OF NET INVESTMENT RETURN OF 5% (Minimum Monthly Income per $1,000 of Annuity Value) - ---------- ---------------------------------------------------------------------------------------------------------------------- FEMALE AGE MALE ---------------------------------------------------------------------------------------------------------------------- AGE 60 61 62 63 64 65 66 67 68 69 70 ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ---------- 60 5.19 5.23 5.27 5.31 5.34 5.39 5.42 5.46 5.50 5.54 5.58 61 5.23 5.27 5.31 5.35 5.39 5.43 5.47 5.52 5.56 5.60 5.64 62 5.27 5.31 5.35 5.39 5.44 5.48 5.53 5.57 5.62 5.67 5.71 63 5.31 5.35 5.39 5.44 5.49 5.53 5.58 5.63 5.68 5.73 5.78 64 5.34 5.39 5.44 5.48 5.53 5.59 5.64 5.69 5.74 5.79 5.85 65 5.38 5.43 5.48 5.53 5.58 5.64 5.69 5.75 5.80 5.86 5.92 66 5.42 5.47 5.52 5.58 5.63 5.69 5.75 5.81 5.87 5.93 5.99 67 5.45 5.51 5.56 5.62 5.68 5.74 5.80 5.87 5.93 6.00 6.06 68 5.49 5.55 5.61 5.67 5.73 5.80 5.86 5.93 6.00 6.06 6.14 69 5.53 5.59 5.65 5.71 5.78 5.85 5.92 5.99 6.06 6.13 6.21 70 5.56 5.63 5.69 5.76 5.83 5.90 5.97 6.05 6.13 6.21 6.29 - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ----------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) VARIABLE ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET FIXED ANNUITY BENEFIT INVESTMENT RETURN IS WITH 10 YEARS OF PAYMENTS ----------------------------------------------------- GUARANTEED 3 1/2% 5% ------------------------------- ------ -- MALES FEMALES MALES FEMALES MALES FEMALES ----- ------- ----- ------- ----- ------- 60 5.77 5.06 5.43 4.80 6.36 5.70 61 5.89 5.16 5.57 4.90 6.50 5.81 62 6.02 5.28 5.72 5.01 6.65 5.91 63 6.16 5.40 5.88 5.13 6.81 6.03 64 6.29 5.52 6.05 5.25 6.97 6.15 65 6.44 5.66 6.23 5.39 7.16 6.28 66 6.59 5.80 6.43 5.54 7.35 6.43 67 6.74 5.94 6.64 5.70 7.56 6.58 68 6.90 6.10 6.87 5.87 7.79 6.76 69 7.06 6.26 7.11 6.06 8.03 6.95 70 7.23 6.43 7.38 6.27 8.30 7.15
Equitable will notify the payee under a Variable Annuity Benefit of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each variable payment. Any election, change, revocation or designation shall be made, and will take effect, in the same manner as a change of beneficiary. If a commutation right under an Annuity Benefit is exercised, Equitable may defer payment in accordance with Section 4.06. PART IV - GENERAL PROVISIONS. SECTION 4.01 CONTRACT. The Contract constitutes the entire agreement between the parties and the provisions of the Contract alone will govern with respect to the rights and obligations of Equitable. A copy of the application is incorporated in and made a part of this Contract. Nothing in the application referred to in Section 1.02 nor any modification, amendment, or supplement to any such document will in any way be construed to enlarge, change, vary or in any other way affect the obligations of Equitable as expressly provided in the Contract. The Contract may not be modified as to Equitable, nor may any of Equitable's rights or requirements be waived, except in writing and by an authorized officer of Equitable. The Contract may be changed by amendment or replacement upon agreement between the Owner and Equitable without the consent of any other person provided that such change does not reduce any Annuity Benefit provided before such change and provided that no rights, privileges or benefits which have accrued to the Participant under the Contract may be reduced or forfeited except by the expressed consent of the Participant. SECTION 4.02 STATUTORY COMPLIANCE. Equitable reserves the right to amend the Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the Contract to reflect changes in the Code, or in regulations or published rulings of the Internal Revenue Service so that the Contract will continue to be an "annuity" as defined in Section 72 of the Code. Any Annuity benefit, Cash Value or death benefit available under the Contract shall not be less than the minimum benefits required by any statute of the state in which the Contract is delivered. SECTION 4.03 PARTICIPATION IN SURPLUS. The Contract and all other contracts in the same class of contracts shall be combined for the purpose of ascertaining the annual surplus of Equitable to be apportioned to said contracts as a dividend and the portion of any such dividend that is to be allocated to the Contract shall be determined by Equitable. The participation of this class of contracts in annual surplus is, however, expected to be minimal. Any amount so allocated to the Contract shall be payable as of January 1 of the calendar year in which a dividend is apportioned and will be payable in cash and shall be allocated by Equitable to the Fixed Income Account maintained hereunder for the Participant. No Annuity Benefit will enter into the determination of any surplus to be apportioned to the Contract as a dividend. SECTION 4.04 BENEFICIARY. The Participant, as of the Participation Date, is to name a beneficiary entitled to receive any death benefit payable with respect to the Participant pursuant to Section 2.09. The Participant may change such beneficiary from time to time while Accounts for the Participant are being maintained hereunder. Any such change will be made by written notice in a form satisfactory to Equitable. A change will, upon receipt at Equitable's Processing Office, take effect as of the time the written notice was signed, whether or not the Participant is living on the date of receipt, but without further liability as to any payment or other settlement made by Equitable before receipt of such change. No. 11939C NQ-I ----------- Page Twelve Page Thirteen ------------- GENERAL PROVISIONS (CONTINUED) Unless otherwise specified in the application, if the Participant has named two or more persons as beneficiary, the beneficiary will be the named person or persons who survive the Participant, and if more than one survive they will share equally. Any part of a death benefit payable with respect to the Participant pursuant to Section 2.09 for which there is no named beneficiary living at the death of the Participant will be payable in a single sum to the children of the Participant who survive the Participant, in equal shares, or should none survive, then to the Participant's executors or administrators. If the Participant so elects in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by the Participant, with respect to the beneficiary, subject to Equitable's rules then in effect. If at the death of the Participant there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. SECTION 4.05 FUTURE CONTRIBUTIONS. Equitable reserves the right at its sole discretion to prohibit further Contributions under the Contract upon written notice to the Participant. SECTION 4.06 DEFERMENT. Payments by Equitable from the Participant's Fixed Income Account pursuant to the provisions of Section 2.06, Sections 2.07 and 2.07A, and Section 2.09, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.05, may be deferred for up to six months after receipt of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. Interest at the current Guaranteed Interest Rate for the Participant's Fixed Income Account will be allowed on any such payment deferred for 30 days or more. Except as provided in this Section, payments by Equitable from the Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account pursuant to the provisions of Section 2.06, Sections 2.07 and 2.07A, and Section 2.09, or any commuted payments arising from a Variable Annuity Benefit pursuant to Section 3.05, will be made within seven days after receipt, at Equitable's Processing Office, of a written request for such surrender or withdrawal, or receipt of due proof of death of the Participant, respectively, or receipt of due documentation for such commutation payment pursuant to Section 3.05. During any period when (i) the sale of securities or the determination of the New Accumulation Unit Value or the Average New Annuity Unit Value is not reasonably practicable because an emergency, defined by the Securities and Exchange Commission, exists, or the New York Stock Exchange is closed or trading on such Exchange is restricted, or (ii) the Securities and Exchange Commission may by order permit postponement for the protection of persons having interests in the Separate Accounts, Equitable reserves the right: (a) to defer determination of Cash Values or Annuity Values and payment of Cash Values and Annuity Values, arising from an amount in the Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (b) to defer payment of any portion of the death benefit arising from an amount in a Participant's Stock Account, Balanced Account, Aggressive Stock Account or Money Market Account; (c) to defer the payment of any Variable Annuity Benefit under the Contract or the application of any such Benefit to provide for any other payment called for by the Contract; or (d) in the event of (a) above, to defer application of such amounts to provide any Annuity Benefit permitted under the Contract. SECTION 4.07 ANNUAL NOTICE. At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date (1) the Annuity Value of the Fixed Income Account, (2) the total number of Accumulation Units credited to the Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account, (3) the New Accumulation Unit Values, (4) the sum of the Cash Values of the Fixed Income Account, Stock Account, Balanced Account, Aggressive Stock Account and Money Market Account and (5) the amount of death benefit payable with respect to the Participant. After the Retirement Date, Equitable will notify the Participant of the number of Annuity Units and the Average New Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.08 AGE AND SEX. If the age or sex of the Participant has been misstated, any benefits will be those which would have been purchased at the correct age and sex. Any overpayments or underpayments made by Equitable will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. No. 11939C NQ-I ------------- Page Thirteen EX-99.4BAMENDMENTS 10 FORMS OF ENDORSEMENTS TO GROUP ANNUITY CONTRACTS ESTELLA A. DEVIAN Assistant Vice President [EQUITABLE LOGO] JAN 12 1990 Mr. Fredric L. Bodner, JD Chief, Health and Life Policy Bureau Agency Building One Nelson A. Rockefeller Plaza Albany, New York 12257 Re: Minumum Distribution Endorsements for use with our Group Annuity Contracts and Certificates Dear Mr. Bodner: We are filing herewith for your approval the following contract endorsements:
For Use With Contract Description of Endorsement No. Group Annuity Contract Approved On Tax Qualified Market - -------------- ---------------------- ----------- ------------------------------ PF17110CI 11929CI 2/29/80 IRA/SEP PF17111CT 11930CT 2/29/80 TSA PF17112CT-U 11930CT 2/29/80 TSA-University PF17113CH 11931CH 2/29/80 Non-Corporate Keogh/HR10 PF17114CP 11932CP 11/24/86 Employee Deferred Compensation PF17115C-C 11938C-C 3/09/87 Corporate Trusteed PF17116C-C 11938C-C 3/09/87 Trusteed HR-10 Plans
We are also filing for your approval the following certificate endorsements:
For Use With Group Annuity Certificate Description of Endorsement No. Certificate Approved On Tax Qualified Market - -------------- ----------------- ----------- ------------------------------ PF17110I 11933I 4/19/82 IRA/SEP PF17111T 11934T 4/19/82 TSA PF17112T-U 11934T 4/19/82 TSA-University PF17113H 11935H 4/19/82 Trusteed Non-Corporate Keogh/HR-10 PF17114P 11936P 4/19/82 Employee Deferred Compensation PF17115C 11938C 3/09/87 Corporate Trusteed PF17116C 11938C 3/09/87 Trusteed HR-10 Plan
These endorsements permit partial distributions to comply with the minimum distribution requirements of Internal Revenue Code 401(2)(9) even though these distributions may be after the Participant has attained the Retirement Date under the certificate. THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Two Penn Plaza, New York, N.Y. 10121 Mr. Bodner - 2 - If you have questions concerning these endorsements, please call me collect at (212) 714-5301 or Manager Robert Heck at (212) 714-5247. Sincerely, /s/ Estella A. Devian Estella A. Devian Assistant Vice President 7263L ESTELLA A. DEVIAN Assistant Vice President [EQUITABLE LOGO] DEC 28 1989 Mr. Fredric L. Bodner, JD Chief, Health and Life Policy Bureau Agency Building One Nelson A. Rockefeller Plaza Albany, New York 12257 Re: Minumum Distribution Endorsements for use with our Group Annuity Contracts and Certificates Dear Mr. Bodner: We are filing herewith for your approval the following contract endorsements:
For Use With Contract Description of Endorsement No. Group Annuity Contract Approved On Tax Qualified Market - -------------- ---------------------- ----------- ------------------------------ PF17110CI 11929CI 2/29/80 IRA/SEP PF17111CT 11930CT 2/29/80 TSA PF17112CT-U 11930CT 2/29/80 TSA-University PF17113CH 11931CH 2/29/80 Non-Corporate Keogh/HR10 PF17114CP 11932CP 11/24/86 Employee Deferred Compensation PF17115C-C 11938C-C 3/09/87 Corporate Trusteed PF17116C-C 11938C-C 3/09/87 Trusteed HR-10 Plans
We are also filing for your approval the following certificate endorsements:
For Use With Group Annuity Certificate Description of Endorsement No. Certificate Approved On Tax Qualified Market - -------------- ----------------- ----------- ------------------------------ PF17110I 11933I 4/19/82 IRA/SEP PF17111T 11934T 4/19/82 TSA PF17112T-U 11934T 4/19/82 TSA-University PF17113H 11935H 4/19/82 Trusteed Non-Corporate Keogh/HR-10 PF17114P 11936C 4/19/82 Employee Deferred Compensation PF17115C 11938C 3/09/87 Corporate Trusteed PF17116C 11938C 3/09/87 Trusteed HR-10 Plan
These endorsements permit partial distributions to comply with the minimum distribution requirements of Internal Revenue Code 401(2)(9) even though these distributions may be after the Participant has attained the Retirement Date under the certificate. THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Two Penn Plaza, New York, N.Y. 10121 Mr. Bodner - 2 - If you have questions concerning these endorsements, please call me collect at (212) 714-5301 or Manager Robert Heck at (212) 714-5247. Sincerely, /s/ Estella A. Devian Estella A. Devian Assistant Vice President 7263L THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective November 1, 1989, Equitable hereby amends Group Annuity Contract No. 11929CI as follows: 1. A new section, SECTION 1.11A REQUIRED DISTRIBUTIONS, is added as follows: SECTION 1.11A REQUIRED DISTRIBUTIONS. Notwithstanding any provisions in the certificate to the contrary, distributions from the contract which are intended to satisfy the minimum distribution requirements set forth in the Code and the regulations must be equal to a least the amounts and must be taken at least as frequently as specified in the Code and the regulations. 2. In SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNT, the phrase "on or before the Retirement Date" is deleted from the definition of "Accumulation Unit." 3. SECTION 1.19 CODE is replaced by the following: SECTION 1.19 CODE. The term "Code" means the Internal Revenue Code of 1986, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. 4. In SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS, the second paragraph is replaced by the following: Participation in the Separate Account under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 5. In SECTION 2.03 GUARANTEED INTEREST DIVISION, the third paragraph is replaced by the following: Participation in the Guaranteed Interest Division under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 6. In SECTION 2.05 TRANSFERS AMONG DIVISIONS, the first sentence is changed to the following: The Participant, upon written request, may transfer all or part of the amount the Participant has in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; and (2) amounts in the Money Market Division may be transferred to other Divisions. 7. In SECTION 2.06 TERMINATION OF PARTICIPATION, the following changes are made: (a) The first sentence of the first paragraph is changed to the following: Subject to any applicable restrictions under the terms of the Plan, the Participant may elect by written notice to terminate participation under the Contract. (b) The phrase "Prior to a Participant's Retirement Date" is deleted from the first sentence of the third paragraph. 8. In SECTION 2.07 PARTIAL WITHDRAWALS, the phrase "before such Participant's Retirement Date" is deleted from the first paragraph. 9. SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE is replaced by the following: SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Participation Year, if the Annuity Account Value on that date is less than $10,000, Equitable will withdraw from the Divisions an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Account Value and (ii) any withdrawals pursuant to Section 2.07 during that Participation Year. The charge will be allocated among the Divisions in proportion to the amounts that the Participant has in the Divisions. If the Annuity Account Value is less than $10,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of termination of participation under the Contract pursuant to Section 2.06 or 2.09, Equitable will determine the portion of the administrative charge applicable to the completed portion of the current Participation Year and withdraw such amount in lieu of the annual administrative charge described in this Section for the applicable part of that Participation Year. PF 17110CI 10. In SECTION 2.09 DEATH BENEFIT, the following phrases are deleted from the first paragraph: "and before such Participant's Retirement Date," and "at any time prior to the Retirement Date." 11. In SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS, the following changes are made: (a) The first paragraph is replaced by the following: As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of the certificate in a single sum, (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by Equitable, as elected by the Participant or (iii) to take partial withdrawals in amounts and at times as required by the Code, pursuant to Section 1.11A, subject to Equitable's rules then in effect and any other applicable requirements under the Code. (b) The phrase "before the Retirement Date" is deleted from the third paragraph. 12. In SECTION 3.05 PAYMENT OF ANNUITY BENEFITS, the following changes are made: (a) The first paragraph is deleted and the second paragraph is replaced by the following: A Participant's entire interest shall be distributed beginning not later than April 1 of the year following the calendar year in which the Participant attains age 70 years and six months. Distributions may be made in such amounts as the Participant may request, provided such requested amounts are at least equal to the minimum amounts required to be distributed under the Code and provided further that such requested distributions are in accordance with Equitable's rules in effect at the time of each request. (b) Item (ii) in the sixth paragraph is replaced by the following: (ii) such distribution will begin no later than one year after the Participant's death, unless the Participant's spouse is the designated beneficiary, in which case distributions must begin no later than the date on which the Participant would have attained age 70 years and six months. 13. In SECTION 4.05 BENEFICIARY, the following sentence is added to the end of the last paragraph: Any such election must meet the minimum distribution requirements under the Code, as described in Section 1.11A. 14. In SECTION 4.06 DISQUALIFICATION, the phrase "before the Retirement Date" is deleted. 15. In SECTION 4.09 ANNUAL NOTICE, the phrase "up to and including the Retirement Date" is deleted. Agreed to by: THE EQUITABLE LIFE ASSURANCE UNITED STATES TRUST COMPANY SOCIETY OF THE UNITED STATES By ___________________________________ By _________________________________ President Title ________________________________ By _________________________________ Vice President and Secretary Dated ________________________________ Date of Issue ______________________ At ___________________________________ PF 17110CI THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective November 1, 1989, Equitable hereby amends Group Annuity Contract No. 11930CT as follows: 1. In SECTION 1.11A RETIREMENT DATE, the third and fourth sentences of the first paragraph are changed to the following: Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Processing Office. No Retirement Date shall be earlier than the Participant's 55th birthday or later than the date specified in the Code. 2. SECTION 1.11B REQUIRED DISTRIBUTIONS is replaced by the following: SECTION 1.11B REQUIRED DISTRIBUTIONS. Notwithstanding any provisions in the certificate to the contrary, distributions from the contract which are intended to satisfy the minimum distribution requirements set forth in the Code and the regulations must be equal to at least the amounts and must be taken at least as frequently as specified in the Code and the regulations. For benefits accrued prior to January 1, 1987, distributions must commence no later than the attainment of age 75. 3. In SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNT, the phrase "on or before the Retirement Date" is deleted from the definition of "Accumulation Unit." 4. SECTION 1.19 CODE is replaced by the following: SECTION 1.19 CODE. The term "Code" means the Internal Revenue Code of 1986, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. 5. In SECTION 2.01 CONTRIBUTIONS, the phrase "or under a Plan of an Employer described in clause (ii) of Section 1.01" is deleted from the first sentence of the third paragraph. 6. In SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS, the second paragraph is replaced by the following: Participation in the Separate Account under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 7. In SECTION 2.03 GUARANTEED INTEREST DIVISION, the third paragraph is replaced by the following: Participation in the Guaranteed Interest Division under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 8. In SECTION 2.05 TRANSFERS AMONG DIVISIONS, the first sentence is changed to the following: The Participant, upon written request, may transfer all or part of the amount the Participant has in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; and (2) amounts in the Money Market Division may be transferred to other Divisions. 9. In SECTION 2.06 TERMINATION OF PARTICIPATION, the following changes are made: (a) The first sentence of the first paragraph is changed to the following: Subject to any applicable restrictions under the terms of the Agreement or the Plan, the Participant may elect by written notice to terminate Participation under the Contract. (b) The phrase "Prior to a Participant's Retirement Date" is deleted from the first sentence of the fourth paragraph. PF 17111CT 10. In SECTION 2.07 PARTIAL WITHDRAWALS, the phrase "before such Participant's Retirement Date" is deleted from the first paragraph. 11. In SECTION 2.09 DEATH BENEFIT, the following phrases are deleted from the first paragraph: "and before such Participant's Retirement Date" and "at any time prior to the Retirement Date." 12. In SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS, the following changes are made: (a) The first paragraph is replaced by the following: As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Account Value less any outstanding loan shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of the certificate in a single sum, (ii) to apply the Annuity Account Value less any outstanding loan or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by Equitable, as elected by the Participant or (iii) to take partial withdrawals in amounts and at times as required by the Code, pursuant to Section 1.11B, subject to Equitable's rules then in effect and any other applicable requirements under the Code. (b) The phrase "before the Retirement Date" is deleted from the third paragraph. (c) The phrase "any shorter period which meets the minimum distribution rules under the Code, or" is added to the end of item (i) in the fifth paragraph. 13. In SECTION 4.05 BENEFICIARY, the following sentence is added to the end of the last paragraph: Any such election must meet the minimum distribution requirements under the Code, as described in Section 1.11B. 14. In SECTION 4.06 DISQUALIFICATION, the phrase "before the Retirement Date" is deleted. 15. In SECTION 4.09 ANNUAL NOTICE, the phrase "up to and including the Retirement Date" is deleted. Agreed to by: UNITED STATES TRUST COMPANY THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES By By ----------------------------------- ----------------------------------- President Title By --------------------------------- ----------------------------------- Vice President and Secretary Dated Date of Issue --------------------------------- ------------------------ At ------------------------------------ PF 17111CT THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES This endorsement is issued only to Participants covered under Plans issued in conjunction with Optional Retirement or Tax-Sheltered Annuity Programs or Plans adopted by Universities. To the extent that any of the provisions modified herein have been previously modified in Rider PF 17041T-U, this endorsement shall govern. Effective November 1, 1989, Equitable hereby amends Group Annuity Contract No. 11930CT as follows: 1. In SECTION 1.11A RETIREMENT DATE, the third and fourth sentences of the first paragraph are changed to the following: Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Processing Office. No Retirement Date shall be earlier than the Participant's 55th birthday or later than the date specified in the Code. 2. SECTION 1.11B REQUIRED DISTRIBUTIONS is replaced by the following: SECTION 1.11B REQUIRED DISTRIBUTIONS. Notwithstanding any provisions in the certificate to the contrary, distributions from the contract which are intended to satisfy the minimum distribution requirements set forth in the Code and the regulations must be equal to at least the amounts and must be taken at least as frequently as specified in the Code and the regulations. For benefits accrued prior to January 1, 1987, distributions must commence no later than the attainment of age 75. 3. In SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNT, the phrase "on or before the Retirement Date" is deleted from the definition of "Accumulation Unit." 4. SECTION 1.19 CODE is replaced by the following: SECTION 1.19 CODE. The term "Code" means the Internal Revenue Code of 1986, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. 5. In SECTION 2.01 CONTRIBUTIONS, the phrase "or under a Plan of an Employer described in clause (ii) of Section 1.01" is deleted from the first sentence of the third paragraph. 6. In SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS, the second paragraph is replaced by the following: Participation in the Separate Account under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 7. In SECTION 2.03 GUARANTEED INTEREST DIVISION, the third paragraph is replaced by the following: Participation in the Guaranteed Interest Division under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 8. In SECTION 2.05 TRANSFERS AMONG DIVISIONS, the first sentence is changed to the following: The Participant, upon written request, may transfer all or part of the amount the Participant has in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; and (2) amounts in the Money Market Division may be transferred to other Divisions. 9. In SECTION 2.06 TERMINATION OF PARTICIPATION, the following changes are made: (a) The first sentence of the first paragraph is changed to the following: Subject to any applicable restrictions under the terms of the Agreement or the Plan, the Participant may elect by written notice to terminate Participation under the Contract. (b) The phrase "Prior to a Participant's Retirement Date" is deleted from the first sentence of the fourth paragraph. PF 17112CT-U 10. In SECTION 2.07 PARTIAL WITHDRAWALS, the first paragraph is replaced by the following: Subject to any applicable restrictions under the terms of the Agreement or the Plan, whichever is applicable, or to applicable laws or regulations, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Divisions. 11. In SECTION 2.09 DEATH BENEFIT, the following phrases are deleted from the first paragraph: "and before such Participant's Retirement Date" and "at any time prior to the Retirement Date." 12. In SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS, the following changes are made: (a) The first paragraph is replaced by the following: As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Account Value less any outstanding loan shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of the certificate in a single sum, if such election is permitted by the Plan or Agreement, (ii) to receive not more than a specific percentage or dollar amount of the Cash Value of the certificate in a single sum (if permitted by the Pan or Agreement) and to apply the remainder of the Cash Value to provide an Annuity Benefit on any annuity form offered by Equitable, as elected by the Participant, (iii) to apply the Annuity Account Value less any outstanding loan or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other from offered by Equitable and permitted by the Plan or Agreement, as elected by the Participant or (iv) to take partial withdrawals in amounts and at times as required by the Code, pursuant to Section 1.11B (if permitted by the Plan or Agreement), subject to Equitable's rules then in effect and any other applicable requirements under the Code. A Participant may elect to divide the applicable value between a partial sum payment and an annuity form, if such election is in accordance with the Plan or Agreement. (b) The phrase "before the Retirement Date" is deleted from the third paragraph. (c) The phrase "any shorter period which meets the minimum distribution rules under the Code, or" is added to the end of item (i) in the fifth paragraph. 13. In SECTION 4.05 BENEFICIARY, the following sentence is added to the end of the last paragraph: Any such election must meet the minimum distribution requirements under the Code, as described in Section 1.11B. 14. In SECTION 4.06 DISQUALIFICATION, the phrase "before the Retirement Date" is deleted. 15. In SECTION 4.09 ANNUAL NOTICE, the phrase "up to and including the Retirement Date" is deleted. Agreed to by: UNITED STATES TRUST COMPANY THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES By By ----------------------------------- ----------------------------------- President Title By --------------------------------- ----------------------------------- Vice President and Secretary Dated Date of Issue --------------------------------- ------------------------ At ------------------------------------ PF 17112CT-U THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective November 1, 1989, Equitable hereby amends Group Annuity Contract No. 11931CH as follows: 1. SECTION 1.02 PLAN is replaced by the following: SECTION 1.02A PLAN. The term "Plan" means the Non-Trusteed Money Purchase/Profit Sharing Prototype Plan For Unincorporated Employers, sponsored by Equitable, which has been determined by the Internal Revenue Service to meet the requirements for qualification under Section 4.01(a) of the Code. 2. A new section, SECTION 1.11A REQUIRED DISTRIBUTIONS, is added as follows: SECTION 1.11A REQUIRED DISTRIBUTIONS. Notwithstanding any provisions in the certificate to the contrary, distributions from the contract which are intended to satisfy the minimum distribution requirements set forth in the Code and the regulations must be equal to at least the amounts and must be taken at least as frequently as specified in the Code and the regulations. 3. In SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS, the phrase "on or before the Retirement Date" is deleted from the definition of "Accumulation Unit." 4. SECTION 1.19 CODE is replaced by the following: SECTION 1.19 CODE. The term "Code" means the Internal Revenue Code of 1986, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. 5. In SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS, the second paragraph is replaced by the following: Participation in the Separate Account under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 6. In SECTION 2.03 GUARANTEED INTEREST DIVISION, the third paragraph is replaced by the following: Participation in the Guaranteed Interest Division under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 7. In SECTION 2.05 TRANSFERS AMONG DIVISIONS, the first sentence is changed to the following: The Participant, upon written request, may transfer all or part of the amount the Participant has in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions, and (2) amounts in the Money Market Division may be transferred to other Divisions. 8. In SECTION 2.06 TERMINATION OF PARTICIPATION, the following changes are made: (a) The first sentence of the first paragraph is changed to the following: Subject to any applicable restrictions under the terms of the Plan, the Participant may elect by written notice to terminate participation under the Contract. (b) The phrase "Prior to a Participant's Retirement Date" is deleted from the first sentence of the third paragraph. PF 17113CH 9. In SECTION 2.07 PARTIAL WITHDRAWALS, the phrase, "before such Participant's Retirement Date" is deleted from the first paragraph. 10. SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE is replaced by the following: SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Participation Year, if the Annuity Account Value on that date is less than $10,000, Equitable will withdraw from the Divisions an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Account Value and (ii) any withdrawals pursuant to Section 2.07 during that Participation Year. The charge will be allocated among the Divisions in proportion to the amounts that the Participant has in the Divisions. If the Annuity Account Value is less than $10,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of termination of participation under the Contract pursuant to Section 2.06 or 2.09, Equitable will determine the portion of the administrative charge applicable to the completed portion of the current Participation Year and withdraw such amount in lieu of the administrative charge described in this Section for the applicable part of that Participation Year. 11. In SECTION 2.09 DEATH BENEFIT, the following phrases are deleted from the first paragraph: "and before such Participant's Retirement Date," and "at any time prior to the Retirement Date." 12. In SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS, the following changes are made: (a) The first paragraph is replaced by the following: As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of the certificate in a single sum, (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by Equitable, as elected by the Participant or (iii) to take partial withdrawals in amounts and at times as required by the Code, pursuant to Section 1.11A, subject to Equitable's rules then in effect and any other applicable requirements under the Code. (b) The phrase "before the Retirement Date" is deleted from the third paragraph. 13. In SECTION 4.05 BENEFICIARY, the following sentence is added to the end of the last paragraph: Any such election must meet the minimum distribution requirements under the Code, as described in Section 1.11A. 14. In SECTION 4.06 DISQUALIFICATION, the phrase "before the Retirement Date" is deleted. 15. In SECTION 4.09 ANNUAL NOTICE, the phrase "up to and including the Retirement Date" is deleted.
Agreed to by: THE EQUITABLE LIFE ASSURANCE UNITED STATES TRUST COMPANY SOCIETY OF THE UNITED STATES By By -------------------------------------------- --------------------------------------------- President Title By ----------------------------------------- --------------------------------------------- Vice President and Secretary Dated Date of Issue ----------------------------------------- ---------------------------------- At --------------------------------------------
PF 17113CH THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective November 1, 1989, Equitable hereby amends Group Annuity Contract No. 11932CP as follows: 1. A new section, SECTION 1.11A REQUIRED DISTRIBUTIONS, is added as follows: SECTION 1.11A REQUIRED DISTRIBUTIONS, Notwithstanding any provisions in the certificate to the contrary, distributions from the contract which are intended to satisfy the minimum distribution requirements set forth in the Code and the regulations must be equal to at least the amounts and must be taken at least as frequently as specified in the Code and the regulations. 2. In SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNT, the phrase "on or before the Retirement Date" is deleted from the definition of "Accumulation Unit." 3. SECTION 1.19 CODE is replaced by the following: SECTION 1.19 CODE, The term "Code" means the Internal Revenue Code of 1986, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. 4. In SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS, the second paragraph is replaced by the following: Participation in the Separate Account under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 6. In SECTION 2.05 TRANSFERS AMONG DIVISIONS, the first sentence is changed to the following: The Participant, upon written request, may transfer all or part of the amount the Participant has in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; and (2) amounts in the Money Market Division may be transferred to other Divisions. 7. In SECTION 2.06 TERMINATION OF PARTICIPATION, the following changes are made: (a) The first sentence of the first paragraph is changed to the following: Subject to any applicable restrictions under the terms of the Plan, the Participant may elect by written notice to terminate participation under the Contract. (b) The phrase "Prior to a Participant's Retirement Date" is deleted from the first sentence of the third paragraph. 8. In SECTION 2.07 PARTIAL WITHDRAWALS, the phrase "before such Participant's Retirement Date" is deleted from the first paragraph. PF17114CP 9. In SECTION 2.09 DEATH BENEFIT, the following phrases are deleted from the first paragraph: "and before such Participant's Retirement Date" and "at any time prior to the Retirement Date." 10. In SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS, the following changes are made: (a) The first paragraph is replaced by the following: As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of the certificate in a single sum, (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by Equitable, as elected by the Participant or (iii) to take partial withdrawals in amounts and at times as required by the Code, pursuant to Section 1.11A, subject to Equitable's rules then in effect and any other applicable requirements under the Code. (b) The phrase "before the Retirement Date" is deleted from the third paragraph. 11. In SECTION 4.05 BENEFICIARY, the following sentence is added to the end of the last paragraph: Any such election must meet the minimum distribution requirements under the Code, as described in Section 1.11A. 12. In SECITON 4.06 DISQUALIFICATION, the phrase "before the Retirement Date" is deleted. 13. In SECTION 4.09 ANNUAL NOTICE, the phrase "up to and including the Retirement Date" is deleted. Agreed to by: THE EQUITABLE LIFE ASSURANCE UNITED STATES TRUST COMPANY SOCIETY OF THE UNITED STATES By_____________________________ By_____________________________ President Title__________________________ By_____________________________ Vice President and Secretary Dated__________________________ Date of Issue__________________ At_____________________________ PF17114CP THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective November 1, 1989, Equitable hereby amends Group Annuity Contract No. 11938C-C as follows: 1. A new section, SECTION 1.11A REQUIRED DISTRIBUTIONS, is added as follows: SECTION 1.11A REQUIRED DISTRIBUTIONS. Notwithstanding any provisions in the certificate to the contrary, distributions from the contract which are intended to satisfy the minimum distribution requirements set forth in the Code and the regulations must be equal to at least the amounts and must be taken at least as frequently as specified in the Code and the regulations. 2. In SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNT, the phrase "on or before the Retirement Date" is deleted from the definition of "Accumulation Unit." 3. In SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS, the second paragraph is replaced by the following: Participation in the Separate Account under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 4. In SECTION 2.03 GUARANTEED INTEREST DIVISION, the third paragraph is replaced by the following: Participation in the Guaranteed Interest Division under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 5. In SECTION 2.05 TRANSFERS AMONG DIVISIONS, the phrase "At any time before a Participant's Retirement Date" is deleted from the first paragraph. 6. In SECTION 2.06 TERMINATION OF PARTICIPATION, the following changes are made: (a) The first sentence of the first paragraph is changed to the following: Subject to any applicable restrictions under the terms of the Plan, the Participant may elect by written notice to terminate participation under the Contract. (b) The phrase "Prior to a Participant's Retirement Date" is deleted from the first sentence of the third paragraph. 7. In SECTION 2.07 PARTIAL WITHDRAWALS, the phrase "before such Participant's Retirement Date" is deleted from the first paragraph. 8. In SECTION 2.09 DEATH BENEFIT, the phrase "and before such Participant's Retirement Date" is deleted from the first paragraph and the phrase "at any time prior to the Retirement Date" is deleted from the sixth paragraph. 9. In SECTION 2.09 DEATH BENEFIT, the following sentence is added to the end of the third paragraph and the end of the fourth paragraph: Any election for an Annuity Benefit must meet the minimum distribution requirements under the Code. PF 17115C-C 10. In SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS, the following changes are made: (a) The first paragraph is replaced by the following: As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Account Value less any outstanding loan shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of the certificate in a single sum, (ii) to apply the Annuity Account Value less any outstanding loan or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by Equitable, as elected by the Participant or (iii) to take partial withdrawals in amounts and at times as required by the Code, pursuant to Section 1.11A, subject to Equitable's rules then in effect and any other applicable requirements under the Code. (b) The phrase "before the Retirement Date" is deleted from the third paragraph. (c) The phrase "any shorter period which meets the minimum distribution rules under the Code, or" is added to the end of item (i) in the fifth paragraph. 11. In SECTION 4.06 DISQUALIFICATION, the phrase "before the Retirement Date" is deleted. 12. In SECTION 4.09 ANNUAL NOTICE, the phrase "up to and including the Retirement Date" is deleted. Agreed to by: THE EQUITABLE LIFE ASSURANCE UNITED STATES TRUST COMPANY SOCIETY OF THE UNITED STATES By___________________________________ By __________________________________ President Title _______________________________ By __________________________________ Vice President and Secretary Dated _______________________________ Date of Issue _______________________ At __________________________________ PF 17115C-C THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES For Participants in HR-10 Plans, effective November 1, 1989, we have amended Group Annuity Contract No. 11938C-C as follows: SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE is replaced by the following: As of the last day of each Participation Year, if the Annuity Account Value on that date is less than $10,000, Equitable will withdraw from the Divisions an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Account Value and (ii) any withdrawals pursuant to Section 2.07 during that Participation Year. The charge will be allocated among the Divisions in proportion to the amounts that the Participant has in the Divisions. For this purpose, any loan reserve account will be deemed to be included within the Guaranteed Interest Division. The portion of the charge attributable to the Guaranteed Interest Division and any loan reserve account will be first withdrawn from the Guaranteed Interest Division and then, if the amount a Participant has in the Guaranteed Interest Division is not sufficient, the remaining allocation will be withdrawn from the portion of the loan reserve account that earns interest at the most current rate credited to the Guaranteed Interest Division. If the Annuity Account Value is less than $10,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of termination of participation under the Contract pursuant to Section 2.06 or 2.09, Equitable will determine the portion of the administrative charge applicable to the completed portion of the current Participation Year and withdraw such amount in lieu of the annual administrative charge described in this Section for the applicable part of that Participation Year. Agreed to by: THE EQUITABLE LIFE ASSURANCE UNITED STATES TRUST COMPANY SOCIETY OF THE UNITED STATES By_________________________ By____________________________ President Title______________________ By____________________________ Vice President and Secretary Dated______________________ Date of Issue_________________ At_________________________ PF 17116C-C THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective November 1, 1989, Equitable hereby amends your certificate issued under Group Annuity Contract No. 11929CI as follows: 1. A new section, SECTION 1.11A REQUIRED DISTRIBUTIONS, is added as follows: SECTION 1.11A REQUIRED DISTRIBUTIONS. Notwithstanding any provisions in the certificate to the contrary, distributions from the contract which are intended to satisfy the minimum distribution requirements set forth in the Code and the regulations must be equal to at least the amounts and must be taken at least as frequently as specified in the Code and the regulations. 2. In SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNT, the phrase "on or before the Retirement Date" is deleted from the definition of "Accumulation Unit." 3. SECTION 1.19 CODE is replaced by the following: SECTION 1.19 CODE. The term "Code" means the Internal Revenue Code of 1986, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. 4. In SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS, the second paragraph is replaced by the following: Participation in the Separate Account under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 5. In SECTION 2.03 GUARANTEED INTEREST DIVISION, the third paragraph is replaced by the following: Participation in the Guaranteed Interest Division under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 6. In SECTION 2.05 TRANSFERS AMONG DIVISIONS, the first sentence is changed to the following: The Participant, upon written request, may transfer all or part of the amount the Participant has in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; and (2) amounts in the Money Market Division may be transferred to other Divisions. 7. In SECTION 2.06 TERMINATION OF PARTICIPATION, the following changes are made: (a) The first sentence of the first paragraph is changed to the following: Subject to any applicable restrictions under the terms of the Plan, the Participant may elect by written notice to terminate participation under the Contract. (b) The phrase "Prior to a Participant's Retirement Date" is deleted from the first sentence of the third paragraph. 8. In SECTION 2.07 PARTIAL WITHDRAWALS, the phrase "before such Participant's Retirement Date" is deleted from the first paragraph. 9. SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE is replaced by the following: SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Participation Year, if the Annuity Account Value on that date is less than $10,000, Equitable will withdraw from the Divisions an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Account Value and (ii) any withdrawals pursuant to Section 2.07 during that Participation Year. The charge will be allocated among the Divisions in proportion to the amounts that the Participant has in the Divisions. If the Annuity Account Value is less than $10,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of termination of participation under the Contract pursuant to Section 2.06 or 2.09, Equitable will determine the portion of the administrative charge applicable to the completed portion of the current Participation Year and withdraw such amount in lieu of the annual administrative charge described in this Section for the applicable part of that Participation Year. PF 17110I 10. In SECTION 2.09 DEATH BENEFIT, the following phrases are deleted from the first paragraph: "and before such Participant's Retirement Date," and "at any time prior to the Retirement Date." 11. In SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS, the following changes are made: (a) The first paragraph is replaced by the following: As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of the certificate in a single sum, (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by Equitable, as elected by the Participant or (iii) to take partial withdrawals in amounts and at times as required by the Code, pursuant to Section 1.11A, subject to Equitable's rules then in effect and any other applicable requirements under the Code. (b) The phrase "before the Retirement Date" is deleted from the third paragraph. 12. In SECTION 3.05 PAYMENT OF ANNUITY BENEFITS, the following changes are made: (a) The first paragraph is deleted and the second paragraph is replaced by the following: A Participant's entire interest shall be distributed beginning not later than April 1 of the year following the calendar year in which the Participant attains age 70 years and six months. Distributions may be made in such amounts as the participant may request, provided such requested amounts are at least equal to the minimum amounts required to be distributed under the Code and provided further that such requested distributions are in accordance with Equitable's rules in effect at the time of each request. (b) Item (ii) in the sixth paragraph is replaced by the following: (ii) such distribution will begin no later than one year after the Participant's death, unless the Participant's spouse is the designated beneficiary, in which case distributions must begin no later than the date on which the Participant would have attained age 70 years and six months. 13. In SECTION 4.05 BENEFICIARY, the following sentence is added to the end of the last paragraph: Any such election must meet the minimum distribution requirements under the Code, as described in Section 1.11A. 14. In SECTION 4.06 DISQUALIFICATION, the phrase "before the Retirement Date" is deleted. 15. In SECTION 4.09 ANNUAL NOTICE, the phrase "up to and including the Retirement Date" is deleted. Vice President SPECIMEN and Secretary SPECIMEN President PF 17110I THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective November 1, 1989, Equitable hereby amends your certificate issued under Group Annuity Contract No. 11930CT as follows: 1. In SECTION 1.11A RETIREMENT DATE, the third and fourth sentences of the first paragraph are changed to the following: Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Processing Office. No Retirement Date shall be earlier than the Participant's 55th birthday or later than the date specified in the Code. 2. SECTION 1.11B REQUIRED DISTRIBUTIONS is replaced by the following: SECTION 1.11B REQUIRED DISTRIBUTIONS. Notwithstanding any provisions in the certificate to the contrary, distributions from the contract which are intended to satisfy the minimum distribution requirements set forth in the Code and the regulations must be equal to at least the amounts and must be taken at least as frequently as specified in the Code and the regulations. For benefits accrued prior to January 1, 1987, distributions must commence no later than the attainment of age 75. 3. In SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNT, the phrase "on or before the Retirement Date" is deleted from the definition of "Accumulation Unit." 4. SECTION 1.19 CODE is replaced by the following: SECTION 1.19 CODE. The term "Code" means the Internal Revenue Code of 1986, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. 5. In SECTION 2.01 CONTRIBUTIONS, the phrase "or under a Plan of an Employer described in clause (ii) of Section 1.01" is deleted from the first sentence of the third paragraph. 6. In SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS, the second paragraph is replaced by the following: Participation in the Separate Account under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 7. In SECTION 2.03 GUARANTEED INTEREST DIVISION, the third paragraph is replaced by the following: Participation in the Guaranteed Interest Division under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 8. In SECTION 2.05 TRANSFERS AMONG DIVISIONS, the first sentence is changed to the following: The Participant, upon written request, may transfer all or part of the amount the Participant has in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; and (2) amounts in the Money Market Division may be transferred to other Divisions. 9. In SECTION 2.06 TERMINATION OF PARTICIPATION, the following changes are made: (a) The first sentence of the first paragraph is changed to the following: Subject to any applicable restrictions under the terms of the Agreement or the Plan, the Participant may elect by written notice to terminate Participation under the Contract. (b) The Phrase "Prior to a Participant's Retirement Date" is deleted from the first sentence of the fourth paragraph. PF 17111T 10. In SECTION 2.07 PARTIAL WITHDRAWALS, the phrase "before such Participant's Retirement Date" is deleted from the first paragraph. 11. In SECTION 2.09 DEATH BENEFIT, the following phrases are deleted from the first paragraph: "and before such Participant's Retirement Date" and "at any time prior to the Retirement Date." 12. In SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS, the following changes are made: (a) The first paragraph is replaced by the following: As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Account Value less any outstanding loan shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of the certificate in a single sum, (ii) to apply the Annuity Account Value less any outstanding loan or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by Equitable, as elected by the Participant or (iii) to take partial withdrawals in amounts and at times as required by the Code, pursuant to Section 1.11B, subject to Equitable's rules then in effect and any other applicable requirements under the Code. (b) The phrase "before the Retirement Date" is deleted from the third paragraph. (c) The phrase "any shorter period which meets the minimum distribution rules under the Code, or" is added to the end of item (i) in the fifth paragraph. 13. In SECTION 4.05 BENEFICIARY, the following sentence is added to the end of the last paragraph: Any such election must meet the minimum distribution requirements under the Code, as described in Section 1.11B. 14. In SECTION 4.06 DISQUALIFICATION, the phrase "before the Retirement Date" is deleted. 15. In SECTION 4.09 ANNUAL NOTICE, the phrase "up to and including the Retirement Date" is deleted. SPECIMEN Vice President SPECIMEN President and Secretary PF 17111T THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES This endorsement is issued only to Participants covered under Plans issued in conjunction with Optional Retirement or Tax-Sheltered Annuity Programs or Plans adopted by Universities. To the extent that any of the provisions modified herein have been previously modified in Rider PF 17041T-U, this endorsement shall govern. Effective November 1, 1989, Equitable hereby amends your certificate issued under Group Annuity Contract No. 11930CT as follows: 1. In SECTION 1.11A RETIREMENT DATE, the third and fourth sentences of the first paragraph are changed to the following: Any election for such change must be made in writing by the Participant and shall not take effect until received by Equitable at its Processing Office. No Retirement Date shall be earlier than the Participant's 55th birthday or later than the date specified in the Code. 2. SECTION 1.11B REQUIRED DISTRIBUTIONS is replaced by the following: SECTION 1.11B REQUIRED DISTRIBUTIONS. Notwithstanding any provisions in the certificate to the contrary, distributions from the contract which are intended to satisfy the minimum distribution requirements set forth in the Code and the regulations must be equal to at least the amounts and must be taken at least as frequently as specified in the Code and the regulations. For benefits accrued prior to January 1, 1987, distributions must commence no later than the attainment of age 75. 3. In SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNT, the phrase "on or before the Retirement Date" is deleted from the definition of "Accumulation Unit." 4. SECTION 1.19 CODE is replaced by the following: SECTION 1.19 CODE. The term "Code" means the Internal Revenue Code of 1986, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. 5. In SECTION 2.01 CONTRIBUTIONS, the phrase "or under a Plan of an Employer described in clause (ii) of Section 1.01" is deleted from the first sentence of the third paragraph. 6. In SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS, the second paragraph is replaced by the following: Participation in the Separate Account under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 7. In SECTION 2.03 GUARANTEED INTEREST DIVISION, the third paragraph is replaced by the following: Participation in the Guaranteed Interest Division under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the participant and (iii) termination of participation pursuant to Section 2.06. 8. In SECTION 2.05 TRANSFERS AMONG DIVISIONS, the first sentence is changed to the following: The Participant, upon written request, may transfer all or part of the amount the Participant has in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; and (2) amounts in the Money Market Division may be transferred to other Divisions. 9. In SECTION 2.06 TERMINATION OF PARTICIPATION, the following changes are made: (a) The first sentence of the first paragraph is changed to the following: Subject to any applicable restrictions under the terms of the Agreement or the Plan, the Participant may elect by written notice to terminate Participation under the Contract. (b) The phrase "Prior to a Participant's Retirement Date" is deleted from the first sentence of the fourth paragraph. PF 17112T-U 10. In SECTION 2.07 PARTIAL WITHDRAWALS, the first paragraph is replaced by the following: Subject to any applicable restrictions under the terms of the Agreement or the Plan, whichever is applicable, or to applicable laws or regulations, a Participant may elect by written notice to Equitable to make a partial withdrawal from the Divisions. 11. In SECTION 2.09 DEATH BENEFIT, the following phrases are deleted from the first paragraph: "and before such Participant's Retirement Date," and "at any time prior to the Retirement Date." 12. In SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS, the following changes are made: (a) The first paragraph is replaced by the following: As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Account Value less any outstanding loan shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of the certificate in a single sum, if such election is permitted by the Plan or Agreement, (ii) to receive not more than a specific percentage or dollar amount of the Cash Value of the certificate in a single sum (if permitted by the Plan or Agreement) and to apply the remainder of the Cash Value to provide an Annuity Benefit on any annuity form offered by Equitable, as elected by the Participant, (iii) to apply the Annuity Account Value less any outstanding loan or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by Equitable and permitted by the Plan or Agreement, as elected by the Participant or (iv) to take partial withdrawals in amounts and at times as required by the Code, pursuant to Section 1.11B (if permitted by the Plan or Agreement), subject to Equitable's rules then in effect and any other applicable requirements under the Code. A Participant may elect to divide the applicable value between a partial sum payment and an annuity form, if such election is in accordance with the Plan or Agreement. (b) The phrase "before the Retirement Date" is deleted from the third paragraph. (c) the phrase "any shorter period which meets the minimum distribution rules under the Code, or" is added to the end of item (i) in the fifth paragraph. 13. In SECTION 4.05 BENEFICIARY, the following sentence is added to the end of the last paragraph: Any such election must meet the minimum distribution requirements under the Code, as described in Section 1.11B. 14. In SECTION 4.06 DISQUALIFICATION, the phrase "before the Retirement Date" is deleted. 15. In SECTION 4.09 ANNUAL NOTICE, the phrase "up to and including the Retirement Date" is deleted. Vice President SPECIMEN and Secretary SPECIMEN President PF 17112T-U THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective November 1, 1989, Equitable hereby amends your certificate issued under Group Annuity Contract No. 11931CH as follows: 1. SECTION 1.02 PLAN is replaced by the following: SECTION 1.02A PLAN. The term "Plan" means the Non-Trusted Money Purchase/Profit Sharing Prototype Plan For Unincorporated Employers, sponsored by Equitable, which has been determined by the Internal Revenue Service to meet the requirements for qualification under Section 401(a) of the Code. 2. A new section, SECTION 1.11A REQUIRED DISTRIBUTIONS, is added as follows: SECTION 1.11A REQUIRED DISTRIBUTIONS. Notwithstanding any provisions in the certificate to the contrary, distributions from the contract which are intended to satisfy the minimum distribution requirements set forth in the Code and the regulations must be equal to at least the amounts and must be taken at least as frequently as specified in the Code and the regulations. 3. In SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS, the phrase "on or before the Retirement Date" is deleted from the definition of "Accumulation Unit." 4. SECTION 1.19 CODE is replaced by the following: SECTION 1.19 CODE. The term "Code" means the Internal Revenue Code of 1986, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. 5. In SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS, the second paragraph is replaced by the following: Participation in the Separate Account under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 6. In SECTION 2.03 GUARANTEED INTEREST DIVISION, the third paragraph is replaced by the following: Participation in the Guaranteed Interest Division under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 7. In SECTION 2.05 TRANSFERS AMONG DIVISIONS, the first sentence is changed to the following: The Participant, upon written request, may transfer all or part of the amount the Participant has in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; and (2) amounts in the Money Market Division may be transferred to other Divisions. 8. In SECTION 2.06 TERMINATION OF PARTICIPATION, the following changes are made: (a) The first sentence of the first paragraph is changed to the following: Subject to any applicable restrictions under the terms of the Plan, the Participant may elect by written notice to terminate participation under the Contract. (b) The phrase "Prior to a Participant's Retirement Date" is deleted from the first sentence of the third paragraph. PF 17113H 9. In SECTION 2.07 PARTIAL WITHDRAWALS, the phrase "before such Participant's Retirement Date" is deleted from the first paragraph. 10. SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE is replaced by the following: SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Participation Year, if the Annuity Account Value on that date is less than $10,000, Equitable will withdraw from the Divisions an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Account Value and (ii) any withdrawals pursuant to Section 2.07 during that Participation Year. The charge will be allocated among the Divisions in proportion to the amounts that the Participant has in the Divisions. If the Annuity Account Value is less than $10,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of termination of participation under the Contract pursuant to Section 2.06 or 2.09, Equitable will determine the portion of the administrative charge applicable to the completed portion of the current Participation Year and withdraw such amount in lieu of the annual administrative charge described in this Section for the applicable part of that Participation Year. 11. In SECTION 2.09 DEATH BENEFIT, the following phrases are deleted from the first paragraph: "and before such Participant's Retirement Date," and "at any time prior to the Retirement Date." 12. In SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS, the following changes are made: (a) The first paragraph is replaced by the following: As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects to (i) to receive the Cash Value of the certificate in a single sum, (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by Equitable, as elected by the Participant or (iii) to take partial withdrawals in amounts and at times as required by the Code, pursuant to Section 1.11A, subject to Equitable's rules then in effect and any other applicable requirements under the Code. (b) The phrase "before the Retirement Date" is deleted from the third paragraph. 13. In SECTION 4.05 BENEFICIARY, the following sentence is added to the end of the last paragraph: Any such election must meet the minimum distribution requirements under the Code, as described in Section 1.11 A. 14. In SECTION 4.06 DISQUALIFICATION, the phrase "before the Retirement Date" is deleted. 15. In SECTION 4.09 ANNUAL NOTICE, the phrase "up to and including the Retirement Date" is deleted. /s/ Pauline Sherman /s/ Edward D. Miller Pauline Sherman, Vice President, Edward D. Miller, President and Secretary and Associate General Counsel Chief Executive Officer PF 17113H THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective November 1, 1989, Equitable hereby amends your certificate issued under Group Annuity Contract No. 11938CP as follows: 1. A new section, SECTION 1.11A REQUIRED DISTRIBUTIONS, is added as follows: SECTION 1.11A REQUIRED DISTRIBUTIONS. Notwithstanding any provisions in the certificate to the contrary, distributions from the contract which are intended to satisfy the minimum distribution requirements set forth in the Code and the regulations must be equal to at least the amounts and must be taken at least as frequently as specified in the Code and the regulations. 2. In SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNT, the phrase "on or before the Retirement Date" is deleted from the definition of "Accumulation Unit." 3. SECTION 1.19 CODE is replaced by the following: SECTION 1.19 CODE. The term "Code" means the Internal Revenue Code of 1986, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. 4. In SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS, the second paragraph is replaced by the following: Participation in the Separate Account under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 5. In SECTION 2.03 GUARANTEED INTEREST DIVISION, the third paragraph is replaced by the following: Participation in the Guaranteed Interest Division under the contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 6. In SECTION 2.05 TRANSFERS AMONG DIVISIONS, the first sentence is changed to the following: The Participant, upon written request, may transfer all or part of the amount the Participant has in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; and (2) amounts in the Money Market Division may be transferred to other Divisions. 7. In SECTION 2.06 TERMINATION OF PARTICIPATION, the following changes are made: (a) The first sentence of the first paragraph is changed to the following: Subject to any applicable restrictions under the terms of the Plan, the Participant may elect by written notice to terminate participation under the Contract. (b) The phrase "Prior to a Participant's Retirement Date" is deleted from the first sentence of the third paragraph. 8. In SECTION 2.07 PARTIAL WITHDRAWALS, the phrase "before such Participant's Retirement Date" is deleted from the first paragraph. PF 17114P 9. In SECTION 2.09 DEATH BENEFIT, the following phrases are deleted from the first paragraph: "and before such Participant's Retirement Date" and "at any time prior to the Retirement Date." 10. In SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS, the following changes are made: (a) The first paragraph is replaced by the following: As of a Participant's Retirement Date, provided such participant is then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of the certificate in a single sum, (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by Equitable, as elected by the Participant or (iii) to take partial withdrawals in amounts and at times as required by the Code, pursuant to Section 1.11A, subject to Equitable's rules then in effect and any other applicable requirements under the Code. (b) The phrase "before the Retirement Date" is deleted from the third paragraph. 11. In SECTION 4.05 BENEFICIARY, the following sentence is added to the end of the last paragraph: Any such election must meet the minimum distribution requirements under the Code, as described in Section 1.11A. 12. In SECTION 4.06 DISQUALIFICATION, the phrase "before the Retirement Date" is deleted. 13. In SECTION 4.09 ANNUAL NOTICE, the phrase "up to and including the Retirement date" is deleted. Vice President SPECIMEN and Secretary SPECIMEN President PF 17114P THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective November 1, 1989, Equitable hereby amends your certificate issued under Group Annuity Contract No. 11938C-C as follows: 1. A new section, SECTION 1.11A REQUIRED DISTRIBUTIONS, is added as follows: SECTION 1.11A REQUIRED DISTRIBUTIONS. Notwithstanding any provisions in the certificate to the contrary, distributions from the contract which are intended to satisfy the minimum distribution requirements set forth in the Code and the regulations must be equal to at least the amounts and must be taken at least as frequently as specified in the Code and the regulations. 2. In SECTION 1.16 DEFINITIONS RELATING TO THE SEPARATE ACCOUNT, the phrase "on or before the Retirement Date" is deleted from the definition of "Accumulation Unit." 3. In SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS, the second paragraph is replaced by the following: Participation in the Separate Account under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 4. In SECTION 2.03 GUARANTEED INTEREST DIVISION, the third paragraph is replaced by the following: Participation in the Guaranteed Interest Division under the Contract terminates on the earliest of (i) election and commencement of annuity benefits pursuant to Section 3.03, (ii) the death of the Participant and (iii) termination of participation pursuant to Section 2.06. 5. In SECTION 2.05 TRANSFERS AMONG DIVISIONS, the phrase "At any time before a Participant's Retirement Date" is deleted from the first paragraph. 6. In SECTION 2.06 TERMINATION OF PARTICIPATION, the following changes are made: (a) The first sentence of the first paragraph is changed to the following: Subject to any applicable restrictions under the terms of the Plan, the Participant may elect by written notice to terminate participation under the Contract. (b) The phrase "Prior to a Participant's Retirement Date" is deleted from the first sentence of the third paragraph. 7. In SECTION 2.07 PARTIAL WITHDRAWALS, the phrase "before such Participant's Retirement Date" is deleted from the first paragraph. 8. In SECTION 2.09 DEATH BENEFIT, the phrase "and before such Participant's Retirement Date" is deleted from the first paragraph and the phrase "at any time prior to the Retirement Date" is deleted from the sixth paragraph. 9. In SECTION 2.09 DEATH BENEFIT, the following sentence is added to the end of the third paragraph and the end of the fourth paragraph: Any election for an Annuity Benefit must meet the minimum distribution requirements under the Code. PF 17115C 10. In SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS, the following changes are made: (a) The first paragraph is replaced by the following: As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Account Value less any outstanding loan shall be applied to provide the Normal Form of Annuity Benefit, unless such Participant elects (i) to receive the Cash Value of the certificate in a single sum, (ii) to apply the Annuity Account Value less any outstanding loan or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by Equitable, as elected by the Participant or (iii) to take partial withdrawals in amounts and at times as required by the Code, pursuant to Section 1.11A, subject to Equitable's rules then in effect and any other applicable requirements under the Code. (b) The phrase "before the Retirement Date" is deleted from the third paragraph. (c) The phrase "any shorter period which meets the minimum distribution rules under the Code, or" is added to the end of item (i)in the fifth paragraph. 11. In SECTION 4.06 DISQUALIFICATION, the phrase "before the Retirement Date" is deleted. 12. In SECTION 4.09 ANNUAL NOTICE, the phrase "up to and including the Retirement Date" is deleted. SPECIMEN Vice President SPECIMEN President and Secretary PF 17115C THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES For Participants in HR-10 Plans, effective November 1, 1989, we have amended your Certificate issued under Group Annuity Contract No. 11938C-C as follows: SECTION 2.08 ANNUAL ADMINSTRATIVE CHARGE is replaced by the following: As of the last day of each Participation Year, if the Annuity Account Value on that date is less than $10,000, Equitable will withdraw from the Divisions an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Account Value and (ii) any withdrawals pursuant to Section 2.07 during that Participation Year. The charge will be allocated among the Divisions in proportion to the amounts that the Participant has in the Divisions. For this purpose, any loan reserve account will be deemed to be included within the Guaranteed Interest Division. The portion of the charge attributable to the Guaranteed Interest Division and any loan reserve account will be first withdrawn from the Guaranteed Interest Division and then, if the amount a Participant has in the Guaranteed Interest Division is not sufficient, the remaining allocation will be withdrawn from the portion of the loan reserve account that earns interest at the most current rate credited to the Guaranteed Interest Division. If the Annuity Account Value is less than $10,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of termination of participation under the Contract pursuant to Section 2.06 or 2.09, Equitable will determine the portion of the administrative charge applicable to the completed portion of the current Participation Year and withdraw such amount in lieu of the annual administrative charge described in this Section for the applicable part of that Participation Year. Vice President SPECIMEN and Secretary SPECIMEN President PF17116C Estella A. Devian Assistant Vice President THE EQUITABLE DEC 28 1989 Mr. Fredric L. Bodner, JD Chief, Health & Life Policy Bureau Agency Building One Nelson A. Rockefeller Plaza Albany, New York 12257 Re: Group Annuity Riders PF17100C, PF17100C-C, PF17101C and PF17101C-C Dear Mr. Bodner: We are hereby filing for approval Riders PF17100C and PF17101C which are to be used with our qualified trusteed Group Annuity Certificate 11938C approved on March 9, 1987 (File No. 87030090-0093), and Riders PF17100C-C and PF17101C-C which are to be used with Group Annuity Contract 11938C-C which was approved on March 9, 1987 (File No. 87030090-0093). Rider PF17100C provides for partial vesting and will be given upon request to both new and in force qualified trusteed corporate and unincorporated certificate owners in plans which do not provide for full and immediate vesting and therefore require reallocation of forfeitures. Rider PF17101C creates a single suspense account certificate to receive the forfeitures under the plan. Riders PF17100C-C and PF17101C-C similarly amend the Group Annuity Contract. We would appreciate receiving your approval as soon as possible. If you have any questions concerning these riders, please call Manager Robert Heck collect at (212) 714-5287. Sincerely, /s/ Estella A. Devian Estella A. Devian Assistant Vice President jg/7285L THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Two Penn Plaza, New York, N.Y. 10121 THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES This rider is designed for certificates issued in connection with plans which do not provide for full and immediate vesting and therefore require reallocation of forfeitures. The following provisions apply only if a Suspense Account Certificate (Group Annuity Certificate No. 11938C with this rider and Rider No. PF 17101C appended) has been issued under the Plan. Effective immediately, Equitable hereby amends your certificate issued under Group Annuity Contract No. 11938C-C as follows: 1. A new section, SECTION 1.19 SUSPENSE ACCOUNT CERTIFICATE, is added as follows: SECTION 1.19 SUSPENSE ACCOUNT CERTIFICATE. The term "Suspense Account Certificate" means a certificate issued for the purpose of investing amounts which have been forfeited, as provided in the Plan, until such amounts can be reallocated to the other certificates in accordance with the terms of the Plan. 2. A new section, SECTION 1.20 INTER-CERTIFICATE TRANSFER, is added as follows: SECTION 1.20 INTER-CERTIFICATE TRANSFER. The term "Inter-certificate Transfer" means a transfer of (i) funds which have been forfeited, as provided in the Plan, from one certificate to the Suspense Account Certificate; or (ii) from the Suspense Account Certificate to one or more other certificates for the purpose of reallocating forfeitures under the plan. 3. A new section, SECTION 2.07C DISTRIBUTIONS OF FORFEITURES, is added as follows: SECTION 2.07C DISTRIBUTIONS OF FORFEITURES. If the Participant terminates participation pursuant to Section 2.06 or requests a partial withdrawal pursuant to Section 2.07, and the Owner notifies Equitable (on a form acceptable to Equitable) that a forfeiture has occurred under the terms of the Plan, the Owner may make: (i) an Inter-certificate Transfer to the Suspense Account Certificate of an amount equal to the forfeiture; or (ii) a partial withdrawal pursuant to Section 2.07 of an amount equal to the forfeiture. Equitable is not responsible for calculating the amount of the forfeiture. Such Inter-certificate Transfer or partial withdrawal will count toward the available Free Corridor Amount as defined in Section 2.07B. There will be no charge made in conjunction with an Inter-certificate Transfer. However, to the extent that the amount of any partial withdrawal made pursuant to Section 2.07 exceeds the Free Corridor Amount, Equitable will apply any applicable partial withdrawal charges, pursuant to Section 2.07A. If (a) the Owner has made (i) an Inter-certificate Transfer or (ii) a partial withdrawal, in accordance with Section 2.07C; (b) there is still Annuity Account Value; and (c) the Owner has not made any election under Section 3.03 or any other Section of the certificate, then following receipt of a properly completed change of ownership form, Equitable will change ownership of the certificate to the Participant, pursuant to Section 1.05A, who shall then be entitled to exercise all rights under the certificate; provided, however, that no new Contributions may be made at any time after such change of ownership. In any event, Equitable will not be responsible for any tax consequences which may occur as a result of new Contributions. 4. With respect to SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY, the first sentence is replaced by the following: Subject to any restrictions under the Plan, the entire interest of any Participant under the Contract is nonforfeitable. Vice President SPECIMEN and Secretary SPECIMEN President PF 17100C THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES This rider is designed for certificates issued in connection with plans which do not provide for full and immediate vesting and therefore require reallocation of forfeitures. The following provisions apply only if a Suspense Account Certificate (Group Annuity Certificate No. 11938C with this rider and Rider No. PF 17101C appended) has been issued under the Plan. Effective immediately, Equitable hereby amends Group Annuity Contract No. 11938C-C as follows: 1. A new section, SECTION 1.19 SUSPENSE ACCOUNT CERTIFICATE, is added as follows: SECTION 1.19 SUSPENSE ACCOUNT CERTIFICATE. The term "Suspense Account Certificate" means a certificate issued for the purpose of investing amounts which have been forfeited, as provided in the Plan, until such amounts can be reallocated to the other certificates in accordance with the terms of the Plan. 2. A new section, SECTION 1.20 INTER-CERTIFICATE TRANSFER, is added as follows: SECTION 1.20 INTER-CERTIFICATE TRANSFER. The term "Inter-certificate Transfer" means a transfer of funds (i) which have been forfeited, as provided in the Plan, from one certificate to the Suspense Account Certificate; or (ii) from the Suspense Account Certificate to one or more other certificates for the purpose of reallocating forfeitures under the Plan. 3. A new section, SECTION 2.07C DISTRIBUTIONS OF FORFEITURES, is added as follows: SECTION 2.07C DISTRIBUTIONS OF FORFEITURES. If the Participant terminates participation pursuant to Section 2.06 or requests a partial withdrawal pursuant to Section 2.07, and the Owner notifies Equitable (on a form acceptable to Equitable) that a forfeiture has occurred under the terms of the Plan, the Owner may make: (i) an Inter-certificate Transfer to the Suspense Account Certificate of an amount equal to the forfeiture; or (ii) a partial withdrawal pursuant to Section 2.07 of an amount equal to the forfeiture. Equitable is not responsible for calculating the amount of the forfeiture. Such Inter-certificate Transfer or partial withdrawal will count toward the available Free Corridor Amount as defined in Section 2.07B. There will be no charge made in conjunction with an Inter-certificate Transfer. However, to the exetent that the amount of such partial withdrawal exceeds the Free Corridor Amount, Equitable will apply any applicable partial withdrawal charges, pursuant to Section 2.07A. If (a) the Owner has made (i) an Inter-certificate Transfer or (ii) a partial withdrawal, in accordance with Section 2.07C; (b) there is still Annuity Account Value; and (c) the Owner has not made any election under Section 3.03 or any other Section of the certificate, then following receipt of a properly completed change of ownership form, Equitable will change ownership of the certificate to the Participant, pursuant to Section 1.05A, who shall then be entitled to exercise all rights under the certificate; provided, however, that no new Contributions may be made at any time after such change of ownership. In any event, Equitable will not be responsible for any tax consequences which may occur as a result of new Contributions. 4. With respect to SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY, the first sentence is replaced by the following: Subject to any restrictions under the Plan, the entire interest of any Participant under the Contract is nonforfeitable. Agreed to by: UNITED STATES TRUST COMPANY By_____________________________________ Title _________________________________ Dated _________________________________ At ____________________________________ THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES By /s/ John B. Carter ------------------------------------ John B. Carter President By /s/ Benjamin H. Walker ------------------------------------ Benjamin H. Walker Vice President and Secretary Date of Issue _________________________ PF 17100C-C THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective immediately, Equitable hereby amends your certificate issued under Group Annuity Contract No. 11938C-C as follows: 1. Notwithstanding anything in the certificate to the contrary, Contributions may only be allocated to the Guaranteed Interest Division. No Contributions may be allocated, or subsequently transferred, to any of the Separate Account Investment Divisions. 2. A new section, SECTION 1.06A INITIAL DEPOSIT, is added as follows: SECTION 1.06A INITIAL DEPOSIT. The term "Initial Deposit" means a required initial payment made to Equitable by the Owner with respect to a Suspense Account Certificate. The Initial Deposit, the amount of which will be determined by Equitable, will be held under the Suspense Account Certificate from the issue date until participation under the Suspense Account Certificate is terminated in order to maintain a minimum Annuity Account Value. Upon termination of participation under the Suspense Account Certificate, the entire Annuity Account Value will be paid to the Owner. 3. The following paragraph is added after the second paragraph of SECTION 2.07A PARTIAL WITHDRAWAL CHARGES: Any applicable withdrawal charge will be waived on any amount withdrawn if that amount is reallocated as a Contribution to the remaining certificates issued under the Plan, as provided for by the Plan. If any amount withdrawn is not reallocated to the remaining certificates, the applicable withdrawal charge will be deducted from the Annuity Account Value. 4. With respect to SECTION 2.09 DEATH BENEFIT, the phrase "made pursuant to Section 2.07" is deleted from the penultimate paragraph. 5. In SECTION 4.10A TRUSTEE'S RESPONSIBILITY, the phrase "or ownership has been assigned to the Participant pursuant to Section 2.07C' is added to the end of the first sentence. Vice President SPECIMEN and Secretary SPECIMEN President PF 17101C THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES This endorsement applies only for certificates issued as Suspense Account Certificates. Effective immediately, Equitable hereby amends Group Annuity Contract No. 11938C-C as follows: 1. Notwithstanding anything in the certificate to the contrary, Contributions may only be allocated to the Guranteed Interest Division. No Contributions may be allocated, or subsequently transferred, to any of the Separate Account Investment Divisions. 2. A new Section, SECTION 1.06A INITIAL DEPOSIT, is added as follows: SECTION 1.06A INITIAL DEPOSIT. The term "Initial Deposit" means a required initial payment made to Equitable by the Owner with respect to a Suspense Account Certificate. The Initial Deposit, the amount of which will be determined by Equitable, will be held under the Suspense Account Certificate from the issue date until participation under the Suspense Account Certificate is terminated in order to maintain a minimum Annuity Account Value. Upon termination of participation under the Suspense Account Certificate, the entire Annuity Account Value will be paid to the Owner. 3. The following paragraph is added after the second paragraph of SECTION 2.07A PARTIAL WITHDRAWAL CHARGES: Any applicable withdrawal charge will be waived on any amount withdrawn if that amount is reallocated as a Contribution to the remaining certificates issued under the Plan, as provided for by the Plan. If any amount withdrawn is not reallocated to the remaining certificates, the applicable withdrawal charge will be deducted from the Annuity Account Value. 4. With respect to SECTION 2.09 DEATH BENEFIT, the phrase "made pursuant to Section 2.07" is deleted from the penultimate paragraph. 5. In SECTION 4.10A TRUSTEE'S RESPONSIBILITY, the phrase "or ownership has been assigned to the Participant pursuant to Section 2.07C" is added to the end of the first sentence. Agreed to by: UNITED STATES TRUST COMPANY THE EQUITABLE LIFE ASSURANCE OF NEW YORK SOCIETY OF THE UNITED STATES By By /s/ John B. Carter ------------------------------------- --------------------------------- President Title ----------------------------------- By /s/ Benjamin H. Walker Dated --------------------------------- ----------------------------------- Vice President and Secretary At Date of Issue -------------------------------------- ----------------------- PF 17101C-C Estella A. Devian Assistant Vice President THE EQUITABLE SEP 29 1989 Mr. Fredric L. Bodner, JD Chief, Health & Life Policy Bureau Agency Building One Nelson A. Rockefeller Plaza Albany, New York 12257 Re: Administrative Charge Waiver Endorsement For Group Annuities Dear Fred: We are filing for your approval the following endorsements:
Form Number For Use With Approval Date - ----------- ------------ ------------- PF 17104C Group Annuity Certificate No. 11938C 3-9-87 (File No. 87030090-0093) PF 17104C-C Group Annuity Contract No. 11938C-C 3-9-87 " PF 17105P Group Annuity Certificate No. 11936P 4-19-82 (File No. 82010997) PF 17105CP Group Annuity Contract No. 11932CP 2-29-80 (File No. 80020034) PF 17106T Group Annuity Certificate No. 11934T 4-19-82 (File No. 82010990-1001, 82041322) PF 17106CT Group Annuity Contract No. 11930CT 2-29-80 (File No. 80020031-38)
The endorsements provide for the waiver of the annual administrative charge described in Section 2.08 of the above-referenced certificates/contracts for Participants with annuity account values of $25,000 or more. Previously, all Participants under these contracts were required to pay the annual administrative charge. If you have any questions, please call me collect at (212) 714-5301. I look forward to receiving your approval. Very truly yours, /s/ Estella A. Devian Estella A. Devian Assistant Vice President jg/7133L 1/9/90 Jack Fitzgerald will review immediately THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES . Two Penn Plaza, New York, N.Y. 10121 THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective on October 1, 1989, for any Participant under a Trusteed Plan maintained by a corporation, we have amended your Certificate issued under Group Annuity contract No. 11938C-C as follows: SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE is replaced by the following: As of the last day of each Participation Year, if the Annuity Account Value on that date is less than $25,000, Equitable will withdraw from the Divisions an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Account Value and (ii) any withdrawals pursuant to Section 2.07 during that Participation Year. The charge will be allocated among the Divisions in proportion to the amounts that the Participant has in the Divisions. For this purpose, any loan reserve account will be deemed to be included within the Guaranteed Interest Division. The portion of the charge attributable to the Guaranteed Interest Division and any loan reserve account will be first withdrawn from the Guaranteed Interest Division and then, if the amount a Participant has in the Guaranteed Interest Division is not sufficient, the remaining allocation will be withdrawn from the portion of the loan reserve account that earns interest at the most current rate credited to the Guaranteed Interest Division. If the Annuity Account Value is less than $25,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of termination of participation under the Contract pursuant to Section 2.06 or 2.09, Equitable will determine the portion of the administrative charge applicable to the completed portion of the current Participation Year and withdraw such amount in lieu of the annual administrative charge described in this Section for the applicable part of that Participation Year. Vice President SPECIMEN and Secretary SPECIMEN President PF 17104C THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective on October 1, 1989, for any Participant under a Trusteed Plan maintained by a corporation, we have amended your Group Annuity Contract No. 11938C-C as follows: SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE is replaced by the following: As of the last day of each Participation Year, if the Annuity Account Value on that date is less than $25,000, Equitable will withdraw from the Divisions an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Account Value and (ii) any withdrawals pursuant to Section 2.07 during that Participation Year. The charge will be allocated among the Divisions in proportion to the amounts that the Participant has in the Divisions. For this purpose, any loan reserve account will be deemed to be included within the Guaranteed Interest Division. The portion of the charge attributable to the Guaranteed Interest Division and any loan reserve account will be first withdrawn from the Guaranteed Interest Division and then, if the amount a Participant has in the Guaranteed Interest Division is not sufficient, the remaining allocation will be withdrawn from the portion of the loan reserve account that earns interest at the most current rate credited to the Guaranteed Interest Division. If the Annuity Account Value is less than $25,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of termination of participation under the Contract pursuant to Section 2.06 or 2.09, Equitable will determine the portion of the administrative charge applicable to the completed portion of the current Participation Year and withdraw such amount in lieu of the annual administrative charge described in this Section for the applicable part of that Participation Year. Agreed to by: UNITED STATES TRUST COMPANY THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES By By SPECIMEN ---------------------------- ------------------------------ President Title By SPECIMEN ------------------------- ------------------------------ Vice President and Secretary Dated Date of Issue ------------------------- ------------------- At ---------------------------- PF 17104C-C THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective October 1, 1989, we have amended your Certificate issued under Group Annuity Contract No. 11932CP as follows: SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE, is replaced by the following: As of the last day of each Participation Year, if the Annuity Account Value on that date is less than $25,000, Equitable will withdraw from the Divisions an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Account value and (ii) any withdrawals pursuant to Section 2.07 during that Participation Year. The charge will be allocated among the Divisions in proportion to the amounts that the Participant has in the Divisions. If the Annuity Account Value is less than $25,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of termination of participation under the Contract pursuant to Section 2.06 or 2.09, Equitable will determine the portion of the administrative charge applicable to the completed portion of the current Participation Year and withdraw such amount in lieu of the annual administrative charge described in this Section for the applicable part of that Participation Year. /s/ Molly K. Heines /s/ Joseph J. Melone Molly K. Heines Joseph J. Melone Vice President and Secretary Chairman of the Board PF 17105P THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective on October 1, 1989, we have amended your Group Annuity Contract No. 11932CP as follows: SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE is replaced by the following: As of the last day of each Participation Year, if the Annuity Account Value on that date is less than $25,000, Equitable will withdraw from the Divisions an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Account Value and (ii) any withdrawals pursuant to Section 2.07 during that Participation Year. The charge will be allocated among the Divisions in proportion to the amounts that the Participant has in the Divisions. If the Annuity Account Value is less than $25,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of termination of participation under the Contract pursuant to Section 2.06 or 2.09, Equitable will determine the portion of the administrative charge applicable to the completed portion of the current Participation Year and withdraw such amount in lieu of the annual administrative charge described in this Section for the applicable part of that Participation Year. Agreed to by: UNITED STATES TRUST COMPANY THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES By By SPECIMEN ---------------------------- ---------------------------------- President Title By SPECIMEN ---------------------------- --------------------------------- Vice President and Secretary Dated Date of Issue ------------------------- ---------------------- At ---------------------------- PF 17105CP THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective on October 1, 1989, we have amended your Certificate issued under Group Annuity contract No. 11930CT as follows: SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE is replaced by the following: As of the last day of each Participation Year, if the Annuity Account Value on that date is less than $25,000, Equitable will withdraw from the Divisions an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Account Value and (ii) any withdrawals pursuant to Section 2.07 during that Participation Year. The charge will be allocated among the Divisions in proportion to the amounts that the Participant has in the Divisions. For this purpose, any loan reserve account will be deemed to be included within the Guaranteed Interest Division. The portion of the charge attributable to the Guaranteed Interest Division and any loan reserve account will be first withdrawn from the Guaranteed Interest Division and then, if the amount a Participant has in the Guaranteed Interest Division is not sufficient, the remaining allocation will be withdrawn from the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. If the Annuity Account Value is less than $25,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of termination of participation under the Contract pursuant to Section 2.06 or 2.09, Equitable will determine the portion of the administrative charge applicable to the completed portion of the current Participation Year and withdraw such amount in lieu of the annual administrative charge described in this Section for the applicable part of that Participation Year. Vice President SPECIMEN and Secretary SPECIMEN President PF 17106T THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective on October 1, 1989, we have amended your Group Annuity Contract No. 11930CT as follows: SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE is replaced by the following: As of the last day of each Participation Year, if the Annuity Account Value on that date is less than $25,000, Equitable will withdraw from the Divisions an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Account Value and (ii) any withdrawals pursuant to Section 2.07 during that Participation Year. The charge will be allocated among the Divisions in proportion to the amounts that the Participant has in the Divisions. For this purpose, any loan reserve account will be deemed to be included within the Guaranteed Interest Division. The portion of the charge attributable to the Guaranteed Interest Division and any loan reserve account will be first withdrawn from the Guaranteed Interest Division and then, if the amount a Participant has in the Guaranteed Interest Division is not sufficient, the remaining allocation will be withdrawn from the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. If the Annuity Account Value is less than $25,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of termination of participation under the Contract pursuant to Section 2.06 or 2.09, Equitable will determine the portion of the administrative charge applicable to the completed portion of the current Participation Year and withdraw such amount in lieu of the annual administrative charge described in this Section for the applicable part of that Participation Year. Agreed to by: UNITED STATES TRUST COMPANY THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES By By SPECIMEN ---------------------------- ---------------------------------- President Title By SPECIMEN ---------------------------- --------------------------------- Vice President and Secretary Dated Date of Issue ------------------------- ---------------------- At ---------------------------- PF 17106CT [EQUITABLE LOGO] JAN 20 1989 Mr. John S. Fitzgerald, JD, CLU, JD Senior Insurance Policy Examiner Insurance Department Agency Building One Empire State Plaza Albany, New York 12257 Re: Riders PF 17075C-C and PF 17075C Dear Mr. Bodner: We are filing for your approval Rider PF 17075C-C and Rider PF 17075C, to be used with Group Annuity Contract No. 11938C-C, and Group Annuity Certificate 11938C, respectively. These riders contain provisions which will permit Participants under this contract to take out loans against their annuity account values. These loans will have an adjustable loan interest rate. These riders replace the previously filed Riders 17074C-C and PF 17074C, which were filed on August 30, 1988 (your file no. 88090127-28). Riders 17074C-C and PF 17074C are hereby withdrawn. I look forward to receiving your approval of these riders. If you have any questions, please call Alex Unger at (212) 714-4482. Very truly yours, /s/ Estella A. Devian Estella A. Devian Assistant Vice President 1bc/6765L-2 THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES o Two Penn Plaza, New York, NY 10121 THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Equitable has amended your Certificate issued under Group Annuity Contract No. 11938C-C as follows: 1. SECTION 1.17 ANNUITY ACCOUNT VALUE is replaced by the following: SECTION 1.17 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts that a Participant has in the Guaranteed Interest Division, the Investment Divisions of the Separate Account and any loan reserve account. 2. SECTION 1.18 CASH VALUE is replaced by the following: SECTION 1.18 CASH VALUE. With respect to the Participant, the term "Cash Value" means an amount equal to the greater of (i) or (ii), less any outstanding loan, where (i) is Annuity Account Value less 6% of the Contributions made during the current and five prior Participation Years, which had not been previously withdrawn pursuant to Section 2.07A, and (ii) is the sum of (a) the Free Corridor Amount as defined in Section 2.07B and (b) 94% of the Annuity Account Value less the Free Corridor Amount. 3. SECTION 1.18A CODE is replaced by the following: SECTION 1.18A CODE. The term "Code" means the Internal Revenue Code of 1986, as now or hereafter amended. 4. With respect to SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS, the first paragraph is replaced by the following: SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any date when an amount is allocated to or withdrawn or transferred from an Investment Division, the Participant will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units a Participant has in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Sections 2.07, 2.08 or 2.10 or transferred from the Investment Division pursuant to Section 2.05. The amount a Participant has in an Investment Division on any date is equal to the product (i) the number of Accumulation Units that a Participant has in the Investment Division on that date and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. 5. With respect to SECTION 2.03 GUARANTEED INTEREST DIVISION, the second paragraph is replaced by the following: The amount a Participant has in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 or 2.10 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Section 2.07, 2.08 or 2.10 or transferred from the Guaranteed Interest Division, pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division pursuant to Section 2.04. Equitable guarantees that the rate at which interest accrues will never be less than 4% per annum. 6. With respect to SECTION 2.04 ALLOCATION TO DIVISIONS, the second and third paragraphs are replaced by the following: Any amount that a Participant has directed to be transferred to one or more Divisions pursuant to Section 2.05 or 2.10 will be allocated as of the date Equitable receives at the Processing Office the written request for such transfer to the appropriate Investment Division. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division at the end of each Participation Year, at the time of each transfer from the Division pursuant to Section 2.05 or 2.10, at the time of each withdrawal pursuant to Section 2.07, at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, upon termination of participation pursuant to Section 2.06 and upon death of the Participation pursuant to Section 2.09. 7. With respect to SECTION 2.06 TERMINATION OF PARTICIPATION, the third paragraph is replaced by the following: Prior to a Participant's Retirement Date, Equitable reserves the right to pay the Annuity Account Value less any outstanding loan under the Contract and terminate such Participant's participation under the Contract. This right may be exercised with respect to the Participant only if both (i) no Contributions have been made under the Contract during the last three completed Participation Years, and (ii) the Annuity Account Value is less than $500. Equitable reserves the right to terminate a Participant's participation under the Contract if at least 120 days have elapsed since the issue date shown on the certificate issued to such Participant under the Contract and no Contributions have been made under the Contract with respect to such Participant. 8. With respect to SECTION 2.07 PARTIAL WITHDRAWALS, the fourth paragraph is replaced by the following: Equitable may decline to accept a request for a partial withdrawal of less than $300. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, Equitable will so advise the Participant and reserves the right to pay the Annuity Account Value less any outstanding loan to the Participant, and terminate such Participant's participation under the Contract. 9. With respect to SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE, the first paragraph is replaced by the following: PF 17075C ________ Page One Page Two -------- SECTION 2.08 ANNUAL ADMINISTRATIVE CHARGE. AS of the last day of each Participation Year before a Participant's Retirement Date, Equitable will withdraw from the Divisions an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Account Value and (ii) any withdrawals pursuant to Section 2.07 during that Participation Year. The charge will be allocated among the Divisions in proportion to the amounts that the Participant has in the Divisions. For this purpose, any loan reserve account will be deemed to be included within the Guaranteed Interest Division. The portion of the charge attributable to the Guaranteed Interest Division and any loan reserve account will be first withdrawn from the Guaranteed Interest Division and then, if the amount a Participant has in the Guaranteed Interest Division is not sufficient, the remaining allocation will be withdrawn from the portion of the loan reserve account that earns interest at the most current rate credited to the Guaranteed interest Division. 10. With respect to SECTION 2.09 DEATH BENEFIT, the sixth paragraph is replaced by the following: The amount of the death benefit with respect to a Participant at any time prior to the Retirement Date is equal to the greater of (i) the Annuity Account Value less any outstanding loan and (ii) the minimum death benefit with respect to such Participant. Such minimum death benefit is the sum of all Contributions made with respect to such Participant pursuant to Section 2.01 less any outstanding loan and less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount being withdrawn is to the Annuity Account Value. 11. A new section, SECTION 2.10 LOANS, is added as follows: SECTION 2.10 LOANS. Unless otherwise restricted by the Plan or the Code, the Participant may apply for and receive a loan under the certificate before the Retirement Date if an agreement between the Trustee and Equitable relating to such loans ("Trustee Agreement") has been executed and is in effect on the Loan Effective Date, as defined below. However, future amendments of or changes in the Code may require revision or elimination of the loan provisions as provided below. A loan is effective ("Loan Effective Date") on the first day of the month following the date on which the Participant's loan agreement and application form ("Loan Agreement"), properly completed and signed by the Participant, is approved by the Trustee and accepted by Equitable at Equitable's Processing Office. The provisions of the certificate requiring spousal consent in order to receive a loan will apply if the Participant is married. The maximum amount of principal loaned to the Participant ("loan amount") may not be more than (i) 80% of the Annuity Account Value under the certificate, if such Annuity Account Value is between $3,750 and $12,500, (ii) $10,000, if the Annuity Account Value is between $12,500 and $20,000, and (iii) 50% of the Annuity Account Value if the Annuity Account Value is greater than or equal to $20,000, but in no event shall the loan amount exceed $50,000 less the excess (if any) of the highest outstanding balance of all loans from qualified plans and any Code s.403(b) tax-sheltered annuities ("403(b) annuities") of the Employer during the one-year period ending on the day before the Loan Effective Date, over the outstanding balance of all loans from qualified plans and 403(b) annuities of the Employer on the Loan Effective Date. The minimum loan amount permitted is $3,000. On the Loan Effective Date, Equitable will transfer to a loan reserve account an amount equal to the sum of (i) the loan amount, which will earn interest at an effective annual rate of not less than the rate we charge for loan interest reduced by 2% during the loan term and (ii) 25% of the loan amount, which will earn interest at the most current rate credited to the Guaranteed Interest Division. The excess of the loan interest we charge over the amount of interest we credit to the loan reserve account as set forth in (i) above will be retained by Equitable as a service charge. The Participant may specify from which Divisions these amounts are to be transferred. In the absence of direction by the Participant, or if the Participant's directions cover only part of the amount required to be transferred to the loan reserve account, Equitable will transfer the required (or additional required) amounts from each Division in proportion to the amount the Participant has in such Divisions. Except as hereinafter provided, the funds in the loan reserve account, including the interest credited thereon , are not available for transfer or withdrawal until the loan is repaid and the funds are released. Beginning on a date designated by Equitable which shall be no later than the first day of the third month following the Loan Effective Date and quarterly thereafter, the amount of interest earned at the effective annual rate of not less than the rate we charge for loan interest reduced by 2% during the prior quarter will be transferred to the portion of the loan reserve account that earns interest at the most current rate credited to the Guaranteed Interest Division. Upon full repayment of the loan by the Participant, Equitable will credit the most current rate credited to the Guaranteed Interest Division to the full loan reserve account. Sixty day after the loan is fully repaid, any amount remaining in the loan reserve account will be transferred to the Guaranteed Interest Division and may be withdrawn, transferred or annuitized as described in the certificate. Beginning on a date designated by Equitable which shall be no later than the first day of the third month following the Loan Effective Date and not less frequently than quarterly thereafter (each, a "Loan Repayment Date"), substantially level loan payments for the duration of the Loan Term, as hereinafter defined, must be made to Equitable. Such payments will be equal to the sum of (a) and (b) where (a) is the loan interest, calculated at the rate described below, computed as of the applicable Loan Repayment Date, and (b) is an amortized portion of the loan amount. PF 17075C ________ Page Two Page Three ---------- Interest on a loan accrues daily at an adjustable loan interest rate. Equitable will determine the rate at the beginning of each Loan Year, as defined below (each, a "date of determination"), subject to the following paragraphs. This rate will apply to any outstanding loan amount under the certificate during the Loan Year next following the date of determination. The maximum loan interest rate for a twelve month period ending on the day before an anniversary of the Loan Effective Date ("Loan Year") shall be the greater of: (1) the "Published Monthly Average," as defined below, for the calendar month that ends two months before the date of determination; or (2) 5%. "Published Monthly Average" means the Monthly Average Corporate yield shown in Moody's Corporate Bond Yield Averages published by Moody's Investors Service, Inc., or any successor thereto. If such averages are no longer published, we will use such other averages as may be established by regulation by the insurance supervisory official of the jurisdiction in which the Contract, under which this certificate is issued, is delivered. In no event will the loan interest rate for a Participation Year be greater than the maximum rate permitted by applicable law. We reserve the right to establish a rate lower than the maximum. No change in the rate shall be less than 1/2 of 1% a year. We may increase the rate whenever the maximum rate as determined by clause (1) of the preceding paragraph increases by 1/2 of 1% or more. We will reduce the rate to or below the maximum rate as determined by clause (1) of the preceding paragraph if such maximum is lower than the rate being charged by 1/2 of 1% or more. We will notify you of the initial loan interest rate when you take a loan. We will also give you advance written notice within 30 days of any increase or decrease in the interest rate of any outstanding loan. Upon receipt at our Processing Office of a surrender request for a certificate with a loan outstanding, Equitable will deduct the unpaid loan balance, including accrued interest and any applicable withdrawal charges from the surrender proceeds. Should death be the cause of certificate termination, Equitable will deduct any unpaid loan balance (including accrued interest) from the death benefit proceeds. On any Loan Repayment Date following the first anniversary of the Loan Effective Date, additional loan payments may be made with the regular loan payment. The loan, including the full amount of interest due thereon, may be repaid in full on the first loan anniversary date or any time thereafter. Any loan repayment accepted will be applied first to repay the interest due and then to reduce the loan amount. Any partial loan repayment will result in a transfer of an amount equal to the principal repaid from (i) the portion of the loan reserve account that earns interest at the effective annual rate of not less than the rate we charge for loan interest reduced by 2% to (ii) the portion of the loan reserve account that earns interest at the most current rate credited to the Guaranteed interest Division. Sixty days after a partial repayment is made, the principal amount repaid will be transferred from the portion of the loan reserve account that earns interest at the most current rate credited to the Guaranteed Interest Division to the Guaranteed Interest Division and may be withdrawn, transferred or annuitized as described elsewhere herein. Any late loan repayment or any loan repayment in an amount which is less than the amount due will result in a declaration of default with respect to the unpaid portion of the loan amount due on that Loan Repayment Date. The loan term ("Loan Term") will be either (i) ten years, if the Participant represents that the purpose of the loan is to acquire a dwelling unit which, within a reasonable period of time, is to be used as the principal residence of the Participant or (ii) five years. In any event, the Loan Term may not extend beyond the earliest of (i) the Retirement Date, (ii) the date of the termination of the certificate, (iii) the date of the termination of the Trustee Agreement, (iv) the date the Trustee notifies Equitable that the Participant has died, (v) the date the Participant terminates his or her employment or (vi) any date provided for such loans by future Federal tax rules, including acceleration of the loan repayment in order that the operation of the loan provisions does not adversely affect the tax treatment of the certificate. 12. SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS is replaced by the following: SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Account Value less any outstanding loan shall be applied to provide the Normal Form of Annuity Benefit, unless the Owner on behalf of the Participant and, if applicable , the Participant's spouse elects (i) to receive the Cash Value of the certificate in a single sum or (ii) to apply the Annuity Account Value less any outstanding loan or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by Equitable, subject to Equitable's rules then in effect, the terms of the Plan, and any other applicable requirements under the Code. Equitable will provide notice and election forms to the Owner not more-than six months before the Participant's Retirement Date. If the Owner elects to terminate a Participant's participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Value. Equitable will have the right to require the Owner to furnish pertinent information to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. Equitable may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form. The Participant may only elect an annuity form pursuant to which either (i) the Annuity Account Value less any outstanding loan or Cash Value, whichever is applicable, will be paid to the Participant and the Participant's beneficiary over a period not exceeding the joint lives of the Participant and the Participant's spouse or (ii) more than 50% PF 17075C __________ Page Three Page Four --------- of the Annuity Account Value less any outstanding loan or Cash Value, whichever is applicable, will be paid to the Participant during the Participant's life. 13. With respect to SECTION 3.04 AMOUNT OF ANNUITY BENEFITS, the first paragraph is replaced by the following: SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If the Owner elects pursuant to the first or third paragraph of Section 3.03 to receive an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value less any outstanding loan if the payments under the annuity form elected are contingent upon the survival of a person or (ii) the Cash Value if the payments under the annuity form elected are not contingent upon the survival of a person. If such amount is applied on or after the completion of five Participation Years with respect to such Participant: (1) the balance, less any Contribution made on behalf of the Participant during the current and five prior Participation Years, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown herein or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee; (2) any Contributions made on behalf of the Participant during the current and five prior Participation Years shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown herein or (ii) Equitable's current individual rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. 14. A new section, SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS APPLICABLE TO PLANS, is added as follows: SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS APPLICABLE TO PLANS. If participation under the Contract is pursuant to the terms of a Plan, then the provisions of this Section shall supersede any contrary provisions in the Contract and certificate. Unless a married Participant and the Participant's spouse elect otherwise in accordance with the terms of the Plan and as provided in this Section, as of a Participant's Retirement Date, the Annuity Account Value shall be applied to provide a "Qualified Joint and Survivor Annuity." A "Qualified Joint and Survivor Annuity" is an Annuity Benefit for the life of the Participant with a survivor annuity for the life of the Participant's spouse which is not less than 50% and not more than 100% of the annuity which is payable during the joint lives of the Participant and the Participant's spouse. If the Participant is not married and does not elect otherwise, the Annuity Account Value shall be applied to provide a life annuity. In addition, unless an optional form of benefit is elected pursuant to the terms of the Plan and this Section, if a married Participant dies before payment of the Participant's Annuity Account Value or Cash Value has commenced, then the death benefit described in Section 2.09 shall be applied to provide a life annuity for the Participant's spouse. The Participant may elect, on a form acceptable to the Employer and Equitable, within the 90 consecutive day period before the date as of which payment of an annuity is to commence, not to receive payment in the form of a Qualified Joint and Survivor Annuity, or, if the Participant is unmarried, a life annuity, in which case the Participant may elect to apply the Annuity Account Value or Cash Value, as the case may be, in any other form of payment available under the terms of the Plan and the Contract. The Participant may also elect, on a form acceptable to the Employer and Equitable, on the first day of the Plan year in which the Participant attains age 35 (or the date on which the Participant ceases to work for the Employer if earlier), for a beneficiary other than the Participant's spouse to receive the death benefit. An election under either of the two preceding sentences must be consented to by the Participant's spouse in writing before a notary or a representative of the Plan and must be limited to a benefit for a specific beneficiary. However, no spousal consent will be required if the Participant can prove to the satisfaction of the Employer and Equitable, that the Participant has no spouse or else that the spouse cannot be located. Each election to designate a beneficiary other than the Participant's spouse must be consented to by the spouse and any election made under this paragraph to waive the spouse's benefits may be revoked without the consent of the spouse at any time prior to the date as of which payments commence. Any consent to waive the spouse's benefits shall be valid only with regard to the spouse who signs it. Any new waiver or change of beneficiary will require a new spousal consent. The provisions requiring spousal consent in this Section shall also apply with regard to a Participant's election to terminate participation or make partial withdrawals pursuant to Sections 2.06 and 2.07 and with regard to a Participant's application for a loan. A spouse's written consent, witnessed by a representative of the Plan or a notary, must be given on a form acceptable to the Employer and Equitable, within the 90 consecutive day period prior to such payment, withdrawal or loan, unless the Participant can show that the Participant has no spouse or that the spouse cannot be located. If the Annuity Account Value applied to provide the spousal benefits on the date payment is to commence is in the aggregate less than $3,500, Equitable may choose to make payment in a single sum rather than the form of a Qualified Joint and Survivor Annuity or life annuity as described herein. Upon any payment made pursuant to this Section, Equity will be released from any and all liability for payment with respect to the Contributions made for the Participant. 15. SECTION 4.06 DISQUALIFICATION is replaced by the following: PF 17075C _________ Page Four Page Five --------- SECTION 4.06 DISQUALIFICATION. In the event that an annuity purchased hereunder with respect to a Participant fails to qualify as an Annuity described in Section 1.03, Equitable shall have the right, upon receiving notice of such fact before the Retirement Date, to terminate participation with respect to such Participant under the Contract and pay at the direction of the Owner the Annuity Account Value less any outstanding loan and less a deduction for the appropriate part attributable to the Owner of any Federal income tax payable by Equitable which would not have been payable if the Owner had an Annuity under the Contract. 16. SECTION 4.09 ANNUAL NOTICE is replaced by the following: SECTION 4.09 ANNUAL NOTICE. At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date: (1) the amount the Participant has in the Guaranteed Interest Division, (2) the total number of Accumulation Units the Participant has in the Stock Division, Balanced Division, Aggressive Stock Division, and Money Market Division, (3) the Accumulation Unit Value, (4) the amount the Participant has in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the amount in the loan reserve account, (6) the Cash Value and (7) the amount of death benefit payable with respect to the Participant. After the Retirement Date, Equitable will notify the Participant of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SPECIMEN Vice President SPECIMEN President and Secretary PF 17075C _________ Page Five THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Equitable has amended Group Annuity Contract No. 11938C-C as follows: 1. SECTION 1.17 ANNUITY ACCOUNT VALUE is replaced by the following: SECTION 1.17 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts that a Participant has in the Guaranteed Interest Division, the Investment Divisions of the Separate Account and any loan reserve account. 2. SECTION 1.18 CASH VALUE is replaced by the following: SECTION 1.18 CASH VALUE. With respect to the Participant, the term "Cash Value" means an amount equal to the greater of (i) or (ii), less any outstanding loan, where (i) is the Annuity Account Value less 6% of the Contributions made during the current and five prior Participation Years, which had not been previously withdrawn pursuant to Section 2.07A, and (ii) is the sum of (a) the Free Corridor Amount as defined in Section 2.07B and (b) 94% of the Annuity Account Value less the Free Corridor Amount. 3. SECTION 1.18A CODE is replaced by the following: SECTOIN 1.18A CODE. The term "Code" means the Internal Revenue Code of 1986, as now or hereafter amended. 4. With respect to SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS, the first paragraph is replaced by the following: SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any date when an amount is allocated to or withdrawn or transferred from an Investment Division, the Participant will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units a Participant has in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Sections 2.07, 2.08 or 2.10 or transferred from the Investment Division pursuant to Section 2.05. The amount a Participant has in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units that a Participant has in the Investment Division on that date and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. 5. With respect to SECTION 2.03 GUARANTEED INTEREST DIVISION, the second paragraph is replaced by the following: The amount a Participant has in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 or 2.10 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Section 2.07, 2.08 or 2.10 or transferred from the Guaranteed Interest Division, pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division pursuant to Section 2.04. Equitable guarantees that the rate at which interest accrues will never be less than 4% per annum. 6. With respect to SECTION 2.04 ALLOCATION TO DIVISIONS, the second and third paragraphs are replaced by the following: Any amount that a Participant has directed to be transferred to one or more Divisions pursuant to Section 2.05 or 2.10 will be allocated as of the date Equitable receives at the Processing Office the written request for such transfer to the appropriate Investment Division. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division at the end of each Participation Year, at the time of each transfer from the Division pursuant to Section 2.05 or 2.10, at the time of each withdrawal pursuant to Section 2.07, at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, upon termination of participation pursuant to Section 2.06 and upon death of the Participant pursuant to Section 2.09. 7. With respect to SECTION 2.06 TERMINATION OF PARTICIPATION, the third paragraph is replaced by the following: Prior to a Participant's Retirement Date, Equitable reserves the right to pay the Annuity Account Value less any outstanding loan under the Contract and terminate such Participant's participation under the Contract. This right may be exercised with respect to the Participant only if both (i) no Contributions have been made under the Contract during the last three completed Participation Years, and (ii) the Annuity Account value is less than $500. Equitable reserves the right to terminate a Participant's participation under the Contract if at least 120 days have elapsed since the issue date shown on the certificate issued to such Participant under the Contract and no Contributions have been made under the Contract with respect to such Participant. 8. With respect to SECTION 2.07 PARTIAL WITHDRAWALS, the fourth paragraph is replaced by the following: Equitable may decline to accept a request for a partial withdrawal of less than $300. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, Equitable will so advise the Participant and reserves the right to pay the Annuity Account Value less any outstanding loan to the Participant, and terminate such Participant's participation under the Contract. 9. With respect to SECTION 2.08 ANNUAL ADMINSTRATIVE CHARGE, the first paragraph is replaced by the following: PF17075C-C --------- Page One Page Two --------- SECTION 2.08 ANNUAL ADMINSTRATIVE CHARGE. As of the last day of each Participation Year before a Participant's Retirement Date, Equitable will withdraw from the Divisions an annual administrative charge equal to the lesser of $30 or 2% of the sum of (i) the Annuity Account Value and (ii) any withdrawals pursuant to Section 2.07 during that Participation Year. The charge will be allocated among the Divisions in proportion to the amounts that the Participant has in the Divisions. For this purpose, any loan reserve account will be deemed to be included within the Guaranteed Interest Division. The portion of the charge attributable to the Guaranteed Interest Division and any loan reserve account will be first withdrawn from the Guaranteed Interest Division and then, if the amount a Participant has in the Guaranteed Interest Division is not sufficient, the remaining allocation will be withdrawn from the portion of the loan reserve account that earns interest at the most current rate credited to the Guaranteed Interest Division. 10. With respect to SECTION 2.09 DEATH BENEFIT, the sixth paragraph is replaced by the following: The amount of the death benefit with respect to a Participant at any time prior to the Retirement Date is equal to the greater of (i) the Annuity Account Value less any outstanding loan and (ii) the minimum death benefit with respect to such Participant. Such minimum death benefit is the sum of all Contributions made with respect to such Participant pursuant to Section 2.01 less any outstanding loan and less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by any Previous such withdrawal) by an amount which is in the same proportion as the amount being withdrawn is to the Annuity Account Value. 11. A new section, SECTION 2.10 LOANS, is added as follows: SECTION 2.10 LOANS. Unless otherwise restricted by the Plan or the Code, the Participant may apply for and receive a loan under the certificate before the Retirement Date if an agreement between the Trustee and Equitable relating to such loans ("Trustee Agreement") has been executed and is in effect on the Loan Effective Date, as defined below. However, future amendments of or changes in the Code may require revision or elimination of the loan provisions as provided below. A loan is effective ("Loan Effective Date") on the first day of the month following the date on which the Participant's loan agreement and application form ("Loan Agreement"), properly completed and signed by the Participant, is approved by the Trustee and accepted by Equitable at Equitable's Processing Office. The provisions of the certificate requiring spousal consent in order to receive a loan will apply if the Participant is married. The maximum amount of principal loaned to the Participant ("loan amount") may not be more than (i) 80% of the Annuity Account Value under the certificate, if such Annuity Account Value is between $3,750 and $12,500, (ii) $10,000, if the Annuity Account Value is between $12,500 and $20,000, and (iii) 50% of the Annuity Account Value if the Annuity Account Value is greater than or equal to $20,000, but in no event shall the loan amount exceed $50,000 less the excess (if any) of the highest outstanding balance of all loans from qualified plans and any Code s403(b) tax-sheltered annuities ("403(b) annuities") of the Employer during the one-year period ending on the day before the Loan Effective Date, over the outstanding balance of all loans from qualified plans and 403(b) annuities of the Employer on the Loan Effective Date. The minimum loan amount permitted is $3,000. On the Loan Effective Date, Equitable will transfer to a loan reserve account an amount equal to the sum of (i) the loan amount, which will earn interest at an effective annual rate of not less than the rate we charge for loan interest reduced by 2% during the loan term and (ii) 25% of the loan amount, which will earn interest at the most current rate credited to the Guaranteed Interest Division. The excess of the loan interest we charge over the amount of interest we credit to the loan reserve account as set forth in (i) above will be retained by Equitable as a service charge. The Participant may specify from which Divisions these amounts are to be transferred. In the absence of direction by the Participant, or if the Participant's directions cover only part of the amount required to be transferred to the loan reserve account, Equitable will transfer the required (or additional required) amounts from each Division in proportion to the amount the Participant has in such Divisions. Except as hereinafter provided, the funds in the loan reserve account, including the interest credited thereon, are not available for transfer or withdrawal until the loan is repaid and the funds are released. Beginning on a date designated by Equitable, which shall be no later than the first day of the third month following the Loan Effective Date and quarterly thereafter, the amount of interest earned at the effective annual rate of not less than the rate we charge for loan interest reduced by 2% during the prior quarter will be transferred to the portion of the loan reserve account that earns interest at the most current rate credited to the Guaranteed Interest Division. Upon full repayment of the loan by the Participant, Equitable will credit the most current rate credited to the Guaranteed Interest Division to the full loan reserve account. Sixty days after the loan is fully repaid, any amounts remaining in the loan reserve account will be transferred to the Guaranteed Interest Division and may be withdrawn, transferred or annuitized as described in the certificate. Beginning on a date designated by Equitable which shall be no later than the first day of the third month following the Loan Effective Date and not less frequently than quarterly thereafter (each, a "Loan Repayment Date"), substantially level loan payments for the duration of the Loan Term, as hereinafter defined, must be made to Equitable. Such payments will be equal to the sum of (a) and (b) where (a) is the loan interest, calculated at the rate described below, computed as of the applicable Loan Repayment Date, and (b) is an amortized portion of the loan amount. --------- PF 17075C-C Page Two Page Three ---------- Interest on a loan accrues daily at an adjustable loan interest rate. Equitable will determine the rate at the beginning of each Loan Year, as defined below (each, a "date of determination"), subject to the following paragraphs. This rate will apply to any outstanding loan amount under the certificate during the Loan Year next following the date of determination. The maximum loan interest rate for a twelve month period ending on the day before an anniversary of the Loan Effective Date ("Loan Year") shall be the greater of: (1) the "Published Monthly Average," as defined below, for the calendar month that ends two months before the date of determination; or (2) 5%. "Published Monthly Average" means the Monthly Average Corporate yield shown in Moody's Corporate Bond Yield Averages published by Moody's Investors Service, Inc., or any successor thereto. If such averages are no longer published, we will use such other averages as may be established by regulation by the insurance supervisory official of the jurisdiction in which the Contract, under which this certificate is issued, is delivered. In no event will the loan interest rate for a Participation Year be greater than the maximum rate permitted by applicable law. We reserve the right to establish a rate lower than the maximum. No change in the rate shall be less than 1/2 of 1% a year. We may increase the rate whenever the maximum rate as determined by clause (1) of the preceding paragraph increases by 1/2 of 1% or more. We will reduce the rate to or below the maximum rate as determined by clause (1) of the preceding paragraph if such maximum is lower than the rate being charged by 1/2 of 1% or more. We will notify you of the initial loan interest rate when you take a loan. We will also give you advance written notice within 30 days of any increase or decrease in the interest rate of any outstanding loan. Upon receipt at our Processing Office of a surrender request for a certificate with a loan outstanding, Equitable will deduct the unpaid loan balance, including accrued interest and any applicable withdrawal charges from the surrender proceeds. Should death be the cause of certificate termination, Equitable will deduct any unpaid loan balance (including accrued interest) from the death benefit proceeds. On any Loan Repayment Date following the first anniversary of the Loan Effective Date, additional loan payments may be made with the regular loan payment. The loan, including the full amount of interest due thereon, may be repaid in full on the first loan anniversary date or any time thereafter. Any loan repayment accepted will be applied first to repay the interest due and then to reduce the loan amount. Any partial loan repayment will result in a transfer of an amount equal to the principal repaid from (i) the portion of the loan reserve account that earns interest at the effective annual rate of not less than the rate we charge for loan interest reduced by 2% to (ii) the portion of the loan reserve account that earns interest at the most current rate credited to the Guaranteed Interest Division. Sixty days after a partial repayment is made, the principal amount repaid will be transferred from the portion of the loan reserve account that earns interest at the most current rate credited to the Guaranteed Interest Division and may be withdrawn, transferred or annuitized as described elsewhere herein. Any late loan repayment or any loan repayment in an amount which is less than the amount due will result in a declaration of default with respect to the unpaid portion of the loan amount due on that Loan Repayment Date. The loan term ("Loan Term") will be either (i) ten years, if the Participant represents that the purpose of the loan is to acquire a dwelling unit which, within a reasonable period of time, is to be used as the principal residence of the Participant or (ii) five years. In any event, the Loan Term may not extend beyond the earliest of (i) Retirement Date, (ii) the date of the termination of the certificate, (iii) the date of the termination of the Trustee Agreement, (iv) the date the Trustee notifies Equitable that the Participant has died, (v) the date the Participant terminates his or her employment or (vi) any date provided for such loans by future Federal tax rules, including acceleration of the loan repayment in order that the operation of the loan provisions does not adversely affect the tax treatment of the certificate. 12. SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS is replaced by the following: SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of a Participant's Retirement Date, provided such Participant is then living, the Annuity Account Value less any outstanding loan shall be applied to provide the Normal Form of Annuity Benefit, unless the Owner on behalf of the Participant and, if applicable, the Participant's spouse elects (i) to receive the Cash Value of the certificate in a single sum or (ii) to apply the Annuity Account Value less any outstanding loan or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by Equitable, subject to Equitable's rules then in effect, the terms of the Plan, and any other applicable requirements under the Code. Equitable will provide notice and election forms to the Owner not more than six months before the Participant's Retirement Date. If the Owner elects to terminate a Participant's participation under the Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive an Annuity Benefit in lieu of the Cash Value. Equitable will have the right to require the Owner to furnish pertinent information to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. Equitable may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form. The Participant may only elect an annuity form pursuant to which either (i) the Annuity Account Value less any outstanding loan or Cash Value, whichever is applicable, will be paid to the Participant and Participant's beneficiary over a period not exceeding the joint lives of the Participant and the Participant's spouse or (ii) more than 50% ---------- PF 17075C-C Page Three Page Four --------- of the Annuity Account Value less any outstanding loan or Cash Value, whichever is applicable, will be paid to the Participant during the Participant's life. 13. With respect to SECTION 3.04 AMOUNT OF ANNUITY BENEFITS, the first paragraph is replaced by the following: SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If the Owner elects pursuant to the first or third paragraph of Section 3.03 to receive an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value less any outstanding loan if the payments under the annuity form elected are contingent upon the survival of a person or (ii) the Cash Value if the payments under the annuity form elected are not contingent upon the survival of a person. If such amount is applied on or after the completion of five Participation Years with respect to such Participant: (1) the balance, less any Contribution made on behalf of the Participant during the current and five prior Participation Years, shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown herein or (ii) Equitable's current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee; (2) any Contributions made on behalf of the Participant during the current and five prior Participation Years shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown herein or (ii) Equitable's current individual rates applicable to funds which derive from sources outside Equitable, whichever rates would provide a larger benefit with respect to the payee. If such current individual annuity rates are used, such Participant's certificate will be replaced by an Equitable supplementary contract. 14. A new section, SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS APPLICABLE TO PLANS, is added as follows: SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS APPLICABLE TO PLANS. If participation under the Contract is pursuant to the terms of a Plan, then the provisions of this Section shall supersede any contrary provisions in the Contract and certificate. Unless a married Participant and the Participant's spouse elect otherwise in accordance with the terms of the Plan and as provided in this Section, as of a Participant's Retirement Date, the Annuity Account Value shall be applied to provide a "Qualified Joint and Survivor Annuity." A "Qualified Joint and Survivor Annuity" is an Annuity Benefit for the life of the Participant with a survivor annuity for the life of the Participant's spouse which is not less than 50% and not more than 100% of the annuity which is payable during the joint lives of the Participant and the Participant's spouse. If the Participant is not married and does not elect otherwise, the Annuity Account Value shall be applied to provide a life annuity. In addition, unless an optional form of benefit is elected pursuant to the terms of the Plan and this Section, if a married Participant dies before payment of the Participant's Annuity Account Value or Cash Value has commenced, then the death benefit described in Section 2.09 shall be applied to provide a life annuity for the Participant's spouse. The Participant may elect, on a form acceptable to the Employer and Equitable, within the 90 consecutive day period before the date as of which payment of an annuity is to commence, not to receive payment in the form of a Qualified Joint and Survivor Annuity, or, if the Participant is unmarried, a life annuity, in which case the Participant may elect to apply the Annuity Account Value or Cash Value, as the case may be, in any other form of payment available under the terms of the Plan and the Contract. The Participant may also elect, on a form acceptable to the Employer and Equitable, on the first day of the Plan year in which the Participant attains age 35 (or the date on which the Participant ceases to work for the Employer if earlier), for a beneficiary other than the Participant's spouse to receive the death benefit. An election under either of the two preceding sentences must be consented to by the Participant's spouse in writing before a notary or a representative of the Plan and must be limited to a benefit for a specific beneficiary. However, no spousal consent will be required if the Participant can prove to the satisfaction of the Employer and Equitable, that the Participant has no spouse or else that the spouse cannot be located. Each election to designate a beneficiary other than the Participant's spouse must be consented to by the spouse and any election made under this paragraph to waive the spouse's benefits may be revoked without the consent of the spouse at any time prior to the date as of which payments commence. Any consent to waive the spouse's benefits shall be valid only with regard to the spouse who signs it. Any new waiver or change of beneficiary will require a new spousal consent. The provisions requiring spousal consent in the Section shall also apply with regard to a Participant's election to terminate participation or make partial withdrawals pursuant to Sections 2.06 and 2.07 and with regard to a Participant's application for a loan. A spouse's written consent, witnessed by a representative of the Plan or notary, must be given on a form acceptable to the Employer and Equitable, within the 90 consecutive day period prior to such payment, withdrawal or loan, unless the Participant can show that the Participant has no spouse or that spouse cannot be located. If the Annuity Account Value applied to provide the spousal benefits on the date payment is to commence is in the aggregate less than $3,500, Equitable may choose to make payment in a single sum rather than in the form of a Qualified Joint and Survivor Annuity or life annuity as described herein. Upon any payment made pursuant to this Section, Equitable will be released from any and all liability for payment with respect to the Contributions made for the Participant. 15. SECTION .406 DISQUALIFICATION is replaced by the following: --------- PF 17075C-C Page Four Page Five --------- SECTION 4.06 DISQUALIFICATION. In the event that an annuity purchased hereunder with respect to a Participant fails to qualify as an Annuity described in Section 1.03, Equitable shall have the right, upon receiving notice of such fact before the Retirement Date, to terminate participation with respect to such Participant under the Contract and pay at the direction of the Owner the Annuity Account Value less any outstanding loan and less a deduction for the appropriate part attributable to the Owner of any Federal income tax payable by Equitable which would not have been payable if the Owner had an Annuity under the Contract. 16. SECTION 4.09 ANNUAL NOTICE is replaced by the following: SECTION 4.09 ANNUAL NOTICE. At the end of each Participation Year up to and including the Retirement Date, Equitable will furnish the Participant with a notice showing as of a specified recent date: (1) the amount the Participant has in the Guaranteed Interest Division, (2) the total number of Accumulation Units the Participant has in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Value, (4) the amount the Participant has in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the amount in the loan reserve account, (6) the Cash Value and (7) the amount of death benefit payable with respect to the Participant. After the Retirement Date, Equitable will notify the Participant of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. Agreed to by: UNITED STATES TRUST COMPANY THE EQUITABLE LIFE ASSURANCE OF NEW YORK SOCIETY OF THE UNITED STATES By ___________________________ By_____________________________________ President Title_________________________ By_____________________________________ Vice President and Secretary Dated_________________________ Date of Issue__________________________ At____________________________ --------- PF 17075C-C Page Five [Equitable LOGO] January 18, 1989 Mr. Fredric L. Bodner, JD Chief, Health & Life Policy Bureau Agency Building One Nelson A. Rockefeller Plaza Albany, New York 12257 Re: Endorsements PF 17080C-C, PF 17081C-C, PF 17080C and PF 17081C Dear Mr. Bodner: We are filing for your approval Endorsements PF 17080C-C and PF 17081C-C for use with Group Annuity Contract No. 11938C-C, (approved by the Department on March 9, 1987), and Endorsements PF 17080C and PF 17081C for use with Group Annuity Certificate No. 11938C, (approved by the Department on March 9, 1987), issued under Group Annuity Contract No. 11938C-C. These endorsements exempt certain Participants, as explained below, from the payment of surrender charges and partial withdrawal charges. Endorsements PF 17080C-C and PF 17080C will be issued in the Qualified Trusteed market to both Corporate and Non-Corporate (Keogh/HR10) plans, and is applicable to any Participant who has attained the age of 59 1/2 years and has been a Participant for a minimum of five years. Endorsements PF 17081C-C and PF 17081C will be issued to Corporate plans only, and are applicable to any Participant who has attained the age of 59 1/2 years and is retired or has terminated employment with the employer. If you have any questions regarding these endorsements, please call Bob Heck collect at (212) 714-5247. I look forward to receiving your approval. Sincerely, /s/ Estella A. Devian Estella A. Devian Assistant Vice President 1bc/6765L THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES O Two Penn Plaza, New York 10121 THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective immediately, your Certificate issued under Group Annuity Contract No. 11938C-C is hereby amended as follows: 1. With respect to SECTION 1.18 CASH VALUE, the following new paragraph is added at the end of the section: No Withdrawal Charge: With respect to a Participant who has been a Participant for at least five Participation Years and who has attained the age of 59 1/2 years, the term "Cash Value" means an amount equal to the Annuity Account Value. 2. With respect to SECTION 2.07A PARTIAL WITHDRAWAL CHARGES, the following new paragraph is added at the end of the section: With respect to partial withdrawals requested by the Owner, there will be no partial withdrawal charge for any Participant who has been a Participant for at least five Participation Years and who has attained the age of 59 1/2 years. Vice President /s/ Benjamin H. Walker and Secretary /s/ John B. Carter President PF 17080C THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective immediately, Equitable hereby amends Group Annuity Contract 11938C-C as follows: 1. With respect to SECTION 1.18 CASH VALUE, the following new paragraph is added at the end of the section: No Withdrawal Charge: With respect to a Participant who has been a Participant for at least five Participation Years and who has attained the age of 59 1/2 years, the term "Cash Value" means an amount equal to the Annuity Account Value. 2. With respect to SECTION 2.07A PARTIAL WITHDRAWAL CHARGES, the following new paragraph is added at the end of the section: With respect to partial withdrawals requested by the Owner, there will be no partial withdrawal charge for any Participant who has been a Participant for at least five Participation Years and who has attained the age of 59 1/2 years. Agreed to by: UNITED STATES TRUST COMPANY THE EQUITABLE LIFE ASSURANCE OF NEW YORK SOCIETY OF THE UNITED STATES By By /s/ John B. Carter -------------------------- --------------------------------- Title President ----------------------- Dated ---------------------- By /s/ Benjamin H. Walker At --------------------------------- -------------------------- Vice President and Secretary Date of Issue --------------------- PF 17080C-C THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective immediately, Equitable hereby amends Group Annuity Contract 11938C-C as follows: 1. With respect to SECTION 1.18 CASH VALUE, the following new paragraph is added at the end of the section: No Withdrawal Charge: With respect to a Participant under a Trusteed Plan maintained by a corporation which Participant has attained the age of 59 1/2 years, the term "Cash Value" means an amount equal to the Annuity Account Value for withdrawals due to retirement or termination of employment. The Participant's retirement or termination of employment must be verified by the Trustee. Such verification should be in the form of a statement signed by the Trustee and accompanying the request for withdrawal. The request for withdrawal must be signed by both the Participant and the Trustee. The withdrawal charge will be imposed if this verification is not received at our Processing Office together with the withdrawal request. 2. With respect to SECTION 2.07A PARTIAL WITHDRAWAL CHARGES, the following new paragraph is added at the end of the section: With respect to partial withdrawals requested by the Owner, there will be no partial withdrawal charge for any Participant under a Trusteed Plan maintained by a corporation if the Participant has attained the age of 59 1/2 years and if the partial withdrawal is requested due to retirement or termination of employment. The Participant's retirement or termination of employment must be verified by the Trustee. Such verification should be in the form of a statement signed by the Trustee and accompanying the request for withdrawal. The request for withdrawal must be signed by both the Participant and the Trustee. The partial withdrawal charge will be imposed if this verification is not received at our Processing Office together with the withdrawal request. Agreed to by: UNITED STATES TRUST COMPANY THE EQUITABLE LIFE ASSURANCE OF NEW YORK SOCIETY OF THE UNITED STATES By By /s/ John B. Carter ------------------------- ---------------------------------- President Title By /s/ Benjamin H. Walker ---------------------- ---------------------------------- Vice President and Secretary Dated Date of Issue ----------------------- ----------------------- At ------------------------- PF 17081C-C THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective immediately, your certificate issued under Group Annuity Contract 11938C-C is hereby amended as follows: 1. With respect to SECTION 1.18 CASH VALUE, the following new paragraph is added at the end of the section: No Withdrawal Charge: With respect to a Participant under a Trusteed Plan maintained by a corporation which Participant has attained the age of 59 1/2 years, the term "Cash Value" means an amount equal to the Annuity Account Value for withdrawals due to retirement or termination of employment. The Participant's retirement or termination of employment must be verified by the Trustee. Such verification should be in the form of a statement signed by the Trustee and accompanying the request for withdrawal. The request for withdrawal must be signed by both the Participant and the Trustee. The withdrawal charge will be imposed if this verification is not received at our Processing Office together with the withdrawal request. 2. With respect to SECTION 2.07A PARTIAL WITHDRAWAL CHARGES, the following new paragraph is added at the end of the section: With respect to partial withdrawals requested by the Owner, there will be no partial withdrawal charge for any Participant under a Trusteed Plan maintained by a corporation if the Participant has attained the age of 59 1/2 years and if the partial withdrawal is requested due to retirement or termination of employment. The Participant's retirement or termination of employment must be verified by the Trustee. Such verification should be in the form of a statement signed by the Trustee and accompanying the request for withdrawal. The request for withdrawal must be signed by both the Participant and the Trustee. The partial withdrawal charge will be imposed if this verification is not received at our Processing Office together with the withdrawal request. Vice President /s/ Benjamin H. Walker and Secretary /s/John B. Carter President PF 17081C {EQUITABLE LOGO] January 5, 1989 Mr. Frederic L. Bodner, JD Chief, Health & Life Policy Bureau Agency Building One Nelson A. Rockefeller Plaza Albany, New York 12257 Re: Endorsements PF 17082CT and PF 17082T Dear Mr. Bodner: We are filing for your approval Endorsement PF 17082CT for use with Group Annuity Contract No. 11930CT (approved by the Department on February 29, 1980) and Endorsement PF 17082T for use with Group Annuity Certificate No. 11934T (approved by the Department on April 19, 1982), issued under Group Annuity Contract No. 11930CT. These endorsements exempt certain Participants, as explained below, from the payment of surrender charges and partial withdrawal charges. Endorsements PF 17082CT and PF 17082T will be issued in the Tax Sheltered Annuity market and are applicable to any Participant who has attained the age of 59 1/2 years, has been a Participant for a minimum of five years and is separated from service. This form is exempt from Flesch Score requirements. If you have any questions regarding these endorsements, please call Bob Heck collect at (212) 714-5247. I look forward to receiving your approval. Sincerely, /s/ Estella A. Devian Estella A. Devian Assistant Vice President 1bc/6760L THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective immediately, Equitable hereby amends Group Annuity Contract 11930CT as follows: 1. With respect to section entitled "Early Withdrawal Charges" on Page Two, the following item is added following item (v): or (vi) the attainment of age 55 years, the completion of five Participation years and separation from service. 2. With respect to SECTION 1.18 CASH VALUE, the following item is added following item (v) of the paragraph entitled "No Withdrawal Charge": or (vi) the attainment of 55 years, the completion of five Participation Years and separation from service. Agreed to by: UNITED STATES TRUST COMPANY THE EQUITABLE LIFE ASSURANCE OF NEW YORK SOCIETY OF THE UNITED STATES By By /s/ John B. Carter ------------------------- ---------------------------------- President Title By /s/ Benjamin H. Walker ---------------------- ---------------------------------- Vice President and Secretary Date Date of Issue ----------------------- ----------------------- At ------------------------- PF 17082CT THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective immediately, Equitable hereby amends your certificate issued under Group Annuity Contract 11930CT as follows: 1. With respect to section entitled "Early Withdrawal Charges" on Page Two, the following item is added following item (v): or (vi) the attainment of age 55 years, the completion of five Participation Years and separation from service. 2. With respect to SECTION 1.18 CASH VALUE, the following item is added following item (v) of the paragraph entitled "No Withdrawal Charge": or (vi) the attainment of age 55 years, the completion of five Participation Years and separation from service. SPECIMEN Vice President SPECIMEN President and Secretary PF 17082T [NEW YORK STATE EMBLEM] STATE OF NEW YORK INSURANCE DEPARTMENT AGENCY BUILDING ONE THE GOVERNOR NELSON A. ROCKEFELLER JAMES P. CORCORAN EMPIRE STATE PLAZA SUPERINTENDENT OF ALBANY, NEW YORK 12257 INSURANCE September 28, 1989 Refer to: John S. Fitzgerald File No. 89090578-79; 88080528-30 Ms. Estella A. Devian Assistant Vice President Equitable Life Assurance Society of the United States 2 Penn Plaza New York, New York 10121 RE: PF 17073CP-NY PF 17073P-NY Dear Ms. Devian: In your submittal letter of September 21, 1989, you advised that these endorsements intended for the Internal Revenue Code Section 457 public employee deferred compensation market are only slightly revised from the previously approved endorsements, bearing the same policy form numbers, approved on April 17, 1989, file numbers 88080528-29. The only revision to the endorsements now allows the contract holder to transfer all of the assets of the plan currently issued under the contract to another funding vehicle after five years (or such shorter period as may be mutually agreed upon) without incurring any withdrawal charges. The revised endorsements also allow the contract holder the option of renewing its agreement with Equitable for a mutually agreed upon period not to exceed five years. The previous endorsements provided for a five year contract term and a five year renewal period. Because the previously approved versions of the endorsements were never issued, we can approve these revised versions on a substitution basis. We have substituted the revised copy of the above captioned forms, forwarded with your letter September 21, 1989, for the ones previously approved on April 17, 1989. Enclosed please find a duplicate copy of each form bearing our stamp of approval dated April 17, 1989. Very truly yours, /s/ Fredric L. Bodner Fredric L. Bodner, JD Chief, Health & Life Policy Bureau /amm encls. THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES This endorsement is issued specifically for purposes of compliance with the regulations of the New York State Deferred Compensation Board ("Regulations"). If those Regulations are withdrawn, superseded or otherwise modified such that the need for this endorsement no longer exists, the provisions of this endorsement will cease to apply. For Plans established by Employers in the State of New York, Group Annuity Contract 11932CP is hereby amended as follows: 1. The following paragraph is added to the "EARLY WITHDRAWAL CHARGE" provision on Page Two of the Contract: The above statements notwithstanding, after the completion of a period agreed upon by the Employer and Equitable not to exceed five Participation Years from the date as of which an agreement is entered into between the Employer and Equitable ("period") and after the completion of each successive period, any assets of the Plan which are currently invested in certificates issued under the Contract will be transferred as soon as administratively practicable to a successor funding agency designated by the Employer unless, not later than 7 days before the date on which a transfer would otherwise occur, the Employer, in accordance with the procedures specified in Section 9003.2 of the Regulations, notifies Equitable to renew that agreement. Such funds will be transferred in a single sum and no early withdrawal charges, surrender charges, market value adjustments or other fees will be applied in connection with such a transfer. Equitable will not be responsible for the validity of any certification made by the Employer. 2. With respect to SECTION 1.10 GUARANTEED INTEREST RATE, the second paragraph is replaced by the following: Equitable will from time to time establish and make available for new Participants in Plans established by Employers in the State of New York (i) an Initial Guaranteed Interest Rate, (ii) one or more Minimum Guaranteed Interest Rates and (iii) the applicable effective period(s) for such Rates. A new Class of Participants may be established effective with the effective date of the occurrence of (i), (ii) or (iii) above or any combination thereof. 3. With respect to SECTION 1.18 CASH VALUE, the paragraph below is added following the first paragraph: The above statements notwithstanding, after the completion of a period agreed upon by the Employer and Equitable not to exceed five Participation Years from the date as of which an agreement is entered into between the Employer and Equitable ("period") and after the completion of each successive period, any assets of the Plan which are currently invested in certificates issued under the Contract will be transferred as soon as administratively practicable to a successor funding agency designated by the Employer unless, not later than 7 days before the date on which a transfer would otherwise occur, the Employer, in accordance with the procedures specified in Section 9003.2 of the Regulations, notifies Equitable to renew that agreement. Such funds will be transferred in a single sum and early withdrawal charges, surrender charges, market value adjustments or other fees will be applied in connection with such a transfer. Equitable will not be responsible for the validity of any certification made by the Employer. Agreed to by: UNITED STATES TRUST COMPANY THE EQUITABLE LIFE ASSURANCE OF NEW YORK SOCIETY OF THE UNITED STATES By By /s/ John B. Carter ------------------------- ---------------------------------- President Title By /s/ Benjamin H. Walker ---------------------- ---------------------------------- Vice President and Secretary Date Date of Issue ----------------------- ----------------------- At ------------------------- PF 17073CP-NY THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES This endorsement is issued specifically for purposes of compliance with the regulations of the New York State Deferred Compensation Board ("Regulations"). If those Regulations are withdrawn, superseded or otherwise modified such that the need for this endorsement no longer exists, the provisions of this endorsement will cease to apply. For Plans established by Employers in the State of New York, Group Annuity Contract 11932CP is hereby amended as follows: 1. The following paragraph is added to the "EARLY WITHDRAWAL CHARGE" provision on Page Two of the Contract: The above statements notwithstanding, after the completion of a period agreed upon by the Employer and Equitable not to exceed five Participation Years from the date as of which an agreement is entered into between the Employer and Equitable ("period") and after the completion of each successive period, any assets of the Plan which are currently invested in certificates issued under the Contract will be transferred as soon as administratively practicable to a successor funding agency designated by the Employer unless, not later than 7 days before the date on which a transfer would otherwise occur, the Employer, in accordance with the procedures specified in Section 9003.2 of the Regulations, notifies Equitable to renew that agreement. Such funds will be transferred in a single sum and no early withdrawal charges, surrender charges, market value adjustments or other fees will be applied in connection with such a transfer. Equitable will not be responsible for the validity of any certification made by the Employer. 2. With respect to SECTION 1.10 GUARANTEED INTEREST RATE, the second paragraph is replaced by the following: Equitable will from time to time establish and make available for new Participants in Plans established by Employers in the State of New York (i) an Initial Guaranteed Interest Rate, (ii) one or more Minimum Guaranteed Interest Rates and (iii) the applicable effective period(s) for such Rates. A new Class of Participants may be established effective with the effective date of the occurrence of (i), (ii) or (iii) above or any combination thereof. 3. With respect to SECTION 1.18 CASH VALUE, the paragraph below is added following the first paragraph: The above statements notwithstanding, after the completion of a period agreed upon by the Employer and Equitable not to exceed five Participation Years from the date as of which an agreement is entered into between the Employer and Equitable ("period") and after the completion of each successive period, any assets of the Plan which are currently invested in certificates issued under the Contract will be transferred as soon as administratively practicable to a successor funding agency designated by the Employer unless, not later than 7 days before the date on which a transfer would otherwise occur, the Employer, in accordance with the procedures specified in Section 9003.2 of the Regulations, notifies Equitable to renew that agreement. Such funds will be transferred in a single sum and early withdrawal charges, surrender charges, market value adjustments or other fees will be applied in connection with such a transfer. Equitable will not be responsible for the validity of any certification made by the Employer. Agreed to by: UNITED STATES TRUST COMPANY THE EQUITABLE LIFE ASSURANCE OF NEW YORK SOCIETY OF THE UNITED STATES By By /s/ John B. Carter ------------------------- ---------------------------------- President Title By /s/ Benjamin H. Walker ---------------------- ---------------------------------- Vice President and Secretary Date Date of Issue ----------------------- ----------------------- At ------------------------- PF 17073CP-NY [EQUITABLE LOGO] AUG 28 1989 Mr. Ralph D. Spaulding Insurance Department Agency Building One Empire State Plaza Albany, New York 12257 Re: PF 17085C-NQ, Filing for delivery Your File No. 89060005 Dear Mr. Spaulding: On June 8, 1989, your department approved our filing of PF 17085NQ (File No. 8906005). This form is for use with our Group Annuity Certificate No. 11940NQ, issued under Group Annuity Contract No. 11937C-NQ. We neglected to file for delivery the corresponding contract form, PF 17085C-NQ, for use with Group Annuity Contract No. 11937C-NQ. It has been filed and approved in Rhode Island, the home state of the contract holder, and will be issued there. I apologize for any inconvenience this oversight may have caused. If you have any questions, please call Alex Unger at (212) 714-4482. I look forward to receiving your approval. Very truly yours, /s/ Estella A. Devian Estella A. Devian Assistant Vice President THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Two Penn Plaza, New York, NY 10121 EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective April 7, 1989, this endorsement is made part of Group Annuity Contract No. 11937CNQ. The Contract Holder is changed from Rhode Island Hospital Trust National Bank to Bank of New England -- Old Colony, N.A. All references in the Contract and any riders or endorsements issued under the Contract to Rhode Island Hospital Trust are hereby changed to Bank of New England -- Old Colony, N.A. Agreed to by: BANK OF NEW ENGLAND -- THE EQUITABLE LIFE ASSURANCE OLD COLONY, N.A. SOCIETY OF THE UNITED STATES By By /s/ John B. Carter ----------------------------------- -------------------------------- Title John B. Carter --------------------------------- President Dated --------------------------------- By /s/ Benjamin H. Walker At -------------------------------- ------------------------------------ Benjamin H. Walker Vice President and Secretary Date of Issue --------------------- PF 17085CNQ [EQUITABLE LOGO] ESTELLA A. DEVIAN Assistant Vice President May 23, 1989 Mr. Frederic L. Bodner, JD Chief, Health & Life Policy Bureau Agency Building One Nelson A. Rockefeller Plaza Albany, New York 12257 Re: Endorsement PF 17085NQ Dear Mr. Bodner: We are filing for your approval Endorsement PF 17085NQ for use with Group Annuity Certificate No. 11937NQ (approved by the Department on December 6, 1985), issued under Group Annuity Contract No. 11937C-NQ. This endorsement changes the contract holder named on page 3 of the certificate from Rhode Island Hospital Trust National Bank to Bank of New England - Old Colony, N.A. This form is exempt from Flesch score requirements. If you have any questions regarding this endorsement, please call Alex Unger collect at (212) 714-4482. I look forward to receiving your approval. Very truly yours, /s/ Estella A. Devian Estella A. Devian Assistant Vice President 1bc/6965L ESTELLA A. DEVIAN Assistant Vice President [EQUITABLE LOGO] Feb 20 1990 Mr. Frederic L. Bodner, JD Chief, Health & Life Policy Bureau Agency Building One Nelson A. Rockefeller Plaza Albany, New York 12257 Re: Endorsement PF 17085NQ File No. 89060005 Dear Mr. Bodner: We are refiling for your approval Endorsement PF 17085NQ for use with Group Annuity Certificate No. 11937NQ (approved by the Department on December 6, 1985), issued under Group Annuity Contract No. 11937C-NQ. This endorsement changes the contract holder named on page 3 of the certificate from Rhode Island Hospital Trust National Bank to Bank of New England - Old Colony, N.A. This Endorsement was previously filed by the Deparmtnent on June 8, 1989 with an Effective Date of April 7, 1989. This Endorsement to the Group Annuity Contract was not signed until December 1989 with an Effective Date of December 1. No other changes have been made in the Endorsement. We apologize for any inconvenience this refiling may cause. This form is exempt from Flesch score requirements. If you have any questions regarding this endorsement, please call Robert Heck collect at (212) 714-5247. I look forward to receiving your approval. Very truly yours, /s/ Estella A. Devian Estella A. Devian Assistant Vice President jg/7355L THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Two Penn Plaza, New York, N.Y. 10121 THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Effective April 7, 1989, your certificate issued under Group Annuity Contract 11937CNQ as been amended as follows: On Page 3 or your certificate, the identity of the contract holder is changed from RHODE ISLAND HOSPITAL TRUST COMPANY to BANK OF NEW ENGLAND - OLD COLONY, N.A. SPECIMEN Vice President SPECIMEN President and Secretary PF 17085NQ EX-99.4CENDORSEMENT 11 UNIT INVESTMENT TRUST ENDORSEMENT THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Unit Investment In this endorsement "we" and "our" mean the Trust Endorsement Equitable Life Assurance Society of the United States. "You" means the owner of the Contract at the time the owner's right is exercised. - -------------------------------------------------------------------------------- EFFECTIVE DATE: DECEMBER 18, 1987 This endorsement is made part of Individual Annuity Contract No. 112-94T as of the Effective Date. It should be attached to and kept with your Contract. On the Effective Date of this endorsement we exercise our right under the Contract to operate Separate Accounts A and E as a unit investment trust. As a result, Separate Account E has been combined with and into Separate Account A. Separate Account A is now operating in unit investment trust form. It is referred to herein as "the Separate Account". The Separate Account is made up of investment divisions. The investment assets of the former Separate Account A have been exchanged for shares of the stock portfolio of The Equitable Trust (the "Trust"). Those shares are held by the stock investment division of the Separate Account. The investment assets of the former Separate Account E have been exchanged for shares of the money market portfolio of the Trust. Those shares are held by the money market division of the Separate Account. As a result of this change in operations, as of the Effective Date of this endorsement, the Contract to which the endorsement is attached is amended as follows: 1. With respect to the first page of the Contract, the agreement and the first paragraph are replaced by the following: EQUITABLE AGREES, subject to the provisions of this Contract, to allocate the single premium and to pay benefits in the manner hereinafter described. After the deductions specified on page two, the balance of the single premium will be allocated to THE STOCK DIVISION, or to THE MONEY MARKET OF THE SEPARATE ACCOUNT, or will be divided between the Stock Division and the Money Market Division, in accordance with the Allocation to Investment Divisions provision on page two. Before the Retirement Date, amounts may be transferred between the Stock Division and the Money Market Division in accordance with the Transfers Between Investment Divisions provision on page seven. An administrative charge is made in each Contract Year before the Retirement Date as provided on page two. 2. With respect to the first page of the Contract, the third and fourth paragraphs are replaced by the following: If the Annuitant is living at the Retirement Date and another mode of settlement has not been elected, the Cash Value of the amount the Annuitant has in the Stock Division will be applied to purchase a variable annuity, and the Cash Value of the amount the Annuitant has in the Money Market Division will be applied to purchase a fixed annuity, in accordance with the Annuity Commencing on Retirement Date provision on page seven. The Annuity will be payable monthly commencing on the Retirement Date. Payments will be made for 10 years certain and thereafter for the remaining lifetime of the Annuitant. The amount of each annuity payment will be equal to the sum of any fixed annuity payment and any variable annuity payment. The amount of any variable annuity payments may increase or decrease, depending on the investment experience of the Stock Division of the Separate Account. Such payments will increase if the average daily rate of investment return in the Stock Division is equivalent to more than 3 1/2% annually, and will decrease if it is equivalent to less than 3 1/2% annually. The daily rate of investment return is before deduction of charges equivalent to a maximum charge of 1% annually, but after any deductions to provide for taxes. These charges include a daily charge for death benefits, mortality risk, expenses and expense risk, plus the investment advisory fee charges and direct operating expense charges of the Trust. 3. With respect to the first page of the Contract, the last six sentences are replaced by the following: Deferred Life Annuity, 10 Years Certain, On a Fixed or Variable or Combination Fixed and Variable Basis, Death Benefit Before Retirement Date. Premiums payable Until Retirement Date or Until Prior Death. Cash Value Based on Stock Division or Money Market Division of the Separate Account or Both. Nonparticipating. THE CASH VALUE AND VARIABLE ANNUITY PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT. 4. With respect to Page Two of the Contract, the section entitled GUIDE TO CONTRACT PROVISIONS is replaced by the following: GUIDE TO CONTRACT PROVISIONS Page The Single Premium........................................................2 Owner.....................................................................5 Non-transferability.......................................................5 Beneficiary...............................................................5 General Provisions........................................................5 The Separate Account......................................................6 Cash Value................................................................7 Transfers Between Investment Divisions....................................7 S 17060T Rev. 10/87 Unit Investment Trust Endorsement Page 1 Death Benefit Before Retirement Date......................................7 Annuity Commencing on Retirement Date.....................................7 Optional Retirement Date..................................................7 Non-Qualification.........................................................7 Optional Modes of Settlement...........................................8-11 A copy of the application will be found following page four. 5. With respect to Page Two of the Contract, the section entitled ALLOCATION TO SEPARATE ACCOUNTS is replaced by the following: ALLOCATION TO THE INVESTMENT DIVISIONS. After deduction of the above charges the balance of the premium will be applied to purchase Accumulation Units in the Stock Division or in the Money Market Division or will be divided between the two Investment Divisions in accordance with the allocation percentages specified on page three. The number of Accumulation Units purchased in each Investment Division is equal to the amount so applied to that Investment Division, divided by the Accumulation Unit Value of the Investment Division for the date on which the premium is received at the Processing Office or, if later, the Date of Issue of this Contract. The Accumulation Unit Value for either Investment Division may increase or decrease, depending on the investment experience of the Investment Division, but the number of Accumulation Units which have already been purchased will not change because of any subsequent change in an Accumulation Unit Value. If Equitable's rules permit, proceeds of Contracts funded in Equitable's Investment Divisions of the Separate Account for qualified plans may be applied under this Contract without deductions to purchase Accumulation Units in the Stock Division or the Money Market Division or in both Investment Divisions, in accordance with the same allocation percentages as apply to the single premium and in the same manner as the premium. The date the amount is applied shall be the date on which appropriate Equitable requirements to make available the proceeds are met, including receipt by Equitable of a specific request for such application, signed by the Owner. The amount applied shall be deemed to be a premium only for purposes of the Death Benefit Before Retirement Date provision. 6. With respect to Page Two of the Contract, the section entitled ADMINISTRATIVE CHARGE is replaced by the following: ADMINISTRATIVE CHARGE. At the end of each Contract Year before the Retirement Date, the total number of Accumulation Units then credited to this Contract will be reduced to reflect an annual charge for administrative expenses. The annual charge will be $15, or if less, 2% of the sum of (a) the total Cash Value of this Contract at the end of the Contract Year, and (b) the total withdrawal, if any, made during the Contract Year. The charge will be allocated between the Investment Divisions in proportion to their contract Cash Values. A proportionate reduction for part of a Contract Year will be made before determination of the Cash Value, if this Contract is surrendered for its total Cash Value, the Annuitant dies or annuity payments commence during a Contract Year. 7. With respect to Page Five of the Contract, the section entitled DEFERMENT is replaced by the following: DEFERMENT. The payment of the total Cash Value or a partial withdrawal will be made within seven days after receipt or written request for surrender or withdrawal during the lifetime of the Annuitant, and the payment of the Death Benefit will be made within seven days after receipt of due proof of death of the Annuitant, except as provided in this provision. Equitable reserves the right to defer determination and payment of the total Cash Value, any partial withdrawal, the Death Benefit, and the determination and application or payment of any amount under the Variable Benefit Options of the Optional Modes of Settlement during (1) any period when the sale of securities or the determination of an Accumulation Unit Value or the Annuity Unit Value is not reasonably practicable because the New York Stock Exchange is closed or conditions are such that, under rules and regulations adopted by the Securities and Exchange Commission, trading on such exchange is deemed to be restricted or an emergency is deemed to exist, or (2) any other period during which the Securities and Exchange Commission may, by order, permit postponement for the protection of persons having interests in the Stock Division or the Money Market Division of the Separate Account. 8. With respect to Page Five of the Contract, the section entitled ANNUAL NOTICE is replaced by the following: ANNUAL NOTICE. With respect to each Contract Year before the Retirement Date, Equitable will furnish the Owner with a notice showing as of a specified recent date the number of Accumulation Units credited under this Contract and the Accumulation Unit Values credited under this Contract for the Stock Division or the Money Market Division of the Separate Account. 9. With respect to Page Six of the Contract, the section entitled THE SEPARATE ACCOUNTS is replaced by the following: THE SEPARATE ACCOUNT. The Separate Account is Separate Account A (in unit investment trust form). Equitable established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited or charged against it without regard to Equitable's other income, gains or losses. Assets are put in the Separate Account to support the Contract and other variable annuity contracts and certificates. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities and variable insurance. The assets of the Separate Account are the property of Equitable. The portion of its assets equal to the reserves and other contract liabilities with respect to the Separate Account will not be chargeable with liabilities arising out of any other business we conduct. Equitable may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to Equitable's General Account. S 17060T Rev. 10/87 Unit Investment Trust Endorsement Page 2 The Separate Account consists of "Investment Divisions". Each Investment Division may invest its assets in a separate class (or series) of shares of a designated trust or investment company where each class (or series) represents a separate portfolio in the trust or investment company. Equitable retains the right to change the designated trust or investment company or to add designated trusts or investment companies. The Investment Divisions available on the Effective Date of this endorsement are the Stock Division and the Money Market Division. Equitable will value the assets of each Investment Division on each business day. A business day is any day on which Equitable is open, the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio securities in which an Investment Division is invested that the Accumulation Unit Value or Annuity Unit Value might be materially affected by changes in the value of those securities, as determined by Equitable. Equitable may, at it discretion, invest the assets of any Investment Division in any investment permitted by applicable law. Equitable may rely conclusively on the opinion of counsel (including attorneys in its employ) as to what investments it is permitted by law to make. Equitable reserves the right (i) to cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) to run the Separate Account under the direction of a committee, and to discharge such committee at any time; (iii) to restrict or eliminate any voting rights of Annuitants or other persons who have voting rights as to the Separate Account; (iv) to operate the Separate Account by making direct investments, or in any other form; (v) to add Investment Divisions (or sub-divisions of Investment Divisions) to, or remove Investment Divisions (or sub-divisions of Investment Divisions) of the Separate Account; (vi) to combine any two or more Investment Divisions (or sub-divisions of Investment Divisions)of the Separate Account; and (vii) to withdraw from any Investment Division and to allocate to another Investment Division assets determined by Equitable to be associated with this Contract. The term "Investment Division" in the Contract shall then refer to any other Investment Division in which the assets were placed. If the exercise of these rights results in a material change in the underlying investments of an Investment Division, the Annuitants will be notified of such exercise. Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for taxes) at a rate not to exceed .74% per year for death benefits, mortality risk, expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision below. The relative proportion of these charges may be modified. This daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust (or any other designated trust or investment company), shall not in the aggregate exceed a total annual rate of 1.0% of the value of the assets of the Investment Divisions attributable to the Contract. The maximum rate may not be altered without approval by the Contract Owner. 10. With respect to Page Six of the Contract, the section entitled DEFINITIONS RELATING TO THE SEPARATE ACCOUNTS is replaced by the following: DEFINITIONS RELATING TO THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT. VALUATION PERIOD: Each business day together with any non-business day or consecutive non-business day immediately preceding such business day will constitute a Valuation Period. NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) dividend by (b), minus (c), where (a) is the net asset value of the shares of the Trust (or any other designated trust or investment company) that belong to the Investment Division at the end of the Valuation Period (including the per share amount of any dividend or capital gain distribution paid to the Investment Division in the current Valuation Period), before giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period, but after any amounts charged against the Investment Division in the Valuation Period for taxes. (b) is the net asset value of the shares of the Trust (or any other designated trust or investment company) that belonged to the Investment Division at the end of the preceding Valuation Period, after giving effect to any amounts allocated to or withdrawn from the Investment Division for that Valuation Period. (c) is the daily asset charge for this Contract times the number of calendar days in the Valuation Period. The net asset value of the shares of a trust or investment company held by an Investment Division shall be the value reported to Equitable by that trust or investment company. ACCUMULATION UNIT: The Accumulation Unit is a unit used in determining the amount an Annuitant has in an Investment Division of the Separate Account on or before the Retirement Date. ACCUMULATION UNIT VALUE: With respect to this Contract, the initial Accumulation Unit Value associated with each investment option was established as follows: Investment Option Value Date Established ----------------- ----- ---------------- Stock $10.00 November 1, 1968 Money Market $10.00 September 4, 1974 The Accumulation Unit Value for each subsequent Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such Valuation Period. ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable from the Stock Division of the Separate Account under the Variable Benefit Options of the Optional Modes of Settlement. S 17060T Rev. 10/87 Unit Investment Trust Endorsement Page 3 ANNUITY UNIT VALUE: With respect to this Contract, the initial Annuity Unit Value was established at $1.00 as of November 1, 1968. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period, reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor, times (i) .00009425 in order to recognize the Assumed Base Rate of Net Investment Return of 3 1/2% per year used in the determination of the number of Annuity Units. AVERAGE ANNUITY UNIT VALUE: With respect to this Contract, the Average Annuity Unit Value for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods ending in such month. 11. With respect to Page Seven of the Contract, the section entitled CASH VALUE is replaced by the following: CASH VALUE. The total Cash Value of this Contract at any time, on or before the Retirement Date is equal to the sum of the Cash Value of the amount the Annuitant has in the Stock Division and the Cash Value of the amount the Annuitant has in the Money Market Division, each of which is equal to the total number of Accumulation Units credited to this Contract for the Investment Division as of the date the Cash Value is determined (after any reduction as specified in the Administrative Charge provision on page two), multiplied by the Accumulation Unit Value for the Investment Division on such date. On or before the Retirement Date, while the Annuitant is living, the Owner may surrender this Contract for its total Cash Value determined as of the date of receipt of written request for surrender at the Processing Office. On or before the Retirement Date, while the Annuitant is living, the Owner may make a partial withdrawal from the total Cash Value of the Contract upon written request to Equitable. A partial withdrawal will not be permitted by Equitable unless (1) the amount of the partial withdrawal requested is at least $300, and (2) the total Cash Value of the Contract after the withdrawal is at least $200. Unless otherwise specified by the Owner, the amount to be withdrawn from each Investment Division shall be in the same proportion to the Cash Value of the as the amount of the partial withdrawal requested is to the total Cash Value. A partial withdrawal will result in a reduction in the number of Accumulation Units credited to an Investment Division, from which a withdrawal is made equal to the amount withdrawn from such Investment Division divided by the Accumulation Unit Value of the Investment Division, for the date on which written request for withdrawal is received at the Processing Office. A partial withdrawal will result in a reduction of the Death Benefit, as described in the provision below. 12. With respect to Page Seven of the Contract, the section entitled TRANSFERS BETWEEN SEPARATE ACCOUNTS is replaced by the following: TRANSFERS BETWEEN INVESTMENT DIVISIONS. At any time before the Retirement Date, while the Annuitant is living, the Owner, upon written request, may transfer all or part of the Cash Value from one Investment Division to the other, provided that if less than all of the Contract Cash Value in an Investment Division is transferred to the other Investment Division, the amount transferred must be at least $300. In the event of a transfer, the number of Accumulation Units credited to the Investment Division from which the transfer is made will be reduced by a number determined by dividing the amount transferred by the Accumulation Unit Value for such Investment Division for the date on which the Owner's written request for the transfer is received at the Processing Office, and the number of Accumulation Units credited to the Investment Division to which the transfer is being made will be increased by a number determined by dividing the amount transferred by the Accumulation Unit Value for such Investment Division for such date. Equitable reserves the right to limit the number of transfers between Investment Divisions, but will not limit transfers to less than two in a Contract Year. 13. With respect to Page Seven of the Contract, the section entitled ANNUITY COMMENCING ON RETIREMENT DATE is replaced by the following: ANNUITY COMMENCING ON RETIREMENT DATE. On the Retirement Date, if the Annuitant is then living and the Owner has not surrendered this Contract for its total Cash Value or elected some other mode or modes of settlement, the Cash Value of the amount the Annuitant has in the Money Market Division on that date will be applied under the Fixed Benefit Life Income Option and the Cash Value of the amount the Annuitant has in the Stock Division on that date will be applied under the Variable Benefit Life Income Option of the Optional Modes of Settlement provision to provide a monthly annuity payable for 10 years certain and thereafter for the remaining lifetime of the Annuitant. 14. With respect to Page Eight of the Contract, the first sentence in the section entitled FIXED BENEFIT OPTIONS is replaced by the following: Payments under the Fixed Benefit Options will not be affected by the investment experience of an Investment Division after proceeds are applied under such options. 15. With respect to Page Eight of the Contract, the first paragraph in the section entitled VARIABLE BENEFIT OPTIONS is replaced by the following: Under Options D and E the amount of the initial monthly installment will be determined by the Table of Initial Installments on page eleven, except that a higher initial installment, as determined by Equitable, may be payable. The amount of the second and third monthly installments will be the same as the amount of the initial monthly installment. The amount of the fourth or any subsequent monthly installment will be the number of Annuity Units multiplied by the Average Annuity Unit Value for the second calendar month S 17060T Rev. 10/87 Unit Investment Trust Endorsement Page 4 immediately preceding the due date of the installment. The number of Annuity Units is equal to the amount of the first installment divided by the Annuity Unit Value for the due date of the first installment. The fourth and subsequent monthly installments may increase or decrease in amount, depending on the investment experience of the Stock Division. Installments under a Variable Benefit Option will not be increased or decreased in amount because of mortality or expense experience. 16. With respect to the last page of the Contract, the last six sentences are replaced by the following: Deferred Life Annuity, 10 Years Certain, On a Fixed or Variable or Combination Fixed and Variable Basis, Death Benefit Before Retirement Date. Premiums payable Until Retirement Date or Until Prior Death. Cash Value Based on Stock Division or Money Market Division of the Separate Account or Both. Non-participating. THE CASH VALUE AND VARIABLE ANNUITY PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT. 17. All other references in the Contract to "Separate Account A", "Separate Account E" or "Separate Account" are changed to "the Stock Division", "the Money Market Division" or "Investment Division", respectively. THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES By SPECIMEN By SPECIMEN ---------------------------------- ------------------------------------- President Vice President and Secretary Date of Issue ----------------------- S 17060T Rev. 10/87 Unit Investment Trust Endorsement Page 5 EX-99.4DCONTRACTS 12 FORMS OF GROUP ANNUITY CONTRACTS Annuitant: JOHN DOE Contract Number: 00 000 000 Issue Date: FEB 28, 1992 Contract Date: FEB 28, 1992 Retirement Date: JAN 1, 2020 THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York, New York 10116 AGREES o TO ALLOCATE the Contributions made to this Contract, after deduction of any applicable tax charge, to the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division of the Separate Account (referred to in this Contract as the "Investment Divisions") or to the Guaranteed Interest Division, in accordance with Sections 2.02, 2.03 and 2.04, as directed by the Owner, and o TO APPLY the Annuity Account Value at the Retirement Date to provide you with an Annuity Benefit or a Cash Value if you are then living, and o TO PROVIDE the Owner with the other rights and benefits of this Contract. This is the entire Contract. In this Contract, "we", "our" and "us" mean The Equitable Life Assurance Society of the United States. "You" and "your" mean the Annuitant, with respect to a right exercised by the Owner on behalf of the Annuitant. TEN DAYS TO EXAMINE CONTRACT--The Owner may cancel this Contract by returning it to us within ten days after receipt of it. Upon such cancellation, we will refund any Contribution made to us under this Contract. /s/ Molly K. Heines /s/ Richard H. Jenrette Vice President and Secretary Chairman of the Board and Chief Executive Officer THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASED RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.24 IS 5% OR 3.5%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISKS, EXPENSES AND EXPENSE RISK, PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE TRUST. No. 92CTRA This Contract is issued in consideration of the payment to us of the Contributions made under the terms of this Contract. The provisions on the following pages are part of this Contract. - -------------------------------------------------------------------------------- TABLE OF CONTENTS DEFINITIONS Page Section 1.01 - Annuitant..........................................4 1.02 - Annuity............................................4 1.03 - Annuity Account Value..............................4 1.04 - Annuity Benefit....................................4 1.05 - Cash Value.........................................4 1.06 - Class of Contracts.................................4 1.07 - Code...............................................4 1.08 - Contract Date......................................4 1.09 - Contract Year......................................4 1.10 - Contribution.......................................4 1.11 - Divisions..........................................4 1.12 - Eligible Annuity Certain...........................5 1.13 - Employer...........................................5 1.14 - Guaranteed Interest Rate...........................5 1.15 - Joint and Survivor Life Annuity Form....................................5 1.16 - Life Annuity Form..................................5 1.17 - Normal Form........................................5 1.18 - Owner..............................................5 1.19 - Period Certain Annuity.............................5 1.20 - Plan...............................................5 1.21 - Processing Office..................................5 1.22 - Retirement Date....................................5 1.23 - Separate Account...................................5 1.24 - Separate Account Definitions.......................6 1.25 - Transaction Date...................................7 1.26 - Trust..............................................7 1.27 - Trustee............................................7 1.28 - Trusteed Plan......................................7 ANNUITY ACCOUNT VALUE Section 2.01 - Contributions......................................7 2.02 - Separate Account Investment Divisions.......................................7 2.03 - Guaranteed Interest Division.......................8 2.04 - Allocation to Divisions............................8 2.05 - Transfers Among Divisions..........................8 2.06 - Termination of this Contract.......................8 2.07 - Partial Withdrawals................................9 2.08 - Charges for Partial Withdrawals....................9 2.09 - Free Corridor Amount...............................9 2.10 - Loans.............................................10 2.11 - Annual Administrative Charge......................11 2.12 - Death Benefit.....................................11 ANNUITY BENEFITS Section 3.01 - Fixed Annuity Benefit.............................12 3.02 - Variable Annuity Benefit..........................12 3.03 - Election and Commencement of Annuity Benefits............................12 3.04 - Amount of Annuity Benefits........................13 3.05 - Payment of Annuity Benefits.......................13 3.06 - Special Annuity and Spousal Consent Provisions.............................16 GENERAL PROVISIONS Section 4.01 - Contract..........................................16 4.02 - Statutory Compliance..............................16 4.03 - Assignments and Nontransferability................................17 4.04 - Beneficiary.......................................17 4.05 - Disqualification..................................17 4.06 - Future Contributions..............................17 4.07 - Deferment.........................................17 4.08 - Annual Notice.....................................17 4.09 - Trustee's Responsibility..........................17 4.10 - Age...............................................18 No. 92CTRA Page 2 OWNER: TRUSTEES OF THE ABC PLAN ANNUITANT: JOHN DOE CONTRACT NUMBER: 000 000 000 ISSUE DATE: FEB 28, 1992 CONTRACT DATE: FEB 28, 1992 RETIREMENT DATE: JAN 1, 2020 INITIAL GUARANTEED INTEREST RATE: 7.50% TO MAR 31, 1992 MINIMUM GUARANTEED INTEREST RATE: 6.00% TO DEC 31, 1992 3.00% AFTER DEC 31, 1992 BENEFICIARY: JANE DOE FORM NUMBER: 92CTRA ******************************************************************************** TABLE OF GUARANTEED VALUES ISSUE AGE 38 MALE $1,000 ANNUAL CONTRIBUTION NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY SINCE FIRST CONTRIBUTION CASH VALUE ANNUITY AT AGE 65 - -------------------------- ---------- ------------------------- 1 983 6.62 2 1,958 16.20 3 2,963 26.67 4 3,998 36.83 5 5,064 46.70 6 6,162 56.28 7 7,349 65.58 8 8,580 74.61 9 9,848 83.38 10 11,154 91.89 11 12,500 100.16 12 13,886 108.18 13 15,313 115.97 14 16,783 123.53 15 18,298 131.18 16 19,857 138.63 17 21,464 145.90 18 23,118 152.80 19 24,853 159.69 20 26,639 166.03 24 (Age 62) 34,697 189.57 27 (Age 65) 41,098 205.49 THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000 CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE (SEE SECTION 2.11) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE CONTRIBUTIONS MADE IN THE CURRENT AND 5 PRIOR CONTRACT YEARS (SEE SECTION 1.05). THE TABLES ASSUME THAT 100% OF ALL CONTRIBUTIONS AND EARNINGS ARE ALLOCATED TO AND REMAIN IN THE GUARANTEED INTEREST DIVISION. YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS. THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A SETTLEMENT WILL BE SUBJECT TO A CHARGE (SEE SECTION 3.04). * ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO SURVIVOR) WITH JOINT ANNUITANT THE SAME AGE AS THE ANNUITANT. No. 92CTRA Page 3 - -------------------------------------------------------------------------------- PART I - DEFINITIONS SECTION 1.01 ANNUITANT. The term "Annuitant" means the individual shown on Page 3 of this Contract for whom this Contract has been purchased. SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in accordance with the terms of a Plan. SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts in the Guaranteed Interest Division, and the Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03 and any loan reserve provision, described in Section 2.10. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by us pursuant to Section 3.04 of this Contract. Various Sections of this Contract (Sections 1.15, 1.16, 1.17, 3.01 and 3.02) refer to "monthly payments" to be made under an Annuity Benefit. The Owner may wish to have your Annuity Benefit paid at other intervals, such as quarterly, semi-annually, or annually, instead of monthly. The Owner may elect this at the time the Annuity Benefit form is elected as described in Section 3.03; in that event, all references in this Contract to "monthly payments" will be deemed to mean payments at the frequency you elect subject to our rules at the time of election. SECTION 1.05 CASH VALUE. The term "Cash Value" means an amount equal to the greater of (i) or (ii), less any outstanding loan, where (i) is the Annuity Account Value less 6% of the Contributions made during the current and five prior Contract Years, which had not been previously withdrawn pursuant to Section 2.07, and (ii) is the sum of (a) the Free Corridor Amount as defined in Section 2.09 and (b) 94% of the Annuity Account Value less the Free Corridor Amount. NO WITHDRAWAL CHARGE: If you have attained the age of 59 years and 6 months, the term "Cash Value" means an amount equal to he Annuity Account Value for withdrawals due to retirement or termination of employment. Your retirement or termination of employment must be verified by the Trustee. Such verification should be in the form of a statement signed by the Trustee and accompanying the request for withdrawal. The request for withdrawal must be signed by both you and the Trustee. The withdrawal charge will be imposed if this verification is not received at our Processing Office together with the withdrawal request. However, if the Annuitant is age 60 or older on the Contract Date and it is Contract Year 5, item (ii)(b) above will be 95% of the Annuity Account Value less the Free Corridor Amount. SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all Contracts with a Contract Date in the same calendar year. The term "Contract" means this Contract. SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.08 CONTRACT DATE. The term "Contract Date" means the date of receipt by us of both the application for this Contract, properly signed and completed, and a Contribution. SECTION 1.09 CONTRACT YEAR. The term "Contract Year" means the twelve month period beginning on (i) the Contract Date, and (ii) each anniversary thereafter, unless otherwise agreed to in writing by us. SECTION 1.10 CONTRIBUTION. The term "Contribution" means a payment made to us on your behalf with respect to this Contract. We are under no obligation to accept any Contribution less than $20.00. SECTION 1.11 DIVISIONS. The terms "Division" or "Divisions" mean, singly or severally as the case may be, the following divisions described in this Contract: (i) the Guaranteed Interest Division, and (ii) the Investment Divisions of the Separate Account. No. 92CTRA Page 4 SECTION 1.12 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by us which extends beyond your attainment of age 59 years and 6 months and does not permit any prepayment of the unpaid principal (that is, no withdrawal or single sum payment) prior to your attainment of age 59 years and 6 months. SECTION 1.13 EMPLOYER. The term "Employer" means the corporate employer adopting the Plan, or any such employer that assumes in writing the obligations of the Plan. SECTION 1.14 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means the interest that we credit at effective annual rates in the Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of this Contract. Section 2.03 describes the determination of the rate to apply thereafter. SECTION 1.15 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.16 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity issued by us providing monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.17 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under this Contract means, (i) if you have a living spouse at your Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with your spouse as the contingent annuitant (with 100% of the monthly payment continued to your spouse), and (ii) if you do not have a living spouse at your Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.18 OWNER. The term "Owner" of the Contract is the person or entity as stated on Page 3 of this Contract. Notwithstanding any provisions in this Contract to the contrary, only the Owner can exercise all the rights under this Contract while you are living. When exercising such right, the Owner does not need the consent of anyone who has only a conditional or future ownership interest in this Contract unless the Owner delegates rights to such person. Under this Contract the Owner is the Trustee, defined in Section 1.27. While you are living, the Owner of this Contract on your behalf may change the Owner by written notice satisfactory to us. The change will take effect on the date the Owner signs the notice, except it will not apply to any payment we make or other actions we take before we receive the notice. SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by us which does not permit any prepayment of the unpaid principal, (that is, you cannot elect to receive part of your payments as a single sum payment with the remainder paid in monthly annuity payments). SECTION 1.20 PLAN. The term "Plan" means a defined contribution plan adopted by the Employer that is intended to meet the requirements for qualification under Section 401(a) of the Code. SECTION 1.21 PROCESSING OFFICE. The term "Processing Office" means our Individual Annuity Center, P.O. Box 2996, G.P.O., New York, New York 10116, or such other location as we shall designate by advance written notice to the Owner, the Employer or the Plan's trustee, as applicable, and to you. SECTION 1.22 RETIREMENT DATE. The term "Retirement Date" means the date on which you attain the retirement age as shown on Page 3 of this Contract. Before the Retirement Date an election may be made to change the Retirement Date to another Retirement Date permitted under the Plan, which may be any date after the filing of the election other than the 29th, 30th or 31st day of any month. The Retirement Date selected, either initially, or by later change, must be in accordance with the terms of the Plan. No Retirement Date shall be later than the date you attain age 70 years and 6 months. Any election for such change must be made in writing by you and shall not take effect until received by us at our Processing Office. SECTION 1.23 SEPARATE ACCOUNT. The term "Separate Account" means Separate Account A which is organized as a unit investment trust, a type of investment company. We established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited to or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts and No. 92CTRA Page 5 certificates. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities or variable life insurance. The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to these contracts will not be chargeable with liabilities arising out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to our General Account. The Separate Account consists of "Investment Divisions". Each Investment Division may invest its assets in a separate class (or series) of shares of a designated Trust or investment company where each class (or series) represents a separate portfolio in the Trust. We reserve the right to change the designated trust or investment company or to add designated trusts or investment companies. The Investment Divisions available are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. The Guaranteed Interest Division is not part of the Separate Account, but rather is an asset of our General Account. We will value the assets of each Investment Division on each business Day. A business day is any day on which we are open, the New York Exchange is open for trading and there is a sufficient degree of trading in the portfolio securities in which an Investment Division is invested to materially affect the Accumulation Unit Value. We may, at our discretion, invest the assets of any Investment Division in any investment permitted by applicable law. We may rely conclusively on the opinion of counsel (including attorneys in our employ) as to what investments we are permitted by law to make. We reserve the right to (i) cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such committee at any time; (iii) restrict or eliminate any of the Owner's voting rights as to the Separate Account; (iv) operate the Separate Account by making direct investments, or in any other form; (v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or remove Investment Divisions (or sub-divisions of Investment Divisions) from the Separate Account (the term "Investment Division" in this Contract shall then refer to any other Investment Division in which the assets, of a class of contracts to which this Contract belongs, were placed); (vi) combine any two or more Investment Divisions (or sub-divisions of Investment Divisions) of the Separate Account; and (vii) withdraw from any Investment Division and to allocate to another Investment Division assets determined by us to be associated with the class of contracts to which this contract belongs. If the exercise of these rights results in a material change in the underlying investments of an Investment Division, the Owner and you will be notified of such exercise, as required by law. Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for applicable tax charge) at a rate not to exceed 1.49% per year for each of the Stock, Money Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock Division, for financial accounting, death benefits, mortality risk, expenses and expense risk. The charge shall be made in accordance with Subsection (c) of the Net Investment Factor provision in Section 1.24. The relative proportion of these charges may be modified. This daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust, shall not exceed a total annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to this Contract. SECTION 1.24 SEPARATE ACCOUNT DEFINITIONS. VALUATION PERIOD: Each business day together with any consecutive preceding nonbusiness days. NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b), minus (c), where No. 92CTRA Page 6 (a) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the Valuation Period before giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period. For this purpose, we use the share value reported to us by the Trust. (b) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the preceding Valuation Period (after any amounts allocated or withdrawn for that Valuation Period). (c) is the daily Separate Account charge for the expenses of this Contract times the number of calendar days in the Valuation Period. ACCUMULATION UNIT: An "Accumulation Unit" is the unit which is purchased in an Investment Division where Contributions are invested and which is used in determining the amount in an Investment Division. ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of each Accumulation Unit in an Investment Division on a given date. The Accumulation Unit Value for a Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such Valuation Period. ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable from the Stock Division of the Separate Account under a Variable Annuity Benefits as defined in Section 3.02. ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1, 1968. On August 27, 1981, the date the first contribution was put into the Stock Division, the Annuity Unit Value was at $1.26 and $1.52 for contracts with Assumed Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar month is equal to the average of the Annuity Unit Value for all Valuation Periods ending in such month. SECTION 1.25 TRANSACTION DATE. The term "Transaction Date" means the business day we receive a Contribution or a written contract transaction request providing the information we need at the Processing Office. In the case of a transfer request initiated through the use of a touch tone telephone, as described in Section 2.05, the Transaction Date is the business day the telephone transaction is received. SECTION 1.26 TRUST. The term "Trust" means the designated trust or investment company in which Separate Account assets are invested. SECTION 1.27 TRUSTEE. The term "Trustee" means the person or persons named as trustee under a Trusteed Plan and such trustee's successors. Under this Contract, the Trustee is the Owner. SECTION 1.28 TRUSTEED PLAN. The term "Trusteed Plan" means a Plan under which there is maintained a trust forming a part of the Plan. - ------------------------------------------------------------------------------- PART II - ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. The Employer or the Trustee, as applicable, is to make Contributions from time to time on such dates and in such amounts as determined by the Employer pursuant to the terms of the Plan. The Employer or the Trustee is to specify the amount allocated to each Division. Each contribution, received by us will, before its allocation under this Contract, be reduced by the amount of any applicable tax charge as determined by us. Contributions will be allocated to the Division in accordance with instructions received on the application unless later changed. Pursuant to the terms of the Plan, we will accept rollover contributions and transfers made on your behalf from a plan qualified under 401(a) of the Code or from a conduit individual retirement arrangement as described in Section 408 of the Code. SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when an amount is allocated to, or withdrawn or transferred from, an Investment Division, the Annuity Account Value will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing No. 92CTRA Page 7 said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Section 2.07, 2.08, 2.10 or 2.11 or transferred from the Investment Division pursuant to Section 2.05. The amount in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units in the Investment Division on that date and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under this Contract terminates on the earliest of (i) Election and Commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii) termination of this Contract pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division becomes part of our general assets which support the guarantees of this Contract and other contracts. The amount in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 or Section 2.10 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Section 2.07, 2.08, 2.10 or 2.11 or transferred from the Guaranteed Interest Division pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division on a Transaction Date pursuant to Section 2.04. We will credit the amount in the Guaranteed Interest Division with interest at effective annual rates that we determine. For each Class of Contracts we determine a yearly guaranteed interest rate that will remain in effect throughout the next year. We guarantee that this yearly guaranteed interest rate will never be less than 3%. Participation in the Guaranteed Interest Division under this Contract terminates on the earliest of (i) Election and Commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii) termination of this Contract pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section 2.01 is allocated (after deduction of any applicable tax charge) to one or more Divisions, as specified to us in writing. Allocation percentages must be in whole numbers and the sum must equal 100. The allocation is made as of the Transaction Date on which we have received both such Contribution and such direction. Contributions made to an Investment Division purchase Accumulation Units in that Investment Division, using the Accumulation Unit Value next computed after the Transaction Date. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the Transaction Date with respect to each transfer from the Division pursuant to Section 2.05, (iii) on the Transaction Date with respect to each withdrawal pursuant to Section 2.07, (iv) at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, (v) upon termination of this Contract pursuant to Section 2.06, and (vi) upon your death pursuant to Section 2.12. SECTION 2.05 TRANSFERS AMONG DIVISIONS. Upon written request or through the use of a touch tone telephone, the Owner may transfer all or part of the amounts in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; and (2) amounts in the Money Market Division may be transferred to other Divisions. Written authorization for touch tone telephone initiated transfers is only required when authorization for telephone transfers is requested. (Upon advance written notice to the Owner, we reserve the right to discontinue the acceptance of transfer requests through the use of a touch tone telephone.) All transfers will be made on the Transaction Date and will be subject to our rules in effect at the time of transfer. With respect to the Investment Divisions, the transfer will be made at the Accumulation Unit Value next computed after the Transaction Date. No transfers are permitted to the Money Market Division from the other Divisions. SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the terms of the Plan, including the spousal consent rules set forth in Section 3.06, the Owner may elect by written notice to terminate this Contract. We will determine the Cash Value of this Contract as of the Transaction Date. If this Contract is terminated, surrendered or exchanged prior to the Retirement Date, any applicable tax charges we have paid may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on terminations, unless a change in applicable law has occurred with respect to this Contract. The payment of such Cash Value may be deferred by us in accordance with the provisions of Section 4.07. No. 92CTRA Page 8 Subject to the terms of the Plan, we reserve the right to pay the Annuity Account Value less any outstanding loan under this Contract and terminate this Contract if (i) no Contributions are made on your behalf during the last three completed Contract Years, and the Annuity Account Value is less than $500 or (ii) a partial withdrawal is made that would result in your Annuity Account Value falling below $500. We reserve the right to terminate this Contract if no contributions have been made within 120 days of the Contract Date. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount in the Divisions under this Contract and the Annuity Account Value with respect to this Contract shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any restrictions under the terms of the Plan, the Owner may elect, by written notice to us, to make a partial withdrawal from the Divisions. Partial withdrawals are subject to the spousal consent rules set forth in Section 3.06. On the Transaction Date, we will pay the lesser of the Cash Value or the amount of partial withdrawal requested to the Owner (or such other person designated by the Owner to us in advance via written instructions). The amount paid plus any withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the amounts in the Divisions. Unless instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts in such Divisions. Upon any partial withdrawal payment, we will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by us in accordance with the provisions of Section 4.07. We may decline to accept a request for a partial withdrawal of less than $300. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, we will so advise the Owner and reserve the right to pay the Annuity Account Value less any outstanding loan, and terminate this Contract. SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. There will be no partial withdrawal charge if the amount of the partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.09. However, if the amount of partial withdrawal requested is greater than the Free Corridor Amount, we will (i) first withdraw from the Divisions an amount equal to the excess of the amount requested over the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge, if applicable. Such withdrawal charge will be calculated in the following manner: (a) Withdrawals of Contributions made on your behalf during the current and five prior Contract Years will be subject to a charge of 6% of the amount withdrawn (including such charge). (b) Withdrawals of other amounts will not be subject to any withdrawal charges. For purposes of determining withdrawal charges described in this Section, amounts withdrawn up to the Free Corridor Amount will not be considered a withdrawal of any Contributions. Any excess withdrawals, i.e. those pursuant to item (ii) above, shall be considered withdrawals of Contributions in the order received, with the older Contributions first. With respect to partial withdrawals requested by the Owner, there will be no partial withdrawal charge if (i) you have completed at least 5 Contract Years and you have attained the age of 59 years and 6 months or (ii) you have attained age 59 years and 6 months and have retired or terminated employment. Your retirement or termination of employment must be verified by the Trustee. Such verification should be in the form of a statement signed by the Trustee and accompanying the request for withdrawal. The request for withdrawal must be signed by both you and the Trustee. The partial withdrawal charge will be imposed if this verification is not received at our Processing Office together with the withdrawal request. If withdrawals are made from this Contract prior to the Retirement Date, any applicable tax charges we have paid with respect to this Contract may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on withdrawals, unless a change in applicable law has occurred with respect to this Contract. SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means an amount equal to the excess, if any, of (i) 10% of the Annuity Account Value on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the current Contract Year. No. 92CTRA Page 9 SECTION 2.10 LOANS. Unless otherwise restricted by the Plan, or the Code, the Owner may get a loan under this Contract on your behalf before the Election and Commencement of Annuity Benefits, if an agreement between the Owner and us relating to such loan ("Trustee Agreement") has been executed and is in effect on the "Loan Effective Date", as defined below. Plan loans are subject to the spousal consent rules set forth in Section 3.06. Future restrictions in the Code may require revision or withdrawal of the loan provisions as provided below. The Annuity Account Value (including the loan reserve account as described below) will be the sole security for the loan. If your loan agreement and application form ("Loan Agreement") is properly completed and signed by you, approved by the Owner, accepted by us and received at the Processing Office by the 15th of the month, the loan is effective on the first day of the following month. If your Loan Agreement is properly completed and signed by you, approved by the Owner, accepted by us and received at the Processing Office after the 15th of the month, the loan is effective on the first day of the second month following. The Owner may establish a reasonable interest rate for the loan provided that such rate is not (1) less than an effective annual rate of 6% or (2) greater than the maximum rate permitted by applicable laws. Beginning the first day of the third month following the effective date of the loan and quarterly on the first day of the month thereafter, loan repayments must be made to us. Loan requests shall be amortized in substantially level payments over the term of the loan. If the effective annual rate of the loan is 6%, such repayments will be equal to the sum of (a) and (b) where (a) is the loan interest, calculated at an effective annual rate of 6%; and (b) is an amortized portion of the loan principal. If the effective annual rate of the loan is greater than 6%, such payments will be equal to the sum of (a), (b) and (c) where (a) is the loan interest, calculated at an effective annual rate of 6%, (b) is an amortized portion of the loan principal, and (c) is the loan interest, calculated at the effective annual rate determined by the Owner less the loan interest calculated at an effective annual rate of 6% ("Excess Interest"). Any Excess Interest received by us will be allocated among the Divisions in accordance with Section 2.04 and may be withdrawn, transferred or annuitized as described in this Contract. By each due date, if the amount of the loan payment is less than the amortized loan interest and principal due calculated at an effective annual rate of 6% or the loan repayment is not received at our Processing Office, we will deduct and treat as a partial withdrawal from the loan reserve account an amount equal to the amortized interest and principal payments due plus any applicable withdrawal charges and any required income tax withholding. Specifically, an amount equal to the principal payment will be deducted from the portion of the loan reserve account which earns interest at an effective annual rate of 4%, and an amount equal to the interest payment, calculated at the effective annual rate of 6%, plus any applicable withdrawal charges and required income tax withholding will be deducted from the portion of the loan reserve account which earns interest at the Guaranteed Interest Rate. Amounts deducted, if the amount of the loan repayment is less than the amount due or the loan payment is not received at our Processing Office, may be reportable to the IRS and other appropriate government authorities as taxable distributions. In addition, you may be subject to a 10% penalty tax on the taxable portion of the amounts deducted. The amount of the loan may not be more than 50% of the Annuity Account Value. In no event shall the loan amount exceed $50,000 less the highest outstanding balance under this Contract during the one year period ending the day before the effective date of the loan. The minimum loan permitted is $1,000. For this purpose, the Annuity Account Value is taken as of the Loan Effective Date. Only one outstanding loan is permitted at a time under this Contract. As a condition for granting a loan, we will require you to represent that the loan amount requested, when aggregated with loans (principal plus interest) from all qualified plans of your Employer, does not exceed 50% of the value of your nonforfeitable accrued benefits, and in no event exceeds $50,000 less the highest outstanding balance of all loans from qualified plans during the one year period ending on the day before the effective date of the loan. The provisions of this Contract require spousal consent in order to receive a loan if you are married. No. 92CTRA Page 10 The loan term will be either (i) ten years, if you represent that the purpose of the loan is to acquire, build or substantially rehabilitate a dwelling unit which, within a reasonable period of time, is to be used as your principal residence or (ii) five years. In any event, the loan term may not extend beyond the earlier of (i) the Election and Commencement of Annuity Benefits pursuant to Section 3.03, (ii) the date we receive written notice to terminate this Contract pursuant to Section 2.06, (iii) the date we pay a death benefit pursuant to Section 2.12, and (iv) any date provided for such loans by future Federal tax rules including acceleration of the loan repayment in order that the operation of the loan provisions do not adversely affect the tax treatment of this Contract. Future Federal tax rules may also impose certain additional requirements to obtain the ten year loan period described above which may apply to existing ten year loans. On the Loan Effective Date, we will transfer to a loan reserve account an amount equal to the sum of (i) the loan amount, which will earn interest at the effective annual rate of 4% during the loan term and (ii) 25% of the loan amount, which will earn interest at the Guaranteed Interest Rate, as defined in this Contract. With the Owner's approval you may specify from which Divisions these amounts are to be transferred. In the absence of direction from the Owner, or if your directions cover only part of the amount required to be transferred to the loan reserve account, we will transfer the required (or additional required) amounts from each Division in proportion to the amount that you have in such Division. On the first day of the third month following the effective date of the loan and quarterly thereafter (or first business day thereafter, if such day is not a business day), the amount of interest earned at 4% annually during the prior quarter will be transferred to the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. The loan must be repaid in part on each quarterly due date and may be repaid in full at any time on or after the first loan anniversary and must include the full interest due. Any payments received will first be applied to interest due, with the balance applied towards repayment of the loan. Any partial loan repayment will result in a transfer of the amount equal to the principal repaid from (i) the portion of the loan reserve account that earns interest at the effective annual rate of 4% to (ii) the Guaranteed Interest Division and may be withdrawn, transferred or annuitized as described in this Contract. Partial withdrawals or transfers may not be made from the loan reserve account. Upon full repayment of the loan, any amounts remaining in the loan reserve account will be transferred to the Guaranteed Interest Division and may be withdrawn, transferred or annuitized as described in this Contract. Upon termination of this Contract pursuant to Section 2.06 or 2.12 or annuitization pursuant to Section 3.04 prior to the full repayment of the loan, the loan reserve account shall be zero. SECTION 2.11 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract Year, if the Annuity Account Value on that date is less than $25,000, we will withdraw from the Divisions an Annual Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account Value including the amount of any withdrawals pursuant to Section 2.07 during that Contract Year. The charge will be allocated among the Divisions in proportion to the amounts in the Divisions. For this purpose, any loan reserve account is included within the Guaranteed Interest Division. The portion of the charge attributable to the Guaranteed Interest Division and any loan reserve account will be first withdrawn from the Guaranteed Interest Division and then, if the amount in the Guaranteed Interest Division is not sufficient, the remaining allocation will be withdrawn from the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. If the Annuity Account Value is less than $25,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of termination of this Contract pursuant to Section 2.06 or 2.12, we will prorate the Annual Administrative Charge applicable to the completed portion of the current Contract Year and withdraw such amount in lieu of the Annual Administrative Charge described in this Section for the applicable part of that Contract Year. If the Annuity Account Value is $25,000 or greater at the end of a Contract Year, the Annual Administrative charge is zero. SECTION 2.12 DEATH BENEFIT. If we ascertain that you have died while you have amounts in the Divisions, we will, upon receipt of due proof of your death, and subject to the terms of the Plan including the spousal survivor benefit rules set forth in Section 3.06, pay to the beneficiary designated to receive such payment under Section 4.04 of this Contract, the death benefit payable. If the beneficiary under this Contract is the Trustee, the Trustee may, subject to the terms of the Plan, change the beneficiary within 31 days after we receive due proof of your death. The change shall be made in the same manner and subject to the same provisions as apply to a change of beneficiary during your lifetime. No. 92CTRA Page 11 If the Trustee changes the beneficiary of this Contract after your death according to the terms of the Plan, the Trustee may elect an Annuity Benefit on any annuity form offered by us or one of our affiliated or subsidiary life insurance companies, subject to our rules then in effect, for the benefit of the beneficiary. The beneficiary may not revoke or change any election made by the Trustee. If the Trustee does not make an election, the beneficiary may make such election for the beneficiary's own benefit. Any election of an Annuity Benefit must meet the minimum distribution requirements as described in Section 3.05. If the beneficiary under this Contract is not the Trustee, and you are married at the time of your death, we will pay the death benefit under this Contract to your spouse in the form of a Life Annuity, unless your spouse makes an election for a single sum payment or for an Annuity Benefit on any other annuity form offered by us, subject to our rules then in effect. Any election of an Annuity Benefit must meet the minimum distribution requirements as described in Section 3.05. The amount of the death benefit is equal to the greater of (i) the Annuity Account Value less any outstanding loan and (ii) the minimum death benefit. Such minimum death benefit is the sum of all Contributions made pursuant to Section 2.01 (before reduction for any applicable tax charge) less any outstanding loan and less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount being withdrawn is to the Annuity Account Value. Upon payment of the death benefit, the amount you have in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability from which the Annuity Account Value arose. - ------------------------------------------------------------------------------- PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the terms of this Contract with respect to a payee is the amount provided pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Stock Division of the Separate Account. Such Variable Annuity Benefit will increase if the average daily rate of investment return in the Stock Division is equivalent to more than 6.75% or 5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25% annually, depending on whether the applicable assumed base rate of Net Investment Return referred to in Section 1.24 is 5% or 3.5%, respectively. The daily rate of investment return is before deduction of charges, as described in Section 1.23, not to exceed the maximum rate of 1.75% after any deductions to provide for any applicable tax charge. These charges include a daily charge for financial accounting, death benefits, mortality risk, expenses and expense risk, plus the investment advisory fee charges and direct operating expense charges of the Trust. The amount of the first, second and third payments under any Variable Annuity Benefit provided under the terms of this Contract with respect to a payee is the monthly amount provided with respect to a payee pursuant to the fourth paragraph of Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. (As described in Section 3.05, we will notify the payee how each Variable Annuity payment is determined.) SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. Subject to the terms of the Plan, including the spousal consent and survivor rules described in Section 3.06, as of your Retirement Date, provided you are then living, the Annuity Account Value less any outstanding loan shall be applied to provide the Normal Form of Annuity Benefit, unless an election is made (i) to receive the Cash Value of this Contract in a single sum, (ii) to apply the Annuity Account Value, (less any outstanding loan as set forth in Section 2.10) or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by us or one of our affiliated or subsidiary life insurance companies, or (iii) to take partial withdrawals in amounts and at times as required by the minimum distribution rules of Section 401(a)(9) of the Code and applicable Treasury Regulations, pursuant to Section 3.05, subject to our rules then in effect and any other applicable requirements under the Code. No. 92CTRA Page 12 We will provide notice and election forms to the Owner not more than six months before your Retirement Date. If an election is made to terminate this Contract pursuant to Section 2.06, an election may be made to receive an Annuity Benefit in lieu of the Cash Value. We will have the right to require pertinent information to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. We may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary life insurance companies. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If, pursuant to the first or third paragraph of Section 3.03, an election is made to receive an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value less any outstanding loan if the annuity form elected involves life contingencies or (ii) the Cash Value if the annuity form elected does not involve life contingencies. The amount applied to provide an Annuity Benefit may be reduced by any applicable tax charge on annuity considerations, as we determine. If we have previously deducted any applicable tax charges from Contributions as provided in Section 2.01, we will not again deduct charges for the same taxes before application to provide an Annuity Benefit, unless a change in applicable law has occurred with respect to this Contract. The balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) our current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, your Contract will be governed by our supplementary contract then in effect. The amount to be applied to provide an Annuity Benefit will, in addition to any tax charge reduction, be reduced by an administrative charge. The amount of such charge will be determined from time to time in accordance with our general practices applicable on a uniform basis to all contracts of the same type as this Contract. After the application of an amount to provide an Annuity Benefit, the amounts in the Divisions and the Annuity Account Value shall be zero. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the terms of this Contract, as indicated, on the Joint and Survivor Life Annuity Form (with 100% of the amount of your payment continued to your spouse). The amount of income provided under the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form, is based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females at age zero. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form are based on a 50-50 split of males and females at age zero and an Assumed Base Rate of Net Investment Return of 3.5% or 5%, whichever applies pursuant to Section 1.24. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females at age zero if such annuity form provides for a Fixed Annuity Benefit, and on the projected 1983 Basic Table "a" adjusted to a unisex basis based on a 50-50 split of males and females at age zero and an Assumed Base Rate of Net Investment Income Return of 5% or 3.5%, whichever applies pursuant to Section 1.24, if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract will be distributed or begin to be distributed, in accordance with Section 401(a)(9) of the Code and the applicable Treasury Regulations thereunder, no later than the first day of April following the calendar year in which you attain age 70 years and 6 months ("Required Beginning Date") or such later date as specified in such Section or regulations. Your entire interest may be distributed, as you elect, over (a) your life, or the lives of you and your designated beneficiary, or (b) a period certain not extending beyond your life expectancy, or the joint and last survivor expectancy of you and your designated beneficiary. Distributions must be made in periodic payments at intervals of no longer than one year. In addition, payments must be either nonincreasing or they may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the Proposed Treasury Regulations, or any successor Regulation thereto. All distributions made hereunder shall be made in accordance with the requirements of Section 401(a)(9) of the Code, including the incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and applicable Treasury Regulations, including the minimum distribution incidental benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or any successor Regulation thereto. Notwithstanding the above paragraphs and the following paragraphs of this Section 3.05, while any distribution shall be subject to such requirements of the Code and regulations, any distribution shall also be subject to the terms of this Contract. That is, the forms of distribution shall be those which are made available by us at the time of your election. No. 92CTRA Page 13 For purposes of determining the "period certain" referred to in the first paragraph of this Section, life expectancy is computed by use of the expected return multiples in Table V and VI of Treasury Regulation Section 1.72-9. Unless you otherwise elect prior to the time distributions are required to begin, those life expectancies shall be recalculated annually. Such election shall be irrevocable and shall apply to all subsequent years. The life expectancy of a non-spouse beneficiary may not be recalculated. Instead, life expectancy will be calculated using the attained age of such beneficiary during the calendar year in which you attain age 70 years and 6 months, and payments for subsequent years shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. If you die after distribution of your interest described in this Contract has begun, the remaining portion of such interest will continue to be distributed as rapidly as under the method of distribution being used prior to your death. If you die before distribution of your interest begins, distribution of your entire interest shall be completed no later than December 31 of the calendar year containing the fifth anniversary of your death, except to the extent that an election is made to receive death benefit distributions in accordance with (1) or (2) below: (1) If your interest is payable to a designated beneficiary, then your entire interest may be distributed over the life of, or over a period certain not greater than the life expectancy of, the designated beneficiary. Such distributions must commence on or before December 31 of the calendar year immediately following the calendar year of your death. (2) If the designated beneficiary is your surviving spouse, the date distributions that are required to begin in accordance with (1) above shall not be earlier than the later of (A) December 31 of the calendar year immediately following the calendar year of your death or (B) December 31 of the calendar year in which you would have attained age 70 years and 6 months. For purposes of determining the "period certain" referred to in the immediately preceding paragraph, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of distributions beginning after your death, unless otherwise elected by the surviving spouse by the time distributions are required to begin, life expectancies shall be recalculated annually. Such election shall be irrevocable by the surviving spouse and shall apply to all subsequent years. In the case of any other designated beneficiary, life expectancies shall be calculated using the attained age of such beneficiary during the calendar year in which distributions are required to begin pursuant to this Section, and payments for any subsequent calendar year shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. Distributions under this Section are considered to have begun if distributions are made because you have reached your Required Beginning Date or if prior to the Required Beginning Date distributions irrevocably commence to you over a period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1 of the Proposed Treasury Regulations or any successor Regulation thereto. Evidence of each payee's survival must be furnished to us either by personal endorsement of the check drawn for payment or by other means satisfactory to us. If a benefit payment under the terms of this Contract was based on information that is subsequently found to be incorrect, benefits will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by us will be charged against and underpayments will be added to any payments thereafter falling due under the terms of this Contract with respect to a payee, affecting as many such payments as are necessary to correct the overpayment or underpayment. Our liability with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under this Contract. If we receive evidence satisfactory to us that (i) a payee entitled to receive any payment under the terms of this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, we may, unless the Plan provides to the contrary, make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If a variable annuity form made available by us provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. No. 92CTRA Page 14 Upon an election, pursuant to Section 3.03, of an annuity form providing payments for a period certain, such Owner may designate (in accordance with the terms of the Plan and with the right to change such designation in accordance with the terms of the Plan) a payee to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person unless the Plan provides to the contrary) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's estate in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, we will pay in a single sum to such payee's estate the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis applicable in determining the annuity amount. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. We will require satisfactory evidence of the age of any person upon whose life an annuity form depends.
- ------------------------------------------------------------------------------ TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE (Minimum Monthly Income per $1,000 of Annuity Account Value) - ---------------------------------------------------------------------------------------------------------------------------------- Age 60 61 62 63 64 65 66 67 68 69 70 - ---------------------------------------------------------------------------------------------------------------------------------- 60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88 61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96 62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03 63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11 64 4.89 4.94 5.00 5.05 5.10 5.14 5.19 65 5.00 5.06 5.11 5.17 5.22 5.27 66 5.12 5.18 5.24 5.29 5.35 67 5.24 5.31 5.37 5.43 68 5.37 5.44 5.51 69 5.52 5.59 70 5.67 - ----------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Account Value) - ------------------------------------------------------------- VARIABLE ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS Age 3.5% 5% - ------------------------------------------------------------- 60 5.27 6.16 61 5.39 6.28 62 5.52 6.41 63 5.66 6.55 64 5.81 6.70 65 5.97 6.86 66 6.15 7.03 67 6.33 7.21 68 6.53 7.41 69 6.74 7.62 70 6.97 7.85 - ------------------------------------------------------------- We will, with respect to each payment under a Variable Annuity Benefit, notify the payee of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each variable payment. Such notice will be mailed with each payment. Any election, change, revocation or designation shall be made, and will take effect on the Transaction Date, in the same manner as a change of beneficiary as described in Section 4.04. If a commutation right under an Annuity Benefit is exercised, we may defer payment in accordance with Section 4.07. No. 92CTRA Page 15 SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS. If you are married, your interest in this Contract shall be paid in the Normal Form joint and survivor annuity, and if you are unmarried, your interest shall be paid in the Normal Form life annuity, unless you elect otherwise as described in this Section. If you are married and die before payment of your interest has commenced, your interest shall be paid to your surviving spouse in the form of a life annuity, unless at the time of your death there was a contrary election made pursuant to this Section. The foregoing notwithstanding, your surviving spouse may elect, before payment is to commence, to have payment made in any form permitted under the terms of this Contract. You may elect, at any time within the 90 consecutive day period before the first day of the first period for which your interest is paid as an annuity or in any other form, not to have your interest paid in the Normal Form in which case it shall be paid in any other form elected under the terms of this Contract. If such interest is to be paid to your spouse upon your death, you may elect, during the period beginning on the first day of the plan year of the Plan in which you attain age 35 (or, if you separate from service prior to that plan year, beginning on the date of separation) and ending with your death, for a beneficiary other than your spouse to receive payment of the value of your interest. In addition, if you will not yet attain age 35 by the end of any current plan year, you may make a special qualified election to designate a beneficiary other than your spouse to receive payment of the value of your interest. Such special qualified election shall be effective for the period beginning on the date of such election and ending on the first day of the plan year in which you will attain age 35. Amounts payable in accordance with this Section will be automatically reinstated as of the first day of the plan year in which you attain age 35 unless a new election designating a beneficiary other than the spouse is made in accordance with the requirements of this Section. Any election described in the foregoing paragraph must be consented to by your spouse in writing before a notary public or a representative of the Plan, unless you can prove that there is no spouse or that the spouse cannot be located. Also, if you have become legally separated from your spouse or have been abandoned (within the meaning of local law) and have a court order to such effect, spousal consent is not required unless a qualified domestic relations order provides otherwise. Your election must designate a specific beneficiary (including any class of beneficiaries or any contingent beneficiaries) that may not be changed without further consent of the spouse, unless the spouse's consent expressly permits designation by you without further consent of the spouse. The spouse's consent under this Section shall acknowledge the effect of the election. In addition, the spouse's consent (or the establishment that the consent of the spouse may not be obtained) shall only be valid with respect to such spouse. Your waiver of the Normal Form joint and survivor annuity shall not be effective unless the election designates a form of benefit payment which may not be changed without spousal consent (or the spouse expressly permits designations by you without any further spousal consent). A consent that permits designations by you without any requirement of further consent by such spouse must acknowledge that the spouse has the right to limit consent to a specific beneficiary, and a specific form of benefit where applicable, and that the spouse voluntarily elects to relinquish either or both of such rights. If you make an election under this Section you may revoke that election, without spousal consent, at any time before the first day of the first period for which an amount is paid as an annuity or in any other form. The provision requiring spousal consent in this Section shall also apply with regard to your election to terminate this Contract or make partial withdrawals pursuant to Sections 2.06 and 2.07 and with respect to a beneficiary designation set forth in Section 4.04. Spousal consent, as described in this Section, is also required in the 90 day period before a Plan loan is granted to you pursuant to Section 2.10. If the Annuity Account Value applied to provide the spousal benefits on the date payment is to commence is in the aggregate less than $3,500, we may choose to make payment in a single sum rather than in the form of a Qualified Joint and Survivor Annuity or Life Annuity as described herein. Upon any payment made pursuant to this Section, we will be released from any and all liability for payment with respect to the Contributions made for you. - ------------------------------------------------------------------------------- PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the parties and the terms of this Contract alone will govern with respect to our rights and obligations. A copy of the application is incorporated in and made part of this Contract. This Contract may not be modified, nor may any of our rights or requirements be waived, except in writing and by our authorized officer. The terms of this Contract may be changed by amendment or replacement upon agreement between the Owner and us without the consent of any other person, provided the change does not reduce any annuity benefit. SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall No. 92CTRA Page 16 include, but not be limited to, the right to conform this Contract to reflect changes in the Code, applicable Treasury Regulations or in regulations or published rulings of the Internal Revenue Service so that this Contract will continue to be an Annuity under a qualified plan. SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY. No interest of yours or of a beneficiary under this Contract may be transferred to any person other than us upon the surrender of this Contract. Except as permitted under Section 401(a)(13) of the Code, no right or interest of you or any other payee or beneficiary in this Contract shall be (a) assignable; (b) subject to any lien; or (c) liable for, or subject to, any obligation or liability of any person. The preceding sentence shall not apply to an assignment, transfer or attachment pursuant to a qualified domestic relations order, as defined in Section 414(p) of the Code. SECTION 4.04 BENEFICIARY. The Owner, as of the Contract Date, is to provide us with an initial designation of the beneficiary entitled to receive any death benefit payable with respect to you pursuant to Section 2.12. Subject to the Plan and spousal consent and survivor rules of Section 3.06, you may change such designation from time to time during your lifetime and while this Contract is in force. If the beneficiary is the Trustee, the Trustee will have the right within 31 days of the day we receive due proof of your death and pursuant to the provisions of the Plan, to change the beneficiary entitled to receive your death benefits. If the Trustee is not the beneficiary, the beneficiary will be your spouse unless he or she has given duly witnessed written consent to the designation of another beneficiary as described in Section 3.06, or you establish prior to your death that he or she cannot be located. Such spousal consent must be on file with the Trustee while this Contract is owned by the Trustee. If the Trustee is not the Owner, such spousal consent must be presented to us with the change of beneficiary request or with proof of your death and election of an Annuity Benefit. SECTION 4.05 DISQUALIFICATION. In the event that the Plan fails to qualify as a Plan under Section 401(a) of the Code and applicable Treasury Regulations, we reserve the right, upon receiving notice of such fact, to transfer the Annuity Account Value under this Contract to another annuity contract issued by us on your life, or one of our affiliated subsidiary life insurance corporations, or to terminate this Contract and pay to the Owner the Annuity Account Value less deduction for applicable taxes, solely at our option. In the event that this Contract fails to qualify as an Annuity under a qualified Plan as described in Section 1.02, we shall have the right, upon receiving notice of such fact, to terminate this Contract and pay at the direction of the Owner the Annuity Account Value less any outstanding loan and less a deduction for the appropriate part attributable to the Owner of any Federal income tax payable which would not have been payable if you had an Annuity. SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to the Employer, we reserve the right at our sole discretion to limit Contributions under this Contract. SECTION 4.07 DEFERMENT. Applications of proceeds to a variable annuity, payment of a death benefit and payment of any portion of your Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange has been closed or trading on it is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Securities Exchange Commission, by order, permits us to defer payments in order to protect persons with interests in the Investment Divisions. We can defer payment of any portion of your Annuity Account Value in the Guaranteed Interest Division for up to six months while you are living. SECTION 4.08. ANNUAL NOTICE. At the end of each Contract Year, we will furnish you with a notice showing the following: (1) the amount in the Guaranteed Interest Division, (2) the total number of Accumulation Units in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Value, (4) the amount in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the amount in the loan reserve account, (6) the Cash Value, and (7) the amount of death benefit. No. 92CTRA Page 17 We will also furnish annual calendar year reports concerning the status of the annuity and any other reports required by the Code or applicable Treasury Regulations. After your Retirement Date, we will notify you of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.09 TRUSTEE'S RESPONSIBILITY. The Trustee shall hold this Contract on your behalf and your beneficiaries as an asset of the trust, unless this Contract is distributed to you pursuant to the terms of the Plan. The Trustee shall be responsible for transferring all payment made under this Contract to the Annuitant and the Annuitant's beneficiaries in accordance with the terms of the Plan and the applicable provisions of the Code. We shall make no payment hereunder without written instructions from the Trustee, and we shall be fully discharged of any liability therefor to the extent such payments are made to and at the direction of the Trustee. SECTION 4.10 AGE. If your age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by us will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. No. 92CTRA Page 18 - ------------------------------------------------------------------------------- APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, New York, New York 10116-2996 QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR: EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY - ------------------------------------------------------------------------------- 1. TYPE OF PURCHASE (Complete One Plan Only) a. | | TSA Public School (GV-PS-I) b. | | TSA 501(c)(3) Organization (GV-501-I) c. | | TSA University (GV-PS-U-I) d. | | IRA Individual (including IRA to IRA transfers) (GV-IRA 4971) e. | | IRA Unit Billed (including IRA to IRA transfers) (GV-IRA 4971) f. | | IRA QUALIFIED PLAN ROLLOVER--(QP IRA) (Distribution from a Qualified Plan) (GV-IRA 4971-71) g. | | EDC (Public Employee Deferred Compensation (GV-EDC 4991) h. | | EDC (Tax Exempt Organization)(GV-EDC 4991-SU-080) i. | | SEP (Simplified Employee Pension)(GV-SEP 4981) j. | | SARSEP (Salary Reduction SEP) ____________ k. |x| CORPORATE TRUSTEED (GV-CORP 4941-41) l. | | KEOGH/HR-10 TRUSTEE (GV HR-10 4911-11) (trustee owned) m. | | Keogh/HR-10 (GV-HR-10 4911) (not trustee owned) (issued to existing units only) - ------------------------------------------------------------------------------- DO NOT COMPLETE THIS SECTION IF BOX 1.d OR 1.f CHECKED ABOVE 2. EMPLOYER/PLAN NAME |A|B|C| | C|O|M|P|A|N|Y| | | | | | | | | | | | | | | | | | | | | | | | | | | 3. | | EXISTING UNIT NO. | | | | | | | - | | |X| NEW UNIT |0|0|0|1|2|3|-|4|5|6| (FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP, OR TRUSTEED PLANS. FORM 983-135B IS REQUIRED.) - ------------------------------------------------------------------------------- 4. PROPOSED ANNUITANT Print name to appear on Contract. |J|o|h|n| | | | | | | | | | | | | | | | | | |O|E | | | | | | | First Middle Initial Last a. |x| Mr. | | Mrs. | | Miss | | Ms. | | Other _______ b. Date of Birth: Year 1954 Month JANUARY Day 27 ----- -------- ---- c. Age at Nearest Birthday: 38 d. |x| Male | | Female ------ e. Annuitant's Mailing Address: f. State of Residence: N.J. ---- No., St. |1|7| |E|L|M| |S|T|R|E|E|T| | | | | | | | | | | | | City |A|N|Y|T|O|W|N| | | | | | | | | | | | | | | | | | State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1| g. Telephone Number (101) 222-3456 |x| Home | | Work h. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9| i. Are you associated with or employed by a member of National Association of Securities Dealers, Inc. (NASD)? | | Yes |x| No 5. OWNER (Print Name) - If Trusteed or EDC Plan Print Name of Owner; for all other Markets Print Name of Annuitant. JOHN DOE ------------------------------------------------------------ a. Title ---------------------------------------------------- 6. RETIREMENT AGE 65 -------------------------------------------- 7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death Benefit upon Annuitant's death before Retirement Date.) BENEFICIARY MUST BE THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS.) JANE DOE - WIFE ----------------------------------------------------------- ----------------------------------------------------------- ----------------------------------------------------------- 8. CONTRIBUTION ALLOCATION Guaranteed Interest Division 20% -- Stock Division 20% -- Money Market Division 20% -- Balanced Division 20% -- Aggressive Stock Division 20% -- (PERCENTAGES IN WHOLE NUMBERS) Total 100% 9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F) a. Reminder Notice (Billing) Required | | Yes |x| No IF YES, complete b-c-d-e b. REMINDER DATE Required for Individual IRA or otherwise must agree with existing unit or attached 983-135B. MONTH _________ DAY _________ c. REMINDER FREQUENCY | | Annual | |Semi-Annual | | Quarterly | |Monthly Available for TSA, EDC, SARSEP AND CORPORATE TRUSTEED AND UNIT BILLED IRA ONLY: | | Semi-Monthly | | Bi-Weekly d. REMINDER AMOUNT $______________________ e. BILLING MONTHS TO BE EXCLUDED - TSA ONLY - ---------------------------------------------------------- - ---------------------------------------------------------- - ---------------------------------------------------------- 10. EXPECTED FIRST CONTRACT YEAR CONTRIBUTION. $ 1000 ----------- If an advanced billing and/or contract date are requested, complete #9b and #12. - -------------------------------------------------------------------------------- (FOR PROCESSING OFFICE USE) Unit Name ____________________________ Reminder Date__________________________ Cert. or App# ________________________ Amendment Required_____________________ EDC Emp. Add._________________________ Emp. Fed. ID # ________________________ Frequency ____________________________ Contract Date _________________________ Receipt Date Batch # Inquiry # Processor - -------------------------------------------------------------------------------- 180-1000 10. Did you receive the Separate Account Prospectus? |x|Yes | |No Date shown on Prospectus January 1, 1992 ----------------------------- Date of any supplement to Prospectus -------------------- 11. Items (a) through (f) are to be answered by the annuitant. We are required by the NASD to ask these questions. (a) Name of Employer: ABC COMPANY ---------------------------------- (b) Address of Employer: 10 MAIN STREET ------------------------------------------------------ ANYTOWN, NJ ------------------------------------------------------ (c) Occupation SALES ------------------------------------------- (d) Assuming the contract applied for will be issued, will any existing insurance or annuity be replaced or changed (or has it been)? | | Yes |x| No (e) Estimated Family Annual Income $100,000 ----------------------- (f) Estimated Net Worth $250,000 ----------------------- (g) Investment Objective: | | Income |x| Income & Growth | | Aggressive Growth | | Growth | | Safety Of Principal 12. SPECIAL INSTRUCTIONS - -------------------------------------------------------------- - -------------------------------------------------------------- - -------------------------------------------------------------- - -------------------------------------------------------------- - -------------------------------------------------------------- 13. AMOUNT PAID WITH THIS FORM: $ 1000 --------- (If a check is submitted with this request, no advanced Contract Date is permitted.) BACKDATING IS NOT PERMITTED. NOTE: Amount paid will be credited upon receipt at Equitable's Processing Office, subject to return if the contract is not issued. The Contract Date will be the date of receipt by Equitable of this application, properly signed and completed, and Contribution at Equitable's Processing Office. - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- AGREEMENT All information and statements furnished in this application are true and complete to the best of my knowledge and belief. I understand and acknowledge that no Agent has the authority to make or modify any contract on Equitable's behalf, or to waive or alter any of Equitable's rights and regulations. IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT. UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S) OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND COMPLETE. - -------------------------------------------------------------------------------- LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR ANNUITY APPLICATION WITH INFORMATION YOU KNOW IS FALSE OR TO LEAVE OUT MATERIAL FACTS - -------------------------------------------------------------------------------- X_________________________________ Date __________ City ___________ State_______ Signature of Annuitant X_________________________________ Date __________ City ___________ State_______ Signature of Authorized Individual (REQUIRED FOR EDC AND TRUSTEED) OR OWNER - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- AGENT'S SECTION Will any existing Insurance or annuity be replaced or changed (or has it been), assuming the Contract will be issued? | | Yes | | No | | | | I (we) certify that a prospectus for the Contract has been given to the proposed Annuitant and that no written sales materials other than those approved by The Equitable have been used. EQUI-VEST issues must adequately reflect the commission interest of all Agents on previous contracts. - ------------------------------------------------------------------------------------------------------------------------------------ Print Agent's Name(s) Initial of Last Agent Agent Agency District Agent's (Service Agent first) Name Number % Code Manager Code Signature - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------ FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS ______ Date ______ District EQS ________ Date ________ - ------------------------------------------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------- (For ASU Use) ASU Code and App. No ________________________________ ASU Rec'd ___________________________________________ ASU Rec'd ___________________________________________ Date to Proc. Off ________________________Campaign | | Agent(s) shown above is Equity Qualified and is licensed in the state where the request is signed. Above Agent information verified by ASM (Registered Rep) - -------------------------------------------------------------------------------- Application reviewed by _________________________________ - -------------------------------------------------------------------------------- 180-1000 [EQUITABLE LOGO] Owner: Annuitant: Contract Number: Issue Date: Contract Date: Retirement Date: - -------------------------------------------------------------------------------- THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P O Box 2996, New York, New York 10116-2996 AGREES o TO ALLOCATE the Contributions made to the Contract, after deduction of any applicable tax charge, to the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division of the Separate Account (referred to in this Contract as the "Investment Divisions")or to the Guaranteed Interest Division, in accordance with Sections 2.02, 2.03 and 2.04, as directed by the Owner, and o TO APPLY the Annuity Account Value at the Retirement Date to provide you with an Annuity Benefit or a Cash Value benefit if you are then living, and o TO PROVIDE the Owner with the other rights and benefits of this Contract. This is the entire Contract. In this Contract, "we", "our" and "us" mean The Equitable Life Assurance Society of the United States. "You" and "your" mean the Annuitant, with respect to a right exercised by the Owner on behalf of the Annuitant. TEN DAYS TO EXAMINE CONTRACT - The Owner may cancel this Contract by returning it to us within ten days after receipt of it. Upon such cancellation, we will refund any Contribution made to us under this Contract, plus or minus any investment gain or loss experienced in the Investment Divisions of the Separate Account from the date such Contribution is allocated to such Investment Division to the date we receive the returned Contract. /s/ Pauline Sherman /s/ Edward D. Miller Pauline Sherman, Vice President, Secretary & Edward D. Miller Associate General Counsel President and Chief Executive Officer THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.24 IS 5% OR 3.5%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISKS, EXPENSES AND EXPENSE RISK, PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE TRUST. No. 92CTRB This Contract is issued in consideration of the payment to us of the Contributions made under the terms of this Contract. The provisions on the following pages are part of this Contract. - -------------------------------------------------------------------------------- TABLE OF CONTENTS DEFINITIONS Page Section 1.01 - Annuitant....................................................4 1.02 - Annuity......................................................4 1.03 - Annuity Account Value........................................4 1.04 - Annuity Benefit..............................................4 1.05 - Cash Value...................................................4 1.06 - Class of Contracts...........................................4 1.07 - Code.........................................................4 1.08 - Contract Date................................................4 1.09 - Contract Year................................................4 1.10 - Contribution.................................................4 1.11 - Divisions....................................................4 1.12 - Eligible Annuity Certain.....................................5 1.13 - Employer.....................................................5 1.14 - Guaranteed Interest Rate.....................................5 1.15 - Joint and Survivor Life Annuity Form.................................................5 1.16 - Life Annuity Form............................................5 1.17 - Normal Form..................................................5 1.18 - Owner........................................................5 1.19 - Period Certain Annuity.......................................5 1.20 - Plan.........................................................5 1.21 - Processing Office............................................5 1.22 - Retirement Date..............................................5 1.23 - Separate Account.............................................5 1.24 - Separate Account Definitions..................................................6 1.25 - Transaction Date.............................................7 1.26 - Trust........................................................7 1.27 - Trustee......................................................7 1.28 - Trusteed Plan................................................7 ANNUITY ACCOUNT VALUE Section 2.01 - Contributions................................................7 2.02 - Separate Account Investment Divisions.........................................7 2.03 - Guaranteed Interest Division.....................................................8 2.04 - Allocation to Divisions......................................8 2.05 - Transfers Among Divisions....................................8 2.06 - Termination of this Contract.................................8 2.07 - Partial Withdrawals..........................................9 2.08 - Charges for Partial Withdrawals..............................9 2.09 - Free Corridor Amount.........................................9 2.10 - Loans.......................................................10 2.11 - Annual Administrative Charge................................11 2.12 - Death Benefit...............................................11 ANNUITY BENEFITS Section 3.01 - Fixed Annuity Benefit.......................................12 3.02 - Variable Annuity Benefit....................................12 3.03 - Election and Commencement Of Annuity Benefits.........................................12 3.04 - Amount of Annuity Benefits..................................13 3.05 - Payment of Annuity Benefits.................................13 3.06 - Special Annuity and Spousal Consent Provisions..........................................16 GENERAL PROVISIONS Section 4.01 - Contract....................................................16 4.02 - Statutory Compliance........................................16 4.03 - Assignments and Nontransferability..........................................17 4.04 - Beneficiary.................................................17 4.05 - Disqualification............................................17 4.06 - Future Contributions........................................17 4.07 - Deferment...................................................17 4.08 - Annual Notice...............................................17 4.09 - Trustee's Responsibility....................................18 4.10 - Age.........................................................18 No. 92CTRB Page 2 - -------------------------------------------------------------------------------- PART I - DEFINITIONS SECTION 1.01 ANNUITANT. The term "Annuitant" means the individual shown on Page 3 of this Contract for whom this Contract has been purchased. SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in accordance with the terms of a Plan. SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts in the Guaranteed Interest Division, and the Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03 and any loan reserve provision, described in Section 2.10. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by us pursuant to Section 3.04 of this Contract. Various Sections of this Contract (Sections 1.15, 1.16, 1.17, 3.01 and 3.02) refer to "monthly payments" to be made under an Annuity Benefit. The Owner may wish to have your Annuity Benefit paid at other intervals, such as quarterly, semi-annually, or annually, instead of monthly. The Owner may elect this at the time the Annuity Benefit form is elected as described in Section 3.03; in that event, all references in this Contract to "monthly payments" will be deemed to mean payments at the frequency you elect subject to our rules at the time of election. SECTION 1.05 CASH VALUE. The term "Cash Value" means an amount equal to the greater of (i) or (ii), less any outstanding loan, where (i) is the Annuity Account Value less 6% of the Contributions made during the current and five prior Contract Years, which had not been previously withdrawn pursuant to Section 2.07, and (ii) is the sum of (a) the Free Corridor Amount as defined in Section 2.09 and (b) 94% of the Annuity Account Value less the Free Corridor Amount. NO WITHDRAWAL CHARGE: If you have attained the age of 59 years and 6 months, the term "Cash Value" means an amount equal to the Annuity Account Value for withdrawals due to retirement or termination of employment. Your retirement or termination of employment must be verified by the Trustee. Such verification should be in the form of a statement signed by the Trustee and accompanying the request for withdrawal. The request for withdrawal must be signed by both you and the Trustee. The withdrawal charge will be imposed if this verification is not received at our Processing Office together with the withdrawal request. However, if the Annuitant is age 60 or older on the Contract Date and it is Contract Year 5, item (ii)(b) above will be 95% of the Annuity Account Value less the Free Corridor Amount. SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all Contracts with a Contract Date in the same calendar year. The term "Contract" means this Contract. SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.08 CONTRACT DATE. The term "Contract Date" means the date of receipt by us of both the application for this Contract, properly signed and completed, and a Contribution. SECTION 1.09 CONTRACT YEAR. The term "Contract Year" means the twelve month period beginning on (i) the Contract Date, and (ii) each anniversary thereafter, unless otherwise agreed to in writing by us. SECTION 1.10 CONTRIBUTION. The term "Contribution" means a payment made to us on your behalf with respect to this Contract. We are under no obligation to accept any Contribution less than $20.00. SECTION 1.11 DIVISIONS. The terms "Division" or "Divisions" mean, singly or severally as the case may be, the following divisions described in this Contract: (i) the Guaranteed Interest Division, and (ii) the Investment Divisions of the Separate Account. No. 92CTRB Page 4 SECTION 1.12 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by us which extends beyond your attainment of age 59 years and 6 months and does not permit any prepayment of the unpaid principal (that is, no withdrawal or single sum payment) prior to your attainment of age 59 years and 6 months. SECTION 1.13 EMPLOYER. The term "Employer" means the corporate employer adopting the Plan, or any such employer that assumes in writing the obligations of the Plan. SECTION 1.14 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means the interest that we credit at effective annual rates in the Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of this Contract. Section 2.03 describes the determination of the rate to apply thereafter. SECTION 1.15 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.16 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity issued by us providing monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.17 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under this Contract means, (i) if you have a living spouse at your Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with your spouse as the contingent annuitant (with 100% of the monthly payment continued to your spouse), and (ii) if you do not have a living spouse at your Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.18 OWNER. The term "Owner" of the Contract is the person or entity as stated on Page 3 of this Contract. Notwithstanding any provisions in this Contract to the contrary, only the Owner can exercise all the rights under this Contract while you are living. When exercising such right, the Owner does not need the consent of anyone who has only a conditional or future ownership interest in this Contract unless the Owner delegates rights to such person. Under this Contract the Owner is the Trustee, defined in Section 1.27. While you are living, the Owner of this Contract on your behalf may change the Owner by written notice satisfactory to us. The change will take effect on the date the Owner signs the notice, except it will not apply to any payment we make or other actions we take before we receive the notice. SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by us which does not permit any prepayment of the unpaid principal, (that is, you cannot elect to receive part of your payments as a single sum payment with the remainder paid in monthly annuity payments). SECTION 1.20 PLAN. The term "Plan" means a defined contribution plan adopted by the Employer that is intended to meet the requirements for qualification under Section 401(a) of the Code. SECTION 1.21 PROCESSING OFFICE. The term "Processing Office" means our Individual Annuity Center, P O Box 2996, New York, New York 10116-2996, or such other location as we shall designate by advance written notice to the Owner, the Employer or the Plan's trustee, as applicable, and to you. SECTION 1.22 RETIREMENT DATE. The term "Retirement Date" means the date on which you attain the retirement age as shown on Page 3 of this Contract. Before the Retirement Date an election may be made to change the Retirement Date to another Retirement Date permitted under the Plan, which may be any date after the filing of the election other than the 29th, 30th or 31st day of any month. The Retirement Date selected, either initially or by later change, must be in accordance with the terms of the Plan. No Retirement Date shall be later than the date you attain age 70 years and 6 months. Any election for such change must be made in writing by you and shall not take effect until received by us at our Processing Office. SECTION 1.23 SEPARATE ACCOUNT. The term "Separate Account" means Separate Account A which is organized as a unit investment trust, a type of investment company. We established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited to or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts and certificates. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities or variable life insurance. No. 92CTRB Page 5 The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to these contracts will not be chargeable with liabilities arising out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to our General Account. The Separate Account consists of "Investment Divisions". Each Investment Division may invest its assets in a separate class (or series) of shares of a designated Trust or investment company where each class (or series) represents a separate portfolio in the Trust. We reserve the right to change the designated trust or investment company or to add designated trusts or investment companies. The Investment Divisions available are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. The Guaranteed Interest Division is not part of the Separate Account, but rather is an asset of our General Account. We will value the assets of each Investment Division on each business day. A business day is any day on which we are open, the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio securities in which an Investment Division is invested to materially affect the Accumulation Unit Value. We may, at our discretion, invest the assets of any Investment Division in any investment permitted by applicable law. We may rely conclusively on the opinion of counsel (including attorneys in our employ) as to what investments we are permitted by law to make. We reserve the right to (i) cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such committee at any time; (iii) restrict or eliminate any of the Owner's voting rights as to the Separate Account; (iv) operate the Separate Account by making direct investments, or in any other form; (v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or remove Investment Divisions (or sub-divisions of Investment Divisions) from the Separate Account (the term "Investment Division" in this Contract shall then refer to any other Investment Division in which the assets, of a class of contracts to which this Contract belongs, were placed); (vi) combine any two or more Investment Divisions (or sub-divisions of Investment Divisions) of the Separate Account; and (vii) withdraw from any Investment Division and to allocate to another Investment Division assets determined by us to be associated with the class of contracts to which this Contract belongs. If the exercise of these rights results in a material change in the underlying investments of an Investment Division, the Owner and you will be notified of such exercise, as required by law. Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for applicable tax charge) at a rate not to exceed 1.49% per year for each of the Stock, Money Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock Division, for financial accounting, death benefits, mortality risk, expenses and expense risk. The charge shall be made in accordance with Subsection (c) of the Net Investment Factor provision in Section 1.24. The relative proportion of these charges may be modified. This daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust, shall not exceed a total annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to this Contract. SECTION 1.24 SEPARATE ACCOUNT DEFINITIONS. VALUATION PERIOD: Each business day together with any consecutive preceding nonbusiness days. NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b), minus (c), where No. 92CTRB Page 6 (a) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the Valuation Period before giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period. For this purpose, we use the share value reported to us by the Trust. (b) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the preceding Valuation Period (after any amounts allocated or withdrawn for that Valuation Period). (c) is the daily Separate Account charge for the expenses of this Contract times the number of calendar days in the Valuation Period. ACCUMULATION UNIT: An "Accumulation Unit" is the unit which is purchased in an Investment Division where Contributions are invested and which is used in determining the amount in an Investment Division. ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of each Accumulation Unit in an Investment Division on a given date. The Accumulation Unit Value for a Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such Valuation Period. ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable from the Stock Division of the Separate Account under a Variable Annuity Benefit as defined in Section 3.02. ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1, 1968. On August 27, 1981, the date the first contribution was put into the Stock Division, the Annuity Unit Value was at $1.26 and $1.52 for contracts with Assumed Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods ending in such month. SECTION 1.25 TRANSACTION DATE. The term "Transaction Date" means the business day we receive a Contribution or a written contract transaction request providing the information we need at the Processing Office. In the case of a transfer request initiated through the use of a touch tone telephone, as described in Section 2.05, the Transaction Date is the business day the telephone transaction is received. SECTION 1.26 TRUST. The term "Trust" means the designated trust or investment company in which Separate Account assets are invested. SECTION 1.27 TRUSTEE. The term "Trustee" means the person or persons named as trustee under a Trusteed Plan and such Trustee's successors. Under this Contract, the Trustee is the Owner. SECTION 1.28 TRUSTEED PLAN. The term "Trusteed Plan" means a Plan under which there is maintained a trust forming a part of the Plan. - -------------------------------------------------------------------------------- PART II - ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. The Employer or the Trustee, as applicable, is to make Contributions from time to time on such dates and in such amounts as determined by the Employer pursuant to the terms of the Plan. The Employer or the Trustee is to specify the amount allocated to each Division. Each contribution, received by us will, before its allocation under this Contract, be reduced by the amount of any applicable tax charge as determined by us. Contributions will be allocated to the Division in accordance with instructions received on the application unless later changed. Pursuant to the terms of the Plan, we will accept rollover contributions and transfers made on your behalf from a plan qualified under 401(a) of the Code or from a conduit individual retirement arrangement as described in Section 408 of the Code. SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when an amount is allocated to, or withdrawn or transferred from, an Investment Division, the Annuity Account Value will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units in an Investment Division on any date is equal to (i) the sum of any No. 92CTRB Page 7 Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Sections 2.07, 2.08, 210 or 2.11 or transferred from the Investment Division pursuant to Section 2.05. The amount in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units in the Investment Division on that date and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under this Contract terminates on the earliest of (i) Election and Commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii) termination of this Contract pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division becomes part of our general assets which support the guarantees of this Contract and other contracts. The amount in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 or Section 2.10 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Section 2.07, 2.08, 2.10 or 2.11 or transferred from the Guaranteed Interest Division pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division on a Transaction Date pursuant to Section 2.04. We will credit the amount in the Guaranteed Interest Division with interest at effective annual rates that we determine. For each Class of Contracts we determine a yearly guaranteed interest rate that will remain in effect throughout the next year. We guarantee that this yearly guaranteed interest rate will never be less than 3%. Participation in the Guaranteed Interest Division under this Contract terminates on the earliest of (i) Election and Commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii) termination of this Contract pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section 2.01 is allocated (after deduction of any applicable tax charge) to one or more Divisions, as specified to us in writing. Allocation percentages must be in whole numbers and the sum must equal 100. The allocation is made as of the Transaction Date on which we have received both such Contribution and such direction. Contributions made to an Investment Division purchase Accumulation Units in that Investment Division, using the Accumulation Unit Value next computed after the Transaction Date. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the Transaction Date with respect to each transfer from the Division pursuant to Section 2.05, (iii) on the Transaction Date with respect to each withdrawal pursuant to Section 2.07, (iv) at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, (v) upon termination of this Contract pursuant to Section 2.06, and (vi) upon your death pursuant to Section 2.12. SECTION 2.05 TRANSFERS AMONG DIVISIONS. Upon written request or through the use of a touch tone telephone, the Owner may transfer all or part of the amounts in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; and (2) amounts in the Money Market Division may be transferred to other Divisions. Written authorization for touch tone telephone initiated transfers is only required when authorization for telephone transfers is requested. (Upon advance written notice to the Owner, we reserve the right to discontinue the acceptance of transfer requests through the use of a touch tone telephone.) All transfers will be made on the Transaction Date and will be subject to our rules in effect at the time of transfer. With respect to the Investment Divisions, the transfer will be made at the Accumulation Unit Value next computed after the Transaction Date. No transfers are permitted to the Money Market Division from the other Divisions. SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the terms of the Plan, including the spousal consent rules set forth in Section 3.06, the Owner may elect by written notice to terminate this Contract. We will determine the Cash Value of this Contract as of the Transaction Date. If this Contract is terminated, surrendered or exchanged prior to the Retirement Date, any applicable tax charges we have paid may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on terminations, unless a change in applicable law has occurred with respect to this Contract. The payment of such Cash Value may be deferred by us in accordance with the provisions of Section 4.07. No. 92CTRB Page 8 Subject to the terms of the Plan, we reserve the right to pay the Annuity Account Value less any outstanding loan under this Contract and terminate this Contract if (i) no Contributions are made on your behalf during the last three completed Contract Years, and the Annuity Account Value is less than $500 or (ii) a partial withdrawal is made that would result in your Annuity Account Value falling below $500. We reserve the right to terminate this Contract if no contributions have been made within 120 days of the Contract Date. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount in the Divisions under this Contract and the Annuity Account Value with respect to this Contract shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any restrictions under the terms of the Plan, the Owner may elect, by written notice to us, to make a partial withdrawal from the Divisions. Partial withdrawals are subject to the spousal consent rules set forth in Section 3.06. On the Transaction Date, we will pay the lesser of the Cash Value or the amount of partial withdrawal requested to the Owner (or such other person designated by the Owner to us in advance via written instructions). The amount paid plus any withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the amounts in the Divisions. Unless instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts in such Divisions. Upon any partial withdrawal payment, we will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by us in accordance with the provisions of Section 4.07. We may decline to accept a request for a partial withdrawal of less than $300. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, we will so advise the Owner and reserve the right to pay the Annuity Account Value less any outstanding loan, and terminate this Contract. SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. There will be no partial withdrawal charge if the amount of the partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.09. However, if the amount of partial withdrawal requested is greater than the Free Corridor Amount, we will (i) first withdraw from such Divisions an amount equal to the excess of the amount requested over the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge, if applicable. Such withdrawal charge will be calculated in the following manner: (a) Withdrawals of Contributions made on your behalf during the current and five prior Contract Years will be subject to a charge of 6% of the amount withdrawn (including such charge). (b) Withdrawals of other amounts will not be subject to any withdrawal charges. For purposes of determining withdrawal charges described in this Section, amounts withdrawn up to the Free Corridor Amount will not be considered a withdrawal of any Contributions. Any excess withdrawals, i.e. those pursuant to item (ii) above, shall be considered withdrawals of Contributions in the order received, with the older Contributions first. With respect to partial withdrawals requested by the Owner, there will be no partial withdrawal charge if (i) you have completed at least 5 Contract Years and you have attained the age of 59 years and 6 months or (ii) you have attained age 59 years and 6 months and have retired or terminated employment. Your retirement or termination of employment must be verified by the Trustee. Such verification should be in the form of a statement signed by the Trustee and accompanying the request for withdrawal. The request for withdrawal must be signed by both you and the Trustee. The partial withdrawal charge will be imposed if this verification is not received at our Processing Office together with the withdrawal request. If withdrawals are made from this Contract prior to the Retirement Date, any applicable tax charges we have paid with respect to this Contract may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on withdrawals, unless a change in applicable law has occurred with respect to your Contract. SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means an amount equal to the excess, if any, of (i) 10% of the Annuity Account Value on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the current Contract Year. No. 92CTRB Page 9 SECTION 2.10 LOANS. Unless otherwise restricted by the Plan, or the Code, the Owner may get a loan under this Contract on your behalf before the Election and Commencement of Annuity Benefits, if an agreement between the Owner and us relating to such loan ("Trustee Agreement") has been executed and is in effect on the "Loan Effective Date", as defined below. Plan loans are subject to the spousal consent rules set forth in Section 3.06. Future restrictions in the Code may require revision or withdrawal of the loan provisions as provided below. The Annuity Account Value (including the loan reserve account as described below) will be the sole security for the loan. If your loan agreement and application form ("Loan Agreement") is properly completed and signed by you, approved by the Owner, accepted by us and received at the Processing Office by the 15th of the month, the loan is effective on the first day of the following month. If your Loan Agreement is properly completed and signed by you, approved by the Owner, accepted by us and received at the Processing Office after the 15th of the month, the loan is effective on the first day of the second month following. The Owner may establish a reasonable interest rate for the loan provided that such rate is not (1) less than an effective annual rate of 6% or (2) greater than the maximum rate permitted by applicable laws. Beginning the first day of the third month following the effective date of the loan and quarterly on the first day of the month thereafter, loan repayments must be made to us. Loan requests shall be amortized in substantially level payments over the term of the loan. If the effective annual rate of the loan is 6%, such repayments will be equal to the sum of (a) and (b) where (a) is the loan interest, calculated at an effective annual rate of 6%, and (b) is an amortized portion of the loan principal. If the effective annual rate of the loan is greater than 6%, such payments will be equal to the sum of (a), (b) and (c) where (a) is the loan interest, calculated at an effective annual rate of 6%, (b) is an amortized portion of the loan principal, and (c) is the loan interest, calculated at the effective annual rate determined by the Owner less the loan interest calculated at an effective annual rate of 6% ("Excess Interest"). Any Excess Interest received by us will be allocated among the Divisions in accordance with Section 2.04 and may be withdrawn, transferred or annuatized as described in this Contract. By each due date, if the amount of the loan payment is less than the amortized loan interest and principal due calculated at an effective annual rate of 6% or the loan repayment is not received at our Processing Office, we will deduct and treat as a partial withdrawal from the loan reserve account an amount equal to the amortized interest and principal payments due plus any applicable withdrawal charges and any required income tax withholding. Specifically, an amount equal to the principal payment will be deducted from the portion of the loan reserve account which earns interest at an effective annual rate of 4%, and an amount equal to the interest payment, calculated at the effective annual rate of 6%, plus any applicable withdrawal charges and required income tax withholding will be deducted from the portion of the loan reserve account which earns interest at the Guaranteed Interest Rate. Amounts deducted, if the amount of the loan repayment is less than the amount due or the loan payment is not received at our Processing Office, may be reportable to the IRS and other appropriate government authorities as taxable distributions. In addition, you may be subject to a 10% penalty tax on the taxable portion of the amounts deducted. The amount of the loan may not be more than 50% of the Annuity Account Value. In no event shall the loan amount exceed $50,000 less the highest outstanding balance under this Contract during the one year period ending the day before the effective date of the loan. The minimum loan permitted is $1,000. For this purpose, the Annuity Account Value is taken as of the Loan Effective Date. Only one outstanding loan is permitted at a time under this Contract. As a condition for granting a loan, we will require you to represent that the loan amount requested, when aggregated with loans (principal plus interest) from all qualified plans of your Employer, does not exceed 50% of the value of your nonforfeitable accrued benefits, and in no event exceeds $50,000 less the highest outstanding balance of all loans from qualified plans during the one year period ending on the day before the effective date of the loan. The provisions of this Contract require spousal consent in order to receive a loan if you are married. No. 92CTRB Page 10 The loan term will be either (i) ten years, if you represent that the purpose of the loan is to acquire, build or substantially rehabilitate a dwelling unit which, within a reasonable period of time, is to be used as your principal residence or (ii) five years. In any event, the loan term may not extend beyond the earlier of (i) the Election and Commencement of Annuity Benefits pursuant to Section 3.03, (ii) the date we receive written notice to terminate this Contract pursuant to Section 2.06, (iii) the date we pay a death benefit pursuant to Section 2.12, and (iv) any date provided for such loans by future Federal tax rules including acceleration of the loan repayment in order that the operation of the loan provisions do not adversely affect the tax treatment of this Contract. Future Federal tax rules may also impose certain additional requirements to obtain the ten year loan period described above which may apply to existing ten year loans. On the Loan Effective Date, we will transfer to a loan reserve account an amount equal to the sum of (i) the loan amount, which will earn interest at the effective annual rate of 4% during the loan term and (ii) 25% of the loan amount, which will earn interest at the Guaranteed Interest Rate, as defined in this Contract. With the Owner's approval you may specify from which Divisions these amounts are to be transferred. In the absence of direction from the Owner, or if your directions cover only part of the amount required to be transferred to the loan reserve account, we will transfer the required (or additional required) amounts from each Division in proportion to the amount that you have in such Division. On the first day of the third month following the effective date of the loan and quarterly thereafter (or first business day thereafter, if such day is not a business day), the amount of interest earned at 4% annually during the prior quarter will be transferred to the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. The loan must be repaid in part on each quarterly due date and may be repaid in full at any time on or after the first loan anniversary and must include the full interest due. Any payments received will first be applied to interest due, with the balance applied towards repayment of the loan. Any partial loan repayment will result in a transfer of the amount equal to the principal repaid from (i) the portion of the loan reserve account that earns interest at the effective annual rate of 4% to (ii) the Guaranteed Interest Division and may be withdrawn, transferred or annuitized as described in this Contract. Partial withdrawals or transfers may not be made from the loan reserve account. Upon full repayment of the loan, any amounts remaining in the loan reserve account will be transferred to the Guaranteed Interest Division and may be withdrawn, transferred or annuitized as described in this Contract. Upon termination of this Contract pursuant to Section 2.06 or 2.12 or annuitization pursuant to Section 3.04 prior to the full repayment of the loan, the loan reserve account shall be zero. SECTION 2.11 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract Year, if the Annuity Account Value on that date is less than $25,000, we will withdraw from the Divisions an Annual Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account Value including the amount of any withdrawals pursuant to Section 2.07 during that Contract Year. The charge will be allocated among the Divisions in proportion to the amounts in the Divisions. For this purpose, any loan reserve account is included within the Guaranteed Interest Division. The portion of the charge attributable to the Guaranteed Interest Division and any loan reserve account will be first withdrawn from the Guaranteed Interest Division and then, if the amount in the Guaranteed Interest Division is not sufficient, the remaining allocation will be withdrawn from the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. If the Annuity Account Value is less than $25,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of termination of this Contract pursuant to Section 2.06 or 2.12, we will prorate the Annual Administrative Charge applicable to the completed portion of the current Contract Year and withdraw such amount in lieu of the Annual Administrative Charge described in this Section for the applicable part of that Contract Year. If the Annuity Account Value is $25,000 or greater at the end of a Contract Year, the Annual Administrative charge is zero. SECTION 2.12 DEATH BENEFIT. If we ascertain that you have died while you have amounts in the Divisions, we will, upon receipt of due proof of your death, and subject to the terms of the Plan including the spousal survivor benefit rules set forth in Section 3.06, pay to the beneficiary designated to receive such payment under Section 4.04 of this Contract, the death benefit payable. If the beneficiary under this Contract is the Trustee, the Trustee may, subject to the terms of the Plan, change the beneficiary within 31 days after we receive due proof of your death. The change shall be made in the same manner and subject to the same provisions as apply to a change of beneficiary during your lifetime. No. 92CTRB Page 11 If the Trustee changes the beneficiary of this Contract after your death according to the terms of the Plan, the Trustee may elect an Annuity Benefit on any annuity form offered by us or one of our affiliated or subsidiary life insurance companies, subject to our rules then in effect, for the benefit of the beneficiary. The beneficiary may not revoke or change any election made by the Trustee. If the Trustee does not make an election, the beneficiary may make such election for the beneficiary's own benefit. Any election of an Annuity Benefit must meet the minimum distribution requirements as described in Section 3.05. If the beneficiary under this Contract is not the Trustee, and you are married at the time of your death, we will pay the death benefit under this Contract to your spouse in the form of a Life Annuity, unless your spouse makes an election for a single sum payment or for an Annuity Benefit on any other annuity form offered by us, subject to our rules then in effect. Any election of an Annuity Benefit must meet the minimum distribution requirements as described in Section 3.05. The amount of the death benefit is equal to the greater of (i) the Annuity Account Value less any outstanding loan and (ii) the minimum death benefit. Such minimum death benefit is the sum of all Contributions made pursuant to Section 2.01 (before reduction for any applicable tax charge) less any outstanding loan and less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount being withdrawn is to the Annuity Account Value. Upon payment of the death benefit, the amount you have in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability from which the Annuity Account Value arose. - -------------------------------------------------------------------------------- PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the terms of this Contract with respect to a payee is the amount provided pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Stock Division of the Separate Account. Such Variable Annuity Benefit will increase if the average daily rate of investment return in the Stock Division is equivalent to more than 6.75% or 5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25% annually, depending on whether the applicable assumed base rate of Net Investment Return referred to in Section 1.24 is 5% or 3.5%, respectively. The daily rate of investment return is before deduction of charges, as described in Section 1.23, not to exceed the maximum rate of 1.75% after any deductions to provide for any applicable tax charge. These charges include a daily charge for financial accounting, death benefits, mortality risk, expenses and expense risk, plus the investment advisory fee charges and direct operating expense charges of the Trust. The amount of the first, second and third payments under any Variable Annuity Benefit provided under the terms of this Contract with respect to a payee is the monthly amount provided with respect to a payee pursuant to the fifth paragraph of Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. (As described in Section 3.05, we will notify the payee how each Variable Annuity payment is determined.) SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. Subject to the terms of the Plan, including the spousal consent and survivor rules described in Section 3.06, as of your Retirement Date, provided you are then living, the Annuity Account Value less any outstanding loan shall be applied to provide the Normal Form of Annuity Benefit, unless an election is made (i) to receive the Cash Value of this Contract in a single sum, (ii) to apply the Annuity Account Value, (less any outstanding loan as set forth in Section 2.10) or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by us or one of our affiliated or subsidiary life insurance companies, or (iii) to take partial withdrawals in amounts and at times as required by the minimum distribution rules of Section 401(a)(9) of the Code and applicable Treasury Regulations, pursuant to Section 3.05, subject to our rules then in effect and any other applicable requirements under the Code. No. 92CTRB Page 12 We will provide notice and election forms to the Owner not more than six months before your Retirement Date. If an election is made to terminate this Contract pursuant to Section 2.06, an election may be made to receive an Annuity Benefit in lieu of the Cash Value. We will have the right to require pertinent information to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. We may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary life insurance companies. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If, pursuant to the first or third paragraph of Section 3.03, an election is made to receive an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value less any outstanding loan if the annuity form elected involves life contingencies or (ii) the Cash Value if the annuity form elected does not involve life contingencies. The amount applied to provide an Annuity Benefit may be reduced by any applicable tax charge on annuity considerations, as we determine. If we have previously deducted any applicable tax charges from Contributions as provided in Section 2.01, we will not again deduct charges for the same taxes before application to provide an Annuity Benefit, unless a change in applicable law has occurred with respect to this Contract. The balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) our current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, your Contract will be governed by our supplementary contract then in effect. The amount to be applied to provide an Annuity Benefit will, in addition to any tax charge reduction, be reduced by an administrative charge. The amount of such charge will be determined from time to time in accordance with our general practices applicable on a uniform basis to all contracts of the same type as this Contract. After the application of an amount to provide an Annuity Benefit, the amounts in the Divisions and the Annuity Account Value shall be zero. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the terms of this Contract, as indicated, on the Joint and Survivor Life Annuity Form (with 100% of the amount of your payment continued to your spouse). The amount of income provided under the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form, is based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females at age zero. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form are based on a 50-50 split of males and females at age zero and an Assumed Base Rate of Net Investment Return of 3.5% or 5%, whichever applies pursuant to Section 1.24. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females at age zero if such annuity form provides for a Fixed Annuity Benefit, and on the projected 1983 Basic Table "a" adjusted to a unisex basis based on a 50-50 split of males and females at age zero and an Assumed Base Rate of Net Investment Income Return of 5% or 3.5%, whichever applies pursuant to Section 1.24, if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract will be distributed or begin to be distributed, in accordance with Section 401(a)(9) of the Code and the applicable Treasury Regulations thereunder, no later than the first day of April following the calendar year in which you attain age 70 years and 6 months ("Required Beginning Date") or such later date as specified in such Section or regulations. Your entire interest may be distributed, as you elect, over (a) your life, or the lives of you and your designated beneficiary, or (b) a period certain not extending beyond your life expectancy, or the joint and last survivor expectancy of you and your designated beneficiary. Distributions must be made in periodic payments at intervals of no longer than one year. In addition, payments must be either nonincreasing or they may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the Proposed Treasury Regulations, or any successor Regulation thereto. All distributions made hereunder shall be made in accordance with the requirements of Section 40(a)(9) of the Code, including the incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and applicable Treasury Regulations, including the minimum distribution incidental benefit requirement of Section 1.401(a)(9)-2 of the. Proposed Treasury Regulations, or any successor Regulation thereto. Notwithstanding the above paragraphs and the following paragraphs of this Section 3.05, while any distribution shall be subject to such requirements of the Code and regulations, any distribution shall also be subject to the terms of this Contract. That is, the forms of distribution shall be those which are made available by us at the time of your election. No. 92CTRB Page 13 For purposes of determining the "period certain" referred to in the first paragraph of this Section, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless you otherwise elect prior to the time distributions are required to begin, those life expectancies shall be recalculated annually. Such election shall be irrevocable and shall apply to all subsequent years. The life expectancy of a non-spouse beneficiary may not be recalculated. Instead, life expectancy will be calculated using the attained age of such beneficiary during the calendar year in which you attain age 70 years and 6 months, and payments for subsequent years shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. If you die after distribution of your interest described in this Contract has begun, the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution being used prior to your death. If you die before distribution of your interest begins, distribution of your entire interest shall be completed no later than December 31 of the calendar year containing the fifth anniversary of your death, except to the extent that an election is made to receive death benefit distributions in accordance with (1) or (2) below: (1) If your interest is payable to a designated beneficiary, then your entire interest may be distributed over the life of, or over a period certain not greater than the life expectancy of, the designated beneficiary. Such distributions must commence on or before December 31 of the calendar year immediately following the calendar year of your death. (2) If the designated beneficiary is your surviving spouse, the date distributions that are required to begin in accordance with (1) above shall not be earlier than the later of (A) December 31 of the calendar year immediately following the calendar year of your death or (B) December 31 of the calendar year in which you would have attained age 70 years and 6 months. For purposes of determining the "period certain" referred to in the immediately preceding paragraph, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of distributions beginning after your death, unless otherwise elected by the surviving spouse by the time distributions are required to begin, life expectancies shall be recalculated annually. Such election shall be irrevocable by the surviving spouse and shall apply to all subsequent years. In the case of any other designated beneficiary, life expectancies shall be calculated using the attained age of such beneficiary during the calendar year in which distributions are required to begin pursuant to this Section, and payments for any subsequent calendar year shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. Distributions under this Section are considered to have begun if distributions are made because you have reached your Required Beginning Date or if prior to the Required Beginning Date distributions irrevocably commence to you over a period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1 of the Proposed Treasury Regulations or any successor Regulation thereto. Evidence of each payee's survival must be furnished to us either by personal endorsement of the check drawn for payment or by other means satisfactory to us. If a benefit payment under the terms of this Contract was based on information that is subsequently found to be incorrect, benefits will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by us will be charged against and underpayments will be added to any payments thereafter falling due under the terms of this Contract with respect to a payee, affecting as many such payments as are necessary to correct the overpayment or underpayment. Our liability with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under this Contract. If we receive evidence satisfactory to us that (i) a payee entitled to receive any payment under the terms of this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, we may, unless the Plan provides to the contrary, make the payments (in the case of a minor, at a rate not exceeding %200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If a variable annuity form made available by us provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. No. 92CTRB Page 14 Upon an election, pursuant to Section 3.03, of an annuity form providing payments for a period certain, such Owner may designate (in accordance with the terms of the Plan and with the right to change such designation in accordance with the terms of the Plan) a payee to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person unless the Plan provides to the contrary) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's estate in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, we will pay in a single sum to such payee's estate the commuted value of any remaining payments or installments, The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis applicable in determining the annuity amount. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. We will require satisfactory evidence of the age of any person upon whose life an annuity form depends. - -------------------------------------------------------------------------------- TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE (Minimum Monthly Income per $1,000 of Annuity Account Value)
- -------------------------------------------------------------------------------------------------------------------------------- Age 60 61 62 63 64 65 66 67 68 69 70 - -------------------------------------------------------------------------------------------------------------------------------- 60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88 61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96 62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03 63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11 64 4.89 4.94 5.00 5.05 5.10 5.14 5.19 65 5.00 5.06 5.11 5.17 5.22 5.27 66 5.12 5.18 5.24 5.29 5.35 67 5.24 5.31 5.37 5.43 68 5.37 5.44 5.51 69 5.52 5.59 70 5.67 - --------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Account Value) - -------------------------------------------------------------------------------- VARIABLE ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS Age 3.5% 5% - -------------------------------------------------------------------------------- 60 5.27 6.16 61 5.39 6.28 62 5.52 6.41 63 5.66 6.55 64 5.81 6.70 65 5.97 6.86 66 6.15 7.03 67 6.33 7.21 68 6.53 7.41 69 6.74 7.62 70 6.97 7.85 - -------------------------------------------------------------------------------- We will, with respect to each payment under a Variable Annuity Benefit, notify the payee of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each variable payment. Such notice will be mailed with each payment. Any election, change, revocation or designation shall be made, and will take effect on the Transaction Date, in the same manner as a change of beneficiary as described in Section 4.04. If a commutation right under an Annuity Benefit is exercised, we may defer payment in accordance with Section 4.07. No. 92CTRB Page 15 SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS. If you are married, your interest in this Contract shall be paid in the Normal Form joint and survivor annuity, and if you are unmarried, your interest shall be paid in the Normal Form life annuity, unless you elect otherwise as described in this Section. If you are married and die before payment of your interest has commenced, your interest shall be paid to your surviving spouse in the form of a life annuity, unless at the time of your death there was a contrary election made pursuant to this Section. The foregoing notwithstanding, your surviving spouse may elect, before payment is to commence, to have payment made in any form permitted under the terms of this Contract. You may elect, at any time within the 90 consecutive day period before the first day of the first period for which your interest is paid as an annuity or in any other form, not to have your interest paid in the Normal Form in which case it shall be paid in any other form elected under the terms of this Contract. If such interest is to be paid to your spouse upon your death, you may elect, during the period beginning on the first day of the plan year of the Plan in which you attain age 35 (or, if you separate from service prior to that plan year, beginning on the date of separation) and ending with your death, for a beneficiary other than your spouse to receive payment of the value of your interest. In addition, if you will not yet attain age 35 by the end of any current plan year, you may make a special qualified election to designate a beneficiary other than your spouse to receive payment of the value of your interest. Such special qualified election shall be effective for the period beginning on the date of such election and ending on the first day of the plan year in which you will attain age 35. Amounts payable in accordance with this Section will be automatically reinstated as of the first day of the plan year in which you attain age 35 unless a new election designating a beneficiary other than the spouse is made in accordance with the requirements of this Section. Any election described in the foregoing paragraph must be consented to by your spouse in writing before a notary public or a representative of the Plan, unless you can prove that there is no spouse or that the spouse cannot be located. Also, if you have become legally separated from your spouse or have been abandoned (within the meaning of local law) and have a court order to such effect, spousal consent is not required unless a qualified domestic relations order provides otherwise. Your election must designate a specific beneficiary (including any class of beneficiaries or any contingent beneficiaries) that may not be changed without further consent of the spouse, unless the spouse's consent expressly permits designation by you without further consent of the spouse. The spouse's consent under this Section shall acknowledge the effect of the election. In addition, the spouse's consent (or the establishment that the consent of the spouse may not be obtained) shall only be valid with respect to such spouse. Your waiver of the Normal Form joint and survivor annuity shall not be effective unless the election designates a form of benefit payment which may not be changed without spousal consent (or the spouse expressly permits designations by you without any further spousal consent). A consent that permits designations by you without any requirement of further consent by such spouse must acknowledge that the spouse has the right to limit consent to a specific beneficiary, and a specific form of benefit where applicable, and that the spouse voluntarily elects to relinquish either or both of such rights. If you make an election under this Section you may revoke that election, without spousal consent, at any time before the first day of the first period for which an amount is paid as an annuity or in any other form. The provision requiring spousal consent in this Section shall also apply with regard to your election to terminate this Contract or make partial withdrawals pursuant to Sections 2.06 and 2.07 and with respect to a beneficiary designation set forth in Section 4.04. Spousal consent, as described in this Section, is also required in the 90 day period before a Plan loan is granted to you pursuant to Section 2.10. If the Annuity Account Value applied to provide the spousal benefits on the date payment is to commence is in the aggregate less than $3,500, we may choose to make payment in a single sum rather than in the form of a Qualified Joint and Survivor Annuity or Life Annuity as described herein. Upon any payment made pursuant to this Section, we will be released from any and all liability for payment with respect to the Contributions made for you. - -------------------------------------------------------------------------------- PART IV - General PROVISIONS SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the parties and the terms of this Contract alone will govern with respect to our rights and obligations. A copy of the application is incorporated in and made part of this Contract. This Contract may not be modified, nor may any of our rights or requirements be waived, except in writing and by our authorized officer. The terms of this Contract may be changed by amendment or replacement upon agreement between the Owner and us without the consent of any other person, provided the change does not reduce any annuity benefit. SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform this Contract to reflect changes in the Code, applicable Treasury Regulations or in regulations or published rulings of the Internal Revenue Service so that this Contract will continue to be an Annuity under a qualified plan. No. 92CTRB Page 16 SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY. No interest of yours or of a beneficiary under this Contract may be transferred to any person other than us upon the surrender of this Contract. Except as permitted under Section 401(a)(13) of the Code, no right or interest of you or any other payee or beneficiary in this Contract shall be (a) assignable; (b) subject to any lien; or (c) liable for, or subject to, any obligation or liability of any person. The preceding sentence shall not apply to an assignment, transfer or attachment pursuant to a qualified domestic relations order, as defined in Section 414(p) of the Code. SECTION 4.04 BENEFICIARY. The Owner, as of the Contract Date, is to provide us with an initial designation of the beneficiary entitled to receive any death benefit payable with respect to you pursuant to Section 2.12. Subject to the Plan and spousal consent and survivor rules of Section 3.06, you may change such designation from time to time during your lifetime and while this Contract is in force. If the beneficiary is the Trustee, the Trustee will have the right within 31 days of the day we receive due proof of your death and pursuant to the provisions of the Plan, to change the beneficiary entitled to receive your death benefits. If the Trustee is not the beneficiary, the beneficiary will be your spouse unless he or she has given duly witnessed written consent to the designation of another beneficiary as described in Section 3.06, or you establish prior to your death that he or she cannot be located. Such spousal consent must be on file with the Trustee while this Contract is owned by the Trustee. If the Trustee is not the Owner, such spousal consent must be presented to us with the change of beneficiary request or with proof of your death and election of an Annuity Benefit. SECTION 4.05 DISQUALIFICATION. In the event that the Plan fails to qualify as a Plan under Section 401(a) of the Code and applicable Treasury Regulations, we reserve the right, upon receiving notice of such fact, to transfer the Annuity Account Value under this Contract to another annuity contract issued by us on your life, or one of our affiliated subsidiary life insurance corporations, or to terminate this Contract and pay to the Owner the Annuity Account Value less deduction for applicable taxes, solely at our option. In the event that this Contract fails to qualify as an Annuity under a qualified Plan as described in Section 1.02, we shall have the right, upon receiving notice of such fact, to terminate this Contract and pay at the direction of the Owner the Annuity Account Value less any outstanding loan and less a deduction for the appropriate part attributable to the Owner of any Federal income tax payable which would not have been payable if you had an Annuity. SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to the, Employer, we reserve the right at our sole discretion to limit Contributions under this Contract. SECTION 4.07 DEFERMENT. Applications of proceeds to a variable annuity, payment of a death benefit and payment of any portion of your Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange has been closed or trading on it is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Securities Exchange Commission, by order, permits us to defer payments in order to protect persons with interests in the Investment Divisions. We can defer payment of any portion of your Annuity Account Value in the Guaranteed Interest Division for up to six months while you are living. SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year, we will furnish you with a notice showing the following: (1) the amount in the Guaranteed Interest Division, (2) the total number of Accumulation Units in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Value, (4) the amount in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the amount in the loan reserve account, (6) the Cash Value, and (7) the amount of death benefit. No. 92CTRB Page 17 We will also furnish annual calendar year reports concerning the status of the annuity and any other reports required by the Code or applicable Treasury Regulations. After your Retirement Date, we will notify you of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.09 TRUSTEE'S RESPONSIBILITY. The Trustee shall hold this Contract on your behalf and your beneficiaries as an asset of the trust, unless this Contract is distributed to you pursuant to the terms of the Plan. The Trustee shall be responsible for transferring all payment made under this Contract to the Annuitant and the Annuitant's beneficiaries in accordance with the terms of the Plan and the applicable provisions of the Code. We shall make no payment hereunder without written instructions from the Trustee, and we shall be fully discharged of any liability therefor to the extent such payments are made to and at the direction of the Trustee. SECTION 4.10 AGE. If your age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by us will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. No. 92CTRB Page 18 - ------------------------------------------------------------------------------- APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, New York, New York 10116-2996 QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR: EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY - ------------------------------------------------------------------------------- 1. TYPE OF PURCHASE (Complete One Plan Only) a. | | TSA Public School (GV-PS-I) b. | | TSA 501(c)(3) Organization (GV-501-I) c. | | TSA University (GV-PS-U-I) d. | | IRA Individual (including IRA to IRA transfers) (GV-IRA 4971) e. | | IRA Unit Billed (including IRA to IRA transfers) (GV-IRA 4971) f. | | IRA QUALIFIED PLAN ROLLOVER--(QP IRA) (Distribution from a Qualified Plan) (GV-IRA 4971-71) g. | | EDC (Public Employee Deferred Compensation (GV-EDC 4991) h. |X| EDC (Tax Exempt Organization)(GV-EDC 4991-SU-080) i. | | SEP (Simplified Employee Pension)(GV-SEP 4981) j. | | SARSEP (Salary Reduction SEP) ____________ k. | | CORPORATE TRUSTEED (GV-CORP 4941-41) l. | | KEOGH/HR-10 TRUSTEE (GV HR-10 4911-11) (trustee owned) m. | | Keogh/HR-10 (GV-HR-10 4911) (not trustee owned) (issued to existing units only) - ------------------------------------------------------------------------------- DO NOT COMPLETE THIS SECTION IF BOX 1.d OR 1.f CHECKED ABOVE 2. EMPLOYER/PLAN NAME |A|B|C| | C|O|M|P|A|N|Y| | | | | | | | | | | | | | | | | | | | | | | | | | | 3. | | EXISTING UNIT NO. | | | | | | | - | | |X| NEW UNIT |0|0|0|1|2|3|-|4|5|6| (FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP, OR TRUSTEED PLANS. FORM 983-135B IS REQUIRED.) - ------------------------------------------------------------------------------- 4. PROPOSED ANNUITANT Print name to appear on Contract. |J|o|h|n| | | | | | | | | | | | | | | | | | |O|E | | | | | | | First Middle Initial Last a. |x| Mr. | | Mrs. | | Miss | | Ms. | | Other _______ b. Date of Birth: Year 1954 Month JANUARY Day 27 ----- -------- ---- c. Age at Nearest Birthday: 38 d. |x| Male | | Female ------ e. Annuitant's Mailing Address: f. State of Residence: N.J. ---- No., St. |1|7| |E|L|M| |S|T|R|E|E|T| | | | | | | | | | | | | City |A|N|Y|T|O|W|N| | | | | | | | | | | | | | | | | | State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1| g. Telephone Number (101) 222-3456 |x| Home | | Work h. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9| i. Are you associated with or employed by a member of National Association of Securities Dealers, Inc. (NASD)? | | Yes |x| No 5. OWNER (Print Name) - If Trusteed or EDC Plan Print Name of Owner; for all other Markets Print Name of Annuitant. JOHN DOE ------------------------------------------------------------ a. Title ---------------------------------------------------- 6. RETIREMENT AGE 65 -------------------------------------------- 7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death Benefit upon Annuitant's death before Retirement Date.) BENEFICIARY MUST BE THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS.) JANE DOE - WIFE ----------------------------------------------------------- ----------------------------------------------------------- ----------------------------------------------------------- 8. CONTRIBUTION ALLOCATION Guaranteed Interest Division 20% -- Stock Division 20% -- Money Market Division 20% -- Balanced Division 20% -- Aggressive Stock Division 20% -- (PERCENTAGES IN WHOLE NUMBERS) Total 100% 9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F) a. Reminder Notice (Billing) Required | | Yes |x| No IF YES, complete b-c-d-e b. REMINDER DATE Required for Individual IRA or otherwise must agree with existing unit or attached 983-135B. MONTH _________ DAY _________ c. REMINDER FREQUENCY | | Annual | |Semi-Annual | | Quarterly | |Monthly Available for TSA, EDC, SARSEP AND CORPORATE TRUSTEED AND UNIT BILLED IRA ONLY: | | Semi-Monthly | | Bi-Weekly d. REMINDER AMOUNT $______________________ e. BILLING MONTHS TO BE EXCLUDED - TSA ONLY - ---------------------------------------------------------- - ---------------------------------------------------------- - ---------------------------------------------------------- 10. EXPECTED FIRST CONTRACT YEAR CONTRIBUTION. $ 1000 ----------- If an advanced billing and/or contract date are requested, complete #9b and #12. - -------------------------------------------------------------------------------- (FOR PROCESSING OFFICE USE) Unit Name ____________________________ Reminder Date__________________________ Cert. or App# ________________________ Amendment Required_____________________ EDC Emp. Add._________________________ Emp. Fed. ID # ________________________ Frequency ____________________________ Contract Date _________________________ Receipt Date Batch # Inquiry # Processor - -------------------------------------------------------------------------------- 180-1000 10. Did you receive the Separate Account Prospectus? |x|Yes | |No Date shown on Prospectus January 1, 1992 ----------------------------- Date of any supplement to Prospectus -------------------- 11. Items (a) through (f) are to be answered by the annuitant. We are required by the NASD to ask these questions. (a) Name of Employer: ABC COMPANY ---------------------------------- (b) Address of Employer: 10 MAIN STREET ------------------------------------------------------ ANYTOWN, NJ ------------------------------------------------------ (c) Occupation SALES ------------------------------------------- (d) Assuming the contract applied for will be issued, will any existing insurance or annuity be replaced or changed (or has it been)? | | Yes |x| No (e) Estimated Family Annual Income $100,000 ----------------------- (f) Estimated Net Worth $250,000 ----------------------- (g) Investment Objective: | | Income |x| Income & Growth | | Aggressive Growth | | Growth | | Safety Of Principal 12. SPECIAL INSTRUCTIONS - -------------------------------------------------------------- - -------------------------------------------------------------- - -------------------------------------------------------------- - -------------------------------------------------------------- - -------------------------------------------------------------- 13. AMOUNT PAID WITH THIS FORM: $ 1000 --------- (If a check is submitted with this request, no advanced Contract Date is permitted.) BACKDATING IS NOT PERMITTED. NOTE: Amount paid will be credited upon receipt at Equitable's Processing Office, subject to return if the contract is not issued. The Contract Date will be the date of receipt by Equitable of this application, properly signed and completed, and Contribution at Equitable's Processing Office. - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- AGREEMENT All information and statements furnished in this application are true and complete to the best of my knowledge and belief. I understand and acknowledge that no Agent has the authority to make or modify any contract on Equitable's behalf, or to waive or alter any of Equitable's rights and regulations. IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT. UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S) OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND COMPLETE. - -------------------------------------------------------------------------------- LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR ANNUITY APPLICATION WITH INFORMATION YOU KNOW IS FALSE OR TO LEAVE OUT MATERIAL FACTS - -------------------------------------------------------------------------------- X_________________________________ Date __________ City ___________ State_______ Signature of Annuitant X_________________________________ Date __________ City ___________ State_______ Signature of Authorized Individual (REQUIRED FOR EDC AND TRUSTEED) OR OWNER - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- AGENT'S SECTION Will any existing Insurance or annuity be replaced or changed (or has it been), assuming the Contract will be issued? | | Yes | | No | | | | I (we) certify that a prospectus for the Contract has been given to the proposed Annuitant and that no written sales materials other than those approved by The Equitable have been used. EQUI-VEST issues must adequately reflect the commission interest of all Agents on previous contracts. - ------------------------------------------------------------------------------------------------------------------------------------ Print Agent's Name(s) Initial of Last Agent Agent Agency District Agent's (Service Agent first) Name Number % Code Manager Code Signature - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------ FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS ______ Date ______ District EQS ________ Date ________ - ------------------------------------------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------- (For ASU Use) ASU Code and App. No ________________________________ ASU Rec'd ___________________________________________ ASU Rec'd ___________________________________________ Date to Proc. Off ________________________Campaign | | Agent(s) shown above is Equity Qualified and is licensed in the state where the request is signed. Above Agent information verified by ASM (Registered Rep) - -------------------------------------------------------------------------------- Application reviewed by _________________________________ - -------------------------------------------------------------------------------- 180-1000 Owner: ABC STATE DEFERRED COMPENSATION PROGRAM Annuitant: JOHN DOE Contract Number: 00 000 000 Issue Date: FEB 28, 1992 Contract Date: FEB 28, 1992 Retirement Date: JAN 1, 2020 THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York, New York 10116 AGREES o TO ALLOCATE the Contributions made to this Contract after deduction of any applicable tax charge, to the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division of the Separate Account (referred to in this Contract as the "Investment Divisions") or to the Guaranteed Interest Division, in accordance with Sections 2.02, 2.03 and 2.04 as directed by you, and o TO APPLY the Annuity Account Value at the Retirement Date to provide the Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant is then living, and o TO PROVIDE you with the other rights and benefits of this Contract. This is the entire Contract. These agreements are subject to the provisions of this Contract. In this Contract, "we", "our" and "us" mean The Equitable Life Assurance Society of the United States. "You" and "your" mean the Employer at the time a right is exercised by the Employer. TEN DAYS TO EXAMINE CONTRACT - You may cancel this Contract by returning it to us within ten days after receipt of it. Upon such cancellation, we will refund any Contribution made to us on the Annuitant's behalf under this Contract. /s/ Molly K. Heines /s/ Richard H. Jenrette Vice President and Secretary Chairman of the Board and Chief Executive Officer THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75% FOR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.24 IS 5% OR 3.5%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISKS, EXPENSES AND EXPENSE RISK, PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE TRUST. No. 92 EDCA This Contract is issued in consideration of the payment to us of the Contributions made under the terms of this Contract. The provisions on the following pages are part of this Contract. - ------------------------------------------------------------------------------- TABLE OF CONTENTS Definitions Page Section 1.01 - Annuitant................................4 1.02 - Annuity..................................4 1.03 - Annuity Account Value....................4 1.04 - Annuity Benefit..........................4 1.05 - Cash Value...............................4 1.06 - Class of Contracts.......................5 1.07 - Code.....................................5 1.08 - Contract.................................5 1.09 - Contract Date............................5 1.10 - Contract Year............................5 1.11 - Contribution.............................5 1.12 - Divisions................................5 1.13 - Eligible Annuity Certain.................5 1.14 - Employer.................................5 1.15 - Guaranteed Interest Rate.................5 1.16 - Joint and Survivor Life Annuity Form.............................5 1.17 - Life Annuity Form........................5 1.18 - Normal Form..............................5 1.19 - Period Certain Annuity...................5 1.20 - Plan.....................................5 1.21 - Processing Office........................6 1.22 - Retirement Date..........................6 1.23 - Separate Account.........................6 1.24 - Separate Account Definitions.............7 1.25 - Substituted Beneficiary..................7 1.26 - Transaction Date.........................7 1.27 - Trust....................................7 ANNUITY ACCOUNT VALUE Section 2.01 - Contributions............................8 2.02 - Separate Account Investment Divisions................................8 2.03 - Guaranteed Interest Division.............8 2.04 - Allocation to Divisions..................8 2.05 - Transfers Among Divisions................9 2.06 - Termination of this Contract.............9 2.07 - Partial Withdrawals......................9 2.08 - Charges for Partial Withdrawals..............................9 2.09 - Free Corridor Amount....................10 2.10 - Annual Administrative Charge..................................10 2.11 - Death Benefit...........................10 ANNUITY BENEFITS Section 3.01 - Fixed Annuity Benefit...................10 3.02 - Variable Annuity Benefit................11 3.03 - Election and Commencement of Annuity Benefits........................11 3.04 - Amount of Annuity Benefits..............11 3.05 - Payment of Annuity Benefits.............12 GENERAL PROVISIONS Section 4.01 - Contract................................14 4.02 - Statutory Compliance....................14 4.03 - Nonforfeitability, Nontransfer- ability and Assignments.................14 4.04 - Beneficiary.............................15 4.05 - Disqualification of Plan or Contract........................15 4.06 - Future Contributions....................15 4.07 - Deferment...............................15 4.08 - Annual Notice...........................15 4.09 - Age.....................................15 4.10 - Ownership Right of Employer.............15 No. 92 EDCA Page 2
OWNER: ABC STATE DEFERRED COMPENSATION PROGRAM ANNUITANT: JOHN DOE CONTRACT NUMBER: 00 000 000 ISSUE DATE: FEB 28, 1992 CONTRACT DATE: FEB 28, 1992 RETIREMENT DATE: JAN 1, 2020 INITIAL GUARANTEED INTEREST RATE: 7.50% TO MAR 31, 1992 MINIMUM GUARANTEED INTEREST RATE: 6.00% TO DEC 31, 1992 3.00% AFTER DEC 31, 1992 BENEFICIARY: JANE DOE FORM NUMBER: 92 EDCA - --------------------------------------------------------------------------------------------------------------- TABLE OF GUARANTEED VALUES ISSUE AGE 38 MALE $1000 ANNUAL CONTRIBUTION NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY SINCE FIRST CONTRIBUTION CASH VALUE ANNUITY AT AGE 65* ------------------------ ---------- ------------------ 1 976 6.62 2 1,946 16.20 3 2,944 26.67 4 3,998 38.83 5 5,064 46.70 6 6,220 56.28 7 7,362 65.58 8 8,538 74.61 9 9,841 83.38 10 11,204 91.89 11 12,628 100.16 12 14,117 108.18 13 15,673 115.97 14 17,143 123.53 15 18,658 131.18 16 20,217 138.63 17 21,824 145.90 18 23,478 152.80 19 25,213 159.69 20 26,999 166.03 24 (Age 62) 34,697 189.57 27 (Age 65) 41,098 205.49
THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000 CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE (SEE SECTION 2.10) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE ANNUITY ACCOUNT VALUE (SEE SECTION 1.05). THE TABLES ASSUME THAT 100% OF ALL CONTRIBUTIONS AND EARNINGS ARE ALLOCATED TO AND REMAIN IN THE GUARANTEED INTEREST DIVISION. YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS. THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A SETTLEMENT WITHIN 5 YEARS OF THE CONTRACT DATE WILL BE SUBJECT TO A CHARGE (SEE SECTION 3.04). *ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO SURVIVOR) WITH JOINT ANNUITANT THE SAME AGE AS THE ANNUITANT. No. 92 EDCA Page 2 PART I - DEFINITIONS SECTION 1.01 ANNUITANT. The term "Annuitant" means an individual who participates in a Plan, or, if the Plan permits, a beneficiary under the Plan, as shown on Page 3 of this Contract, and on whose behalf this Contract is purchased and is maintained. SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in accordance with the terms of the Plan. SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts that you have in the Guaranteed Interest Division and the Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by us pursuant to Section 3.04 of this Contract. Various sections of this Contract (Sections 1.16, 1.17, 1.18, 1.19, 3.01, and 3.02) refer to monthly payments to be made under an Annuity Benefit. You may elect to have the Annuity Benefit paid at other intervals, such as quarterly, semi-annually, or annually, instead of monthly. You may elect this at the time you elect the Annuity Benefit form as described in Section 3.03; in that event, all references in this Contract to monthly payments will be deemed to mean payments at the frequency you elect, subject to our rules at the time of election. SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value less any applicable withdrawal charge determined as follows: The withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the excess of (i) the sum of the Annuity Account Value over (ii) the Free Corridor Amount defined in Section 2.09. (b) is the excess, if any, of (i) 8% of the total Contributions made on the Annuitant's behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to Section 2.08. However, notwithstanding the above, if the Annuitant is age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. A withdrawal charge will not apply, which means the Cash Value will equal the Annuity Account Value upon any of the following occurrences: (i) the later of the completion of at least five Contract Years and the Annuitant's attainment of age 59 years and 6 months, or (ii) the completion of at least twelve Contract Years, or (iii) a request is made for a refund of a Contribution in excess of the amount that may be contributed under Section 457 of the Code within one month of the date on which the Contribution is made, or (iv) the Annuitant's attainment of age 55, his completion of at least five Contract Years and the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase an Eligible Annuity Certain, defined in Section 1.13, or (v) the Annuitant's completion of at least three Contract Years and the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase a Period Certain Annuity, defined in Section 1.19, where the certain period of such annuity is at least ten years, or (vi) the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase a life annuity distribution, pursuant to the terms of this Contract, or (vii) the Annuitant dies and a death benefit is payable to the beneficiary. No. 92 EDCA Page 4 The above statements notwithstanding, we reserve the right to modify or waive any early withdrawal charges in order to comply with any applicable state or local legal or regulatory requirements. Any such modification or waiver will apply equally to all Annuitants under a Plan subject to such a state or local legal or regulatory requirement. SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all Contracts with a Contract Date in the same calendar year. SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.08 CONTRACT. The term "Contract" means this Contract. SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt by us of both the application for this Contract, properly signed and completed, and a Contribution. SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month period beginning on (i) the Contract Date, and (ii) each anniversary thereafter, unless otherwise agreed to in writing by us. SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us pursuant to the terms of the Plan to this Contract. We are under no obligation to accept any Contribution less than $20.00. SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or severally as the case may be, the following divisions described in this Contract: (i) the Guaranteed Interest Division, and (ii) the Investment Divisions of the Separate Account. SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means a Period Certain Annuity issued by us which extends beyond the Annuitant's attainment of age 59 years and 6 months and does not permit any prepayment of the unpaid principal (that is, no withdrawal or single sum payment) prior to your attainment of age 59 years and 6 months. SECTION 1.14 EMPLOYER. The term "Employer" means one of the following types of entity which is eligible to adopt, has adopted, and maintains a Plan: (i) a State, a political subdivision of a State, or an agency or instrumentality of a State or political subdivision of a State, or (ii) any other organization exempt from tax under the Code which has adopted and maintains a Plan for a select group of management or highly compensated employees within the meaning of the Employee Retirement Income Security Act of 1974, as amended. The Employer is the Owner of and beneficiary under this Contract. SECTION 1.15 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means the effective annual rate at which interest accrued on the amount in the Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of this Contract. Section 2.03 describes the determination of the rate to apply thereafter. SECTION 1.16 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by you. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.17 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity issued by us providing monthly payments during the lifetime of the person upon whose Life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.18 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under this Contract means (i) if the Annuitant has a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (with 100% of the monthly payment amount continued to the spouse), and (ii) if the Annuitant does not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by us which does not permit any prepayment of the unpaid principal (that is, you cannot elect to receive part of the payment as a single sum payment with the remainder paid in monthly annuity payments). SECTION 1.20 PLAN. The term "Plan" refers to an "Eligible Deferred Compensation Plan" meeting the requirements of Section 457(b) of the Code and applicable Treasury Regulations which is established and maintained by an Employer for the benefit of individuals performing services for the Employer and their beneficiaries. No. 92 EDCA Page 5 SECTION 1.21 PROCESSING OFFICE. The term "Processing Office" means our Individual Annuity Center, P.O. Box 2996, GPO, New York, New York 10116, or such other location as we shall designate by advance written notice to the Employer or the Plan's Trustee, as applicable. SECTION 1.22 RETIREMENT DATE. The term "Retirement Date" means the date on which the Annuitant attains the retirement age as shown on Page 3 of this Contract. Before the Retirement Date the Employer may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be earlier than the Retirement Date provided under the Plan nor shall it be later than the date the Annuitant attains age 70 years and 6 months. Any election for such change must be made in writing by you and shall not take effect until received by us at the Processing Office. SECTION 1.23 SEPARATE ACCOUNT. The term "Separate Account" means Separate Account A which is organized as a unit investment trust, a type of investment company. We established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited to or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts and certificates. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities or variable life insurance. The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to these contracts will not be chargeable with liabilities arising out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to our General Account. The Separate Account consists of "Investment Divisions". Each Investment Division may invest its assets in a separate class (or series) of shares of a designated Trust where each class (or series) represents a separate portfolio in such Trust. We reserve the right to change the designated trust or investment company or to add designated trusts or investment companies. The Investment Divisions available are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. The Guaranteed Interest Division is not part of the Separate Account, but rather is an asset of our General Account. We will value the assets of each Investment Division on each business day. A business day is any day on which we are open, the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio securities in which an Investment Division is invested to materially affect the Accumulation Unit Value. We may, at our discretion, invest the assets of any Investment Division in any investment permitted by applicable law. We may rely conclusively on the opinion of counsel (including attorneys in our employ) as to what investments we are permitted by law to make. We reserve the right to: (i) cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such committee at any time; (iii) restrict or eliminate any voting rights as to the Separate Account; (iv) operate the Separate Account by making direct investments, or in any other form; (v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or remove Investment Divisions (or sub-divisions of Investment Divisions) from the Separate Account (the term "Investment Division" in this Contract shall then refer to any other Investment Division in which the assets, of a class of contracts to which this Contract belongs, were placed); (vi) combine any two or more Investment Divisions (or sub-divisions of Investment Divisions) of the Separate Account; and (vii) withdraw from any Investment Division and to allocate to another Investment Division assets determined by us to be associated with the class of contracts to which this Contract belongs. If the exercise of these rights results in a material change in the underlying investments of an Investment Division, you will be notified of such exercise, as required by law. No. 92 EDCA Page 6 Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for applicable tax charges) at a rate not to exceed 1.49% per year for each of the Stock, Money Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock Division, for financial accounting, death benefits, mortality risk, expenses and expense risk. The charge shall be made in accordance with Subsection (c) of the Net Investment Factor provision in Section 1.24. The relative proportion of these charges may be modified. This daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust, shall not exceed a total annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to this Contract. SECTION 1.24 SEPARATE ACCOUNT DEFINITIONS. VALUATION PERIOD: Each business day together with any preceding consecutive non-business days. NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b), minus (c) where (a) is the value of the Investment Division's shares of the Corresponding portfolio of the Trust at the end of the Valuation Period before giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period. For this purpose, we use the share value reported to us by the Trust. (b) is the value of the Investment Division's shares of the Corresponding portfolio of the Trust at the end of the preceding Valuation Period (after taking into account any amounts allocated or withdrawn for that Valuation Period). (c) is the daily Separate Amount charge for the expenses of this Contract times, the number of calendar days in the Valuation Period. ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an Investment Division where Contributions made on the Annuitant's behalf are invested and which is used in determining the amount in an Investment Division. ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of each Accumulation Unit in an Investment Division on a given date. The Accumulation Unit Value for a Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for that Investment Division for such Valuation Period. ANNUITY UNIT: The "Annuity Unit" is a unit used in determining amounts payable from the Stock Division of the Separate Account under a Variable Annuity Benefit as defined in Section 3.02. ANNUITY UNIT VALUE: An "Annuity Unit Value" was fixed at $1.00 on November 1, 1968. On August 27, 1981, the date the first Contribution was put into the Stock Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods ending in such month. SECTION 1.25 SUBSTITUTED BENEFICIARY. The term "Substituted Beneficiary" refers to the beneficiary designated under the Plan by the Annuitant to receive death benefits payable under the Plan, where the Employer has elected, pursuant to Section 4.04 to designate such person to receive the death benefit payable under Section 2.11. SECTION 1.26 TRANSACTION DATE. The term "Transaction Date" means the business day we receive a Contribution or a written contract transaction request providing the information we need at the Processing Office. In the case of a transfer request initiated through the use of a touch tone telephone, as described in Section 2.05, the Transaction Date is the business day the telephone transaction is received. SECTION 1.27 TRUST. The term "Trust" means the designated trust or investment company in which Separate Account assets are invested. No. 92 EDCA Page 7 PART II - ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. You are to make Contributions form time to time on such dates and in such amounts as you determine pursuant to the terms of the Plan. Contributions will be allocated to the Divisions in accordance with the instructions received on the application, unless later changed. Each Contribution received by us on the Annuitant's behalf will, before its allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. If the Plan permits, we will accept transfers made from another eligible deferred compensation plan meeting the requirements of Section 457 of the Code or other funds invested under the Employer's Plan. SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when an amount is allocated to, or withdrawn or transferred from, an Investment Division, the Annuity Account Value will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Sections 2.07 or 2.08 or transferred from the Investment Division pursuant to Section 2.05. The amount in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units in the Investment Division on that date and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under this Contract terminates on the earliest of (i) Election and Commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of the Annuitant's death or (iii) Termination of this Contract pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division becomes part of our general assets which support the guarantees of this Contract and other contracts. The amount in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Sections 2.07, 2.08 or 2.10 or transferred from the Guaranteed Interest Division pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division on a Transaction Date pursuant to Section 2.04. We will credit the amount you have in the Guaranteed Interest Division with interest at effective annual rates that we determine. For each Class of Contracts we determine a yearly guaranteed interest rate that will remain in effect throughout the next year. We guarantee that this yearly guaranteed interest rate will never be less than 3%. Participation in the Guaranteed Interest Division under the terms of this Contract terminates on the earliest of (i) Election and Commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of Annuitant's death or (iii) Termination of this Contract pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section 2.01 is allocated (after deduction for any applicable tax charge) to one or more Divisions, at your sole direction as specified to us. Allocation percentages must be in whole numbers and the sum must equal 100. The allocation is made as of the Transaction Date on which we have received both such Contribution and such direction. Contributions made to an Investment Division purchase Accumulation Units in that Investment Division, using the Accumulation Unit Value next computed after the Transaction Date. If your Plan permits, and you provide us with advance written instructions to do so, we will accept allocation instructions directly from the Annuitant. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the Transaction Date with respect to each transfer from the Division pursuant to Section 2.05, (iii) on the Transaction Date with respect to each withdrawal pursuant to Section 2.07, (iv) at the time of application on amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, (v) upon termination of this Contract pursuant to Section 2.06 and (vi) upon the Annuitant's death pursuant to Section 2.11. No. 92 EDCA Page 8 SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request or through the use of a touch tone telephone, transfer all of part of the amount you have in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; and (2) amounts in the Money Market Division may be transferred to other Divisions. Written authorization for touch tone telephone initiated transfers is only required when authorization for telephone transfers is requested. Upon advance written notice to you, we reserve the right to discontinue the acceptance of transfer requests through the use of a touch tone telephone. If the Plan permits and you provide us with advance written instructions to do so, we will accept transfer instructions directly from the Annuitant. All transfers will be effective on the Transaction Date and will be subject to our rules in effect at the time of transfer. With respect to the Investment Divisions, the transfer will be made at the Accumulation Unit Value next computed after the Transaction Date. No transfers are permitted to the Money Market Division from the other Divisions. SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the terms of the Plan, you may elect by written notice to terminate this Contract. We will determine the Cash Value of this Contract as of the Transaction Date. If this Contract is terminated, surrendered or exchanged prior to the Annuitant's Retirement Date, any applicable tax charges we have paid may be deducted. If we previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on terminations, unless a change in applicable law has occurred with respect to this Contract. Cash Value payments may be deferred by us in accordance with the provisions of Section 4.07. Subject to the terms of the Plan, we reserve the right to pay the Annuity Account Value under this Contract and terminate this Contract if (i) you make no Contributions during the last three completed Contract Years, or (ii) you make a partial withdrawal that would result in the Annuitant's Annuity Account Value falling below $500. We also reserve the right to terminate this Contract if no Contributions have been made within 120 days from the Contract Date shown on Page 3 of this Contract. We will pay the Cash Value or Annuity Account Value, as applicable, directly to you unless you give us written notice at the time of termination that you request us to make payment to the Annuitant or another person, and that such payment is permissible under the Plan. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount in the Divisions under this Contract and the Annuity Account Value with respect to this Contract shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any restrictions under the terms of the Plan, you may elect by written notice to us to make a partial withdrawal from the Divisions. On the Transaction Date, we will pay the lesser of the Cash Value or the amount of partial withdrawal requested to you. The amount paid plus any withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the amounts you have in the Divisions. Unless instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts that you have in such Divisions. We will pay the Cash Value or Annuity Account Value, as applicable, directly to you unless you give us written notice at the time of the withdrawal that you request us to make payment to the Annuitant or another person, and that such payment is permissible under the Plan. Upon any partial withdrawal payment, we will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by us in accordance with the provisions of Section 4.07. We may decline to accept a request for a partial withdrawal less than $300. If a withdrawal under this Section would result in an Annuity Account Value of less than $500, we will so advise you and reserve the right to pay the Annuity Account Value to you, and terminate this Contract. SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. NO WITHDRAWAL CHARGE FOR PARTIAL WITHDRAWALS: There will be no charge for a partial withdrawal if (a) the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity Account Value, pursuant to Section 1.05. WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than the Free Corridor Amount, we will (i) first withdraw from the Divisions an amount equal to the Free Corridor Amount in proportion to the amount you have in them, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a partial withdrawal charge. Such partial withdrawal charge will be equal to the lesser of (a) or (b) where: No. 92 EDCA Page 9 (a) is an amount equal to 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the amount withdrawn in excess of the Free Corridor Amount (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the total Contributions made on the Annuitant's behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to this Section. If withdrawals are made from this Contract prior to the Annuitant's Retirement Date, any applicable tax charges we have paid with respect to this Contract may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on withdrawals, unless a change in applicable law has occurred with respect to this Contract. SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means if the Annuitant has completed three Contract Years or attained age 59 years and 6 months an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the current Contract Year. If the Annuitant has not completed three Contract Years or attained age 59 years and 6 months, the Free Corridor Amount is zero. SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract Year, if the Annuity Account Value on that date is less than $25,000, we will withdraw from the Divisions an Annual Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account Value including the amount of any withdrawals pursuant to Section 2.07 during that Contract Year. The charge will be allocated among the Divisions in proportion to the amounts you have in the Divisions. If the Annuity Account Value is $25,000 or greater at the end of a Contract Year, the Annual Administrative Charge is zero. If the Annuity Account Value is less than $25,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of termination of this Contract pursuant to Sections 2.06 or 2.11, we will prorate the Annual Administrative Charge applicable to the completed portion of the current Contract Year and withdraw such amount in lieu of the Annual Administrative Charge described in this Section for the applicable part of that Contract Year. SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of the Annuitant's death, we will pay to you as beneficiary in a single sum the amount of the death benefit. You may change the beneficiary or the payment method of the death benefit as permitted by the Plan, pursuant to Section 4.04. The amount of the death benefit is equal to the greater of (i) the Annuity Account Value and (ii) the minimum death benefit. Such minimum death benefit is the sum of all Contributions made by you pursuant to Section 2.01 (before reduction for any applicable tax charge) less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount that was withdrawn is to the Annuity Account Value. If, in accordance with the provisions in Section 2.01, the cash value of another annuity contract issued by us or one of our affiliated or subsidiary life insurance companies, which provides for a death benefit before retirement equal to the greater of the contract cash value or an alternate amount based on premiums paid or contributions made under the annuity contract, is transferred to this Contract, such cash value or alternative amount as of the date of transfer will be included in the "sum of all Contributions" in lieu of the amount of cash value transferred for purposes of the death benefit under this Contract. We will pay the death benefit to the beneficiary in the form of an Annuity Benefit if you have made the election described in the last paragraph of Section 4.04. Also in accordance with the last paragraph of Section 4.04, if no such election is in effect at your death, we will pay the death benefit to the beneficiary in a single sum, unless the beneficiary elects, before we pay the death benefit, to apply the death benefit to an Annuity Benefit. Upon payment of the death benefit, the amount you have in the Divisions and the Annuity Account Value under this Contract shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. - ------------------------------------------------------------------------------- PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. No. 92 EDCA Page 10 The amount of each monthly payment under any Fixed Annuity Benefit provided under the terms of this Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Stock Division of the Separate Account. Such Variable Annuity Benefit will increase if the average daily rate of investment return in the Stock Division is equivalent to more than 6.75% or 5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25% annually, depending on whether the applicable assumed base rate of net investment return referred to in Section 1.24 is 5% or 3.5%, respectively. The daily rate of investment return is before deduction of charges, as described in Section 1.23, not to exceed the maximum rate of 1.75% after any deductions to provide for tax charges. These charges include a daily charge for financial accounting, death benefits, mortality risk, expenses and expense risk, plus the investment advisory fee charges and direct operating expense charges of the Trust. The amount of the first, second and third payments under any Variable Annuity Benefit provided under the terms of this Contract with respect to a payee is the monthly amount provided with respect to the payee pursuant to the fourth paragraph of section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. (As described in Section 3.05, we will notify the payee how each Variable Annuity payment is determined.) SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of the Annuitant's Retirement Date, provided the Annuitant is then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless you elect, subject to the terms of the Plan and the provisions of the Code, (i) to have the Cash Value paid in a single sum, (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by us or one of our affiliated or subsidiary life insurance companies, as elected by you or (iii) to take partial withdrawals in amounts and at times as required by the distribution rules of Section 457(d) and 401(a)(9) of the Code and applicable Treasury Regulations, pursuant to Section 3.05, and subject to our rules then in effect. Notice and election forms will be provided to you not more than six months prior to the Retirement Date. (On your prior written request we will also provide notice and election forms directly to the Annuitant.) If you elect prior to the Annuitant's Retirement Date to terminate this Contract pursuant to Section 2.06, you may elect to have an Annuity Benefit paid in lieu of the Cash Value. If your Plan permits and you provide us written instructions to do so in advance of payment, we will make payment of the Cash Value, Annuity Benefits or partial withdrawals directly to the Annuitant, Substituted Beneficiary or other payee designated by you. We will have the right to require you to furnish pertinent information to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. We may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary life insurance companies. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect pursuant to the first or third paragraph of Section 3.03 to have paid an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value if the annuity form elected involves life contingencies, or (ii) the Cash Value if the annuity form elected does not involve life contingencies. The amount applied to provide an Annuity Benefit may be reduced by a charge for any applicable taxes on annuity considerations, as we determine. If we have previously deducted charges for applicable taxes from Contributions as provided in Section 2.01, we will not again deduct charges for the same taxes before application to provide an Annuity Benefit, unless a change in applicable law has occurred with respect to this Contract. The balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) our current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, this Contract will be governed by our supplementary contract then in effect. No. 92 EDCA Page 11 If an amount is applied to an Annuity Benefit, the amount to be applied will, in addition to any tax charge reduction, be reduced by an administrative charge. The amount of such charge will be determined from time to time in accordance with our general practices applicable on a uniform basis to all contracts of the same type as this Contract. After the application of an amount to provide an Annuity Benefit, the amounts you have in the Divisions and the Annuity Account Value shall be zero. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the terms of this Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (with 100% of the amount of your payment continued to your spouse). The amount of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, is based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and Joint Survivor Life Annuity Form are based on a 50-50 split of males and females at age zero and an Assumed Base Rate of Net Investment Return of 3.5% or 5%, whichever applies pursuant to Section 1.23. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females at age zero if such annuity form provides for a Fixed Annuity Benefit, and on the projected 1983 Basic Table "a" adjusted to a unisex basis based on a 50-50 split of males and females at age zero and an Assumed Base Rate of Net Investment Income Return of 5% or 3.5%, whichever applies pursuant to Section 1.23, if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Pursuant to Sections 457(d) and 401(a)(9) of the Code, and subject to the terms of the Plan, the entire interest of the Annuitant will be distributed or begin to be distributed, no later than the first day of April following the calendar year in which the Annuitant attains 70 years and 6 months ("Required Beginning Date"). The entire interest may be distributed, as elected pursuant to the Plan and this Contract, over (a) the life of the Annuitant, or the lives of the Annuitant and a designated beneficiary, or (b) a period certain not extending beyond the Annuitant's life expectancy, or the joint and last survivor life expectancy of the Annuitant and a designated beneficiary. Distributions must be made in periodic payments at intervals of no longer than one year. In addition, payments must be either nonincreasing or they may increase only as provided in Q&A F-3 of Section 1.401(a)(9)-1 of the Proposed Treasury Regulations, or any successor Regulation thereto. All distributions made hereunder shall be made in accordance with the requirements of Section 401(a)(9) of the Code, including the incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and applicable Treasury Regulations, including the minimum distribution incidental benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or any successor Regulation thereto. For purposes of determining the "period certain" referred to in the first paragraph of this Section, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless otherwise elected prior to the time distributions are required to begin, those life expectancies shall be recalculated annually. Such election shall be irrevocable and shall apply to all subsequent years. The life expectancy of a non-spouse beneficiary may not be recalculated. Instead, life expectancy will be calculated using the attained age of such beneficiary during the calendar year in which the Annuitant attains age 70 years and 6 months, and payments for subsequent years shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. If the Annuitant dies after distribution of the interest described in the first paragraph of this Section has begun, the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution being used prior to the Annuitant's death. Notwithstanding the above paragraphs and the following paragraphs of this Section 3.05, while any distribution shall be subject to such requirements of the Code and regulations, and distribution shall also be subject to the terms of this Contract. That is, the forms of distribution shall be those which are made available by us at the time of your election. If the Annuitant dies before distribution of the interest described in the first paragraph of this Section begins, distribution of the entire interest shall be completed no later than December 31 of the calendar year containing the fifth anniversary of the Annuitant's death, except to the extent that an election is made to receive death benefit distributions in accordance with (1) or (2) below: (1) If the Annuitant's interest is payable to a designated beneficiary, then the entire interest may be distributed over a period certain not greater than the life expectancy of the designated beneficiary. Such distributions must commence on or before December 31 of the calendar year immediately following the calendar year of the Annuitant's death. If the designated beneficiary is not the Annuitant's surviving spouse, a period certain Annuity Benefit cannot exceed 15 years, (even if life expectancy is greater than 15 years). (2) If the designated beneficiary is he Annuitant's surviving spouse, the date distributions that are required to begin in accordance with (1) above shall not be earlier than the later of (A) December 31 of the calendar year immediately following the calendar year of the Annuitant's death or (B) December 31 of the calendar year in which the Annuitant would have attained age 70 years and 6 months. No. 92 EDCA Page 12 For purposes of determining the "period certain" referred to in the immediately preceding paragraph, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of distributions beginning after the Annuitant's death,, unless otherwise elected by the surviving spouse by the time distributions are required to begin, life expectancies shall be recalculated annually. Such election shall be irrevocable by the surviving spouse and shall apply to all subsequent years. In the case of any other designated beneficiary, life expectancies shall be calculated using the attained age of such beneficiary during the calendar year in which distributions are required to begin pursuant to this Section, and payments for any subsequent calendar year shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. Distributions under this Section are considered to have begun if distributions are made because the Required Beginning Date was reached, or, if prior to the Required Beginning Date, distributions irrevocably commence to an individual over a period permitted an in an annuity form acceptable under Section 1.401(a)(9) of the Proposed Treasury Regulations or any successor Regulation thereto. Evidence of each payee's survival must be furnished to us either by personal endorsement of the check drawn for payment or by other means satisfactory to us. If a benefit payment under the terms of this Contract was based on information that is subsequently found to be incorrect, the benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by us will be charged against, and underpayments will be added to, any payments thereafter falling due under this Contract with respect to the payee, affecting as many such payments as are necessary to correct the overpayment or underpayment. Our liability, with respect to the payee, is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under this Contract. If we receive evidence satisfactory to us that (i) a payee entitled to receive any payment under this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, we may make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If a variable annuity form made available by us provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Pursuant to Section 3.03, upon the election of an annuity form providing payment for a period certain, you (or the Annuitant, if you have advised us in writing that it is permitted under the terms of the Plan) may designate (with the right to change such designation) a payee to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. Subject to the terms of the Plan, the payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's estate in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, we will pay in a single sum to such payee's estate the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis applicable in determining the annuity amount. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last period due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. We will require satisfactory evidence of the age of any person upon whose life an annuity form depends. No. 92 EDCA Page 13
- --------------------------------------------------------------------------------------------------------------------------------- TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE (Minimum Monthly Income per $1,000 of Annuity Account Value) - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ---------- Age 60 61 62 63 64 65 66 67 68 69 70 - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ---------- 60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88 61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96 62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03 63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11 64 4.89 4.94 5.00 5.05 5.10 5.14 5.19 65 5.00 5.06 5.11 5.17 5.22 5.27 66 5.12 5.18 5.24 5.29 5.35 67 5.24 5.31 5.37 5.43 68 5.37 5.44 5.51 69 5.52 5.59 70 5.67 - ----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ----------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Account Value) VARIABLE ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS Age 3.5% 5% - ------------- ------------------------ ---------------------- 60 5.27 6.16 61 5.39 6.28 62 5.52 6.41 63 5.66 6.55 64 5.81 6.70 65 5.97 6.86 66 6.15 7.03 67 6.33 7.21 68 6.53 7.41 69 6.74 7.62 70 6.97 7.85 We will, with respect to each payment of a Variable Annuity Benefit, notify the payee of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each variable payment. Such notice will be mailed with each payment. Any election, change, revocation or designation shall be made, and will take effect on the Transaction Date, in the same manner as a change of beneficiary as described in Section 4.04. If a commutation right under an Annuity Benefit is exercised, we may defer payment in accordance with Section 4.07. - ------------------------------------------------------------------------------- PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT. The Contract constitutes the entire Contract between the parties and the terms of this Contract alone will govern with respect to our rights and obligations. A copy of the application is incorporated in and made part of this Contract. This Contract may not be modified, nor may any of our rights or requirements be waived, except in writing and by our authorized officer. The terms of this Contract may be changed by amendment or replacement upon agreement between the Owner and us without the consent of any other person. SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the term of this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform this Contract to reflect changes in the Code, applicable Treasury Regulations or in regulations or published rulings of the Internal Revenue Service so that this Contract will continue to be an Annuity utilized to fund a plan qualifying under Section 457 of the Code. SECTION 4.03 NONFORFEITABILITY, NONTRANSFERABILITY AND ASSIGNMENTS. The entire interest under this Contract is nonforfeitable except by surrender to us. Any interest under the terms of this Contract may not be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than us. No amount payable under the terms of this Contract may be assigned or commuted, unless specifically provided for under the terms of this Contract, or encumbered by the payee, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. No. 92 EDCA Page 14 SECTION 4.04 BENEFICIARY. You, as beneficiary, are entitled to receive any death benefit payable under this Contract pursuant to Section 2.11. Upon the Annuitant's death you may, by written request to our Processing Office, at any time up to and including provision of due proof of such death, change the beneficiary designation for the Section 2.11 death benefit from you to the Substitute Beneficiary. Subject to the terms of the Plan, the Substitute Beneficiary may elect to receive the death benefit payable under Section 2.11 in the form of an Annuity Benefit rather than as a single sum. Any such election must meet the minimum distribution rules of Sections 457(d) and 401(a)(9) of the Code and applicable Treasury Regulations, as described in Section 3.05. SECTION 4.05 DISQUALIFICATION OF PLAN OR CONTRACT. In the event that the Plan fails to qualify as an Eligible Deferred Compensation Plan under Section 457 of the Code and applicable Treasury Regulations, we reserve the right, upon receiving notice of such fact, to transfer the Annuity Account Value under this Contract to another annuity contract issued by us or one of our affiliated or subsidiary life insurance companies on the life of the Annuitant, or to terminate this Contract and pay to the Annuity Account Value less a deduction for applicable taxes, solely at our option. In the event that this Contract fails to qualify as an Annuity as described in Section 1.02, we will have the right, upon receiving notice of such fact, to terminate this Contract and pay to you the Annuity Account Value less a deduction for the appropriate part attributable to you of any income tax payable by you which would not have been payable if you had an Annuity. SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to you, we reserve the right to limit Contributions under this Contract if required by law. SECTION 4.07 DEFERMENT. Applications of proceeds to a variable annuity, payment of a death benefit and payment of any portion of the Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange has been closed or trading on it is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Securities and Exchange Commission, by order, permits us to defer payments in order to protect persons with interests in the Investment Divisions. We can defer payment of any portion of the Annuity Account Value in the Guaranteed Interest Division for up to six months while the Annuitant is living. SECTION 4.08. ANNUAL NOTICE. At the end of each Contract Year, we will furnish you with a notice showing the following: (1) the amount in the Guaranteed Interest Division, (2) the total number of Accumulation Units in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Value, (4) the amount you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the Cash Value, and (6) the amount of death benefit payable with respect to the Annuitant. We will also furnish annual calendar year reports concerning the status of the annuity and any other reports required by the Code or applicable Treasury Regulations. After your Retirement Date, we will notify the Employer of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.09 AGE. If the Annuitant's age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by us will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. SECTION 4.10 OWNERSHIP RIGHT OF EMPLOYER. Notwithstanding any other provision of the terms of this Contract, until amounts under this Contract are distributed or made available to the Annuitant or the Annuitant's beneficiary in accordance with the terms of this Contract and the terms of the Plan, this Contract remains solely the property of the Employer subject only to claims of the Employer's general creditors. This Section shall be construed and administered in accordance with Section 457(b)(6) of the Code and the regulations thereunder. No. 92 EDCA Page 15 APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, New York, New York 10116-2996 QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR: EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY ------------------------------------------------------------------------------- TYPE OF PURCHASE (Complete One Plan Only) A. |_| TSA PUBLIC SCHOOL (GV-PS-I) B. |_| TSA 501(c)(3) ORGANIZATION (GV-501-I) C. |_| TSA University (GV-PS-U-I) D. |_| IRA Individual (including IRA to IRA transfers) (GV-IRA 4971) E. |_| IRA Unit Billed (including IRA to IRA transfers) (GV-IRA 4971) F. |_| IRA QUALIFIED PLAN ROLLOVER-- (QP IRA) (Distribution from a Qualified Plan) (GV-IRA 4971-71) G. |X| EDC (Public Employee Deferred Compensation) (GV-EDC 4991) H. |_| EDC (Tax Exempt Organization) (GV-EDC 4991-SU-808) I. |_| SEP (Simplified Employee Pension) (GV-SEP 4981) J. |_| SARSEP (Salary Reduction SEP) _________________________________________ K. |_| CORPORATE TRUSTEED (GV-CORP 4941-41) L. |_| KEOGH/HR-10 TRUSTEE (GV HR-10 4911-11) (trustee owned) M. |_| KEOGH/HR-10 (GV-HR-10 4911) (not trustee owned) (issued to existing units only) - -------------------------------------------------------------------------------- DO NOT COMPLETE THIS SECTION IF BOX 1.D OR 1.F CHECKED ABOVE 2. EMPLOYER/PLAN NAME |A|B|C|_|S|T|A|T|E|_|D|E|F|E|R|R|E|D|_|C|O|M|P|E|N|S|A|T|I|O|N|_|P|R|O|G|R|A|M| 3. |_| EXISTING UNIT NO. |_|_|_|_|_|_|-|_|_|_| |_| NEW UNIT |_|_|_|_|_|_|-|_|_|_| (FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP, OR TRUSTEED PLANS, FORM 983-135B IS REQUIRED.) - -------------------------------------------------------------------------------- 4. PROPOSED ANNUITANT Print name to appear on Contract. |J|O|H|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|D|O|E|_|_|_|_|_| First Middle Initial Last A. |X| Mr. |_| Mrs. |_| Ms. |_| Other ____ B. Date of Birth: Year 1954 Month JANUARY Day 27 ---- ------- -- C. Age at Nearest Birthday: 38 D. |X| Male |_| Female ---- E. Annuitant's Mailing Address: F. State of Residence: N.J. -------- No. St. |1|7|_|E|L|M|_|S|T|R|E|E|T|_|_|_|_|_|_|_|_|_|_|_|_| City |A|N|Y|T|O|W|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1| G. Telephone Number (101) 222 - 3456 |X| Home |_| Work H. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9| I. Are you associated with or employed by a member of National Association of Securities Dealers, Inc. (NASD)? |_| Yes |X| No 5. OWNER (Print Name) -- If Trusteed or EDC Plan Print Name of Owner; for all other Markets Print Name of Annuitant. JOHN DOE --------------------------------------------------------------------------- a. Title _________________________________________ 6. RETIREMENT AGE __65_______________________________ 7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death Benefit upon Annuitant's death before Retirement Date.) (BENEFICIARY MUST BE THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS). ABC STATE DEFERRED COMPENSATION PROGRAM - EMPLOYER --------------------------------------------------------------------------- --------------------------------------------------------------------------- --------------------------------------------------------------------------- 8. CONTRIBUTION ALLOCATION Guaranteed Interest Division ____% Stock Division ____% Money Market Division ____% Balanced Division ____% Aggressive Stock Division ____% (PERCENTAGES IN WHOLE NUMBERS) Total 100% 9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F) A. Reminder Notice (Billing) Required |_| Yes |_| No IF YES, COMPLETE B-C-D-E B. REMINDER DATE Required for Individual IRA or otherwise must agree with existing unit or attached 983-135B. MONTH _________ DAY __________ C. REMINDER FREQUENCY |_| Annual |_| Semi-Annual |_| Quarterly |_| Monthly Available for TSA, EDC, SARSEP AND CORPORATE TRUSTEED AND UNIT BILLED IRA ONLY: |_| Semi-Monthly |_| Bi-Weekly D. REMINDER AMOUNT $_____________________________________________________ E. BILLING MONTHS TO BE EXCLUDED - TSA ONLY --------------------------------------------------------------------------- --------------------------------------------------------------------------- --------------------------------------------------------------------------- 10. EXPECTED FIRST CONTRACT YEAR Contribution. $1000 ------------------------------------------------------------- If an advanced billing and/or contract date are requested, complete #9b and #12. - -------------------------------------------------------------------------------- (FOR PROCESSING OFFICE USE) Unit Name ____________________________ Reminder Date ________________________ Cert. or App# ________________________ Amendment Required____________________ EDC Emp. Add. ________________________ Emp. Fed. ID# ________________________ Frequency ____________________________ Contract Date ________________________ Receipt Date Batch # Inquiry # Processor - -------------------------------------------------------------------------------- 180-1000B - -------------------------------------------------------------------------------- 10. Did you receive the Separate Account Prospectus? |X| Yes |_| No Date shown on Prospectus January 1, 1992 Date of any supplement to Prospectus ______________________________________ 11. Items (a) through (f) are to be answered by the annuitant. We are required by the NASD to ask these questions. (a) Name of Employer: ABC Company ----------------------------------------------------- (b) Address of Employer: 10 Main Street --------------------------------------------------------------------------- Anytown, NJ --------------------------------------------------------------------------- (c) Occupation Sales ------------------------------------------------------------- (d) Assuming the contract applied for will be issued, will any existing insurance or annuity be replaced or changed (or has it been)? |_| Yes |x| No (e) Estimated Family Annual Income $100,000 (f) Estimated Net Worth $250,000 (g) Investment Objective: |_| Income |X| Income & Growth |_| Aggressive Growth |_| Growth |_| Safety of Principal 12. SPECIAL INSTRUCTIONS --------------------------------------------------------------------------- --------------------------------------------------------------------------- --------------------------------------------------------------------------- --------------------------------------------------------------------------- --------------------------------------------------------------------------- 13. AMOUNT PAID WITH THIS FORM: $1000 ----------------------------------------------- (If a check is submitted with this request, no advanced Contract Date is permitted.) BACKDATING IS NOT PERMITTED. NOTE: Amount paid will be credited upon receipt at Equitable's Processing Office, subject to return if the contract is not issued. The Contract Date will be the date of receipt by Equitable of this application, properly signed and completed, and Contribution at Equitable's Processing Office. ================================================================================ AGREEMENT All information and statements furnished in this application are true and complete to the best of my knowledge and belief. I understand and acknowledge that no Agent has the authority to make or modify any contract on Equitable's behalf, or to waive or alter any of Equitable's rights and regulations. IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO THE INVESTMENT FUNDS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT. UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S) OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND COMPLETE. - -------------------------------------------------------------------------------- LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR ANNUITY APPLICATION WITH INFORMATION YOU KNOW IS FALSE OR TO LEAVE OUT MATERIAL FACTS. - -------------------------------------------------------------------------------- x__________________________________ Date_______ City __________ State __________ Signature of Annuitant x__________________________________ Date_______ City __________ State __________ Signature of Authorized Individual (REQUIRED FOR EDC AND TRUSTEED) OR Owner ================================================================================ AGENT'S SECTION Will any existing insurance or annuity be replaced or changed (or has it been), assuming the Contract will be issued? |_| Yes |_| No |_| I (we) certify that a prospectus for the Contract has been given to the proposed Annuitant and that no written sales materials other than those approved by The Equitable have been used. EQUI-VEST issues must adequately reflect the commission interest of all Agents on previous contracts. - -------------------------------------------------------------------------------- Print Agent's Name(s) Initial of Agent Agent Agency District Agent's (Service Agent first) Last Name Number % Code Manager Code Signature - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- For Agency Compliance File: Initials of Agency EQS_ Date_ District EQS_ Date_ - -------------------------------------------------------------------------------- (FOR ASU USE) ASU Code and App. No. __________________________________________________________ ASU Rec'd. _____________________________________________________________________ Date to Proc. Off. ________________________________________________ Campaign |_| Agent(s) shown above is Equity Qualified and is licensed in the state where the request is signed. Above Agent information verified by ASM (Registered Rep) - -------------------------------------------------------------------------------- Application reviewed by ________________________________________________________ - -------------------------------------------------------------------------------- 180-1000B [THE EQUITABLE LOGO] Owner: Annuitant: Contract Number: Issue Date: Contract Date: Retirement Date: - -------------------------------------------------------------------------------- THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P O Box 2996, New York, New York 10116-2996 AGREES o TO ALLOCATE the Contributions made to this Contract after deduction of any applicable tax charge, to the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division of the Separate Account (referred to in this Contract as the "Investment Divisions") or to the Guaranteed Interest Division, in accordance with Sections 2.02, 2.03 and 2.04, as directed by you, and o TO APPLY the Annuity Account Value at the Retirement Date to provide the Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant is then living, and o TO PROVIDE you with the other rights and benefits of this Contract. This is the entire Contract. In this Contract, "we", "our" and "us" mean The Equitable Life Assurance Society of the United States. "You" and "your" mean the Employer at the time a right is exercised by the Employer. TEN DAYS TO EXAMINE CONTRACT -- You may cancel this Contract by returning it to us within ten days after receipt of it. Upon such cancellation, we will refund any Contribution made to us on the Annuitant's behalf under this Contract, plus or minus any investment gain or loss experienced in the Investment Divisions of the Separate Account from the date such Contribution was allocated to such Investment Division to the date we receive the returned Contract. /s/Pauline Sherman /s/Edward D. Miller Pauline Sherman Edward D. Miller Vice President, Secretary & President and Associate General Counsel Chief Executive Officer THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.24 IS 5% OR 3.5%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISKS, EXPENSES AND EXPENSE RISK, PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE TRUST. No. 92 EDCB This Contract is issued in consideration of the payment to us of the Contributions made under the terms of this Contract. The provisions on the following pages are part of this Contract. - -------------------------------------------------------------------------------- TABLE OF CONTENTS DEFINITIONS Page Section 1.01 - Annuitant ................................................4 1.02 - Annuity ..................................................4 1.03 - Annuity Account Value ....................................4 1.04 - Annuity Benefit ..........................................4 1.05 - Cash Value ...............................................4 1.06 - Class of Contracts........................................5 1.07 - Code .....................................................5 1.08 - Contract..................................................5 1.09 - Contract Date ............................................5 1.10 - Contract Year ............................................5 1.11 - Contribution .............................................5 1.12 - Divisions.................................................5 1.13 - Eligible Annuity Certain..................................5 1.14 - Employer..................................................5 1.15 - Guaranteed Interest Rate..................................5 1.16 - Joint and Survivor Life Annuity Form......................5 1.17 - Life Annuity Form.........................................5 1.18 - Normal Form...............................................5 1.19 - Period Certain Annuity ...................................5 1.20 - Plan......................................................5 1.21 - Processing Office.........................................6 1.22 - Retirement Date ..........................................6 1.23 - Separate Account .........................................6 1.24 - Separate Account Definitions..............................7 1.25 - Substituted Beneficiary ..................................7 1.26 - Transaction Date .........................................7 1.27 - Trust ....................................................7 ANNUITY ACCOUNT VALUE Section 2.01 - Contributions ............................................8 2.02 - Separate Account Investment Divisions.....................8 2.03 - Guaranteed Interest Division .............................8 2.04 - Allocation to Divisions ..................................8 2.05 - Transfers Among Divisions ................................9 2.06 - Termination of this Contract .............................9 2.07 - Partial Withdrawals ......................................9 2.08 - Charges for Partial Withdrawals ..........................9 2.09 - Free Corridor Amount ....................................10 2.10 - Annual Administrative Charge ............................10 2.11 - Death Benefit............................................10 ANNUITY BENEFITS Section 3.01 - Fixed Annuity Benefit ...................................10 3.02 - Variable Annuity Benefit.................................11 3.03 - Election and Commencement of Annuity Benefits............11 3.04 - Amount of Annuity Benefits...............................11 3.05 - Payment of Annuity Benefits .............................12 GENERAL PROVISIONS Section 4.01 - Contract.................................................14 4.02 - Statutory Compliance ....................................14 4.03 - Nonforfeitability, Nontransferability and Assignments....14 4.04 - Beneficiary .............................................15 4.05 - Disqualification of Plan or Contract.....................15 4.06 - Future Contributions ....................................15 4.07 - Deferment ...............................................15 4.08 - Annual Notice............................................15 4.09 - Age......................................................15 4.10 - Ownership Right of Employer..............................15 No. 92 EDCB Page 2 PART I -- DEFINITIONS SECTION 1.01 ANNUITANT. The term "Annuitant" means an individual who participates in a Plan or, if the Plan permits, a beneficiary under the Plan, as shown on Page 3 of this Contract, and on whose behalf this Contract is purchased and is maintained. SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in accordance with the terms of the Plan. SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts that you have in the Guaranteed Interest Division and the Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by us pursuant to Section 3.04 of this Contract. Various sections of this Contract (Sections 1.16, 1.17, 1.18, 1.19, 3.01, and 3.02) refer to monthly payments to be made under an Annuity Benefit. You may elect to have the Annuity Benefit paid at other intervals, such as quarterly, semi-annually, or annually, instead of monthly. You may elect this at the time you elect the Annuity Benefit form as described in Section 3.03; in that event, all references in this Contract to monthly payments will be deemed to mean payments at the frequency you elect, subject to our rules at the time of election. SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value less any applicable withdrawal charge determined as follows: The withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the excess of (i) the sum of the Annuity Account Value over (ii) the Free Corridor Amount defined in Section 2.09. (b) is the excess, if any, of (i) 8% of the total Contributions made on the Annuitant's behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to Section 2.08. However, notwithstanding the above, if the Annuitant is age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. A withdrawal charge will not apply, which means the Cash Value will equal the Annuity Account Value upon any of the following occurrences: (i) the later of the completion of at least five Contract Years and the Annuitant's attainment of age 59 years and 6 months, or (ii) the completion of at least twelve Contract Years, or (iii) a request is made for a refund of a Contribution in excess of the amount that may be contributed under Section 457 of the Code within one month of the date on which the Contribution is made, or (iv) the Annuitant's attainment of age 55, his completion of at least five Contract Years and the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase an Eligible Annuity Certain, defined in Section 1.13, or (v) the Annuitant's completion of at least three Contract Years and the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase a Period Certain Annuity, defined in Section 1.19, where the certain period of such annuity is at least ten years, or (vi) the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase a life annuity distribution, pursuant to the terms of this Contract, or (vii) the Annuitant dies and a death benefit is payable to the beneficiary. No. 92 EDCB Page 4 The above statements notwithstanding, we reserve the right to modify or waive any early withdrawal charges in order to comply with any applicable state or local legal or regulatory requirements. Any such modification or waiver will apply equally to all Annuitants under a Plan subject to such a state or local legal or regulatory requirement. SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all Contracts with a Contract Date in the same calendar year. SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.08 CONTRACT. The term "Contract" means this Contract. SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt by us of both the application for this Contract, properly signed and completed, and a Contribution. SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month period beginning on (i) the Contract Date, and (ii) each anniversary thereafter, unless otherwise agreed to in writing by us. SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us pursuant to the terms of the Plan to this Contract. We are under no obligation to accept any Contribution less than $20.00. SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or severally as the case may be, the following divisions described in this Contract: (i) the Guaranteed Interest Division, and (ii) the Investment Divisions of the Separate Account. SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means a Period Certain Annuity issued by us which extends beyond the Annuitant's attainment of age 59 years and 6 months and does not permit any prepayment of the unpaid principal (that is, no withdrawal or single sum payment) prior to your attainment of age 59 years and 6 months. SECTION 1.14 EMPLOYER. The term "Employer" means one of the following types of entity which is eligible to adopt, has adopted, and maintains a Plan: (i) a State, a political subdivision of a State, or an agency or instrumentality of a State or political subdivision of a State, or (ii) any other organization exempt from tax under the Code which has adopted and maintains a Plan for a select group of management or highly compensated employees within the meaning of the Employee Retirement Income Security Act of 1974, as amended. The Employer is the Owner of and beneficiary under this Contract. SECTION 1.15 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means the effective annual rate at which interest accrued on the amount in the Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of this Contract. Section 2.03 describes the determination of the rate to apply thereafter. SECTION 1.16 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by you. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.17 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity issued by us providing monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.18 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under this Contract means (i) if the Annuitant has a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (with 100% of the monthly payment amount continued to the spouse), and (ii) if the Annuitant does not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by us which does not permit any prepayment of the unpaid principal (that is, you cannot elect to receive part of the payments as a single sum payment with the remainder paid in monthly annuity payments). SECTION 1.20 PLAN. The term "Plan" refers to an "Eligible Deferred Compensation Plan" meeting the requirements of Section 457(b) of the Code and applicable Treasury Regulations which is established and maintained by an Employer for the benefit of individuals performing services for the Employer and their beneficiaries. No. 92 EDCB Page 5 SECTION 1.21 PROCESSING OFFICE. The term "Processing Office" means our Individual Annuity Center, P O Box 2996, New York, New York 10116-2996, or such other location as we shall designate by advance written notice to the Employer or the Plan's Trustee, as applicable. SECTION 1.22 RETIREMENT DATE. The term "Retirement Date" means the date on which the Annuitant attains the retirement age as shown on Page 3 of this Contract. Before the Retirement Date the Employer may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be earlier than the Retirement Date provided under the Plan nor shall it be later than the date the Annuitant attains age 70 years and 6 months. Any election for such change must be made in writing by you and shall not take effect until received by us at the Processing Office. SECTION 1.23 SEPARATE ACCOUNT. The term "Separate Account" means Separate Account A which is organized as a unit investment trust, a type of investment company. We established the Separate Account and it is maintained in accordance with the laws of New York State; Realized and unrealized gains and losses from the assets of the Separate Account are credited to or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts and certificates. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities or variable life insurance. The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to these contracts will not be chargeable with liabilities arising out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to our General Account. The Separate Account consists of "Investment Divisions". Each Investment Division may invest its assets in a separate class (or series) of shares of a designated Trust where each class (or series) represents a separate portfolio in such Trust. We reserve the right to change the designated trust or investment company or to add designated trusts or investment companies. The Investment Divisions available are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. The Guaranteed Interest Division is not part of the Separate Account, but rather is an asset of our General Account. We will value the assets of each Investment Division on each business day. A business day is any day on which we are open, the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio securities in which an Investment Division is invested to materially affect the Accumulation Unit Value. We may, at our discretion, invest the assets of any Investment Division in any investment permitted by applicable law. We may rely conclusively on the opinion of counsel (including attorneys in our employ) as to what investments we are permitted by law to make. We reserve the right to (i) cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such committee at any time; (iii) restrict or eliminate any voting rights as to the Separate Account; (iv) operate the Separate Account by making direct investments, or in any other form; (v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or remove Investment Divisions (or sub-divisions of Investment Divisions) from the Separate Account (the term "investment Division" in this Contract shall then refer to any other Investment Division in which the assets, of a class of contracts to which this Contract belongs, were placed); (vi) combine any two or more Investment Divisions (or sub-divisions of Investment Divisions) of the Separate Account; and (vii) withdraw from any Investment Division and to allocate to another Investment Division assets determined by us to be associated with the class of contracts to which this Contract belongs. If the exercise of these rights results in a material change in the underlying investments of an Investment Division, you will be notified of such exercise, as required by law. No. 92 EDCB Page 6 Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for applicable tax charges) at a rate not to exceed 1.49% per year for each of the Stock, Money Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock Division, for financial accounting, death benefits, mortality risk, expenses and expense risk. The charge shall be made in accordance with Subsection (c) of the Net Investment Factor provision in Section 1.24. The relative proportion of these charges may be modified. This daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust, shall not exceed a total annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to this Contract. SECTION 1.24 SEPARATE ACCOUNT DEFINITIONS. VALUATION PERIOD: Each business day together with any preceding consecutive non-business days. NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b), minus (c), where (a) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the Valuation Period before giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period. For this purpose, we use the share value reported to us by the Trust. (b) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the preceding Valuation Period (after taking into account any amounts allocated or withdrawn for that Valuation Period). (c) is the daily Separate Account charge for the expenses of this Contract, times the number of calendar days in the Valuation Period. ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an Investment Division where Contributions made on the Annuitant's behalf are invested and which is used in determining the amount in an Investment Division. ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of each Accumulation Unit in an Investment Division on a given date. The Accumulation Unit Value for a Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for that Investment Division for such Valuation Period. ANNUITY UNIT: The "Annuity Unit" is a unit used in determining amounts payable from the Stock Division of the Separate Account under a Variable Annuity Benefit as defined in Section 3.02. ANNUITY UNIT VALUE: An "Annuity Unit Value" was fixed at $1.00 on November 1, 1968. On August 27, 1981, the date the first Contribution was put into the Stock Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar month is equal to the average of the Annuity Unit Values for all Valuation' Periods ending in such month. SECTION 1.25 SUBSTITUTED BENEFICIARY. The term "Substituted Beneficiary" refers to the beneficiary designated under the Plan by the Annuitant to receive death benefits payable under the Plan, where the Employer has elected, pursuant to Section 4.04 to designate such person to receive the death benefit payable under Section 2.11. SECTION 1.26 TRANSACTION DATE. The term "Transaction Date" means the business day we receive a Contribution or a written contract transaction request providing the information we need at the Processing Office. In the case of a transfer request initiated through the use of a touch tone telephone, as described in Section 2.05, the Transaction Date is the business day the telephone transaction is received. SECTION 1.27 TRUST. The term "Trust" means the designated trust or investment company in which Separate Account assets are invested. No. 92 EDCB Page 7 - -------------------------------------------------------------------------------- PART II -- ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. You are to make Contributions from time to time on such dates and in such amounts as you determine pursuant to the terms of the Plan; Contributions will be allocated to the Divisions in accordance with the instructions received on the application, unless later changed. Each Contribution received by us on the Annuitant's behalf will, before its allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. If the Plan permits, we will accept transfers made from another eligible deferred compensation plans meeting the requirements of Section 457 of the Code or other funds invested under the Employer's Plan. SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when an amount is allocated to, or withdrawn or transferred from, an Investment Division, the Annuity Account Value will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Sections 2.07 or 2.08 or transferred from the Investment Division pursuant to Section 2.05. The amount in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units in the Investment Division on that date and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under this Contract terminates on the earliest of (i) Election and Commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of the Annuitant's death or (iii) Termination of this Contract pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division becomes part of our general assets which support the guarantees of this Contract and other contracts. The amount in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Sections 2.07, 2.08 or 2.10 or transferred from the Guaranteed Interest Division pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division on a Transaction Date pursuant to Section 2.04. We will credit the amount you have in the Guaranteed Interest Division with interest at effective annual rates that we determine. For each Class of Contracts we determine a yearly guaranteed interest rate that will remain in effect throughout the next year. We guarantee that this yearly guaranteed interest rate will never be less than 3%. Participation in the Guaranteed Interest Division under the terms of this Contract terminates on the earliest of (i) Election and Commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of the Annuitant's death or (iii) Termination of this Contract pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section 2.01 is allocated (after deduction for any applicable tax charge) to one or more Divisions, at your sole direction as specified to us. Allocation percentages must be in whole numbers and the sum must equal 100. The allocation is made as of the Transaction Date on which we have received both such Contribution and such direction. Contributions made to an Investment Division purchase Accumulation Units in that Investment Division, using the Accumulation Unit Value next computed after the Transaction Date. If your Plan permits, and you provide us with advance written instructions to do so, we will accept allocation instructions directly from the Annuitant. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the Transaction Date with respect to each transfer from the Division pursuant to Section 2.05, (iii) on the Transaction Date with respect to each withdrawal pursuant to Section 2.07, (iv) at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, (v) upon Termination of this Contract pursuant to Section 2.06 and (vi) upon the Annuitant's death pursuant to Section 2.11. No. 92 EDCB Page 8 SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request or through the use of a touch tone telephone, transfer all or part of the amount you have in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; and (2) amounts in the Money Market Division may be transferred to other Divisions. Written authorization for touch tone telephone initiated transfers is only required when authorization for telephone transfers is requested. Upon advance written notice to you, we reserve the right to discontinue the acceptance of transfer requests through the use of a touch tone telephone. If the Plan permits and you provide us with advance written instructions to do so, we will accept transfer instructions directly from the Annuitant. All transfers will be effective on the Transaction Date and will be subject to our rules in effect at the time of transfer. With respect to the Investment Divisions, the transfer will be made at the Accumulation Unit Value next computed after the Transaction Date. No transfers are permitted to the Money Market Division from the other Divisions. SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the terms of the Plan, you may elect by written notice to terminate this Contract. We will determine the Cash Value of this Contract as of the Transaction Date. If this Contract is terminated, surrendered or exchanged prior to the Annuitant's Retirement Date, any applicable tax charges we have paid may be deducted. If we previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on terminations, unless a change in applicable law has occurred with respect to this Contract. Cash Value payments may be deferred by us in accordance with the provisions of Section 4.07. Subject to the terms of the Plan, we reserve the right to pay the Annuity Account Value under this Contract and terminate this Contract if (i) you make no Contributions during the last three completed Contract Years, or (ii) you make a partial withdrawal that would result in the Annuitant's Annuity Account Value falling below $500. We also reserve the right to terminate this Contract if no Contributions have been made within 120 days from the Contract Date shown on Page 3 of this Contract. We will pay the Cash Value or Annuity Account Value, as applicable, directly to you unless you give us written notice at the time of termination that you request us to make payment to the Annuitant or another person, and that such payment is permissible under the Plan. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount in the Divisions under this Contract and the Annuity Account Value with respect to this Contract shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any restrictions under the terms of the Plan, you may elect by written notice to us to make a partial withdrawal from the Divisions. On the Transaction Date, we will pay the lesser of the Cash Value or the amount of partial withdrawal requested to you. The amount paid plus any withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the amounts you have in the Divisions. Unless instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts that you have in such Divisions. We will pay the Cash Value or Annuity Account Value, as applicable, directly to you unless you give us written notice at the time of the withdrawal that you request us to make payment to the Annuitant or another person, and that such payment is permissible under the Plan. Upon any partial withdrawal payment, we will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by us in accordance with the provisions of Section 4.07. We may decline to accept a request for a partial withdrawal of less than $300. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, we will so advise you and reserve the right to pay the Annuity Account Value to you, and terminate this Contract. SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. NO WITHDRAWAL CHARGE FOR PARTIAL WITHDRAWALS: There will be no charge for a partial withdrawal if (a) the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity Account Value, pursuant to Section 1.05. WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than the Free Corridor Amount, we will (i) first withdraw from the Divisions an amount equal to the Free Corridor Amount in proportion to the amount you have in them, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a partial withdrawal charge. Such partial withdrawal charge will be equal to the lesser of (a) or (b) where: No. 92 EDCB Page 9 (a) is an amount equal to 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the amount withdrawn in excess of the Free Corridor Amount (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the total Contributions made on the Annuitant's behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to this Section. If withdrawals are made from this Contract prior to the Annuitant's Retirement Date, any applicable tax charges we have paid with respect to this Contract may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on withdrawals, unless a change in applicable law has occurred with respect to this Contract. SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means if the Annuitant has completed three Contract Years or attained age 59 years and 6 months an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the current Contract Year. If the Annuitant has not completed three Contract Years or attained age 59 years and 6 months, the Free Corridor Amount is zero. SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract Year, if the Annuity Account Value on that date is less than $25,000, we will withdraw from the Divisions an Annual Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account Value including the amount of any withdrawals pursuant to Section 2.07 during that Contract Year. The charge will be allocated among the Divisions in proportion to the amounts you have in the Divisions. If the Annuity Account Value is $25,000 or greater at the end of a Contract Year, the Annual Administrative Charge is zero. If the Annuity Account Value is less than $25,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of termination of this Contract pursuant to Sections 2.06 or 2.11, we will prorate the Annual Administrative Charge applicable to the completed portion of the current Contract Year and withdraw such amount in lieu of the Annual Administrative Charge described in this Section for the applicable part of that Contract Year. SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of the Annuitant's death, we will pay to you as beneficiary in a single sum the amount of the death benefit. You may change the beneficiary or the payment method of the death benefit as permitted by the Plan, pursuant to Section 4.04. The amount of the death benefit is equal to the greater of (i) the Annuity Account Value and (ii) the minimum death benefit. Such minimum death benefit is the sum of all Contributions made by you pursuant to Section 2.01 (before reduction for any applicable tax charge) less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount that was withdrawn is to the Annuity Account Value. If, in accordance with the provisions of Section 2.01, the cash value of another annuity contract issued by us or one of our affiliated or subsidiary life insurance companies, which provides for a death benefit before retirement equal to the greater of the contract cash value or an alternate amount based on premiums paid or contributions made under the annuity contract, is transferred to this Contract, such cash value or alternative amount as of the date of transfer will be included in the "sum of all Contributions" in lieu of the amount of cash value transferred for purposes of the death benefit under this Contract. We will pay the death benefit to the beneficiary in the form of an Annuity Benefit if you have made the election described in the last paragraph of Section 4.04. Also in accordance with the last paragraph of Section 4.04, if no such election is in effect at your death, we will pay the death benefit to the beneficiary in a single sum, unless the beneficiary elects, before we pay the death benefit, to apply the death benefit to an Annuity Benefit. Upon payment of the death benefit, the amount you have in the Divisions and the Annuity Account Value under this Contract shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. - -------------------------------------------------------------------------------- PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. No. 92 EDCB Page 10 The amount of each monthly payment under any Fixed Annuity Benefit provided under the terms of this Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Stock Division of the Separate Account. Such Variable Annuity Benefit will increase if the average daily rate of investment return in the Stock Division is equivalent to more than 6.75% or 5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25% annually, depending on whether the applicable assumed base rate of net investment return referred to in Section 1.24 is 5% or 3.5%, respectively. The daily rate of investment return is before deduction of charges, as described in Section 1.23, not to exceed the maximum rate of 1.75% after any deductions to provide for tax charges. These charges include a daily charge for financial accounting, death benefits, mortality risk, expenses and expense risk, plus the investment advisory fee charges and direct operating expense charges of the Trust. The amount of the first, second and third payments under any Variable Annuity Benefit provided under the terms of this Contract with respect to a payee is the monthly amount provided with respect to the payee pursuant to the fifth paragraph of Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. (As described in Section 3.05, we will notify the payee how each Variable Annuity payment is determined.) SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of the Annuitant's Retirement Date, provided the Annuitant is then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless you elect, subject to the terms of the Plan and the provisions of the Code, (i) to have the Cash Value paid in a single sum, (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by us or one of our affiliated or subsidiary life insurance companies, as elected by you or (iii) to take partial withdrawals in amounts and at times as required by the distribution rules of Section 457(d) and 401(a)(9) of the Code and applicable Treasury Regulations, pursuant to Section 3.05, and subject to our rules then in effect. Notice and election forms will be provided to you not more than six months prior to the Retirement Date. (On your prior written request we will also provide notice and election forms directly to the Annuitant). If you elect prior to the Annuitant's Retirement Date to terminate this Contract pursuant to Section 2.06, you may elect to have an Annuity Benefit paid in lieu of the Cash Value. If your Plan permits and you provide us written instructions to do so in advance of payment, we will make payment of the Cash Value, Annuity Benefits or partial withdrawals directly to the Annuitant, Substituted Beneficiary or other payee designated by you. We will have the right to require you to furnish pertinent information to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. We may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary life insurance companies. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect pursuant to the first or third paragraph of Section 3.03 to have paid an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value if the annuity form elected involves life contingencies, or (ii) the Cash Value if the annuity form elected does not involve life contingencies. The amount applied to provide an Annuity Benefit may be reduced by a charge for any applicable taxes on annuity considerations, as we determine. If we have previously deducted charges for applicable taxes from Contributions as provided in Section 2.01, we will not again deduct charges for the same taxes before application to provide an Annuity Benefit, unless a change in applicable law has occurred with respect to this Contract. The balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) our current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, this Contract will be governed by our supplementary contract then in effect. No. 92 EDCB Page 11 If an amount is applied to provide an Annuity Benefit, the amount to be applied will, in addition to any tax charge reduction, be reduced by an administrative charge. The amount of such charge will be determined from time to time in accordance with our general practices applicable on a uniform basis to all contracts of the same type as this Contract. After the application of an amount to provide an Annuity Benefit, the amounts you have in the Divisions and the Annuity Account Value shall be zero. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the terms of this Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (with 100% of the amount of your payment continued to your spouse). The amount of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, is based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on a 50-50 split of males and females at age zero and an Assumed Base Rate of Net Investment Return of 3.5% or 5%, whichever applies pursuant to Section 1.23. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females at age zero if such annuity form provides for a Fixed Annuity Benefit, and on the projected 1983 Basic Table "a" adjusted to a unisex basis based on a 50-50 split of males and females at age zero and an Assumed Base Rate of Net Investment Income Return of 5% or 3.5%, whichever applies pursuant to Section 1.23, if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Pursuant to Sections 457(d) and 401(a)(9) of the Code, and subject to the terms of the Plan, the entire interest of the Annuitant will be distributed or begin to be distributed, no later than the first day of April following the calendar year in which the Annuitant attains 70 years and 6 months ("Required Beginning Date"). The entire interest may be distributed, as elected pursuant to the Plan and this Contract, over (a) the life of the Annuitant, or the lives of the Annuitant and a designated beneficiary, or (b) a period certain not extending beyond the Annuitant's life expectancy, or the joint and last survivor life expectancy of the Annuitant and a designated beneficiary. Distributions must be made in periodic payments at intervals of no longer than one year. In addition, payments must be either nonincreasing or they may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the Proposed Treasury Regulations, or any successor Regulation thereto. All distributions made hereunder shall be made in accordance with the requirements of Section 401(a)(9) of the Code, including the incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and applicable Treasury Regulations, including the minimum distribution incidental benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or any successor Regulation thereto. For purposes of determining the "period certain" referred to in the first paragraph of this Section, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless otherwise elected prior to the time distributions are required to begin, those life expectancies shall be recalculated annually. Such election shall be irrevocable and shall apply to all subsequent years. The life expectancy of a non-spouse beneficiary may not be recalculated. Instead, life expectancy will be calculated using the attained age of such beneficiary during the calendar year in which the Annuitant attains age 70 years and 6 months, and payments for subsequent years shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. If the Annuitant dies after distribution of the interest described in the first paragraph of this Section has begun, the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution being used prior to the Annuitant's death. Notwithstanding the above paragraphs and the following paragraphs of this Section 3.05, while any distribution shall be subject to such requirements of the Code and regulations, any distribution shall also be subject to the terms of this Contract. That is, the forms of distribution shall be those which are made available by us at the time of your election. If the Annuitant dies before distribution of the interest described in the first paragraph of this Section begins, distribution of the entire interest shall be completed no later than December 31 of the calendar year containing the fifth anniversary of the Annuitant's death, except to the extent that an election is made to receive death benefit distributions in accordance with (1) or (2) below: (1) If the Annuitant's interest is payable to a designated beneficiary, then the entire interest may be distributed over a period certain not greater than the life expectancy of the designated beneficiary. Such distributions must commence on or before December 31 of the calendar year immediately following the calendar year of the Annuitant's death. If the designated beneficiary is not the Annuitant's surviving spouse, a period certain Annuity Benefit cannot exceed 15 years, (even if life expectancy is greater than 15 years). (2) If the designated beneficiary is the Annuitant's surviving spouse, the date distributions that are required to begin in accordance with (1) above shall not be earlier than the later of (A) December 31 of the calendar year immediately following the calendar year of the Annuitant's death or (B) December 31 of the calendar year in which the Annuitant would have attained age 70 years and 6 months. No. 92 EDCB Page 12 For purposes of determining the "period certain" referred to in the immediately preceding paragraph, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of distributions beginning after the Annuitant's death, unless otherwise elected by the surviving spouse by the time distributions are required to begin, life expectancies shall be recalculated annually. Such election shall be irrevocable by the surviving spouse and shall apply to all subsequent years. In the case of any other designated beneficiary, life expectancies shall be calculated using the attained age of such beneficiary during the calendar year in which distributions are required to begin pursuant to this Section, and payments for any subsequent calendar year shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. Distributions under this Section are considered to have begun if distributions are made because the Required Beginning Date was reached, or, if prior to the Required Beginning Date, distributions irrevocably commence to an individual over a period permitted and in an annuity form acceptable under Section 1.401(a)(9) of the Proposed Treasury Regulations or any successor Regulation thereto. Evidence of each payee's survival must be furnished to us either by personal endorsement of the check drawn for payment or by other means satisfactory to us. If a benefit payment under the terms of this Contract was based on information that is subsequently found to be incorrect, the benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by us will be charged against, and underpayments will be added to, any payments thereafter falling due under this Contract with respect to the payee, affecting as many such payments as are necessary to correct the overpayment or underpayment. Our liability, with respect to a payee, is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under this Contract. If we receive evidence satisfactory to us that (i) a payee entitled to receive any payment under this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, we may make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If a variable annuity form made available by us provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Pursuant to Section 3.03, upon the election of an annuity form providing payments for a period certain, you (or the Annuitant, if you have advised us in writing that it is permitted under the terms of the Plan) may designate (with the right to change such designation) a payee to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. Subject to the terms of the Plan, the payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's estate in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, we will pay in a single sum to such payee's estate the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis applicable in determining the annuity amount. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. We will require satisfactory evidence of the age of any person upon whose life an annuity form depends. No. 92 EDCB Page 13 TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE (Minimum Monthly Income per $1,000 of Annuity Account Value)
- ------------------------------------------------------------------------------------------------------------------------------------ Age 60 61 62 63 64 65 66 67 68 69 70 - ------------------------------------------------------------------------------------------------------------------------------------ 60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88 61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96 62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03 63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11 64 4.89 4.94 5.00 5.05 5.10 5.14 5.19 65 5.00 5.06 5.11 5.17 5.22 5.27 66 5.12 5.18 5.24 5.29 5.35 67 5.24 5.31 5.37 5.43 68 5.37 5.44 5.51 69 5.52 5.59 70 5.67 - ------------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Account Value) - -------------------------------------------------------------------------------- VARIABLE ANNUITY BENEFIT IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS Age 3.5% 5% - -------------------------------------------------------------------------------- 60 5.27 6.16 61 5.39 6.28 62 5.52 6.41 63 5.66 6.55 64 5.81 6.70 65 5.97 6.86 66 6.15 7.03 67 6.33 7.21 68 6.53 7.41 69 6.74 7.62 70 6.97 7.85 - -------------------------------------------------------------------------------- We will, with respect to each payment of a Variable Annuity Benefit, notify the payee of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each variable payment. Such notice will be mailed with each payment. Any election, change, revocation or designation shall be made, and will take effect on the Transaction Date, in the same manner as a change of beneficiary, as described in Section 4.04. If a commutation right under an Annuity Benefit is exercised, we may defer payment in accordance with Section 4.07. - -------------------------------------------------------------------------------- PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the parties and the terms of this Contract alone will govern with respect to our rights and obligations. A copy of the application is incorporated in and made part of this Contract. This Contract may not be modified, nor may any of our rights or requirements be waived, except in writing and by our authorized officer. The terms of this Contract may be changed by amendment or replacement upon agreement between the Owner and us without the consent of any other person. SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform this Contract to reflect changes in the Code, applicable Treasury Regulations, or in regulations or published rulings of the Internal Revenue Service so that this Contract will continue to be an Annuity utilized to fund a plan qualifying under Section 457 of the Code. SECTION 4.03 NONFORFEITABILITY, NONTRANSFERABILITY AND ASSIGNMENTS. The entire interest under this Contract is nonforfeitable except by surrender to us. Any interest under the terms of this Contract may not be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than us. No amount payable under the terms of this Contract may be assigned or commuted, unless specifically provided for under the terms of this Contract, or encumbered by the payee, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. No. 92 EDCB Page 14 SECTION 4.04 BENEFICIARY. You, as beneficiary, are entitled to receive any death benefit payable under this Contract pursuant to Section 2.11. Upon the Annuitant's death you may, by written request to our Processing Office, at any time up to and including provision of due proof of such death, change the beneficiary designation for the Section 2.11 death benefit from you to the Substitute Beneficiary. Subject to the terms of the Plan, the Substitute Beneficiary may elect to receive the death benefit payable under Section 2.11 in the form of an Annuity Benefit rather than as a single sum. Any such election must meet the minimum distribution rules of Sections 457(d) and 401(a)(9) of the Code and applicable Treasury Regulations, as described in Section 3.05. SECTION 4.05 DISQUALIFICATION OF PLAN OR CONTRACT. In the event that the Plan fails to qualify as an Eligible Deferred Compensation Plan under Section 457 of the Code and applicable Treasury Regulations, we reserve the right, upon receiving notice of such fact, to transfer the Annuity Account Value under this Contract to another annuity contract issued by us or one of our affiliated or subsidiary life insurance companies on the life of the Annuitant, or to terminate this Contract and pay to you the Annuity Account Value less a deduction for applicable taxes, solely at our option. In the event that this Contract fails to qualify as an Annuity as described in Section 1.02, we will have the right, upon receiving notice of such fact, to terminate this Contract and pay to you the Annuity Account Value less a deduction for the appropriate part attributable to you of any income tax payable by you which would not have been payable if you had an Annuity. SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to you, we reserve the right to limit Contributions under this Contract if required by law. SECTION 4.07 DEFERMENT. Applications of proceeds to a variable annuity, payment of a death benefit and payment of any portion of the Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange has been closed or trading on it is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Securities and Exchange Commission, by order, permits us to defer payments in order to protect persons with interests in the Investment Divisions. We can defer payment of any portion of the Annuity Account Value in the Guaranteed Interest Division for up to six months while the Annuitant is living. SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year, we will furnish you with a notice showing the following: (1) the amount in the Guaranteed Interest Division, (2) the total number of Accumulation Units in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Value, (4) the amount you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the Cash Value, and (6) the amount of death benefit payable with respect to the Annuitant. We will also furnish annual calendar year reports concerning the status of the annuity and any other reports required by the Code or applicable Treasury Regulations. After the Retirement Date, we will notify the Employer of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.09 AGE. If the Annuitant's age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by us will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. SECTION 4.10 OWNERSHIP RIGHT OF EMPLOYER. Notwithstanding any other provision of the terms of this Contract, until amounts under this Contract are distributed or made available to the Annuitant or the Annuitant's beneficiary in accordance with the terms of this Contract and the terms of the Plan, this Contract remains solely the property of the Employer subject only to claims of the Employer's general creditors. This Section shall be construed and administered in accordance with Section 457(b)(6) of the Code and the regulations thereunder. No. 92 EDCB Page 15 ANNUITANT: JOHN DOE CONTRACT NUMBER: 92HR1A ISSUE DATE: FEB 28, 1992 CONTRACT DATE: FEB 28, 1992 RETIREMENT DATE: JAN 1, 2020 THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York, New York 10116 AGREES o TO ALLOCATE the Contributions made to this Contract, after deduction of any applicable tax charge, to the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division of the Separate Account (referred to in this Contract as the "Investment Divisions") or to the Guaranteed Interest Division, in accordance with Sections 2.02, 2.03 and 2.04, as directed by you, and o TO APPLY the Annuity Account Value at the Retirement Date to provide you with an Annuity Benefit or a Cash Value benefit if you are then living, and o TO PROVIDE you with the other rights and benefits of this Contract. This is the entire Contract. In this Contract, "we", "our" and "us" mean The Equitable Life Assurance Society of the United States. "You" and "your" mean the Annuitant (Owner) at the time a right is exercised by the Annuitant (Owner). TEN DAYS TO EXAMINE CONTRACT -- You may cancel this contract by returning it to us within ten days after receipt of it. Upon such cancellation, we will refund any Contribution made to us on your behalf under this Contract SPECIMEN SPECIMEN /s/Molly K. Heines /s/Richard H. Jenrette Chairman of the Board Vice President and Secretary and Chief Executive Officer THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT FACTOR REFERRED TO IN SECTION 1.24 IS 5% OR 3.5%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSE AND EXPENSE RISK, PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE TRUST. No. 92HR1A This Contract is issued in consideration of the payment to us of the Contributions made under the terms of this Contract. The provisions on the following pages are parts of this Contract. - -------------------------------------------------------------------------------- TABLE OF CONTENTS DEFINITIONS Page Section 1.01 - Annuitant..........................................4 1.02 - Annuity............................................4 1.03 - Annuity Account Value..............................4 1.04 - Annuity Benefit....................................4 1.05 - Cash Value.........................................4 1.06 - Class of Contracts.................................5 1.07 - Code...............................................5 1.08 - Contract...........................................5 1.09 - Contract Date......................................5 1.10 - Contract Year......................................5 1.11 - Contribution.......................................5 1.12 - Divisions..........................................5 1.13 - Eligible Annuity Certain...........................5 1.14 - Employer...........................................5 1.15 - Guaranteed Interest Rate...........................5 1.16 - Joint and Survivor Life Annuity Form...............5 1.17 - Life Annuity Form..................................5 1.18 - Normal Form........................................5 1.19 - Period Certain Annuity.............................5 1.20 - Plan...............................................5 1.21 - Processing Office..................................6 1.22 - Retirement Date....................................6 1.23 - Separate Account...................................6 1.24 - Separate Account Definitions.......................7 1.25 - Transaction Date...................................7 1.26 - Trust..............................................7 ANNUITY ACCOUNT VALUE Section 2.01 - Contributions......................................8 2.02 - Separate Account Investment Divisions..............8 2.03 - Guaranteed Interest Division.......................8 2.04 - Allocation to Divisions............................8 2.05 - Transfers Among Divisions..........................8 2.06 - Termination of this Contract.......................9 2.07 - Partial Withdrawals................................9 2.08 - Charges for Partial Withdrawals....................9 2.09 - Free Corridor Amount..............................10 2.10 - Annual Administrative Charge......................10 2.11 - Death Benefit.....................................10 ANNUITY BENEFITS Section 3.01 - Fixed Annuity Benefit.............................11 3.02 - Variable Annuity Benefit..........................11 3.03 - Election and Commencement of Annuity Benefits.....11 3.04 - Amount of Annuity Benefits........................11 3.05 - Payment of Annuity Benefits.......................12 3.06 - Special Annuity and Spousal Consent Provisions....14 GENERAL PROVISIONS Section 4.01 - Contract..........................................15 4.02 - Statutory Compliance..............................15 4.03 - Assignments and Nontransferability................15 4.04 - Beneficiary.......................................15 4.05 - Disqualification..................................16 4.06 - Future Contributions..............................16 4.07 - Deferment.........................................16 4.08 - Annual Notice.....................................16 4.09 - Age...............................................16 No. 92HR1A Page 2 OWNER: JOHN DOE ANNUITANT: JOHN DOE CONTRACT NUMBER: 00 000 000 ISSUE DATE: FEB 28, 1992 CONTRACT DATE: FEB 28, 1992 RETIREMENT DATE: JAN 1, 2020 INITIAL GUARANTEED INTEREST RATE: 7.50% TO MAR 31, 1992 MINIMUM GUARANTEED INTEREST RATE: 6.00% TO DEC 31, 1992 3.00% AFTER DEC 31, 1992 BENEFICIARY: JANE DOE FORM NUMBER: 92HR1A - -------------------------------------------------------------------------------- TABLE OF GUARANTEED VALUES ISSUE AGE 38 MALE $1,000 ANNUAL CONTRIBUTION NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY SINCE FIRST CONTRIBUTION CASH VALUE ANNUITY AT AGE 65 - ----------------------- ---------- ----------------- 1 977 6.63 2 1,946 16.20 3 2,944 26.67 4 3,998 36.84 5 5,064 46.70 6 6,220 56.28 7 7,362 65.59 8 8,538 74.62 9 9,841 83.38 10 11,204 91.90 11 12,629 100.16 12 14,118 108.18 13 15,673 115.97 14 17,144 123.54 15 18,658 131.18 16 20,218 138.64 17 21,824 145.90 18 23,479 152.80 19 25,213 159.70 20 27,000 166.03 24 (Age 62) 34,697 189.57 27 (Age 65) 41,098 205.49 THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000 CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE (SEE SECTION 2.10) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE ANNUITY ACCOUNT VALUE (SEE SECTION 1.05). THE TABLES ASSUME THAT 100% OF ALL CONTRIBUTIONS AND EARNINGS ARE ALLOCATED TO AND REMAIN IN THE GUARANTEED INTEREST DIVISION. YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS. THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A SETTLEMENT WILL BE SUBJECT TO A CHARGE (SEE SECTION 3.04). *ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO SURVIVOR) WITH JOINT ANNUITANT THE SAME AGE AS THE ANNUITANT. No. 92HR1A Page 3 - -------------------------------------------------------------------------------- PART I -- DEFINITIONS SECTION 1.01 ANNUITANT. The term "Annuitant" means the Owner of this Contract, as shown on Page 3 of this Contract, and on whose behalf this Contract is purchased and is maintained and who exercises all rights under the terms of this Contract. SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in accordance with the terms of the Plan. SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts that you have in the Guaranteed Interest Division and the Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by us pursuant to Section 3.04 of this Contract. Various sections of this Contract (Sections 1.16, 1.17, 1.18, 3.01 and 3.02) refer to monthly payments to be made under an Annuity Benefit. You may wish to have your Annuity Benefit paid at other intervals, such as quarterly, semi-annually, or annually, instead of monthly. You may elect this at the time you elect the Annuity Benefit form as described in Section 3.03; in that event, all references in this Contract to monthly payments will be deemed to mean payments at the frequency you elect, subject to our rules at the time of election. SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value less an applicable withdrawal charge determined as follows: The withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the excess of (i) the Annuity Account Value over (ii) the Free Corridor Amount defined in Section 2.09; and (b) is the excess, if any, of (i) 8% of the total Contributions made on your behalf during the Current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to Section 2.08. However, notwithstanding the above, if you are age 60 years or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. However, a withdrawal charge will not apply, which means the Cash Value will equal the Annuity Account Value, upon any of the following occurrences: (i) your attainment of age 59 years and 6 months and your completion of at least five Contract Years, or (ii) your completion of at least twelve Contract Years, or (iii) your attainment of age 55 years, your completion of at least five Contract Years and the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase an Eligible Annuity Certain, defined in Section 1.13, or (iv) your completion of at least three Contract Years and the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase a Period Certain Annuity, defined in Section 1.19, where the certain period of such annuity is at least ten years, or (v) the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase a life annuity distribution option, pursuant to the terms of this Contract, or (vi) you die and the withdrawal is made by the beneficiary. No. 92HR1A Page 4 SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all Contracts with a Contract Date in the same calendar year. SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.08 CONTRACT. The term "Contract" means this Contract. SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt by us both the application for this Contract, properly signed and completed, and a Contribution. SECTION 1.10 CONTRACT YEAR. The term Contract Year" means the twelve month period beginning on (i) the Contract Date, and (ii) each anniversary thereafter, unless otherwise agreed to in writing by us. SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us for you with respect to an Annuity purchased for you under Plan. We are under no obligation to accept any Contribution less than $20.00. SECTION 1.12 DIVISIONS. The term "Division" or "Divisions" mean, singly or severally as the case may be, the following divisions described in this Contract: (i) the Guaranteed Interest Division, and (ii) the Investment Divisions of the Separate Account. SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by us which extends beyond your attainment of age 59 years and 6 months and does not permit any prepayment of the unpaid principal (that is, no withdrawal or single sum payment) prior to your attainment of age 59 years and 6 months. SECTION 1.14 EMPLOYER. The term "Employer" means the sole proprietor or the partnership adopting the Plan, or any successor unincorporated trade or business that assumes in writing the obligations of the Plan. SECTION 1.15 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in the Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of this Contract. Section 2.03 describes determination of the rate to apply thereafter. SECTION 1.16 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by you. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.17 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity issued by us providing monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.18 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under this Contract means (i) if you have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (with 100% of the monthly payment amount continued to your spouse), and (ii) if you do not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by us which does not permit any prepayment of the unpaid principal (that is, you cannot elect to receive part of your payments as a single sum payment with the remainder paid in monthly annuity payments). SECTION 1.20 PLAN. The term "Plan" means the Standardized Non-Trusteed Defined Contribution Plan for Unincorporated Employers, a prototype plan for self-employed individuals and their employees which is sponsored by us. No. 92HR1A Page 5 SECTION 1.21 PROCESSING OFFICE. The term "Processing Office" means our Individual Annuity Center, P.O. Box 2996, G.P.O., New York, New York 10116, or such other location as we shall designate by advance written notice to the Employer or the trustee, as applicable, and to you. SECTION 1.22 RETIREMENT DATE. The term "Retirement Date" means the date on which you attain the retirement age as sown on Page 3 of this Contract. Before the Retirement Date you may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th or 31st day of any month). No Retirement Date shall be earlier than the date you attain age 59 years and 6 months nor shall it be later than the date you attain age 70 years and 6 months. Any election for such change must be made in writing by you and shall not take effect until received by us at our Processing Office. SECTION 1.23 SEPARATE ACCOUNT. The term "Separate Account" means our Separate Account A which is organized as a unit investment trust, a type of investment company. We have established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts and certificates. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities and variable life insurance. The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to these contracts will not be chargeable with liabilities arising out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to our General Account. The Separate Account consists of "Investment Divisions". Each Investment Division may invest its assets in a separate class (or series) of shares of a designated Trust where each class (or series) represents a separate portfolio in such Trust. We reserve the right to change the designated trust or investment company or to add designated trusts or investment companies. The Investment Divisions available are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. The Guaranteed Interest Division is not part of the Separate Account but rather is an asset of our General Account. We will value the assets of each Investment Division on each business day. A business day is any day on which we are open, the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio securities in which an Investment Division is invested to materially affect the Accumulation Unit Value. We may, at our discretion, invest the assets of any Investment Division in any investment permitted by applicable law. We may rely conclusively on the opinion of counsel (including attorneys in our employ) as to what investments we are permitted by law to make. We reserve the right to (i) cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such committee at any time; (iii) restrict or eliminate any voting rights as to the Separate Account; (iv) operate the Separate Account by making direct investments, or in any other form; (v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or remove Investment Divisions (or sub-divisions of Investment Divisions) from the Separate Account (the term "Investment Division" in this Contract shall then refer to any other Investment Division in which the assets, of a Class of Contracts to which this Contract belongs, were placed); (vi) combine any two or more Investment Divisions (or sub-divisions of Investment Divisions) of the Separate Account; and (vii) withdraw from any Investment Division and to allocate to another Investment Division assets determined by us to be associated with the Class of Contracts to which this Contract belongs. No. 92HR1A Page 6 If the exercise of these rights results in a material change in the underlying investments of an Investment Division, you will be notified of such exercise, as required by law. Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for applicable tax charges) at a rate not to exceed 1.49% per year for each of the Stock, Money Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock Division, for financial accounting, death benefits, mortality risk, expenses and expense risk. The charge shall be made in accordance with Subsection (c) of the Net Investment Factor provision in Section 1.24. The relative proportion of these charges may be modified. This daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust, shall not exceed a total annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to this Contract. SECTION 1.24 SEPARATE ACCOUNT DEFINITIONS. VALUATION PERIOD: Each business day together with any preceding consecutive non-business days. NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b), minus (c), where (a) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the Valuation Period giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period. For this purpose, we use the share value reported to us by the Trust. (b) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the preceding Valuation Period (after any amounts allocated or withdrawn for that Valuation Period). (c) is the daily Separate Account charge for the expenses of this Contract, times the number of calendar days in the Valuation Period. ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an Investment Division where your Contributions are invested and which is used in determining the amount you have in an Investment Division. ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of each Accumulation Unit in an Investment Division on a given date. The Accumulation Unit Value for a Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for that Investment Division for such Valuation Period. ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable from the Stock Division of the Separate Account under a Variable Annuity Benefit as defined in Section 3.02. ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1, 1968. On August 27, 1981, the date the first contribution was put into the Stock Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods ending in such month. SECTION 1.25 TRANSACTION DATE. The term "Transaction Date" means the business day we receive a Contribution or a written contract transaction request providing the information we need at the Processing Office. In the case of a transfer request initiated through the use of a touch tone telephone as described in Section 2.05, the term Transaction Date means the business day the telephone transaction is received. SECTION 1.26 TRUST. The term "Trust" means the designated trust or investment company in which Separate Account assets are invested. No. 92HR1A Page 7 - -------------------------------------------------------------------------------- PART II -- ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. The Employer is to make Contributions from time to time on such dates and in such amounts as determined by the Employer pursuant to the terms of the Plan or Agreement. Contributions will be allocated to the Divisions in accordance with the instructions received on the application, unless later changed. Each Contribution received by us with respect to you will, before its allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. Pursuant to the terms of the Plan, we will accept rollover contributions and transfers made on your behalf from a plan qualified under Section 401(a) of the Code or from a conduit individual retirement arrangement as described in Section 408 of the Code. SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when an amount is allocated to, or withdrawn or transferred from, an Investment Division, the Annuity Account Value will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Section 2.07 or 2.10 or transferred from the Investment Division pursuant to Section 2.05. The amount in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units in the Investment Division on that date, and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under the terms of this Contract terminates on the earliest of (i) Election and the Commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii) Termination of this Contract pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division becomes part of our general assets, which support the guarantees of this Contract and other contracts. The amount in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Section 2.07, 2.10 or 2.11 or transferred from the Guaranteed Interest Division, pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division on a Transaction Date pursuant to Section 2.04. We will credit the amount you have in the Guaranteed Interest Division with interest at effective annual rates that we determine. For each Class of Contracts we determine a yearly guaranteed interest rate that will remain in effect throughout the next year. We guarantee that this yearly guaranteed interest rate will never be less than 3%. Participation in the Guaranteed Interest Division under the terms of this Contract terminates on the earliest (i) Election and Commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii) Termination of this Contract pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section 2.01 is allocated (after deduction of any applicable tax charge) to one or more Divisions, at your sole direction as specified to us. Allocation percentages must be in whole numbers and the sum must equal 100. The allocation is made as of the Transaction Date on which we have received both such Contribution and such direction. Contributions made to an Investment Division purchase Accumulation Units in that Investment Division, using the Accumulation Unit Value next computed after the Transaction Date Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the Transaction Date with respect to each transfer from the Division pursuant to Section 2.05, (iii) on the Transaction Date with respect to each withdrawal pursuant to Section 2.07, (iv) at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, (v) upon Termination of this Contract pursuant to Section 2.06, and (vi) upon your death pursuant to Section 2.11. SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request or through the use of a touch tone telephone, transfer all or part of the amount you have in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; (2) amounts in the Money Market Division may be No. 92HR1A Page 8 transferred to other Divisions. Written authorization for touch tone telephone initiated transfers is only required when authorization for telephone transfers is requested. (Upon advance written notice to you, we reserve the right to discontinue the acceptance of transfer requests through the use of a touch tone telephone.) All transfers will be effective on the Transaction Date and will be subject to our rules in effect at the time of transfer. With respect to the Investment Divisions, the transfer will be made at the Accumulation Unit Value next computed after the Transaction Date. No transfers are permitted to the Money Market Division from the other Divisions. SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the terms of the Plan, including the spousal consent rules set forth in Section 3.06, you may elect, by written notice, to terminate this Contract. We will determine the Cash Value under this Contract as of the Transaction Date. If this Contract is terminated, surrendered or exchanged prior to your Retirement Date, any applicable tax charges we have paid may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on terminations, unless a change in a applicable law has occurred with respect to your Contract. The payment of such Cash Value may be deferred by us in accordance with the provisions of Section 4.07. If no tax has been previously deducted or if such a tax is due at termination, we will deduct the amount due. Subject to the terms of the Plan, we reserve the right to pay the Annuity Account Value under this Contract and terminate this Contract if (i) no Contributions are made on your behalf during the last three completed Contract Years, and the Annuity Account Value is less than $500 or (ii) a partial withdrawal is made that would result in your Annuity Account Value falling below $500. We also reserve the right to terminate this Contract if no Contributions have been made within 120 days from the Contract Date shown on Page 3 of this Contract. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under the terms of the Plan, you may elect, by written notice to us, to make a partial withdrawal from the Divisions. Partial withdrawals are subject to spousal consent rules set forth in Section 3.06. On the Transaction Date, we will pay the lesser of the Cash Value or the amount of partial withdrawal requested to the person entitled to receive such payment as designated in writing by you. The amount paid plus any withdrawal charge applicable pursuant to Section 2.08 will be drawn from the amounts you have in the Divisions. Unless instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts that you have in such Divisions. Upon any partial withdrawal payment, we will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by us in accordance with the provisions of Section 4.07. We may decline to accept a request for a partial withdrawal of less than $300. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, we will so advise you and reserve the right to pay the Annuity Account Value to you, and terminate this Contract. SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity Account Value pursuant to Section 1.05. WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than the Free Corridor Amount, we will (i) first withdraw from the Divisions an amount equal to the Free Corridor Amount in proportion to the amount you have in them, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a partial withdrawal charge. Such partial withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter No. 92HR1A Page 9 of the amount withdrawn in excess of the Free Corridor Amount (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the total Contributions made on your behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to this Section. If withdrawals are made from this Contract prior to the Retirement Date, any applicable tax charges we have paid with respect to this Contract may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on withdrawals, unless a change in applicable law has occurred with respect to your Contract. SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means if you have completed three Contract Years or attained age 59 years and 6 months, an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the current Contract Year. If you have not completed three Contract Years or attained age 59 years and 6 months, the Free Corridor Amount is zero. SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract Year, if the Annuity Account Value on that date is less than $10,000, we will withdraw from the Divisions an Annual Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account Value including the amount of any withdrawals pursuant to Section 2.07 during that Contract Year. The charge will be allocated among the Divisions in proportion to the amounts that you have in the Divisions. If the Annuity Account Value is less than $10,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of termination of this Contract pursuant to Section 2.06 or 2.11, we will prorate the Annual Administrative Charge applicable to the completed portion of the Current Contract Year and withdraw such amount in lieu of the full Annual Administrative Charge described in this Section for the applicable part of that Contract Year. If the Annuity Account Value is $10,000 or greater at the end of a Contract Year, the Annual Administrative Charge is zero. SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of your death we will pay (subject to the terms of the Plan, in the spousal survivor benefit rules set forth in Section 3.06) to the beneficiary designated to receive such payment, pursuant to Section 4.04 of this Contract, the amount of death benefit payable. The amount of the death benefit is equal to the greater of (i) the Annuity Account Value and (ii) your minimum death benefit. Such minimum death benefit is the sum of all Contributions made pursuant to Section 2.01 (before reduction for any applicable tax charge) less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce your minimum death benefit (as adjusted by any previous withdrawal) by an amount which is in the same proportion as the amount that was withdrawn is to the Annuity Account Value. If, in accordance with the provisions of Section 2.01, the cash value of another annuity contract issued by us or one of our affiliated or subsidiary life insurance companies, which provides for a death benefit before retirement equal to the greater of the contract cash value or an alternate amount based on premiums paid or contributions made under the annuity contract, is transferred to this Contract, such cash value or alternative amount as of the date of transfer will be included in the "sum of all Contributions" in lieu of the amount of cash value transferred for purposes of the death benefit under this Contract. We will pay the death benefit to the beneficiary in the form of an Annuity Benefit if you have made the election described in the last paragraph of Section 4.04. Also in accordance with the last paragraph of Section 4.04, if no such election is in effect at your death, we will pay the death benefit to the beneficiary in a single sum, unless the beneficiary elects, before we pay the death benefit, to apply the death benefit to an Annuity Benefit, subject to the minimum distribution requirement of the Code as described in Section 3.06 and our rules then in effect. Upon payment of the death benefit, the amount you have in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. No. 92HR1A Page 10 - -------------------------------------------------------------------------------- PART III -- ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the terms of this Contract with respect to a payee is the amount provided pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Stock Division of the Separate Account. Such Variable Annuity Benefit will increase if the average daily rate of investment return in the Stock Division is equivalent to more than 6.75% or 5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25% annually, depending on whether the applicable assumed base rate of Net Investment Return referred to in Section 1.24 is 5% or 3.5%, respectively. The daily rate of investment return is before deduction of charges, as described in Section 1.23, not to exceed the maximum rate of 1.75% after any deductions to provide for any applicable tax charge. These charges include a daily charge for financial accounts, death benefits, mortality risk, expenses and expense risk, plus the investment advisory fee charges and direct operating expense charges of the Trust. The amount of the first, second and third payments under any Variable Annuity Benefit provided under the terms of this Contract with respect to a payee is the monthly amount provided pursuant to the fourth paragraph of Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment by the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. (As described in Section 3.05, we will notify the payee how each Variable Annuity Payment is determined.) SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your Retirement Date, provided you are then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless you elect (i) to receive the Cash Value in a single sum or (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by us, or one of our affiliated or subsidiary life insurance companies, as elected by you, or (iii) to take partial withdrawals pursuant to Section 2.07 in the amounts and at times as required by the minimum distribution rules of Section 401(a)(9) of the Code and applicable Treasury Regulations, pursuant to Sections 2.07 and 3.05, subject to our rules then in effect and any other applicable requirements under the Code. We will provide notice and election forms to you not more than six months before your Retirement Date. If you elect to terminate this Contract, pursuant to Section 2.06, an election may be made to receive an Annuity Benefit in lieu of the Cash Value. We will have the right to require you to furnish pertinent information to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. We may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary life insurance companies. An election to receive Annuity Benefits in accordance with this Section is subject to the spousal consent and spousal survivor rules set forth in Section 3.06 of this Contract. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value if the annuity form elected involves life contingencies or (ii) the Cash Value if the payments under the annuity form elected does not involve life contingencies. The amount applied to provide an Annuity Benefit may be reduced by any applicable tax charge on annuity considerations, as we determine. If we have previously deducted any applicable tax charges from Contributions as provided in Section 2.01, we will not again deduct charges for the same taxes before application to provide an Annuity Benefit, unless a change in applicable law has occurred with respect to your Contract. The balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) our current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, your Contract will be governed by our supplementary contract then in effect. No. 92HR1A Page 11 The amount to be applied to provide an Annuity Benefit will, in addition to any tax charge reduction, be reduced by an administrative charge. The amount of such charge will be determined from time to time in accordance with our general practices applicable on a uniform basis to all contracts of the same type as this Contract. After the application of an amount to provide an Annuity Benefit, the amounts you have in the Divisions and the Annuity Account Value shall be zero. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the terms of this Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (with 100% of the amount of your payment continued to your spouse). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, are based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form are based on a 50-50 split of males and females and an Assumed Base Rate of Net Investment Return of 3.5% or 5%, whichever applies pursuant to Section 1.24. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females if such annuity from provides for a Fixed Annuity Benefit, and on the projected 1983 Basic Table "a" adjusted to a unisex basis based on a 50-50 split of males and females and an Assumed Base Rate of Net Investment Income Return of 5% or 3.5%, whichever applies pursuant to Section 1.24, if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract will be distributed or begin to be distributed in accordance with Section 401(a)(9) of the Code and the applicable Treasury Regulations thereunder, no later than the first day of April following the calendar year in which you attain age 70 years and 6 months ("Required Beginning Date") or such later date as specified in such section or regulations. Your entire interest may be distributed, as you elect over (a) the life, or the lives of you and or your designated beneficiary, or (b) a period certain not extending beyond your life expectancy, or the joint and last survivor expectancy of you and your designated beneficiary. Distributions must be made in periodic payments at intervals of no longer than one year. In addition, payments must be either nonincreasing or they may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the proposed Treasury Regulations, or any successor Regulation thereto. All distributions made hereunder shall be made in accordance with the requirements of Section 401(a)(9) of the Code, including the incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and applicable Treasury Regulations, including the minimum distribution incidental benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or any successor Regulation thereto. Notwithstanding the above paragraphs and the following paragraphs of this Section 3.05, while any distribution shall be subject to such requirements of the Code and regulations, any distribution shall also be subject to the terms of this Contract. That is, the forms of distribution shall be those which are made available by us at the time of your election. For purposes of determining the "period certain" referred to in the first paragraph of this Section, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless you otherwise elect prior to the time distributions are required to begin, those life expectancies shall be recalculated annually. Such election shall be irrevocable and shall apply to all subsequent years. The life expectancy of a non-spouse beneficiary may not be recalculated. Instead, life expectancy will be calculated using the attained age of such beneficiary during the calendar year in which you attain age 70 years and 6 months, and payments for subsequent years shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. If you die after distribution of your interest in this Contract has begun, the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution being used prior to your death. If you die before distribution of your interest in this Contract begins, distribution of your entire interest shall be completed no later than December 31 of the calendar year containing the fifth anniversary of your death, except to the extent that an election is made to receive death benefit distributions in accordance with (1) or (2) below: (1) If your interest is payable to a designated beneficiary, then your entire interest may be distributed over the life of, or over a period certain not greater than the life expectancy of, the designated beneficiary. Such distributions must commence on or before December 31 of the calendar year immediately following the calendar year of your death. No. 92HR1A Page 12 (2) If the designated beneficiary is your surviving spouse, the date distributions that are required to begin in accordance with (1) above shall not be earlier than the later of (A) December 31 of the calendar year immediately following the calendar year of your death or (B) December 31 of the calendar year in which you would have attained age 70 years and 6 months. For purposes of determining the "period certain" referred to in the immediately preceding paragraph, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of distributions beginning after your death, unless otherwise elected by the surviving spouse by the time distributions are required to begin, life expectancies shall be recalculated annually. Such election shall be irrevocable by the surviving spouse and shall apply to all subsequent years. In the case of any other designated beneficiary, life expectancies shall be calculated using the attained age of such beneficiary during the calendar year in which distributions are required to begin pursuant to this Section, and payments for any subsequent calendar year shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. Distributions under this Section are considered to have begun if distributions are made because you have reached your Required Beginning Date or if prior to the Required Beginning Date distributions irrevocably commence to you over a period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1 of the Proposed Treasury Regulations or any successor Regulation thereto. Evidence of each payee's survival must be furnished to us either by personal endorsement of the check drawn for payment or by other means satisfactory to us. If a benefit payment under the terms of this Contract was based on information that is subsequently found to be incorrect, your benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by us will be charged against and underpayments will be added to any payment thereafter falling due under the terms of this Contract with respect to the payee, affecting as many such payments as are necessary to correct the overpayment or underpayment. Our liability, with respect to a payee, is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under this Contract. If we receive evidence satisfactory to us that (i) a payee entitled to receive any payment under the terms of this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee or other representative of the estate of such payee has been appointed, we may make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If a variable annuity form made available by us provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one or two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Pursuant to Section 3.03, upon your election of an annuity form providing payments for a period certain, you may designate (with the right to change such designation) a payee to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's estate in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, we will pay in a single sum to such payee's estate the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis applicable in determining the annuity amount. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. No. 92HR1A Page 13 Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. We will require satisfactory evidence of the age of any person upon whose life an annuity form depends. - -------------------------------------------------------------------------------- TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE (Minimum Monthly Income per $1,000 of Annuity Account Value)
- --------------------------------------------------------------------------------------------------------------------------------- Age 60 61 62 63 64 65 66 67 68 69 70 - --------------------------------------------------------------------------------------------------------------------------------- 60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88 61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96 62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03 63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11 64 4.89 4.94 5.00 5.05 5.10 5.14 5.19 65 5.00 5.06 5.11 5.17 5.22 5.27 66 5.12 5.18 5.24 5.29 5.35 67 5.24 5.31 5.37 5.43 68 5.37 5.44 5.51 69 5.52 5.59 70 5.67 - ---------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Account Value) ------------------------------------------------------------ VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS Age 3.5% 5.0% ------------------------------------------------------------ 60 5.27 6.16 61 5.39 6.28 62 5.52 6.41 63 5.66 6.55 64 5.81 6.70 65 5.97 6.86 66 6.15 7.03 67 6.33 7.21 68 6.53 7.41 69 6.74 7.62 70 6.97 7.85 ----------------------------------------------------------- We will, with respect to each payment under a Variable Annuity Benefit, notify the payee of the number of Annuity Units and the Average Unit Value used in determining the amount of each variable payment. Such notice will be mailed with each payment. Any election, change, revocation or designation shall be made, and will take effect on the Transaction Date, in the same manner as a change of beneficiary, as described in Section 4.04. If a commutation right under an Annuity Benefit is exercised, we may defer payment in accordance with Section 4.07. SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS. If you are married, your interest in this Contract shall be paid in the Normal Form joint and survivor annuity, and if you are unmarried, your interest shall be paid in the Normal Form life annuity, unless you elect otherwise as described in this Section. If you are married and die before payment of your interest has commenced, your interest shall be paid to your surviving spouse in the form of a life annuity, unless at the time of your death there was a contrary election made pursuant to this Section. The foregoing notwithstanding, your surviving spouse may elect, before payment is to commence, to have payment made in any form permitted under the terms of this Contract. You may elect, at any time within the 90 consecutive day period before the first day of the first period for which your interest is paid as an annuity or in any other form, not to have your interest paid in the Normal Form in which case it shall be paid in any other form elected under the terms of this Contract. If such interest is to be paid to your spouse upon your death, you may elect, during the period beginning on the first day of the plan year of the Plan in which you attain age 35 years (or if you separate from Service prior to that plan year, beginning on the date of separation) and ending with your death, for a beneficiary other than your spouse to receive payment of the value of your interest. In addition, if you will not yet attain age 35 years by the end of any current plan year, you may make a special qualified election to designate a beneficiary other than your spouse to receive payment of the value of your interest. Such special qualified election shall be effective for the period beginning on the date of such election and ending on the first day of the plan year in which you will attain age 35. Amounts payable in accordance with this Section will be automatically reinstated as of the first day of the plan year in which you attain age 35 unless a new election designating a beneficiary other than the spouse is made in accordance with the requirements of this Section. No. 92HR1A Page 14 Any election described in the foregoing paragraph must be consented to by your spouse in writing before a notary or a representative of the Plan unless you can prove that there is no spouse or that the spouse cannot be located. Also, if you have become legally separated from your spouse or have been abandoned (within the meaning of local law) and have a court order to such effect, spousal consent is not required unless a qualified domestic relations order provides otherwise. Your election must designate a specific beneficiary (including any class of beneficiaries or any contingent beneficiaries) that may not be changed without further consent of the spouse, unless the spouse's consent expressly permits designation by you without further consent of the spouse. The spouse's consent under this Section shall acknowledge the effect of the election. In addition, the spouse's consent (or the establishment that the consent of the spouse may not be obtained) shall only be valid with respect to such spouse. Your waiver of the Normal Form joint and survivor annuity shall not be effective unless the election designates a form of benefit payment which may not be changed without spousal consent (or the spouse expressly permits designations by you without any further spousal consent). A consent that permits designations by you without any requirement of further consent by such spouse must acknowledge that the spouse has the right to limit consent to a specific beneficiary, and a specific form of benefit where applicable, and that the spouse voluntarily elects to relinquish either or both of such rights. If you make an election under this Section, you may revoke that election, without spousal consent, at any time before the first day of the first period for which an amount is paid as an annuity or in any other form. The provision requiring spousal consent in this Section shall also apply with regard to your election to terminate this Contract or make partial withdrawals pursuant to Sections 2.06 and 2.07, with respect to death benefits under Section 2.11 with respect to the Election and Commencement of Annuity Benefits pursuant to Section 3.03, and with respect to a beneficiary designation set forth in Section 4.04. If the Annuity Account Value applied to provide the spousal benefits on the date payment is to commence is in the aggregate less than $3,500, we may choose to make payment in a single sum rather than in the form of a Qualified Joint and Survivor Life Annuity or Life Annuity as described herein. Upon any payment made pursuant to this Section, we will be released from any and all liability for payment with respect to the Contributions made for you. - -------------------------------------------------------------------------------- PART IV -- GENERAL PROVISIONS SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the parties and the terms of this Contract alone will govern with respect to our rights and obligations. A copy of the application is incorporated in and made part of this Contract. This Contract may not be modified, nor may any of our rights or requirements be waived, except in writing and by our authorized officer. The terms of this Contract may be changed by amendment or replacement upon agreement between you and us without the consent of any other person. SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the terms of this Contract to reflect changes in the Code, applicable Treasury Regulations, or regulations or published rulings of the Internal Revenue Service so this Contract will continue to be an Annuity used to fund a plan qualified under Section 401(a) of the Code. SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY. No interest of yours or of a beneficiary under this Contract may be transferred to any person other than us upon the surrender of this Contract. Except as permitted under Section 401(a)(13) of the Code, no right or interest of you or any other payee or beneficiary in this Contract shall be (a) assignable; (b) subject to any lien; or (c) liable for, or subject to, any obligation or liability of any person. The preceding sentence shall not apply to an assignment, transfer or attachment pursuant to a qualified domestic relations order, as defined in Section 414(p) of the Code. SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an initial designation of the beneficiary entitled to receive any death benefit payable pursuant to Section 2.11. Subject to the spousal consent and survivor rules of Section 3.06, you may change such designation from time to time during your lifetime and while this Contract is in force. Any such designation or change will be made by written notice in a form satisfactory to us. A change will, upon receipt at the Processing Office, take effect as of the time the written notice was signed, whether or not you are living on the date of receipt, but without further liability as to any payment or other settlement made by us before receipt of such change. Unless otherwise specified in the designation, if you have designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive you, and if more than one survive they will share equally. No. 92HR1A Page 15 Any part of a death benefit payable pursuant to Section 2.11 for which there is no designated beneficiary living at your death will be payable in a single sum to your children who survive you, in equal shares, or should none survive, then to your estate. If you elect in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity previously elected by you, with respect to the beneficiary, subject to our rules then in effect. If at your death there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. Any such election must meet the minimum distribution requirements under the Code, as described in Section 3.05. The foregoing notwithstanding, any designation of beneficiary is subject to the Spousal Consent rules set forth in Section 3.06. SECTION 4.05 DISQUALIFICATION. In the event that this Contract fails to qualify as an Annuity as described in Section 1.02, we will have the right, upon receiving notice of such fact before the Retirement Date, to terminate this Contract and pay to you the Annuity Account Value less a deduction for the appropriate part attributable to you of any Federal income tax payable which would not have been payable if you had an Annuity. In the event that the Plan fails to qualify as a Plan under Section 401(a) of the Code and applicable Treasury Regulations, we reserve the right, upon receiving notice of such fact, to transfer the Annuity Account Value under this Contract to another annuity contract issued by us, an affiliate or subsidiary, on your life, or to terminate this Contract and pay to you the Annuity Account Value less deduction for applicable taxes, solely at our option. SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to the Employer, we reserve the right at our sole discretion to limit contributions to this Contract. SECTION 4.07 DEFERMENT. Applications of proceeds to a variable annuity, payment of a death benefit and payment of any portion of your Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange has been closed or trading on it is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Securities Exchange Commission, by order, permits us to defer payments in order to protect persons with interests in the Investment Divisions. We can defer payments of any portion of your Annuity Account Value in the Guaranteed Interest Division for up to six months while you are living. SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year, we will furnish you with a notice showing the following: (1) the amount you have in the Guaranteed Interest Division, (2) the total number of Accumulation Units you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Values, (4) the amount you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the Cash Value, and (6) the amount of your death benefit. We will also furnish annual calendar year reports concerning the status of the annuity and any other reports required by the Code or applicable Treasury Regulations. After the Retirement Date, we will notify you of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.09 AGE. If your age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by us will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. No. 92HR1A Page 16 - -------------------------------------------------------------------------------- APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES PROCESSING OFFICE: INDIVIDUAL ANNUITY CENTER, P.O. BOX 2996, NEW YORK, NEW YORK 10116-2996 QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR: EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY - -------------------------------------------------------------------------------- TYPE OF PURCHASE (Complete One Plan Only) A. |_| TSA PUBLIC SCHOOL (GV-PS-I) B. |_| TSA 501(C)(3) ORGANIZATION (GV-501-I) C. |_| TSA University (GV-PS-U-I) D. |_| IRA Individual (Including IRA to IRA transfers) (GV-IRA 4971) E. |_| IRA Unit Billed (Including IRA to IRA transfers) (GV-IRA 4971) F. |_| IRA QUALIFIED PLAN ROLLOVER-- (QP IRA) (Distribution from a Qualified Plan) (GV-IRA 4971-71) G. |_| EDC (Public Employee Deferred Compensation) (GV-EDC 4991) H. |_| EDC (Tax Exempt Organization) (GV-EDC 4991-SU-080) I. |_| SEP (Simplified Employee Pension) (GV-SEP 4981) J. |_| SARSEP (Salary Reduction SEP) _________________________________________ K. |_| CORPORATE TRUSTEED (GV-CORP 4941-41) L. |_| KEOGH/HR-10 TRUSTEE (GV HR-10 4911-11) (trustee owned) M. |X| KEOGH/HR-10 (GV-HR-10 4911) (not trustee owned) (issued to existing units only) - -------------------------------------------------------------------------------- DO NOT COMPLETE THIS SECTION IF 1.D OR 1.F CHECKED ABOVE 2. EMPLOYER/PLAN NAME |A|B|C|_|C|O|M|P|A|N|Y|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| 3. |_| EXISTING UNIT NO. |_|_|_|_|_|_|-|_|_|_| |x| NEW UNIT |0|0|0|1|2|3|-|4|5|6| (FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP, OR TRUSTEED PLANS. FORM 983-135B IS REQUIRED) - -------------------------------------------------------------------------------- 4. PROPOSED ANNUITANT Print name to appear on Contract. |J|O|H|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|D|O|E|_|_|_|_|_| FIRST MIDDLE INITIAL LAST A. |X| MR. |_| MRS. |_| MS. |_| OTHER ____ B. Date of Birth: Year 1954 Month JANUARY Day 27 ---- ------- -- C. Age at Nearest Birthday: 38 D. |X| Male |_| Female ---- E. Annuitant's Mailing Address: F. State of Residence: N.J. ---- No., St. |1|7|_|E|L|M|_|S|T|R|E|E|T|_|_|_|_|_|_|_|_|_|_|_|_| City |A|N|Y|T|O|W|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1| G. Telephone Number (101) 222 - 3456 |X| Home |_| Work H. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9| I. Are you associated with or employed by a member of National Association of Securities Dealers, Inc.(NASD)? |_| Yes |X| No 5. OWNER (Print Name) -- If Trusteed or EDC Plan Print Name of Owner, for all other Markets Print Name of Annuitant. JOHN DOE ----------------------------------------------------------------------------- a. Title ____________________________________________________________________ 6. RETIREMENT AGE 65 --------------------------------------------------------------- 7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death Benefit upon Annuitant's death before Retirement Date.) (BENEFICIARY MUST BE THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS.) JANE DOE - WIFE ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- 8. CONTRIBUTION ALLOCATION Guaranteed Interest Division 20% ----- Stock Division 20% ----- Money Market Division 20% ----- Balanced Division 20% ----- Aggressive Stock Division 20% ----- (PERCENTAGES IN WHOLE NUMBERS) Total 100% 9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F) A. Reminder Notice (Billing) Required |_| Yes |X| No IF YES, COMPLETE B-C-D-E B. REMINDER DATE Required for Individual IRA or otherwise must agree with existing unit or attached 983-135B. MONTH _________ DAY __________ C. REMINDER FREQUENCY |_| Annual |_| Semi-Annual |_| Quarterly |_| Monthly Available for TSA, EDC, SARSEP AND CORPORATE TRUSTEED AND UNIT BILLED IRA ONLY: |_| Semi-Monthly |_| Bi-Weekly D. REMINDER AMOUNT $_________________________________ E. BILLING MONTHS TO BE EXCLUDED - TSA ONLY ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- 10.EXPECTED FIRST CONTRACT YEAR Contribution. $1000 ---------------------------------------------------------------- IF AN ADVANCED BILLING AND/OR CONTRACT DATE ARE REQUESTED, COMPLETE #9B AND #12. - -------------------------------------------------------------------------------- (FOR PROCESSING OFFICE USE) Unit Name ___________________________ Reminder Date ___________________________ Cert. or App# _______________________ Amendment Required_______________________ EDC Emp. Add. _______________________ Emp. Fed. ID# ___________________________ Frequency ___________________________ Contract Date ___________________________ - -------------------------------------------------------------------------------- Receipt Date Batch # Inquiry # Processor - -------------------------------------------------------------------------------- 180-1000 - -------------------------------------------------------------------------------- 10. Did you receive the Separate Account Prospectus? |X| Yes |_| No Date shown on Prospectus January 1, 1992 ---------------------------------------------------- Date of any supplement to Prospectus _______________________________________ 11. Items (a) through (f) are to be answered by the annuitant. We are required by the NASD to ask these questions. (a) Name of Employer: ABC Company ------------------------------------------------------ (b) Address of Employer: 10 Main Street --------------------------------------------------------------------------- Anytown, NJ --------------------------------------------------------------------------- (c) Occupation Sales ------------------------------------------------------------- (d) Assuming the contract applied for will be issued, will any existing insurance or annuity be replaced or changed (or has it been)? | | Yes |X| No (e) Estimated Family Annual Income $100,000 ---------------------------------------- (f) Estimated Net Worth $250,000 ----------------------------------------------------- (g) Investment Objective: |_| Income |X| Income & Growth |_| Aggressive Growth |_| Growth |_| Safety of Principal 12. SPECIAL INSTRUCTIONS ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- 13. Amount paid with this form: $1000 (If a check is submitted with this request, no advanced Contract Date is permitted.) BACKDATING IS NOT PERMITTED. NOTE: Amount paid will be credited upon receipt at Equitable's Processing Office, subject to return if the certificate is not issued. The Contract Date will be the date of receipt by Equitable of this application, properly signed and completed, and Contribution at Equitable's Processing Office. - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- AGREEMENT All information and statements furnished in this application are true and complete to the best of my knowledge and belief. I understand and acknowledge that no Agent has the authority to make or modify any contract on Equitable's behalf, or to waive or alter any of Equitable's rights and regulations. IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT. UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S) OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND COMPLETE. - -------------------------------------------------------------------------------- LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR ANNUITY APPLICATION WITH INFORMATION YOU KNOW IS FALSE OR TO LEAVE OUT MATERIAL FACTS. - -------------------------------------------------------------------------------- X__________________________________ Date_______ City __________ State __________ Signature of Annuitant X__________________________________ Date_______ City __________ State __________ Signature of Authorized Individual (REQUIRED FOR EDC AND TRUSTEED) OR OWNER - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- AGENT'S SECTION Will any existing insurance or annuity be replaced or changed (or has it been), assuming the Contract will be issued? | | Yes | | No |_| I (we) certify that a prospectus for the Contract has been given to the proposed Annuitant and that no written sales materials other than those approved by Equitable have been used. EQUI-VEST issues must adequately reflect the commission interest of all Agents on previous contracts. - -------------------------------------------------------------------------------- Print Agent's Name(s) Initial of Agent Agent Agency District Agent's (Service Agent first) Last Name Number % Code Manager Code Signature - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS___ Date ___ District EQS ___ Date ____ - -------------------------------------------------------------------------------- (FOR ASU USE) ASU Code and App. No. __________________________________________________________ ASU Rec'd. _____________________________________________________________________ Date to Proc. Off. ________________________________________________ Campaign |_| Agent(s) shown above is Equity Qualified and is licensed in the state where the request is signed. Above Agent information verified by ASM (Registered Rep) - -------------------------------------------------------------------------------- Application reviewed by ________________________________________________________ - -------------------------------------------------------------------------------- 180-1000 Owner: [THE EQUITABLE LOGO] Annuitant: Contract Number: Issue Date: Contract Date: Retirement Date: - -------------------------------------------------------------------------------- THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P O Box 2996, New York, New York 10116-2996 AGREES o TO ALLOCATE the Contributions made to this Contract, after deduction of any applicable tax charge, to the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division of the Separate Account (referred to in this Contract as the "Investment Divisions") or to the Guaranteed Interest Division, in accordance with Sections 2.02, 2.03 and 2.04, as directed by you, and o TO APPLY the Annuity Account Value at the Retirement Date to provide you with an Annuity Benefit or a Cash Value benefit if you are then living, and o TO PROVIDE you with the other rights and benefits of this Contract. This is the entire Contract. In this Contract, "we", "our" and "us" mean The Equitable Life Assurance Society of the United States. "You" and "your" mean the Annuitant (Owner) at the time a tight is exercised by the Annuitant (Owner). TEN DAYS TO EXAMINE CONTRACT -- You may cancel this Contract by returning it to us within ten days after receipt of it. Upon such cancellation, we will refund any Contribution made to us on your behalf under this Contract, plus or minus any investment gain or loss experienced in the Investment Divisions of the Separate Account from the date such Contribution is allocated to such Investment Division to the date we receive the returned Contract. /s/ Pauline Sherman /s/ Edward D. Miller Pauline Sherman, Vice President, Secretary & Edward D. Miller Associate General Counsel President and Chief Executive Officer THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT FACTOR REFERRED TO IN SECTION 1.24 IS 5% OR 3.5%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE TRUST. NO. 92HR1B This Contract is issued in consideration of the payment to us of the Contributions made under the terms of this Contract. The provisions on the following pages are part of this Contract. - -------------------------------------------------------------------------------- TABLE OF CONTENTS DEFINITIONS Page Section 1.01 - Annuitant..........................................4 1.02 - Annuity............................................4 1.03 - Annuity Account Value..............................4 1.04 - Annuity Benefit....................................4 1.05 - Cash Value.........................................4 1.06 - Class of Contracts.................................5 1.07 - Code...............................................5 1.08 - Contract...........................................5 1.10 - Contract Year......................................5 1.11 - Contribution.......................................5 1.12 - Divisions..........................................5 1.13 - Eligible Annuity Certain...........................5 1.14 - Employer...........................................5 1.15 - Guaranteed Interest Rate...........................5 1.16 - Joint and Survivor Life Annuity Form.......................................5 1.17 - Life Annuity Form..................................5 1.18 - Normal Form........................................5 1.19 - Period Certain Annuity ............................5 1.20 - Plan...............................................5 1.21 - Processing Office..................................6 1.22 - Retirement Date....................................6 1.23 - Separate Account...................................6 1.24 - Separate Account Definitions........................................7 1.25 - Transaction Date ..................................7 1.26 - Trust .............................................7 ANNUITY ACCOUNT VALUE Section 2.01 - Contributions......................................8 2.02 - Separate Account Investment Divisions...............................8 2.03 - Guaranteed Interest ...............................8 Division...........................................8 2.04 - Allocation to Divisions............................8 2.05 - Transfers Among Divisions..........................8 2.06 - Termination of this Contract.......................9 2.07 - Partial Withdrawals................................9 2.08 - Charges for Partial Withdrawals........................................9 2.09 - Free Corridor Amount..............................10 2.10 - Annual Administrative Charge .....................10 2.11 - Death Benefit.....................................10 ANNUITY BENEFITS Section 3.01 - Fixed Annuity Benefit ............................11 3.02 - Variable Annuity Benefit..........................11 3.03 - Election and Commencement of Annuity Benefits...............................11 3.04 - Amount of Annuity Benefits........................11 3.05 - Payment of Annuity Benefits ......................12 3.06 - Special Annuity and Spousal Consent Provisions................................14 GENERAL PROVISIONS Section 4.01 - Contract..........................................15 4.02 - Statutory Compliance..............................15 4.03 - Assignments and Nontransferability................................15 4.04 - Beneficiary ......................................15 4.05 - Disqualification..................................16 4.06 - Future Contributions .............................16 4.07 - Deferment ........................................16 4.08 - Annual Notice.....................................16 4.09 - Age...............................................16 NO. 92HR1B Page 2 - -------------------------------------------------------------------------------- PART I -- DEFINITIONS SECTION 1.01 ANNUITANT. The term "Annuitant" means the Owner of this Contract, as shown on Page 3 of this Contract, and on whose behalf this Contract is purchased and is maintained and who exercises all rights under the terms of this Contract. SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in accordance with the terms of the Plan. SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts that you have in the Guaranteed Interest Division and the Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by us pursuant to Section 3.04 of this Contract. Various sections of this Contract (Sections 1.16, 1.17, 1.18, 3.01 and 3.02) refer to monthly payments to be made under an Annuity Benefit. You may wish to have your Annuity Benefit paid at other intervals, such as quarterly, semi-annually, or annually, instead of monthly. You may elect this at the time you elect the Annuity Benefit form as described in Section 3.03; in that event, all references in this Contract to monthly payments will be deemed to mean payments at the frequency you elect, subject to our rules at the time of election. SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value less an applicable withdrawal charge determined as follows: The withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 O% thereafter of the excess of (i) the Annuity Account Value over (ii) the Free Corridor Amount defined in Section 2.09; and (b) is the excess, if any, of (i) 8% of the total Contributions made on your behalf during the Current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to Section 2.08. However, notwithstanding the above, if you are age 60 years or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. However, a withdrawal charge will not apply, which means the Cash Value will equal the Annuity Account Value, upon any of the following occurrences: (i) your attainment of age 59 years and 6 months and your completion of at least five Contract Years, or (ii) your completion of at least twelve Contract Years, or (iii) your attainment of age 55 years, your completion of at least five Contract Years and the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase an Eligible Annuity Certain, defined in Section 1.13, or (iv) your completion of at least three Contract Years and the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase a Period Certain Annuity, defined in Section 1.19, where the certain period of such annuity is at least ten years, or (v) the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase a life annuity distribution option, pursuant to the terms of this Contract, or (vi) you die and the withdrawal is made by the beneficiary. NO. 92HR1B Page 4 SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all Contracts with a Contract Date in the same calendar year. SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.O8 CONTRACT. The term "Contract" means this Contract. SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt by us of both the application for this Contract, properly signed and completed, and a Contribution. SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month period beginning on (i) the Contract Date, and (ii) each anniversary thereafter, unless otherwise agreed to in writing by us. SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us for you with respect to an Annuity purchased for you under the Plan. We are under no obligation to accept any Contribution less than $20.00. SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or severally as the case may be, the following divisions described in this Contract: (i) the Guaranteed Interest Division, and (ii) the Investment Divisions of the Separate Account. SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by us which extends beyond your attainment of age 59 years and 6 months and does not permit any prepayment of the unpaid principal (that is, no withdrawal or single sum payment) prior to your attainment of age 59 years and 6 months. SECTION 1.14 EMPLOYER. The term "Employer" means the sole proprietor or the partnership adopting the Plan, or any successor unincorporated trade or business that assumes in writing the obligations of the Plan. SECTION 1.15 GUARANTEED INTEREST RATE. The term "Guaranteed interest Rate" means the effective annual rate at which interest accrues on the amount in the Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of this Contract. Section 2.03 describes determination of the rate to apply thereafter. SECTION 1.16 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by you. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.17 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity issued by us providing monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.18 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under this Contract means (i) if you have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (with 100% of the monthly payment amount continued to your spouse), and (ii) if you do not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by us which does not permit any prepayment of the unpaid principal (that is, you cannot elect to receive part of your payments as a single sum payment with the remainder paid in monthly annuity payments). SECTION 1.20 PLAN. The term "Plan" means the Standardized Non-Trusteed Defined Contribution Plan for Unincorporated Employers, a prototype plan for self-employed individuals and their employees which is sponsored by us. No. 92HR1B Page 5 SECTION 1.21 PROCESSING OFFICE. The term "Processing Office" means our Individual Annuity Center, P O Box 2996, New York, New York 10116-2996, or such other location as we shall designate by advance written notice to the Employer or the trustee, as applicable, and to you. SECTION 1.22 RETIREMENT DATE. The term "Retirement Date" means the date on which you attain the retirement age as shown on Page 3 of this Contract. Before the Retirement Date you may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th or 31st day of any month). No Retirement Date shall be earlier than the date you attain age 59 years and 6 months nor shall it be later than the date you attain age 70 years and 6 months. Any election for such change must be made in writing by you and shall not take effect until received by us at our Processing Office. SECTION 1.23 SEPARATE ACCOUNT. The term "Separate Account" means our Separate Account A which is organized as a unit investment trust, a type of investment company. We have established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts and certificates. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities and variable life insurance. The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to these contracts will not be chargeable with liabilities arising out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to our General Account. The Separate Account consists of "Investment Divisions". Each Investment Division may invest its assets in a separate class (or series) of shares of a designated Trust where each class (or series) represents a separate portfolio in such Trust. We reserve the right to change the designated trust or investment company or to add designated trusts or investment companies. The Investment Divisions available are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. The Guaranteed Interest Division is not part of the Separate Account but rather is an asset of our General Account. We will value the assets of each Investment Division on each business day. A business day is any day on which we are open, the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio securities in which an Investment Division is invested to materially affect the Accumulation Unit Value. We may, at our discretion, invest the assets of any Investment Division in any investment permitted by applicable law. We may rely conclusively on the opinion of counsel (including attorneys in our employ) as to what investments we are permitted by law to make. We reserve the right to (i) cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such committee at any time; (iii) restrict or eliminate any voting rights as to the Separate Account; (iv) operate the Separate Account by making direct investments, or in any other form; (v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or remove Investment Divisions (or sub-divisions of Investment Divisions) from the Separate Account (the term "Investment Division" in this Contract shall then refer to any other Investment Division in which the assets, of a Class of Contracts to which this Contract belongs, were placed); (vi) combine any two or more` Investment Divisions (or sub-divisions of Investment Divisions) of the Separate Account; and (vii) withdraw from any Investment Division and to allocate to another Investment Division assets determined by us to be associated with the Class of Contracts to which this Contract belongs. NO. 92HR1B Page 6 If the exercise of these rights results in a material change in the underlying investments of an Investment Division, you will be notified of such exercise, as required by law. Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for applicable tax charges) at a rate not to exceed 1.49% per year for each of the Stock, Money Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock Division, for financial accounting, death benefits, mortality risk, expenses and expense risk. The charge shall be made in accordance with Subsection (c) of the Net Investment Factor provision in Section 1.24. The relative proportion of these charges may be modified. This daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust, shall not exceed a total annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to this Contract. SECTION 1.24 SEPARATE ACCOUNT DEFINITIONS. VALUATION PERIOD: Each business day together with any preceding consecutive non-business days. NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b), minus (c), where (a) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the Valuation Period before giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period. For this purpose, we use the share value reported to us by the Trust. (b) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the preceding Valuation Period (after any amounts allocated or withdrawn for that Valuation Period). (c) is the daily Separate Account charge for the expenses of this Contract, times the number of calendar days in the Valuation Period. ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an Investment Division where your Contributions are invested and which is used in determining the amount you have in an Investment Division. ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of each Accumulation Unit in an Investment Division on a given date. The Accumulation Unit Value for a Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for that Investment Division for such Valuation Period. ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable from the Stock Division of the Separate Account under a Variable Annuity Benefit as defined in Section 3.02. ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1, 1968. On August 27, 1981, the date the first contribution was put into the Stock Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods ending in such month. SECTION 1.25 TRANSACTION DATE. The term "Transaction Date" means the business day we receive a Contribution or a written contract transaction request providing the information we need at the Processing Office. In the case of a transfer request initiated through the use of a touch tone telephone as described in Section 2.05, the term Transaction Date means the business day the telephone transaction is received. SECTION 1.26 TRUST. The term "Trust" means the designated trust or investment company in which Separate Account assets are invested. NO. 92HR1B Page 7 - -------------------------------------------------------------------------------- PART II -- ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. The Employer is to make Contributions from time to time on such dates and in such amounts as determined by the Employer pursuant to the terms of the Plan or Agreement. Contributions will be allocated to the Divisions in accordance with the instructions received on the application, unless later changed. Each Contribution received by us with respect to you will, before its allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. Pursuant to the terms of the Plan, we will accept rollover contributions and transfers made on your behalf from a plan qualified under Section 401(a) of the Code or from a conduit individual retirement arrangement as described in Section 408 of the Code. SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when an amount is allocated to, or withdrawn or transferred from, an Investment Division, the Annuity Account Value will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Section 2.07 or 2.10 or transferred from the Investment Division pursuant to Section 2.05. The amount in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units in the Investment Division on that date, and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under the terms of this Contract terminates on the earliest of (i) Election and Commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii) Termination of this Contract pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division becomes part of our general assets, which support the guarantees of this Contract and other contracts. The amount in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Section 2.07, 2.10 or 2.11 or transferred from the Guaranteed Interest Division, pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division on a Transaction Date pursuant to Section 2.04. We will credit the amount you have in the Guaranteed Interest Division with interest at effective annual rates that we determine. For each Class of Contracts we determine a yearly guaranteed interest rate that will remain in effect throughout the next year. We guarantee that this yearly guaranteed interest rate will never be less than 3%. Participation in the Guaranteed Interest Division under the terms of this Contract terminates on the earliest of (i) Election and Commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii) Termination of this Contract pursuant to. Section 2.06. SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section 2.01 is allocated (after deduction of any applicable tax charge) to one or more Divisions, at your sole direction as specified to us. Allocation percentages must be in whole numbers and the sum must equal 100. The allocation is made as of the Transaction Date on which we have received both such Contribution and such direction. Contributions made to an Investment Division purchase Accumulation Units in that Investment Division, using the Accumulation Unit Value next computed after the Transaction Date. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the Transaction Date with respect to each transfer from the Division pursuant to Section 2.05, (iii) on the Transaction Date with respect to each withdrawal pursuant to Section 2.07, (iv) at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, (v) upon Termination of this Contract pursuant to Section 2.06, and (vi) upon your death pursuant to Section 2.11. SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request or through the use of a touch tone telephone, transfer all or part of the amount you have in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; (2) amounts in the Money Market Division may be transferred to other Divisions. Written authorization for touch tone telephone initiated transfers is only required when authorization for telephone transfers is requested. (Upon advance written notice to you, we reserve the right to discontinue the acceptance of transfer requests through the use of a touch tone telephone.) All transfers will be effective on the Transaction Date and will be subject to our rules in effect at the time of transfer. With respect to the Investment Divisions, the transfer will be made at the Accumulation Unit Value next computed after the Transaction Date. No transfers are permitted to the Money Market Division from the other Divisions. NO. 92HR1B Page 8 SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the terms of the Plan, including the spousal consent rules set forth in Section 3.06, you may elect, by written notice, to terminate this Contract. We will determine the Cash Value under this Contract as of the Transaction Date. If this Contract is terminated, surrendered or exchanged prior to your Retirement Date, any applicable tax charges we have paid may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on terminations, unless a change in applicable law has occurred with respect to your Contract. The payment of such Cash Value may be deferred by us in accordance with the provisions of Section 4.07. If no tax has been previously deducted or if such a tax is due at termination, we will deduct the amount due. Subject to the terms of the Plan, we reserve the right to pay the Annuity Account Value under this Contract and terminate this Contract if (i) no Contributions are made on your behalf during the last three completed Contract Years, and the Annuity Account Value is less than $500 or (ii) a partial withdrawal is made that would result in your Annuity Account Value falling below $500. We also reserve the right to terminate this Contract if no Contributions have been made within 120 days from the Contract Date shown on Page 3 of this Contract. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under the terms of the Plan, you may elect, by written notice to us, to make a partial withdrawal from the Divisions. Partial withdrawals are subject to spousal consent rules set forth in Section 3.06. On the Transaction Date, we will pay the lesser of the Cash Value or the amount of partial withdrawal requested to the person entitled to receive such payment as designated in writing by you. The amount paid plus any withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the amounts you have in the Divisions. Unless instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts that you have in such Divisions. Upon any partial withdrawal payment, we will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by us in accordance with the provisions of Section 4.07. We may decline to accept a request for a partial withdrawal of less than $300. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, we will so advise you and reserve the right to pay the Annuity Account Value to you, and terminate this Contract. SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity Account Value pursuant to Section 1.05. WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than the Free Corridor Amount, we will (i) first withdraw from the Divisions an amount equal to the Free Corridor Amount in proportion to the amount you have in them, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a partial withdrawal charge. Such partial withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter NO. 92HR1B Page 9 of the amount withdrawn in excess of the Free Corridor Amount (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the total Contributions made on your behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to this Section. If withdrawals are made from this Contract prior to the Retirement Date, any applicable tax charges we have paid with respect to this Contract may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on withdrawals, unless a change in applicable law has occurred with respect to your Contract. SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means if you have completed three Contract Years or attained age 59 years and 6 months, an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the current Contract Year. If you have not completed three Contract Years or attained age 59 years and 6 months, the Free Corridor Amount is zero. SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract Year, if the Annuity Account Value on that date is less than $10,000, we will withdraw from the Divisions an Annual Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account Value including the amount of any withdrawals pursuant to Section 2.07 during that Contract Year. The charge will be allocated among the Divisions in proportion to the amounts that you have in the Divisions. If the Annuity Account Value is less than $10,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of termination of this Contract pursuant to Section 2.06 or 2.11, we will prorate the Annual Administrative Charge applicable to the completed portion of the Current Contract Year and withdraw such amount in lieu of the full Annual Administrative Charge described in this Section for the applicable part of that Contract Year. If the Annuity Account Value is $10,000 or greater at the end of a Contract Year, the Annual Administrative Charge is zero. SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of your death we will pay (subject to the terms of the Plan, in the spousal survivor benefit rules set forth in Section 3.06) to the beneficiary designated to receive such payment, pursuant to Section 4.04 of this Contract, the amount of death benefit payable. The amount of the death benefit is equal to the greater of (i) the Annuity Account Value and (ii) your minimum death benefit. Such minimum death benefit is the sum of all Contributions made pursuant to Section 2.01 (before reduction for any applicable tax charge) less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce your minimum death benefit (as adjusted by any previous withdrawal) by an amount which is in the same proportion as the amount that was withdrawn is to the Annuity Account Value. If, in accordance with the provisions of Section 2.01, the cash value of another annuity contract issued by us or one of our affiliated or subsidiary life insurance companies, which provides for a death benefit before retirement equal to the greater of the contract cash value or an alternate amount based on premiums paid or contributions made under the annuity contract, is transferred to this Contract, such cash value or alternative amount as of the date of transfer will be included in the "sum of all Contributions" in lieu of the amount of cash value transferred for purposes of the death benefit under this Contract. We will pay the death benefit to the beneficiary in the form of an Annuity Benefit if you have made the election described in the last paragraph of Section 4.04. Also in accordance with the last paragraph of Section 4.04, if no such election is in effect at your death, we will pay the death benefit to the beneficiary in a single sum, unless the beneficiary elects, before we pay the death benefit, to apply the death benefit to an Annuity Benefit, subject to the minimum distribution requirement of the Code as described in Section 3.06 and our rules then in effect. Upon payment of the death benefit, the amount you have in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. NO. 92HR1B Page 10 - -------------------------------------------------------------------------------- PART III -- ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the terms of this Contract with respect to a payee is the amount provided pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Stock Division of the Separate Account. Such Variable Annuity Benefit will increase if the average daily rate of investment return in the Stock Division is equivalent to more than 6.75% or 5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25% annually, depending on whether the applicable assumed base rate of Net Investment Return referred to in Section 1.24 is 5% or 3.5%, respectively. The daily rate of investment return is before deduction of charges, as described in Section 1.23, not to exceed the maximum rate of 1.75% after any deductions to provide for any applicable tax charge. These charges include a daily charge for financial accounts, death benefits, mortality risk, expenses and expense risk, plus the investment advisory fee charges and direct operating expense charges of the Trust. The amount of the first, second and third payments under any Variable Annuity Benefit provided under the terms of this Contract with respect to a payee is the monthly amount provided pursuant to the fifth paragraph of Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment by the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. (As described in Section 3.05, we will notify the payee how each Variable Annuity Payment is determined.) SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your Retirement Date, provided you are then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless you elect (i) to receive the Cash Value in a single sum or (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by us, or one of our affiliated or subsidiary life insurance companies, as elected by you, or (iii) to take partial withdrawals pursuant to Section 2.07 in the amounts and at times as required by the minimum distribution rules of Section 401(a)(9) of the Code and applicable Treasury Regulations, pursuant to Sections 2.07 and 3.05, subject to our rules then in effect and any other applicable requirements under the Code. We will provide notice and election forms to you not more than six months before your Retirement Date. If you elect to terminate this Contract, pursuant to Section 2.06, an election may be made to receive an Annuity Benefit in lieu of the Cash Value. We will have the right to require you to furnish pertinent information to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. We may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary life insurance companies. An election to receive Annuity Benefits in accordance with this Section is subject to the spousal consent and spousal survivor rules set forth in Section 3.06 of this Contract. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value if the annuity form elected involves life contingencies or (ii) the Cash Value if the payments under the annuity form elected does not involve life contingencies. The amount applied to provide an Annuity Benefit may be reduced by any applicable tax charge on annuity considerations, as we determine. If we have previously deducted any applicable tax charges from Contributions as provided in Section 2.01, we will not again deduct charges for the same taxes before application to provide an Annuity Benefit, unless a change in applicable law has occurred with respect to your Contract. The balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) our current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, your Contract will be governed by our supplementary contract then in effect. NO. 92HR1B Page 11 The amount to be applied to provide an Annuity Benefit will, in addition to any tax charge reduction, be reduced by an administrative charge. The amount of such charge will be determined from time to time in accordance with our general practices applicable on a uniform basis to all contracts of the same type as this Contract. After the application of an amount to provide an Annuity Benefit, the amounts you have in the Divisions and the Annuity Account Value shall be zero. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the terms of this Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (with 100% of the amount of your payment continued to your spouse). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, are based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form are based on a 50-50 split of males and females and an Assumed Base Rate of Net Investment Return of 3.5% or 5%,whichever applies pursuant to Section 1.24. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females if such annuity form provides for a Fixed Annuity Benefit, and on the projected 1983 Basic Table "a" adjusted to a unisex basis based on a 50-50 split of males and females and an Assumed Base Rate of Net Investment Income Return of 5% or 3.5%, whichever applies pursuant to Section 1.24, if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract will be distributed or begin to be distributed in accordance with Section 401(a)(9) of the Code and the applicable Treasury Regulations thereunder, no later than the first day of April following the calendar year in which you attain age 70 years and 6 months ("Required Beginning Date") or such later date as specified in such section or regulations. Your entire interest may be distributed, as you elect over (a) the life, or the lives of you and or your designated beneficiary, or (b) a period certain not extending beyond your life expectancy, or the joint and last survivor expectancy of you and your designated beneficiary. Distributions must be made in periodic payments at intervals of no longer than one year. In addition, payments must be either non-increasing or they may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the proposed Treasury Regulations, or any successor Regulation thereto. All distributions made hereunder shall be made in accordance with the requirements of Section 401(a)(9) of the Code, including the incidental death benefit requirements of Section 401(a)(9)(G)of the Code, and applicable Treasury Regulations, including the minimum distribution incidental benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or any successor Regulation thereto. Notwithstanding the above paragraphs and the following paragraphs of this Section 3.05, while any distribution shall be subject to such requirements of the Code and regulations, any distribution shall also be subject to the terms of this Contract. That is, the forms of distribution shall be those which are made available by us at the time of your election. For purposes of determining the "period certain" referred to in the first paragraph of this Section, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless you otherwise elect prior to the time distributions are required to begin, those life expectancies shall be recalculated annually. Such election shall be irrevocable and shall apply to all subsequent years. The life expectancy of a non-spouse beneficiary may not be recalculated. Instead, life expectancy will be calculated using the attained age of such beneficiary during the calendar year in which you attain age 70 years and 6 months, and payments for subsequent years shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. If you die after distribution of your interest in this Contract has begun, the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution being used prior to your death. If you die before distribution of your interest in this Contract begins, distribution of your entire interest shall be completed no later than December 31 of the calendar year containing the fifth anniversary of your death, except to the extent that an election is made to receive death benefit distributions in accordance with (1) or (2) below: (1) If your interest is payable to a designated beneficiary, then your entire interest may be distributed over the life of, or over a period certain not greater than the life expectancy of, the designated beneficiary. Such distributions must commence on or before December 31 of the calendar year immediately following the calendar year of your death. NO. 92HR1B Page 12 (2) If the designated beneficiary is your surviving spouse, the date distributions that are required to begin in accordance with (1) above shall not be earlier than the later of (A) December 31 of the calendar year immediately following the calendar year of your death or (B) December 31 of the calendar year in which you would have attained age 70 years and 6 months. For purposes of determining the "period certain" referred to in the immediately preceding paragraph, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of distributions beginning after your death, unless otherwise elected by the surviving spouse by the time distributions are required to begin, life expectancies shall be recalculated annually. Such election shall be irrevocable by the surviving spouse and shall apply to all subsequent years. In the case of any other designated beneficiary, life expectancies shall be calculated using the attained age of such beneficiary during the calendar year in which distributions are required to begin pursuant to this Section, and payments for any subsequent calendar year shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. Distributions under this Section are considered to have begun if distributions are made because you have reached your Required Beginning Date or if prior to the Required Beginning Date distributions irrevocably commence to you over a period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1 of the Proposed Treasury Regulations or any successor Regulation thereto. Evidence of each payee's survival must be furnished to us either by personal endorsement of the check drawn for payment or by other means satisfactory to us. If a benefit payment under the terms of this Contract was based on information that is subsequently found to be incorrect, your benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by us will be charged against and underpayments will be added to any payment thereafter falling due under the terms of this Contract with respect to the payee, affecting as many such payments as are necessary to correct the overpayment or underpayment. Our liability, with respect to a payee, is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under this Contract. If we receive evidence satisfactory to us that (i) a payee entitled to receive any payment under the terms of this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii)) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee or other representative of the estate of such payee has been appointed, we may make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect hereto. If a variable annuity form made available by us provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one or two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Pursuant to Section 3.03, upon your election of an annuity form providing payments for a period certain, you may designate (with the right to change such designation) a payee to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable` after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's estate in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, we will pay in a single sum to such payee's estate the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis applicable in determining the annuity amount. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. NO. 92HR1B Page 13 Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. We will require satisfactory evidence of the age of any person upon whose life an annuity form depends. - -------------------------------------------------------------------------------- TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE (Minimum Monthly Income per $1,000 OF Annuity Account Value)
- -------------------------------------------------------------------------------------------- Age 60 61 62 63 64 65 66 67 68 69 70 - -------------------------------------------------------------------------------------------- 60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88 61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96 62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03 63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11 64 4.89 4.94 5.00 5.05 5.10 5.14 5.19 65 5.00 5.06 5.11 5.17 5.22 5.27 66 5.12 5.18 5.24 5.29 5.35 67 5.24 5.31 5.37 5.43 68 5.37 5.44 5.51 69 5.52 5.59 70 5.67 - --------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Account Value) - -------------------------------------------------------------------------------- VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS Age 3.5% 5.0% - -------------------------------------------------------------------------------- 60 5.27 6.16 61 5.39 6.28 62 5.52 6.41 63 5.66 6.55 64 5.81 6.70 65 5.97 6.86 66 6.15 7.03 67 6.33 7.21 68 6.53 7.41 69 6.74 7.62 70 6.97 7.85 - -------------------------------------------------------------------------------- We will, with respect to each payment under a Variable Annuity Benefit, notify the payee of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each variable payment. Such notice will be mailed with each payment. Any election, change, revocation or designation shall be made, and will take effect on the Transaction Date, in the same manner as a change of beneficiary, as described in Section 4.04. If a commutation right under an Annuity Benefit is exercised, we may defer payment in accordance with Section 4.07. SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS. If you are married, your interest in this Contract shall be paid in the Normal Form joint and survivor annuity, and if you are unmarried, your interest shall be paid in the Normal Form life annuity, unless you elect otherwise as described in this Section. If you are married and die before payment of your interest has commenced, your interest shall be paid to your surviving spouse in the form of a life annuity, unless at the time of your death there was a contrary election made pursuant to this Section. The foregoing notwithstanding, your surviving spouse may elect, before payment is to commence, to have payment made in any form permitted under the terms of this Contract. You may elect, at any time within the 90 consecutive day period before the first day of the first period for which your interest is paid as an annuity or in any other form, not to have your interest paid in the Normal Form in which case it shall be paid in any other form elected under the terms of this Contract. If such interest is to be paid to your spouse upon your death, you may elect, during the period beginning on the first day of the plan year of the Plan in which you attain age 35 years (or if you separate from Service prior to that plan year, beginning on the date of separation) and ending with your death, for a beneficiary other than your spouse to receive payment of the value of your interest. In addition, if you will not yet attain age 35 years by the end of any current plan year, you may make a special qualified election to designate a beneficiary other than your spouse to receive payment of the value of your interest. Such special qualified election shall be effective for the period beginning on the date of such election and ending on the first day of the plan year in which you will attain age 35. Amounts payable in accordance with this Section will be automatically reinstated as of the first day of the plan year in which you attain age 35 unless a new election designating a beneficiary other than the spouse is made in accordance with the requirements of this Section. NO. 92HR1B Page 14 Any election described in the foregoing paragraph must be consented to by your spouse in writing before a notary or a representative of the Plan unless you can prove that there is no spouse or that the spouse cannot be located. Also, if you have become legally separated from your spouse or have been abandoned (within the meaning of local law) and have a court order to such effect, spousal consent is not required unless a qualified domestic relations order provides otherwise. Your election must designate a specific beneficiary (including any class of beneficiaries or any contingent beneficiaries) that may not be changed without further consent of the spouse, unless the spouse's consent expressly permits designation by you without further consent of the spouse. The spouse's consent under this Section shall acknowledge the effect of the election. In addition, the spouse's consent (or the establishment that the consent of the spouse may not be obtained) shall only be valid with respect to such spouse. Your waiver of the Normal Form joint and survivor annuity shall not be effective unless the election designates a form of benefit payment which may not be changed without spousal consent (or the spouse expressly permits designations by you without any further spousal consent). A consent that permits designations by you without any requirement of further consent by such spouse must acknowledge that the spouse has the right to limit consent to a specific beneficiary, and a specific form of benefit where applicable, and that the spouse voluntarily elects to relinquish either or both of such rights. If you make an election under this Section, you may revoke that election, without spousal consent, at any time before the first day of the first period for which an amount is paid as an annuity or in any other form. The provision requiring spousal consent in this Section shall also apply with regard to your election to terminate this Contract or make partial withdrawals pursuant to Sections 2.06 and 2.07, with respect to death benefits under Section 2.11 with respect to the Election and Commencement of Annuity Benefits pursuant to Section 3.03, and with respect to a beneficiary designation set forth in Section 4.04. If the Annuity Account Value applied to provide the spousal benefits on the date payment is to commence is in the aggregate less than $3,500, we may choose to make payment in a single sum rather than in the form of a Qualified Joint and Survivor Life Annuity or Life Annuity as described herein. Upon any payment made pursuant to this Section, we will be released from any and all liability for payment with respect to the Contributions made for you. - -------------------------------------------------------------------------------- PART IV -- GENERAL PROVISIONS SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the parties and the terms of this Contract alone will govern with respect to our rights and obligations. A copy of the application is incorporated in and made part of this Contract. This Contract may not be modified, nor may any of our rights or requirements be waived, except in writing and by our authorized officer. The terms of this Contract may be changed by amendment or replacement upon agreement between you and us without the consent of any other person. SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the terms of this Contract to reflect changes in the Code, applicable Treasury Regulations, or regulations or published rulings of the Internal Revenue Service so this Contract will continue to be an Annuity used to fund a plan qualified under Section 401(a) of the Code. SECTION 4.03 ASSIGNMENTS AND NON-TRANSFERABILITY. No interest of yours or of a beneficiary under this Contract may be transferred to any person other than us upon the surrender of this Contract. Except as permitted under Section 401(a)(13) of the Code, no right or interest of you or any other payee or beneficiary in this Contract shall be (a) assignable; (b) subject to any lien; or (c) liable for, or subject to, any obligation or liability of any person. The preceding sentence shall not apply to an assignment, transfer or attachment pursuant to a qualified domestic relations order, as defined in Section 414(p) of the Code. SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an initial designation of the beneficiary entitled to receive any death benefit payable pursuant to Section 2.11. Subject to the spousal consent and survivor rules of Section 3.06, you may change such designation from time to time during your lifetime and while this Contract is in force. Any such designation or change will be made by written notice in a form satisfactory to us. A change will, upon receipt at the Processing Office, take effect as of the time the written notice was signed, whether or not you are living on the date of receipt, but without further liability as to any payment or other settlement made by us before receipt of such change. Unless otherwise specified in the designation, if you have designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive you, and if more than one survive they will share equally. NO. 92HR1B Page 15 Any part of a death benefit payable pursuant to Section 2.11 for which there is no designated beneficiary living at your death will be payable in a single sum to your children who survive you, in equal shares, or should none survive, then to your estate. If you elect in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity previously elected by you, with respect to the beneficiary, subject to our rules then in effect. If at your death there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. Any such election must meet the minimum distribution requirements under the Code, as described in Section 3.05. The foregoing notwithstanding, any designation of beneficiary is subject to the Spousal Consent rules set forth in Section 3.06. SECTION 4.05 DISQUALIFICATION. In the event that this Contract fails to qualify as an Annuity as described in Section 1.02, we will have the right, upon receiving notice of such fact before the Retirement Date, to terminate this Contract and pay to you the Annuity Account Value less a deduction for the appropriate part attributable to you of any Federal income tax payable which would not have been payable if you had an Annuity. In the event that the Plan fails to qualify as a Plan under Section 401(a) of the Code and applicable Treasury Regulations, we reserve the right, upon receiving notice of such fact, to transfer the Annuity Account Value under this Contract to another annuity contract issued by us, an affiliate or subsidiary, on your life, or to terminate this Contract and pay to you the Annuity Account Value less deduction for applicable taxes, solely at our option. SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to the Employer, we reserve the right at our sole discretion to limit contributions to this Contract. SECTION 4.07 DEFERMENT. Applications of proceeds to a variable annuity, payment of a death benefit and payment of any portion of your Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange has been closed or trading on it is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Securities Exchange Commission, by order, permits us to defer payments in order to protect persons with interests in the Investment Divisions. We can defer payments of any portion of your Annuity Account Value in the Guaranteed Interest Division for up to six months while you are living. SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year, we will furnish you with a notice showing the following: (1) the amount you have in the Guaranteed Interest Division, (2) the total number of Accumulation Units you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Values, (4) the amount you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the Cash Value, and (6) the amount of your death benefit. We will also furnish annual calendar year reports concerning the status of the annuity and any other reports required by the Code or applicable Treasury Regulations. After the Retirement Date, we will notify you of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.09 AGE. If your age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by us will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. NO. 92HR1B Page 16 OWNER: JOHN DOE ANNUITANT: JOHN DOE CONTRACT NUMBER: 00 000 000 ISSUE DATE: FEB 28, 1992 CONTRACT DATE: FEB 28,1992 RETIREMENT DATE: JAN 1, 2020 THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York, New York 10116 AGREES o TO ALLOCATE the Contributions made to this Contract, after deduction of any applicable tax charge, to the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division (referred to in this Contract as the "Investment Divisions") or to the Guaranteed Interest Division, in accordance with Sections 2,02, 2.03 and 2.04 as directed by you, and o TO APPLY the Annuity Account Value at the Retirement Date to provide the Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant is then living, and o TO PROVIDE the Annuitant with the other rights and benefits of this Contract. This is the entire Contract. In this Contract "we", "our", and "us" mean The Equitable Life Assurance Society of the United States ("Equitable"). "You" and "your" mean the Annuitant at the time a right is exercised by the Annuitant. TEN DAYS TO EXAMINE CONTRACT--You may cancel this Contract by returning it to us within ten days after receipt of it. Upon such cancellation, we will refund any Contribution made to us under this Contract. /s/ Molly K. Heines /s/ Richard H. Jenrette Vice President and Secretary Chairman of the Board and Chief Executive Officer THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.22 IS 5% OR 3.5%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE INVESTMENT ADVISORY FEE CHARGE AND DIRECT OPERATING EXPENSE CHARGES OF THE TRUST. No. 92 IRAA The Contract is issued in consideration of the payment to us of the Contributions made under the terms of the Contract. The provisions on the following pages are part of this Contract. A copy of the application is incorporated in and made part of this Contract. - -------------------------------------------------------------------------------- TABLE OF CONTENTS DEFINITIONS Page Section 1.01 - Annuitant..........................................4 1.02 - Annuity............................................4 1.03 - Annuity Account Value..............................4 1.04 - Annuity Benefit....................................4 1.05 - Cash Value.........................................4 1.06 - Class of Contracts.................................4 1.07 - Code...............................................4 1.08 - Contract...........................................4 1.09 - Contract Date......................................4 1.10 - Contract Year......................................4 1.11 - Contribution.......................................4 1.12 - Divisions..........................................5 1.13 - Eligible Annuity Certain...........................5 1.14 - Guaranteed Interest Rate...........................5 1.15 - Joint and Survivor Life Annuity Form....................................5 1.16 - Life Annuity Form..................................5 1.17 - Normal Form........................................5 1.18 - Period Certain Annuity.............................5 1.19 - Processing Office..................................5 1.20 - Retirement Date....................................5 1.21 - Separate Account...................................5 1.22 - Separate Account Definitions.......................6 1.23 - Transaction Date...................................7 1.24 - Trust..............................................7 ANNUITY ACCOUNT VALUE Section 2.01 - Contribution.......................................7 2.02 - Separate Account Investment Divisions.......................................7 2.03 - Guaranteed Interest Division.......................7 2.04 - Allocation to Divisions............................7 2.05 - Transfers Among Divisions..........................8 2.06 - Termination of this Contract.......................8 2.07 - Partial Withdrawals................................8 2.08 - Charges for Partial Withdrawals....................8 2.09 - Free Corridor Amount...............................8 2.10 - Annual Administrative Charge.......................9 2.11 - Death Benefit......................................9 ANNUITY BENEFITS Section 3.01 - Fixed Annuity Benefit..............................9 3.02 - Variable Annuity Benefit...........................9 3.03 - Election and Commencement of Annuity Benefits............................10 3.04 - Amount of Annuity Benefits........................10 3.05 - Payment of Annuity Benefits.......................10 GENERAL PROVISIONS Section 4.01 - Contract..........................................12 4.02 - Statutory Compliance..............................13 4.03 - Nonforfeitability, Nontransferability, and Assignments....................................13 4.04 - Beneficiary.......................................13 4.05 - Disqualification..................................13 4.06 - Future Contributions..............................13 4.07 - Deferment.........................................13 4.08 - Annual Notice.....................................13 4.09 - Age and Sex.......................................13 No. 92 IRAA Page 2 OWNER: JOHN DOE ANNUITANT: JOHN DOE CONTRACT NUMBER: 00 000 000 ISSUE DATE: FEB 28, 1992 CONTRACT DATE: FEB 28,1992 RETIREMENT DATE: JAN 1, 2020 INITIAL GUARANTEED INTEREST RATE: 7.50% to MAR 31, 1992 MINIMUM GUARANTEED INTEREST RATE: 6.00% TO DEC 31, 1992 3.00% AFTER DEC 31, 1992 BENEFICIARY: JANE DOE FORM NUMBER: 92IRAA - -------------------------------------------------------------------------------- TABLE OF GUARANTEED VALUES ISSUE AGE 38 MALE $1000 ANNUAL CONTRIBUTION NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY SINCE FIRST CONTRIBUTION CASH VALUE ANNUITY AT AGE 65 - ------------------------ ---------- ----------------- 1 983 6.61 2 1,958 16.17 3 2,963 26.62 4 3,998 36.76 5 5,064 46.61 6 6,220 56.96 7 7,362 67.37 8 8,538 77.25 9 9,870 86.97 10 11,263 95.47 11 12,719 103.72 12 14,242 111.73 13 15,832 119.50 14 17,337 127.05 15 18,887 134.38 16 20,484 141.49 17 22,129 148.40 18 23,822 155.10 19 25,567 161.61 20 27,364 167.94 24 (Age 62) 35,108 191.43 27 (Age 65) 41,547 207.32 THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000 CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE (SEE SECTION 2.10) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE ACCOUNT VALUE (SEE SECTION 1.05). THE TABLES ASSUME THAT 100% OF ALL CONTRIBUTIONS AND EARNINGS ARE ALLOCATED TO AND REMAIN IN THE GUARANTEED INTEREST DIVISION. YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS. THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A SETTLEMENT WILL BE SUBJECT TO A CHARGE (SEE SECTION 3.04). *ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO SURVIVOR) WITH JOINT ANNUITANT THE SAME AGE AS THE ANNUITANT. No. 92 IRAA Page 3 - -------------------------------------------------------------------------------- PART I--DEFINITIONS SECTION 1.01 ANNUITANT. The term "Annuitant" means the person who owns this Contract as shown on page 3 and who exercises all rights under the terms of this Contract. SECTION 1.02 ANNUITY. The Term "Annuity" means an individual retirement annuity contract meeting the requirements of Section 408(b) of the Code. SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts that you have in the Guaranteed Interest Division and the Investment Divisions of the Separate Account, pursuant to Sections 2.02 and 2.03. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Section 3.04 of this Contract. Various sections of this Contract (Sections 1.15, 1.16, 3.01, and 3.02) refer to monthly payments to be made under an Annuity Benefit. You may wish to have your Annuity Benefit paid at other intervals, such as quarterly, semi-annually, or annually, instead of monthly. You may elect this at the time you elect the Annuity Benefit form described in Section 3.03; in that event, all references in this Contract to monthly payments will be deemed to mean payments at the frequency you elect, subject to our rules at the time of election. SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value less any applicable withdrawal charge determined as follows: The withdrawal charge equals the lesser of (a) or (b) where (a) equals 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the excess of (i) the Annuity Account Value over (ii) the Free Corridor Amount defined in Section 2.09; and (b) is the excess, if any, of (i) 8% of the total Contributions made during the Current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior charges for partial withdrawals made pursuant to Section 2.08. However, notwithstanding the above, if you are age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. A withdrawal charge will not apply, which means the Cash Value will equal the Annuity Account Value upon any of the following occurrences: (i) your attainment of age 59 and 6 months and your completion of at least five Contract Years, or (ii) a request is made for a refund of a contribution in excess of amounts allowed to be contributed under Section 408 of the Code within one month of the date on which the contribution is made, or (iii) you die and a distribution is made to the beneficiary, or (iv) your attainment of age 55, your completion of at least five Contract Years and you use the amount withdrawn to purchase from us an Eligible Annuity Certain, or (v) your completion of at least three Contract Years and you use the amount withdrawn to purchase from us a Period Certain Annuity of at least 10 years, or (vi) your Annuity Account Value is applied to the election of a Life Annuity Form or Joint and Survivor Life Annuity Form distribution option, or (vii) your completion of at least twelve Contract Years. SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all Contracts with a Contract Date in the same calendar year. SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.08 CONTRACT. The term "Contract" means this Contract, which is intended to qualify as an individual retirement annuity contract under Section 408(b) of the Code. This Contract is established for the exclusive benefit of you or your beneficiaries. SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt by us of both an application for this Contract, properly signed and completed, and a Contribution. SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month period beginning on (i) the Contract Date, and (ii) each anniversary thereafter, unless otherwise agreed to in writing by us. SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made in cash or by check to us with respect to this Contract. We are under no obligation to ac- No. 92 IRAA Page 4 cept any Contribution less than $20.00 Except in the case of a rollover contribution (as permitted by Sections 402(a)(5), 402(a)(6), 402(a)(7), 403(a)(4), 402(b)(8), or 408(d)(3) of the Code), no Contributions will be accepted unless they are in cash, and the total of such Contributions shall not exceed $2,000 for any taxable year. In addition, amounts directly transferred to this Contract, from an individual retirement account, or annuity contract meeting the requirements of Section 408 of the Code are also not subject to the $2,000 limit on contributions. SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or severally as the case may be, the following Divisions described in this Contract: (a) the Guaranteed Interest Division, and (b) the Investment Division of the Separate Account. SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by us, which extends beyond your attainment of age 59 and 6 months and does not permit any prepayment of the unpaid principal (that is no withdrawal or single sum payment) prior to your attainment of age 59 and 6 months. SECTION 1.14 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in the Guaranteed Interest Division. The initial rate to apply is shown on page 3 of this Contract. Section 2.03 describes the determination of the rate to apply thereafter. SECTION 1.15 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by you. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.16 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity issued by us providing monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.17 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under this Contract means, (i) if you have a living spouse at your Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with your spoons as the contingent annuitant (with 100% of the monthly payment amount continued to your spouse), and (ii) if you do not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.18 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by us which does not permit any prepayment of the unpaid principal (that is, you cannot elect to receive part of your payments as a single sum payment with the remainder paid in monthly annuity payments). SECTION 1.19 PROCESSING OFFICE. The term "Processing Office" means our Individual Annuity Center, P.O. Box 2996, G.P.O., New York, New York 10116, or such other location as we shall designate by advance written notice to you. SECTION 1.20 RETIREMENT DATE. The term "Retirement Date" means the date on which you attain your retirement age as shown on page 3 of this Contract. Before the Retirement Date you may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be earlier than the date you attain age 59 and 6 months nor shall be later than the first day of April following the calendar year in which you attain age 70 and 6 months. Any election for such change must be made in writing by you and shall not take effect until received by us at our Processing Office. SECTION 1.21 SEPARATE ACCOUNT. The term "Separate Account" means our Separate Account A, which is organized as a unit investment trust (a type of investment company). We established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited to or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities and variable life insurance. The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to these Contracts will not be chargeable with liabilities arising out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to our General Account. The Separate Account consists of "Investment Divisions". Each Investment Division may invest its assets in a separate class (or series) of shares of a designated Trust where each class (or series) represents a separate portfolio in the Trust. We reserve the right to change the designated Trust or to add designated trusts or investment companies. The Investment Divisions available are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. The Guaranteed Interest Division is not part No. 92 IRAA Page 5 of the Separate Account, but rather is an asset of our General Account. We will value the assets of each Investment Division on each business day. A business day is any day on which Equitable is open, the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio securities in which an Investment Division is invested to materially affect the Accumulation Unit Value. We may, at our discretion, invest the assets of any Investment Division in any investment permitted by applicable law. We may rely conclusively on the opinion of counsel (including attorneys in our employ) as to what investments it is permitted by law to make. We reserve the right to (i) cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such a committee at any time; (iii) restrict or eliminate any voting rights as to the Separate Account; (iv) operate the Separate Account by making direct investments, or in any other form; (v) add Investment Divisions (or subdivisions of Investment Divisions) to, or remove Investment Divisions (or subdivisions of Investment Divisions) from the Separate Account (the term "Investment Division" in this Contract shall then refer to any other Investment Division in which the assets of a Class of Contracts to which this Contract belongs, were placed); (vi) combine any two or more Investment Divisions (or subdivisions of Investment Divisions) of the Separate Account; and (vii) withdraw from any Investment Division and to allocate to another Investment Division assets determined by us to be associated with the Class of Contracts to which this Contract belongs. If the exercise of these rights results in a material change in the underlying investments of an Investment Division, you will be notified of such exercise, as required by law. Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for any applicable tax charges) at a rate not to exceed 1.49% per year for each of the Stock, Money Market and Balanced Divisions, and 1.34% per year, for the Aggressive Stock Division, for financing accounting, death benefits, mortality risk, expenses and expense risks. The charge shall be made in accordance with Subsection (c) of the Net Investment Factor provision in Section 1.22. The relative proportion of these charges may be modified. The daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust shall not exceed a total annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to this Contract. The maximum rate may not be altered without your approval. SECTION 1.22 SEPARATE ACCOUNT DEFINITIONS. VALUATION PERIOD: Each business day together with any preceding consecutive non-business days. NET INVESTMENT FACTOR: For the Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b), minus (c), where (a) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the Valuation Period before giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period. For this purpose, we use the share value reported to us by the Trust. (b) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the preceding Valuation Period (after taking into account any amounts allocated or withdrawn for that Valuation Period). (c) is the daily asset charge for the expenses of this Contract, times the number of calendar days in the Valuation Period. ACCUMULATION UNIT: an "Accumulation Unit" is a unit which is purchased in an Investment Division where your Contributions are invested and which is used in determining the amount you have in an Investment Division. ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of each Accumulation Unit in an Investment Division on a given date. The Accumulation Unit Value for a Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such Valuation Period. ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable from the Stock Division of the Separate Account under a Variable Annuity Benefit as defined in Section 3.02. ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1, 1968. On August 27, 1981, the date the first Contribution was put into the Stock Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for No. 92 IRAA Page 6 a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5% and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods ending in such month. SECTION 1.23 TRANSACTION DATE. The term "Transaction Date" means the business day we receive a Contribution or a written contract transaction request providing the information we need at the Processing Office. In the case of a transfer request initiated through the use of a touch tone telephone as described in Section 2.05, the term "Transaction Date" means the business day the telephone transaction is received. SECTION 1.24 Trust. The term "Trust" means the designated trust or investment company in which Separate Account assets are invested. - -------------------------------------------------------------------------------- PART II--ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. Contributions under this Contract are not fixed and may be made at any time and in any amount subject to the limits described in Section 1.11 of this Contract. (If you make a Contribution which qualifies as a qualified plan rollover within the meaning of Section 402(a)(5) or 403(b)(8) of the Code, and such amount will be commingled with other Contributions under this Contract, such rollover contributions may not be rolled over to a qualified plan at a future date, unless otherwise provided by the Code). Each Contribution received by us will, before its allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. Contributions will be allocated to the Division in accordance with the instructions received on your application, unless later changed. Except in the case of a rollover Contribution (as permitted by 402(a)(5), 402(a)(6), 402(a)(7), 403(a)(4), 403(b)(8), or 408(d)(3) of the Code), no Contributions will be accepted unless they are in cash, and the total of such Contributions shall not exceed $2,000 for any taxable year. Amounts transferred to this Contract from an individual retirement account or annuity contract meeting the requirements of Section 408 of the Code are not subject to the $2,000 limit on contributions. SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when an amount is allocated to or withdrawn or transferred from an Investment Division, you will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units you have in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units have been withdrawn pursuant to Sections 2.07 or 2.08 or transferred from the Investment Division pursuant to Section 2.05. The amount in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units in the Investment Division on the date and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under this Contract terminates on the earliest of (i) your election and commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii) Termination of this Contract, pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division becomes part of our general assets, which support the guarantees of this Contract and other contracts. The amount in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Section 2.07, 2.08, or 2.10 or transferred from the Guaranteed Interest Division, pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division on a Transaction Date, pursuant to Section 2.04. We will credit the amount you have in the Guaranteed Interest Division with interest at effective annual rates that we determine. For each Class of Contracts, we determine a yearly guaranteed interest rate that will remain in effect throughout the next year. We guarantee that this yearly guaranteed interest rate will never be less than 3%. Participation in the Guaranteed Interest Division under this Contract terminates on the earliest of (i) your election and commencement of annuity benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, and (iii) Termination of this Contract, pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section 2.01 is allocated (after deduction of any applicable tax charge) to one or more Divisions, at your sole direction as specified to us. Allocation percentages must be in whole numbers and the sum must equal 100. The allocation is made as of the Transaction No. 92 IRAA Page 7 Date on which we have received both such Contribution and such direction. Contributions made to an Investment Division purchase Accumulation Units in that Investment Division, using the Accumulation Unit Value next computed after the Transaction Date. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the Transaction Date with respect to each transfer from the Division pursuant to Section 2.05, (iii) on the Transaction Date with respect to each withdrawal pursuant to Section 2.07, (iv) at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, (v) upon Termination of this Contract pursuant to Section 2.06, and (vi) upon your death pursuant to Section 2.11. SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request, or through the use of a touch tone telephone, transfer all or part of the amount you have in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; (2) amounts in the Money Market Division may be transferred to other Divisions. Written authorization for touch tone telephone initiated transfers is only required when authorization for telephone transfer is requested. Upon advance written notice to you, we reserve the right to discontinue the acceptance of transfer requests through the use of a touch tone telephone. All transfers will be effective on the Transaction Date and will be subject to our rules in effect at the time of transfer. With respect to the Investment Division; the transfer will be made at the Accumulation Unit Value next computed after the Transaction Date. No transfers are permitted to the Money Market Division from the other Divisions. SECTION 2.06 TERMINATION OF THIS CONTRACT. You may elect by written notice to terminate this Contract. We will determine the Cash Value as of the Transaction Date we receive your written election. If this Contract is terminated, surrendered or exchanged prior to your Retirement Date, any applicable tax charges we have paid may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on terminations, unless a change in applicable law has occurred with respect to your Contract. The payment of such Cash Value may be deferred by us in accordance with the provisions of Section 4.07. We reserve the right to pay the Annuity Account Value under the Contract and terminate this Contract. This right may be exercised if (i) no Contributions are made on your behalf during the last three completed Contract Years and the Annuity Account Value is less than $500, or (ii) a partial withdrawal that would result in your Annuity Account Value falling below $500. We also reserve the right to terminate this Contract if no Contributions have been made within 120 months of the Contract Date shown on page 3 of this Contract. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount you have in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.07 PARTIAL WITHDRAWALS. You may elect, by written notice to us, to make a partial withdrawal from the Divisions. On the Transaction Date, we will pay the lesser of the Cash Value or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by you. The amount paid plus any withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the amounts you have in the Divisions. Unless we are instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts that you have in such Divisions. Upon any partial withdrawal payment, we will be released from and any all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by us in accordance with the provisions of Section 4.07. We may decline to accept a request for a partial withdrawal of less than $300. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, we will so advise you and reserve the right to pay the Annuity Account Value to you, and terminate this Contract. SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity Account Value, pursuant to Section 1.05. WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than the Free Corridor Amount, we will (i) first withdraw from the Divisions an amount equal to the Free Corridor Amount, in proportion to the amount you have in them, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a partial withdrawal charge. Such partial withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the amount withdrawn in excess of the Free Corridor No. 92 IRAA Page 8 Amount (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the total Contributions made on your behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to this Section. However, notwithstanding the above, if your are age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. If withdrawals are made from this Contract prior to the Retirement Date, any applicable tax charges we have paid with respect to this Contract may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on withdrawals, unless a change in applicable law has occurred with respect to your contract. SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means, if you have completed three Contract Years or attained age 59 and 6 months, an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the current Contract year. If you have not completed three Contract years or attained age 59 and 6 months, the Free Corridor Amount is zero. SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract Year, if the Annuity Account Value on that date is less than $10,000, we will withdrawn from the Divisions an Annual Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account Value, including the amount of any withdrawals pursuant to Section 2.07 during that Contract Year. The charge will be allocated among the Divisions in proportion to the amounts that you have in the Divisions. If the Annuity Account Value is less than $10,000, on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03, or (b) the date of Termination of this Contract pursuant to Section 2.06 or 2.11, we will prorate the Annual Administrative Charge applicable to the completed portion of the Current Contract Year and withdraw such amount in lieu of the Annual Administrative Charge applicable to the completed portion of the Current Contract Year and withdraw such amount in lieu of the full Annual Administrative Charge described in this Section for the applicable part of that Contract Year. If the Annuity Account Value is $10,000 or greater at the end of a Contract Year, the Annual Administrative Charge is zero. SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of your death , we will pay to the beneficiary designated by you to receive such payment, pursuant to Section 4.04 of this contract, the amount of death benefit payable. The amount of the death benefit is equal to the greater of (i) the Annuity Account Value and (ii) the minimum death benefit. Such minimum death benefit is the sum of all Contributions made pursuant to Section 2.01 (before reduction for any applicable tax charge) less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount that was withdrawn is to the Annuity Account Value. If, in accordance with the provisions of Section 3.02, the Cash Value of another annuity contract issued by us, or one of our affiliated or subsidiary life insurance companies, which provides for a death benefit before retirement equal to the greater of the contract Cash Value or an alternate amount based on premiums paid or Contributions made under the annuity contract is transferred to this Contract, such Cash Value or alternative amount as of the date of transfer will be included in the "sum of all Contributions" in lieu of the amount of Cash Value transferred for purposes of the death benefit under this Contract. We will pay the death benefit to your beneficiary in the form of an Annuity Benefit if you have made the election described in the last paragraph of Section 4.04. Also, in accordance with the last paragraph of Section 4.04, if no such election is in effect at your death, we will pay the death benefit to your beneficiary in a single sum, unless the beneficiary elects, before we pay the death benefit, to apply the death benefit to an Annuity Benefit. Upon payment of the death benefit, the amount you have in the Divisions and the Annuity Account Value will be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. - -------------------------------------------------------------------------------- PART III--ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The Amount of each monthly payment under any Fixed Annuity Benefit provided under this Contract with respect to a payee is the amount provided pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Stock Division. Such Variable Annuity Benefit will increase if the average daily rate of investment return in the Stock Division is equivalent to more than 6.75% or 5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25% annually, depending on whether the applicable assumed based rate of net investment return referred to in Section 1.22 is 5% or 3.5%, respectively. The daily rate of investment return is No. 92 IRAA Page 9 before deduction of charges, as described in Section 1.21, not to exceed the maximum rate of 1.75% after any deductions to provide for any applicable tax charge. These charges include a daily charge for financial accounting, death benefits, mortality risk, expenses and expense risk, plus the investment advisory fee charges and direct operating expense charges of the Trust. The amount of the first, second and third payments under any Variable Annuity Benefit provided under this Contract with respect to a payee is the monthly amount provided with respect to a payee pursuant to the fourth paragraph of Section 3.04. The amount of the fifth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. (As described in Section 3.05, we will notify the payee how each Variable Annuity payment is determined). SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your Retirement Date, provided you are then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless you elect (i) to receive the Cash Value of this Contract in a single sum or (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by us, or one of our affiliated or subsidiary life insurance companies, as elected by you, or (iii) to take partial withdrawals in amounts and at times as required by the Code, pursuant to Sections 2.07 and 3.05, subject to our rules then in effect and any other applicable requirements under the Code. We will provide notice and election forms to you not more than six months before your Retirement Date. If you elect to terminate this Contract, prior to the Retirement Date, pursuant to Section 2.06, an election may be made to receive an Annuity Benefit in lieu of the Cash Value. We will have the right to require you to furnish pertinent information to provide an Annuity Benefit and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. We may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form, issued by us or one of our affiliated or subsidiary life insurance companies. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value if the annuity form elected involves life contingencies or (ii) the Cash Value, if the Annuity Form elected does not involve life contingencies. The amount applied to provide an Annuity Benefit may be reduced by any applicable tax charge on annuity considerations, as we determine, If we have previously deducted any applicable tax charge from Contributions as provided in Section 2.01, we will not again deduct charges for the same taxes before application to provide an Annuity Benefit, unless a change in applicable law has occurred with respect to your Contract. The balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below, or (ii) our current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, your contract will be governed by our supplementary contract then in effect. If an amount is applied to provide an Annuity Benefit, the amount to be applied will, in addition to any tax charge reduction, be reduced by an administrative charge. The amount of such charge will be determined from time to time in accordance with our general practices applicable on a uniform basis to all contracts of the same type as this Contract. After the application of an amount to provide an Annuity Benefit, the amounts you have in the Divisions and the Annuity Account Value shall be zero. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under this Contract, as indicated, on the Joint and Survivor Life Annuity Form (with 100% of the amount of your payment continued to your spouse). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on 3.5% interest and the 1983 Individual Annuity Table "a". The amount of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and the Joint and Survivor Life Annuity Form are based on the 1983 Individual Annuity Table "a" and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section 1.22. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us based on 3.5% interest and the 1983 Individual Annuity Table "a" if such annuity form provides for a Fixed Annuity Benefit, and on the same such Table and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, which applies pursuant to Section 1.22 if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract will be distributed or begin to be distributed, in accordance with Section 401(a)(9) of the Code and the applicable Treasury Regulations thereunder no later than the first day of April following the calendar year in which you attain age 70 and 6 months ("Required Beginning Date"). Your entire interest may be distributed, as you elect, over (a) your life, or the lives of you and your designated beneficiary, or (b) a period certain not extending beyond your life expectancy, or the joint and last survivor expectancy of you and your designed benefi- No. 92 IRAA Page 10 ciary. Distributions must be made in periodic payments at intervals of no longer than one year. In addition, payments must be either non-increasing or they may increase only as provided in Q&A F-3 of Section 1.401(a)(9)-1 of the proposed Treasury Regulations, or any successor Regulation thereto. All distributions made hereunder shall be made in accordance with the requirements of Section 401(a)(9) of the Code, including the incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and applicable Treasury Regulations, including the minimum distribution incidental benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or any successor Regulation thereto. Notwithstanding the above paragraphs and the following paragraphs of this Section 3.05, while any distribution shall be subject to such requirements of the Code and regulations, any distribution shall also be subject to the terms of this Contract. That is, the forms of distribution shall be those which are made available by us at the time of your election. For purposes of determining the "period certain" referred to in the first paragraph of this Section, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless you otherwise elect prior to the time distributions are required to begin, those life expectancies shall be recalculated annually. Such election shall be irrevocable and shall apply to all subsequent years. The life expectancy of a non-spouse beneficiary may not be recalculated. Instead, life expectancy will be calculated using the attained age of such beneficiary during the calendar year in which you attain age 70 and 6 months, and payments for subsequent years shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. If you die after distribution of your interest in this Contract has begun, the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution being used prior to your death. If you die before distribution of your interest begins, distribution of your entire interest shall be completed no later than December 31 of the calendar year containing the fifth anniversary of your death, except to the extent that an election is made to receive death benefit distributions in accordance with (1) or (2) below: (1) If your interest is payable to a designated beneficiary, then your entire interest may be distributed over the life of, or over a period certain not greater than the life expectancy of, the designated beneficiary. Such distributions must commence on or before December 31 of the calendar year immediately following the calendar year of your death. (2) If the designated beneficiary is your surviving spouse, the date that distributions are required to begin in accordance with (1) above shall not be earlier than the later of (A) December 31 of the calendar year immediately following the calendar year of your death or (B) December 31 of the calendar year in which you would have attained age 70 and 6 months. For purposes of determining the "period certain" referred to in the immediately preceding paragraph, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of distributions beginning after your death, unless otherwise elected by the surviving spouse by the time distributions are required to begin, life expectancies shall be recalculated annually. Such election shall be irrevocable by the surviving spouse and shall apply to all subsequent years. In the case of any other designated beneficiary, life expectancies shall be calculated using the attained age of such beneficiary during the calendar year in which distributions are required to begin, pursuant to this Section, and payments for any subsequent calendar year shall be calculated based on life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. Distributions under this Section are considered to have begun if distributions are made because you have reached your Required Beginning Date or if prior to the Required Beginning Date, distributions irrevocably commence to you over a period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1 of the Proposed Treasury Regulations or any successor Regulation thereto. Evidence of each payee's survival must be furnished to us either by personal endorsement of the check drawn for payment or by other means satisfactory to us. If a benefit payment under this Contract was based on information that is subsequently found to be incorrect, your benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by us will be charged against and underpayments will be added to any payments thereafter falling due under this Contract with respect to the payee, affecting as many such payments as are necessary to correct the overpayment or underpayment. Our liability with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under this Contract. If we receive evidence satisfactory to us that (i) a payee entitled to receive any payment under this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, we may make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If a variable annuity form made available by us provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, the payee thereunder may elect, without the concurrence of any other person, to receive the No. 92 IRAA Page 11 commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Pursuant to Section 3.03, upon your election of an annuity form providing payments for a period certain, you may designate (with the right to change such designation) a payee or payees to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's estate in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, we will pay in a single sum to such payee's estate the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis applicable in determining the annuity amount. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. We will require satisfactory evidence of the age of any person upon whose life an annuity form depends. We will, with respect to each payment under a Variable Annuity Benefit, notify the payee of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each variable payment. Such notice will be mailed with each payment. Any election, change, revocation or designation shall be made, and will take effect on the Transaction Date, in the same manner as a change of beneficiary, as described in Section 4.04. If a commutation right under an Annuity Benefit is exercised, we may defer payment in accordance with Section 4.07. TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE (Minimum Monthly Income per $1,000 of Annuity Account Value)
- ---------------------------------------------------------------------------------------------------------------------------------- Age 60 61 62 63 64 65 66 67 68 69 70 - ---------------------------------------------------------------------------------------------------------------------------------- 60 4.51 4.56 4.61 4.66 4.71 4.76 4.81 4.85 4.90 4.94 4.99 61 4.59 4.65 4.70 4.75 4.81 4.86 4.91 4.96 5.01 5.06 62 4.69 4.74 4.80 4.85 4.91 4.97 5.02 5.07 5.13 63 4.78 4.84 4.90 4.96 5.02 5.08 5.14 5.20 64 4.88 4.95 5.01 5.08 5.14 5.20 5.27 65 4.99 5.06 5.13 5.20 5.27 5.34 66 5.11 5.18 5.26 5.33 5.41 67 5.24 5.31 5.39 5.47 68 5.37 5.45 5.54 69 5.51 5.60 70 5.67 - ----------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1000 of Annuity Value)
- ------------------------------------------------------------------------------------------------- VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS: 3.5% 5.0% AGE MALES FEMALES MALES FEMALES - ------------------------------------------------------------------------------------------------- 60 5.57 5.00 6.46 5.89 61 5.71 5.11 6.60 6.00 62 5.86 5.23 6.75 6.11 63 6.03 5.36 6.92 6.24 64 6.20 5.49 7.09 6.37 65 6.39 5.64 7.28 6.51 66 6.58 5.79 7.47 6.66 67 6.80 5.96 7.69 6.83 68 7.02 6.13 7.92 7.00 69 7.27 6.32 8.16 7.19 70 7.53 6.53 8.42 7.40 - -------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------- PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT. This Contract constitutes the entire agreement between the parties and the provisions of this Contract alone govern with respect to our rights and obligations. A copy of the application is incorporated in and made part of this Contract. This Contract may not be modified nor may any of our rights or requirements be waived, except in writing and by an authorized officer of Equitable. This Contract may be changed by amendment or replacement upon agreement between you and us without the consent of any other person. No. 92 IRAA Page 12 SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such rights shall include, but not be limited to, the right to conform this Contract to reflect changes in the Code, applicable Treasury Regulations, or published rulings of the Internal Revenue Service so that this Contract will continue to be an Annuity. SECTION 4.03 NONFORFEITABILITY, NONTRANSFERABILITY, AND ASSIGNMENTS. Your entire interest under the Contract is nonforfeitable. This Contract is nontransferable except by surrender to us. Your interest under this Contract may not be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than Equitable. No amount payable under this Contract may be assigned, commuted, or encumbered by the payee, unless otherwise permitted as described herein, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an initial designation of the beneficiary entitled to receive any death benefit payable pursuant to Section 2.11. You may change such designation from time to time during your lifetime and while this Contract is in force. Any such designation or change will be made by written notice in a form satisfactory to us. A change will, upon receipt at the Processing Office, take effect as of the time the written notice was signed, whether or not you are living on the Transaction Date, but without further liability as to any payment or other settlement made by us before receipt of such change. Unless otherwise specified in the designation, if you have designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive you, and if more than one survive, they will share equally. Any part of a death benefit payable pursuant to Section 2.11 for which there is no designated beneficiary living at your death will be payable in a single sum to your children who survive you, in equal shares, or should none survive, then to your estate. In you elect in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by you, with respect to the beneficiary, subject to our rules then in effect. If at your death there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. Any such election must meet the minimum distribution requirements under the Code, as described in Section 3.05. SECTION 4.05 DISQUALIFICATION. In the event that this Contract fails to qualify as an Annuity, we will have the right, upon receiving notice of such fact, prior to the Retirement Date, to terminate this Contract and pay to you the Annuity Account Value less a deduction for the appropriate part attributable to you of any Federal income tax payable which would not have been payable if you had an Annuity. SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to you, we reserve the right, at our sole discretion, to limit Contributions under this Contract, as required by law or if such Contributions are in excess of the maximum amounts as permitted under the Code. SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment of a death benefit and payment of any portion of your Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange has been closed or trading on it is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Securities and Exchange Commission, by order, permits us to defer payment in order to protect persons with interests in the Investment Divisions. We can defer payment of any portion of your Annuity Account Value in the Guaranteed Interest Division for up to six months while you are living. SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year we will furnish you with a notice showing the following: (1) the amount you have in the Guaranteed Interest Division, (2) the total number of Accumulation Units you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Values, (4) the amount you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the Annuity Account Value, (6) the Cash Value, and (7) the amount of death benefit payable with respect to you. We will also furnish annual calendar year reports concerning the status of the Annuity and any other reports required by the Code or applicable Treasury Regulations. After the Retirement Date, we will notify you of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.09 AGE AND SEX. If your age or sex has been misstated, any benefits will be those which would have been purchased at the correct age or sex. Any overpayments or underpayments made by us will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. No. 92 IRAA Page 13 Owner: [EQUITABLE LOGO] Annuitant: Contract Number: Issue Date: Contract Date: Retirement Date: - -------------------------------------------------------------------------------- THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P O Box 2996, New York, New York 10116-2996 AGREES o TO ALLOCATE the Contributions made to this Contract, after deduction of any applicable tax charge, to the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division (referred to in this Contract as the "Investment Divisions") or to the Guaranteed Interest Division, in accordance with Sections 2.02, 2.03 and 2.04 as directed by you, and o TO APPLY the Annuity Account Value at the Retirement Date to provide the Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant is then living, and o TO PROVIDE the Annuitant with the other rights and benefits of this Contract. This is the entire Contract. In this Contract "we", "our", and "us" mean The Equitable Life Assurance Society of the United States ("Equitable"). "You" and "your" mean the Annuitant at the time a right is exercised by the Annuitant. TEN DAYS TO EXAMINE CONTRACT - You may cancel this Contract by returning it to us within ten days after receipt of it. Upon such cancellation, we will refund any Contribution made to us under this Contract, plus or minus any investment gain or loss experienced in the Investment Divisions of the Separate Account from the date such Contribution is allocated to such Investment Division to the date we receive the returned Contract. /s/Molly K. Heines /s/Joseph J. Melone Molly K. Heines Joseph J. Melone Vice President and Secretary Chairman of the Board and Chief Executive Officer THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.22 IS 5% OR 3.5%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE INVESTMENT ADVISORY FEE CHARGE AND DIRECT OPERATING EXPENSE CHARGES OF THE TRUST. No. 92 IRAB The Contract is issued in consideration of the payment to us of the Contributions made under the terms of the Contract. The provisions on the following pages are part of this Contract. A copy of the application is incorporated in and made part of this Contract. - -------------------------------------------------------------------------------- TABLE OF CONTENTS DEFINITIONS Page Section 1.01 - Annuitant...................................................4 1.02 - Annuity.....................................................4 1.03 - Annuity Account Value.......................................4 1.04 - Annuity Benefit.............................................4 1.05 - Cash Value..................................................4 1.06 - Class of Contracts..........................................4 1.07 - Code........................................................4 1.08 - Contract....................................................4 1.09 - Contract Date...............................................4 1.10 - Contract Year...............................................4 1.11 - Contribution................................................4 1.12 - Divisions...................................................5 1.13 - Eligible Annuity Certain....................................5 1.14 - Guaranteed Interest Rate....................................5 1.15 - Joint and Survivor Life Annuity Form................................................5 1.16 - Life Annuity Form...........................................5 1.17 - Normal Form.................................................5 1.18 - Period Certain Annuity......................................5 1.19 - Processing Office...........................................5 1.20 - Retirement Date.............................................5 1.21 - Separate Account............................................5 1.22 - Separate Account Definitions.................................................6 1.23 - Transaction Date............................................7 1.24 - Trust.......................................................7 ANNUITY ACCOUNT VALUE Section 2.01 - Contributions...............................................7 2.02 - Separate Account Investment Divisions........................................7 2.03 - Guaranteed Interest Division................................7 2.04 - Allocation to Divisions.....................................7 2.05 - Transfers Among Divisions...................................8 2.06 - Termination of this Contract................................8 2.07 - Partial Withdrawals.........................................8 2.08 - Charges for Partial Withdrawals.............................8 2.09 - Free Corridor Amount........................................9 2.10 - Annual Administrative Charge................................9 2.11 - Death Benefit...............................................9 ANNUITY BENEFITS Section 3.01 - Fixed Annuity Benefit.......................................9 3.02 - Variable Annuity Benefit....................................9 3.03 - Election and Commencement of Annuity Benefits........................................10 3.04 - Amount of Annuity Benefits.................................10 3.05 - Payment of Annuity Benefits................................10 GENERAL PROVISIONS Section 4.01 - Contract...................................................12 4.02 - Statutory Compliance.......................................13 4.03 - Nonforfeitability, Nontransferability, and Assignments........................13 4.04 - Beneficiary................................................13 4.05 - Disqualification...........................................13 4.06 - Future Contributions.......................................13 4.07 - Deferment..................................................13 4.08 - Annual Notice..............................................13 4.09 - Age and Sex................................................13 No. 92 IRAB Page 2 - -------------------------------------------------------------------------------- PART I - DEFINITIONS SECTION 1.01 ANNUITANT. The term "Annuitant" means the person who owns this Contract as shown on page 3 and who exercises all rights under the terms of this Contract. SECTION 1.02 ANNUITY. The term "Annuity" means an individual retirement annuity contract meeting the requirements of Section 408(b) of the Code. SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts that you have in the Guaranteed Interest Division and the Investment Divisions of the Separate Account, pursuant to Sections 2.02 and 2.03. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Section 3.04 of this Contract. Various sections of this Contract (Sections 1.15, 1.16, 3.01, and 3.02) refer to monthly payments to be made under an Annuity Benefit. You may wish to have your Annuity Benefit paid at other intervals, such as quarterly, semiannually, or annually, instead of monthly. You may elect this at the time you elect the Annuity Benefit form described in Section 3.03; in that event, all references in this Contract to monthly payments will be deemed to mean payments at the frequency you elect, subject to our rules at the time of election. SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value less any applicable withdrawal charge determined as follows: The withdrawal charge equals the lesser of (a) or (b) where (a) equals 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the excess of (i) the Annuity Account Value over (ii) the Free Corridor Amount defined in Section 2.09; and (b) is the excess, if any, of (i) 8% of the total Contributions made during the Current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior charges for partial withdrawals made pursuant to Section 2.08. However, notwithstanding the above, if you are age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. A withdrawal charge will not apply, which means the Cash Value will equal the Annuity Account Value upon any of the following occurrences: (i) your attainment of age 59 and 6 months and your completion of at least five Contract Years, or (ii) a request is made for a refund of a contribution in excess of amounts allowed to be contributed under Section 408 of the Code within one month of the date on which the contribution is made, or (iii) you die and a distribution is made to the beneficiary, or (iv) your attainment of age 55, your completion of at least five Contract Years and you use the amount withdrawn to purchase from us an Eligible Annuity Certain, or (v) your completion of at least three Contract Years and you use the amount withdrawn to purchase from us a Period Certain Annuity of at least 10 years, or (vi) your Annuity Account Value is applied to the election of a Life Annuity Form or Joint and Survivor Life Annuity Form distribution option, or (vii) your completion of at least twelve Contract Years. SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all Contracts with a Contract Date in the same calendar year. SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.08 CONTRACT. The term "Contract" means this Contract, which is Intended to qualify as an individual retirement annuity contract under Section 408(b) of the Code. This Contract is established for the exclusive benefit of you or your beneficiaries. SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt by us of both an application for this Contract, properly signed and completed, and a Contribution. SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month period beginning on (i) the Contract Date, and (ii) each anniversary thereafter, unless otherwise agreed to in writing by us. SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made in cash or by check to us with respect to this Contract. We are under no obligation to accept any Contribution less than $20.00. No. 92 IRAB Page 4 Except in the case of a rollover contribution (as permitted by Sections 402(a)(5), 402(a)(6), 402(a)(7), 403(a)(4), 402(b)(8), or 408(d)(3) of the Code), no Contributions will be accepted unless they are in cash, and the total of such Contributions shall not exceed $2,000 for any taxable year. In addition, amounts directly transferred to this Contract, from an individual retirement account, or annuity contract meeting the requirements of Section 408 of the Code are also not subject to the $2,000 limit on contributions. SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or severally as the case may be, the following Divisions described in this Contract: (a) the Guaranteed Interest Division, and (b) the Investment Divisions of the Separate Account. SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by us, which extends beyond your attainment of age 59 and 6 months and does not permit any prepayment of the unpaid principal (that is no withdrawal or single sum payment) prior to your attainment of age 59 and 6 months. SECTION 1.14 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in the Guaranteed Interest Division. The initial rate to apply is shown on page 3 of this Contract. Section 2.03 describes the determination of the rate to apply thereafter. SECTION 1.15 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by you. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.16 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity issued by us providing monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.17 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under this Contract means, (i) if you have a living spouse at your Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with your spouse as the contingent annuitant (with 100% of the monthly payment amount continued to your spouse), and (ii) if you do not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.18 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by us which does not permit any prepayment of the unpaid principal (that is, you cannot elect to receive part of your payments as a single sum payment with the remainder paid in monthly annuity payments). SECTION 1.19 PROCESSING OFFICE. The term "Processing Office" means our Individual Annuity Center, P O Box 2996, New York, New York 10116-2996, or such other location as we shall designate by advance written notice to you. SECTION 1.20 RETIREMENT DATE. The term "Retirement Date" means the date on which you attain your retirement age as shown on page 3 of this Contract. Before the Retirement Date you may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be earlier than the date you attain age 59 and 6 months nor shall be later than the first day of April following the calendar year in which you attain age 70 and 6 months. Any election for such change must be made in writing by you and shall not take effect until received by us at our Processing Office. SECTION 1.21 SEPARATE ACCOUNT. The term "Separate Account" means our Separate Account A, which is organized as a unit investment trust (a type of investment company). We established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited to or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities and variable life insurance. The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to these Contracts will not be chargeable with liabilities arising out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to our General Account. The Separate Account consists of "Investment Divisions". Each Investment Division may invest its assets in a separate class (or series) of shares of a designated Trust where each class (or series) represents a separate portfolio in the Trust. We reserve the right to change the designated Trust or to add designated trusts or investment companies. The Investment Divisions available are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. The Guaranteed Interest Division is not part of the Separate Account, but rather is an asset of our General Account. No. 92 IRAB Page 5 We will value the assets of each Investment Division on each business day. A business day is any day on which Equitable is open, the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio securities in which an Investment Division is invested to materially affect the Accumulation Unit Value. We may, at our discretion, invest the assets of any Investment Division in any investment permitted by applicable law. We may rely conclusively on the opinion of counsel (including attorneys in our employ) as to what investments it is permitted by law to make. We reserve the right to (i) cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such a committee at any time; (iii) restrict or eliminate any voting rights as to the Separate Account; (iv) operate the Separate Account by making direct investments, or in any other form; (v) add Investment Divisions (or subdivisions of Investment Divisions) to, or remove Investment Divisions (or subdivisions of Investment Divisions) from the Separate Account (the term "Investment Division" in this Contract shall then refer to any other Investment Division in which the assets of a Class of Contracts to which this Contract belongs, were placed); (vi) combine any two or more Investment Divisions (or subdivisions of Investment Divisions) of the Separate Account; and (vii) withdraw from any Investment Division and to allocate to another Investment Division assets determined by us to be associated with the Class of Contracts to which this Contract belongs. If the exercise of these rights results in a material change in the underlying investments of an Investment Division, you will be notified of such exercise, as required by law. Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for any applicable tax charges) at a rate not to exceed 1.49% per year for each of the Stock, Money Market and Balanced Divisions, and 1.34% per year, for the Aggressive Stock Division, for financial accounting, death benefits, mortality risk, expenses and expense risks. The charge shall be made in accordance with Subsection (c) of the Net Investment Factor provision in Section 1.22. The relative proportion of these charges may be modified. The daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust shall not exceed a total annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to this Contract. The maximum rate may not be altered without your approval. SECTION 1.22 SEPARATE ACCOUNT DEFINITIONS. VALUATION PERIOD: Each business day together with any preceding consecutive non-business days. NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b), minus (c), where (a) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the Valuation Period before giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period. For this purpose, we use the share value reported to us by the Trust. (b) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the preceding Valuation Period (after taking into account any amounts allocated or withdrawn for that Valuation Period). (c) is the daily asset charge for the expenses of this Contract, times the number of calendar days in the Valuation Period. ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an Investment Division where your Contributions are invested and which is used in determining the amount you have in an Investment Division. ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of each Accumulation Unit in an Investment Division on a given date. The Accumulation Unit Value for a Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such Valuation Period. ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable from the Stock Division of the Separate Account under a Variable Annuity Benefit as defined in Section 3.02. ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1, 1968. On August 27, 1981, the date the first Contribution was put into the Stock Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. No. 92 IRAB Page 6 AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods ending in such month. SECTION 1.23 TRANSACTION DATE. The term "Transaction Date" means the business day we receive a Contribution or a written contract transaction request providing the information we need at the Processing Office. In the case of a transfer request initiated through the use of a touch tone telephone as described in Section 2.05, the term "Transaction Date" means the business day the telephone transaction is received. SECTION 1.24 TRUST. The term "Trust" means the designated trust or investment company in which Separate Account assets are invested. - -------------------------------------------------------------------------------- PART II - ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. Contributions under this Contract are not fixed and may be made at any time and in any amount subject to the limits described in Section 1.11 of this Contract. (If you make a Contribution which qualifies as a qualified plan rollover within the meaning of Section 402(a)(5) or 403(b)(8) of the Code, and such amount will be commingled with other Contributions under this Contract, such rollover contributions may not be rolled over to a qualified plan at a future date, unless otherwise provided by the Code). Each Contribution received by us will, before its allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. Contributions will be allocated to the Division in accordance with the instructions received on your application, unless later changed. Except in the case of a rollover Contribution (as permitted by 402(a)(5), 402(a)(6), 402(a)(7), 403(a)(4), 403(b)(8), or 408(d)(3) of the Code), no Contributions will be accepted unless they are in cash, and the total of such Contributions shall not exceed $2,000 for any taxable year. Amounts transferred to this Contract from an individual retirement account or annuity contract meeting the requirements of Section 408 of the Code are not subject to the $2,000 limit on contributions. SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when an amount is allocated to or withdrawn or transferred from an Investment Division, you will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units you have in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Sections 2.07 or 2.08 or transferred from the Investment Division pursuant to Section 2.05. The amount in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units in the Investment Division on that date and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under this Contract terminates on the earliest of (i) your election and commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii) Termination of this Contract, pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division becomes part of our general assets, which support the guarantees of this Contract and other contracts. The amount in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Section 2.07, 2.08, or 2.10 or transferred from the Guaranteed Interest Division, pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division on a Transaction Date, pursuant to Section 2.04. We will credit the amount you have in the Guaranteed Interest Division with interest at effective annual rates that we determine. For each Class of Contracts, we determine a yearly guaranteed interest rate that will remain in effect throughout the next year. We guarantee that this yearly guaranteed interest rate will never be less than 3%. Participation in the Guaranteed Interest Division under this Contract terminates on the earliest of (i) your election and commencement of annuity benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, and (iii) Termination of this Contract, pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section 2.01 is allocated (after deduction of any applicable tax charge) to one or more Divisions, at your sole direction as specified to us. Allocation percentages must be in whole numbers and the sum must equal 100. The allocation is made as of the Transaction Date on which we have received both such Contribution and such direction. Contributions made to an Investment Division purchase Accumulation Units in that Investment Division, using the Accumulation Unit Value next computed after the Transaction Date. No. 92 IRAB Page 7 Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the Transaction Date with respect to each transfer from the Division pursuant to Section 2.05, (iii) on the Transaction Date with respect to each withdrawal pursuant to Section 2.07, (iv) at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, (v) upon Termination of this Contract pursuant to Section 2.06, and (vi) upon your death pursuant to Section 2.11. SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request, or through the use of a touch tone telephone, transfer all or part of the amount you have in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; (2) amounts in the Money Market Division may be transferred to other Divisions. Written authorization for touch tone telephone initiated transfers is only required when authorization for telephone transfers is requested. Upon advance written notice to you, we reserve the right to discontinue the acceptance of transfer requests through the use of a touch tone telephone. All transfers will be effective on the Transaction Date and will be subject to our rules in effect at the time of transfer. With respect to the Investment Division, the transfer will be made at the Accumulation Unit Value next computed after the Transaction Date. No transfers are permitted to the Money Market Division from the other Divisions. SECTION 2.06 TERMINATION OF THIS CONTRACT. You may elect by written notice to terminate this Contract. We will determine the Cash Value as of the Transaction Date we receive your written election. If this Contract is terminated, surrendered or exchanged prior to your Retirement Date, any applicable tax charges we have paid may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on terminations, unless a change in applicable law has occurred with respect to your Contract. The payment of such Cash Value may be deferred by us in accordance with the provisions of Section 4.07. We reserve the right to pay the Annuity Account Value under the Contract and terminate this Contract. This right may be exercised if (i) no Contributions are made on your behalf during the last three completed Contract Years and the Annuity Account Value is less than $500, or (ii) a partial withdrawal that would result in your Annuity Account Value falling below $500. We also reserve the right to terminate this Contract if no Contributions have been made within 120 days of the Contract Date shown on page 3 of this Contract. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount you have in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.07 PARTIAL WITHDRAWALS. You may elect, by written notice to us, to make a partial withdrawal from the Divisions. On the Transaction Date, we will pay the lesser of the Cash Value or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by you. The amount paid plus any withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the amounts you have in the Divisions. Unless we are instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts that you have in such Divisions. Upon any partial withdrawal payment, we will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by us in accordance with the provisions of Section 4.07. We may decline to accept a request for a partial withdrawal of less than $300. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, we will so advise you and reserve the right to pay the Annuity Account Value to you, and terminate this Contract. SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity Account Value, pursuant to Section 1.05. WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than the Free Corridor Amount, we will (i) first withdraw from the Divisions an amount equal to the Free Corridor Amount, in proportion to the amount you have in them, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a partial withdrawal charge. Such partial withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the amount withdrawn in excess of the Free Corridor Amount (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the total Contributions made on your behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to this Section. No. 92 IRAB Page 8 However, notwithstanding the above, if you are age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. If withdrawals are made from this Contract prior to the Retirement Date, any applicable tax charges we have paid with respect to this Contract may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on withdrawals, unless a change in applicable law has occurred with respect to your contract. SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means, if you have completed three Contract Years or attained age 59 and 6 months, an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the current Contract Year. If you have not completed three Contract Years or attained age 59 and 6 months, the Free Corridor Amount is zero. SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract Year, if the Annuity Account Value on that date is less than $10,000, we will withdraw from the Divisions an Annual Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account Value, including the amount of any withdrawals pursuant to Section 2.07 during that Contract Year. The charge will be allocated among the Divisions in proportion to the amounts that you have in the Divisions. If the Annuity Account Value is less than $10,000, on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03, or (b) the date of Termination of this Contract pursuant to Section 2.06 or 2.11, we will prorate the Annual Administrative Charge applicable to the completed portion of the Current Contract Year and withdraw such amount in lieu of the full Annual Administrative Charge described in this Section for the applicable part of that Contract Year. If the Annuity Account Value is $10,000 or greater at the end of a Contract Year, the Annual Administrative Charge is zero. SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of your death, we will pay to the beneficiary designated by you to receive such payment, pursuant to Section 4.04 of this Contract, the amount of death benefit payable. The amount of the death benefit is equal to the greater of (i) the Annuity Account Value and (ii) the minimum death benefit. Such minimum death benefit is the sum of all Contributions made pursuant to Section 2.01 (before reduction for any applicable tax charge) less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount that was withdrawn is to the Annuity Account Value. If, in accordance with the provisions of Section 2.01, the Cash Value of another annuity contract issued by us, or one of our affiliated or subsidiary life insurance companies, which provides for a death benefit before retirement equal to the greater of the contract Cash Value or an alternate amount based on premiums paid or Contributions made under the annuity contract is transferred to this Contract, such Cash Value or alternative amount as of the date of transfer will be included in the "sum of all Contributions" in lieu of the amount of Cash Value transferred for purposes of the death benefit under this Contract. We will pay the death benefit to your beneficiary in the form of an Annuity Benefit if you have made the election described in the last paragraph of Section 4.04. Also, in accordance with the last paragraph of Section 4.04, if no such election is in effect at your death, we will pay the death benefit to your beneficiary in a single sum, unless the beneficiary elects, before we pay the death benefit, to apply the death benefit to an Annuity Benefit. Upon payment of the death benefit, the amount you have in the Divisions and the Annuity Account Value will be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. - -------------------------------------------------------------------------------- PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under this Contract with respect to a payee is the amount provided pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Stock Division. Such Variable Annuity Benefit will increase if the average daily rate of investment return in the Stock Division is equivalent to more than 6.75% or 5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25% annually, depending on whether the applicable assumed base rate of net investment return referred to in Section 1.22 is 5% or 3.5%, respectively. The daily rate of investment return is before deduction of charges, as described in Section 1.21, not to exceed the maximum rate of 1.75% after No. 92 IRAB Page 9 any deductions to provide for any applicable tax charge. These charges include a daily charge for financial accounting, death benefits, mortality risk, expenses and expense risk, plus the investment advisory fee charges and direct operating expense charges of the Trust. The amount of the first, second and third payments under any Variable Annuity Benefit provided under this Contract with respect to a payee is the monthly amount provided with respect to a payee pursuant to the fifth paragraph of Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. (As described in Section 3.05, we will notify the payee how each Variable Annuity payment is determined). SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your Retirement Date, provided you are then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless you elect (i) to receive the Cash Value of this Contract in a single sum or (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by us, or one of our affiliated or subsidiary life insurance companies, as elected by you, or (iii) to take partial withdrawals in amounts and at times as required by the Code, pursuant to Sections 2.07 and 3.05, subject to our rules then in effect and any other applicable requirements under the Code. We will provide notice and election forms to you not more than six months before your Retirement Date. If you elect to terminate this Contract, prior to the Retirement Date, pursuant to Section 2.06, an election may be made to receive an Annuity Benefit in lieu of the Cash Value. We will have the right to require you to furnish pertinent information to provide an Annuity Benefit and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. We may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form, issued by us or one of our affiliated or subsidiary life insurance companies. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value if the annuity form elected involves life contingencies or (ii) the Cash Value, if the Annuity Form elected does not involve life contingencies. The amount applied to provide an Annuity Benefit may be reduced by any applicable tax charge on annuity considerations, as we determine. If we have previously deducted any applicable tax charge from Contributions as provided in Section 2.01, we will not again deduct charges for the same taxes before application to provide an Annuity Benefit, unless a change in applicable law has occurred with respect to your Contract. The balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below, or (ii) our current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, your contract will be governed by our supplementary contract then in effect. If an amount is applied to provide an Annuity Benefit, the amount to be applied will, in addition to any tax charge reduction, be reduced by an administrative charge. The amount of such charge will be determined from time to time in accordance with our general practices applicable or a uniform basis to all contracts of the same type as this Contract. After the application of an amount to provide an Annuity Benefit, the amounts you have in the Divisions and the Annuity Account Value shall be zero. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under this Contract, as indicated, on the Joint and Survivor Life Annuity Form (with 100% of the amount of your payment continued to your spouse). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on 3.5% interest and the 1983 Individual Annuity Table "a". The amount of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and the Joint and Survivor Life Annuity Form are based on the 1983 Individual Annuity Table "a" and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section 1.22. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us based on 3.5% interest and the 1983 Individual Annuity Table "a" if such annuity form provides for a Fixed Annuity Benefit, and on the same such Table and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section 1.22 if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract will be distributed or begin to be distributed, in accordance with Section 401(a)(9) of the Code and the applicable Treasury Regulations thereunder no later than the first day of April following the calendar year in which you attain age 70 and 6 months ("Required Beginning Date"). Your entire interest may be distributed, as you elect, over (a) your life, or the lives of you and your designated beneficiary, or (b) a period certain not extending beyond your life expectancy, or the joint and last survivor expectancy of you and your designated beneficiary. Distributions must be made in periodic payments at intervals of no longer than one year. In No. 92 IRAB Page 10 addition, payments must be either non-increasing or they may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the proposed Treasury Regulations, or any successor Regulation thereto. All distributions made hereunder shall be made in accordance with the requirements of Section 401(a)(9) of the Code, including the incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and applicable Treasury Regulations, including the minimum distribution incidental benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or any successor Regulation thereto. Notwithstanding the above paragraphs and the following paragraphs of this Section 3.05, while any distribution shall be subject to such requirements of the Code and regulations, any distribution shall also be subject to the terms of this Contract. That is, the forms of distribution shall be those which are made available by us at the time of your election. For purposes of determining the "period certain" referred to in the first paragraph of this Section, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless you otherwise elect prior to the time distributions are required to begin, those life expectancies shall be recalculated annually. Such election shall be irrevocable and shall apply to all subsequent years. The life expectancy of a non-spouse beneficiary may not be recalculated. Instead, life expectancy will be calculated using the attained age of such beneficiary during the calendar year in which you attain age 70 and 6 months, and payments for subsequent years shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. If you die after distribution of your interest in this Contract has begun, the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution being used prior to your death. If you die before distribution of your interest begins, distribution of your entire interest shall be completed no later than December 31 of the calendar year containing the fifth anniversary of your death, except to the extent that an election is made to receive death benefit distributions in accordance with (1) or (2) below: (1) If your interest is payable to a designated beneficiary, then your entire interest may be distributed over the life of, or over a period certain not greater than the life expectancy of, the designated beneficiary. Such distributions must commence on or before December 31 of the calendar year immediately following the calendar year of your death. (2) If the designated beneficiary is your surviving spouse, the date that distributions are required to begin in accordance with (1) above shall not be earlier than the later of (A) December 31 of the calendar year immediately following the calendar year of your death or (B) December 31 of the calendar year in which you would have attained age 70 and 6 months. For purposes of determining the "period certain" referred to in the immediately preceding paragraph, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of distributions beginning after your death, unless otherwise elected by the surviving spouse by the time distributions are required to begin, life expectancies shall be recalculated annually. Such election shall be irrevocable by the surviving spouse and shall apply to all subsequent years. In the case of any other designated beneficiary, life expectancies shall be calculated using the attained age of such beneficiary during the calendar year in which distributions are required to begin, pursuant to this Section, and payments for any subsequent calendar year shall be calculated based on life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. Distributions under this Section are considered to have begun if distributions are made because you have reached your Required Beginning Date or if prior to the Required Beginning Date, distributions irrevocably commence to you over a period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1 of the Proposed Treasury Regulations or any successor Regulation thereto. Evidence of each payee's survival must be furnished to us either by personal endorsement of the check drawn for payment or by other means satisfactory to us. If a benefit payment under this Contract was based on information that is subsequently found to be incorrect, your benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by us will be charged against and underpayments will be added to any payments thereafter falling due under this Contract with respect to the payee, affecting as many such payments as are necessary to correct the overpayment or underpayment. Our liability with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under this Contract. If we receive evidence satisfactory to us that (i) a payee entitled to receive any payment under this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, we may make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from a11 liability with respect thereto. If a variable annuity form made available by us provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, the payee thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. No. 92 IRAB Page 11 Pursuant to Section 3.03, upon your election of an annuity form providing payments for a period certain, you may designate (with the right to change such designation) a payee or payees to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's estate in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, we will pay in a single sum to such payee's estate the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis applicable in determining the annuity amount. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. We will require satisfactory evidence of the age of any person upon whose life an annuity form depends. We will, with respect to each payment under a Variable Annuity Benefit, notify the payee of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each variable payment. Such notice will be mailed with each payment. Any election, change, revocation or designation shall be made, and will take effect on the Transaction Date, in the same manner as a change of beneficiary, as described in Section 4.04. If a commutation right under an Annuity Benefit is exercised, we may defer payment in accordance with Section 4.07. TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE (Minimum Monthly Income per $1,000 of Annuity Account Value)
- --------------------------------------------------------------------------------------------------------------------------------- Age 60 61 62 63 64 65 66 67 68 69 70 - --------------------------------------------------------------------------------------------------------------------------------- 60 4.51 4.56 4.61 4.66 4.71 4.76 4.81 4.85 4.90 4.94 4.99 61 4.59 4.65 4.70 4.75 4.81 4.86 4.91 4.96 5.01 5.06 62 4.69 4.74 4.80 4.85 4.91 4.97 5.02 5.07 5.13 63 4.78 4.84 4.90 4.96 5.02 5.08 5.14 5.20 64 4.88 4.95 5.01 5.08 5.14 5.20 5.27 65 4.99 5.06 5.13 5.20 5.27 5.34 66 5.11 5.18 5.26 5.33 5.41 67 5.24 5.31 5.39 5.47 68 5.37 5.45 5.54 69 5.51 5.60 70 5.67 - ---------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Value) - -------------------------------------------------------------------------------- VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS: 3.5% 5.0% Age Males Females Males Females - -------------------------------------------------------------------------------- 60 5.57 5.00 6.46 5.89 61 5.71 5.11 6.60 6.00 62 5.86 5.23 6.75 6.11 63 6.03 5.36 6.92 6.24 64 6.20 5.49 7.09 6.37 65 6.39 5.64 7.28 6.51 66 6.58 5.79 7.47 6.66 67 6.80 5.96 7.69 6.83 68 7.02 6.13 7.92 7.00 69 7.27 6.32 8.16 7.19 70 7.53 6.53 8.42 7.40 - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT. This Contract constitutes the entire agreement between the parties and the provisions of this Contract alone govern with respect to our rights and obligations. A copy of the application is incorporated in and made part of this Contract. This Contract may not be modified nor may any of our rights or requirements be waived, except in writing and by an authorized officer of Equitable. This Contract may be changed by amendment or replacement upon agreement between you and us without the consent of any other person. No. 92 IRAB Page 12 SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such rights shall include, but not be limited to, the right to conform this Contract to reflect changes in the Code, applicable Treasury Regulations, or published rulings of the Internal Revenue Service so that this Contract will continue to be an Annuity. SECTION 4.03 NONFORFEITABILITY, NONTRANSFERABILITY, AND ASSIGNMENTS. Your entire interest under the Contract is nonforfeitable. This Contract is nontransferable except by surrender to us. Your interest under this Contract may not be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than Equitable. No amount payable under this Contract may be assigned, commuted, or encumbered by the payee, unless otherwise permitted as described herein, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an initial designation of the beneficiary entitled to receive any death benefit payable pursuant to Section 2.11. You may change such designation from time to time during your lifetime and while this Contract is in force. Any such designation or change will be made by written notice in a form satisfactory to us. A change will, upon receipt at the Processing Office, take effect as of the time the written notice was signed, whether or not you are living on the Transaction Date, but without further liability as to any payment or other settlement made by us before receipt of such change. Unless otherwise specified in the designation, if you have designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive you, and if more than one survive, they will share equally. Any part of a death benefit payable pursuant to Section 2.11 for which there is no designated beneficiary living at your death will be payable in a single sum to your children who survive you, in equal shares, or should none survive, then to your estate. If you elect in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by you, with respect to the beneficiary, subject to our rules then in effect. If at your death there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. Any such election must meet the minimum distribution requirements under the Code, as described in Section 3.05. SECTION 4.05 DISQUALIFICATION. In the event that this Contract fails to qualify as an Annuity, we will have the right, upon receiving notice of such fact, prior to the Retirement Date, to terminate this Contract and pay to you the Annuity Account Value less a deduction for the appropriate part attributable to you of any Federal income tax payable which would not have been payable if you had an Annuity. SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to you, we reserve the right, at our sole discretion, to limit Contributions under this Contract, as required by law or if such Contributions are in excess of the maximum amounts as permitted under the Code. SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment of a death benefit and payment of any portion of your Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange has been closed or trading on it is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Securities and Exchange Commission, by order, permits us to defer payment in order to protect persons with interests in the Investment Divisions. We can defer payment of any portion of your Annuity Account Value in the Guaranteed Interest Division for up to six months while you are living. SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year we will furnish you with a notice showing the following: (1) the amount you have in the Guaranteed Interest Division, (2) the total number of Accumulation Units you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Values, (4) the amount you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the Annuity Account Value, (6) the Cash Value, and (7) the amount of death benefit payable with respect to you. We will also furnish annual calendar year reports concerning the status of the Annuity and any other reports required by the Code or applicable Treasury Regulations. After the Retirement Date, we will notify you of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.09 AGE AND SEX. If your age or sex has been misstated, any benefits will be those which would have been purchased at the correct age or sex. Any overpayments or underpayments made by us will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. No. 92 IRAB Page 13 Owner: [EQUITABLE LOGO] Annuitant: Contract Number: Issue Date: Contract Date: Retirement Date: - -------------------------------------------------------------------------------- THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P O Box 2996, New York, New York 10116-2996 AGREES o TO ALLOCATE the Contributions made to this Contract after deduction of any applicable tax charge, to the Stock Division, Balanced Division, Aggressive Stock Division, Money Market Division of the Separate Account (referred to in this Contract as the Investment Divisions of the Separate Account) or to the Guaranteed Interest Division, in accordance with Sections 2.02, 2.03 and 2.04 or in part to any one, as directed by you. o TO APPLY the Annuity Account Value at the Retirement Date to provide an Annuity Benefit or a Cash Value benefit if the Annuitant is then living, and o TO PROVIDE you with the other rights and benefits of this Contract. This is the entire Contract. In this Contract, "we", "our" and "us" mean The Equitable Life Assurance Society of the United States. "You" and "your" mean the Owner, at the time a right is exercised by the Owner. TEN DAYS TO EXAMINE CONTRACT - You may cancel this Contract by returning it to us within ten days after receipt of it. Upon such cancellation, we will refund any Contribution made to us under this Contract. /s/Molly K. Heines /s/Joseph J. Melone Molly K. Heines Joseph J. Melone Vice President and Secretary Chairman of the Board THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.23 IS 5% OR 3.5%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE TRUST. No. 92NQCA This Contract is issued in consideration of the payment to us of the Contributions made under the terms of this Contract. The provisions on the following pages are part of this Contract. - -------------------------------------------------------------------------------- TABLE OF CONTENTS PART I - DEFINITIONS Page Section 1.01 - Annuitant....................................................4 1.02 - Annuity Account Value........................................4 1.03 - Annuity Benefit..............................................4 1.04 - Cash Value...................................................4 1.05 - Class of Contracts...........................................4 1.06 - Code.........................................................4 1.07 - Contract.....................................................4 1.08 - Contract Date................................................4 1.09 - Contract Year................................................4 1.10 - Contribution.................................................4 1.11 - Deposit Option Benefits......................................4 1.12 - Divisions....................................................4 1.13 - Free Corridor Amount.........................................4 1.14 - Guaranteed Interest Rate.....................................5 1.15 - Joint and Survivor Life Annuity Form.........................5 1.16 - Life Annuity Form............................................5 1.17 - Normal Form..................................................5 1.18 - Owner........................................................5 1.19 - Period Certain Annuity.......................................5 1.20 - Processing Office............................................5 1.21 - Retirement Date..............................................5 1.22 - Separate Account.............................................5 1.23 - Separate Account Definitions.................................6 1.24 - Transaction Date.............................................7 1.25 - Trust........................................................7 PART II - ANNUITY ACCOUNT VALUE Section 2.01 - Contributions................................................7 2.02 - Separate Account Investment Divisions........................7 2.03 - Guaranteed Interest Division.................................8 2.04 - Allocation to Divisions......................................8 2.05 - Transfers Among Divisions....................................8 2.06 - Termination of this Contract.................................8 2.07 - Partial Withdrawals..........................................9 2.08 - Charges for Partial Withdrawals..............................9 2.09 - Annual Administrative Charge................................10 2.10 - Death Benefit...............................................10 2.11 - Owner Death Benefit Distribution Rules.....................10 2.12 - Contribution Limit..........................................11 PART III - ANNUITY BENEFITS Section 3.01 - Fixed Annuity Benefit.......................................11 3.02 - Variable Annuity Benefit....................................11 3.03 - Election and Commencement of Annuity Benefits...............11 3.04 - Amount of Annuity Benefits..................................12 3.05 - Payment of Annuity Benefits.................................12 PART IV - GENERAL PROVISIONS Section 4.01 - Contract....................................................14 4.02 - Statutory Compliance........................................14 4.03 - Beneficiary.................................................14 4.04 - Future Contributions........................................14 4.05 - Deferment...................................................14 4.06 - Annual Notice...............................................14 4.07 - Assignments.................................................15 4.08 - Age and Sex.................................................15 No. 92NQCA Page 2 - -------------------------------------------------------------------------------- PART I - DEFINITIONS SECTION 1.01 ANNUITANT. The term "Annuitant" means the individual shown on page 3 of this Contract. SECTION 1.02 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts in the Guaranteed Interest Division and the Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03. SECTION 1.03 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by us pursuant to Section 3.04 of this Contract. Various Sections of this Contract (Sections 1.15, 1.16, 3.01 and 3.02) refer to monthly payments to be made under an Annuity Benefit. An election may be to have your Annuity Benefit paid at other intervals, such as quarterly, semi-annually, or annually, instead of monthly. This election may be made at the time the Annuity Benefit form as described in Section 3.03 is elected: in that event, all references in this Contract to monthly payments will be deemed to mean payments at the frequency you elected, subject to our rule at the time of election. SECTION 1.04 CASH VALUE. The term "Cash Value" means an amount equal to the greater of (i) or (ii) below: (i) the Annuity Account Value less 6% of the Contributions made during the current and five prior Contract Years, which had not been previously withdrawn pursuant to Sections 2.07 and 2.08. (ii) the sum of (a) the Free Corridor Amount as defined in Section 1.13 and (b) 94% of the Annuity Account Value less the Free Corridor Amount. However, if the Annuitant was age 59 or older on the Contract Date and it is Contract Year 5, item (ii) (b) above will be 95% of the Annuity Account Value less the Free Corridor Amount. If it is Contract Year 6, item (ii) (b) above will be 96% of the Annuity Account Value less the Free Corridor Amount. SECTION 1.05 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all contracts with a Contract Date in the same calendar year. SECTION 1.06 CODE. The term "Code" means the Internal Revenue Code of 1986, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.07 CONTRACT. The term "Contract" means this Contract. SECTION 1.08 CONTRACT DATE. The term "Contract Date" means the Date of receipt by us of both the application for this Contract, properly signed and completed, and a Contribution. SECTION 1.09 CONTRACT YEAR. The term "Contract Year" means the twelve month period beginning on (i) the Contract Date, and (ii) each anniversary thereof, unless otherwise agreed to in writing by us. SECTION 1.10 CONTRIBUTION. The term "Contribution" means a payment made to us for the Annuitant with respect to an Annuity purchased under this Contract. We are under no obligation to accept an Initial Contribution of less than $1,000.00 or, for Payroll Deductions and any Subsequent Contributions, a Contribution of less than $50.00. SECTION 1.11 DEPOSIT OPTION BENEFIT. The term "Deposit Option Benefit" means a benefit derived from amounts on deposit for a period approved by us, subject to our rules then in effect and any other applicable requirements under the Code. Interest payments will be made at the end of each one, three, six or twelve month interval, as elected by you, and provided that the amount of each payment made at the end of the designated interval is at least $20. We reserve the right to change the payment frequency for payments of less than $20. SECTION 1.12 DIVISION. The term "Division" or "Divisions" mean, singly or severally as the case may be, the following divisions described in this Contract: (i) the Guaranteed Interest Division, and (ii) the Investment Divisions of the Separate Account. SECTION 1.13 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means an amount equal to the excess, if any, of (i) 10% of the Annuity Account Value on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to Section 2.07 or 2.08 in the current Contract Year. No. 92NQCA Page 4 SECTION 1.14 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in the Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of this Contract. Section 2.03 describes the determination of the rate to apply thereafter. SECTION 1.15 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.16 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity issued by us providing monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.17 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under this Contract means the Fixed Annuity Benefit payable on the Life Annuity Form, as defined in Sections 3.01 and 1.16, with 10 years of payments guaranteed (10 years certain period). In addition, if the Annuitant dies before the certain period has ended, payments will continue to the beneficiary designated to receive such payments for the balance of the certain period. SECTION 1.18 OWNER. The Owner of this Contract is the person shown as "Owner" on page 3 unless otherwise stated in the application, or later changed. Notwithstanding any provisions in this Contract to the contrary, only the Owner can exercise the rights under this Contract. While the Annuitant is living, the Owner of this Contract may change the Owner by written notice satisfactory to us. The change will take effect on the date the Owner signs the notice, except it will not apply to any payment we make or other actions we take before we receive the notice. SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by us which does not permit any prepayment of the unpaid principal (that is, you cannot elect to receive part of your payments as a single sum payment with the remainder paid in monthly annuity payments). SECTION 1.20 PROCESSING OFFICE. The term "Processing Office" means Equitable Individual Annuity Center, P O Box 2996, New York, New York 10116-2996, or such other location as we shall designate upon advance written notice to you. SECTION 1.21 RETIREMENT DATE. The term "Retirement Date" means the date on which the Annuitant attains the retirement age shown on Page 3 of this Contract. Before the Retirement Date the Annuitant may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th or 31st day of any month). Any election for such change must be made in writing by you and shall not take effect until received by us at our Processing Office. SECTION 1.22 SEPARATE ACCOUNT. The term "Separate Account" means Separate Account A which is organized as a unit investment trust, a type of investment company. We established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited to or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts and certificates. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities and variable life insurance. The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to these contracts will not be chargeable with liabilities arising out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to our General Account. The Separate Account consists of "Investment Divisions" Each Investment Division may invest its assets in a separate class (or series) of shares of a designated Trust where each class (or series) represents a separate portfolio in the Trust or investment company. We reserve the right to change the Trust or to add a Trust. The Investment Divisions are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. The Guaranteed Interest Division is not a part of the Separate Account A but rather is an asset of our General Account. No. 92NQCA Page 5 We will value the assets of each Investment Division on each business day. A business day is any day on which we are open, the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio securities in which an Investment Division is invested to materially affect the Accumulation Unit Value. We may, at our discretion, invest the assets of any Investment Division in any investment permitted by applicable law. We may rely conclusively on the opinion of counsel (including attorneys in our employ) as to what investments we are permitted by law to make. We reserve the right to (i) cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such committee at any time; (iii) restrict or eliminate any voting rights as to the Separate Account; (iv) operate the Separate Account by making direct investments, or in any other form; (v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or remove Investment Divisions (or sub-divisions of Investment Divisions) from the Separate Account (the term "Investment Division" in this Contract shall then refer to any other Investment Division in which the assets, of a Class of Contracts to which this Contract belongs, were placed); (vi) combine any two or more Investment Divisions (or sub-divisions of Investment Divisions) of the Separate Account; and (vii) withdraw from any Investment Division and to allocate to another Investment Division assets determined by us to be associated with the Class of Contracts to which this Contract belongs. If the exercise of these rights results in a material change in the underlying investments of an Investment Division, you will be notified of such exercise, as required by law. Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for taxes) at a rate not to exceed 1.49% per year for each of the Stock, Money Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock Division, for financial accounting, death benefits, mortality risk, expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.23. The relative proportion of these charges may be modified. This daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust, shall not in the aggregate exceed a total annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to this Contract. SECTION 1.23 SEPARATE ACCOUNT DEFINITIONS. VALUATION PERIOD: Is each business day together with any consecutive preceding non-business days. NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b), minus (c), where (a) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the Valuation Period before giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period. For this purpose, we use the share value reported to us by the Trust. (b) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the preceding Valuation Period (after any amounts allocated to or withdrawn for that Valuation Period). (c) is the daily Separate Account charge for the expenses of this Contract, times the number of calendar days in the Valuation Period. ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in the Investment Division where Contributions are invested and are used in determining the amount in an Investment Division. No. 92NQCA Page 6 ACCUMULATION UNIT VALUE: The "Accumulation Unit Value" is the dollar value of each Accumulation Unit in an Investment Division. The Accumulation Unit Value for a Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for that Investment Division for such Valuation Period. ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable from the Stock Division of the Separate Account under a Variable Annuity Benefit as defined in Section 3.02. ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1, 1968. On August 27, 1981, the date the first contribution was put into the Stock Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed Base rates of 5% and 3.5% a year, respectively. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE ANNUITY UNIT VALUE: With respect to this Contract, the Average Annuity Unit Value for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods ending in such month. SECTION 1.24 TRANSACTION DATE. The Transaction Date is the business day we receive a Contribution or a written contract transaction request providing the information we need at the Processing Office. In the case of a transfer request initiated through the use of a touch tone telephone as described in Section 2.05, the Transaction Date is the business day the telephone transaction is received. SECTION 1.25 TRUST. The term "Trust" means the designated trust or investment company in which assets of the Separate Account are invested. - -------------------------------------------------------------------------------- PART II - ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. Contributions made by you can be classified, as described under subsections A and B below, as specified on the application for this Contract. If Contributions are made under more than one classification, separate Contracts will be issued for each classification. A. Post-August 13, 1982 Classification All Contributions of new funds as well as any Contributions resulting from a transfer to this Contract from a deferred annuity contract, other than those described in subsection B below will be treated as within this classification. B. Pre-August 14, 1982 Classification Amounts transferred to this Contract through a tax free exchange of a deferred annuity contract, where such transferred amount represents amounts invested in or credited to investments in annuity contracts prior to August 14, 1982 will be treated as within this classification. Each Contribution received by us will, before its allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. Contributions will be allocated to the Division in accordance with instructions received in your application, unless later changed. If the Annuitant was age 57 or younger on the Contract Date, no additional Contributions are permitted under the Contract after completion of the Contract Year in which the Annuitant attains age 59. If the Annuitant was age 58 or older on the Contract Date, no additional Contributions are permitted under the Contract after the first anniversary of the Contract Date. SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when an amount is allocated to or withdrawn or transferred from an Investment Division, the Annuity Account Value will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by No. 92NQCA Page 7 the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Sections 2.07 or 2.09 or transferred from the Investment Division pursuant to Section 2.05. The amount in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units in the Investment Division on that date and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under this Contract terminates on the earliest of (i) the election and commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of the Annuitant's death, or (iii) termination of this Contract pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division becomes part of our general assets, which support the guarantees of this Contract and other contracts. The amount in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Section 2.07 or 2.09 or transferred from the Guaranteed Interest Division, pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division on a Transaction Date pursuant to Section 2.04. We will credit the amount you have in the Guaranteed Interest Division with interest at effective annual rates that we determine. For each Class of Contracts we determine a yearly guaranteed interest rate that will remain in effect throughout the next year. We guarantee that this yearly guaranteed interest rate will never be less than 3%. Participation in the Guaranteed Interest Division terminates on the earliest of (i) the Retirement Date, (ii) receipt of due proof of the Annuitant's death, or (iii) termination of this Contract pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section 2.01, is allocated (after deduction of any applicable tax charge) to one or more Divisions, at your sole direction. Allocation percentages must be in whole numbers and the sum must equal 100%. The allocation is made as of the Transaction Date on which we have received both such Contribution and such direction. Contributions made to an investment Division purchase Accumulation Units in that Investment Division, using the Accumulation Unit Value next computed after the Transaction Date. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the Transaction Date with respect to each transfer from the Division pursuant to Section 2.05, (iii) on the Transaction Date with respect to each withdrawal pursuant to Section 2.07, (iv) at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, (v) at the time of application of amounts in the Guaranteed Interest Division to provide forms of benefits offered by us pursuant to Section 3.03, (vi) upon termination of participation pursuant to Section 2.06, (vii) upon the Annuitant's death pursuant to Section 2.10, and (viii) at the end of the period during which payments pursuant to the provisions of Section 2.06, 2.07 and 2.10, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.05, were deferred pursuant to Section 4.05. SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request, or through the use of a touch tone telephone, transfer all or part of the amount you have in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; (2) amounts in the Money Market Division may be transferred to other Divisions. Written authorization for touch tone telephone initiated transfers is only required when authorization for telephone transfers is requested. Upon advance written notice to you we reserve the right to discontinue acceptance of transfer requests through the use of touch tone telephones. All transfers will be made on the Transaction Date and will be subject to our rules in effect at the time of transfer. With respect to the Investment Divisions, the transfers will be made at the Accumulation Unit Value next computed after the Transaction Date. No transfers are permitted to the Money Market Division from the other Divisions. SECTION 2.06 TERMINATION OF THIS CONTRACT. On or before the Retirement Date, and while the Annuitant is alive, you may elect by written notice to terminate this Contract. We will determine the Cash Value under this Contract as of the Transaction Date. Such cash value will be subject to the termination charge described below: If you terminate this Contract, we will pay you the greater of (i) the Annuity Account Value after the withdrawal charge has been imposed as described in 2.08, or (ii) the Free Corridor amount, plus 94% of your remaining Annuity Account Value. No. 92NQCA Page 8 For purposes of calculating the Withdrawal Charge, (1) the oldest Contribution will be treated as the first withdrawn and the most recent Contributions will be treated next, and (2) amounts withdrawn up to the Free Corridor Amount will not be considered a withdrawal of any of your Contributions. No Withdrawal Charge will be applied if the amount withdrawn is applied to the election of a life annuity distribution option, or if the Annuitant dies and the death benefit is withdrawn by the beneficiary specified to us. If this Contract is terminated prior to the Retirement Date, any applicable tax charges we have paid may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on termination, unless a change in applicable law has occurred with respect to this Contract. The payment of such Cash Value to you may be deferred by us in accordance with the provisions of Section 4.05. If no tax has been previously deducted or if such a tax is due at termination, we will deduct the amount due. Prior to the Retirement Date, we reserve the right to pay the Annuity Account Value under this Contract and terminate this Contract if (i) no Contributions are made during the last three completed Contract Years, and the Annuity Account Value is less than $500, or (ii) after three Contract Years and the Annuity Account Value is less than $500. We also reserve the right to terminate this Contract if no Contributions have been made within 120 days of the Contract Date shown on Page 3 of this Contract. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.07 PARTIAL WITHDRAWALS. You may elect by written notice to us to make a partial withdrawal from the Divisions before the Retirement Date while the Annuitant is alive. On the Transaction Date, we will pay the lesser of the Cash Value or the amount of partial withdrawal requested by you. The amount paid plus any withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the amounts you have in the Divisions. Unless instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts that you have in such Divisions. Upon any partial withdrawal payment, we will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by us in accordance with the provisions of Section 4.05. We may decline to accept a request for a partial withdrawal of less than $300. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, we will so advise you and reserve the right to pay the Annuity Account Value to you, and terminate this Contract. SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. There will be no withdrawal charge (i) if the amount of the partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 1.13, (ii) the amount withdrawn is applied to the election of a life annuity distribution option, or (iii) a death benefit is withdrawn by the beneficiary. However, if the amount of partial withdrawal requested is greater than the Free Corridor Amount, we will (i) first withdraw from such Divisions an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge, if applicable. Such withdrawal charge will be calculated in the following manner: (a) Withdrawals of Contributions made by you during the current and five prior Contract Years will be subject to a charge of 6% of the amount withdrawn (including such charge). (b) Withdrawals of other amounts will not be subject to any withdrawal charges. We will pay you the lesser of (a) the amount requested or (b) the Cash Value. For purposes of determining withdrawal charges described in this Section, amounts withdrawn up to the Free Corridor Amount will not be considered a withdrawal of any Contributions. Any excess withdrawals, i.e. those pursuant to item (ii) in the immediate preceding paragraph, shall be considered withdrawals of older contributions first and more recent contributions next. No. 92NQCA Page 9 If withdrawals are made from this Contract prior to the Retirement Date, any applicable tax charges we have paid with respect to this Contract may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on withdrawals, unless a change in applicable law has occurred with respect to this contract. SECTION 2.09 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract Year before your Retirement Date, we will withdraw from the Divisions an Annual Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account Value including the amount of the sum of (i) the Annuity Account Value and (ii) any withdrawals pursuant to Section 2.07 during that Contract Year. The charge will be allocated among the Divisions in proportion to the amounts that you have in the Divisions. As of the Retirement Date and before application of the Annuity Account Value or Cash Value pursuant to Section 3.03, or upon termination of this Contract pursuant to Section 2.06 or Sections 2.10 and 2.11 during a Contract Year, if the Annuity Account Value is less than $10,000, we will withdraw the Annual Administrative Charge described in this Section for the applicable part of that Contract Year. However, if the Annuity Account Value is $10,000 or greater at the end of the Contract Year, the Annual Administrative Charge is zero. SECTION 2.10 DEATH BENEFIT. If we ascertain that the Annuitant has died, upon receipt of due proof of such death, we will pay to the beneficiary you designated pursuant to Section 4.03 to receive such payment, the amount of death benefit payable under this Contract. The amount of the death benefit under this Contract is equal to the greater of (i) the Annuity Account Value and (ii) the minimum death benefit under this Contract. Such minimum death benefit is the sum of all contributions made pursuant to Section 2.01 (before reduction for any applicable tax charge), less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount that was withdrawn is to the Annuity Account Value. We will pay the death benefit to the beneficiary in the form of an Annuity Benefit if you have made the election described in the last paragraph of Section 4.03. Also in accordance with the last paragraph of Section 4.03, if no such election is in effect at the Annuitant's death, we will pay the death benefit to the beneficiary in a single sum, unless the beneficiary elects before we pay the death benefit (i) to apply the death benefit to an Annuity Benefit on any annuity form offered by us; (ii) to apply the death benefit to provide any other form of benefit payment offered by us; or (iii) to apply the death benefit to provide any combination of forms of benefit payment offered by us. All benefit payment elections will be subject to our rules then in effect and any other applicable requirements under the Code. Upon payment of the death benefit, the amount in the Divisions and the Annuity Account Value with respect to this Contract shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.11 OWNER DEATH DISTRIBUTION RULES. Upon the death of the Owner before an Annuitant's Retirement Date: (i) if you are both the Owner and the Annuitant, we will pay the death benefit in accordance with Sections 2.10 and 4.03. (ii) If you are not the Annuitant, the designated beneficiary will succeed as Owner, notwithstanding the existence of any co-owner. The entire amount in the Divisions subject to any applicable withdrawal charges as described in the Contract must either: a) be completely distributed by the fifth anniversary of your death, or b) within 1 year after your death as a life annuity or installment option, for a period of not longer than the life expectancy of the designated beneficiary. However, if the designated beneficiary is your spouse, the entire amount the Annuitant has in the Divisions must then be distributed no later than 5 years after the spouse's death. If payments under an Annuity Benefit had commenced prior to your death, such payments will continue to be made over a period not longer than the period provided for under the Annuity Benefit elected. If the Annuitant dies before the entire amount the Annuitant has in the Divisions is distributed, we will pay the death benefit in Section 2.10. No. 92NQCA Page 10 The designated beneficiary is the same as the beneficiary who is entitled to the death benefit upon your death. Where more than one Owner is named, the date of death of the Owner will be deemed to be the date of death of the first Owner to die. SECTION 2.12 CONTRIBUTION LIMIT. We may refuse to accept a Contribution made with respect to an Annuitant if the total prior Contributions made exceed (or if acceptance of such Contribution would cause the total Contributions to exceed) the following: (i) $500,000, if the Annuitant's current age last birthday is 75 or less. (ii) $250,000, if the Annuitant's current age last birthday is 76-79. We may refuse to accept any Contribution made with respect to an Annuitant if such Annuitant's current age last birthday is 80 or greater. - -------------------------------------------------------------------------------- PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under this Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Stock Division of the Separate Account. Such Variable Annuity Benefit will increase if the average daily rate of investment return in the Stock Division is equivalent to more than 6.75% or 5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25% annually, depending on whether the applicable assumed base rate of net investment return referred to in Section 1.23 is 5% or 3.5%, respectively. The daily rate of investment return is before deduction of charges, as described in Section 1.22, not to exceed the maximum rate of 1.75% after any deductions to provide for any applicable tax charge. These charges include a daily charge for financial accounting, death benefits, mortality risk, expenses and expense risk, plus the investment advisory fee charges and direct operating expense charges of the Trust. The amount of the first, second and third payments under any Variable Annuity Benefit provided under this Contract with respect to a payee is the monthly amount provided with respect to a payee pursuant to the 5th paragraph of Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment by the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. (As described in Section 3.05, we will notify the payee how each variable Annuity Payment is determined). SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of the Annuitant's Retirement Date, provided the Annuitant is then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless you elect, (i) to receive the Cash Value of the Contract in a single sum, (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by us or one of our affiliated or subsidiary life insurance companies, as elected by you, or (iii) to apply the Cash Value to provide any other form of benefit payment offered by us, subject to our rules then in effect. We will provide notice and election forms to you not more than six months before the Retirement Date. If you elect to terminate this Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive any form of benefit payment offered by us, subject to our rules then in effect and any other applicable requirements under the Code. No. 92NQCA Page 11 We will have the right to require you to furnish pertinent information to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. We may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary life insurance companies. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect pursuant to the first or third paragraph of Section 3.03 to have an Annuity Benefit paid in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value if the annuity form elected involves life contingencies or (ii) the Cash Value if the annuity form elected does not involve life contingencies. The amount applied to provide an Annuity Benefit may be reduced by a charge for any applicable taxes on annuity considerations, as we determine. If we have previously deducted charges for applicable taxes from contributions as provided in Section 2.01, we will not again deduct charges for the same taxes before application to provide an Annuity Benefit, unless a change in applicable law has occurred with respect to this Contract. The balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) our current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, your Contract will be governed by our supplementary contract then in effect. The amount to be applied to provide an Annuity Benefit will in addition to any tax charge reduction, be reduced by an administrative charge. The amount of such charge will be determined from time to time in accordance with our general practices applicable on a uniform basis to all contracts of the same type as this Contract. After the application of an amount to provide an Annuity Benefit, the amounts you have in the Divisions and the Annuity Account Value shall be zero. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the terms of this Contract, as indicated on the Life Annuity Form with Ten Years Certain. The amount of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form with Ten Years Certain is based on 3.5% interest and the 1983 Individual Annuity Table "a". The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form with Ten Years Certain is based on the 1983 Individual Annuity Table "a" and on an Assumed Base Rate of Net Investment Return of 3.5% or 5%, whichever applies pursuant to Section 1.22. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us based on 3.5% interest and the 1983 Individual Annuity Table "a" if such annuity form provides for a Fixed Annuity Benefit and on the same such Table and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies, pursuant to Section 1.22, if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Evidence of each payee's survival must be furnished to us either by personal endorsement of the check drawn for payment or by other means satisfactory to us. If a benefit payable under this Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by us will be charged against and underpayments will be added to any payments thereafter falling due under the terms of this Contract with respect to the payee affecting as many such payments as are necessary to correct the overpayment or underpayment. Our liability with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the terms of this Contract. If we receive evidence satisfactory to us that (i) a payee entitled to receive any payment under the terms of this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, we may make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. Upon your election pursuant to Section 3.03 of an annuity form providing payments for a period certain, you may designate (with the right to change such designation) a payee to receive any payments that may become due after the death of the person or persons upon, whose life or lives the income may depend. No. 92NQCA Page 12 The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's estate in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, we will pay in a single sum to such payee's estate the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis originally used to determine such payments. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. We will require satisfactory evidence of the age of any person upon whose life an annuity form depends. - -------------------------------------------------------------------------------- TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM WITH TEN YEARS CERTAIN (Minimum Monthly Income per $1,000 of Annuity Account Value)
- ------------------------------------------------------------------------------------------------------ Monthly Income Monthly Income Age Males Females Age Males Females - ------------------------------------------------------------------------------------------------------ 60 5.42 4.93 73 7.40 6.76 61 5.54 5.04 74 7.57 6.95 62 5.67 5.14 75 7.75 7.15 63 5.80 5.25 76 7.92 7.34 64 5.94 5.37 77 8.09 7.54 65 6.08 5.50 78 8.26 7.74 66 6.23 5.63 79 8.42 7.94 67 6.38 5.77 80 8.57 8.14 68 6.54 5.92 81 8.71 8.32 69 6.71 6.07 82 8.85 8.50 70 6.88 6.23 83 8.98 8.67 71 7.05 6.40 84 9.09 8.83 72 7.22 6.58 85 9.20 8.97 - ------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Account Value)
- ---------------------------------------------------------------------------------------------------------- VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM WITH TEN YEARS CERTAIN IF ASSUMED BASE RATE OF RETURN IS: 3.5% 5.0% ---- ---- Age Males Females Males Females - ---------------------------------------------------------------------------------------------------------- 60 5.42 4.93 6.28 5.80 61 5.54 5.04 6.40 5.90 62 5.67 5.14 6.52 6.00 63 5.80 5.25 6.64 6.11 64 5.94 5.37 6.78 6.22 65 6.08 5.50 6.92 6.34 66 6.23 5.63 7.06 6.47 67 6.38 5.77 7.21 6.60 68 6.54 5.92 7.36 6.74 69 6.71 6.07 7.52 6.89 70 6.88 6.23 7.68 7.05 - ----------------------------------------------------------------------------------------------------------
We will with respect to each payment under a Variable Annuity Benefit, notify the payee of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each variable payment. Such notice will be mailed with each payment. Any election, change, revocation or designation shall be made, and will take effect, in the same manner as a change of beneficiary as described in Section 4.03. If a commutation right under an Annuity Benefit is exercised, we may defer payment in accordance with Section 4.05. No. 92NQCA Page 13 - -------------------------------------------------------------------------------- PART V - GENERAL PROVISIONS SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the parties and the provisions of this Contract alone will govern with respect to our rights and obligations. A copy of the application is incorporated in and made part of this Contract. This Contract may not be modified, nor may any of our rights or requirements be waived, except in writing and by our authorized officer. The terms of this Contract may be changed by amendment or replacement upon agreement between you and us without the consent of any other person who has a contingent or additional interest in this Contract. SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform this Contract and any certificate to reflect changes in the Code, applicable Treasury Regulations, or published rulings of the Internal Revenue Service so this Contract will continue to be an "annuity" as described in Section 72 of the Code. SECTION 4.03 BENEFICIARY. As of the Contract Date, you are to provide us with an initial designation of the beneficiary entitled to receive any death benefit payable pursuant to Section 2.10 unless otherwise specified in the application the person designated as beneficiary on the death of the Annuitant under Section 2.10 will also be the designated beneficiary who succeeds as "Owner" on your death while the Annuitant is alive under Section 2.11. You may change such designation from time to time during the Annuitant's lifetime and while the Contract is in force. Any such designation or change will be made by written notice in a form satisfactory to us. A change will, upon receipt at the Processing Office, take effect as of the date the written notice was signed, whether or not you are living on the date of receipt, but without further liability as to any payment or other settlement made by us before receipt of such change. Unless otherwise specified in the application, if you have named two or more persons as beneficiary, the beneficiary will be the named person or persons who survive you, and if more than one survive they will share equally. Any part of a death benefit payable pursuant to Section 2.10 for which there is no named beneficiary living at your death will be payable in a single sum to your children, who survive you, in equal shares, or should none survive, then to your estate. If you so elect in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by you, with respect to the beneficiary, subject to our rules then in effect. If at your death there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. SECTION 4.04 FUTURE CONTRIBUTIONS. We reserve the right at our sole discretion to limit Contributions under this Contract. SECTION 4.05 DEFERMENT. Application of proceeds to a variable annuity, payment of a death benefit when Section 2.10 or any payment required under Section 2.11 and payment of any portion of your Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange has been closed or trading on it is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Security and Exchange Commission, by order, permits us to defer payment in order to protect persons with interests in the Investment Divisions. We can defer payment of any portion of your Annuity Account Value in the Guaranteed Interest Division for up to six months while you are living. SECTION 4.06 ANNUAL NOTICE. At the end of each Contract Year up to and including the Retirement Date, we will furnish you with a notice showing the following: (1) the amount in the Guaranteed Interest Division, (2) the total number of Accumulation Units in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Value, No. 92NQCA Page 14 (4) the amount in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division. (5) the Cash Value, and (6) the amount of the death benefit. We will also furnish annual calendar year reports concerning the status of the annuity and any other reports required by the Code or applicable Treasury Regulations. After the Retirement Date, we will notify you of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.07 ASSIGNMENTS. This Contract may not be assigned as collateral or security for a loan. Otherwise, you may assign this Contract before the Retirement Date but we will not be bound by an assignment unless it is in writing and we have received it. Your rights and those of any other persons referred to in this Contract will be subject to the assignment. We assume no responsibility for the validity of any assignment. No amounts payable under this Contract to a payee other than you may be assigned, unless permitted herein, by that payee, nor will they be subject to the claims of creditors or to legal process, except to the extent permitted by law. SECTION 4.08 AGE AND SEX. If the age or sex of any person upon whose life an Annuity Benefit depends has been misstated, any benefits will be those which would have been purchased at the correct age and sex. Any overpayments or underpayments made by us will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. No. 92NQCA Page 15 Owner: Annuitant: Contract Number: Issue Date: Contract Date: Retirement Date: - ------------------------------------------------------------------------------- THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P O Box 2996, New York, New York 10116-2996 AGREES o TO ALLOCATE the Contributions made to this Contract after deduction of any applicable tax charge, to the Stock Division, Balanced Division, Aggressive Stock Division, Money Market Division of the Separate Account (referred to in this Contract as the Investment Divisions of the Separate Account) or to the Guaranteed Interest Division, in accordance with Sections 2.02, 2.03 and 2.04 or in part to any one, as directed by you. o TO APPLY the Annuity Account Value at the Retirement Date to provide an Annuity Benefit or a Cash Value benefit if the Annuitant is then living, and o TO PROVIDE you with the other rights and benefits of this Contract. This is the entire Contract. In this Contract, "we", "our" and "us" mean The Equitable Life Assurance Society of the United States. "You" and "your" mean the Owner, at the time a right is exercised by the Owner. TEN DAYS TO EXAMINE CONTRACT - You may cancel this Contract by returning it to us within ten days after receipt of it. Upon such cancellation, we will refund any Contribution made to us under this Contract, plus or minus any investment gain or loss experienced in the Investment Divisions of the Separate Account from the date such Contribution is allocated to such Investment Division to the date we receive the returned Contract. /s/ Molly K. Heines /s/ Joseph J. Melone Molly K. Heines Joseph J. Melone Vice President and Secretary Chairman of the Board THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.23 IS 5% OR 3.5%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE TRUST. No. 92NQCB This Contract is issued in consideration of the payment to us of the Contributions made under the terms of this Contract. The provisions on the following pages are part of this Contract. - ------------------------------------------------------------------------------- TABLE OF CONTENTS PART I - DEFINITIONS Page Section 1.01 - Annuitant.............................................. 4 1.02 - Annuity Account Value ................................. 4 1.03 - Annuity Benefit ....................................... 4 1.04 - Cash Value............................................. 4 1.05 - Class of Contracts..................................... 4 1.06 - Code................................................... 4 1.07 - Contract............................................... 4 1.08 - Contract Date.......................................... 4 1.09 - Contract Year.......................................... 4 1.10 - Contribution .......................................... 4 1.11 - Deposit Option Benefits ............................... 4 1.12 - Divisions.............................................. 4 1.13 - Free Corridor Amount .................................. 4 1.14 - Guaranteed Interest Rate............................... 5 1.15 - Joint and Survivor Life Annuity Form .......................................... 5 1.16 - Life Annuity Form...................................... 5 1.17 - Normal Form............................................ 5 1.18 - Owner.................................................. 5 1.19 - Period Certain Annuity ................................ 5 1.20 - Processing Office...................................... 5 1.21 - Retirement Date ....................................... 5 1.22 - Separate Account ...................................... 5 1.23 - Separate Account Definitions............................................ 6 1.24 - Transaction Date ...................................... 7 1.25 - Trust ................................................. 7 PART II - ANNUITY ACCOUNT VALUE Section 2.01- Contributions .......................................... 7 2.02 - Separate Account Investment Divisions .................................. 7 2.03 - Guaranteed Interest Division .......................... 8 2.04 - Allocation to Divisions ............................... 8 2.05 - Transfers Among Divisions ............................. 8 2.06 - Termination of this Contract .......................... 8 2.07 - Partial Withdrawals ................................... 9 2.08 - Charges for Partial Withdrawals ....................... 9 2.09 - Annual Administrative Charge ..........................10 2.10 - Death Benefit..........................................10 2.11 - Owner Death Benefit Distribution Rules.....................................10 2.12 - Contribution Limit.....................................11 PART III - ANNUITY BENEFITS Section 3.01 - Fixed Annuity Benefit .................................11 3.02 - Variable Annuity Benefit...............................11 3.03 - Election and Commencement of Annuity Benefits ...................................1l 3.04 - Amount of Annuity Benefits.............................12 3.05 - Payment of Annuity Benefits ...........................12 PART IV - GENERAL PROVISIONS Section 4.01 - Contract...............................................14 4.02 - Statutory Compliance ..................................14 4.03 - Beneficiary ...........................................14 4.04 - Future Contributions ..................................14 4.05 - Deferment .............................................14 4.06 - Annual Notice..........................................14 4.07 - Assignments ...........................................15 4.08 - Age and Sex ...........................................15 No. 92NQCB Page 2 PART I - DEFINITIONS SECTION 1.01 ANNUITANT. The term "Annuitant" means the individual shown on page 3 of this Contract. SECTION 1.02 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts in the Guaranteed Interest Division and the Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03. SECTION 1.03 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by us pursuant to Section 3.04 of this Contract. Various Sections of this Contract (Sections 1.15, 1.16, 3.01 and 3.02) refer to monthly payments to be made under an Annuity Benefit. An election may be to have your Annuity Benefit paid at other intervals, such as quarterly, semi-annually, or annually, instead of monthly. This election may be made at the time the Annuity Benefit form as described in Section 3.03 is elected: in that event, all references in this Contract to monthly payments will be deemed to mean payments at the frequency you elected, subject to our rule at the time of election. SECTION 1.04 CASH VALUE. The term "Cash Value" means an amount equal to the greater of (i) or (ii) below: (i) the Annuity Account Value less 6% of the Contributions made during the current and five prior Contract Years, which had not been previously withdrawn pursuant to Sections 2.07 and 2.08. (ii) the sum of (a) the Free Corridor Amount as defined in Section 1.13 and (b) 94% of the Annuity Account Value less the Free Corridor Amount. However, if the Annuitant was age 59 or older on the Contract Date and it is Contract Year 5, item (ii) (b) above will be 95% of the Annuity Account Value less the Free Corridor Amount. If it is Contract Year 6, item (ii) (b) above will be 96% of the Annuity Account Value less the Free Corridor Amount. SECTION 1.05 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all contracts with a Contract Date in the same calendar year. SECTION 1.06 CODE. The term "Code" means the Internal Revenue Code of 1986, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.07 CONTRACT. The term "Contract" means this Contract. SECTION 1.08 CONTRACT DATE. The term "Contract Date" means the Date of receipt by us of both the application for this Contract, properly signed and completed, and a Contribution. SECTION 1.09 CONTRACT YEAR. The term "Contract Year" means the twelve month period beginning on (i) the Contract Date, and (ii) each anniversary thereof, unless otherwise agreed to in writing by us. SECTION 1.10 CONTRIBUTION. The term "Contribution" means a payment made to us for the Annuitant with respect to an Annuity purchased under this Contract. We are under no obligation to accept an Initial Contribution of less than $1,000.00 or, for Payroll Deductions and any Subsequent Contributions, a Contribution of less than $50.00. SECTION 1.11 DEPOSIT OPTION BENEFIT. The term "Deposit Option Benefit" means a benefit derived from amounts on deposit for a period approved by us, subject to our rules then in effect and any other applicable requirements under the Code. Interest payments will be made at the end of each one, three, six or twelve month interval, as elected by you, and provided that the amount of each payment made at the end of the designated interval is at least $20. We reserve the right to change the payment frequency for payments of less than $20. SECTION 1.12 DIVISION. The term "Division" or "Divisions" mean, singly or severally as the case may be, the following divisions described in this Contract: (i) the Guaranteed Interest Division, and (ii) the Investment Divisions of the Separate Account. SECTION 1.13 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means an amount equal to the excess, if any, of (i) 10% of the Annuity Account Value on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to Section 2.07 or 2.08 in the current Contract Year. No. 92NQCB Page 4 SECTION 1.14 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in the Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of this Contract. Section 2.03 describes the determination of the rate to apply thereafter. SECTION 1.15 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.16 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity issued by us providing monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.17 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under this Contract means the Fixed Annuity Benefit payable on the Life Annuity Form, as defined in Sections 3.01 and 1.16, with 10 years of payments guaranteed (10 years certain period). In addition, if the Annuitant dies before the certain period has ended, payments will continue to the beneficiary designated to receive such payments for the balance of the certain period. SECTION 1.18 OWNER. The Owner of this Contract is the person shown as "Owner" on page 3 unless otherwise stated in the application, or later changed. Notwithstanding any provisions in this Contract to the contrary, only the Owner can exercise the rights under this Contract. While the Annuitant is living, the Owner of this Contract may change the Owner by written notice satisfactory to us. The change will take effect on the date the Owner signs the notice, except it will not apply to any payment we make or other actions we take before we receive the notice. SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by us which does not permit any prepayment of the unpaid principal (that is, you cannot elect to receive part of your payments as a single sum payment with the remainder paid in monthly annuity payments). SECTION 1.20 PROCESSING OFFICE. The term "Processing Office" means Equitable Individual Annuity Center, P O Box 2996, New York, New York 10116-2996, or such other location as we shall designate upon advance written notice to you. SECTION 1.21 RETIREMENT DATE. The term "Retirement Date" means the date on which the Annuitant attains the retirement age shown on Page 3 of this Contract. Before the Retirement Date the Annuitant may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th or 31st day of any month). Any election for such change must be made in writing by you and shall not take effect until received by us at our Processing Office. SECTION 1.22 SEPARATE ACCOUNT. The term "Separate Account" means Separate Account A which is organized as a unit investment trust, a type of investment company. We established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited to or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts and certificates. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities and variable life insurance. The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to these contracts will not be chargeable with liabilities arising out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to our General Account. The Separate Account consists of "Investment Divisions" Each Investment Division may invest its assets in a separate class (or series) of shares of a designated Trust where each class (or series) represents a separate portfolio in the Trust or investment company. We reserve the right to change the Trust or to add a Trust. The Investment Divisions are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. The Guaranteed Interest Division is not a part of the Separate Account A but rather is an asset of our General Account. No. 92NQCB Page 5 We will value the assets of each Investment Division on each business day. A business day is any day on which we are open, the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio securities in which an Investment Division is invested to materially affect the Accumulation Unit Value. We may, at our discretion, invest the assets of any Investment Division in any investment permitted by applicable law. We may rely conclusively on the opinion of counsel (including attorneys in our employ) as to what investments we are permitted by law to make. We reserve the right to (i) cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such committee at any time; (iii) restrict or eliminate any voting rights as to the Separate Account; (iv) operate the Separate Account by making direct investments, or in any other form; (v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or remove Investment Divisions (or sub-divisions of Investment Divisions) from the Separate Account (the term "Investment Division" in this Contract shall then refer to any other Investment Division in which the assets, of a Class of Contracts to which this Contract belongs, were placed); (vi) combine any two or more Investment Divisions (or sub-divisions of Investment Divisions) of the Separate Account; and (vii) withdraw from any Investment Division and to allocate to another Investment Division assets determined by us to be associated with the Class of Contracts to which this Contract belongs. If the exercise of these rights results in a material change in the underlying investments of an Investment Division, you will be notified of such exercise, as required by law. Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for taxes) at a rate not to exceed 1.49% per year for each of the Stock, Money Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock Division, for financial accounting, death benefits, mortality risk, expenses and expense risk. The charge shall be made in accordance with (c) of the Net Investment Factor provision in Section 1.23. The relative proportion of these charges may be modified. This daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust, shall not in the aggregate exceed a total annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to this Contract. SECTION 1.23 SEPARATE ACCOUNT DEFINITIONS. VALUATION PERIOD: Is each business day together with any consecutive preceding non-business days. NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b), minus (c), where (a) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the Valuation Period before giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period. For this purpose, we use the share value reported to us by the Trust. (b) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the preceding Valuation Period (after any amounts allocated to or withdrawn for that Valuation Period). (c) is the daily Separate Account charge for the expenses of this Contract, times the number of calendar days in the Valuation Period. ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in the Investment Division where Contributions are invested and are used in determining the amount in an Investment Division. No. 92NQCB Page 6 ACCUMULATION UNIT VALUE: The "Accumulation Unit Value" is the dollar value of each Accumulation Unit in an Investment Division. The Accumulation Unit Value for a Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for that Investment Division for such Valuation Period. ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable from the Stock Division of the Separate Account under a Variable Annuity Benefit as defined in Section 3.02. ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1, 1968. On August 27, 1981, the date the first contribution was put into the Stock Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed Base rates of 5% and 3.5% a year, respectively. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE ANNUITY UNIT VALUE: With respect to this Contract, the Average Annuity Unit Value for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods ending in such month. SECTION 1.24 TRANSACTION DATE. The Transaction Date is the business day we receive a Contribution or a written contract transaction request providing the information we need at the Processing Office. In the case of a transfer request initiated through the use of a touch tone telephone as described in Section 2.05, the Transaction Date is the business day the telephone transaction is received. SECTION 1.25 TRUST. The term "Trust" means the designated trust or investment company in which assets of the Separate Account are invested. - -------------------------------------------------------------------------------- PART II - ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. Contributions made by you can be classified, as described under subsections A and B below, as specified on the application for this Contract. If Contributions are made under more than one classification, separate Contracts will be issued for each classification. A. Post-August 13, 1982 Classification All Contributions of new funds as well as any Contributions resulting from a transfer to this Contract from a deferred annuity contract, other than those described in subsection B below will be treated as within this classification. B. Pre-August 14, 1982 Classification Amounts transferred to this Contract through a tax free exchange of a deferred annuity contract, where such transferred amount represents amounts invested in or credited to investments in annuity contracts prior to August 14, 1982 will be treated as within this classification. Each Contribution received by us will, before its allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. Contributions will be allocated to the Division in accordance with instructions received in your application, unless later changed. If the Annuitant was age 57 or younger on the Contract Date, no additional Contributions are permitted under the Contract after completion of the Contract Year in which the Annuitant attains age 59. If the Annuitant was age 58 or older on the Contract Date, no additional Contributions are permitted under the Contract after the first anniversary of the Contract Date. SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when an amount is allocated to or withdrawn or transferred from an Investment Division, the Annuity Account Value will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by No. 92NQCB Page 7 the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Sections 2.07 or 2.09 or transferred from the Investment Division pursuant to Section 2.05. The amount in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units in the Investment Division on that date and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under this Contract terminates on the earliest of (i) the election and commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of the Annuitant's death, or (iii) termination of this Contract pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division becomes part of our general assets, which support the guarantees of this Contract and other contracts. The amount in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Section 2.07 or 2.09 or transferred from the Guaranteed Interest Division, pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division on a Transaction Date pursuant to Section 2.04. We will credit the amount you have in the Guaranteed Interest Division with interest at effective annual rates that we determine. For each Class of Contracts we determine a yearly guaranteed interest rate that will remain in effect throughout the next year. We guarantee that this yearly guaranteed interest rate will never be less than 3%. Participation in the Guaranteed Interest Division terminates on the earliest of (i) the Retirement Date, (ii) receipt of due proof of the Annuitant's death, or (iii) termination of this Contract pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section 2.01, is allocated (after deduction of any applicable tax charge) to one or more Divisions, at your sole direction. Allocation percentages must be in whole numbers and the sum must equal 100%. The allocation is made as of the Transaction Date on which we have received both such Contribution and such direction. Contributions made to an Investment Division purchase Accumulation Units in that Investment Division, using the Accumulation Unit Value next computed after the Transaction Date. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the Transaction Date with respect to each transfer from the Division pursuant to Section 2.05, (iii) on the Transaction Date with respect to each withdrawal pursuant to Section 2.07, (iv) at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, (v) at the time of application of amounts in the Guaranteed Interest Division to provide forms of benefits offered by us pursuant to Section 3.03, (vi) upon termination of participation pursuant to Section 2.06, (vii) upon the Annuitant's death pursuant to Section 2.10, and (viii) at the end of the period during which payments pursuant to the provisions of Section 2.06, 2.07 and 2.10, or any commuted payments arising from a Fixed Annuity Benefit pursuant to Section 3.05, were deferred pursuant to Section 4.05. SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request, or through the use of a touch tone telephone, transfer all or part of the amount you have in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; (2) amounts in the Money Market Division may be transferred to other Divisions. Written authorization for touch tone telephone initiated transfers is only required when authorization for telephone transfers is requested. Upon advance written notice to you we reserve the right to discontinue acceptance of transfer requests through the use of touch tone telephones. All transfers will be made on the Transaction Date and will be subject to our rules in effect at the time of transfer. With respect to the Investment Divisions, the transfers will be made at the Accumulation Unit Value next computed after the Transaction Date. No transfers are permitted to the Money Market Division from the other Divisions. SECTION 2.06 TERMINATION OF THIS CONTRACT. On or before the Retirement Date, and while the Annuitant is alive, you may elect by written notice to terminate this Contract. We will determine the Cash Value under this Contract as of the Transaction Date. Such cash value will be subject to the termination charge described below: If you terminate this Contract, we will pay you the greater of (i) the Annuity Account Value after the withdrawal charge has been imposed as described in 2.08, or (ii) the Free Corridor amount, plus 94% of your remaining Annuity Account Value. No. 92NQCB Page 8 For purposes of calculating the Withdrawal Charge, (1) the oldest Contribution will be treated as the first withdrawn and the most recent Contributions will be treated next, and (2) amounts withdrawn up to the Free Corridor Amount will not be considered a withdrawal of any of your Contributions. No Withdrawal Charge will be applied if the amount withdrawn is applied to the election of a life annuity distribution option, or if the Annuitant dies and the death benefit is withdrawn by the beneficiary specified to us. If this Contract is terminated prior to the Retirement Date, any applicable tax charges we have paid may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on termination, unless a change in applicable law has occurred with respect to this Contract. The payment of such Cash Value to you may be deferred by us in accordance with the provisions of Section 4.05. If no tax has been previously deducted or if such a tax is due at termination, we will deduct the amount due. Prior to the Retirement Date, we reserve the right to pay the Annuity Account Value under this Contract and terminate this Contract if (i) no Contributions are made during the last three completed Contract Years, and the Annuity Account Value is less than $500, or (ii) after three Contract Years and the Annuity Account Value is less than $500. We also reserve the right to terminate this Contract if no Contributions have been made within 120 days of the Contract Date shown on Page 3 of this Contract. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.07 PARTIAL WITHDRAWALS. You may elect by written notice to us to make a partial withdrawal from the Divisions before the Retirement Date while the Annuitant is alive. On the Transaction Date, we will pay the lesser of the Cash Value or the amount of partial withdrawal requested by you. The amount paid plus any withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the amounts you have in the Divisions. Unless instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts that you have in such Divisions. Upon any partial withdrawal payment, we will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by us in accordance with the provisions of Section 4.05. We may decline to accept a request for a partial withdrawal of less than $300. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, we will so advise you and reserve the right to pay the Annuity Account Value to you, and terminate this Contract. SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. There will be no withdrawal charge (i) if the amount of the partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 1.13, (ii) the amount withdrawn is applied to the election of a life annuity distribution option, or (iii) a death benefit is withdrawn by the beneficiary. However, if the amount of partial withdrawal requested is greater than the Free Corridor Amount, we will (i) first withdraw from such Divisions an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge, if applicable. Such withdrawal charge will be calculated in the following manner: (a) Withdrawals of Contributions made by you during the current and five prior Contract Years will be subject to a charge of 6% of the amount withdrawn (including such charge). (b) Withdrawals of other amounts will not be subject to any withdrawal charges. We will pay you the lesser of (a) the amount requested or (b) the Cash Value. For purposes of determining withdrawal charges described in this Section, amounts withdrawn up to the Free Corridor Amount will not be considered a withdrawal of any Contributions. Any excess withdrawals, i.e. those pursuant to item (ii) in the immediate preceding paragraph, shall be considered withdrawals of older contributions first and more recent contributions next. No. 92NQCB Page 9 If withdrawals are made from this Contract prior to the Retirement Date, any applicable tax charges we have paid with respect to this Contract may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on withdrawals, unless a change in applicable law has occurred with respect to this contract. SECTION 2.09 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract Year before your Retirement Date, we will withdraw from the Divisions an Annual Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account Value including the amount of the sum of (i) the Annuity Account Value and (ii) any withdrawals pursuant to Section 2.07 during that Contract Year. The charge will be allocated among the Divisions in proportion to the amounts that you have in the Divisions. As of the Retirement Date and before application of the Annuity Account Value or Cash Value pursuant to Section 3.03, or upon termination of this Contract pursuant to Section 2.06 or Sections 2.10 and 2.11 during a Contract Year, if the Annuity Account Value is less than $10,000, we will withdraw the Annual Administrative Charge described in this Section for the applicable part of that Contract Year. However, if the Annuity Account Value is $10,000 or greater at the end of the Contract Year, the Annual Administrative Charge is zero. SECTION 2.10 DEATH BENEFIT. If we ascertain that the Annuitant has died, upon receipt of due proof of such death, we will pay to the beneficiary you designated pursuant to Section 4.03 to receive such payment, the amount of death benefit payable under this Contract. The amount of the death benefit under this Contract is equal to the greater of (i) the Annuity Account Value and (ii) the minimum death benefit under this Contract. Such minimum death benefit is the sum of all contributions made pursuant to Section 2.01 (before reduction for any applicable tax charge), less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount that was withdrawn is to the Annuity Account Value. We will pay the death benefit to the beneficiary in the form of an Annuity Benefit if you have made the election described in the last paragraph of Section 4.03. Also in accordance with the last paragraph of Section 4.03, if no such election is in effect at the Annuitant's death, we will pay the death benefit to the beneficiary in a single sum, unless the beneficiary elects before we pay the death benefit (i) to apply the death benefit to an Annuity Benefit on any annuity form offered by us; (ii) to apply the death benefit to provide any other form of benefit payment offered by us; or (iii) to apply the death benefit to provide any combination of forms of benefit payment offered by us. All benefit payment elections will be subject to our rules then in effect and any other applicable requirements under the Code. Upon payment of the death benefit, the amount in the Divisions and the Annuity Account Value with respect to this Contract shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.11 OWNER DEATH DISTRIBUTION RULES. Upon the death of the Owner before an Annuitant's Retirement Date: (i) If you are both the Owner and the Annuitant, we will pay the death benefit in accordance with Sections 2.10 and 4.03. (ii) If you are not the Annuitant, the designated beneficiary will succeed as Owner, notwithstanding the existence of any co-owner. The entire amount in the Divisions subject to any applicable withdrawal charges as described in this Contract must either: a) be completely distributed by the fifth anniversary of your death, or b) within 1 year after your death as a life annuity or installment option, for a period of not longer than the life expectancy of the designated beneficiary. However, if the designated beneficiary is your spouse, the entire amount the Annuitant has in the Divisions must then be distributed no later than 5 years after the spouse's death. If payments under an Annuity Benefit had commenced prior to your death, such payments will continue to be made over a period not longer than the period provided for under the Annuity Benefit elected. If the Annuitant dies before the entire amount the Annuitant has in the Divisions is distributed, we will pay the death benefit in Section 2.10. No. 92NQCB Page 10 The designated beneficiary is the same as the beneficiary who is entitled to the death benefit upon your death. Where more than one Owner is named, the date of death of the Owner will be deemed to be the date of death of the first Owner to die. SECTION 2.12 CONTRIBUTION LIMIT. We may refuse to accept a Contribution made with respect to an Annuitant if the total prior Contributions made exceed (or if acceptance of such Contribution would cause the total Contributions to exceed) the following: (i) $500,000, if the Annuitant's current age last birthday is 75 or less. (ii) $250,000, if the Annuitant's current age last birthday is 76-79. We may refuse to accept any Contribution made with respect to an Annuitant if such Annuitant's current age last birthday is 80 or greater. - ------------------------------------------------------------------------------- PART III -- ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under this Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Stock Division of the Separate Account. Such Variable Annuity Benefit will increase if the average daily rate of investment return in the Stock Division is equivalent to more than 6.75% or 5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25% annually, depending on whether the applicable assumed base rate of net investment return referred to in Section 1.23 is 5% or 3.5%, respectively. The daily rate of investment return is before deduction of charges, as described in Section 1.22, not to exceed the maximum rate of 1.75% after any deductions to provide for any applicable tax charge. These charges include a daily charge for financial accounting, death benefits, mortality risk, expenses and expense risk, plus the investment advisory fee charges and direct operating expense charges of the Trust. The amount of the first, second and third payments under any Variable Annuity Benefit provided under this Contract with respect to a payee is the monthly amount provided with respect to a payee pursuant to the 5th paragraph of Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment by the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. (As described in Section 3.05, we will notify the payee how each variable Annuity Payment is determined). SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of the Annuitant's Retirement Date, provided the Annuitant is then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless you elect, (i) to receive the Cash Value of the Contract in a single sum, (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by us or one of our affiliated or subsidiary life insurance companies, as elected by you, or (iii) to apply the Cash Value to provide any other form of benefit payment offered by us, subject to our rules then in effect. We will provide notice and election forms to you not more than six months before the Retirement Date. If you elect to terminate this Contract pursuant to Section 2.06 before the Retirement Date, an election may be made to receive any form of benefit payment offered by us, subject to our rules then in effect and any other applicable requirements under the Code. No. 92NQCB Page 11 We will have the right to require you to furnish pertinent information to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. We may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary life insurance companies. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS, If you elect pursuant to the first or third paragraph of Section 3.03 to have an Annuity Benefit paid in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value if the annuity form elected involves life contingencies or (ii) the Cash Value if the annuity form elected does not involve life contingencies. The amount applied to provide an Annuity Benefit may be reduced by a charge for any applicable taxes on annuity considerations, as we determine. If we have previously deducted charges for applicable taxes from contributions as provided in Section 2.01, we will not again deduct charges for the same taxes before application to provide an Annuity Benefit, unless a change in applicable law has occurred with respect to this Contract. The balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) our current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, your Contract will be governed by our supplementary contract then in effect. The amount to be applied to provide an Annuity Benefit will in addition to any tax charge reduction, be reduced by an administrative charge. The amount of such charge will be determined from time to time in accordance with our general practices applicable on a uniform basis to all contracts of the same type as this Contract. After the application of an amount to provide an Annuity Benefit, the amounts you have in the Divisions and the Annuity Account Value shall be zero. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the terms of this Contract, as indicated on the Life Annuity Form with Ten Years Certain. The amount of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form with Ten Years Certain is based on 3.5% interest and the 1983 Individual Annuity Table "a". The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form with Ten Years Certain is based on the 1983 Individual Annuity Table "a" and on an Assumed Base Rate of Net Investment Return of 3.5% or 5%, whichever applies pursuant to Section 1.22. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us based on 3.5% interest and the 1983 Individual Annuity Table "a" if such annuity form provides for a Fixed Annuity Benefit and on the same such Table and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies, pursuant to Section 1.22, if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Evidence of each payee's survival must be furnished to us either by personal endorsement of the check drawn for payment or by other means satisfactory to us. If a benefit payable under this Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by us will be charged against and underpayments will be added to any payments thereafter falling due under the terms of this Contract with respect to the payee affecting as many such payments as are necessary to correct the overpayment or underpayment. Our liability with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under the terms of this Contract. If we receive evidence satisfactory to us that (i) a payee entitled to receive any payment under the terms of this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, we may make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. Upon your election pursuant to Section 3.03 of an annuity form providing payments for a period certain, you may designate (with the right to change such designation) a payee to receive any payments that may become due after the death of the person or persons upon, whose life or lives the income may depend. No. 92NQCB Page 12 The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's estate in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, we will pay in a single sum to such payee's estate the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis originally used to determine such payments. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. We will require satisfactory evidence of the age of any person upon whose life an annuity form depends. - ------------------------------------------------------------------------------- TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM WITH TEN YEARS CERTAIN (Minimum Monthly Income per $1,000 of Annuity Account Value) - ------------------------------------------------------------------------------- Monthly Income Monthly Income Age Males Females Age Males Females - ---------- ------------- -------------- -------- -------------- --------------- 60 5.42 4.93 73 7.40 6.76 61 5.54 5.04 74 7.57 6.95 62 5.67 5.14 75 7.75 7.15 63 5.80 5.25 76 7.92 7.34 64 5.94 5.37 77 8.09 7.54 65 6.08 5.50 78 8.26 7.74 66 6.23 5.63 79 8.42 7.94 67 6.38 5.77 80 8.57 8.14 68 6.54 5.92 81 8.71 8.32 69 6.71 6.07 82 8.85 8.50 70 6.88 6.23 83 8.98 8.67 71 7.05 6.40 84 9.09 8.83 72 7.22 6.58 85 9.20 8.97 - ---------- ------------- -------------- -------- -------------- --------------- ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Account Value) - ------------------------------------------------------------------------------- VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM WITH TEN YEARS CERTAIN IF ASSUMED BASE RATE OF RETURN 1S: 3.5% 5.0% Age Males Females Males Females - --------------- ------------ --------------- ---------------- ----------------- 60 5.42 4.93 6.28 5.80 61 5.54 5.04 6.40 5.90 62 5.67 5.14 6.52 6.00 63 5.80 5.25 6.64 6.11 64 5.94 5.37 6.78 6.22 6.08 5.50 6.92 6.34 65 66 6.23 5.63 7.06 6.47 67 6.38 5.77 7.21 6.60 68 6.54 5.92 7.36 6.74 69 6.71 6.07 7.52 6.89 70 6.88 6.23 7.68 7.05 - --------------- ------------ --------------- ---------------- ----------------- We will with respect to each payment under a Variable Annuity Benefit, notify the payee of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each variable payment. Such notice will be mailed with each payment. Any election, change, revocation or designation shall be made, and will take effect, in the same manner as a change of beneficiary as described in Section 4.03. If a commutation right under an Annuity Benefit is exercised, we may defer payment in accordance with Section 4.05. No. 92NQCB Page 13 - ------------------------------------------------------------------------------- PART IV -- GENERAL PROVISIONS SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the parties and the provisions of this Contract alone will govern with respect to our rights and obligations. A copy of the application is incorporated in and made part of this Contract. This Contract may not be modified, nor may any of our rights or requirements be waived, except in writing and by our authorized officer. The terms of this Contract may be changed by amendment or replacement upon agreement between you and us without the consent of any other person who has a contingent or additional interest in this Contract. SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform this Contract and any certificate to reflect changes in the Code, applicable Treasury Regulations, or published rulings of the Internal Revenue Service so this Contract will continue to be an "annuity" as described in Section 72 of the Code. SECTION 4.03 BENEFICIARY. As of the Contract Date, you are to provide us with an initial designation of the beneficiary entitled to receive any death benefit payable pursuant to Section 2.10 unless otherwise specified in the application the person designated as beneficiary on the death of the Annuitant under Section 2.10 will also be the designated beneficiary who succeeds as "Owner" on your death while the Annuitant is alive under Section 2.11. You may change such designation from time to time during the Annuitant's lifetime and while the Contract is in force. Any such designation or change will be made by written notice in a form satisfactory to us. A change will, upon receipt at the Processing Office, take effect as of the date the written notice was signed, whether or not you are living on the date of receipt, but without further liability as to any payment or other settlement made by us before receipt of such change. Unless otherwise specified in the application, if you have named two or more persons as beneficiary, the beneficiary will be the named person or persons who survive you, and if more than one survive they will share equally. Any part of a death benefit payable pursuant to Section 2.10 for which there is no named beneficiary living at your death will be payable in a single sum to your children, who survive you, in equal shares, or should none survive, then to your estate. If you so elect in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by you, with respect to the beneficiary, subject to our rules then in effect. If at your death there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. SECTION 4.04 FUTURE CONTRIBUTIONS. We reserve the right at our sole discretion to limit Contributions under this Contract. SECTION 4.05 DEFERMENT. Application of proceeds to a variable annuity, payment of a death benefit when Section 2.10 or any payment required under Section 2.11 and payment of any portion of your Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange has been closed or trading on it is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Security and Exchange Commission, by order, permits us to defer payment in order to protect persons with interests in the Investment Divisions. We can defer payment of any portion of your Annuity Account Value in the Guaranteed Interest Division for up to six months while you are living. SECTION 4.06 ANNUAL NOTICE. At the end of each Contract Year up to and including the Retirement Date, we will furnish you with a notice showing the following: (1) the amount in the Guaranteed Interest Division, (2) the total number of Accumulation Units in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Value, No. 92NQCB Page 14 (4) the amount in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division. (5) the Cash Value, and (6) the amount of the death benefit. We will also furnish annual calendar year reports concerning the status of the annuity and any other reports required by the Code or applicable Treasury Regulations. After the Retirement Date, we will notify you of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.07 ASSIGNMENTS. This Contract may not be assigned as collateral or security for a loan. Otherwise, you may assign this Contract before the Retirement Date but we will not be bound by an assignment unless it is in writing and we have received it. Your rights and those of any other persons referred to in this Contract will be subject to the assignment. We assume no responsibility for the validity of any assignment. No amounts payable under this Contract to a payee other than you may be assigned, unless permitted herein, by that payee, nor will they be subject to the claims of creditors or to legal process, except to the extent permitted by law. SECTION 4.08 AGE AND SEX. If the age or sex of any person upon whose life an Annuity Benefit depends has been misstated, any benefits will be those which would have been purchased at the correct age and sex. Any overpayments or underpayments made by us will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. No. 92NQCB Page 15 OWNER: ALL STATE DEFERRED COMPENSATION PROGRAM ANNUITANT: JOHN DOE CONTRACT NUMBER: 00 000 000 ISSUE DATE: JAN 1, 1992 CONTRACT DATE: JAN 1, 1992 RETIREMENT DATE: JAN 1, 2020 THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York, New York 10116 AGREES o TO ALLOCATE the Contributions made to this Contract after deduction of any applicable tax charge, to the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division of the Separate Account (referred to in this Contract as the "Investment Divisions") or the Guaranteed Interest Division, in accordance with Sections 2.02, 2.03 and 2.04, as directed by you, and o TO APPLY the Annuity Account Value at the Retirement Date to provide the Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant is then living, and o TO PROVIDE you with the other rights and benefits of this Contract. This is the entire Contract. In this Contract, "we", "our" and "us" mean The Equitable Life Assurance Society of the United States. "You" and "your" mean the Employer at the time a right is exercised by the Employer. TEN DAYS TO EXAMINE CONTRACT -- The Employer may cancel this Contract by returning it to us within ten days after receipt of it. Upon such cancellation, we will refund any Contribution made to us on the Annuitant's behalf under this Contract, plus or minus any investment gain or loss experienced in the Investment Divisions of the Separate Account from the date such Contribution was allocated to such Investment Division to the date we receive the returned contract. /s/ Molly K. Heines /s/ Richard H. Jenrette Vice President and Secretary Chairman of the Board And Chief Executive Officer THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT. THE ANNUITY BENEFITS PAYABLE UNDER THE CONTRACT ARE FIXED ANNUITY BENEFITS. No. 92 PEDB This Contract is issued in consideration of the payment to us of the Contributions made under the terms of this Contract. The provisions on the following pages are part of this Contract. - ------------------------------------------------------------------------------- TABLE OF CONTENTS DEFINITIONS Page Section 1.01 - Annuitant..........................................4 1.02 - Annuity............................................4 1.03 - Annuity Account Value..............................4 1.04 - Annuity Benefit....................................4 1.05 - Cash Value.........................................4 1.06 - Class of Contracts.................................5 1.07 - Code...............................................5 1.08 - Contract...........................................5 1.09 - Contract Date......................................5 1.10 - Contract Year......................................5 1.11 - Contribution.......................................5 1.12 - Divisions..........................................5 1.13 - Eligible Annuity Certain...........................5 1.14 - Employer...........................................5 1.15 - Guaranteed Interest Rate...........................5 1.16 - Normal Form........................................5 1.17 - Period Certain Annuity.............................5 1.18 - Plan...............................................5 1.19 - Processing Office..................................5 1.20 - Retirement Date....................................6 1.21 - Separate Account...................................6 1.22 - Separate Accounts Definitions......................7 1.23 - Substituted Beneficiary............................7 1.24 - Transaction Date...................................7 1.25 - Trust..............................................7 ANNUITY ACCOUNT VALUE Section 2.01 - Contributions......................................7 2.02 - Separate Account Investment Divisions.......................................8 2.03 - Guaranteed Interest Division.......................8 2.04 - Allocation to Divisions............................8 2.05 - Transfers Among Divisions..........................8 2.06 - Termination of this Contract.......................8 2.07 - Partial Withdrawals................................9 2.08 - Charges for Partial Withdrawals........................................9 2.09 - Free Corridor Amount...............................9 2.10 - Annual Administrative Charge......................10 2.11 - Death Benefit.....................................10 ANNUITY BENEFITS Section 3.01 - Fixed Annuity Benefit.............................10 3.02 - Election and Commencement of Annuity Benefits...............................10 3.03 - Amount of Annuity Benefits........................11 3.04 - Payment of Annuity Benefits.......................11 GENERAL PROVISIONS Section 4.01 - Contract..........................................13 4.02 - Statutory Compliance..............................13 4.03 - Nonforfeitability, Nontransferability and Assignments...................................13 4.04 - Beneficiary.......................................14 4.05 - Disqualification..................................14 4.06 - Future Contributions..............................14 4.07 - Deferment.........................................14 4.08 - Annual Notice.....................................14 4.09 - Quarterly Notice..................................14 4.10 - Age...............................................14 4.11 - Right of Employer.................................14 No. 92 PEDB Page 2 OWNER: ABC STATE DEFERRED COMPENSATION PROGRAM ANNUITANT: JOHN DOE CONTRACT NUMBER: 00 000 000 ISSUE DATE: JAN 1, 1992 CONTRACT DATE: JAN 1, 1992 RETIREMENT DATE: JAN 1, 2020 INITIAL GUARANTEED INTEREST RATE: 7.50% TO MAR 31, 1992 MINIMUM GUARANTEED INTEREST RATE: 6:00% TO DEC 31, 1992 3.00% AFTER DEC 31, 1992 BENEFICIARY: JANE DOE FORM NUMBER: 92 PEDB - ------------------------------------------------------------------------------- TABLE OF GUARANTEED VALUES ISSUE AGE 38 MALE $1000 ANNUAL CONTRIBUTION NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY SINCE FIRST CONTRIBUTION CASH VALUE ANNUITY AT AGE 65* - ------------------------ ---------- ------------------ 1 976 6.62 2 1,946 16.20 3 2,944 26.67 4 3,998 36.83 5 5,064 46.70 6 6,220 56.28 7 7,362 65.58 8 8,538 74.61 9 9,841 83.38 10 11,204 91.89 11 12,628 100.16 12 14,117 108.18 13 15,673 115.97 14 17,143 123.53 15 18,658 131.18 16 20,217 138.63 17 21,824 145.90 18 23,478 152.80 19 25,213 159.69 20 26,999 166.03 24 (Age 62) 34,697 189.57 27 (Age 65) 41,098 205.49 THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000 CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE (SEE SECTION 2.10) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE ANNUITY ACCOUNT VALUE (SEE SECTION 1.05). THE TABLES ASSUME THAT 100% OF ALL CONTRIBUTIONS AND EARNINGS ARE ALLOCATED TO AND REMAIN IN THE GUARANTEED INTEREST DIVISION. YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS. THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A SETTLEMENT WILL BE SUBJECT TO A CHARGE (SEE SECTION 3.04). *ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO SURVIVOR) WITH JOINT ANNUITANT THE SAME AGE AS THE ANNUITANT. No. 92 PEDB Page 3 PART I -- DEFINITIONS SECTION 1.01 ANNUITANT. The term "Annuitant" means an individual who participates in a Plan or, if the Plan permits, a beneficiary under the Plan, as shown on Page 3 of this Contract and on whose behalf this Contract has been purchased and is maintained. SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in accordance with the terms of the Plan. SECTION 1.03 ANNUITY ACCOUNT VALUE. The Term "Annuity Account Value" means the sum of the amounts that you have in the Guaranteed Interest Division and the Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by us pursuant to Section 3.04 of this Contract. Various sections of this Contract (Sections 1.17 and 3.01) refer to monthly payments to be made under an Annuity Benefit. You may elect to have the Annuity Benefit paid at other intervals, such as quarterly, semi-annually, or annually, instead of monthly. You may elect this at the time you elect the Annuity Benefit form as described in Section 3.02; in that event, all references in this Contract to monthly payments will be deemed to mean payments at the frequency you elect, subject to our rules at the time of election. SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value less any applicable withdrawal charge determined as follows: The withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the excess of (i) the sum of the Annuity Account Value over (ii) the Free Corridor Amount defined in Section 2.09, and (b) is the excess, if any, of (i) 8% of the total Contributions made on the Annuitant's behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to Section 2.08. The above statements notwithstanding, we reserve the right to modify or waive any early withdrawal charges in order to comply with any applicable state or local requirements. Any such modification or waiver will apply equally to all Annuitants under a Plan subject to such a state or local requirement. However, notwithstanding the above, if the Annuitant is age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. A withdrawal charge will not apply, which means the Cash Value will equal the Annuity Account Value upon any of the following occurrences: (i) the Annuitant's completion of at least five Contract Years and the Annuitant's attainment of age 59 years and 6 months, or (ii) the Annuitant's completion of at least twelve Contract Years, or (iii) a request is made for a refund of a Contribution in excess of the amount that may be contributed under Section 457 of the Code within one month of the date on which the Contribution is made, or (iv) the Annuitant's completion of at least five Contract Years, the Annuitant's attainment of age 55, and the receipt by us of a properly completed settlement election form in order to apply the Annuity Account Value to purchase an Eligible Annuity Certain, defined in Section 1.13, or (v) the Annuitant's completion of at least three Contract Years and the receipt by us of a properly completed settlement election form in order to apply the Annuity Account Value to purchase a Period Certain Annuity, defined in Section 1.17, where the certain period of such annuity is at least ten years, or (vi) the receipt by us of a properly completed settlement election form in order to apply the Annuity Account Value to purchase a Period Certain Annuity, defined in Section 1.16, where the certain period of such annuity is at least 15 years, or No. 92 PEDB Page 4 (vii) the Annuitant dies and a death benefit is payable to the beneficiary. The above statements notwithstanding, after the completion of a period agreed upon by the Employer and us not to exceed five Contract Years from the date as of which an agreement is entered into between the Employer and us ("period") and after the completion of each successive period, any assets of the plan which are currently invested in this Contract will be transferred as soon as administratively practicable to a successor funding agency designated by the Employer unless, not later than 7 days before the date on which a transfer would otherwise occur, the Employer, in accordance with the procedures specified in Section 9003.2 of the Regulations of the Deferred Compensation Board of the State of New York, notifies us to renew that agreement. Such funds will be transferred in a single sum and no early withdrawal charges, surrender charges, market value adjustments or other fees will be applied in connection with such a transfer. We will not be responsible for the validity of any certification made by the Employer. SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all Contracts with a Contract Date in the same calendar year. SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.08 CONTRACT. The term "Contract" means this Contract. SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt by us of both the application for this Contract, properly signed and completed, and a Contribution. SECTION 1.10 CONTRACT YEAR. The term "Contract Year" with respect to you means the twelve month period beginning on (i) the Contract Date, and (ii) each anniversary thereafter, unless otherwise agreed to in writing by us. SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us pursuant to the terms of the Plan to this Contract. We are under no obligation to accept any Contribution less than $20.00. SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or severally as the case may be, the following divisions described in this Contract: (i) the Guaranteed Interest Division, and (ii) the Investment Divisions of the Separate Account. SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means a Period Certain Annuity issued by us which extends beyond the Annuitant's attainment of age 59 years and 6 months and does not permit any prepayment of the unpaid principal (that is, no withdrawal or single sum payment) prior to your attainment of age 59 years and 6 months. SECTION 1.14 EMPLOYER. The term "Employer" means one of the following types of entity which is eligible to adopt, has adopted, and maintains a Plan: (i) a State, a political subdivision of a State, or an agency or instrumentality of a State or political subdivision of a State, or (ii) any other organization (other than a governmental unit) exempt from tax under the Code which has adopted and maintains a Plan for a select group of management or highly compensated employees within the meaning of the Employee Retirement Income Security Act of 1974, as amended. The Employer is the Owner of and beneficiary under this Contract. SECTION 1.15 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means the effective annual rate at which interest accrued on the amount in the Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of this Contract. Section 2.03 describes the determination of the rate to apply thereafter. SECTION 1.16 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under this Contract means a Period Certain Annuity. SECTION 1.17 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by us which does not permit any prepayment of the unpaid principal (that is, you cannot elect to receive part of the payments as a single sum payment with the remainder paid in monthly annuity payments). Any installment payments shall be made over a period which does not exceed your remaining life expectancy. SECTION 1.18 PLAN. The term "Plan" means a program constituting an "Eligible Deferred Compensation Plan" meeting the requirements of Section 457(b) of the Code and applicable Treasury Regulations which is established and maintained by an Employer for the benefit of individuals performing services for the Employer and their beneficiaries. SECTION 1.19 PROCESSING OFFICE. The term "Processing Office" means our Individual Annuity Center, P.O. Box 2996, GPO, New York, New York 10116, or such other location as we shall designate by at advance written notice to the Employer or the Plan's trustee, as applicable. No. 92 PEDB Page 5 SECTION 1.20 RETIREMENT DATE. The term "Retirement Date" means the date on which the Annuitant attains the retirement age as shown on Page 3 of this Contract. Before the Retirement Date the Employer may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be earlier than the Retirement Date provided under the Plan nor shall it be later than the date the Annuitant attains age 70 years and 6 months. Any election for such change must be made in writing by you and shall not take effect until received by us at the Processing Office. SECTION 1.21 SEPARATE ACCOUNT. The term "Separate Account" means Separate Account A which is organized as a unit investment trust, a type of investment company. We established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited to or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts and certificates. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities or life variable insurance. The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to these contracts will not be chargeable with liabilities arising out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to our General Account. The Separate Account consists of "Investment Divisions". Each Investment Division may invest its assets in a separate class (or series) of shares of a designated Trust where each class (or series) represents a separate portfolio in such Trust. We reserve the right to change the designated trust or investment company or to add designated trusts or investment companies. The Investment Divisions available are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. The Guaranteed Interest Division is not part of the Separate Account, but rather is an asset of our General Account. We will value the assets of each Investment Division on each business day. A business day is any day on which we are open, the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio securities in which an Investment Division is invested to materially affect the Accumulation Unit Value. We may, at our discretion, invest the assets of any Investment Division in any investment permitted by applicable law. We may relay conclusively on the opinion of counsel (including attorneys in our employ) as to what investments we are permitted by law to make. We reserve the right to (i) cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such committee at any time; (iii) restrict or eliminate any voting rights as to the Separate Account; (iv) operate the Separate Account by making direct investments, or in any other form; (v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or remove Investment Divisions (or sub-divisions of Investment Divisions) from the Separate Account (the term "Investment Division" in this Contract shall then refer to any other Investment Division in which the assets, of a class of contracts to which this Contract belongs, were placed); (vi) combine any two or more Investment Divisions (or sub-divisions of Investment Divisions) of the Separate Account; and (vii) withdraw from any Investment Division and to allocate to another Investment Division assets determined by us to be associated with the class of contracts to which this Contract belongs. If the exercise of these rights results in a material change in the underlying investments of an Investment Division, you and the Annuitant will be notified of such exercise, as required by law. No. 92 PEDB Page 6 Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for applicable tax charges) at a rate not to exceed 1.49% per year for each of the Stock, Money Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock Division, for financing accounting, death benefits, mortality risk, expenses and expense risk. The charge shall be made i accordance with Subsection (c) of the Net Investment Factor provision in Section 1.22. The relative proportion of these charges may be modified. This daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust, shall not exceed a total annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to this Contract. SECTION 1.22 SEPARATE ACCOUNT DEFINITIONS. VALUATION PERIOD: Each business day together with any preceding consecutive non-business days. NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b), minus (c), where (a) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the Valuation Period before giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period. For this purpose, we use the share value reported to us by the Trust. (b) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the preceding Valuation Period (after taking into account any amounts allocated or withdrawn for that Valuation Period). (c) is the daily Separate Account charge for the expenses of this Contract, times the number of calendar days in the Valuation Period. ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an Investment Division where Contributions made on the Annuitant's behalf are invested and which is used in determining the amount in an Investment Division. ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of each Accumulation Unit in an Investment Division on a given date. The Accumulation Unit Value for a Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for that Investment Division for such Valuation Period. SECTION 1.23 SUBSTITUTED BENEFICIARY. The term "Substituted Beneficiary" refers to the beneficiary designated under the Plan by the Annuitant to receive death benefits payable under the Plan, where the Employer has elected, pursuant to Section 4.04 to designate such person to receive the death benefit payable under Section 2.11. SECTION 1.24 TRANSACTION DATE. The term "Transaction Date" means the business day we received a Contribution or a written contract transaction request providing the information we need at the Processing Office. In the case of a transfer request initiated through the use of a touch tone telephone, as described in Section 2.05, the Transaction Date is the business day the telephone transaction is received. SECTION 1.25 TRUST. The term "Trust" means the designated trust or investment company in which Separate Account assets are invested. - ------------------------------------------------------------------------------- PART II -- ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. You are to make Contributions from time to time on such dates and in such amounts as you determine pursuant to the terms of the Plan. Contributions will be allocated to the Divisions in accordance with the instructions received on the applications, unless later charged. Each Contribution received by us on the Annuitant's behalf will, before its allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. If the Plan permits, we will accept transfers made from another eligible deferred compensation plans meeting the requirements of Section 457 of the Code or other funds invested under the Employer's Plan. No. 92 PEDB Page 7 SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when an amount is allocated to, or withdrawn or transferred from, an Investment Division, the Annuity Account Value will be credited or charged, as the case may be with the number of Accumulation Units determined by dividing said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Sections 2.07, 2.08 or 2.10 or transferred from the Investment Division pursuant to Section 2.05. The amount in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units in the Investment Division on that date and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under the terms of this Contract terminates on the earliest of (i) Election and Commencement of Annuity Benefits pursuant to Section 3.02, (ii) receipt of due proof of the Annuitant's death or (iii) Termination of this Contract pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division becomes part of our general assets which support the guarantees of this Contract and other contracts. The amount in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 or Section 2.10 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Sections 2.07, 2.08 or 2.10 or transferred from the Guaranteed Interest Division pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division on a Transaction Date pursuant to Section 2.04. We will credit the amount you have in the Guaranteed Interest Division with interest at effective annual rates that we determine. For each Class of Contracts we determine a yearly guaranteed interest rate that will remain in effect throughout the next year. We guarantee that this yearly guaranteed interest rate will never be less than 3%. Participation in the Guaranteed Interest Division under the terms of this Contract terminates on the earliest of (i) Election and Commencement of Annuity Benefits pursuant to Section 3.02, (ii) receipt of due proof of the Annuitant's death or (iii) Termination of this Contract pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section 2.01 is allocated (after deduction for any applicable tax charge) to one or more Divisions, at your sole direction as specified to us. Allocation percentages must be in whole numbers and the sum must equal 100. The allocation is made as of the Transaction Date on which we have received both such Contribution and such direction. Contributions made to an Investment Division purchase Accumulation Units in that Investment Division, using the Accumulation Unit Value next computed after the Transaction Date. If your Plan permits, and you provide us with advance written instructions to do so, we will accept allocation instructions directly from the Annuitant. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the Transaction Date with respect to each transfer from the Division pursuant to Section 2.05, (iii) on the Transaction Date with respect to each withdrawal pursuant to Section 2.07, (iv) at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.03, (v) upon termination of this Contract pursuant to Section 2.06 and (vi) upon the Annuitant's death pursuant to Section 2.11. SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request or through the use of a touch tone telephone, transfer all or part of the amount you have in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; and (2) amounts in the Money Market Division may be transferred to other Divisions. Written authorization for touch tone telephone initiated transfers is only required when authorization for telephone transfers is requested. Upon advance written notice to you, we reserve the right to discontinue the acceptance of transfer requests through the use of a touch tone telephone. If your Plan permits, and you provide us with advance written instructions to do so, we will accept transfer instructions directly from the Annuitant. All transfers will be made on the Transaction Date and will be subject to our rules in effect at the time of transfer. With respect to the Investment Divisions, the transfer will be made at the Accumulation Unit Value next computed after the Transaction Date. No transfers are permitted to the Money Market Division from the other Divisions. SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the terms of the Plan, you may elect, by written notice, to terminate this Contract. We will determine the Cash Value under this Contract as of the Transaction Date. If this Contract is terminated, surrendered or exchanged prior to the Annuitant's Retirement Date, any applicable tax charges we have paid may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on terminations, unless a change in applicable law has occurred with respect to this Contract. Cash Value payments may be deferred by us in accordance with the provisions of Section 4.07. No. 92 PEDB Page 8 Subject to the terms of the Plan, we reserve the right to pay the Annuity Account Value under this Contact and terminate this Contract if (i) you make no Contributions on the Annuitant's behalf during the last three completed Contract Years, or (ii) you make a partial withdrawal that would result in the Annuitant's Annuity Account Value falling below $500. We also reserve the right to terminate this Contract if no Contributions have been made within 120 days from the Contract Date shown on Page 3 of this Contract. We will pay the Cash Value or Annuity Account Value, as applicable, directly to you unless you give us written notice at the time of termination that you request us to make payment to the Annuitant or another person, and that such payment is permissible under the Plan. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount in the Divisions under this Contract and the Annuity Account Value with respect to this Contract shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any restrictions under the terms of the Plan, you may elect by written notice to us to make a partial withdrawal from the Divisions. On the Transaction Date, we will pay the lesser of the Cash Value or the amount of partial withdrawal requested to you. The amount paid plus any withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the amounts you have in the Divisions. Unless instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts that you have in such Divisions. We will pay the Cash Value or Annuity Account Value, as applicable, directly to you unless you give us written notice at the time of the withdrawal that you request us to make payment to the Annuitant or another person, and that such payment is permissible under the Plan. Upon any partial withdrawal payment, we will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by us in accordance with the provisions of Section 4.07. We may decline to accept a request for a partial withdrawal of less than $300. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, we will so advise you and reserve the right to pay the Annuity Account Value to you, and terminate this Contract. SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. NO WITHDRAWAL CHARGE FOR PARTIAL WITHDRAWALS: There will be no charge for a partial withdrawal if (a) the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity Account Value, pursuant to Section 1.05. WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than the Free Corridor Amount, we will (i) first withdraw from the Divisions an amount equal to the Free Corridor Amount in proportion to the amount you have in them, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a partial withdrawal charge. Such partial withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the amount withdrawn in excess of the Free Corridor Amount (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the total Contributions made on the your behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to this Section If withdrawals are made from this Contract prior to the Annuitant's Retirement Date, any applicable tax charges we have paid with respect to this Contract may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on withdrawals, unless a change in applicable law has occurred with respect to this Contract. SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means if the Annuitant has completed three Contract Years or attained age 59 years and 6 months an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the current Contract Year. If the Annuitant has not completed three Contract Years or attained age 59 years and 6 months, the Free Corridor Amount is zero. No. 92 PEDB Page 9 SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract Year, if the Annuity Account Value on that date is less than $25,000, we will withdraw from the Divisions an Annual Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account Value including the amount of any withdrawals pursuant to Section 2.07 during that Contract Year. The charge will be allocated among the Divisions in proportion to the amounts you have in the Divisions. If the Annuity Account Value is $25,000 or greater at the end of a Contract Year, the Annual Administrative Charge is zero. If the Annuity Account Value is less than $25,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.02 or (b) the date of termination of this Contract pursuant to Sections 2.06 or 2.11, we will prorate the Annual Administrative Charge applicable to the completed portion of the current Contract Year and withdraw such amount in lieu of the Annual Administrative Charge described in this Section for the applicable part of that Contract Year. SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of the Annuitant's death, we will pay to you as beneficiary in a single sum the amount of the death benefit. You may change the beneficiary or the payment method of the death benefit as permitted by the Plan, pursuant to Section 4.04. The amount of the death benefit is equal to the greater of (i) the Annuity Account Value and (ii) the minimum death benefit. Such minimum death benefit is the sum of all contributions made by you pursuant to Section 2.01 (before reduction for any applicable tax charge) less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount that was withdrawn is to the Annuity Account Value. If, in accordance with the provisions of Section 2.01, the cash value of another annuity contract issued by us or one of our affiliated or subsidiary life insurance companies, which provides for a death benefit before retirement equal to the greater of the contract cash value or an alternate amount based on premiums paid or contributions made under the annuity contract, is transferred to this Contract, such cash value or alternative amount as of the date of transfer will be included in the "sum of all Contributions" in lieu of the amount of cash value transferred for purposes of the death benefit under this Contract. We will pay the death benefit to the beneficiary in the form of an Annuity Benefit if you have made the election described in the last paragraph of Section 4.04. Also in accordance with the last paragraph of Section 4.04, if no such election is in effect at your death, we will pay the death benefit to the beneficiary in a single sum, unless the beneficiary elects, before we pay the death benefit, to apply the death benefit to an Annuity Benefit. Upon payment of the death benefit, the amount you have in the Divisions and the Annuity Account Value under this Contract shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. - ------------------------------------------------------------------------------- PART III -- ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the terms of this Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your Retirement Date, provided the Annuitant is then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless you elect to receive the Cash Value in a single sum, subject to our rules then in effect and any other applicable requirements under the Code. Notice and election forms will be provided to you not more than six months prior to the Retirement Date. (On your prior written request we will also provide notice and election forms directly to the Annuitant). If you elect prior to the Annuitant's Retirement Date to terminate this Contract pursuant to Section 2.06, an election may be made to receive an Annuity Benefit in lieu of the Cash Value. If your Plan permits and you provide us written instructions to do so in advance of payment, we will make payment of the Cash Value, Annuity Benefits or partial withdrawals directly to the Annuitant, Substituted Beneficiary or other payee designated by you. We will have the right to require you to furnish pertinent facts and determinations to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. No. 92 PEDB Page 10 The applicable Annuity Benefit will be provided pursuant to Sections 3.03 and 3.04. SECTION 3.03 AMOUNT OF ANNUITY BENEFITS. If you elect pursuant to the first or third paragraph of Section 3.02 to have paid an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be the Cash Value. The amount applied to provide an Annuity Benefit may be reduced by a charge for any applicable taxes on annuity considerations, as we determine. If we have previously deducted charges for applicable taxes from Contributions as provided in Section 2.01, we will not again deduct charges for the same taxes before application to provide an Annuity Benefit, unless a change in applicable law has occurred with respect to this Contract. The balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) our current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, this Contract will be governed by our supplementary contract then in effect. If an amount is applied to provide an Annuity Benefit the amount to be applied will, in addition to any tax charge reduction, be reduced by an administrative charge. The amount of such charge will be determined from time to time in accordance with our general practices applicable on a uniform basis to all contracts of the same type as this Contract. After the application of an amount to provide an Annuity Benefit the Annuity Account Value shall be zero. The Table of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Account Value will provide under this Contract, as indicated, as a Period Certain Annuity. The amounts of income provided under the Fixed Annuity Benefit payable on the Period Certain Annuity are based on 3.5% interest. We may change the monthly income amounts contained in the Table of Guaranteed Annuity Payments and the basis for determining such amounts, for new Annuitants, by at least 90 days advance notice to the Owner and by an amendment to this Contract. Amounts required for periods certain not shown in the Table will be calculated by us on 3.5% interest. SECTION 3.04 PAYMENT OF ANNUITY BENEFITS. Pursuant to Sections 457(d) and 401(a)(9) of the Code, and subject to the terms of the Plan, the entire interest of the Annuitant will be distributed or begin to be distributed, no later than the first day of April following the calendar year in which the Annuitant attains 70 years and 6 months ("Required Beginning Date"). The entire interest may be distributed, as elected pursuant to the Plan and this Contract, over (a) the life of the Annuitant, or the lives of the Annuitant and a designated beneficiary, or (b) a period certain not extending beyond the Annuitant's life expectancy, or the joint and last survivor life expectancy of the Annuitant and a designated beneficiary. Distributions must be made in periodic payments at intervals of no longer than one year. In addition, payments must be either nonincreasing or they may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the Proposed Treasury Regulations, or any successor Regulation thereto. All distributions made hereunder shall be made in accordance with the requirements of Section 401(a)(9) of the Code, including the incidental death benefit requirements of Section 401 (a)(9)(G) of the Code, and applicable Treasury Regulations, including the minimum distribution incidental benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or any successor Regulation thereto. Notwithstanding the above paragraphs and the following paragraphs of this Section 3.04, while any distribution shall be subject to such requirements of the Code and regulations, any distribution shall also be subject to the terms of this Contract. That is, the forms of distribution shall be those which are made available by us at the time of your election. For purposes of determining the "period certain" referred to in the first paragraph of this Section, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless otherwise elected prior to the time distributions are required to begin, those life expectancies shall be recalculated annually. Such election shall be irrevocable and shall apply to all subsequent years. The life expectancy of a non-spouse beneficiary may not be recalculated. Instead, life expectancy will be calculated using the attained age of such beneficiary during the calendar year in which the Annuitant attains age 70 years and 6 months, and payments for subsequent years shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. If the Annuitant dies after distribution of the interest described in the first paragraph of this Section has begun, the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution being used prior to the Annuitant's death. If the Annuitant dies after distribution of the interest described in the first paragraph of this Section begins, distribution of the entire interest shall be completed no later than December 31 of the calendar year containing the fifth anniversary of the Annuitant's death, except to the extent that an election is made to receive death benefit distributions in accordance with (1) or (2) below: (1) If the Annuitant's interest is payable to a designated beneficiary, then the entire interest may be distributed over a period certain not greater than the life expectancy of the designated beneficiary. Such distributions must commence on or before December 31 of the calendar year immediately following the calendar year of the Annuitant's death. If the designated beneficiary is not the Annuitant's surviving spouse a Period Certain Annuity Benefit cannot exceed 15 years, (even if life expectancy is greater than 15 years). No. 92 PEDB Page 11 (2) If the designated beneficiary is the Annuitant's surviving spouse, the date distributions that are required to begin in accordance with (1) above shall not be earlier than the later of (A) December 31 of the calendar year immediately following the calendar year of the Annuitant's death or (B) December 31 of the calendar year in which the Annuitant would have attained age 70 years and 6 months. For purposes of determining the "period certain" referred to in the immediately preceding paragraph, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of distributions beginning after the Annuitant's death, unless otherwise elected by the surviving spouse by the time distributions are required to begin, life expectancies shall be recalculated annually. Such election shall be irrevocable by the surviving spouse and shall apply to all subsequent years. In the case of any other designated beneficiary, life expectancies shall be calculated using the attained age of such beneficiary during the calendar year in which distributions are required to begin pursuant to this Section, and payments for any subsequent calendar year shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. Distributions under this Section are considered to have begun if distributions are made because the Required Beginning Date was reached, or, if prior to the Required Beginning Date, distributions irrevocably commence to an individual over a period permitted and in an annuity form acceptable under Section 1.401(a)(9) of the Proposed Treasury Regulations or any successor Regulation thereto. Evidence of each payee's survival must be furnished to us either by personal endorsement of the check drawn for payment or by other means satisfactory to us. If a benefit payment under this Contract was based on information that is subsequently found to be incorrect, the benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by us will be charged against and underpayments will be added to any payments thereafter falling due under this Contract with respect to the payee, affecting as many such payments as are necessary to correct the overpayment or underpayment. Our liability, with respect to a payee, is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under this Contract. If we receive evidence satisfactory to us that (i) a payee entitled to receive any payment under this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, we may make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. Pursuant to Section 3.02, upon the election of a Period Certain Annuity, you (or the Annuitant, if you have advised us in writing that it is permitted under the terms of the Plan) may designate (with the right to change such designation) a payee to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. Subject to the terms of the Plan, the payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's estate in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, we will pay in a single sum to such payee's estate the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.02. No. 92 PEDB Page 12 TABLE OF GUARANTEED ANNUITY PAYMENTS FIXED ANNUITY BENEFIT PAYABLE ON THE PERIOD CERTAIN ANNUITY (Minimum Monthly Income per $1,000 of Annuity Account Value) PERIOD CERTAIN PERIOD CERTAIN MONTHLY INCOME (IN YEARS) MONTHLY INCOME (IN YEARS) - ---------------------------------------------------------------------------- 1 $84.65 11 $ 9.09 2 $43.06 12 $ 8.46 3 $29.19 13 $ 7.94 4 $22.27 14 $ 7.49 5 $18.12 15 $ 7.10 6 $15.35 16 $ 6.76 7 $13.38 17 $ 6.47 8 $11.90 18 $ 6.20 9 $10.75 19 $ 5.97 10 $ 9.83 20 $ 5.75 - ---------------------------------------------------------------------------- Any election, change, revocation, or designation shall be made, and will take effect, on the Transaction Date, in the same manner as a change of beneficiary as described in Section 4.04. If a commutation right under an Annuity Benefit is exercised, we may defer payment in accordance with Section 4.07. - ------------------------------------------------------------------------------- PART IV -- GENERAL PROVISIONS SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the parties and the terms of this Contract alone will govern with respect to our rights and obligations. A copy of the application is incorporated in and made part of this Contract. This Contract may not be modified, nor may any of our rights or requirements be waived, except in writing and by our authorized officer. The terms of this Contract may be changed by amendment or replacement upon agreement between you and us without the consent of any other person. This Contract is subject to the rules and regulations of the Deferred Compensation Board of the State of New York, and said rules and regulations are made a part thereof. SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform this Contract to reflect changes in the Code, applicable Treasury Regulations, or in regulations or published rulings of the Internal Revenue Service so that this Contract will continue to be an Annuity under a qualified plan. SECTION 4.03 NONFORFEITABILITY, NONTRANSFERABILITY AND ASSIGNMENTS. The entire interest under this Contract is nonforfeitable except by surrender to us. Any interest under the terms of this Contract may not be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than us. No amount payable under the terms of this Contract may be assigned or commuted, unless specifically provided for under the terms of this Contract, or encumbered by the payee, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. No. 92 PEDB Page 13 SECTION 4.04 BENEFICIARY. You, as beneficiary, are entitled to receive any death benefit payable under this Contract pursuant to Section 2.11. Upon the Annuitant's death you may, by written request to our Processing Office, at any time up to and including provision of due proof of such death, change the beneficiary designation for the Section 2.11 death benefit from you to the Substitute Beneficiary. Subject to the terms of the Plan, the Substitute Beneficiary may elect to receive the death benefit payable under Section 2.11 in the form of an Annuity Benefit rather than as a single sum. Any such election must meet the minimum distribution rules of Sections 457(d) and 401(a)(9) of the Code and applicable Treasury Regulations, as described in Section 3.05. SECTION 4.05 DISQUALIFICATION OF PLAN OR CONTRACT. In the event that the Plan fails to qualify as an Eligible Deferred Compensation Plan under Section 457 of the Code and applicable Treasury Regulations, we reserve the right, upon receiving notice of such fact, to transfer the Annuity Account Value under this Contract to another annuity contract issued by us or one of our affiliated or subsidiary life insurance companies on the life of the Annuitant, or to terminate this Contract and pay to you the Annuity Account Value less a deduction for applicable taxes, solely at our option. In the event that this Contract fails to qualify as an Annuity as described in Section 1.02, we will have the right, upon receiving notice of such fact, to terminate this Contract and pay to you the Annuity Account Value less a deduction for the appropriate part attributable to you of any income tax payable by you which would not have been payable if you had an Annuity. SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to you, we reserve the right to limit Contributions under this Contract if required by law. SECTION 4.07 DEFERMENT. Payment of death benefit and payment of any portion of the Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange has been closed or trading on it is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Securities and Exchange Commission, by order, permits us to defer payments in order to protect persons with interests in the Investment Divisions. We can defer payment of any portion of the Annuity Account Value in the Guaranteed Interest Division for up to six months while the Annuitant is living. SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year, we will furnish you with a notice showing the following: (1) the amount in the Guaranteed Interest Division, (2) the total number of Accumulation Units in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Value, (4) the amount in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the Cash Value, and (6) the amount of death benefit payable with respect to the Annuitant. We will also furnish annual calendar year reports concerning the status of the annuity and any other reports required by the Code or applicable Treasury Regulations. SECTION 4.09 QUARTERLY NOTICE. At least once during each calendar quarter up to and including the Retirement Date, we will furnish you with a notice showing the Annuity Account Value in the Guaranteed Interest Division, Stock Division, Aggressive Stock Division and Money Market Division. SECTION 4.01 AGE. If the Annuitant's age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by us will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. SECTION 4.11 OWNERSHIP RIGHT TO EMPLOYER. Notwithstanding any other provision of the terms of this Contract, until amounts under this Contract are distributed or made available to the Annuitant or the Annuitant's beneficiary in accordance with the terms of this Contract and the terms of the Plan, this Contract remains solely the property of the Employer subject only to claims of the Employer's general creditors. This Section shall be construed and administered in accordance with Section 457(b)(6) of the Code and the regulations thereunder. No. 92 PEDB Page 14 - -------------------------------------------------------------------------------- APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES PROCESSING OFFICE: INDIVIDUAL ANNUITY CENTER, P.O. BOX 2996, NEW YORK, NEW YORK 10116-2996 QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR: EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY - -------------------------------------------------------------------------------- TYPE OF PURCHASE (Complete One Plan Only) A. |_| TSA PUBLIC SCHOOL (GV-PS-I) B. |_| TSA 501(C)(3) ORGANIZATION (GV-501-I) C. |_| TSA University (GV-PS-U-I) D. |_| IRA Individual (Including IRA to IRA transfers) (GV-IRA 4971) E. |_| IRA Unit Billed (Including IRA to IRA transfers) (GV-IRA 4971) F. |_| IRA QUALIFIED PLAN ROLLOVER-- (QP IRA) (Distribution from a Qualified Plan) (GV-IRA 4971-71) G. |X| EDC (Public Employee Deferred Compensation) (GV-EDC 4991) H. |_| EDC (Tax Exempt Organization) (GV-EDC 4991-SU-080) I. |_| SEP (Simplified Employee Pension) (GV-SEP 4981) J. |_| SARSEP (Salary Reduction SEP) _________________________________________ K. |_| CORPORATE TRUSTEED (GV-CORP 4941-41) L. |_| KEOGH/HR-10 TRUSTEE (GV HR-10 4911-11) (trustee owned) M. | | KEOGH/HR-10 (GV-HR-10 4911) (not trustee owned) (issued to existing units only) - -------------------------------------------------------------------------------- DO NOT COMPLETE THIS SECTION IF 1.D OR 1.F CHECKED ABOVE 2. EMPLOYER/PLAN NAME |A|B|C|_|C|O|M|P|A|N|Y|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| 3. |_| EXISTING UNIT NO. |_|_|_|_|_|_|-|_|_|_| |_| NEW UNIT | | | | | | |-| | | | (FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP, OR TRUSTEED PLANS. FORM 983-135B IS REQUIRED) - -------------------------------------------------------------------------------- 4. PROPOSED ANNUITANT Print name to appear on Contract. |J|O|H|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|D|O|E|_|_|_|_|_| FIRST MIDDLE INITIAL LAST A. |X| MR. |_| MRS. |_| MS. |_| OTHER ____ B. Date of Birth: Year 1954 Month JANUARY Day 27 ---- ------- -- C. Age at Nearest Birthday: 38 D. |X| Male |_| Female ---- E. Annuitant's Mailing Address: F. State of Residence: N.J. ---- No., St. |1|7|_|E|L|M|_|S|T|R|E|E|T|_|_|_|_|_|_|_|_|_|_|_|_| City |A|N|Y|T|O|W|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1| G. Telephone Number (101) 222 - 3456 |X| Home |_| Work H. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9| I. Are you associated with or employed by a member of National Association of Securities Dealers, Inc.(NASD)? |_| Yes |X| No 5. OWNER (Print Name) -- If Trusteed or EDC Plan Print Name of Owner, for all other Markets Print Name of Annuitant. JOHN DOE ----------------------------------------------------------------------------- a. Title ____________________________________________________________________ 6. RETIREMENT AGE 65 --------------------------------------------------------------- 7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death Benefit upon Annuitant's death before Retirement Date.) (BENEFICIARY MUST BE THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS.) ABC STATE DEFERRED COMPENSATION PROGRAM - EMPLOYER ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- 8. CONTRIBUTION ALLOCATION Guaranteed Interest Division % ----- Stock Division % ----- Money Market Division % ----- Balanced Division % ----- Aggressive Stock Division % ----- (PERCENTAGES IN WHOLE NUMBERS) Total 100% 9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F) A. Reminder Notice (Billing) Required |_| Yes | | No IF YES, COMPLETE B-C-D-E B. REMINDER DATE Required for Individual IRA or otherwise must agree with existing unit or attached 983-135B. MONTH _________ DAY __________ C. REMINDER FREQUENCY |_| Annual |_| Semi-Annual |_| Quarterly |_| Monthly Available for TSA, EDC, SARSEP AND CORPORATE TRUSTEED AND UNIT BILLED IRA ONLY: |_| Semi-Monthly |_| Bi-Weekly D. REMINDER AMOUNT $_________________________________ E. BILLING MONTHS TO BE EXCLUDED - TSA ONLY ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- 10.EXPECTED FIRST CONTRACT YEAR Contribution. $1000 ---------------------------------------------------------------- IF AN ADVANCED BILLING AND/OR CONTRACT DATE ARE REQUESTED, COMPLETE #9B AND #12. - -------------------------------------------------------------------------------- (FOR PROCESSING OFFICE USE) Unit Name ___________________________ Reminder Date ___________________________ Cert. or App# _______________________ Amendment Required_______________________ EDC Emp. Add. _______________________ Emp. Fed. ID# ___________________________ Frequency ___________________________ Contract Date ___________________________ - -------------------------------------------------------------------------------- Receipt Date Batch # Inquiry # Processor - -------------------------------------------------------------------------------- 180-1000 - -------------------------------------------------------------------------------- 10. Did you receive the Separate Account Prospectus? |X| Yes |_| No Date shown on Prospectus January 1, 1992 ---------------------------------------------------- Date of any supplement to Prospectus _______________________________________ 11. Items (a) through (f) are to be answered by the annuitant. We are required by the NASD to ask these questions. (a) Name of Employer: ABC Company ------------------------------------------------------ (b) Address of Employer: 10 Main Street --------------------------------------------------------------------------- Anytown, NJ --------------------------------------------------------------------------- (c) Occupation Sales ------------------------------------------------------------- (d) Assuming the contract applied for will be issued, will any existing insurance or annuity be replaced or changed (or has it been)? | | Yes |X| No (e) Estimated Family Annual Income $100,000 ---------------------------------------- (f) Estimated Net Worth $250,000 ----------------------------------------------------- (g) Investment Objective: |_| Income |X| Income & Growth |_| Aggressive Growth |_| Growth |_| Safety of Principal 12. SPECIAL INSTRUCTIONS ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- 13. Amount paid with this form: $1000 (If a check is submitted with this request, no advanced Contract Date is permitted.) BACKDATING IS NOT PERMITTED. NOTE: Amount paid will be credited upon receipt at Equitable's Processing Office, subject to return if the certificate is not issued. The Contract Date will be the date of receipt by Equitable of this application, properly signed and completed, and Contribution at Equitable's Processing Office. - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- AGREEMENT All information and statements furnished in this application are true and complete to the best of my knowledge and belief. I understand and acknowledge that no Agent has the authority to make or modify any contract on Equitable's behalf, or to waive or alter any of Equitable's rights and regulations. IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT. UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S) OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND COMPLETE. - -------------------------------------------------------------------------------- LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR ANNUITY APPLICATION WITH INFORMATION YOU KNOW IS FALSE OR TO LEAVE OUT MATERIAL FACTS. - -------------------------------------------------------------------------------- X__________________________________ Date_______ City __________ State __________ Signature of Annuitant X__________________________________ Date_______ City __________ State __________ Signature of Authorized Individual (REQUIRED FOR EDC AND TRUSTEED) OR OWNER - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- AGENT'S SECTION Will any existing insurance or annuity be replaced or changed (or has it been), assuming the Contract will be issued? | | Yes | | No |_| I (we) certify that a prospectus for the Contract has been given to the proposed Annuitant and that no written sales materials other than those approved by Equitable have been used. EQUI-VEST issues must adequately reflect the commission interest of all Agents on previous contracts. - -------------------------------------------------------------------------------- Print Agent's Name(s) Initial of Agent Agent Agency District Agent's (Service Agent first) Last Name Number % Code Manager Code Signature - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS___ Date ___ District EQS ___ Date ____ - -------------------------------------------------------------------------------- (FOR ASU USE) ASU Code and App. No. __________________________________________________________ ASU Rec'd. _____________________________________________________________________ Date to Proc. Off. ________________________________________________ Campaign |_| Agent(s) shown above is Equity Qualified and is licensed in the state where the request is signed. Above Agent information verified by ASM (Registered Rep) - -------------------------------------------------------------------------------- Application reviewed by ________________________________________________________ - -------------------------------------------------------------------------------- 180-1000 OWNER: JOHN DOE ANNUITANT: JOHN DOE CONTRACT NUMBER: 00 000 000 ISSUE DATE: FEB 28, 1992 CONTRACT DATE: FEB 28, 1992 RETIREMENT DATE: JAN 1, 2020 THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York, New York 10116 AGREES o TO ALLOCATE the Contributions made to this Contract, after deduction of any applicable tax charge, to the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division (referred to in this Contract as the "Investment Divisions") or to the Guaranteed Interest Division, in accordance with Sections 2.02, 2.03, and 2.04 as directed by you, and o TO APPLY the Annuity Account Value at the Retirement Date to provide the Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant is then living, and o TO PROVIDE the Annuitant with the other rights and benefits of this Contract. This is the entire Contract. In this Contract "we", "our", and "us" mean The Equitable Life Assurance Society of the United States ("Equitable"). "You" and "your" mean the Annuitant at the time a right is exercised by the Annuitant. TEN DAYS TO EXAMINE CONTRACT - You may cancel this Contract by returning it to us within ten days after receipt of it. Upon such cancellation, we will refund any Contribution made to us under this Contract. /s/ Molly K. Heines /s/ Richard H. Jenrette Vice President and Secretary Chairman of the Board and Chief Executive Officer THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.22 IS 5% OR 3.5%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE TRUST. No. 92 QPIA The Contract is issued in consideration of the payment to us of the Contributions made under the terms of the Contract. The provisions on the following pages are part of this Contract. A copy of the application is incorporated in and made part of this Contract. - -------------------------------------------------------------------------------- TABLE OF CONTENTS DEFINITIONS Page SECTION 1.01 - Annuitant.........................................4 1.02 - Annuity...........................................4 1.03 - Annuity Account Value.............................4 1.04 - Annuity Benefit...................................4 1.05 - Cash Value........................................4 1.06 - Class of Contracts................................4 1.07 - Code..............................................4 1.08 - Contract..........................................4 1.09 - Contract Date.....................................4 1.10 - Contract Year.....................................4 1.11 - Contribution......................................4 1.12 - Divisions.........................................5 1.13 - Eligible Annuity Certain..........................5 1.14 - Guaranteed Interest Rate..........................5 1.15 - Joint and Survivor Life Annuity Form......................................5 1.16 - Life Annuity Form.................................5 1.17 - Normal Form.......................................5 1.18 - Period Certain Annuity............................5 1.19 - Processing Office.................................5 1.20 - Retirement Date...................................5 1.21 - Separate Account..................................5 1.22 - Separate Account Definitions......................6 1.23 - Transaction Date..................................6 1.24 - Trust.............................................7 ANNUITY ACCOUNT VALUE SECTION 2.01 - Contributions.....................................7 2.02 - Separate Account Investment Divisions.........................................7 2.03 - Guaranteed Interest Division......................7 2.04 - Allocation to Divisions...........................7 2.05 - Transfers Among Divisions.........................7 2.06 - Termination of this Contract......................8 2.07 - Partial Withdrawals...............................8 2.08 - Charges for Partial Withdrawals...................8 2.09 - Free Corridor Amount..............................8 2.10 - Annual Administrative Charge......................8 2.11 - Death Benefit.....................................9 ANNUITY BENEFITS SECTION 3.01 - Fixed Annuity Benefit.............................9 3.02 - Variable Annuity Benefit..........................9 3.03 - Election and Commencement of Annuity Benefits...............................9 3.04 - Amount of Annuity Benefits.......................10 3.05 - Payment of Annuity Benefits......................10 GENERAL PROVISIONS SECTION 4.01 - Contract.........................................12 4.02 - Statutory Compliance.............................12 4.03 - Nonforfeitability Nontransferability, and Assignments..................................12 4.04 - Beneficiary......................................12 4.05 - Disqualification.................................13 4.06 - Future Contributions.............................13 4.07 - Deferment........................................13 4.08 - Annual Notice....................................13 4.09 - Age and Sex......................................13 No. 92 QPIA Page 2 OWNER: JOHN DOE ANNUITANT: JOHN DOE CONTRACT NUMBER: 00 000 000 ISSUE DATE: FEB 28, 1992 CONTRACT DATE: FEB 28, 1992 RETIREMENT DATE: JAN 1, 2020 INITIAL GUARANTEED INTEREST RATE: 7.50% TO MAR 31, 1992 MINIMUM GUARANTEED INTEREST RATE: 6.00% TO DEC 31, 1992 3.00% AFTER DEC 31, 1992 BENEFICIARY: JANE DOE FORM NUMBER: 92QPIA ******************************************************************************** TABLE OF GUARANTEED VALUES ISSUE AGE 38 MALE $1000 ANNUAL CONTRIBUTION NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY SINCE FIRST CONTRIBUTION CASH VALUE ANNUITY AT AGE 65 - ------------------------ ---------- ----------------- 1 983 6.61 2 1,958 16.17 3 2,963 26.62 4 3,998 36.76 5 5,064 46.61 6 6,220 56.96 7 7,362 67.37 8 8,538 77.25 9 9,870 86.97 10 11,263 95.47 11 12,719 103.72 12 14,242 111.73 13 15,832 119.50 14 17,337 127.05 15 18,887 134.38 16 20,484 141.49 17 22,129 148.40 18 23,822 155.10 19 25,567 161.61 20 27,364 167.94 24 (Age 62) 35,108 191.43 27 (Age 65) 41,547 207.32 THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000 CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE (SEE SECTION 2.10) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE ANNUITY ACCOUNT VALUE (SEE SECTION 1.05). THE TABLES ASSUME THAT 100% OF ALL CONTRIBUTIONS AND EARNINGS ARE ALLOCATED TO AND REMAIN IN THE GUARANTEED INTEREST DIVISION. YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS. THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A SETTLEMENT WILL BE SUBJECT TO A CHARGE (SEE SECTION 3.04). *ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO SURVIVOR) WITH JOINT ANNUITANT THE SAME AGE AS THE ANNUITANT. No. 92QPIA Page 3 - -------------------------------------------------------------------------------- PART I--DEFINITIONS SECTION 1.01 ANNUITANT. The term "Annuitant" means the person who owns this Contract as shown on page 3 and who exercised all rights under the terms of this Contract. SECTION 1.02 ANNUITY. The term "Annuity" means an individual retirement annuity contract meeting the requirements of Section 408(b) of the Code. SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts that you have in the Guaranteed Interest Division and the Investment Divisions of the Separate Account, pursuant to Sections 2.02 and 2.03. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Section 3.04 of this Contract. Various sections of this Contract (Sections 1.15, 1.16, 3.01, and 3.02) refer to monthly payments to be made under an Annuity Benefit. You may wish to have the Annuity Benefit paid at other intervals, such as quarterly, semi-annually, or annually, instead of monthly. You may elect this at the time you elect the Annuity Benefit form as described in Section 3.03; in that event, all references in this Contract to monthly payments will be deemed to mean payments at the frequency you elect, subject to our rules at the time of election. SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value less any applicable withdrawal charge determined as follows: The withdrawal charge equals the lesser of (a) or (b) where (a) equals 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the excess of (i) the sum of the Annuity Account Value over (ii) the Free Corridor Amount defined in Section 2.09, and (b) is the excess, if any, of (i) 8% of the total Contributions made during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior charges for partial withdrawals made pursuant to Section 2.08. However, notwithstanding the above, if you are age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. A withdrawal charge will not apply, which means the Cash Value will equal the Annuity Account Value upon any of the following occurrences: (i) your attainment of age 59 years and 6 months and your completion of at least five Contract Years, or (ii) a request is made for a refund of a contribution in excess of amounts allowed to be contributed under Section 408 of the Code within one month of the date on which the contribution is made, or (iii) you die and a distribution is made to the beneficiary, or (iv) your attainment of age 55, your completion of at least five Contract Years and you use the amount withdrawn to purchase from us an Eligible Annuity Certain, or (v) your completion of at least three Contract Years and you use the amount withdrawn to purchase from us a Period Certain Annuity of at least 10 years, or (vi) your Annuity Account Value is applied to the election of a Life Annuity Form or Joint and Survivor Life Annuity Form distribution option, or (vii) your completion of at least twelve Contract Years. SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all Contracts with a Contract Date in the same calendar year. SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.08 CONTRACT. The term "Contract" means this Contract, which requires amounts contributed from rollovers of qualified plan distributions hereunder to be applied to the purchase of an individual retirement annuity within the meaning of Section 408(b) of the Code. SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt by us of both an application for this Contract, properly signed and completed, and a Contribution. SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month period beginning on (i) the Contract Date, and (ii) each anniversary thereafter, unless otherwise agreed to in writing by us. SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made in cash or by check to us with respect to this Contract. We are under no obligation to accept any Contribution less than $1,000. No. 92 QPIA Page 4 Such contributions must qualify as "rollover amounts" within the meaning of Section 402(a)(5) or 403(b)(8) of the Code or "rollover contributions" from a "conduit" individual retirement account or annuity described in Section 408(d)(3)(A)(ii) and (iii) of the Code, as the case may be. SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or severally as the case may be, the following Divisions described in this Contract: (a) the Guaranteed Interest Division, and (b) the Investment Divisions of the Separate Account. SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by us, which extends beyond your attainment of age 59 years and 6 months and does not permit any prepayment of the unpaid principal (that is no withdrawal or single sum payment) prior to your attainment of age 59 years and 6 months. SECTION 1.14 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in the Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of this Contract. Section 2.03 describes the determination of the rate to apply thereafter. SECTION 1.15 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose life such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by you. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.16 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity issued by us providing monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.17 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under this Contact means, (i) if you have a living spouse at your Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with your spouse as the contingent annuitant (with 100% of the monthly payment amount continued to your spouse), and (ii) if you do not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.18 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by us which does not permit any prepayment of the unpaid principal (that is, you cannot elect to receive part of the payments as a single sum payment with the remainder paid in monthly annuity payments). SECTION 1.19 PROCESSING OFFICE. The term "Processing Office" means our Individual Annuity Center, P.O. Box 2996, GPO, New York, New York 10116, or such other location as we shall designate by advance written notice to you. SECTION 1.20 RETIREMENT DATE. The term "Retirement Date" means the date on which you attain your retirement age as shown on page 3 of this Contract. Before the Retirement Date you may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be earlier than the day you attain age 59 and 6 months nor shall be later than the first day of April following the calendar year in which you attain age 70 and 6 months. Any election for such change must be made in writing by you and shall not take effect until received by us at our Processing Office. SECTION 1.21 SEPARATE ACCOUNT. The term "Separate Account" means Separate Account A, which is organized as a unit investment trust, (a type of investment company). We established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited to or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities and variable life insurance. The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to these Contracts will not be chargeable with liabilities arising out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to our General Account. The Separate Account consists of "Investment Divisions". Each Investment Division may invest its assets in a separate class (or series) of shares of a designated Trust where each class (or series) represents a separate portfolio in the Trust. We reserve the right to change the designated Trust or to add designated trusts or investment companies. The Investment Divisions available are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. The Guaranteed Interest Division is not part of the Separate Account rather is an asset of our General Account. We will value the assets of each Investment Division on each business day. A business day is any day on which Equitable is open, the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio securities in which an Investment Division is invested to materially affect the Accumulation Unit Value. NO. 92 QPIA Page 5 We may, at our discretion, invest the assets of any Investment Division in any investment permitted by applicable law. We may rely conclusively on the opinion of counsel (including attorneys in our employ) as to what investments it is permitted by law to make. We reserve the right to (i) cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such a committee at any time; (iii) restrict or eliminate any voting rights as to the Separate Account; (iv) operate the Separate Account by making direct investments, or in any other form; (v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or remove Investment Divisions (or sub-divisions of Investment Divisions) from the Separate Account (the term "Investment Division" in this Contract shall then refer to any other Investment Division in which the assets of a class of Contracts to which this Contract belongs, were placed); (vi) combine any two or more Investment Divisions (or sub-divisions of Investment Divisions) of the Separate Account; and (vii) withdraw from any Investment Division and to allocate to another Investment Division assets determined by us to be associated with the class of Contracts to which this Contract belongs. If the exercise of these rights results in a material change in the underlying investments of an Investment Division, you will be notified of such exercise, as required by law. Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for any applicable tax charge) at a rate not to exceed 1.49% per year for each of the Stock, Money Market and Balanced Divisions, and 1.34% per year, for the Aggressive Stock Division, for financial accounting, death benefits, mortality risk, expenses and expense risks. The charge shall be made in accordance with Subsection (c) of the Net Investment Factor provision in Section 1.22. The relative proportion of these charges may be modified. This daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust, shall not exceed a total annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to this Contract. The maximum rate may not be altered without your approval. SECTION 1.22 SEPARATE ACCOUNT DEFINITIONS. VALUATION PERIOD: Each business day together with any preceding consecutive non-business days. NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b), minus (c), where (a) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the Valuation Period before giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period. For this purpose, we use the share value reported to us by the Trust. (b) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the preceding Valuation Period (after taking into account any amounts allocated or withdrawn for that Valuation Period). (c) is the daily asset charge for the expenses of this Contract, times the number of calendar days in the Valuation Period. ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an Investment Division where your Contributions are invested and which is used in determining the amount you have in an Investment Division. ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of each Accumulation Unit in an Investment Division on a given date. The Accumulation Unit Value for a Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for that Investment Division for such Valuation Period. ANNUITY UNIT: The term "Annuity Unit" is a unit used in determining amounts payable from the Stock Division of the Separate Account under a Variable Annuity Benefit as defined in Section 3.02. ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1, 1968. On August 27, 1981, the date the first Contribution was put into the Stock Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods ending in No. 92 QPIA Page 6 such month. SECTION 1.23 TRANSACTION DATE. The term "Transaction Date" means the business day we receive a Contribution or a written contract transaction request providing the information we need at the Processing Office. In the case of a transfer request initiated through the use of a touch tone telephone as described in Section 2.05, the term "Transaction Date" means the business day the telephone transaction is received. SECTION 1.24 TRUST. The term "Trust" means the designated trust or investment company in which Separate Account assets are invested. - -------------------------------------------------------------------------------- PART II -- ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. Contributions under the Contract are Contributions which qualify as "rollover amounts" within the meaning of Section 402(a)(5) or 403(b)(8) of the Code, or "rollover contributions" from a "conduit" individual retirement account or annuity described in Section 408(d)(3)(A)(ii) and (iii) of the Code, as the case may be. Each Contribution received by us will, before its allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. Pursuant to Section 2.06, if no tax has been deducted or if such tax is due at termination of this Contract, we will deduct the amount due. Contributions will be allocated to the Divisions in accordance with the instructions received on your application, unless later changed. SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when an amount is allocated to or withdrawn or transferred from an Investment Division, you will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units you have in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Sections 2.07 or 208 or transferred from the Investment Division pursuant to Section 2.05. The amount in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units in the Investment Division on that date and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under the terms of this Contract terminates on the earliest of (i) your election and commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii) termination of this Contract pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division becomes part of our general assets, which support the guarantees of this Contract and other contracts. The amount in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts, that have been withdrawn from the Guaranteed Interest Division pursuant to Sections 2.07, 208 or 2.10 or transferred from the Guaranteed Interest Division, pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division on a Transaction Date, pursuant to Section 2.04. We will credit the amount you have in the Guaranteed Interest Division with interest at effective annual rates that we determine. For each Class of Contracts, we determine a yearly guaranteed interest rate that will remain in effect throughout the next year. We guarantee that this yearly guaranteed interest rate will never be less than 3%. Participation in the Guaranteed Interest Division under this Contract terminates on the earliest of (i) your election and commencement of annuity benefits pursuant to Section 3.03, (ii) receipt of due proof of your death or (iii) Termination of this Contract pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section 2.01 is allocated (after deduction of any applicable tax charge) to one or more Divisions, at your sole direction as specified to us. Allocation percentages must be in whole numbers and the sum must equal 100. The allocation is made as of the Transaction Date on which we have received both such Contribution and such direction. Contributions made to an Investment Division purchase Accumulation Units in that Investment Division, using the Accumulation Unit Value next computed after the Transaction Date. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the Transaction Date with respect to each transfer from the Division pursuant to Section 2.05, (iii) on the Transaction Date with respect to each withdrawal pursuant to Section 2.07, (iv) at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, (v) upon termination of this Contract pursuant to Section 2.06, and (vi) upon your death pursuant to Section 2.11. SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request, or through the use of a touch tone telephone, transfer all or part of the amount you have No. 92 QPIA Page 7 in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; and (2) amounts in the Money Market Division may be transferred to other Divisions. Written authorization for touch tone telephone initiated transfers is only required when authorization for telephone transfers is requested. Upon advance written notice to you, we reserve the right to discontinue the acceptance of transfer requests through the use of a touch tone telephone. All transfers will be effective on the Transaction Date and will be subject to our rules in effect at the time of transfer. With respect to the Investment Division, the transfer will be made at the Accumulation Unit Value next computed after the Transaction Date. No transfers are permitted to the Money Market Division from the other Divisions. SECTION 2.06 TERMINATION OF THIS CONTRACT. You may elect by written notice to terminate this Contract. We will determine the Cash Value as of the Transaction Date we receive your written election. If this Contract is terminated, surrendered or exchanged prior to your Retirement Date, any applicable tax charges we have paid may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on terminations, unless a change in applicable law has occurred with respect to your Contract. The payment of such Cash Value may be deferred by us in accordance with the provisions of Sections 4.07. We reserve the right to pay the Annuity Account Value under the Contract and terminate this Contract. This right may be exercised if (i) no Contributions are made on your behalf during the last three completed Contract Years and the Annuity Account Value is less than $500, or (ii) a partial withdrawal is made that would result in your Annuity Account Value falling below $500. We also reserve the right to terminate this Contract if no Contributions have been made within 120 months of the Contract Date shown on page 3 of this Contract. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount you have in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.07 PARTIAL WITHDRAWALS. You may elect, by written notice to us, to make a partial withdrawal from the Divisions. On the Transaction Date, we will pay the lesser of the Cash Value or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by you. The amount paid plus any withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the amounts you have in the Divisions. Unless we are instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts that you have in such Divisions. Upon any partial withdrawal payment, we will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by us in accordance with the provisions of Section 4.07. We may decline to accept a request for a partial withdrawal of less than $300. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, we will so advise you and reserve the right to pay the Annuity Account Value to you, and terminate this Contract. SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity Account Value, pursuant to Section 1.05. WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than the Free Corridor Amount, we will (i) first withdraw from the Divisions an amount equal to the Free Corridor Amount, in proportion in the amount you have in them, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a partial withdrawal charge. Such partial withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the amount withdrawn in excess of the Free Corridor Amount (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the total Contributions made on your behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to this Section. However, notwithstanding the above, if you are age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. If withdrawals are made from this Contract prior to the Retirement Date, any applicable tax charges we have paid with respect to this Contract may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on withdrawals, unless a change in applicable law has occurred with respect to your Contract. No. 92 QPIA Page 8 SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means (i) 10% of the sum of the Annuity Account Value on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the Current Contract Year. SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract Year, if the Annuity Account Value on that date is less than $10,000, we will withdraw from the Divisions an Annual Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account Value, including the amount of any withdrawals pursuant to Section 2.07 during that Contract Year. The charge will be allocated among the Divisions in proportion to the amounts you have in the Divisions. If the Annuity Account Value is less than $10,000, on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03, or (b) the date of Termination of this Contract pursuant to Section 2.06 or 2.11, we will prorate the Annual Administrative Charge applicable to the completed portion of the Current Contract Year and withdraw such amount in lieu of the Annual Administrative Charge applicable to the completed portion of the Current Contract Year and withdraw such amount in lieu of the full Annual Administrative Charge described in this Section for the applicable part of that Contract Year. If the Annuity Account Value is $10,000, or greater at the end of a Contract Year, the Annual Administrative Charge is zero. SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of your death, we will pay to the beneficiary designated by you to receive such payment, pursuant to Section 4.04 of this Contract, the amount of death benefit payable with respect to you. The amount of the death benefit is equal to the greater of (i) the Annuity Account Value and (ii) the minimum death benefit. Such minimum death benefit is the sum of all Contributions made pursuant to Section 2.01 (before reduction for any applicable tax charge) less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount that was withdrawn is to the Annuity Account Value. If, in accordance with the provisions of Section 2.01, the cash value of another annuity contract issued by us, or one of our affiliated or subsidiary life insurance companies, which provides for a death benefit before retirement equal to the greater of the contract cash value or an alternate amount based on premiums paid or contributions made under the annuity contract, is transferred to this Contract, such cash value or alternative amount as of the date of transfer will be included in the "sum of all Contributions" in lieu of the amount of cash value transferred for purposes of the death benefit under this Contract. We will pay the death benefit to your beneficiary in the form of an Annuity Benefit if you have made the election described in the last paragraph of Section 4.04. Also, in accordance with the last paragraph of Section 4.04, if no such election is in effect at your death, we will pay the death benefit to your beneficiary in a single sum, unless the beneficiary elects, before we pay the death benefit, to apply the death benefit to an Annuity Benefit. Upon payment of the death benefit, the amount you have in the Divisions and the Annuity Account Value will be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value rose. - -------------------------------------------------------------------------------- PART III -- ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the terms of this Contract with respect to a payee is the amount provided pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFITS. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Stock Division. Such Variable Annuity Benefit will increase if the average daily rate of investment return in the Stock division is equivalent to more than 6.75% or 5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25% annually, depending on whether the applicable assumed base rate of net investment return referred to in Section 1.22 is 5% or 3.5%, respectively. The daily rate of investment return is before deduction of charges, as described in Section 1.21, not exceed the maximum rate of 1.75% after any deductions to provide for any applicable tax charge. These charges include a daily charge for financial accounting, death benefits, mortality risk, expenses and expense risk, plus the investment advisory fee charges and direct operating expense charges of the Trust. The amount of the first, second and third payments under any Variable Annuity Benefit provided under this Contract with respect to a payee is the monthly amount provided with respect to a payee pursuant to the fifth paragraph of Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount No. 92 QPIA Page 9 of the first monthly payment under such benefit by the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. (As described in Section 3.05, we will notify the payee how each Variable Annuity payment is determined). SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your Retirement Date, provided you are then living, the Annuity Account value shall be applied to provide the Normal Form of Annuity Benefit, unless you elect (i) to receive the Cash Value of this Contract in a single sum or (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by us, or one of our affiliated or subsidiary life insurance companies, as elected by you, or (iii) to take partial withdrawals in amounts and at times as required by the Code, pursuant to Sections 2.07 and 3.05, subject to our rules then in effect and any other applicable requirements under the Code. We will provide notice and election forms to you not more than six months before your Retirement Date. If you elect to terminate this Contract prior to the Retirement Date, pursuant to Section 2.06, an election may be made to receive an Annuity Benefit in lieu of the Cash Value. We will have the right to require you to furnish pertinent information to provide an Annuity Benefit and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. We may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form, issued by us or one of our affiliated or subsidiary life insurance companies. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value if the annuity form elected involves life contingencies or (ii) the Cash Value, if the Annuity Form elected does not involve life contingencies. The amount applied to provide an Annuity Benefit may be reduced by any applicable tax charge on annuity considerations, as we determine. If we have previously deducted any applicable tax charge from Contributions as provided in Section 2.01, we will not again deduct charges for the same taxes before application to provide an Annuity Benefit, unless a change in applicable law has occurred with respect to your Contract. The balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed annuity Payments shown below, or (ii) our current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, your contract will be governed by our supplementary contract then in effect. If an amount is applied to provide an Annuity Benefit, the amount to be applied will, in addition to any tax charge reduction, be reduced by an administrative charge. The amount of such charge will be determined from time to time in accordance with our general practices applicable on a uniform basis to all contracts of the same type as this contract. After the application of an amount to provide an Annuity Benefit, the amounts you have in the Divisions and the Annuity Account Value shall be zero. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract, as indicated, on the Joint and Survivor Life Annuity Form (with 100% of the amount of your payment continued to your spouse). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on 3.5% interest and the 1983 Individual Annuity Table "a". The amount of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and the Joint and Survivor Life Annuity Form are based on the 1983 Individual Annuity Table "a" and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section 1.22. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us based on 3.5% interest and the 1983 Individual Annuity Table "a" if such annuity form provides for a Fixed Annuity Benefit, and on the same such Table and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section 1.22 if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract will be distributed or begin to be distributed, in accordance with Section 401(a)(9) of the Code and the applicable Treasury Regulations thereunder no later than the first day of April following the calendar year in which you attain age 70 and 6 months ("Required Beginning Date"). Your entire interest may be distributed, as you elect, over (a) your life, or the lives of you and your designated beneficiary, or (b) a period certain not extending beyond your life expectancy, or the joint and last survivor expectancy of you and your designated beneficiary. Distributions must be made in periodic payments at intervals of no longer than one year. In addition, payments must be either non-increasing or they may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the proposed Treasury Regulations, or any successor Regulation thereto. All distributions made hereunder shall be made in accordance with the requirements of Section 401(a)(9) of the Code, including the incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and applicable Treasury Regulations, including the minimum distribution incidental benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or any successor Regulation thereto. Notwithstanding the above paragraphs and the following No. 92 QPIA Page 10 paragraphs of this Section 3.05, while any distribution shall be subject to such requirements of the Code and regulations, any distribution shall also be subject to the terms of this Contract. That is, the forms of distribution shall be those which are made available by us at the time of your election. For purposes of determining the "period certain" referred to in the first paragraph of this Section, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless you otherwise elect prior to the time distributions are required to begin, those life expectancies shall be recalculated annually. Such election shall be irrevocable and shall apply to all subsequent years. The life expectancy of a non-spouse beneficiary may not be recalculated. Instead, life expectancy will be calculated using the attained age of such beneficiary during the calendar year in which you attain age 70 and 6 months, and payments for subsequent years shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. If you die after distribution of your interest in this Contract has begun, the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution being used prior to your death. If you die before distribution of your interest begins, distribution of your entire interest shall be completed no later than December 31 of the calendar year containing the fifth anniversary of your death, except to the extent that an election is made to receive death benefit distributions in accordance with (1) or (2) below: (1) If your interest is payable to a designated beneficiary, then your entire interest may be distributed over the life of or over a period certain not greater than the life expectancy of, the designated beneficiary. Such distributions must commence on or before December 31 of the calendar year immediately following the calendar year of your death. (2) If the designated beneficiary is your surviving spouse, the date that distributions are required to begin in accordance with (1) above shall not be earlier than the later of (A) December 31 of the calendar year immediately following the calendar year of your death or (B) December 31 of the calendar year in which you would have attained age 70 and 6 months. For purposes of determining the "period certain" referred to in the immediately preceding paragraph, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of distributions beginning after your death, unless otherwise elected by the surviving spouse by the time distributions are required to begin, life expectancies shall be recalculated annually. Such election shall be irrevocable by the surviving spouse and shall apply to all subsequent years. In the case of any other designated beneficiary, life expectancies shall be calculated using the attained age of such beneficiary during the calendar year in which distributions are required to begin, pursuant to this Section, and payments for any subsequent calendar year shall be calculated based on life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. Distributions under this Section are considered to have begun if distributions are made because you have reached your Required Beginning Date or if prior to the Required Beginning Date, distribution irrevocably commence to you over a period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1 of the Proposed Treasury Regulations or any successor Regulation thereto. Evidence of each payee's survival must be furnished to us either by personal endorsement of the check drawn for payment or by other means satisfactory to us. If a benefit payment under this contract was based on information that is subsequently found to be incorrect, your benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by us will be charged against and underpayments will be added to any payments thereafter falling due under this Contract with respect to the payee, affecting as many such payments as are necessary to correct the overpayment or underpayment. Our liability with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under this Contract. If we receive evidence satisfactory to us that (i) a payee entitled to receive any payment under this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, we may make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If a variable annuity form made available by us provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, the payee thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Pursuant to Section 3.03, upon your election of an annuity form providing payments for a period certain, you may designate (with the right to change such designation) a payee or payees to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments No 92 QPIA Page 11 TABLES OF GUARANTEED ANNUITY PAYMENTS (BASED ON AGE NEAREST BIRTHDAY ON DUE DATE OF FIRST PAYMENT) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE (MINIMUM MONTHLY INCOME PER $1,000 OF ANNUITY ACCOUNT VALUE)
- ------------------------------------------------------------------------------------------------------------------------------------ Age 60 61 62 63 64 65 66 67 68 69 70 - ------------------------------------------------------------------------------------------------------------------------------------ 60 4.51 4.56 4.61 4.66 4.71 4.76 4.81 4.85 4.90 4.94 4.99 61 4.59 4.65 4.70 4.75 4.81 4.86 4.91 4.96 5.01 5.06 62 4.69 4.74 4.80 4.85 4.91 4.97 5.02 5.07 5.13 63 4.78 4.84 4.90 4.96 5.02 5.08 5.14 5.20 64 4.88 4.95 5.01 5.08 5.14 5.20 5.27 65 4.99 5.06 5.13 5.20 5.27 5.34 66 5.11 5.18 5.26 5.33 5.41 67 5.24 5.31 5.39 5.47 68 5.37 5.45 5.54 69 5.51 5.60 70 5.67 - ------------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (MINIMUM MONTHLY INCOME PER $1,000 OF ANNUITY VALUE)
- ------------------------------------------------------------------------------------------------------------------------------------ VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS: 3.5% 5.00% ---- ----- Age Males Females Males Females - ------------------------------------------------------------------------------------------------------------------------------------ 60 5.67 5.00 6.46 5.89 61 5.71 5.11 6.60 6.00 62 5.86 5.23 6.75 6.11 63 6.03 5.36 6.92 6.24 64 6.20 5.49 7.09 6.37 65 6.39 5.64 7.28 6.51 66 6.58 5.79 7.47 6.66 67 6.80 5.96 7.69 6.83 68 7.02 6.13 7.92 7.00 69 7.27 6.32 8.16 7.19 70 7.53 6.53 8.42 7.40 - ------------------------------------------------------------------------------------------------------------------------------------
payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's estate in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, we will pay in a single sum to such payee's estate the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis applicable in determining the annuity amount. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. We will require satisfactory evidence of the age of any person upon whose life an annuity form depends. We will, with respect to each payment under a Variable Annuity Benefit, notify the payee of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each variable payment. Such notice will be mailed with each payment. Any election, change, revocation or designation shall be made, and will take effect on the Transaction Date, in the same manner as a change of beneficiary, as described in Section 4.04. If a commutation right under an annuity Benefit is exercised, we may defer payment in accordance with Section 4.07. - -------------------------------------------------------------------------------- PART IV -- GENERAL PROVISIONS SECTION 4.01 CONTRACT. This Contract constitutes the entire agreement between the parties and the provisions of this Contract alone will govern with respect to our rights and obligations. A copy of the application is incorporated in and made part of this Contract. This Contract may not be modified, nor may any of our rights or requirements be waived, except in writing and by an authorized officer of Equitable. This Contract may be changed by amendment or replacement upon agreement between you and us without the consent of any other person. SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform this Contract to reflect changes in the Code, applicable Treasury Regulations, or published rulings of the Internal Revenue Service so that this Contract will continue to be an Annuity under a qualified plan. SECTION 4.03 NONFORFEITABILITY, NONTRANSFERABILITY, AND ASSIGNMENTS. Your entire interest No. 92 QPIA Page 12 under the Contract is nonforfeitable. This Contract is nontransferable except by surrender to us. Your interest under this Contract may not be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than Equitable. No amount payable under this Contract may be assigned, commuted, or encumbered by the payee, unless otherwise permitted as described herein, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an initial designation of the beneficiary entitled to receive any death benefit payable pursuant to Section 2.11. You may change such designation from time to time during your lifetime and while this Contract is in force. Any such designation or change will be made by written notice in a form satisfactory to us. A change will, upon receipt at the Processing Office, take effect as of the time the written notice was signed, whether or not you are living on the Transaction Date, but without further liability as to any payment or other settlement made by us before receipt of such change. Unless otherwise specified in the designation, if you have designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive you, and if more than one survive, they will share equally. Any part of a death benefit payable pursuant to Section 2.11 for which there is no designated beneficiary living at your death will be payable in a single sum to your children who survive you, in equal shares, or should none survive, then to your estate. If you elect in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form annuity elected by you, with respect to the beneficiary, subject to our rules then in effect. If at your death there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. Any such election must meet the minimum distribution requirements under the Code, as described in Section 3.05. SECTION 4.05 DISQUALIFICATION. In the event that this Contract fails to qualify as an Annuity as described in Section 1.02, we will have the right, upon receiving notice of such fact prior to the Retirement Date, to terminate this Contract and pay to you the Annuity Account Value less a deduction for the appropriate part attributable to you of any Federal income tax payable which would not have been payable if you had an Annuity. SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to you, we reserve the right, at our sole discretion, to limit contributions under this Contract, as required by law or if such Contributions are in excess of the maximum amounts as permitted under the Code. SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment of a death benefit and payment of any portion of your Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange has been closed or trading on it is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Securities and Exchange Commission, by order, permits us to defer payment in order to protect persons with interests in the Investment Divisions. We can defer payment of any portion of your Annuity Account Value in the Guaranteed Interest Division for up to six months while you are living. SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year we will furnish you with a notice showing the following: (1) the amount you have in the Guaranteed Interest Division, (2) the total number of Accumulation Units you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Values, (4) the amount you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the Annuity Account Value, (6) the Cash Value, and (7) the amount of death benefit with respect to you. We will also furnish annual calendar year reports concerning the status of the Annuity and any other reports required by the Code or applicable Treasury Regulations. After the Retirement Date, we will notify you of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.09 AGE AND SEX. If your age or sex has been misstated, any benefits will be those which would have been purchased at the correct age or sex. Any overpayments or underpayments made by us will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. No. 92 QPIA Page 13 - -------------------------------------------------------------------------------- APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES PROCESSING OFFICE: INDIVIDUAL ANNUITY CENTER, P.O. BOX 2996, NEW YORK, NEW YORK 10116-2996 QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR: EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY - -------------------------------------------------------------------------------- TYPE OF PURCHASE (Complete One Plan Only) A. |_| TSA PUBLIC SCHOOL (GV-PS-I) B. |_| TSA 501(C)(3) ORGANIZATION (GV-501-I) C. |_| TSA University (GV-PS-U-I) D. |_| IRA Individual (Including IRA to IRA transfers) (GV-IRA 4971) E. |_| IRA Unit Billed (Including IRA to IRA transfers) (GV-IRA 4971) F. |x| IRA QUALIFIED PLAN ROLLOVER-- (QP IRA) (Distribution from a Qualified Plan) (GV-IRA 4971-71) G. |_| EDC (Public Employee Deferred Compensation) (GV-EDC 4991) H. |_| EDC (Tax Exempt Organization) (GV-EDC 4991-SU-080) I. |_| SEP (Simplified Employee Pension) (GV-SEP 4981) J. |_| SARSEP (Salary Reduction SEP) _________________________________________ K. |_| CORPORATE TRUSTEED (GV-CORP 4941-41) L. |_| KEOGH/HR-10 TRUSTEE (GV HR-10 4911-11) (trustee owned) M. |_| KEOGH/HR-10 (GV-HR-10 4911) (not trustee owned) (issued to existing units only) - -------------------------------------------------------------------------------- DO NOT COMPLETE THIS SECTION IF 1.D OR 1.F CHECKED ABOVE 2. EMPLOYER/PLAN NAME |A|B|C|_|C|O|M|P|A|N|Y|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| 3. |_| EXISTING UNIT NO. |_|_|_|_|_|_|-|_|_|_| |x| NEW UNIT |0|0|0|1|2|3|-|4|5|6| (FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP, OR TRUSTEED PLANS. FORM 983-135B IS REQUIRED) - -------------------------------------------------------------------------------- 4. PROPOSED ANNUITANT Print name to appear on Contract. |J|O|H|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|D|O|E|_|_|_|_|_| FIRST MIDDLE INITIAL LAST A. |X| MR. |_| MRS. |_| MS. |_| OTHER ____ B. Date of Birth: Year 1954 Month JANUARY Day 27 ---- ------- -- C. Age at Nearest Birthday: 38 D. |X| Male |_| Female ---- E. Annuitant's Mailing Address: F. State of Residence: N.J. ---- No., St. |1|7|_|E|L|M|_|S|T|R|E|E|T|_|_|_|_|_|_|_|_|_|_|_|_| City |A|N|Y|T|O|W|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1| G. Telephone Number (101) 222 - 3456 |X| Home |_| Work H. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9| I. Are you associated with or employed by a member of National Association of Securities Dealers, Inc.(NASD)? |_| Yes |X| No 5. OWNER (Print Name) -- If Trusteed or EDC Plan Print Name of Owner, for all other Markets Print Name of Annuitant. JOHN DOE ----------------------------------------------------------------------------- a. Title ____________________________________________________________________ 6. RETIREMENT AGE 65 --------------------------------------------------------------- 7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death Benefit upon Annuitant's death before Retirement Date.) (BENEFICIARY MUST BE THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS.) JANE DOE - WIFE ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- 8. CONTRIBUTION ALLOCATION Guaranteed Interest Division 20% ----- Stock Division 20% ----- Money Market Division 20% ----- Balanced Division 20% ----- Aggressive Stock Division 20% ----- (PERCENTAGES IN WHOLE NUMBERS) Total 100% 9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F) A. Reminder Notice (Billing) Required |_| Yes |X| No IF YES, COMPLETE B-C-D-E B. REMINDER DATE Required for Individual IRA or otherwise must agree with existing unit or attached 983-135B. MONTH _________ DAY __________ C. REMINDER FREQUENCY |_| Annual |_| Semi-Annual |_| Quarterly |_| Monthly Available for TSA, EDC, SARSEP AND CORPORATE TRUSTEED AND UNIT BILLED IRA ONLY: |_| Semi-Monthly |_| Bi-Weekly D. REMINDER AMOUNT $_________________________________ E. BILLING MONTHS TO BE EXCLUDED - TSA ONLY ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- 10.EXPECTED FIRST CONTRACT YEAR Contribution. $1000 ---------------------------------------------------------------- IF AN ADVANCED BILLING AND/OR CONTRACT DATE ARE REQUESTED, COMPLETE #9B AND #12. - -------------------------------------------------------------------------------- (FOR PROCESSING OFFICE USE) Unit Name ___________________________ Reminder Date ___________________________ Cert. or App# _______________________ Amendment Required_______________________ EDC Emp. Add. _______________________ Emp. Fed. ID# ___________________________ Frequency ___________________________ Contract Date ___________________________ - -------------------------------------------------------------------------------- Receipt Date Batch # Inquiry # Processor - -------------------------------------------------------------------------------- 180-1000 - -------------------------------------------------------------------------------- 10. Did you receive the Separate Account Prospectus? |X| Yes |_| No Date shown on Prospectus January 1, 1992 ---------------------------------------------------- Date of any supplement to Prospectus _______________________________________ 11. Items (a) through (f) are to be answered by the annuitant. We are required by the NASD to ask these questions. (a) Name of Employer: ABC Company ------------------------------------------------------ (b) Address of Employer: 10 Main Street --------------------------------------------------------------------------- Anytown, NJ --------------------------------------------------------------------------- (c) Occupation Sales ------------------------------------------------------------- (d) Assuming the contract applied for will be issued, will any existing insurance or annuity be replaced or changed (or has it been)? | | Yes |X| No (e) Estimated Family Annual Income $100,000 ---------------------------------------- (f) Estimated Net Worth $250,000 ----------------------------------------------------- (g) Investment Objective: |_| Income |X| Income & Growth |_| Aggressive Growth |_| Growth |_| Safety of Principal 12. SPECIAL INSTRUCTIONS ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- 13. Amount paid with this form: $1000 (If a check is submitted with this request, no advanced Contract Date is permitted.) BACKDATING IS NOT PERMITTED. NOTE: Amount paid will be credited upon receipt at Equitable's Processing Office, subject to return if the certificate is not issued. The Contract Date will be the date of receipt by Equitable of this application, properly signed and completed, and Contribution at Equitable's Processing Office. - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- AGREEMENT All information and statements furnished in this application are true and complete to the best of my knowledge and belief. I understand and acknowledge that no Agent has the authority to make or modify any contract on Equitable's behalf, or to waive or alter any of Equitable's rights and regulations. IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT. UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S) OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND COMPLETE. - -------------------------------------------------------------------------------- LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR ANNUITY APPLICATION WITH INFORMATION YOU KNOW IS FALSE OR TO LEAVE OUT MATERIAL FACTS. - -------------------------------------------------------------------------------- X__________________________________ Date_______ City __________ State __________ Signature of Annuitant X__________________________________ Date_______ City __________ State __________ Signature of Authorized Individual (REQUIRED FOR EDC AND TRUSTEED) OR OWNER - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- AGENT'S SECTION Will any existing insurance or annuity be replaced or changed (or has it been), assuming the Contract will be issued? | | Yes | | No |_| I (we) certify that a prospectus for the Contract has been given to the proposed Annuitant and that no written sales materials other than those approved by Equitable have been used. EQUI-VEST issues must adequately reflect the commission interest of all Agents on previous contracts. - -------------------------------------------------------------------------------- Print Agent's Name(s) Initial of Agent Agent Agency District Agent's (Service Agent first) Last Name Number % Code Manager Code Signature - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS___ Date ___ District EQS ___ Date ____ - -------------------------------------------------------------------------------- (FOR ASU USE) ASU Code and App. No. __________________________________________________________ ASU Rec'd. _____________________________________________________________________ Date to Proc. Off. ________________________________________________ Campaign |_| Agent(s) shown above is Equity Qualified and is licensed in the state where the request is signed. Above Agent information verified by ASM (Registered Rep) - -------------------------------------------------------------------------------- Application reviewed by ________________________________________________________ - -------------------------------------------------------------------------------- 180-1000 << 92 QPIB Missing OWNER: JOHN DOE ANNUITANT: JOHN DOE CONTRACT NUMBER: 00 000 000 ISSUE DATE: FEB 28, 1992 CONTRACT DATE: FEB 28, 1992 RETIREMENT DATE: JAN 1, 2020 THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York, New York 10116 AGREES o TO ALLOCATE the Contributions made to this Contract, after deduction of any applicable tax charge, to the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division (referred to in this Contract as the "Investment Divisions") or to the Guaranteed Interest Division, in accordance with Sections 2.02, 2.03 and 2.04 as directed by you, and o TO APPLY the Annuity Account Value at the Retirement Date to provide the Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant is then living, and o TO PROVIDE the Annuitant with the other rights and benefits of this Contract. This is the entire Contract. In this Contract "we", "our", and "us" mean The Equitable Life Assurance Society of the United States ("Equitable"). "You" and "your" mean the Annuitant at the time a right is exercised by the Annuitant. TEN DAYS TO EXAMINE CONTRACT - You may cancel this Contract by returning it to us within ten days after receipt of it. Upon such cancellation, we will refund any Contribution made to us under this Contract. /s/ Molly K. Heines /s/ Richard H. Jenrette Vice President and Secretary Chairman of the Board and Chief Executive Officer THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.24 IS 5% OR 3.5%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE TRUST. No. 92 SEPA The Contract is issued in consideration of the payment to us of the Contributions made under the terms of the Contract. The provisions on the following pages are part of this Contract. A copy of the application is incorporated in and made part of this Contract. - -------------------------------------------------------------------------------- TABLE OF CONTENTS DEFINITIONS Page Section 1.01 - Annuitant.......................................................4 1.02 - Annuity.........................................................4 1.03 - Annuity Account Value...........................................4 1.04 - Annuity Benefit.................................................4 1.05 - Cash Value......................................................4 1.06 - Class of Contracts..............................................4 1.07 - Code............................................................4 1.08 - Contract........................................................4 1.09 - Contract Date...................................................4 1.10 - Contract Year...................................................5 1.11 - Contribution....................................................5 1.12 - Divisions.......................................................5 1.13 - Eligible Annuity Certain........................................5 1.14 - Employer........................................................5 1.15 - Guaranteed Interest Rate........................................5 1.16 - Joint and Survivor Life Annuity Form............................5 1.17 - Life Annuity Form...............................................5 1.18 - Normal Form.....................................................5 1.19 - Period Certain Annuity..........................................5 1.20 - Plan............................................................5 1.21 - Processing Office...............................................5 1.22 - Retirement Date.................................................5 1.23 - Separate Account................................................5 1.24 - Separate Account Definitions....................................6 1.25 - Transaction Date................................................7 1.26 - Trust...........................................................7 ANNUITY ACCOUNT VALUE Section 2.01 - Contributions...................................................7 2.02 - Separate Account Investment Divisions...........................7 2.03 - Guaranteed Interest Division....................................7 2.04 - Allocation to Divisions.........................................7 2.05 - Transfers Among Divisions.......................................7 2.06 - Termination of this Contract....................................8 2.07 - Partial Withdrawals.............................................8 2.08 - Charges for Partial Withdrawals.................................8 2.09 - Free Corridor Amount............................................8 2.10 - Annual Administrative Charge....................................8 2.11 - Death Benefit...................................................9 ANNUITY BENEFITS Section 3.01 - Fixed Annuity Benefit...........................................9 3.02 - Variable Annuity Benefit........................................9 3.03 - Election and Commencement of Annuity Benefits...................9 3.04 - Amount of Annuity Benefits.....................................10 3.05 - Payment of Annuity Benefits....................................10 GENERAL PROVISIONS Section 4.01 - Contract.......................................................12 4.02 - Statutory Compliance...........................................12 4.03 - Nonforfeitability, Nontransferability, and Assignments.........12 4.04 - Beneficiary....................................................12 4.05 - Disqualification...............................................13 4.06 - Future Contributions...........................................13 4.07 - Deferment......................................................13 4.08 - Annual Notice..................................................13 4.09 - Age............................................................13 No. 92 SEPA Page 2 OWNER: JOHN DOE ANNUITANT: JOHN DOE CONTRACT NUMBER: 00 000 000 ISSUE DATE: FEB 28, 1992 CONTRACT DATE: FEB 28, 1992 RETIREMENT DATE: JAN 1, 2020 INITIAL GUARANTEED INTEREST RATE: 7.50% TO MAR 31, 1992 MINIMUM GUARANTEED INTEREST RATE: 6.00% TO DEC 31, 1992 3.00% AFTER DEC 31, 1992 BENEFICIARY: JANE DOE FORM NUMBER: 92 SEPA - -------------------------------------------------------------------------------- TABLE OF GUARANTEED VALUES ISSUE AGE 38 MALE $1000 ANNUAL CONTRIBUTION NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY SINCE FIRST CONTRIBUTION CASH VALUE ANNUITY AT AGE 65* - -------------------------- ---------- ---------------------------- 1 976 6.62 2 1,946 16.20 3 2,944 26.67 4 3,998 36.83 5 5,064 46.70 6 6,220 57.08 7 7,362 67.50 8 8,538 77.40 9 9,870 87.15 10 11,263 95.66 11 12,719 103.93 12 14,242 111.95 13 15,832 119.74 14 17,337 127.30 15 18,887 134.64 16 20,484 141.77 17 22,129 148.69 18 23,822 155.41 19 25,567 161.94 20 27,364 168.27 24 (Age 62) 35,108 191.82 27 (Age 65) 41,547 207.73 THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000 CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE (SEE SECTION 2.10) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE ANNUITY ACCOUNT VALUE (SEE SECTION 1.05). THE TABLES ASSUME THAT 100% OF ALL CONTRIBUTIONS ARE ALLOCATED TO AND REMAIN IN THE GUARANTEED INTEREST DIVISION. YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS. THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A SETTLEMENT WILL BE SUBJECT TO A CHARGE (SEE SECTION 3.04). *ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO SURVIVOR) WITH JOINT ANNUITANT THE SAME AGE AS THE ANNUITANT. No. 92 SEPA Page 3 - -------------------------------------------------------------------------------- PART I - DEFINITIONS SECTION 1.01 ANNUITANT. The term "Annuitant" means the person who owns this Contract as shown on Page 3 and on whose behalf this Contract has been purchased and maintained, and who exercises all rights under the terms of this Contract. SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in accordance with the written program constituting a "Simplified Employee Pension," as described in Section 408(k) of the Code, as adopted by the Employer, which meets the requirements for qualification under Section 408(b) of the Code. SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts that you have in the Guaranteed Interest Division and the Investment Divisions of the Separate Account, pursuant to Sections 2.02 and 2.03. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Section 3.04 of this Contract. Various sections of this Contract (Sections 1.16, 1.17, 3.01, and 3.02) refer to monthly payments to be made under an Annuity Benefit. You may wish to have your Annuity Benefit paid at other intervals, such as quarterly, semi-annually, or annually, instead of monthly. You may elect this at the time you elect the Annuity Benefit form described in Section 3.03; in that event, all references in this Contract to monthly payments will be deemed to mean payments at the frequency you elect subject to our rules at the time of election. SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value less any applicable withdrawal charge determined as follows: The withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the excess of (i) the Annuity Account Value over (ii) the Free Corridor Amount defined in Section 2.09; and (b) is the excess, if any, of (i) 8% of the total Contributions made during the Current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior charges for partial withdrawals made pursuant to Section 2.08. However, notwithstanding the above, if you are age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. A withdrawal charge will not apply, which means the Cash Value will equal the Annuity Account Value upon any of the following occurrences: (i) your attainment of age 59 years and 6 months and your completion of at least five Contract Years, or (ii) a distribution is made for a refund of a Contribution which exceeds the amounts which hay be contributed pursuant to Section 219 and/or 408(o) of the Code and the request for a distribution is received within one month of the date on which such Contribution was made, or (iii) a distribution of deferrals disallowed by reason of failure to meet the requirements of Section 408(k)(6)(A)(ii) of the Code, including income thereon and less any loss allowable thereto, is made no later than April 15 following the calendar year of the Employer's notification of such disallowance, or (iv) a distribution of "excess contributions," as such term is defined in Section 408(k)(6)(C)(ii) of the Code, including the income thereon and less any loss allowable thereto, is made no later than the end of the plan year of the Simplified Employee Pension following the plan year in which such excess contributions were made, or (v) a distribution of "excess deferrals" as such term is defined in Section 402(g)(2) of the Code, including income thereon and less any loss allowable thereto, is made no later than April 15 following the year in which such excess deferrals were made, or (vi) your completion of at least three Contract Years and you use the amount withdrawn to purchase from us a Period Certain Annuity of at least 10 years, or (vii) your Annuity Account Value is applied to the election of a Life Annuity Form and Joint and Survivor Life Annuity Form distribution option, or (viii) your completion of at least twelve Contract Years, or (ix) your attainment of age 55, your completion of at least five Contract Years and you use the amount withdrawn to purchase from us an Eligible Annuity Certain, or (x) you die and a distribution is made to the beneficiary. SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all Contracts with a Contract Date in the same calendar year. SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.08 CONTRACT. The term "Contract" means this Contract which is established for the exclusive benefit of you or your beneficiary. SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt by us of both the application for this Contract, properly signed and completed, and a Contribution. No. 92 SEPA Page 4 SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month period beginning on (i) the Contract Date, and (ii) each anniversary thereafter, unless otherwise agreed to in writing by us. SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made in cash or by check to us on your behalf with respect to this Contract. We are under no obligation to accept any Contribution less than $20.00 Except in the case of a rollover contribution (as permitted by Sections 402(a)(5), 402(a)(6), 402(a)(7), 403(a)(4), 403(b)(8), or 408(d)(3) of the Code), or a Contribution made in accordance with the terms of a Simplified Employee Pension ("SEP") as contained in Section 408(k) of the Code, no Contributions will be accepted unless they are in cash, and the total of such contributions shall not exceed $2,000 for any taxable year. In addition, amounts transferred to this Contract, to an individual retirement account, or annuity contract meeting the requirements of Section 408 of the Code are also not subject to the $2,000 limit on contributions. SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or severally as the case may be, the following Divisions described in this Contract: (a) the Guaranteed Interest Division, and (b) the Investment Divisions of the Separate Account. SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by us, which extends beyond your attainment of age 59 years and 6 months and does not permit any prepayment of the unpaid principal (that is no withdrawal or single sum payment) prior to your attainment of age 59 years and 6 months. SECTION 1.14 EMPLOYER. The term "Employer" means the sole proprietor, partnership or corporation that assumes in writing the obligations of the program constituting the Simplified Employee Pension. A sole proprietor is deemed to be his/her own Employer and a partnership is deemed to be the Employer of each partner. SECTION 1.15 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in the Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of this Contract. Section 2.03 describes the determination of the rate to apply thereafter. SECTION 1.16 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by you. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.17 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity issued by us providing monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.18 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under this Contract means, (i) if you have a living spouse at your Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with your spouse as the contingent annuitant (with 100% of the monthly payment amount continued to your spouse), and (ii) if you do not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by us which does not permit any prepayment of the unpaid principal (that is, you cannot elect to receive part of your payments as a single sum payment with the remainder paid in monthly annuity payments). SECTION 1.20 PLAN. The term "Plan" means a Simplified Employee Pension Plan as described in Section 408(k) of the Code. SECTION 1.21 PROCESSING OFFICE. The term "Processing Office" means our Individual Annuity Center, P.O. Box 2996, G.P.O., New York, New York 10116, or such other location as we shall designate by advance written notice to you. SECTION 1.22 RETIREMENT DATE. The term "Retirement Date" means the date on which you attain your retirement age as shown on page 3 of this Contract. Before the Retirement Date you may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be earlier than the date you attain age 59 years and 6 months nor shall be later than the first day of April following the calendar year in which you attain age 70 years and 6 months. Any election for such change must be made in writing by you and shall not take effect until received by us at our Processing Office. SECTION 1.23 SEPARATE ACCOUNT. The term "Separate Account" means our Separate Account A, which is organized as a unit investment trust (a type of investment company). We established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited to or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities and variable life insurance. The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to these Contracts will not be chargeable with liabilities arising out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to our General Account. No. 92 SEPA Page 5 The Separate Account consists of "Investment Divisions". Each Investment Division may invest its assets in a separate class (or series) of shares of a designated Trust where each class (or series) represents a separate portfolio in the Trust. We reserve the right to change the designated Trust or to add designated trusts or investment companies. The Investment Divisions available are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. The Guaranteed Interest Division is not part of the Separate Account, but rather is an asset of our General Account. We will value the assets of each Investment Division on each business day. A business day is any day on which Equitable is open, the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio securities in which an Investment Division is invested to materially affect the Accumulation Unit Value. We may, at our discretion, invest the assets of any Investment Division in any investment permitted by applicable law. We may rely conclusively on the opinion of counsel (including attorneys in our employ) as to what investments it is permitted by law to make. We reserve the right to (i) cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such a committee at any time; (iii) restrict or eliminate any voting rights as to the Separate Account; (iv) operate the Separate Account by making direct investments, or in any other form; (v) add Investment Divisions (or subdivisions of Investment Divisions) to, or remove Investment Divisions (or subdivisions of Investment Divisions) from the Separate Account (the term "Investment Division" in this Contract shall then refer to any other Investment Division in which the assets of a Class of Contracts to which this Contract belongs, were placed); (vi) combine any two or more Investment Divisions (or subdivisions of Investment Divisions) of the Separate Account; and (vii) withdraw from any Investment Division and to allocate to another Investment Division assets determined by us to be associated with the Class of Contracts to which this Contract belongs. If the exercise of these rights results in a material change in the underlying investments of an Investment Division, you will be notified of such exercise, as required by law. Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for any applicable tax charges) at a rate not to exceed 1.49% per year for each of the Stock, Money Market and Balanced Divisions, and 1.34% per year, for the Aggressive Stock Division, for financial accounting, death benefits, mortality risk, expenses and expense risks. The charge shall be made in accordance with Subsection (c) of the Net Investment Factor provision in Section 1.24. The relative proportion of these charges may be modified. The daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust shall not exceed a total annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to this Contract. The maximum rate may not be altered without your approval. SECTION 1.24 SEPARATE ACCOUNT DEFINITIONS. VALUATION PERIOD: Each business day together with any preceding consecutive non-business days. NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b), minus (c), where a) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the Valuation Period before giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period. For this purpose, we use the share value reported to us by the Trust. b) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the preceding Valuation Period (after taking into account any amounts allocated or withdrawn for that Valuation Period). c) is the daily asset charge for the expenses of this Contract, times the number of calendar days in the Valuation Period. ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an Investment Division where your Contributions are invested and which is used in determining the amount you have in an Investment Division. ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of each Accumulation Unit in an investment Division on a given date. The Accumulation Unit Value for a Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such Valuation Period. ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable from the Stock Division of the Separate Account under a Variable Annuity Benefit as defined in Section 3.02. ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1, 1968. On August 27, 1981 the date the first Contribution was put into the Stock Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed Base Rates of Net Investment Return of 5% or 3.5% a year, respectively. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall be No. 92 SEPA Page 6 5%, except in states where the rate is not permitted by law. AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods ending in a calendar month. SECTION 1.25 TRANSACTION DATE. The term "Transaction Date" means the business day we receive a Contribution or a written contract transaction request providing the information we need at the Processing Office. In the case of a transfer request initiated through the use of a touch tone telephone as described in Section 2.05, the term "Transaction Date" means the business day the telephone transaction is received. SECTION 1.26 TRUST. The term "Trust" means the designated trust or investment company in which Separate Account assets are invested. - -------------------------------------------------------------------------------- PART II - ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. Contributions under this Contract are not fixed and may be made at any time and in any amount subject to the limits described in Section 1.11 of this Contract. (If you make a Contribution which qualifies as a qualified plan rollover within the meaning of Section 402(a)(5) or 403(b)(8) of the Code, and such amount will be commingled with other Contributions under this Contract, such rollover contributions may not be rolled over to a qualified plan at a future date, unless otherwise provided by the Code). Each Contribution received by us will, before its allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. Contributions will be allocated to the Division in accordance with the instructions received on your application, unless later charged. SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when an amount is allocated to or withdrawn or transferred from an Investment Division, you will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units you have in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Sections 2.07 or 2.08 or transferred from the Investment Division pursuant to Section 2.05. The amount in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units in the Investment Division on that date and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under this Contract terminates on the earliest of (i) your election and commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii) termination of this Contract, pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division becomes part of our general assets, which support the guarantees of this Contract and other contracts. The amount in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Section 2.07, 2.08, or 2.10 or transferred from the Guaranteed Interest Division, pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division on a Transaction Date, pursuant to Section 2.04. We will credit the amount you have in the Guaranteed Interest Division with interest at effective annual rates that we determine. For each Class of Contracts, we determine a yearly guaranteed interest rate that will remain in effect throughout the next year. We guarantee that this yearly guaranteed interest rate will never be less than 3%. Participation in the Guaranteed Interest Division under this Contract terminates on the earliest of (i) your election and commencement of annuity benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, and (iii) Termination of this Contract pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section 2.01 is allocated (after deduction of any applicable tax charge) to one or more Divisions, at your sole direction as specified to us. Allocation percentages must be in whole numbers and the sum must equal 100. The allocation is made as of the Transaction Date on which we have received both such Contribution and such direction. Contributions made to an Investment Division purchase Accumulation Units in that Investment Division, using the Accumulation Unit Value next computed after the Transaction Date. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the Transaction Date with respect to each transfer from the Division pursuant to Section 2.05, (iii) on the Transaction Date with respect to each withdrawal pursuant to Section 2.07, (iv) at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, (v) upon termination of this Contract pursuant to Section 2.06, and (vi) upon your death pursuant to Section 2.11. SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request, or through the use of a touch tone telephone, transfer all or part of the amount you have in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; (2) amounts in the Money Market Division may be trans- No. 92 SEPA Page 7 ferred to other Divisions. Written authorization for touch tone telephone initiated transfers is only required when authorization for telephone transfers is requested. Upon advance written notice to you, we reserve the right to discontinue the acceptance of transfer requests through the use of a touch tone telephone. All transfers will be effective on the Transaction Date and will be subject to our rules in effect at the time of transfer. With respect to the Investment Division, the transfer will be made at the Accumulation Unit Value next computed after the Transaction Date. No transfers are permitted to the Money Market Division from the other Divisions. SECTION 2.06 TERMINATION OF THIS CONTRACT. You may elect by written notice, to terminate this Contract. We will determine the Cash Value as of the Transaction Date. The payment of such Cash Value to you may be deferred by us in accordance with the provisions of Section 4.07. If this Contract is terminated, surrendered or exchanged prior to your Retirement Date, any applicable tax charges we have paid may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on terminations, unless a change in applicable law has occurred with respect to your Contract. We reserve the right to pay the Annuity Account Value under the Contract and terminate this Contract. This right may be exercised if (i) no Contributions are made on your behalf during the last three completed Contract Years and the Annuity Account Value is less than $500, or (ii) a partial withdrawal is made that would result in your Annuity Account Value falling below $500. We also reserve the right to terminate this Contract if no Contributions have been made within 120 months of the Contract Date shown on Page 3 of this Contract. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount you have in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.07 PARTIAL WITHDRAWALS. You may elect, by written notice to us, to make a partial withdrawal from the Divisions. On the Transaction Date, we will pay the lesser of the Cash Value or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by you. The amount paid plus any withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the amounts you have in the Divisions. Unless we are instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts that you have in such Divisions. Upon any partial withdrawal payment, we will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by us in accordance with the provisions of Section 4.07. We may decline to accept a request for a partial withdrawal of less than $300. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, we will so advise you and reserve the right to pay the Annuity Account Value to you, and terminate this Contract. SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity Account Value, pursuant to Section 1.05. WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than the Free Corridor Amount, we will (i) first withdraw from the Divisions an amount equal to the Free Corridor Amount, in proportion to the amount you have in them, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a partial withdrawal charge. Such partial withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the amount withdrawn in excess of the Free Corridor Amount (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the total Contributions made on your behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to this Section. However, notwithstanding the above, if you are age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. If withdrawals are made from this Contract prior to the Retirement Date, any applicable tax charges we have paid with respect to this Contract may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on withdrawals, unless a change in applicable law has occurred with respect to your Contract. SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means, if you have completed three Contract Years or attained age 59 years and 6 months, an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the current Contract Year. If you have not completed three Contract Years or attained age 59 years and 6 months, the Free Corridor Amount is zero. SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract Year, if the Annuity Account Value on that date is less than $10,000, we will withdraw from the Divisions an Annual Administrative Charge equal to the lesser of $30 or 2% of the No. 92 SEPA Page 8 Annuity Account Value, including the amount of any withdrawals pursuant to Section 2.07 during that Contract Year. The charge will be allocated among the Divisions in proportion to the amounts that you have in the Divisions. If the Annuity Account Value is less than $10,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03, or (b) the date of Termination of this Contract pursuant to Section 2.06 or 2.11, we will prorate the Annual Administrative Charge applicable to the completed portion of the Current Contract Year and withdraw such amount in lieu of the Annual Administrative Charge applicable to the completed portion of the Current Contract Year and withdraw such amount in lieu of the full Annual Administrative Charge described in this Section for the applicable part of that Contract Year. If the Annuity Account Value is $10,000 or greater at the end of a Contract Year, the Annual Administrative Charge is zero. SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of your death, we will pay to the beneficiary designated by you to receive such payment, pursuant to Section 4.04 of this Contract, the amount of death benefit payable. The amount of the death benefit is equal to the greater of (i) the Annuity Account Value and (ii) the minimum death benefit. Such minimum death benefit is the sum of all Contributions made pursuant to Section 2.01 (before reduction for any applicable tax charge) less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum Death Benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount that was withdrawn is to the Annuity Account Value. If, in accordance with the provisions of Section 2.01, the Cash Value of another annuity contract issued by us, or one of our affiliated or subsidiary life insurance companies, which provides for a death benefit before retirement equal to the greater of the Contract Cash Value or an alternate amount based on premiums paid or contributions made under the annuity contract, is transferred to this Contract, such Cash Value or alternative amount as of the date of transfer will be included in the sum of all Contributions in lieu of the amount of Cash Value transferred for purposes of the death benefit under this Contract. We will pay the death benefit to your beneficiary in the form of an Annuity Benefit if you have made the election described in the last paragraph of Section 4.04. Also, in accordance with the last paragraph of Section 4.04, if no such election is in effect at your death, we will pay the death benefit to your beneficiary in a single sum, unless the beneficiary elects, before we pay the death benefit, to apply the death benefit to an Annuity Benefit. Upon payment of the death benefit, the amount you have in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. - -------------------------------------------------------------------------------- PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the terms of this Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Stock Division. Such Variable Annuity Benefit will increase if the average daily rate of investment return in the Stock Division is equivalent to more than 6.75% or 5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25% annually, depending on whether the applicable assumed base rate of net investment return referred to in Section 1.24 is 5% or 3.5%, respectively. The daily rate of investment return is before deduction of charges, as described in Section 1.23, not to exceed the maximum rate of 1.75% after any deductions to provide for any applicable tax charge. These charges include a daily charge for financial accounting, death benefits, mortality risk, expenses and expense risk, plus the investment advisory fee charges and direct operating expense charges of the Trust. The amount of the first, second and third payments under any Variable Annuity Benefit provided under this Contract with respect to a payee is the monthly amount provided with respect to a payee pursuant to the fifth paragraph of Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. (As described in Section 3.05, we will notify the payee how each Variable Annuity payment is determined). SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your Retirement Date, provided you are then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless you elect (i) to receive the Cash Value of this Contract in a single sum or (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by us, or one of our affiliated or subsidiary life insurance companies, as elected by you, or (iii) to take partial withdrawals in amounts and at times as required by the Code and, pursuant to Sections 2.07 and 3.05, subject to our rules then in effect and any other applicable requirements under the Code. We will provide notice and election forms to you not more than six months before your Retirement Date. No. 92 SEPA Page 9 If you elect to terminate this Contract, prior to the Retirement Date, pursuant to Section 2.06, an election may be made to receive an Annuity Benefit in Lieu of the Cash Value. We will have the right to require you to furnish pertinent information to provide an Annuity Benefit and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. We may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form, issued by us or one of our affiliated or subsidiary life insurance companies. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value if the annuity form elected involves life contingencies or (ii) the Cash Value, if the Annuity Form elected does not involve life contingencies. The amount applied to provide an Annuity Benefit may be reduced by any applicable tax charge on annuity considerations, as we determine. If we have previously deducted any applicable tax charge from Contributions as provided in Section 2.01, we will not again deduct charges for the same taxes before application to provide an Annuity Benefit, unless a change in applicable law has occurred with respect to your Contract. The balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below, or (ii) our current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, your contract will be governed by our supplementary contract then in effect. If an amount is applied to provide an Annuity Benefit, the amount to be applied will, in addition to any tax charge reduction, be reduced by an administrative charge. The amount of such charge will be determined from time to time in accordance with our general practices applicable on a uniform basis to all contracts of the same type as this Contract. After the application of an amount to provide an Annuity Benefit, the amounts you have in the Divisions and the Annuity Account Value shall be zero. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under this Contract, as indicated, on the Joint and Survivor Life Annuity Form (with 100% of the amount of your payment continued to your spouse). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity form and Joint and Survivor Life Annuity Form are based on 3.5% interest and the 1983 Individual Annuity Table "a" adjusted to a unisex basis based on a 50-50 split of males and females, at age zero. The amount of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and the Joint and Survivor Life Annuity Form are based on a 50-50 split of males and females, at age zero and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section 1.24. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us based on 3.5% interest and the 1983 Individual Annuity Table "a" adjusted to a unisex basis based on a 50-50 split of males and females, at age zero, if such annuity form provides for a Fixed Annuity Benefit, and on the same such projected 1983 Basic Table "a", adjusted to a unisex basis based on a 50-50 split of males and females, at age zero and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section 1.24 if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract will be distributed or begin to be distributed, in accordance with Section 401(a)(9) of the Code and the applicable Treasury Regulations thereunder no later than the first day of April following the calendar year in which you attain age 70 and 6 months ("Required Beginning Date"). Your entire interest may be distributed, as you elect, over (a) your life, or the lives of you and your designated beneficiary, or (b) a period certain not extending beyond your life expectancy, or the joint and last survivor expectancy of you and your designated beneficiary. Distributions must be made in periodic payments at intervals of no longer than one year. In addition, payments must be either non-increasing or they may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the proposed Treasury Regulations, or any successor Regulation thereto. All distributions made hereunder shall be made in accordance with the requirements of Section 401(a)(9) of the Code, including the incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and applicable Treasury Regulations, including the minimum distribution incidental benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or any successor Regulation thereto. Notwithstanding the above paragraphs and the following paragraphs of this Section 3.05, while any distribution shall be subject to such requirements of the Code and regulations, any distribution shall also be subject to the terms of this Contract. That is, the forms of distribution shall be those which are made available by us at the time of your election. For purposes of determining the "period certain" referred to in the first paragraph of this Section, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless you otherwise elect prior to the time distributions are required to begin, those life expectancies shall be recalculated annually. Such election shall be irrevocable and shall apply to all subsequent years. The life expectancy of a non-spouse beneficiary may not be recalculated. Instead, life expectancy will be calculated using the attained age of such beneficiary during the calendar year in which you attain age 70 and six months, and payments for subsequent years shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. If you die after distribution of your interest in this Contract has begun, the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution being used prior to your death. No.92 SEPA Page 10 If you die before distribution of your interest begins, distribution of your entire interest shall be completed no later than December 31 of the calendar year containing the fifth anniversary of your death, except to the extent that an election is made to receive death benefit distributions in accordance with (1) or (2) below: (1) If your interest is payable to a designated beneficiary, then your entire interest may be distributed over the life of, or over a period certain not greater than the life expectancy of, the designated beneficiary. Such distributions must commence on or before December 31 of the calendar year immediately following the calendar year of your death. (2) If the designated beneficiary is your surviving spouse, the date that distributions are required to begin in accordance with (1) above shall not be earlier than the later of (A) December 31 of the calendar year immediately following the calendar year of your death or (B) December 31 of the calendar year in which you would have attained age 70 and 6 months. For purposes of determining the "period certain" referred to in the immediately preceding paragraph, life expectancy is computed by use of the expected return multiples in Table V and VI of Treasury Regulation Section 1.72-9. For purposes of distributions beginning after your death, unless otherwise elected by the surviving spouse by the time distributions are required to begin, life expectancies shall be recalculated annually. Such election shall be irrevocable by the surviving spouse and shall apply to all subsequent years. In the case of any other designated beneficiary, life expectancies shall be calculated using the attained age of such beneficiary during the calendar year in which distributions are required to begin, pursuant to this Section, and payments for any subsequent calendar year shall be calculated based on life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. Distributions under this Section are considered to have begun if distributions are made because you have reached your Required Beginning Date or if prior to the Required Beginning Date, distributions irrevocably commence to you over a period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1 of the Proposed Treasury Regulations or any successor Regulation thereto. Evidence of each payee's survival must be furnished to us either by personal endorsement of the check drawn for payment or by other means satisfactory to us. If a benefit payment under this Contract was based on information that is subsequently found to be incorrect, your benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by us will be charged against and underpayments will be added to any payments thereafter falling due under this Contract with respect to the payee, affecting as many such payments as are necessary to correct the overpayment or underpayment. Our liability with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under this Contract. If we receive evidence satisfactory to us that (i) a payee entitled to receive any payment under this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, we may make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If a variable annuity form made available by us provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, the payee thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Pursuant to Section 3.03, upon your election of an annuity form providing payments for a period certain, you may designate (with the right to change such designation) a payee or payees to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's estate in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, we will pay in a single sum to such payee's estate the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis applicable in determining the annuity amount. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. We will require satisfactory evidence of the age of any person upon whose life an annuity form depends. No. 92 SEPA Page 11 TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% OF PAYMENT AMOUNT CONTINUED TO SPOUSE (Minimum Monthly Income per $1,000 of Annuity Account Value)
- --------------------------------------------------------------------------------------------------------------------------------- Age 60 61 62 63 64 65 66 67 68 69 70 - --------------------------------------------------------------------------------------------------------------------------------- 60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88 61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96 62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03 63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11 64 4.89 4.94 5.00 5.05 5.10 5.14 5.19 65 5.00 5.06 5.11 5.17 5.22 5.27 66 5.12 5.18 5.24 5.29 5.35 67 5.24 5.31 5.37 5.43 68 5.37 5.44 5.51 69 5.52 5.59 70 5.67 - ---------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Account Value) - ----------------------------------------------------------------------- VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS Age 3.5% 5.0% - ----------------------------------------------------------------------- 60 5.27 6.16 61 5.39 6.28 62 5.52 6.41 63 5.66 6.55 64 5.81 6.70 65 5.97 6.86 66 6.15 7.03 67 6.33 7.21 68 6.53 7.41 69 6.74 7.62 70 6.97 7.85 - ----------------------------------------------------------------------- We will, with respect to each payment under a Variable Annuity Benefit, notify the payee of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each variable payment. Such notice will be mailed with each payment. Any election, change, revocation or designation shall be made, and will take effect on the Transaction Date, in the same manner as a change of beneficiary, as described in Section 4.04. If a commutation right under an Annuity Benefit is exercised, we may defer payment in accordance with Section 4.07. - -------------------------------------------------------------------------------- PART IV -- GENERAL PROVISIONS SECTION 4.01 CONTRACT. This Contract constitutes the entire agreement between the parties and the provisions of this Contract alone govern with respect to our rights and obligations. A copy of the application is incorporated in and made part of this Contract. This Contract may not be modified, nor may any of our rights or requirements be waived, except in writing and by an authorized officer of Equitable. This Contract may be changed by amendment or replacement upon agreement between you and us without the consent of any other person. SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such rights shall include, but not be limited to, the right to conform this Contract to reflect changes in the Code, applicable Treasury Regulations, or published rulings of the Internal Revenue Service so that this Contract will continue to be an Annuity. SECTION 4.03 NONFORFEITABILITY, NONTRANSFERABILITY, AND ASSIGNMENTS. Your entire interest under the Contract is nonforfeitable. This Contract is non-transferable except by surrender to us. Your interest under this Contract may not be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than Equitable. No amount payable under this Contract may be assigned, commuted, or encumbered by the payee, unless otherwise permitted as described herein, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an initial designation of the beneficiary entitled to receive any Death Benefit payable pursuant to Section 2.11. Subject to Section 3.06, you may change such designation from time to time during your lifetime and while this Contract is in force. Any such designation or change will be made by written notice in a form satisfactory to us. A change will, upon receipt at the Processing Office, take effect as of the time the written notice was signed, whether or not you are living on the Transaction Date, but without further liability as to any payment or other settlement made by us before receipt of such change. Unless otherwise specified in the designation, if you have designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive you, and if more than one survive, they will share equally. No 92 SEPA Page 12 Any part of a death benefit payable pursuant to Section 2.11 for which there is no designated beneficiary living at your death will be payable in a single sum to your children who survive you, in equal shares, or should none survive, then to your estate. If you elect in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by you, with respect to the beneficiary, subject to our rules then in effect. If at your death there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. Any such election must meet the minimum distribution requirements under the Code, as described in Section 3.05. SECTION 4.05 DISQUALIFICATION. In the event that this Contract fails to qualify as an Annuity, we will have the right, upon receiving notice of such fact, to terminate this Contract and pay to you the Annuity Account Value less a deduction for the appropriate part attributable to you of any Federal income tax payable which would not have been payable if you had an Annuity. SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to you or the Employer, as applicable, we reserve the right, at our sole discretion, to limit Contributions under this Contract, as required by law or if such contributions are in excess of the maximum amounts as permitted under the Code. SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment of a death benefit and payment of any portion of your Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange has been closed or trading on it is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Securities and Exchange Commission, by order, permits us to defer payment in order to protect persons with interests in the Investment Divisions. We can defer payment of any portion of your Annuity Account Value in the Guaranteed Interest Division for up to six months while you are living. SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year we will furnish you with a notice showing the following: (1) the amount you have in the Guaranteed Interest Division, (2) the total number of Accumulation Units you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Values, (4) the amount you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the Annuity Account Value, (6) the Cash Value, and (7) the amount of death benefit payable with respect to you. We will also furnish annual calendar year reports concerning the status of the Annuity and any other reports required by the Code or applicable Treasury Regulations. After the Retirement Date, we will notify you of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each variable Annuity Benefit payment, if any. SECTION 4.09 AGE. If your age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by us will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. No. 92 SEPA Page 13 - -------------------------------------------------------------------------------- APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES PROCESSING OFFICE: INDIVIDUAL ANNUITY CENTER, P.O. BOX 2996, NEW YORK, NEW YORK 10116-2996 QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR: EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY - -------------------------------------------------------------------------------- TYPE OF PURCHASE (Complete One Plan Only) A. |_| TSA PUBLIC SCHOOL (GV-PS-I) B. |_| TSA 501(C)(3) ORGANIZATION (GV-501-I) C. |_| TSA University (GV-PS-U-I) D. |_| IRA Individual (Including IRA to IRA transfers) (GV-IRA 4971) E. |_| IRA Unit Billed (Including IRA to IRA transfers) (GV-IRA 4971) F. |_| IRA QUALIFIED PLAN ROLLOVER-- (QP IRA) (Distribution from a Qualified Plan) (GV-IRA 4971-71) G. |_| EDC (Public Employee Deferred Compensation) (GV-EDC 4991) H. |_| EDC (Tax Exempt Organization) (GV-EDC 4991-SU-080) I. |X| SEP (Simplified Employee Pension) (GV-SEP 4981) J. |_| SARSEP (Salary Reduction SEP) _________________________________________ K. |_| CORPORATE TRUSTEED (GV-CORP 4941-41) L. |_| KEOGH/HR-10 TRUSTEE (GV HR-10 4911-11) (trustee owned) M. |_| KEOGH/HR-10 (GV-HR-10 4911) (not trustee owned) (issued to existing units only) - -------------------------------------------------------------------------------- DO NOT COMPLETE THIS SECTION IF 1.D OR 1.F CHECKED ABOVE 2. EMPLOYER/PLAN NAME |A|B|C|_|C|O|M|P|A|N|Y|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| 3. |_| EXISTING UNIT NO. |_|_|_|_|_|_|-|_|_|_| |x| NEW UNIT |0|0|0|1|2|3|-|4|5|6| (FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP, OR TRUSTEED PLANS. FORM 983-135B IS REQUIRED) - -------------------------------------------------------------------------------- 4. PROPOSED ANNUITANT Print name to appear on Contract. |J|O|H|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|D|O|E|_|_|_|_|_| FIRST MIDDLE INITIAL LAST A. |X| MR. |_| MRS. |_| MS. |_| OTHER ____ B. Date of Birth: Year 1954 Month JANUARY Day 27 ---- ------- -- C. Age at Nearest Birthday: 38 D. |X| Male |_| Female ---- E. Annuitant's Mailing Address: F. State of Residence: N.J. ---- No., St. |1|7|_|E|L|M|_|S|T|R|E|E|T|_|_|_|_|_|_|_|_|_|_|_|_| City |A|N|Y|T|O|W|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1| G. Telephone Number (101) 222 - 3456 |X| Home |_| Work H. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9| I. Are you associated with or employed by a member of National Association of Securities Dealers, Inc.(NASD)? |_| Yes |X| No 5. OWNER (Print Name) -- If Trusteed or EDC Plan Print Name of Owner, for all other Markets Print Name of Annuitant. JOHN DOE ----------------------------------------------------------------------------- a. Title ____________________________________________________________________ 6. RETIREMENT AGE 65 --------------------------------------------------------------- 7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death Benefit upon Annuitant's death before Retirement Date.) (BENEFICIARY MUST BE THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS.) JANE DOE - WIFE ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- 8. CONTRIBUTION ALLOCATION Guaranteed Interest Division 20% ----- Stock Division 20% ----- Money Market Division 20% ----- Balanced Division 20% ----- Aggressive Stock Division 20% ----- (PERCENTAGES IN WHOLE NUMBERS) Total 100% 9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F) A. Reminder Notice (Billing) Required |_| Yes |X| No IF YES, COMPLETE B-C-D-E B. REMINDER DATE Required for Individual IRA or otherwise must agree with existing unit or attached 983-135B. MONTH _________ DAY __________ C. REMINDER FREQUENCY |_| Annual |_| Semi-Annual |_| Quarterly |_| Monthly Available for TSA, EDC, SARSEP AND CORPORATE TRUSTEED AND UNIT BILLED IRA ONLY: |_| Semi-Monthly |_| Bi-Weekly D. REMINDER AMOUNT $_________________________________ E. BILLING MONTHS TO BE EXCLUDED - TSA ONLY ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- 10.EXPECTED FIRST CONTRACT YEAR Contribution. $1000 ---------------------------------------------------------------- IF AN ADVANCED BILLING AND/OR CONTRACT DATE ARE REQUESTED, COMPLETE #9B AND #12. - -------------------------------------------------------------------------------- (FOR PROCESSING OFFICE USE) Unit Name ___________________________ Reminder Date ___________________________ Cert. or App# _______________________ Amendment Required_______________________ EDC Emp. Add. _______________________ Emp. Fed. ID# ___________________________ Frequency ___________________________ Contract Date ___________________________ - -------------------------------------------------------------------------------- Receipt Date Batch # Inquiry # Processor - -------------------------------------------------------------------------------- 180-1000 - -------------------------------------------------------------------------------- 10. Did you receive the Separate Account Prospectus? |X| Yes |_| No Date shown on Prospectus January 1, 1992 ---------------------------------------------------- Date of any supplement to Prospectus _______________________________________ 11. Items (a) through (f) are to be answered by the annuitant. We are required by the NASD to ask these questions. (a) Name of Employer: ABC Company ------------------------------------------------------ (b) Address of Employer: 10 Main Street --------------------------------------------------------------------------- Anytown, NJ --------------------------------------------------------------------------- (c) Occupation Sales ------------------------------------------------------------- (d) Assuming the contract applied for will be issued, will any existing insurance or annuity be replaced or changed (or has it been)? | | Yes |X| No (e) Estimated Family Annual Income $100,000 ---------------------------------------- (f) Estimated Net Worth $250,000 ----------------------------------------------------- (g) Investment Objective: |_| Income |X| Income & Growth |_| Aggressive Growth |_| Growth |_| Safety of Principal 12. SPECIAL INSTRUCTIONS ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- 13. Amount paid with this form: $1000 (If a check is submitted with this request, no advanced Contract Date is permitted.) BACKDATING IS NOT PERMITTED. NOTE: Amount paid will be credited upon receipt at Equitable's Processing Office, subject to return if the certificate is not issued. The Contract Date will be the date of receipt by Equitable of this application, properly signed and completed, and Contribution at Equitable's Processing Office. - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- AGREEMENT All information and statements furnished in this application are true and complete to the best of my knowledge and belief. I understand and acknowledge that no Agent has the authority to make or modify any contract on Equitable's behalf, or to waive or alter any of Equitable's rights and regulations. IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT. UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S) OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND COMPLETE. - -------------------------------------------------------------------------------- LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR ANNUITY APPLICATION WITH INFORMATION YOU KNOW IS FALSE OR TO LEAVE OUT MATERIAL FACTS. - -------------------------------------------------------------------------------- X__________________________________ Date_______ City __________ State __________ Signature of Annuitant X__________________________________ Date_______ City __________ State __________ Signature of Authorized Individual (REQUIRED FOR EDC AND TRUSTEED) OR OWNER - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- AGENT'S SECTION Will any existing insurance or annuity be replaced or changed (or has it been), assuming the Contract will be issued? | | Yes | | No |_| I (we) certify that a prospectus for the Contract has been given to the proposed Annuitant and that no written sales materials other than those approved by Equitable have been used. EQUI-VEST issues must adequately reflect the commission interest of all Agents on previous contracts. - -------------------------------------------------------------------------------- Print Agent's Name(s) Initial of Agent Agent Agency District Agent's (Service Agent first) Last Name Number % Code Manager Code Signature - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS___ Date ___ District EQS ___ Date ____ - -------------------------------------------------------------------------------- (FOR ASU USE) ASU Code and App. No. __________________________________________________________ ASU Rec'd. _____________________________________________________________________ Date to Proc. Off. ________________________________________________ Campaign |_| Agent(s) shown above is Equity Qualified and is licensed in the state where the request is signed. Above Agent information verified by ASM (Registered Rep) - -------------------------------------------------------------------------------- Application reviewed by ________________________________________________________ - -------------------------------------------------------------------------------- 180-1000 [EQUITABLE LOGO] Owner: Annuitant: Contract Number: Issue Date: Contract Date: Retirement Date: - -------------------------------------------------------------------------------- THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P O Box 2996, New York, New York 10116-2996 AGREES o TO ALLOCATE the Contributions made to this Contract, after deduction of any applicable tax charge, to the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division (referred to in this Contract as the "Investment Divisions") or to the Guaranteed Interest Division, in accordance with Sections 2.02, 2.03 and 2.04 as directed by you, and o TO APPLY the Annuity Account Value at the Retirement Date to provide the Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant is then living, and o TO PROVIDE the Annuitant with the other rights and benefits of this Contract. This is the entire Contract. In this Contract "we", "our", and "us" mean The Equitable Life Assurance Society of the United States ("Equitable"). "You" and "your" mean the Annuitant at the time a right is exercised by the Annuitant. TEN DAYS TO EXAMINE CONTRACT -- You may cancel this Contract by returning it to us within ten days after receipt of it. Upon such cancellation, we will refund any Contribution made to us under this Contract, plus or minus any investment gain or loss experienced in the Investment Divisions of the Separate Account from the date such Contribution is allocated to such Investment Division to the date we receive the returned Contract. /s/Molly K. Heines /s/Joseph J. Melone Molly K. Heines Joseph J. Melone Vice President and Secretary Chairman of the Board and Chief Executive Officer THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT 1S EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.24 IS 5% OR 3.5%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE TRUST. No. 92 SEPB The Contract is issued in consideration of the payment to us of the Contributions made under the terms of the Contract. The provisions on the following pages are part of this Contract. A copy of the application is incorporated in and made part of this Contract. - -------------------------------------------------------------------------------- TABLE OF CONTENTS Section 1.01 - Annuitant.....................................................4 1.02 - Annuity.......................................................4 1.03 - Annuity Account Value.........................................4 1.04 - Annuity Benefit...............................................4 1.05 - Cash Value....................................................4 1.06 - Class of Contracts............................................4 1.07 - Code..........................................................4 1.08 - Contract .....................................................4 1.09 - Contract Date.................................................4 1.10 - Contract Year.................................................5 1.11 - Contribution..................................................5 1.12 - Divisions.....................................................5 1.13 - Eligible Annuity Certain......................................5 1.14 - Employer......................................................5 1.15 - Guaranteed Interest Rate......................................5 1.16 - Joint and Survivor Life Annuity Form..................................................5 1.17 - Life Annuity Form.............................................5 1.18 - Normal Form...................................................5 1.19 - Period Certain Annuity........................................5 1.20 - Plan..........................................................5 1.21 - Processing Office.............................................5 1.22 - Retirement Date...............................................5 1.23 - Separate Account..............................................5 1.24 - Separate Account Definitions...................................................6 1.25 - Transaction Date..............................................7 1.26 - Trust.........................................................7 ANNUITY ACCOUNT VALUE Section 2.01 - Contributions.................................................7 2.02 - Separate Account Investment Divisions..........................................7 2.03 - Guaranteed Interest Division......................................................7 2.04 - Allocation to Divisions.......................................7 2.05 - Transfers Among Divisions.....................................7 2.06 - Termination of this Contract..................................8 2.07 - Partial Withdrawals...........................................8 2.08 - Charges for Partial Withdrawals...............................8 2.09 - Free Corridor Amount..........................................8 2.10 - Annual Administrative Charge..................................8 2.11 - Death Benefit.................................................9 ANNUITY BENEFITS Section 3.01 - Fixed Annuity Benefit.........................................9 3.02 - Variable Annuity Benefit......................................9 3.03 - Election and Commencement of Annuity Benefits...........................................9 3.04 - Amount of Annuity Benefits...................................10 3.05 - Payment of Annuity Benefits..................................10 ANNUITY BENEFITS Section 4.01 - Contract.....................................................12 4.02 - Statutory Compliance.........................................12 4.03 - Nonforfeitability, Nontransferability, and Assignments..........................12 4.04 - Beneficiary..................................................12 4.05 - Disqualification.............................................12 4.06 - Future Contributions.........................................12 4.07 - Deferment....................................................13 4.08 - Annual Notice................................................13 4.09 - Age..........................................................13 No. 92 SEPB Page 2 - -------------------------------------------------------------------------------- PART I -- DEFINITIONS SECTION 1.01 ANNUITANT. The term "Annuitant" means the person who owns this Contract as shown on Page 3 and on whose behalf this Contract has been purchased and maintained, and who exercises all rights under the terms of this Contract. SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in accordance with the written program constituting a "Simplified Employee Pension," as described in Section 408(k) of the Code, as adopted by the Employer, which meets the requirements for qualification under Section 408(b) of the Code. SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts that you have in the Guaranteed Interest Division and the Investment Divisions of the Separate Account, pursuant to Sections 2.02 and 2.03. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by Equitable pursuant to Section 3.04 of this Contract. Various sections of this Contract (Sections 1.16, 1.17, 3.01, and 3.02) refer to monthly payments to be made under an Annuity Benefit. You may wish to have your Annuity Benefit paid at other intervals, such as quarterly, semi-annually, or annually, instead of monthly. You may elect this at the time you elect the Annuity Benefit form described in Section 3.03; in that event, all references in this Contract to monthly payments will be deemed to mean payments at the frequency you elect, subject to our rules at the time of election. SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value less any applicable withdrawal charge determined as follows: The withdrawal charge equals the lesser of (a) or (b) where: (a) equals 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the excess of (i) the Annuity Account Value over (ii) the Free Corridor Amount defined in Section 2.09; and (b) is the excess, if any, of (i) 8% of the total Contributions made during the Current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior charges for partial withdrawals made pursuant to Section 2.08. However, notwithstanding the above, if you are age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. A withdrawal charge will not apply, which means the Cash Value will equal the Annuity Account Value upon any of the following occurrences: (i) your attainment of age 59 years and 6 months and your completion of at least five Contract Years, or (ii) a distribution is made for a refund of a Contribution which exceeds the amounts which may be contributed pursuant to Section 219 and/or 408(o) of the Code and the request for a distribution is received within one month of the date on which such Contribution was made, or (iii) a distribution of deferrals disallowed by reason of failure to meet the requirements of Section 408(k)(6)(A)(ii) of the Code, including income thereon and less any loss allowable thereto, is made no later than April 15 following the calendar year of the Employer's notification of such disallowance, or (iv) a distribution of "excess contributions," as such term is defined in Section 408(k)(6)(C)(ii) of the Code, including the income thereon and less any loss allowable thereto, is made no later than the end of the plan year of the Simplified Employee Pension following the plan year in which such excess contributions were made, or (v) a distribution of "excess deferrals" as such term is defined in Section 402(g)(2) of the Code, including income thereon and less any loss allowable thereto, is made no later than April 15 following the year in which such excess deferrals were made, or (vi) your completion of at least three Contract Years and you use the amount withdrawn to purchase from us a Period Certain Annuity of at least 10 years, or (vii) your Annuity Account Value is applied to the election of a Life Annuity Form and Joint and Survivor Life Annuity Form distribution option, or (viii) your completion of at least twelve Contract Years, or (ix) your attainment of age 55, your completion of at least five Contract Years and you use the amount withdrawn to purchase from us an Eligible Annuity certain, or (x) you die and a distribution is made to the beneficiary. SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all Contracts with a Contract Date in the same calendar year. SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.08 CONTRACT. The term "Contract" means this Contract which is established for the exclusive benefit of you or your beneficiary. SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt by us of both the application for this Contract, properly signed and completed, and a Contribution. No. 92 SEPB Page 4 SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month period beginning on (i) the Contract Date, and (ii) each anniversary thereafter, unless otherwise agreed to in writing by us. SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made in cash or by check to us on your behalf with respect to this Contract. We are under no obligation to accept any Contribution less than $20.00. Except in the case of a rollover contribution (as permitted by Sections 402(a)(5), 402(a)(6), 402(a)(7), 403(a)(4), 403(b)(8), or 408(d)(3) of the Code), or a Contribution made in accordance with the terms of a Simplified Employee Pension ("SEP") as contained in Section 408(k) of the Code, no Contributions will be accepted unless they are in cash, and the total of such contributions shall not exceed $2,000 for any taxable year. In addition, amounts transferred to this Contract, to an individual retirement account, or annuity contract meeting the requirements of Section 408 of the Code are also not subject to the $2,000 limit on contributions. SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or severally as the case may be, the following Divisions described in this Contract: (a) the Guaranteed Interest Division, and (b) the Investment Divisions of the Separate Account. SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by us, which extends beyond your attainment of age 59 years and 6 months and does not permit any prepayment of the unpaid principal (that is no withdrawal or single sum payment) prior to your attainment of age 59 years and 6 months. SECTION 1.14 EMPLOYER. The term "Employer" means the sole proprietor, partnership or corporation that assumes in writing the obligations of the program constituting the Simplified Employee Pension. A sole proprietor is deemed to be his/her own Employer and a partnership is deemed to be the Employer of each partner. SECTION 1.15 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in the Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of this Contract. Section 2.03 describes the determination of the rate to apply thereafter. SECTION 1.16 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payment depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. The percentage may be 50% or any higher percentage up to and including 100%, as elected by you. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.17 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity issued by us providing monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.18 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under this Contract means, (i) if you have a living spouse at your Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with your spouse as the contingent annuitant (with 100% of the monthly payment amount continued to your spouse), and (ii) if you do not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by us which does not permit any prepayment of the unpaid principal (that is, you cannot elect to receive part of your payments as a single sum payment with the remainder paid in monthly annuity payments). SECTION 1.20 PLAN. The term "Plan" means a Simplified Employee Pension Plan, as described in Section 408(k) of the Code. SECTION 1.21 PROCESSING OFFICE. The term "Processing Office" means our Individual Annuity Center, P O Box 2996, New York, New York 10116-2996, or such other location as we shall designate by advance written notice to you. SECTION 1.22 RETIREMENT DATE. The term "Retirement Date" means the date on which you attain your retirement age as shown on Page 3 of this Contract. Before the Retirement Date you may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). No Retirement Date shall be earlier than the date you attain age 59 years and 6 months nor shall be later than the first day of April following the calendar year in which you attain age 70 years and 6 months. Any election for such change must be made in writing by you and shall not take effect until received by us at our Processing Office. SECTION 1.23 SEPARATE ACCOUNT. The term the "Separate Account" means our Separate Account A, which is organized as a unit investment trust (a type of investment company). We established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited to or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities and variable life insurance. The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to these Contracts will not be chargeable with liabilities arising out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to our General Account. No. 92 SEPB Page 5 The Separate Account consists of "Investment Divisions". Each Investment Division may invest its assets in a separate class (or series) of shares of a designated Trust where each class (or series) represents a separate portfolio in the Trust. We reserve the right to change the designated Trust or to add designated trusts or investment companies. The Investment Divisions available are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. The Guaranteed Interest Division is not part of the Separate Account, but rather is an asset of our General Account. We will value the assets of each Investment Division on each business day. A business day is any day on which Equitable is open, the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio securities in which an Investment Division is invested to materially affect the Accumulation Unit Value. We may, at our discretion, invest the assets of any Investment Division in any investment permitted by applicable law. We may rely conclusively on the opinion of counsel (including attorneys in our employ) as to what investments it is permitted by law to make. We reserve the right to (i) cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such a committee at any time; (iii) restrict or eliminate any voting rights as to the Separate Account; (iv) operate the Separate Account by making direct investments, or in any other form; (v) add Investment Divisions (or subdivisions of Investment Divisions) to, or remove Investment Divisions (or subdivisions of Investment Divisions) from the Separate Account (the term "Investment Division" in this Contract shall then refer to any other Investment Division in which the assets of a Class of Contracts to which this Contract belongs, were placed); (vi) combine any two or more Investment Divisions (or subdivisions of Investment Divisions) of the Separate Account; and (vii) withdraw from any Investment Division and to allocate to another Investment Division assets determined by us to be associated with the Class of Contracts to which this Contract belongs. If the exercise of these rights results in a material change in the underlying investments of an Investment Division, you will be notified of such exercise, as required by law. Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for any applicable tax charges) at a rate not to exceed 1.49% per year for each of the Stock, Money Market and Balanced Divisions, and 1.34% per year, for the Aggressive Stock Division, for financial accounting, death benefits, mortality risk, expenses and expense risks. The charge shall be made in accordance with Subsection (c) of the Net Investment Factor provision in Section 1.24. The relative proportion of these charges may be modified. The daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust shall not exceed a total annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to this Contract. The maximum rate may not be altered without your approval. SECTION 1.24 SEPARATE ACCOUNT DEFINITIONS. VALUATION PERIOD: Each business day together with any preceding consecutive non-business days. NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b), minus (c), where a) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the Valuation Period before giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period. For this purpose, we use the share value reported to us by the Trust. b) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the preceding Valuation Period (after taking into account any amounts allocated or withdrawn for that Valuation Period). c) is the daily asset charge for the expenses of this Contract, times the number of calendar days in the Valuation Period. ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an Investment Division where your Contributions are invested and which is used in determining the amount you have in an Investment Division. ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of each Accumulation Unit in an Investment Division on a given date. The Accumulation Unit Value for a Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such Valuation Period. ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable from the Stock Division of the Separate Account under a Variable Annuity Benefit as defined in Section 3.02. ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1, 1968. On August 27, 1981, the date the first Contribution was put into the Stock Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed Base Rates of Net Investment Return of 5% or 3.5% a year, respectively. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. No. 92 SEPB Page 6 AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods ending in a calendar month. SECTION 1.25 TRANSACTION DATE. The term "Transaction Date" means the business day we receive a Contribution or a written contract transaction request providing the information we need at the Processing Office. In the case of a transfer request initiated through the use of a touch tone telephone as described in Section 2.05, the term "Transaction Date" means the business day the telephone transaction is received. SECTION 1.26 TRUST. The term "Trust" means the designated trust or investment company in which Separate Account assets are invested. - -------------------------------------------------------------------------------- PART II -- ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. Contributions under this Contract are not fixed and may be made at any time and in any amount subject to the limits described in Section 1.11 of this Contract. (If you make a Contribution which qualifies as a qualified plan rollover within the meaning of Section 402(a)(5) or 403(b)(8) of the Code, and such amount will be commingled with other Contributions under this Contract, such rollover contributions may not be rolled over to a qualified plan at a future date, unless otherwise provided by the Code). Each Contribution received by us will, before its allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. Contributions will be allocated to the Division in accordance with the instructions received on your application, unless later changed. SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when an amount is allocated to or withdrawn or transferred from an Investment Division, you will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units you have in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Sections 2.07 or 2.08 or transferred from the Investment Division pursuant to Section 2.05. The amount in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units in the Investment Division on that date and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under this Contract terminates on the earliest of (i) your election and commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii) termination of this Contract, pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division becomes part of our general assets, which support the guarantees of this Contract and other contracts. The amount in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Section 2.07, 2.08, or 2.10 or transferred from the Guaranteed Interest Division, pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division on a Transaction Date, pursuant to Section 2.04. We will credit the amount you have in the Guaranteed Interest Division with interest at effective annual rates that we determine. For each Class of Contracts, we determine a yearly guaranteed interest rate that will remain in effect throughout the next year. We guarantee that this yearly guaranteed interest rate will never be less than 3%. Participation in the Guaranteed Interest Division under this Contract terminates on the earliest of (i) your election and commencement of annuity benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, and (iii) termination of this Contract, pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section 2.01 is allocated (after deduction of any applicable tax charge) to one or more Divisions, at your sole direction as specified to us. Allocation percentages must be in whole numbers and the sum must equal 100. The allocation is made as of the Transaction Date on which we have received both such Contribution and such direction. Contributions made to an Investment Division purchase Accumulation Units in that Investment Division, using the Accumulation Unit Value next computed after the Transaction Date. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the Transaction Date with respect to each transfer from the Division pursuant to Section 2.05, (iii) on the Transaction Date with respect to each withdrawal pursuant to Section 2.07, (iv) at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, (v) upon termination of this Contract pursuant to Section 2.06, and (vi) upon your death pursuant to Section 2.11. SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request, or through the use of a touch tone telephone, transfer all or part of the amount you have in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; (2) amounts in the Money Market Division may be transferred to other Divisions. Written authorization for touch tone telephone initiated transfers is only required when authorization for telephone transfers is requested. Upon advance written notice to you, we reserve the right to discontinue the acceptance of transfer requests No. 92 SEPB Page 7 through the use of a touch tone telephone. All transfers will be effective on the Transaction Date and will be subject to our rules in effect at the time of transfer. With respect to the Investment Division, the transfer will be made at the Accumulation Unit Value next computed after the Transaction Date. No transfers are permitted to the Money Market Division from the other Divisions. SECTION 2.06 TERMINATION OF THIS CONTRACT. You may elect by written notice, to terminate this Contract. We will determine the Cash Value as of the Transaction Date. The payment of such Cash Value to you may be deferred by us in accordance with the provisions of Section 4.07. If this Contract is terminated, surrendered or exchanged prior to your Retirement Date, any applicable tax charges we have paid may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on terminations, unless a change in applicable law has occurred with respect to your Contract. We reserve the right to pay the Annuity Account Value under the Contract and terminate this Contract. This right may be exercised if (i) no Contributions are made on your behalf during the last three completed Contract Years and the Annuity Account Value is less than $500, or (ii) a partial withdrawal is made that would result in your Annuity Account Value falling below $500. We also reserve the right to terminate this Contract if no Contributions have been made within 120 days of the Contract Date shown on Page 3 of this Contract. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount you have in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.07 PARTIAL WITHDRAWALS. You may elect, by written notice to us, to make a partial withdrawal from the Divisions. On the Transaction Date, we will pay the lesser of the Cash Value or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by you. The amount paid plus any withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the amounts you have in the Divisions. Unless we are instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts that you have in such Divisions. Upon any partial withdrawal payment, we will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by us in accordance with the provisions of Section 4.07. We may decline to accept a request for a partial withdrawal of less than $300. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, we will so advise you and reserve the right to pay the Annuity Account Value to you, and terminate this Contract. SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity Account Value, pursuant to Section 1.05. WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than the Free Corridor Amount, we will (i) first withdraw from the Divisions an amount equal to the Free Corridor Amount, in proportion to the amount you have in them, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a partial withdrawal charge. Such partial withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the amount withdrawn in excess of the Free Corridor Amount (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the total Contributions made on your behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to this Section. However, notwithstanding the above, if you are age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. If withdrawals are made from this Contract prior to the Retirement Date, any applicable tax charges we have paid with respect to this Contract may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on withdrawals, unless a change in applicable law has occurred with respect to your Contract. SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means, if you have completed three Contract Years or attained age 59 years and 6 months, an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the current Contract Year. If you have not completed three Contract Years or attained age 59 years and 6 months, the Free Corridor Amount is zero. SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract Year, if the Annuity Account Value on that date is less than $10,000, we will withdraw from the Divisions an Annual Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account Value, including the amount of any withdrawals pursuant to Section 2.07 during that Contract Year. The charge will be allocated among the Divisions in proportion to the amounts that you have in the Divisions. No. 92 SEPB Page 8 If the Annuity Account Value is less than $10,000, on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03, or (b) the date of Termination of this Contract pursuant to Section 2.06 or 2.11, we will prorate the Annual Administrative Charge applicable to the completed portion of the Current Contract Year and withdraw such amount in lieu of the full Annual Administrative Charge described in this Section for the applicable part of that Contract Year. If the Annuity Account Value is $10,000 or greater at the end of a Contract Year, the Annual Administrative Charge is zero. SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of your death, we will pay to the beneficiary designated by you to receive such payment, pursuant to Section 4.04 of this Contract, the amount of death benefit payable. The amount of the death benefit is equal to the greater of (i) the Annuity Account Value and (ii) the minimum death benefit. Such minimum death benefit is the sum of all Contributions made pursuant to Section 2.01 (before reduction for any applicable tax charge) less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum Death Benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount that was withdrawn is to the Annuity Account Value. If, in accordance with the provisions of Section 2.01, the Cash Value of another annuity contract issued by us, or one of our affiliated or subsidiary life insurance companies, which provides for a death benefit before retirement equal to the greater of the Contract Cash Value or an alternate amount based on premiums paid or contributions made under the annuity contract, is transferred to this Contract, such Cash Value or alternative amount as of the date of transfer will be included in the sum of all Contributions in lieu of the amount of Cash Value transferred for purposes of the death benefit under this Contract. We will pay the death benefit to your beneficiary in the form of an Annuity Benefit if you have made the election described in the last paragraph of Section 4.04. Also, in accordance with the last paragraph of Section 4.04, if no such election is in effect at your death, we will pay the death benefit to your beneficiary in a single sum, unless the beneficiary elects, before we pay the death benefit, to apply the death benefit to an Annuity Benefit. Upon payment of the death benefit, the amount you have in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. - -------------------------------------------------------------------------------- PART III -- ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the terms of this Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Stock Division. Such Variable Annuity Benefit will increase if the average daily rate of investment return in the Stock Division is equivalent to more than 6.75% or 5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25% annually, depending on whether the applicable assumed base rate of net investment return referred to in Section 1.24 is 5% or 3.5%, respectively. The daily rate of investment return is before deduction of charges, as described in Section 1.23, not to exceed the maximum rate of 1.75% after any deductions to provide for any applicable tax charge. These charges include a daily charge for financial accounting, death benefits, mortality risk, expenses and expense risk, plus the investment advisory fee charges and direct operating expense charges of the Trust. The amount of the first, second and third payments under any Variable Annuity Benefit provided under this Contract with respect to a payee is the monthly amount provided with respect to a payee pursuant to the fifth paragraph of Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. (As described in Section 3.05, we will notify the payee how each Variable Annuity payment is determined). SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your Retirement Date, provided you are then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless you elect (i) to receive the Cash Value of this Contract in a single sum or (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other form offered by us, or one of our affiliated or subsidiary life insurance companies, as elected by you, or (iii) to take partial withdrawals in amounts and at times as required by the Code and, pursuant to Sections 2.07 and 3.05, subject to our rules then in effect and any other applicable requirements under the Code. We will provide notice and election forms to you not more than six months before your Retirement Date. If you elect to terminate this Contract, prior to the Retirement Date, pursuant to Section 2.06, an election may be made to receive an Annuity Benefit in lieu of the Cash Value. No. 92 SEPB Page 9 We will have the right to require you to furnish pertinent information to provide an Annuity Benefit and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. We may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form, issued by us or one of our affiliated or subsidiary life insurance companies. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value if the annuity form elected involves life contingencies or (ii) the Cash Value, if the Annuity Form elected does not involve life contingencies. The amount applied to provide an Annuity Benefit may be reduced by any applicable tax charge on annuity considerations, as we determine. If we have previously deducted any applicable tax charge from Contributions as provided in Section 2.01, we will not again deduct charges for the same taxes before application to provide an Annuity Benefit, unless a change in applicable law has occurred with respect to your Contract. The balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below, or (ii) our current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, your contract will be governed by our supplementary contract then in effect. If an amount is applied to provide an Annuity Benefit, the amount to be applied will, in addition to any tax charge reduction, be reduced by an administrative charge. The amount of such charge will be determined from time to time in accordance with our general practices applicable on a uniform basis to all contracts of the same type as this Contract. After the application of an amount to provide an Annuity Benefit, the amounts you have in the Divisions and the Annuity Account Value shall be zero. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under this Contract, as indicated, on the Joint and Survivor Life Annuity Form (with 100% of the amount of your payment continued to your spouse). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on 3.5% interest and the 1983 Individual Annuity Table "a" adjusted to a unisex basis based on a 50-50 split of males and females, at age zero. The amount of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and the Joint and Survivor Life Annuity Form are based on a 50-50 split of males and females, at age zero and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section 1.24. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us based on 3.5% interest and the 1983 Individual Annuity Table "a" adjusted to a unisex basis based on a 50-50 split of males and females, at age zero, if such annuity form provides for a Fixed Annuity Benefit, and on the same such projected 1983 Basic Table "a", adjusted to a unisex basis based on a 50-50 split of males and females, at age zero and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section 1.24 if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract will be distributed or begin to be distributed, in accordance with Section 401(a)(9) of the Code and the applicable Treasury Regulations thereunder no later than the first day of April following the calendar year in which you attain age 70 years and 6 months ("Required Beginning Date"). Your entire interest may be distributed, as you elect, over (a) your life, or the lives of you and your designated beneficiary, or (b) a period certain not extending beyond your life expectancy, or the joint and last survivor expectancy of you and your designated beneficiary. Distributions must be made in periodic payments at intervals of no longer than one year. In addition, payments must be either non-increasing or they may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the proposed Treasury Regulations, or any successor Regulation thereto. All distributions made hereunder shall be made in accordance with the requirements of Section 401(a)(9) of the Code, including the incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and applicable Treasury Regulations, including the minimum distribution incidental benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or any successor Regulation thereto. Notwithstanding the above paragraphs and the following paragraphs of this Section 3.05, while any distribution shall be subject to such requirements of the Code and regulations, any distribution shall also be subject to the terms of this Contract. That is, the forms of distribution shall be those which are made available by us at the time of your election. For purposes of determining the "period certain" referred to in the first paragraph of this Section, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless you otherwise elect prior to the time distributions are required to begin, those life expectancies shall be recalculated annually. Such election shall be irrevocable and shall apply to all subsequent years. The life expectancy of a non-spouse beneficiary may not be recalculated. Instead, life expectancy will be calculated using the attained age of such beneficiary during the calendar year in which you attain age 70 years and 6 months, and payments for subsequent years shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. If you die after distribution of your interest in this Contract has begun, the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution being used prior to your death. No. 92 SEPB Page 10 If you die before distribution of your interest begins, distribution of your entire interest shall be completed no later than December 31 of the calendar year containing the fifth anniversary of your death, except to the extent that an election is made to receive death benefit distributions in accordance with (1) or (2) below: (1) If your interest is payable to a designated beneficiary, then your entire interest may be distributed over the life of, or over a period certain not greater than the life expectancy of, the designated beneficiary. Such distributions must commence on or before December 31 of the calendar year immediately following the calendar year of your death. (2) If the designated beneficiary is your surviving spouse, the date that distributions are required to begin in accordance with (1) above shall not be earlier than the later of (A) December 31 of the calendar year immediately following the calendar year of your death or (B) December 31 of the calendar year in which you would have attained age 70 years and 6 months. For purposes of determining the "period certain" referred to in the immediately preceding paragraph, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of distributions beginning after your death, unless otherwise elected by the surviving spouse by the time distributions are required to begin, life expectancies shall be recalculated annually. Such election shall be irrevocable by the surviving spouse and shall apply to all subsequent years. In the case of any other designated beneficiary, life expectancies shall be calculated using the attained age of such beneficiary during the calendar year in which distributions are required to begin, pursuant to this Section, and payments for any subsequent calendar year shall be calculated based on life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. Distributions under this Section are considered to have begun if distributions are made because you have reached your Required Beginning Date or if prior to the Required Beginning Date, distributions irrevocably commence to you over a period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1 of the Proposed Treasury Regulations or any successor Regulation thereto. Evidence of each payee's survival must be furnished to us either by personal endorsement of the check drawn for payment or by other means satisfactory to us. If a benefit payment under this Contract was based on information that is subsequently found to be incorrect, your benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by us will be charged against and underpayments will be added to any payments thereafter falling due under this Contract with respect to the payee, affecting as many such payments as are necessary to correct the overpayment or underpayment. Our liability with respect to a payee is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under this Contract. If we receive evidence satisfactory to us that (i) a payee entitled to receive any payment under this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, we may make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If a variable annuity form made available by us provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, the payee thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Pursuant to Section 3.03, upon your election of an annuity form providing payments for a period certain, you may designate (with the right to change such designation) a payee or payees to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's estate in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, we will pay in a single sum to such payee's estate the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis applicable in determining the annuity amount. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. We will require satisfactory evidence of the age of any person upon whose life an annuity form depends. No. 92 SEPB Page 11 - -------------------------------------------------------------------------------- TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% OF PAYMENT AMOUNT CONTINUED TO SPOUSE (Minimum Monthly Income per $1,000 of Annuity Account Value)
- ------------------------------------------------------------------------------------------------------------------------------ Age 60 61 62 63 64 65 66 67 68 69 70 - ------------------------------------------------------------------------------------------------------------------------------ 60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88 61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96 62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03 63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11 64 4.89 4.94 5.00 5.05 5.10 5.14 5.19 65 5.00 5.06 5.11 5.17 5.22 5.27 66 5.12 5.18 5.24 5.29 5.35 67 5.24 5.31 5.37 5.43 68 5.37 5.44 5.51 69 5.52 5.59 70 5.67 - ------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Account Value) - ------------------------------------------------------------------------ VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS: Age 3.5% 5.0% - ------------------------------------------------------------------------ 60 5.27 6.16 61 5.39 6.28 62 5.52 6.41 63 5.66 6.55 64 5.81 6.70 65 5.97 6.86 66 6.15 7.03 67 6.33 7.21 68 6.53 7.41 69 6.74 7.62 70 6.97 7.85 - ------------------------------------------------------------------------ We will, with respect to each payment under a Variable Annuity Benefit, notify the payee of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each variable payment. Such notice will be mailed with each payment. Any election, change, revocation or designation shall be made, and will take effect on the Transaction Date, in the same manner as a change of beneficiary, as described in Section 4.04. If a commutation right under an Annuity Benefit is exercised, we may defer payment in accordance with Section 4.07. - -------------------------------------------------------------------------------- PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT. This Contract constitutes the entire agreement between the parties and the provisions of this Contract alone govern with respect to our rights and obligations. A copy of the application is incorporated in and made part of this Contract. This Contract may not be modified, nor may any of our rights or requirements be waived, except in writing and by an authorized officer of Equitable. This Contract may be changed by amendment or replacement upon agreement between you and us without the consent of any other person. SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such rights shall include, but not be limited to, the right to conform this Contract to reflect changes in the Code, applicable Treasury Regulations, or published rulings of the Internal Revenue Service so that this Contract will continue to be an Annuity. SECTION 4.03 NONFORFEITABILITY, NONTRANSFERABILITY, AND ASSIGNMENTS. Your entire interest under the Contract is nonforfeitable. This Contract is non-transferable except by surrender to us. Your interest under this Contract may not be sold, assigned, discounted, or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose to any person other than Equitable. No amount payable under this Contract may be assigned, commuted, or encumbered by the payee, unless otherwise permitted as described herein, and, to the extent permitted by law, no such amount will in any way be subject to any claim against such payee. SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an initial designation of the beneficiary entitled to receive any Death Benefit payable pursuant to Section 2.11. Subject to Section 3.06, you may change such designation from time to time during your lifetime and while this Contract is in force. Any such designation or change will be made by written notice in a form satisfactory to us. A change will, upon receipt at the Processing Office, take effect as of the time the written notice was signed, whether or not you are living on the Transaction Date, but without further liability as to any payment or other settlement made by us before receipt of such change. Unless otherwise specified in the designation, if you have designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive you, and if more than one survive, they will share equally. No. 92 SEPB Page 12 Any part of a death benefit payable pursuant to Section 2.11 for which there is no designated beneficiary living at your death will be payable in a single sum to your children who survive you, in equal shares, or should none survive, then to your estate. If you elect in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by you, with respect to the beneficiary, subject to our rules then in effect. If at your death there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. Any such election must meet the minimum distribution requirements under the Code, as described in Section 3.05. SECTION 4.05 DISQUALIFICATION. In the event that this Contract fails to qualify as an Annuity, we will have the right, upon receiving notice of such fact, to terminate this Contract and pay to you the Annuity Account Value less a deduction for the appropriate part attributable to you of any Federal income tax payable which would not have been payable if you had an Annuity. SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to you or the Employer, as applicable, we reserve the right, at our sole discretion, to limit Contributions under this Contract, as required by law or if such contributions are in excess of the maximum amounts as permitted under the Code. SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment of a death benefit and payment of any portion of your Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange has been closed or trading on it is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Securities and Exchange Commission, by order, permits us to defer payment in order to protect persons with interests in the Investment Divisions. We can defer payment of any portion of your Annuity Account Value in the Guaranteed Interest Division for up to six months while you are living. SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year we will furnish you with a notice showing the following: (1)the amount you have in the Guaranteed Interest Division, (2)the total number of Accumulation Units you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3)the Accumulation Unit Values, (4)the amount you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5)the Annuity Account Value, (6)the Cash Value, and (7)the amount of death benefit payable with respect to you. We will also furnish annual calendar year reports concerning the status of the Annuity and any other reports required by the Code or applicable Treasury Regulations. After the Retirement Date, we will notify you of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.09 AGE. If your age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by us will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. No. 92 SEPB Page 13 OWNER: JOHN DOE ANNUITANT: JOHN DOE CONTRACT NUMBER: 00 000 00 ISSUE DATE: FEB 28, 1992 CONTRACT DATE: FEB 28, 1992 RETIREMENT DATE: JAN 1, 2020 THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York, New York 10116 AGREES o TO ALLOCATE the Contributions made to this Contract, after deduction of any applicable tax charge, to the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division of the Separate Account (referred to in this Contract as the "Investment Divisions") or to the Guaranteed Interest Division, in accordance with Sections 2.02, 2.03 and 2.04 or in part to any one, as directed by you, and o TO APPLY the Annuity Account Value at the Retirement Date to provide the Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant is then living, and o TO PROVIDE the Annuitant with the other rights and benefits of this Contract. This is the entire Contract. In this Contract, "We", "our" and "us" mean the Equitable Life Assurance Society of the United States. "You" and "your" mean the Annuitant at the time a right is exercised by the Annuitant. TEN DAYS TO EXAMINE CONTRACT--You may cancel this Contract by returning it to us within ten days after receipt of it. Upon such cancellation, we will refund any Contribution made to us on your behalf under this Contract. /s/Molly K. Heines /s/Richard H. Jenrette VICE PRESIDENT AND SECRETARY CHAIRMAN OF THE BOARD AND CHIEF EXECUTIVE OFFICER THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.26 IS 5% OR 3.5%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE NOT TO EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE TRUST. No. 92 TSAA This Contract is issued in consideration of the payment to us of the Contributions made under the terms of this Contract. The provisions on the following pages are part of this Contract. - -------------------------------------------------------------------------------- TABLE OF CONTENTS DEFINITIONS Page Section 1.00 - Agreement..........................................4 1.01 - Annuitant..........................................4 1.02 - Annuity............................................4 1.03 - Annuity Account Value..............................4 1.04 - Annuity Benefit....................................4 1.05 - Cash Value.........................................4 1.06 - Class of Contracts.................................5 1.07 - Code...............................................5 1.08 - Contract...........................................5 1.09 - Contract Date......................................5 1.10 - Contract Year......................................5 1.11 - Contribution.......................................5 1.12 - Divisions..........................................5 1.13 - Elective Deferrals.................................5 1.14 - Eligible Annuity Certain...........................5 1.15 - Employer...........................................5 1.16 - ERISA..............................................5 1.17 - Guaranteed Interest Rate...........................5 1.18 - Joint and Survivor Life Annuity Form...............5 1.19 - Life Annuity Form..................................5 1.20 - Normal Form........................................5 1.21 - Period Certain Annuity.............................5 1.22 - Plan...............................................6 1.23 - Processing Office..................................6 1.24 - Retirement Date....................................6 1.25 - Separate Account...................................6 1.26 - Separate Account Definitions.......................7 1.27 - Transaction Date...................................7 1.28 - Trust..............................................7 ANNUITY ACCOUNT VALUE Section 2.01 - Contributions......................................8 2.02 - Separate Account Investment Divisions..............8 2.03 - Guaranteed Interest Division.......................8 2.04 - Allocation to Divisions............................8 2.05 - Transfers Among Divisions..........................8 2.06 - Termination of this Contract.......................9 2.07 - Partial Withdrawals................................9 2.08 - Charges for Partial Withdrawals....................9 2.09 - Free Corridor Amount..............................10 2.10 - Restrictions on Distributions.....................10 2.11 - Annual Administrative Charge......................10 2.12 - Death Benefit.....................................10 2.13 - Loans.............................................11 ANNUITY BENEFITS Section 3.01 - Fixed Annuity Benefit.............................12 3.02 - Variable Annuity Benefit..........................12 3.03 - Election and Commencement of Annuity Benefits.....12 3.04 - Amount of Annuity Benefits........................13 3.05 - Payment of Annuity Benefits.......................13 3.06 - Special Annuity and Spousal Consent Provisions....15 GENERAL PROVISIONS Section 4.01 - Contract..........................................16 4.02 - Statutory Compliance..............................16 4.03 - Nontransferability and Assignments................16 4.04 - Beneficiary.......................................16 4.05 - Disqualification of Plan or Contract..............17 4.06 - Future Contributions..............................17 4.07 - Deferment.........................................17 4.08 - Annual Notice.....................................17 4.09 - Age...............................................17 No. 92 TSAA Page 2 OWNER: JOHN DOE ANNUITANT: JOHN DOE CONTRACT NUMBER: 00 000 00 ISSUE DATE: FEB 28, 1992 CONTRACT DATE: FEB 28, 1992 RETIREMENT DATE: JAN 1, 2020 INITIAL GUARANTEED INTEREST RATE: 7.50% TO MAR 31, 1992 MINIMUM GUARANTEED INTEREST RATE: 6.00% TO DEC 31, 1992 3.00% AFTER DEC 31, 1992 BENEFICIARY: JANE DOE FORM NUMBER: 92 TSAA - -------------------------------------------------------------------------------- TABLE OF GUARANTEED VALUES ISSUE AGE 38 MALE $1000 ANNUAL CONTRIBUTION NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY SINCE FIRST CONTRIBUTION CASH VALUE ANNUITY AT AGE 65* - ------------------------ ---------- ------------------ 1 977 6.63 2 1,946 16.20 3 2,944 26.67 4 3,998 36.84 5 5,064 46.70 6 6,220 56.28 7 7,362 65.59 8 8,538 74.62 9 9,841 83.38 10 11,204 91.90 11 12,629 100.16 12 14,118 108.18 13 15,673 115.97 14 17,144 123.54 15 18,658 131.18 16 20,218 138.64 17 21,824 145.90 18 23,479 152.80 19 25,213 159.70 20 27,000 166.03 24 (Age 62) 34,697 189.57 27 (Age 65) 41,098 205.49 THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000 CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE (SEE SECTION 2.11) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE ANNUITY ACCOUNT VALUE (SEE SECTION 1.05). THE TABLES ASSUME THAT 100% OF ALL CONTRIBUTIONS AND EARNINGS ARE ALLOCATED TO AND REMAIN IN THE GUARANTEED INTEREST DIVISION. YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS. THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A SETTLEMENT WILL BE SUBJECT TO A CHARGE (SEE SECTION 3.04). *ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO SURVIVOR)WITH JOINT ANNUITANT THE SAME AGE AS THE ANNUITANT. No. 92 TSAA Page 3 - -------------------------------------------------------------------------------- PART I--DEFINITIONS SECTION 1.00 AGREEMENT. The term "Agreement" means an agreement described in Treasury Regulation Section 1.403(b)-1(b)(3) between an Employer and an employee of the Employer, in which the Employer agrees to purchase an Annuity for the employee. If Employer contributions to purchase the Annuity result from the employee's agreement to take a reduction in future salary or forgo a future salary increase, such Agreement is referred to as a "Salary Reduction Agreement" within the meaning of Sections 402(g)(3)(C) and 3121(a)(5)(D) of the Code. SECTION 1.01 ANNUITANT. The term "Annuitant" means the owner of this Contract, as shown on page 3 and on whose behalf this Contract has been purchased and is maintained, and who exercises all rights under this Contract. SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in accordance with the terms of the Plan or Agreement, which contract meets the requirements for qualification under Section 403(b) of the Code. SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts that you have in the Guaranteed Interest Division and the Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03, plus any reserve or suspense account pursuant to loans under Section 2.13. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by us pursuant to Section 3.04 of this Contract. Various sections of this Contract (Sections 1.18, 1.19, 1.20, 3.01 and 3.02) refer to monthly payments to be made under an Annuity Benefit. You may wish to have your Annuity Benefit paid at other intervals, such as quarterly, semi-annually, or annually, instead of monthly. You may elect this at the time you elect the Annuity Benefit form as described in Section 3.03; in that event, all references in this Contract to monthly payments will be deemed to mean payments at the frequency you elect, subject to our rules at the time of election. SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value less any applicable withdrawal charge determined as follows: The withdrawal charge equals the lesser of (a) or (b) where (a) equals 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the excess of (i) the Annuity Account Value over (ii) the Free Corridor Amount defined in Section 2.09; and (b) is the excess, if any, of (i) 8% of the total Contributions made on your behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior charges for partial withdrawals made pursuant to Section 2.08. However, notwithstanding the above, if you are age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. A withdrawal charge will not apply, which means the Cash Value will equal the Annuity Account Value upon any of the following occurrences: (i) your attainment of age 59 and 6 months, and your completion of at least five Contract Years, or (ii) you die and a distribution is made to your beneficiary, or (iii) your attainment of age 55, your completion of at least five Contract Years and the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase an Eligible Annuity Certain, defined in Section 1.14, or (iv) your completion of at least three Contract Years and the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase a Period Certain Annuity, defined in Section 1.21, where the certain period of such annuity is at least ten years, or (v) the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase a Life Annuity distribution option, or (vi) your attainment of age 55, your completion of at least five Contract Years, and separation from service, or (vii) your completion of at least twelve Contract Years. No. 92 TSAA Page 4 SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all Contracts with a Contract Date in the same Calendar Year. SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.08 CONTRACT. The term "Contract" means this Contract. SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt by us of both the application for this Contract, properly signed and completed, and a Contribution. SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month period beginning on (i) the Contract Date, and (ii) each anniversary thereafter, unless otherwise agreed to in writing by us. SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us for you with respect to an Annuity purchased for you under the Plan. We are under no obligation to accept any Contribution less than $20.00. Contributions may be either Elective Deferrals or Employer Contributions pursuant to the Plan. The Employer shall indicate to us the amount and type of each Contribution. SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or severally as the case may be, the following Divisions described in this Contract: (a) the Guaranteed Interest Division, and (b) the Investment Division of the Separate Account. SECTION 1.13 ELECTIVE DEFERRALS. The term "Elective Deferrals" means Contributions made pursuant to a Salary Reduction Agreement as defined in Section 1.00. SECTION 1.14 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by us which extends beyond your attainment of age 59 and 6 months and does not permit any prepayment of the unpaid principal (that is, no withdrawal or single sum payment) prior to your attainment of age 59 and 6 months. SECTION 1.15 EMPLOYER. The term "Employer" means (i) an organization described in Section 501(c)(3) of the Code which is exempt from Federal income tax under Section 501(a) of the Code; or (ii) a State, political subdivision of a State, or an agency or instrumentality of any one or more of the foregoing, in connection with services performed by an employee for an educational organization described in Section 170(b)(1)(A)(ii) of the Code. SECTION 1.16 ERISA. The term ERISA means the Employee Retirement Income Security Act as amended. SECTION 1.17 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in the Guaranteed Interest Division. The initial rate to apply is shown on page 3 of this Contract. Section 2.03 describes the determination of the Rate to apply thereafter. SECTION 1.18 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by you. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.19 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity issued by us or one of our affiliated or subsidiary life insurance companies, providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.20 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under this Contract means (i) if you have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (with 100% of the monthly amount payable to your spouse), and (ii) if you do not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.21 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by us or one of our affiliated or subsidiary life insurance companies, which does not permit any prepayment of the unpaid principal (that is, you cannot elect to receive part of your payments as a single sum payment with the remainder paid in monthly annuity payments). No. 92 TSAA Page 5 SECTION 1.22 PLAN. The term "Plan" means a program established by an Employer, for the purchase of Annuities on behalf of employees. The Employer shall be the "Plan Administrator" within the meaning of Section 414(g) of the Code and applicable Treasury Regulations. SECTION 1.23 PROCESSING OFFICE. The term "Processing Office" mean our Individual Annuity Center, P.O. Box 2996, G.P.O., New York, New York 10116, or such other location as we shall designate by advance written notice to the Employer, or the Plan's Trustee, as applicable, and to you. SECTION 1.24 RETIREMENT DATE. The term "Retirement Date" means the date on which you attain your retirement age as shown on page 3 of this Contract. Before the Retirement Date you may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). The Retirement Date selected either initially or by later change must be in accordance with the terms of the Plan. No Retirement Date shall be later than the date of your attainment of age 70 and 6 months. Any election for such change must be made in writing by you and shall not take effect until received by us at our Processing Office. SECTION 1.25 SEPARATE ACCOUNT. The term "Separate Account" means Separate Account A which is organized as a unit investment trust (a type of investment company). We have established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited to or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities and variable life insurance. The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to these Contracts will not be chargeable with liabilities arising out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to our General Account. The Separate Account consists of "Investment Divisions". Each Investment Division may invest its assets in a separate class (or series) of shares of a designated Trust where each class (or series) represents a separate portfolio in the Trust. We reserve the right to change the designated trust or investment company or to add designated trusts or investment companies. The Investment Divisions available are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. The Guaranteed Interest Division is not a part of the Separate Account, but rather is an asset of our General Account. We will value the assets of each Investment Division on each business day. A business day is any day on which we are open, the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio of the securities in which an Investment Division is invested to materially affect the Accumulation Unit Value. We may, at our discretion, invest the assets of any Investment Division in any investment permitted by applicable law. We may rely conclusively on the opinion of counsel (including attorneys in our employ) as to what investments we are permitted by law to make. We reserve the right to (i) cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such committee at any time; (iii) restrict or eliminate any voting rights as to the Separate Account; (iv) operate the Separate Account by making direct investments, or in any other form; (v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or remove Investment Divisions (or sub-divisions of Investment Divisions) from the Separate Account; (The term "Investment Division" in this Contract shall then refer to any other Investment Division in which the asset of a Class of Contracts to which this Contract belongs, were placed); (vi) combine any two or more Investment Divisions (or sub-divisions of Investment Divisions) of the Separate Account; and (vii) withdraw from any Investment Division and to allocate to another Investment Division assets determined by us to be associated with the Class of Contracts to which this Contract belongs. No. 92 TSAA Page 6 If the exercise of these rights in a material change in the underlying investments of an Investment Division, you will be notified of such exercise, as required by law. Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for any applicable tax charges) at a rate not to exceed 1.49% per year for the Stock, Money Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock Division, for financial accounting, death benefits, mortality risk, expenses and expense risk. The charge shall be made in accordance with Subsection (c) of the Net Investment Factor provision in Section 1.25. The relative proportion of these charges may be modified. The daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust shall not exceed a total annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to this Contract. The maximum rate may not be altered without your approval. SECTION 1.26 SEPARATE ACCOUNT DEFINITIONS. VALUATION PERIOD: Each business day together with any preceding consecutive non-business days. NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b), minus (c), where (a) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the Valuation Period before giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period. For this purpose, we use the share value reported to us by the Trust. (b) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the preceding Valuation Period (after any amounts allocated to or withdrawn for that Valuation Period). (c) is the daily asset charge for the expenses of this Contract, times the number of calendar days in the Valuation Period. ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an Investment Division where your Contributions are invested and which is used in determining the amount you have in an Investment Division. ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of each Accumulation Unit in an Investment Division on a given date. The Accumulation Unit Value for a Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such Valuation Period. ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable from the Stock Division of the Separate Account under a Variable Annuity Benefit as defined in Section 3.02. ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1, 1968. On August 27, 1981, the date the first Contribution was put into the Stock Division, the Annuity Account Value was $1.26 and $1.52 for contracts with Assumed Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE ANNUITY UNIT VALUE: The Average Annuity Unit Value for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods ending in such month. SECTION 1.27 TRANSACTION DATE. The Transaction Date is the business day we receive a Contribution or a written contract transaction request providing the information we need at the Processing Office. In the case of a transfer request initiated through the use of a touch tone telephone as described in Section 2.05, the term Transaction Date is the business day the telephone transaction is received. SECTION 1.28 TRUST. The term "Trust" means the designated trust or investment company in which Separate Account assets are invested. NO. 92 TSAA Page 7 - -------------------------------------------------------------------------------- PART II--ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. The Employer is to make Contributions, from time to time on such dates and in such amounts as determined by the Employer pursuant to the terms of the Plan or Agreement. You are to specify the amount to be allocated to each Division. Each Contribution received by us with respect to you will, before its allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. Pursuant to the terms of the Plan, if applicable, you may, with our agreement, (i) transfer to this Contract any amount held under a contract or account that meets the requirements of Section 403(b) of the Code ("Transferred Funds"), or (ii) roll over contributions from a contract or account that meets the requirements of Section 403(b) of the Code, or from a conduit individual retirement arrangement described in (i) above, as to what portion, if any, of the amounts of the Transferred Funds which are exempt from the distribution restrictions described in Section 2.10, and the minimum distribution rules described in Section 3.05, we will treat all such amounts as being subject to such restrictions. Any Transferred Funds from a contract not issued by us will, before allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when an amount is allocated to or withdrawn or transferred from an Investment Division, the Annuity Account Value will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units you have in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Sections 2.07, 2.08 or 2.13, or transferred from the Investment Division pursuant to Section 2.05. The amount you have in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units in the Investment Division on that date, and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under this Contract terminates on the earliest of (i) your election and commencement of annuity benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii) termination of this Contract pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division becomes part of our general assets, which support the guarantees of this Contract and other contracts. The amount in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 or 2.13, plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Section 2.07, 2.08 or 2.13 or transferred from the Guaranteed Interest Division, pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division on a Transaction Date pursuant to Section 2.04. We will credit the amount you have in the Guaranteed Interest Division with interest at effective annual rates that we determine. For each Class of Contracts we determine a yearly guaranteed interest rate that will remain in effect throughout the next year. We guarantee that this yearly guaranteed interest rate will never be less than 3%. Participation in the Guaranteed Interest Division under the terms of this Contract terminates on the earliest of (i) election and commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, and (iii) Termination of this Contract pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section 2.01 is allocated (after deduction of any applicable tax charge) to one or more Divisions, at your sole direction as specified to us. Allocation percentages must be in whole numbers and the sum must equal 100. The allocation is made as of the Transaction Date on which we have received both such Contribution and such direction. Contributions made to an Investment Division purchase Accumulation Units in that Investment Division, using the Accumulation Unit Value next computed after the Transaction Date. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the Transaction Date with respect to each transfer from the Division pursuant to Section 2.05, (iii) on the Transaction Date with respect to each withdrawal pursuant to Section 2.07, (iv) at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, (v) upon Termination of this Contract, pursuant to Section 2.06, and (vi) upon your death pursuant to Section 2.12. SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request or through the use of a touch tone telephone, transfer all or part of the amount you have in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; (2) amounts in the Money Market Division may be transferred to other Divisions. Written authorization for touch tone telephone initiated transfers is only required when authorization for No. 92 TSAA Page 8 telephone transfers is requested. Upon advance written notice to you, we reserve the right to discontinue the acceptance of transfer requests through the use of a touch tone telephone. All transfers will be effective on the Transaction Date and will be subject to our rules in effect at the time of transfer. With respect to the Investment Division, the transfer will be made at the Accumulation Unit Value next computed after the Transaction Date. No transfers are permitted to the Money Market Division from the other Divisions. SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the terms of the Plan, including, for Plans subject to Title I of ERISA, if applicable, the spousal consent rules set forth in Section 3.06, you may elect, by written notice, to terminate this Contract. In addition, termination of the Contract is subject to the restrictions on distributions set forth in Section 2.10 of this Contract. We will determine the Cash Value as of the Transaction Date we receive your written election. The payment of such Cash Value to you may be deferred by us in accordance with the provisions of Section 4.07. Subject to the terms of the Plan, and the restrictions on distributions set forth in Section 2.10, we reserve the right to pay the Annuity Account Value under this Contract and terminate this Contract. This right may be exercised only if both (i) you made no Contributions during the last three completed Contract Years, and the Annuity Account Value is less than $500, or (ii) a partial withdrawal is made that would result in your Annuity Account Value falling below $500. We also reserve the right to terminate this Contract if no Contributions have been made within 120 months of the Contract Date shown on page 3 of this Contract. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. If this Contract is terminated, surrendered or exchanged prior to your Retirement Date, any applicable tax charges we have paid may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on terminations, unless a change in applicable law has occurred with respect to your Contract. SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under the terms of the Plan, and the restrictions on distributions set forth in Section 2.10, you may elect, by written notice to us, to make partial withdrawal from the Divisions. For Plans subject to Title I of ERISA, partial withdrawals may be subject to the spousal consent rules if applicable, set forth in Section 3.06. Following receipt of your written notice, we will pay the lesser of the Cash Value, less any funds restricted pursuant to Section 2.13, or the amount of partial withdrawal requested to the person entitled to receive such payment as you designate to us in writing. The amount paid plus any withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the amounts you have in the Divisions. Unless instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts that you have in such Divisions. Upon any partial withdrawal payment, we will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by us in accordance with the provisions of Section 4.07. We may decline to accept a request for a partial withdrawal of less than $300, or where the request violates the provisions of Sections 2.07 or 3.06. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, we will so advise you and reserve the right to pay the Annuity Account Value to you and terminate this Contract. SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity Account Value, pursuant to Section 1.05. WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than the Free Corridor Amount, we will (i) first withdraw from the Divisions an amount equal to the Free Corridor Amount, in proportion to the amount you have in them, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a partial withdrawal charge. Such partial withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter NO. 92 TSAA Page 9 of the amount withdrawn in excess of the Free Corridor Amount (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the total Contributions made on your behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to this Section. However, notwithstanding the above, if you are age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. If withdrawals are made from this Contract prior to the Retirement Date, any applicable tax charges we have paid with respect to this Contract may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on withdrawals, unless a change in applicable law has occurred with respect to your Contract. SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means if you have completed three Contract Years or attained age 59 and 6 months an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the current Contract Year or pursuant to the repayment of interest or principal on a loan, in the Current Contract Year. If you have not completed three Contract Years or attained age 59 and 6 months, the Free Corridor Amount is zero. SECTION 2.10 RESTRICTIONS ON DISTRIBUTIONS. Notwithstanding anything in this Contract to the contrary, payments of Cash Value pursuant to the termination of this Contract under Section 2.06, partial withdrawals under Section 2.07, death benefits under Section 2.12 or Annuity Benefits under Section 3.03 may be limited as provided in Section 403(b)(11) of the Code and in this Section, to the extent they are attributable to Elective Deferral Contributions made to this Contract after December 31, 1988 and earnings credited after December 31, 1998 on Elective Deferral Contributions made before and after December 31, 1988 (collectively, "Restricted Amounts"). Distributions of Restricted Amounts may not be made until you attain age 59 years and six months, separate from service, die, or become disabled (within the meaning of Section 72(m)(7) of the Code). Distributions of Elective Deferral Contributions made after December 31, 1988--(but not any earnings credited after December 31, 1988 attributable to Elective Deferral Contributions made before or after December 31, 1988) may also be made in the case of hardship (within the meaning of Section 403(b)(11) of the Code and applicable Treasury Regulations). If you request payment of Restricted Amounts on the grounds of disability or hardship you must furnish to us proof of such disability or hardship as may be required by the Plan, the Code, and applicable Treasury Regulations in a form satisfactory to us. SECTION 2.11 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract Year, if the Annuity Account Value on that date is less than $25,000, we will withdraw from the Divisions an Annual Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account Value including the amount of any withdrawals pursuant to Section 2.07 during that Contract Year. The charge will be allocated among the Divisions in proportion to the amounts that you have in the Divisions. For this purpose, any loan reserve amount is included within the Guaranteed Interest Division. The portion of the charge attributable to the Guaranteed Interest Division and any loan reserve account will be first withdrawn from the Guaranteed Interest Division and then, if the amount you have in the Guaranteed Interest Division is not sufficient, the remaining allocation will be withdrawn from the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. If the Annuity Account Value is less than $25,000, on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of Termination of this Contract pursuant to Section 2.06 or 2.12, we will prorate the Annual Administrative Charge applicable to the completed portion of the Current Contract Year and withdraw such amount in lieu of the Annual Administrative Charge described in this Section for the applicable part of that Contract Year. If the Annuity Account Value is $25,000 or greater at the end of a Contract Year, the Annual Administrative Charge is zero. SECTION 2.12 DEATH BENEFIT. Upon receipt of due proof of your death, we will pay to the beneficiary designated to receive such payment, pursuant to Section 4.04 of this Contract, the amount of death benefit payable. The amount of the death benefit is equal to the greater of (i) the Annuity Account Value less any outstanding loan and (ii) the minimum death benefit. Such minimum death benefit is the sum of all Contributions made pursuant to Section 2.01 (before reduction for any applicable tax charge) less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount that was withdrawn is to the Annuity Account Value. If, in accordance with the provisions of Section 2.01, the Cash Value of another annuity contract issued by us, or one of our affiliated or subsidiary life insurance companies, which provides for a death benefit before retirement is equal to the greater of the contract Cash Value or alternate amount based on premiums paid or Contributions made under the annuity contract, is transferred to this Contract, such Cash Value or an alternative amount as of the date of transfer, will be included in the "sum of all Contributions" in lieu of the amount of Cash Value transferred for purposes of the death benefit under this Contract. We will pay the death benefit to the beneficiary in the form of an Annuity Benefit if you have made the election described in the last paragraph of Section 4.04. Also in accordance with the last paragraph of Section 4.04, if no such election is in effect at your death, we will pay the death benefit to the beneficiary in a single sum, unless the beneficiary elects, before we pay the death benefit, to apply the death benefit to an Annuity Benefit, for Plans subject to Title I of ERISA. NO. 92 TSAA Page 10 Distributions pursuant to this Section are subject to the terms of the Plan and the Spousal Consent Rules set forth in Section 3.06 for Plans subject to Title I of ERISA. Upon payment of the death benefit, the amount you have in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.13 LOANS. Unless otherwise restricted by the Plan or the Code, you may effect a loan under this Contract before the election and commencement of Annuity Benefits. However, if the issuance of this Contract is pursuant to the terms of a Plan subject to Title I of ERISA, then loans shall not be available under this Contract. Future restrictions in the Code may require revision or withdrawal of the loan provisions as provided below. Your Annuity Account Value (including the loan reserve account as described below) will be the sole security for the loan. A loan is effective on the first day of the month following the date your loan agreement form is approved by us. The amount of the loan may not be more than (i) 80% of the Annuity Account Value of this Contract, if such total Annuity Account Value is greater than or equal to $3,750 and less than $12,500, (ii) $10,000, if the Annuity Account Value is greater than or equal to $12,500 and less than $20,000, and (iii) 50% of the Annuity Account Value if the Annuity Account Value is greater than or equal to $20,000, but in no event shall the loan amount exceed $50,000 less the highest outstanding balance under this Contract during the one year period ending the day before the effective date of the loan. The minimum loan permitted is $3,000. For this purpose, the Annuity Account Value is taken as of the loan effective date. Only one outstanding loan is permitted at a time under this Contract. As a condition for granting a loan, we will require you to represent that the loan amount requested, when aggregated with loans (principal plus interest) from all qualified plans of your Employer, does not exceed the greater of $10,000 or 50% of the value of your nonforfeitable accrued benefits, and in no event exceeds $50,000 less the highest outstanding balance of all loans from qualified plans during the one year period ending on the day before the effective date of the loan. We reserve the right to also require that you elect not to have income tax withholding apply with respect to an interest and/or loan principal that would otherwise be subject to withholding. The loan term will be either (i) ten years, if you represent that the purpose of the loan is to acquire, build or substantially rehabilitate a dwelling unit which, within a reasonable period of time, is to be used as your principal residence or (ii) five years. In any event, the loan term may not extend beyond, that is, full repayment of the loan will be required upon the earlier of (i) the election and commencement of Annuity Benefits pursuant to Section 3.03, (ii) the date we received written notice from you to terminate this Contract pursuant to Section 2.06, (iii) the date we pay a Death Benefit pursuant to Section 2.12, and (iv) any date provided for such loans by Federal tax rules including acceleration of the loan repayment in order that the operation of the loan provisions do not adversely affect the tax treatment of this Contract. On the loan effective date, we will transfer to a loan reserve account an amount equal to the sum of (i) the loan amount, which will earn interest at the effective annual rate of 4% during the loan term and (ii) 25% of the loan amount, which will earn interest at the Guaranteed Interest Rate, as defined in this Contract. You may specify from which Divisions these amounts are to be transferred. In the absence of your direction, or if your directions cover only part of the amount required to be transferred to the loan reserve account, we will transfer the required (or additional required) amounts from each Division in proportion to the amount that you have in such Divisions. On the first day of the third month following the effective date of the loan and quarterly thereafter (or first business day thereafter, if such day is not a business day), the amount of interest earned at 4% annually during the prior quarter will be transferred to the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. You may not make any partial withdrawals or transfers from the loan reserve account. Beginning the first day of the third month of each quarter following the effective date of the loan and quarterly on the first day of the month thereafter, loan payments must be made to us. Such payments shall be amortized in substantially level payments over the term of the loan and will be equal to the sum of (a) and (b) where (a) is the loan interest, calculated at an effective annual rate of 6%, and (b) is a portion of the loan principal. The loan must be repaid in part on each quarterly due date and may be repaid in full at any time on or after the first loan anniversary and must include the full interest due. Any payments received will first be applied to interest due, with the balance applied towards repayment of the loan. Any partial loan repayment will result in a transfer of the amount equal to the principal repaid from (i) the portion of the loan reserve account that earns interest at the effective annual rate of 4% to (ii) the Guaranteed Interest Division and may be withdrawn, transferred or annuitized as directed in this Contract. By each due date, if the amount of the loan payment is less than the amount due or the loan payment is not received at our Processing Office, we will deduct and treat as a partial withdrawal from the loan reserve account an amount equal to the interest and principal payments due plus any applicable withdrawal charges and any required income tax withholding, if such partial withdrawal will not be a withdrawal of "restricted amounts" as described in Section 2.10 of this Contract. Specifically, an amount equal to the principal payment will be deducted from the portion of the loan reserve account which earns interest at 4%, and an amount equal to the interest payment plus any applicable withdrawal charges and required income tax withholding will be deducted from the portion of the loan reserve account which earns interest at the Guaranteed Interest Rate. NO. 92 TSAA Page 11 To the extent a loan repayment is required and a partial withdrawal cannot be made due to the restrictions described in Section 2.10 of this Contract, a default in a loan payment will occur. We will transfer from the loan reserve account to a suspense account an amount equal to the interest and principal payments due. We will deduct from the loan reserve account a default charge (as defined in this Section) as well as any required income tax withholding. We will treat the amount transferred to the suspense account, plus any required income tax withholding, as a "deemed distribution," that is, such amount will be considered to have been distributed as provided under Section 72(p) of the Code. Specifically, an amount equal to the principal payment due will be transferred from the portion of the loan reserve account which earns interest at 4%, and an amount equal to the interest payment due will be transferred from the portion of the loan reserve account which earns interest at the Guaranteed Interest Rate. Any applicable default charge and required income tax withholding will be deducted from the portion of the loan reserve account which earns interest at the Guaranteed Interest Rate. The default charge on the amount of the deemed distribution is equal to the applicable withdrawal charges which would have applied if such amount had been withdrawn from this Contract at such time. Amounts transferred to the suspense account for the purpose of securing the loan and interest payment due will not be subject to future withdrawal charges when the liability for any such defaulted payment is satisfied by a deduction from the suspense account. Amounts transferred to a suspense account will be held there until Federal income tax rules permit such amounts to be deducted from the Contract to satisfy the defaulted loan and interest payment obligation which will be no later than the date you attain age 59 years and 6 months or notify us in writing that an event has occurred which would permit Restricted Amounts to be distributed from the contract under Section 2.10. Amounts held in the suspense account will earn interest at an effective annual rate of 3%. You will also be charged interest on your defaulted loan and interest payment obligation at an effective annual rate of 3% until such time as any such default payment liability can be satisfied by a deduction from the suspense account. The default charge on such deemed distribution is equal to the applicable withdrawal charges for a withdrawal of an amount equal to the interest and principal payments due plus required income tax withholding. Upon your full repayment of the loan, any amounts remaining in the loan reserve account will be transferred to the Guaranteed Interest Division and may be withdrawn, transferred or annuitized as described in this Contract. - -------------------------------------------------------------------------------- PART III--ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the terms of this Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Stock Division of the Separate Account. Such Variable Annuity Benefit will increase if the average daily rate of investment return in the Stock Division is equivalent to more than 6.75% or 5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25% annually, depending on whether the applicable assumed base rate of net investment return referred to in Section 1.26 is 5% or 3.5%, respectively. The daily rate of investment return is before deduction of charges, as described in Section 1.25, not to exceed the maximum rate of 1.75% after any deductions to provide for any applicable tax charge. These charges include a daily charge for financial accounting, death benefits, mortality risk, expenses and expense risk, plus the investment advisory fee charges and direct operating expense charges of the Trust. The amount of the first, second and third payments under any Variable Annuity Benefit provided under the terms of this Contract with respect to a payee is the monthly amount provided pursuant to the fifth paragraph of Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. As described in Section 3.05, we will notify the payee how each Variable Annuity Benefit is determined. SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your Retirement Date, provided you are then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless you elect (i) to receive the Cash Value in a single sum, or (ii) to apply the Annuity Account Value, (less any outstanding loan as set forth in Section 2.13) or Cash Value, whichever is applicable pursuant to the first paragraph in Section 3.04, to provide an Annuity Benefit on any other annuity form offered by us, or one of our affiliated or subsidiary life insurance companies, as elected by you, or (iii) to take partial withdrawals in amounts and at times as required by the Code, pursuant to Sections 2.07 and 3.05, subject to our rules then in effect and any other applicable requirements under the Code. NO. 92 TSAA Page 12 We will provide notice and election forms to you not more than six months before your Retirement Date. If you elect to terminate this Contract, prior to the Retirement Date, pursuant to Section 2.06, an election may be made to receive an Annuity Benefit in lieu of the Cash Value. We will have the right to require that you furnish pertinent information to provide an Annuity Benefit, and we will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. We may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary life insurance companies. If the issuance of this Contract is pursuant to a Plan subject to Title I of ERISA, the rules set forth in Section 3.06 shall apply to your election and the commencement of annuity benefits. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value if the payments under the annuity form involves life contingencies, or (ii) the Cash Value if the Annuity Form elected does not involve life contingencies. The amount applied to provide an Annuity Benefit may be reduced by any applicable tax charge on annuity considerations, as we determine. If we have previously deducted any applicable tax charge from Contributions as provided in Section 2.01, we will not again deduct charges for the same taxes before application to provide an Annuity Benefit, unless a change in applicable law has occurred with respect to your Contract. The balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) our current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, your Contract will be governed by our supplementary contract then in effect. The amount to be applied to provide an Annuity Benefit will, in addition to any tax charge reduction, be reduced by an administrative charge. The amount of such charge will be determined from time to time in accordance with our general practices applicable on a uniform basis to all contracts of the same type as this Contract. After the application of an amount to provide an Annuity Benefit, the amounts you have in the Divisions and the Annuity Account Value shall be zero. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the terms of this Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (with 100% of the amount of your payment continued to your spouse). The amount of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, are based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females, at age zero. The amount of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and the Joint and Survivor Life Annuity Form are based on a 50-50 split of males and females, at age zero and an Assumed Base Rate of Net Investment Return of 3.5% or 5%, whichever applies pursuant to Section 1.26. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females, at age zero, if such annuity form provides for a Fixed Annuity Benefit, and on the projected 1983 Basic Table "a" adjusted to a unisex basis based on a 50-50 split of males and females, at age zero and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section 1.26, if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Distributions attributed to Contributions of Transferred Funds pursuant to Section 2.01 (where you have provided to us written evidence of such balance as of December 31, 1986 must commence no later than age 75. Such distributions will be made in the normal Form of Annuity Benefit, unless you elect to take payments in a single sum or another form of Annuity Benefit then offered by us. Your entire interest in this Contract attributable to all other Contributions made, and earnings credited hereon must be distributed, or begin to be distributed no later than the first day of April following the calendar year in which you attain age 70 and 6 months ("Required Beginning Date"). Your entire interest may be distributed, as you elect, over (a) your life, or the lives of you and your designated beneficiary, or (b) a period certain not extending beyond your life expectancy, or the joint and last survivor expectancy of you and your designated beneficiary. Distributions must be made in periodic payments at intervals of no longer than one year. In addition, payments must be either nonincreasing or they may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the proposed Treasury Regulations, or any successor Regulation thereto. All distributions made hereunder shall be made in accordance with the requirements of Section 403(b)(10) and 401(a)(9) of the Code, including the incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and applicable Treasury Regulations, including the minimum distribution incidental benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or any successor Regulation thereto. Notwithstanding the above paragraphs and the following paragraphs of this Section 3.05, while any distribution shall be subject to such requirements of the Code and regulations, any distribution shall also be subject to the terms of this Contract. That is, the forms of distribution shall be those which are made available by us at the time of your election. NO. 92 TSAA Page 13 For purposes of determining the "period certain" referred to in the first paragraph of this Section, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless you otherwise elect prior to the time distributions are required to begin, those life expectancies shall be recalculated annually. Such election shall be irrevocable and shall apply to all subsequent years. The life expectancy of a non-spouse beneficiary may not be recalculated. Instead, life expectancy will be calculated using the attained age of such beneficiary during the calendar year in which you attain age 70 and 6 months and payments for subsequent years shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. If you die after distribution of your interest in this Contract has begun, the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution being used prior to your death. If you die before distribution of your interest begins, distribution of your entire interest shall be completed no later than December 31 of the calendar year containing the fifth anniversary of your death, except to the extent that an election is made to receive death benefit distributions in accordance with (1) or (2) below: (1) If your entire interest is payable to a designated beneficiary, then your entire interest may be distributed over the life of, or over a period certain not greater than the life expectancy of, the designated beneficiary. Such distributions must commence on or before December 31 of the calendar year immediately following the calendar year of your death. (2) If the designated beneficiary is your surviving spouse, the date distributions that are required to begin in accordance with (1) above shall not be earlier than the later of (A) December 31 of the calendar year immediately following the calendar year of your death or (B) December 31 of the calendar year in which you would have attained age 70 and 6 months. For purposes of determining the "period certain" referred to in the immediately preceding paragraph, life expectancy is computed by use of the expected return multiples in tables V and VI of Treasury Regulation Section 1.72-9. For purposes of distributions beginning after your death, unless otherwise elected by the surviving spouse by the time distributions are required to begin, life expectancies shall be recalculated annually. Such election shall be irrevocable by the surviving spouse and shall apply to all subsequent years. In the case of any other designated beneficiary, life expectancies shall be calculated using the attained age of such beneficiary during the calendar year in which distributions are required to begin pursuant to this Section, and payments for any subsequent calendar year shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. Distributions under this Section are considered to have begun if distributions are made because you have reached your Required Beginning Date or if prior to the Required Beginning Date distributions irrevocably commence to you over a period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1 of the Proposed Treasury Regulations or any successor Regulation thereto. Evidence of each payee's survival must be furnished to us either by personal endorsement of the check drawn for payment or by other means satisfactory to us. If a benefit payment under the terms of this Contract was based on information that is subsequently found to be incorrect, your benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by us will be charged against and underpayments will be added to any payments thereafter falling due under the terms of this Contract with respect to the payee, affecting as many such payments as are necessary to correct the overpayment or underpayment. Our liability, with respect to a payee, is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under this Contract. If we receive evidence satisfactory to us that (i) a payee entitled to receive any payment under the terms of this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, we may make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If a variable annuity form made available by us provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Pursuant to Section 3.03, upon your election, pursuant to Section 3.03 of an annuity form providing payments for a period certain, you may designate (with the right to change such designation) a person or persons to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a payee to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's estate in accordance with the following paragraph. No. 92 TSAA Page 14 If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, we will pay in a single sum to such payee's estate the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis applicable in determining the annuity amount. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. We will require satisfactory evidence of the age of any person upon whose life an annuity form depends. - -------------------------------------------------------------------------------- TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% OF PAYMENT TO CONTINUE TO SPOUSE (Minimum Monthly Income per $1,000 of Annuity Account Value)
- ------------------------------------------------------------------------------------------------------------------------------------ Age 60 61 62 63 64 65 66 67 68 69 70 - ------------------------------------------------------------------------------------------------------------------------------------ 60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88 61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96 62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03 63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11 64 4.89 4.94 5.00 5.05 5.10 5.14 5.19 65 5.00 5.06 5.11 5.17 5.22 5.27 66 5.12 5.18 5.24 5.29 5.35 67 5.24 5.31 5.37 5.43 68 5.37 5.44 5.51 69 5.52 5.59 70 5.67 - ------------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Account Value) - -------------------------------------------------------------------------------- VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS - -------------------------------------------------------------------------------- Age 3.5% 5% - -------------------------------------------------------------------------------- 60 5.27 6.16 61 5.39 6.28 62 5.52 6.41 63 5.66 6.55 64 5.81 6.70 65 5.97 6.86 66 6.15 7.03 67 6.33 7.21 68 6.53 7.41 69 6.74 7.62 70 6.97 7.85 - -------------------------------------------------------------------------------- We will notify the payee, with respect to each payment under a Variable Annuity Benefit, the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each variable payment. Such notice will be mailed with each payment. Any election, change, revocation or designation shall be made, and will take effect on the Transaction Date, in the same manner as a change of beneficiary, as described in Section 4.04. If a commutation right under an Annuity Benefit is exercised, we may defer payment in accordance with Section 4.07. SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS. If this Contract is issued pursuant to a Plan subject to Title I of ERISA, then the provisions of this Section shall supersede any contrary provisions in this Contract. If you are married, your interest in the Contract shall be paid in the Normal Form joint and survivor annuity, and if you are unmarried, your interest shall be paid in the Normal Form life annuity, unless you elect otherwise as described in this Section. If you are married and die before payment of your interest has commenced, your interest shall be paid to your surviving spouse in the form of a life annuity, unless at the time of your death there was a contrary election made pursuant to this Section. The foregoing notwithstanding, your surviving spouse may elect, before payment is to commence, to have payment made in any form permitted under the terms of this Contract. You may elect, at any time within the 90 consecutive day period before the first day of the first period for which your interest is paid as an annuity or in any other form, not to have your interest paid in the Normal Form, in which case it shall be paid in any other form elected under the terms of this Contract. If such interest is to be paid to your spouse upon your death, you may elect, during the period beginning on the first day of the plan year of the Plan in which you attain age 35 (or, if you separate from service prior to that plan year, beginning on the date of separation) and ending with your death, for a beneficiary other than your spouse to receive payment of the value of your interest. In No. 92 TSAA Page 15 addition, if you will not yet attain age 35 by the end of any current plan year, you may make a special qualified election to designate a beneficiary other than your spouse to receive payment of the value of your interest, which special qualified election shall be effective for the period beginning on the date of such election and ending on the first day of the plan year in which you will attain age 35. Amounts payable in accordance with this Section will be automatically reinstated as of the first day of the plan year in which you attain age 35 unless a new election designating a beneficiary other than the spouse is made in accordance with the requirements of this Section. Any election described in the foregoing paragraph must be consented to by your spouse in writing before a notary or a representative of the Plan unless you can prove that there is no spouse or that the spouse cannot be located. Also, if you have become legally separated from your spouse or have been abandoned (within the meaning of local law) and have a court order to such effect, spousal consent is not required unless a qualified domestic relations order provides otherwise. Your election must designate a specific beneficiary (including any class of beneficiaries or any contingent beneficiaries) that may not be changed without further consent of the spouse, unless the spouse's consent expressly permits designation by you without further consent of the spouse. The spouse's consent under this section shall acknowledge the effect of the election. In addition, the spouse's consent (or the establishment that the consent of the spouse may not be obtained) shall only be valid with respect to such spouse. Your waiver of the Normal Form joint and survivor annuity shall not be effective unless the election designates a form of benefit payment which may not be changed without spousal consent (or the spouse expressly permits designations by you without any further spousal consent). A consent that permits designations by you without any requirement of further consent by such spouse must acknowledge that the spouse has the right to limit consent to a specific beneficiary and a specific form of benefit where applicable, and that the spouse voluntarily elects to relinquish either or both of such rights. If you make an election under this Section, you may revoke that election, without spousal consent, at any time before the first day of the first period for which an amount is paid as an annuity or in any other form. The provisions requiring spousal consent in this Section shall also apply with regard to your election to terminate this Contract or make partial withdrawals pursuant to Sections 2.06 and 2.07, and with respect to a beneficiary designation set forth in Section 4.04. A spouse's written consent, witnessed by a representative of the Plan or a notary public, must be given on a form acceptable to the Employer and us, within the 90 consecutive day period prior to any such payment, or withdrawal, or beneficiary designation, unless you can show that you have no spouse or that the spouse cannot be located. If the Annuity Account Value applied to provide the spousal benefits on the date payment is to commence is in the aggregate less than $3,500, we may choose to make payment in a single sum rather than in the form of a Qualified Joint and Survivor Annuity or Life Annuity as described herein. Upon any payment made pursuant to this Section, we will be released from any and all liability for payment with respect to the Contributions made for you. - -------------------------------------------------------------------------------- PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the parties and the terms of this Contract alone will govern with respect to our rights and obligations. A copy of the application is incorporated in and made part of this Contract. This Contract may not be modified, nor may any of our rights or requirements be waived, except in writing and by our authorized officer. The terms of this Contract may be changed by amendment or replacement upon agreement between you and us without the consent of any other person. SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the terms of this Contract to reflect changes in the Code, or applicable Treasury Regulations, or in regulations or published rulings of the Internal Revenue Service so that this Contract will continue to be an Annuity. SECTION 4.03 NONTRANSFERABILITY AND ASSIGNMENTS. Your entire interest under this Contract is nonforfeitable. No interest of yours (or of a beneficiary) under this Contract may be transferred to any person other than us upon the surrender of this Contract. Except as permitted under applicable law, no right or interest of you or any other payee or beneficiary in this Contract shall be (a) assignable; (b) subject to any lien; (c) liable for, or subject to, any obligation or liability of any person. The preceding sentence shall not apply to any assignment, transfer or attachment pursuant to a qualified domestic relations order (as defined in Section 414(p) of the Code). SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an initial designation of the beneficiary entitled to receive any death benefit payable pursuant to Section 2.12. You may change such designation from time to time during your lifetime, and while this Contract is in force. Any such designation or change must be made by written notice in a form satisfactory to us. A change will, upon receipt at the Processing Office, take effect as of the time the written notice was signed, whether or not you are living on the date of receipt, but without further liability as to any payment or other settlement made by us before receipt of such change. Beneficiary designations are subject to the rules of Section 3.06 if the Contract is issued pursuant to a Plan subject to Title I of ERISA. No. 92 TSAA Page 16 Unless otherwise specified in the designation, if you have designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive you, and if more than one survive, they will share equally. Any part of a death benefit payable pursuant to Section 2.12 for which there is no designated beneficiary living at the time of your death, will be payable in a single sum to your children who survive you, in equal shares, or should none survive, then to your estate. If you elect in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity previously elected by you, with respect to the beneficiary, subject to our rules then in effect. If, at your death, there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. Any such election must meet the minimum distribution requirements under the Code, as described in Section 3.05. SECTION 4.05 DISQUALIFICATION. In the event that the Plan fails to qualify as a Plan under Section 403(b) of the Code and applicable Treasury Regulations, we reserve the right, upon receiving notice of such fact, to transfer the Annuity Account Value under this Contract to another annuity contract issued by us, an affiliate subsidiary, on your life, or to terminate this Contract and pay to you the Annuity Account Value less deduction for applicable taxes, solely at our option. SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to the Employer, we reserve the right at our sole discretion to limit Contributions under this Contract. SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment of a death benefit and payment of any portion of your Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange has been closed or trading on it is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Securities and Exchange Commission, by order, permits us to defer payment in order to protect persons with interests in the Investment Divisions. We can defer payment of any portion of your Annuity Account Value in the Guaranteed Interest Division for up to six months while you are living. SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year we will furnish you with a notice showing the following: (1) the amount you have in the Guaranteed Interest Division, (2) the total number of Accumulation Units you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Values, (4) the amount you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the amount you have in the loan reserve account, (6) the Cash Value, and (7) the amount of death benefit payable with respect to you. We will also furnish annual calendar year reports concerning the status of the annuity and any other reports required by the Code or applicable Treasury Regulations. After the Retirement Date, we will notify you of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.09 AGE. If your age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by us will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. No. 92 TSAA Page 17 - -------------------------------------------------------------------------------- APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES PROCESSING OFFICE: INDIVIDUAL ANNUITY CENTER, P.O. BOX 2996, NEW YORK, NEW YORK 10116-2996 QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR: EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY - -------------------------------------------------------------------------------- TYPE OF PURCHASE (Complete One Plan Only) A. |X| TSA PUBLIC SCHOOL (GV-PS-I) B. |_| TSA 501(C)(3) ORGANIZATION (GV-501-I) C. |_| TSA University (GV-PS-U-I) D. |_| IRA Individual (Including IRA to IRA transfers) (GV-IRA 4971) E. |_| IRA Unit Billed (Including IRA to IRA transfers) (GV-IRA 4971) F. |_| IRA QUALIFIED PLAN ROLLOVER-- (QP IRA) (Distribution from a Qualified Plan) (GV-IRA 4971-71) G. |_| EDC (Public Employee Deferred Compensation) (GV-EDC 4991) H. |_| EDC (Tax Exempt Organization) (GV-EDC 4991-SU-080) I. |_| SEP (Simplified Employee Pension) (GV-SEP 4981) J. |_| SARSEP (Salary Reduction SEP) _________________________________________ K. |_| CORPORATE TRUSTEED (GV-CORP 4941-41) L. |_| KEOGH/HR-10 TRUSTEE (GV HR-10 4911-11) (trustee owned) M. |_| KEOGH/HR-10 (GV-HR-10 4911) (not trustee owned) (issued to existing units only) - -------------------------------------------------------------------------------- DO NOT COMPLETE THIS SECTION IF 1.D OR 1.F CHECKED ABOVE 2. EMPLOYER/PLAN NAME |A|B|C|_|C|O|M|P|A|N|Y|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| 3. |_| EXISTING UNIT NO. |_|_|_|_|_|_|-|_|_|_| |x| NEW UNIT |0|0|0|1|2|3|-|4|5|6| (FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP, OR TRUSTEED PLANS. FORM 983-135B IS REQUIRED) - -------------------------------------------------------------------------------- 4. PROPOSED ANNUITANT Print name to appear on Contract. |J|O|H|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|D|O|E|_|_|_|_|_| FIRST MIDDLE INITIAL LAST A. |X| MR. |_| MRS. |_| MS. |_| OTHER ____ B. Date of Birth: Year 1954 Month JANUARY Day 27 ---- ------- -- C. Age at Nearest Birthday: 38 D. |X| Male |_| Female ---- E. Annuitant's Mailing Address: F. State of Residence: N.J. ---- No., St. |1|7|_|E|L|M|_|S|T|R|E|E|T|_|_|_|_|_|_|_|_|_|_|_|_| City |A|N|Y|T|O|W|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1| G. Telephone Number (101) 222 - 3456 |X| Home |_| Work H. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9| I. Are you associated with or employed by a member of National Association of Securities Dealers, Inc.(NASD)? |_| Yes |X| No 5. OWNER (Print Name) -- If Trusteed or EDC Plan Print Name of Owner, for all other Markets Print Name of Annuitant. JOHN DOE ----------------------------------------------------------------------------- a. Title ____________________________________________________________________ 6. RETIREMENT AGE 65 --------------------------------------------------------------- 7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death Benefit upon Annuitant's death before Retirement Date.) (BENEFICIARY MUST BE THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS.) JANE DOE - WIFE ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- 8. CONTRIBUTION ALLOCATION Guaranteed Interest Division 20% ----- Stock Division 20% ----- Money Market Division 20% ----- Balanced Division 20% ----- Aggressive Stock Division 20% ----- (PERCENTAGES IN WHOLE NUMBERS) Total 100% 9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F) A. Reminder Notice (Billing) Required |_| Yes |X| No IF YES, COMPLETE B-C-D-E B. REMINDER DATE Required for Individual IRA or otherwise must agree with existing unit or attached 983-135B. MONTH _________ DAY __________ C. REMINDER FREQUENCY |_| Annual |_| Semi-Annual |_| Quarterly |_| Monthly Available for TSA, EDC, SARSEP AND CORPORATE TRUSTEED AND UNIT BILLED IRA ONLY: |_| Semi-Monthly |_| Bi-Weekly D. REMINDER AMOUNT $_________________________________ E. BILLING MONTHS TO BE EXCLUDED - TSA ONLY ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- 10.EXPECTED FIRST CONTRACT YEAR Contribution. $1000 ---------------------------------------------------------------- IF AN ADVANCED BILLING AND/OR CONTRACT DATE ARE REQUESTED, COMPLETE #9B AND #12. - -------------------------------------------------------------------------------- (FOR PROCESSING OFFICE USE) Unit Name ___________________________ Reminder Date ___________________________ Cert. or App# _______________________ Amendment Required_______________________ EDC Emp. Add. _______________________ Emp. Fed. ID# ___________________________ Frequency ___________________________ Contract Date ___________________________ - -------------------------------------------------------------------------------- Receipt Date Batch # Inquiry # Processor - -------------------------------------------------------------------------------- 180-1000 - -------------------------------------------------------------------------------- 10. Did you receive the Separate Account Prospectus? |X| Yes |_| No Date shown on Prospectus January 1, 1992 ---------------------------------------------------- Date of any supplement to Prospectus _______________________________________ 11. Items (a) through (f) are to be answered by the annuitant. We are required by the NASD to ask these questions. (a) Name of Employer: ABC Company ------------------------------------------------------ (b) Address of Employer: 10 Main Street --------------------------------------------------------------------------- Anytown, NJ --------------------------------------------------------------------------- (c) Occupation Sales ------------------------------------------------------------- (d) Assuming the contract applied for will be issued, will any existing insurance or annuity be replaced or changed (or has it been)? | | Yes |X| No (e) Estimated Family Annual Income $100,000 ---------------------------------------- (f) Estimated Net Worth $250,000 ----------------------------------------------------- (g) Investment Objective: |_| Income |X| Income & Growth |_| Aggressive Growth |_| Growth |_| Safety of Principal 12. SPECIAL INSTRUCTIONS ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- 13. Amount paid with this form: $1000 (If a check is submitted with this request, no advanced Contract Date is permitted.) BACKDATING IS NOT PERMITTED. NOTE: Amount paid will be credited upon receipt at Equitable's Processing Office, subject to return if the certificate is not issued. The Contract Date will be the date of receipt by Equitable of this application, properly signed and completed, and Contribution at Equitable's Processing Office. - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- AGREEMENT All information and statements furnished in this application are true and complete to the best of my knowledge and belief. I understand and acknowledge that no Agent has the authority to make or modify any contract on Equitable's behalf, or to waive or alter any of Equitable's rights and regulations. IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT. UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S) OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND COMPLETE. - -------------------------------------------------------------------------------- LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR ANNUITY APPLICATION WITH INFORMATION YOU KNOW IS FALSE OR TO LEAVE OUT MATERIAL FACTS. - -------------------------------------------------------------------------------- X__________________________________ Date_______ City __________ State __________ Signature of Annuitant X__________________________________ Date_______ City __________ State __________ Signature of Authorized Individual (REQUIRED FOR EDC AND TRUSTEED) OR OWNER - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- AGENT'S SECTION Will any existing insurance or annuity be replaced or changed (or has it been), assuming the Contract will be issued? | | Yes | | No |_| I (we) certify that a prospectus for the Contract has been given to the proposed Annuitant and that no written sales materials other than those approved by Equitable have been used. EQUI-VEST issues must adequately reflect the commission interest of all Agents on previous contracts. - -------------------------------------------------------------------------------- Print Agent's Name(s) Initial of Agent Agent Agency District Agent's (Service Agent first) Last Name Number % Code Manager Code Signature - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS___ Date ___ District EQS ___ Date ____ - -------------------------------------------------------------------------------- (FOR ASU USE) ASU Code and App. No. __________________________________________________________ ASU Rec'd. _____________________________________________________________________ Date to Proc. Off. ________________________________________________ Campaign |_| Agent(s) shown above is Equity Qualified and is licensed in the state where the request is signed. Above Agent information verified by ASM (Registered Rep) - -------------------------------------------------------------------------------- Application reviewed by ________________________________________________________ - -------------------------------------------------------------------------------- 180-1000 [EQUITABLE LOGO] Owner: Annuitant: Contract Number: Issue Date: Contract Date: Retirement Date: - -------------------------------------------------------------------------------- THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P O Box 2996, New York, New York 10116-2996 AGREES o TO ALLOCATE the Contributions made to this Contract, after deduction of any applicable tax charge, to the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division of the Separate Account (referred to in this Contract as the "Investment Divisions") or to the Guaranteed Interest Division, in accordance with Sections 2.02, 2.03 and 2.04 or in part to any one, as directed by you, and o TO APPLY the Annuity Account Value at the Retirement Date to provide the Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant is then living, and o TO PROVIDE the Annuitant with the other rights and benefits of this Contract. This is the entire Contract. In this Contract, "we", "our" and "us" mean the Equitable Life Assurance Society of the United States. "You" and "your" mean the Annuitant at the time a right is exercised by the Annuitant. TEN DAYS TO EXAMINE CONTRACT-You may cancel this Contract by returning it to us within ten days after receipt of it. Upon such cancellation, we will refund any Contribution made to us on your behalf under this Contract, plus or minus any investment gain or loss experienced in the Investment Divisions of the Separate Account from the date such Contribution is allocated to such Investment Division to the date we receive the returned Contract. /s/Pauline Sherman /s/Edward D. Miller Pauline Sherman, Vice President Edward D. Miller Secretary & Associate General Counsel President and Chief Executive Officer THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.26 IS 5% OR 3.5%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE NOT TO EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE TRUST. No 92 TSAB This Contract is issued in consideration of the payment to us of the Contributions made under the terms of this Contract. The provisions on the following pages are part of this Contract. - -------------------------------------------------------------------------------- TABLE OF CONTENTS DEFINITIONS Page Section 1.00 - Agreement...................................................4 1.01 - Annuitant...................................................4 1.02 - Annuity.....................................................4 1.03 - Annuity Account Value.......................................4 1.04 - Annuity Benefit.............................................4 1.05 - Cash Value..................................................4 1.06 - Class of Contracts..........................................5 1.07 - Code........................................................5 1.08 - Contract ...................................................5 1.09 - Contract Date...............................................5 1.10 - Contract Year...............................................5 1.11 - Contribution................................................5 1.12 - Divisions...................................................5 1.13 - Elective Deferrals..........................................5 1.14 - Eligible Annuity Certain....................................5 1.15 - Employer....................................................5 1.16 - ERISA.......................................................5 1.17 - Guaranteed Interest Rate....................................5 1.18 - Joint and Survivor Life Annuity Form........................5 1.19 - Life Annuity Form...........................................5 1.20 - Normal Form.................................................5 1.21 - Period Certain Annuity......................................5 1.22 - Plan........................................................6 1.23 - Processing Office...........................................6 1.24 - Retirement Date.............................................6 1.25 - Separate Account............................................6 1.26 - Separate Account Definitions................................7 1.27 - Transaction Date............................................7 1.28 - Trust.......................................................7 ANNUITY ACCOUNT VALUE Section 2.01 - Contributions...............................................8 2.02 - Separate Account Investment Divisions.......................8 2.03 - Guaranteed Interest Division................................8 2.04 - Allocation to Divisions.....................................8 2.05 - Transfers Among Divisions...................................8 2.06 - Termination of this Contract................................9 2.07 - Partial Withdrawals.........................................9 2.08 - Charges for Partial Withdrawals.............................9 2.09 - Free Corridor Amount.......................................10 2.10 - Restrictions on Distributions..............................10 2.11 - Annual Administrative Charge...............................10 2.12 - Death Benefit..............................................10 2.13 - Loans......................................................11 ANNUITY BENEFITS Section 3.01 - Fixed Annuity Benefit......................................12 3.02 - Variable Annuity Benefit...................................12 3.03 - Election and Commencement Of Annuity Benefits..............12 3.04 - Amount of Annuity Benefits.................................13 3.05 - Payment of Annuity Benefits................................13 3.06 - Special Annuity and Spousal Consent Provisions.............15 GENERAL PROVISIONS Section 4.01 - Contract...................................................16 4.02 - Statutory Compliance.......................................16 4.03 - Nontransferability and Assignments.........................16 4.04 - Beneficiary................................................16 4.05 - Disqualification Of Plan or Contract.......................17 4.06 - Future Contributions.......................................17 4.07 - Deferment..................................................17 4.08 - Annual Notice..............................................17 4.09 - Age........................................................17 No. 92 TSAB Page 2 - -------------------------------------------------------------------------------- PART I - DEFINITIONS SECTION 1.00 AGREEMENT. The term "Agreement" means an agreement described in Treasury Regulation Section 1.403(b)-l(b)(3) between an Employer and an employee of the Employer, in which the Employer agrees to purchase an Annuity for the employee. If Employer contributions to purchase the Annuity result from the employee's agreement to take a reduction in future salary or forgo a future salary increase, such Agreement is referred to as a "Salary Reduction Agreement" within the meaning of Sections 402(g)(3)(C) and 3121(a)(5)(D) of the Code. SECTION 1.01 ANNUITANT. The term "Annuitant" means the owner of this Contract, as shown on page 3 and on whose behalf this Contract has been purchased and is maintained, and who exercises all rights under this Contract. SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in accordance with the terms of the Plan or Agreement, which contract meets the requirements for qualification under Section 403(b) of the Code. SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts that you have in the Guaranteed Interest Division and the Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03, plus any reserve or suspense account pursuant to loans under Section 2.13. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by us pursuant to Section 3.04 of this Contract. Various sections of this Contract (Sections 1.18, 1.19, 1.20, 3.01 and 3.02) refer to monthly payments to be made under an Annuity Benefit. You may wish to have your Annuity Benefit paid at other intervals, such as quarterly, semi-annually, or annually, instead of monthly. You may elect this at the time you elect the Annuity Benefit form as described in Section 3.03; in that event, all references in this Contract to monthly payments will be deemed to mean payments at the frequency you elect, subject to our rules at the time of election. SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value less any applicable withdrawal charge determined as follows: The withdrawal charge equals the lesser of (a) or (b) where (a) equals 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the excess of (i) the Annuity Account Value over (ii) the Free Corridor Amount defined in Section 2.09; and (b) is the excess, if any, of (i) 8% of the total Contributions made on your behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior charges for partial withdrawals made pursuant to Section 2.08. However, notwithstanding the above, if you are age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. A withdrawal charge will not apply, which means the Cash Value will equal the Annuity Account Value upon any of the following occurrences: (i) your attainment of age 59 and 6 months, and your completion of at least five Contract Years, or (ii) you die and a distribution is made to your beneficiary, or (iii) your attainment of age 55, your completion of at least five Contract Years and the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase an Eligible Annuity Certain, defined in Section 1.14, or (iv) your completion of at least three Contract Years and the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase a Period Certain Annuity, defined in Section 1.21, where the certain period of such annuity is at least ten years, or (v) the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase a Life Annuity distribution option, or (vi) your attainment of age 55, your completion of at least five Contract Years, and separation from service, or (vii) your completion of at least twelve Contract Years. No. 92 TSAB Page 4 SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all Contracts with a Contract Date in the same Calendar Year. SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.08 CONTRACT. The term "Contract" means this Contract. SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt by us of both the application for this Contract, properly signed and completed, and a Contribution. SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month period beginning on (i) the Contract Date, and (ii) each anniversary thereafter, unless otherwise agreed to in writing by us. SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us for you with respect to an Annuity purchased for you under the Plan. We are under no obligation to accept any Contribution less than $20.00. Contributions may be either Elective Deferrals or Employer Contributions pursuant to the Plan. The Employer shall indicate to us the amount and type of each Contribution. SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or severally as the case may be, the following Divisions described in this Contract: (a) the Guaranteed Interest Division, and (b) the Investment Division of the Separate Account. SECTION 1.13 ELECTIVE DEFERRALS. The term "Elective Deferrals" means Contributions made pursuant to a Salary Reduction Agreement as defined in Section 1.00. SECTION 1.14 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by us which extends beyond your attainment of age 59 and 6 months and does not permit any prepayment of the unpaid principal (that is, no withdrawal or single sum payment) prior to your attainment of age 59 and 6 months. SECTION 1.15 EMPLOYER. The term "Employer" means (i) an organization described in Section 501(c)(3) of the Code which is exempt from Federal income tax under Section 501(a) of the Code; or (ii) a State, political subdivision of a State, or an agency or instrumentality of any one or more of the foregoing, in connection with services performed by an employee for an educational organization described in Section 170(b)(1)(A)(ii) of the Code. SECTION 1.16 ERISA. The term ERISA means the Employee Retirement Income Security Act as amended. SECTION 1.17 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in the Guaranteed Interest Division. The initial rate to apply is shown on page 3 of this Contract. Section 2.03 describes the determination of the Rate to apply thereafter. SECTION 1.18 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by you. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.19 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity issued by us or one of our affiliated or subsidiary life insurance companies, providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.20 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under this Contract means (i) if you have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (with 100% of the monthly amount payable to your spouse), and (ii) if you do not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.21 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by us or one of our affiliated or subsidiary life insurance companies, which does not permit any prepayment of the unpaid principal (that is, you cannot elect to receive part of your payments as a single sum payment with the remainder paid in monthly annuity payments). No. 92 TSAB Page 5 SECTION 1.22 PLAN. The term "Plan" means a program established by an Employer, for the purchase of Annuities on behalf of employees. The Employer shall be the "Plan Administrator" within the meaning of Section 414(g) of the Code and applicable Treasury Regulations. SECTION 1.23 PROCESSING OFFICE. The term "Processing Office" means our Individual Annuity Center, P O Box 2996, New York, New York 10116-2996, or such other location as we shall designate by advance written notice to the Employer, or the Plan's Trustee, as applicable, and to you. SECTION 1.24 RETIREMENT DATE. The term "Retirement Date" means the date on which you attain your retirement age as shown on page 3 of this Contract. Before the Retirement Date you may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month). The Retirement Date selected either initially or by later change must be in accordance with the terms of the Plan. No Retirement Date shall be later than the date of your attainment of age 70 and 6 months. Any election for such change must be made in writing by you and shall not take effect until received by us at our Processing Office. SECTION 1.25 SEPARATE ACCOUNT. The term "Separate Account" means Separate Account A, which is organized as a unit investment trust (a type of investment company). We have established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited to or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities and variable life insurance. The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to these Contracts will not be chargeable with liabilities arising out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to our General Account. The Separate Account consists of "Investment Divisions". Each Investment Division may invest its assets in a separate class (or series) of shares of a designated Trust where each class (or series) represents a separate portfolio in the Trust. We reserve the right to change the designated trust or investment company or to add designated trusts or investment companies. The Investment Divisions available are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. The Guaranteed Interest Division is not a part of the Separate Account, but rather is an asset of our General Account. We will value the assets of each Investment Division on each business day. A business day is any day on which we are open, the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio of the securities in which an investment Division is invested to materially affect the Accumulation Unit Value. We may, at our discretion, invest the assets of any Investment Division in any investment permitted by applicable law. We may rely conclusively on the opinion of counsel (including attorneys in our employ) as to what investments we are permitted by law to make. We reserve the right to (i) cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such committee at any time; (iii) restrict or eliminate any voting rights as to the Separate Account; (iv) operate the Separate Account by making direct investments, or in any other form; (v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or remove Investment Divisions (or sub-divisions of Investment Divisions) from the Separate Account; (The term "Investment Division" in this Contract shall then refer to any other Investment Division in which the asset of a Class of Contracts to which this Contract belongs, were placed); (vi) combine any two or more Investment Divisions (or sub-divisions of Investment Divisions) of the Separate Account; and (vii) withdraw from any Investment Division and to allocate to another Investment Division assets determined by us to be associated with the Class of Contracts to which this Contract belongs. No. 92 TSAB Page 6 If the exercise of these rights results in a material change in the underlying investments of an Investment Division, you will be notified of such exercise, as required by law. Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for any applicable tax charges) at a rate not to exceed 1.49% per year for the Stock, Money Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock Division, for financial accounting, death benefits, mortality risk, expenses and expense risk. The charge shall be made in accordance with Subsection (c) of the Net Investment Factor provision in Section 1.26. The relative proportion of these charges may be modified. The daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust shall not exceed a total annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to this Contract. The maximum rate may not be altered without your approval. SECTION 1.26 SEPARATE ACCOUNT DEFINITIONS. VALUATION PERIOD: Each business day together with any preceding consecutive non-business days. NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b), minus (c), where (a) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the Valuation Period before giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period. For this purpose, we use the share value reported to us by the Trust. (b) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the preceding Valuation Period (after any amounts allocated to or withdrawn for that Valuation Period). (c) is the daily asset charge for the expenses of this Contract, times the number of calendar days in the Valuation Period. ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an Investment Division where your Contributions are invested and which is used in determining the amount you have in an Investment Division. ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of each Accumulation Unit in an Investment Division on a given date. The Accumulation Unit Value for a Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such Valuation Period. ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable from the Stock Division of the Separate Account under a Variable Annuity Benefit as defined in Section 3.02. ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1, 1968. On August 27, 1981, the date the first Contribution was put into the Stock Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods ending in such month. SECTION 1.27 TRANSACTION DATE. The Transaction Date is the business day we receive a Contribution or a written contract transaction request providing the information we need at the Processing Office. In the case of a transfer request initiated through the use of a touch tone telephone as described in Section 2.05, the term Transaction Date is the business day the telephone transaction is received. SECTION 1.28 TRUST. The term "Trust" means the designated trust or investment company in which Separate Account assets are invested. No. 92 TSAB Page 7 - -------------------------------------------------------------------------------- PART II - ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. The Employer is to make Contributions, from time to time on such dates and in such amounts as determined by the Employer pursuant to the terms of the Plan or Agreement. You are to specify the amount to be allocated to each Division. Each contribution received by us with respect to you will, before its allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. Pursuant to the terms of the Plan, if applicable, you may, with our agreement, (i) transfer to this Contract any amount held under a contract or account that meets the requirements of Section 403(b) of the Code ("Transferred Funds"), or (ii) roll over contributions from a contract or account that meets the requirements of Section 403(b) of the Code, or from a conduit individual retirement arrangement described in Section 408(d)(3)(A)(iii) of the Code. If you do not provide to us at the time of such transfer as described in (i) above, as to what portion, if any, of the amounts of the Transferred Funds which are exempt from the distribution restrictions described in Section 2.10, and the minimum distribution rules described in Section 3.05, we will treat all such amounts as being subject in such restrictions. Any Transferred Funds from a contract not issued by us will, before allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when an amount is allocated to or withdrawn or transferred from an Investment Division, the Annuity Account Value will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units you have in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Sections 2.07, 2.08 or 2.13, or transferred from the Investment Division pursuant to Section 2.05. The amount you have in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units in the Investment Division on that date, and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under this Contract terminates on the earliest of (i) your election and commencement of annuity benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii) termination of this Contract pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division as part of our general assets, which support the guarantees of this Contract and other contracts. The amount in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 or 2.13, plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Section 2.07, 2.08 or 2.13 or transferred from the Guaranteed Interest Division, pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division on a Transaction Date pursuant to Section 2.04. We will credit the amount you have in the Guaranteed Interest Division with interest at effective annual rates that we determine. For each Class of Contracts we determine a yearly guaranteed interest rate that will remain in effect throughout the next year. We guarantee that this yearly guaranteed interest rate will never be less than 3%. Participation in the Guaranteed Interest Division under the terms of this Contract terminates on the earliest of (i) election and commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, iii) Termination of this Contract pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section 2.01 is allocated (after deduction of any applicable tax charge) to one or more Divisions, at your sole direction as specified to us. Allocation percentages must be in whole numbers and the sum must equal 100. The allocation is made as of the Transaction Date on which we have received both such Contribution and such direction. Contributions made to an Investment Division purchase Accumulation Units in that Investment Division, using the Accumulation Unit Value next computed after the Transaction Date. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the Transaction Date with respect to each transfer from the Division pursuant to Section 2.05, (iii) on the Transaction Date with respect to each withdrawal pursuant to Section 2.07, (iv) at the of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, (v) upon Termination of this Contract, pursuant to Section 2.06, and (vi) upon your death pursuant to Section 2.12. SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request or through the use of a touch tone telephone, transfer all or part of the amount you have in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; (2) amounts in the Money Market Division may be transferred to other Divisions. Written authorization for touch tone telephone initiated transfers is only required when authorization for telephone transfers is requested. Upon advance written notice to you, we reserve the right to No. 92 TSAB Page 8 discontinue the acceptance of transfer requests through the use of a touch tone telephone. All transfers will be effective on the Transaction Date and will be subject to our rules in effect at the time of transfer. With respect to Investment Division, the transfer will be made at the Accumulation Unit Value next computed after the Transaction Date. No transfers are permitted to the Money Market Division from the other Divisions. SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the terms of the Plan, including, for Plans subject to Title I of ERISA, if applicable, the spousal consent rules set forth in Section 3.06, you may elect, by written notice, to terminate this Contract. In addition, termination of the Contract is subject to restrictions on distributions set forth in Section 2.10 of this Contract. We will determine the Cash Value as of the Transaction Date we receive your written election. The payment of such Cash Value to you may be deferred by us in accordance with the provisions of Section 4.07. Subject to the terms of the Plan, and the restrictions on distributions set forth in Section 2.10, we reserve the right to pay the Annuity Account Value under this Contract and terminate this Contract. This right may be exercised only if both (i) you made no Contributions during the last three completed Contract Years, and the Annuity Account Value is less than $500, or (ii) a partial withdrawal is made that would result in your Annuity Account Value falling below $500. We also reserve the right to terminate this Contract if no Contributions have been made within 120 days of the Contract Date shown on page 3 of this Contract. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. If this Contract is terminated, surrendered or exchanged prior to your Retirement Date, any applicable tax charges we have paid may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on terminations, unless a change in applicable law has occurred with respect to your Contract. SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under the terms of the Plan, and the restrictions on distributions set forth in Section 2.10, you may elect, by written notice to us, to make a partial withdrawal from the Divisions. For Plans subject to Title I of ERISA, partial withdrawals may be subject to the spousal consent rules if applicable, set forth in Section 3.06. Following receipt of your written notice, we will pay the lesser of the Cash Value, less any funds restricted pursuant to Section 2.13, or the amount of partial withdrawal requested to the person entitled to receive such payment as you designate to us in writing. The amount paid plus any withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the amounts you have in the Divisions. Unless instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts that you have in such Divisions. Upon any partial withdrawal payment, we will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by us in accordance with the provisions of Section 4.07. We may decline to accept a request for a partial withdrawal of less than $300, or where the request violates the provisions of Sections 2.07 or 3.06. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, we will so advise you and reserve the right to pay the Annuity Account Value to you and terminate this Contract. SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity Account Value, pursuant to Section 1.05. WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than the Free Corridor Amount, we will (i) first withdraw from the Divisions an amount equal to the Free Corridor Amount, in proportion to the amount you have in them, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a partial withdrawal charge. Such partial withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter No. 92 TSAB Page 9 of the amount withdrawn in excess of the Free Corridor Amount (including such charge) pursuant to (ii) of the preceding sentence. (b) the excess, if any, of (i) 8% of the total Contributions made on your behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to this Section. However, notwithstanding the above, if you are age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. If withdrawals are made from this Contract prior to the Retirement Date, any applicable tax charges we have paid with respect to this Contract may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on withdrawals, unless a change in applicable law has occurred with respect to your Contract. SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means if you have completed three Contract Years or attained age 59 and 6 months an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the current Contract Year or pursuant to the repayment of interest or principal on a loan, in the Current Contract Year. If you have not completed three Contract Years or attained age 59 and 6 months, the Free Corrider Amount is zero. SECTION 2.10 RESTRICTIONS ON DISTRIBUTIONS. Notwithstanding anything in this Contract to the contrary, payments of Cash Value pursuant to the termination of this Contract under Section 2.06, partial withdrawals under Section 2.07, death benefits under Section 2.12 or Annuity Benefits under Section 3.03 may be limited as provided in Section 403(b)(11) of the Code and in this Section, to the extent they are attributable to Elective Deferral Contributions made to this Contract after December 31, 1988 and earnings credited after December 31, 1988 on Elective Deferral Contributions made before and after December 31, 1988 (collectively, "Restricted Amounts"). Distributions of Restricted Amounts may not be made until you attain age 59 years and six months, separate from service, die, or become disabled (within the meaning of Section 72(m)(7) of the Code). Distributions of Elective Deferral Contributions made after December 31, 1988-(but not any earnings credited after December 31, 1988 attributable to Elective Deferral Contributions made before or after December 31, 1988) may also be made in the case of hardship (within the meaning of Section 403(b)(ll) of the Code and applicable Treasury Regulations). If you request payment of Restricted Amounts on the grounds of disability or hardship you must furnish to us proof of such disability or hardship as may be required by the Plan, the Code, and applicable Treasury Regulations in a form satisfactory to us. SECTION 2.11 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract Year, if the Annuity Account Value on that date is less than $25,000, we will withdraw from the Divisions an Annual Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account Value including the amount of any withdrawals pursuant to Section 2.07 during that Contract Year. The charge will be allocated among the Divisions in proportion to the amounts that you have in the Divisions. For this purpose, any loan reserve amount is included within the Guaranteed Interest Division. The portion of the charge attributable to the Guaranteed Interest Division and any loan reserve account will be first withdrawn from the Guaranteed Interest Division and then, if the amount you have in the Guaranteed Interest Division is not sufficient, the remaining allocation will be withdrawn from the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. If the Annuity Account Value is less than $25,000, on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03, or (b) the date of Termination of this Contract pursuant to Section or 2.12, we will prorate the Annual Administrative Charge applicable to the completed portion of the Current Contract Year and withdraw such amount in lieu of the Annual Administrative Charge described in this Section for the applicable part of that Contract Year. If the Annuity Account Value is $25,000 or greater at the end of a Contract Year, the Annual Administrative Charge is zero. SECTION 2.12 DEATH BENEFIT. Upon receipt of due proof of your death, we will pay to the beneficiary designated to receive such payment, pursuant to Section 4.04 of this Contract, the amount of death benefit payable. The amount of the death benefit is equal to the greater of (i) the Annuity Account Value less any outstanding loan and (ii) the minimum death benefit. Such minimum death benefit is the sum of all Contributions made pursuant to Section 2.01 (before reduction for any applicable tax charge) less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount that was withdrawn is to the Annuity Account Value. If, in accordance with the provisions of Section 2.01, the Cash Value of another annuity contract issued by us, or one of our affiliated or subsidiary life insurance companies, which provides for a death benefit before retirement is equal to the greater of the contract Cash Value or alternate amount based or premiums paid or Contributions made under the annuity contract, is transferred to this Contract, such Cash Value a alternative amount as of the date of transfer, will be included in the "sum of all Contributions" in lieu of the amount of Cash Value transferred for purposes of the death benefit under this Contract. We will pay the death benefit to the beneficiary in the form of an Annuity Benefit if you have made the election described in the last paragraph of Section 4.04. Also, in accordance with the last paragraph of Section 4.04, if no such election is in effect at your death, we will pay the death benefit to the beneficiary in a single sum, unless the beneficiary elects, before we pay the death benefit, to apply the death benefit to an Annuity Benefit, for Plans subject to Title I of ERISA. No. 92 TSAB Page 10 Distributions pursuant to this Section are subject to the terms of the Plan and the Spousal Consent Rules set forth in Section 3.06 for Plans subject to Title I of ERISA. Upon payment of the death benefit, the amount you have in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.13 LOANS. Unless otherwise restricted by the Plan or the Code, you may effect a loan under this Contract before the election and commencement of Annuity Benefits. However, if the issuance of this Contract is pursuant to the terms of a Plan subject to Title I of ERISA, then loans shall not be available under this Contract. Future restrictions in the Code may require revision or withdrawal of the loan provisions as provided below. Your Annuity Account Value (including the loan reserve account as described below) will be the sole security for the loan. A loan is effective on the first day of the month following the date your loan agreement form is approved by us. The amount of the loan may not be more than (i) 80% of the Annuity Account Value of this Contract, if such total Annuity Account Value is greater than or equal to $3,750 and less than $12,500, (ii) $10,000, if the Annuity Account Value is greater than or equal to $12,500 and less than $20,000, and (iii) 50% of the Annuity Account Value if the Annuity Account Value is greater than or equal to $20,000, but in no event shall the loan amount exceed $50,000 less the highest outstanding balance under this Contract during the one year period ending the day before the effective date of the loan. The minimum loan permitted is $3,000. For this purpose, the Annuity Account Value is taken as of the loan effective date. Only one outstanding loan is permitted at a time under this Contract. As a condition for granting a loan, we will require you to represent that the loan amount requested, when aggregated with loans (principal plus interest) from all qualified plans of your Employer, does not exceed the greater of $10,000 or 50% of the value of your nonforfeitable accrued benefits, and in no event exceeds $50,000 less the highest outstanding balance of all loans from qualified plans during the one year period ending on the day before the effective date of the loan. We reserve the right to also require that you elect not to have income tax withholding apply with respect to an interest and/or loan principal that would otherwise be subject to withholding. The loan term will be either (i) ten years, if you represent that the purpose of the loan is to acquire, build or substantially rehabilitate a dwelling unit which, within a reasonable period of time, is to be used as your principal residence or (ii) five years. In any event, the loan term may not extend beyond, that is, full repayment of the loan will be required upon the earlier of (i) the election and commencement of Annuity Benefits pursuant to Section 3.03, (ii) the date we received written notice from you to terminate this Contract pursuant to Section 2.06, (iii) the date we pay a Death Benefit pursuant to Section 2.12, and (iv) any date provided for such loans by Federal tax rules including acceleration of the loan repayment in order that the operation of the loan provisions do not adversely affect the tax treatment of this Contract. On the loan effective date, we will transfer to a loan reserve account an amount equal to the sum of (i) the loan amount, which will earn interest at the effective annual rate of 4% during the loan term and (ii) 25% of the loan amount, which will earn interest at the Guaranteed Interest Rate, as defined in this Contract. You may specify from which Divisions these amounts are to be transferred. In the absence of your direction, or if your directions cover only part of the amount required to be transferred to the loan reserve account, we will transfer the required (or additional required) amounts from each Division in proportion to the amount that you have in such Divisions. On the first day of the third month following the effective date of the loan and quarterly thereafter (or first business day thereafter, if such day is not a business day), the amount of interest earned at 4% annually during the prior quarter will be transferred to the portion of the loan reserve account that earns interest at the Guaranteed Interest Rate. You may not make any partial withdrawals or transfers from the loan reserve account. Beginning the first day of the third month of each quarter following the effective date of the loan and quarterly on the first day of the month thereafter, loan payments must be made to us. Such payments shall be amortized in substantially level payments over the term of the loan and will be equal to the sum of (a) and (b) where (a) is the loan interest, calculated at an effective annual rate of 6%, and (b) is a portion of the loan principal. The loan must be repaid in part on each quarterly due date and may be repaid in full at any time on or after the first loan anniversary and must include the full interest due. Any payments received will first be applied to interest due, with the balance applied towards repayment of the loan. Any partial loan repayment will result in a transfer of the amount equal to the principal repaid from (i) the portion of the loan reserve account that earns interest at the effective annual rate of 4% to (ii) the Guaranteed Interest Division and may be withdrawn, transferred or annuitized as directed in this Contract. By each due date, if the amount of the loan payment is less than the amount due or the loan payment is not received at our Processing Office, we will deduct and treat as a partial withdrawal from the loan reserve account an amount equal to the interest and principal payments due plus any applicable withdrawal charges and any required income tax withholding, if such partial withdrawal will not be a withdrawal of "restricted amounts" as described in Section 2.10 of this Contract. Specifically, an amount equal to the principal payment will be deducted from the portion of the loan reserve account which earns interest at 4%, and an amount equal to the interest payment plus any applicable withdrawal charges and required income tax withholding will be deducted from the portion of the loan reserve account which earns interest at the Guaranteed Interest Rate. No. 92 TSAB Page 11 To the extent a loan repayment is required and a partial withdrawal cannot be made due to the restrictions described in Section 2.10 of this Contract, a default in a loan payment will occur. We will transfer from the loan reserve account to a suspense account an amount equal to the interest and principal payments due. We will deduct from the loan reserve account a default charge (as defined in this Section) as well as any required income tax withholding. We will treat the amount transferred to the suspense account, plus any required income tax withholding, as a "deemed distribution," that is, such amount will be considered to have been distributed as provided under Section 72(p) of the Code. Specifically, an amount equal to the principal payment due will be transferred from the portion of the loan reserve account which earns interest at 4%, and an amount equal to the interest payment due will be transferred from the portion of the loan reserve account which earns interest at the Guaranteed Interest Rate. Any applicable default charge and required income tax withholding will be deducted from the portion of the loan reserve account which earns interest at the Guaranteed Interest Rate. The default charge on the amount of the deemed distribution is equal to the applicable withdrawal charges which would have applied if such amount had been withdrawn from this Contract at such time. Amounts transferred to the suspense account for the purpose of securing the loan and interest payment due will not be subject to future withdrawal charges when the liability for any such defaulted payment is satisfied by a deduction from the suspense account. Amounts transferred to a suspense account will be held there until Federal income tax rules permit such amounts to be deducted from the Contract to satisfy the defaulted loan and interest payment obligation which will be no later than the date you attain age 59 years and 6 months or notify us in writing that an event has occurred which would permit Restricted Amounts to be distributed from the contract under Section 2.10. Amounts held in the suspense account will earn interest at an effective annual rate of 3%. You will also be charged interest on your defaulted loan and interest payment obligation at an effective annual rate of 3% until such time as any such defaulted payment liability can be satisfied by a deduction from the suspense account. The default charge on such deemed distribution is equal to the applicable withdrawal charges for a withdrawal of an amount equal to the interest and principal payments due plus required income tax withholding. Upon your full repayment of the loan, any amounts remaining in the loan reserve account will be transferred to the Guaranteed Interest Division and may be withdrawn, transferred or annuitized as described in this Contract. - -------------------------------------------------------------------------------- PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the terms of this Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Stock Division of the Separate Account. Such Variable Annuity Benefit will increase if the average daily rate of investment return in the Stock Division is equivalent to more than 6.75% or 5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25% annually, depending on whether the applicable assumed base rate of net investment return referred to in Section 1.26 is 5% or 3.5%, respectively. The daily rate of investment return is before deduction of charges, as described in Section 1.25, not to exceed the maximum rate of 1.75% after any deductions to provide for any applicable tax charge. These charges include a daily charge for financial accounting, death benefits, mortality risk, expenses and expense risk, plus the investment advisory fee charges and direct operating expense charges of the Trust. The amount of the first, second and third payments under any Variable Annuity Benefit provided under the terms of this Contract with respect to a payee is the monthly amount provided pursuant to the fifth paragraph of Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. As described in Section 3.05, we will notify the payee how each Variable Annuity Benefit is determined. SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your Retirement Date, provided you are then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless you elect (i) to receive the Cash Value in a single sum, or (ii) to apply the Annuity Account Value, (less any outstanding loan as set forth in Section 2.13) or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by us, or one of our affiliated or subsidiary life insurance companies, as elected by you, or (iii) to take partial withdrawals in amounts and at times as required by the Code, pursuant to Sections 2.07 and 3.05, subject to our rules then in effect and any other applicable requirements under the Code. No. 92 TSAB Page 12 We will provide notice and election forms to you not more than six months before your Retirement Date. If you elect to terminate this Contract, prior to the Retirement Date, pursuant to Section 2.06, an election may be made to receive an Annuity Benefit in lieu of the Cash Value. We will have the right to require that you furnish pertinent information to provide an Annuity Benefit, and we will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. We may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary life insurance companies. If the issuance of this Contract is pursuant to a Plan subject to Title I of ERISA, the rules set forth in Section 3.06 shall apply to your election and the commencement of annuity benefits. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value if the payments under the annuity form involves life contingencies, or (ii) the Cash Value if the Annuity Form elected does not involve life contingencies. The amount applied to provide an Annuity Benefit may be reduced by any applicable tax charge on annuity considerations, as we determine. If we have previously deducted any applicable tax charge from Contributions as provided in Section 2.01, we will not again deduct charges for the same taxes before application to provide an Annuity Benefit, unless a change in applicable law has occurred with respect to your Contract. The balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) our current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, your Contract will be governed by our supplementary contract then in effect. The amount to be applied to provide an Annuity Benefit will, in addition to any tax charge reduction, be reduced by an administrative charge. The amount of such charge will be determined from time to time in accordance with our general practices applicable on a uniform basis to all contracts of the same type as this Contract. After the application of an amount to provide an Annuity Benefit, the amounts you have in the Divisions and the Annuity Account Value shall be zero. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the terms of this Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (with 100% of the amount of your payment continued to your spouse). The amount of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, are based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females, at age zero. The amount of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and the Joint and Survivor Life Annuity Form are based on a 50-50 split of males and females, at age zero and an Assumed Base Rate of Net Investment Return of 3.5% or 5%, whichever applies pursuant to Section 1.26. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females, at age zero, if such annuity form provides for a Fixed Annuity Benefit, and on the projected 1983 Basic Table "a" adjusted to a unisex basis based on a 50-50 split of males and females, at age zero and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section 1.26, if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Distributions attributed to Contributions of Transferred Funds pursuant to Section 2.01 (where you have provided to us written evidence of such balance as of December 31, 1986) must commence no later than age 75. Such distributions will be made in the normal Form of Annuity Benefit, unless you elect to take payments in a single sum or another form of Annuity Benefit then offered by us. Your entire interest in this Contract attributable to all other Contributions made, and earnings credited thereon must be distributed, or begin to be distributed no later than the first day of April following the calendar year in which you attain age 70 and 6 months ("Required Beginning Date"). Your entire interest may be distributed, as you elect, over (a) your life, or the lives of you and your designated beneficiary, or (b) a period certain not extending beyond your life expectancy, or the joint and last survivor expectancy of you and your designated beneficiary. Distributions must be made in periodic payments at intervals of no longer than one year. In addition, payments must be either nonincreasing or they may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the proposed Treasury Regulations, or any successor Regulation thereto. All distributions made hereunder shall be made in accordance with the requirements of Section 403(b)(10) and 401(a)(9) of the Code, including the incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and applicable Treasury Regulations, including the minimum distribution incidental benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or any successor Regulation thereto. Notwithstanding the above paragraphs and the following paragraphs of this Section 3.05, while any distribution shall be subject to such requirements of the Code and regulations, any distribution shall also be subject to the terms of this Contract. That is, the forms of distribution shall be those which are made available by us at the time of your election. No. 92 TSAB Page 13 For purposes of determining the "period certain" referred to in the first paragraph of this Section, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless you otherwise elect prior to the time distributions are required to begin, those life expectancies shall be recalculated annually. Such election shall be irrevocable and shall apply to all subsequent years. The life expectancy of a non-spouse beneficiary may not be recalculated. Instead, life expectancy will be calculated using the attained age of such beneficiary during the calendar year in which you attain age 70 and 6 months, and payments for subsequent years shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. If you die after distribution of your interest in this Contract has begun, the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution being used prior to your death. If you die before distribution of your interest begins, distribution of your entire interest shall be completed no later than December 31 of the calendar year containing the fifth anniversary of your death, except to the extent that an election is made to receive death benefit distributions in accordance with (1) or (2) below: (1) If your interest is payable to a designated beneficiary, then your entire interest may be distributed over the life of, or over a period certain not greater than the life expectancy of, the designated beneficiary. Such distributions must commence on or before December 31 of the calendar year immediately following the calendar year of your death. (2) If the designated beneficiary is your surviving spouse, the date that distributions are required to begin in accordance with (1) above shall not be earlier than the later of (A) December 31 of the calendar year immediately following the calendar year of your death or (B) December 31 of the calendar year in which you would have attained age 70 and 6 months. For purposes of determining the "period certain" referred to in the immediately preceding paragraph, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of distributions beginning after your death, unless otherwise elected by the surviving spouse by the time distributions are required to begin, life expectancies shall be recalculated annually. Such election shall be irrevocable by the surviving spouse and shall apply to all subsequent years. In the case of any other designated beneficiary, life expectancies shall be calculated using the attained age of such beneficiary during the calendar year in which distributions are required to begin pursuant to this Section, and payments for any subsequent calendar year shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. Distributions under this Section are considered to have begun if distributions are made because you have reached your Required Beginning Date or if prior to the Required Beginning Date distributions irrevocably commence to you over a period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1 of the Proposed Treasury Regulations or any successor Regulation thereto. Evidence of each payee's survival must be furnished to us either by personal endorsement of the check drawn for payment or by other means satisfactory to us. If a benefit payment under the terms of this Contract was based on information that is subsequently found to be incorrect, your benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by us will be charged against and underpayments will be added to any payments thereafter falling due under the terms of this Contract with respect to the payee, affecting as many such payments as are necessary to correct the overpayment or underpayment. Our liability, with respect to a payee, is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under this Contract. If we receive evidence satisfactory to us that (i) a payee entitled to receive any payment under the terms of this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, we may make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If a variable annuity form made available by us provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Pursuant to Section 3.03, upon your election, pursuant to Section 3.03 of an annuity form providing payments for a period certain, you may designate (with the right to change such designation) a person or persons to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a payee to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's estate in accordance with the following paragraph. No. 92 TSAB Page 14 If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, we will pay in a single sum to such payee's estate the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis applicable in determining the annuity amount. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. We will require satisfactory evidence of the age of any person upon whose life an annuity form depends. - -------------------------------------------------------------------------------- TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% OF PAYMENT TO CONTINUE TO SPOUSE (Minimum Monthly Income Per $1,000 OF Annuity Account Value) - ---------------------------------------------------------------------------- Age 60 61 62 63 64 65 66 67 68 69 70 - ---------------------------------------------------------------------------- 60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88 61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96 62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03 63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11 64 4.89 4.94 5.00 5.05 5.10 5.14 5.19 65 5.00 5.06 5.11 5.17 5.22 5.27 66 5.12 5.18 5.24 5.29 5.35 67 5.24 5.31 5.37 5.43 68 5.37 5.44 5.51 69 5.52 5.59 70 5.67 - ---------------------------------------------------------------------------- ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Account Value) - ----------------------------------------------------------------------- VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS Age 3.5% 5.0% - ----------------------------------------------------------------------- 60 5.27 6.16 61 5.39 6.28 62 5.52 6.41 63 5.66 6.55 64 5.81 6.70 65 5.97 6.86 66 6.15 7.03 67 6.33 7.21 68 6.53 7.41 69 6.74 7.62 70 6.97 7.85 - ----------------------------------------------------------------------- We will notify the payee, with respect to each payment under a Variable Annuity Benefit, the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each variable payment. Such notice will be mailed with each payment. Any election, change, revocation or designation shall be made, and will take effect on the Transaction Date, in the same manner as a change of beneficiary, as described in Section 4.04. If a commutation right under an Annuity Benefit is exercised, we may defer payment in accordance with Section 4.07. SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS. If this Contract is issued pursuant to a Plan subject to Title I of ERISA, then the provisions of this Section shall supersede any contrary provisions in this Contract. If you are married, your interest in the Contract shall be paid in the Normal Form joint and survivor annuity, and if you are unmarried, your interest shall be paid in the Normal Form life annuity, unless you elect otherwise as described in this Section. If you are married and die before payment of your interest has commenced, your interest shall be paid to your surviving spouse in the form of a life annuity, unless at the time of your death there was a contrary election made pursuant to this Section. The foregoing notwithstanding, your surviving spouse may elect, before payment is to commence, to have payment made in any form permitted under the terms of this Contract. You may elect, at any time within the 90 consecutive day period before the first day of the first period for which your interest is paid as an annuity or in any other form, not to have your interest paid in the Normal Form, in which case it shall be paid in any other form elected under the terms of this Contract. If such interest is to be paid to your spouse upon your death, you may elect, during the period beginning on the first day of the plan year of the Plan in which you attain age 35 (or, if you separate from service prior to that plan year, beginning on the date of separation) and ending with your death, for a beneficiary other than your spouse to receive payment of the No. 92 TSAB Page 15 value of your interest. In addition, if you will not yet attain age 35 by the end of any current plan year, you may make a special qualified election to designate a beneficiary other than your spouse to receive payment of the value of your interest, which special qualified election shall be effective for the period beginning on the date of such election and ending on the first day of the plan year in which you attain age 35. Amounts payable in accordance with this Section will be automatically reinstated as of the first day of the plan year in which you attain age 35 unless a new election designating a beneficiary other than the spouse is made in accordance with the requirements of this Section. Any election described in the foregoing paragraph must be consented to by your spouse in writing before a notary or a representative of the Plan unless you can prove that there is no spouse or that the spouse cannot be located. Also, if you have become legally separated from your spouse or have been abandoned (within the meaning of local law) and have a court order to such effect, spousal consent is not required unless a qualified domestic relations order provides otherwise. Your election must designate a specific beneficiary (including any class of beneficiaries or any contingent beneficiaries) that may not be changed without further consent of the spouse, unless the spouse's consent expressly permits designation by you without further consent of the spouse. The spouse's consent under this section shall acknowledge the effect of the election. In addition, the spouse's consent (or the establishment that the consent of the spouse may not be obtained) shall only be valid with respect to such spouse. Your waiver of the Normal Form joint and survivor annuity shall not be effective unless the election designates a form of benefit payment which may not be changed without spousal consent (or the spouse expressly permits designations by you without any further spousal consent). A consent that permits designations by you without any requirement of further consent by such spouse must acknowledge that the spouse has the right to limit consent to a specific beneficiary and a specific form of benefit where applicable, and that the spouse voluntarily elects to relinquish either or both of such rights. If you make an election under this Section, you may revoke that election, without spousal consent, at any time before the first day of the first period for which an amount is paid as an annuity or in any other form. The provisions requiring spousal consent in this Section shall also apply with regard to your election to terminate this Contract or make partial withdrawals pursuant to Sections 2.06 and 2.07, and with respect to a beneficiary designation set forth in Section 4.04. A spouse's written consent, witnessed by a representative of the Plan or a notary public, must be given on a form acceptable to the Employer and us, within the 90 consecutive day period prior to any such payment or withdrawal, or beneficiary designation, unless you can show that you have no spouse or that the spouse cannot be located. If the Annuity Account Value applied to provide the spousal benefits on the date payment is to commence is in the aggregate less than $3,500, we may choose to make payment in a single sum rather than in the form of a Qualified Joint and Survivor Annuity or Life Annuity as described herein. Upon any payment made pursuant to this Section, we will be released from any and all liability for payment with respect to the Contributions made for you. - -------------------------------------------------------------------------------- PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the parties and the terms of this Contract alone will govern with respect to our rights and obligations. A copy of the application is incorporated in and made part of this Contract. This Contract may not be modified, nor may any of our rights or requirements be waived, except in writing and by our authorized officer. The terms of this Contract may be changed by amendment or replacement upon agreement between you and us without the consent of any other person. SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the terms of this Contract to reflect changes in the Code, or applicable Treasury Regulations, or in regulations or published rulings of the Internal Revenue Service so that this Contract will continue to be an Annuity. SECTION 4.03 NONTRANSFERABILITY AND ASSIGNMENTS. Your entire interest under this Contract is nonforfeitable. No interest of yours (or of a beneficiary) under this Contract may be transferred to any person other than us upon the surrender of this Contract. Except as permitted under applicable law, no right or interest of you or any other payee or beneficiary in this Contract shall be (a) assignable; (b) subject to any lien; or (c) liable for, or subject to, any obligation or liability of any person. The preceding sentence shall not apply to any assignment, transfer or attachment pursuant to a qualified domestic relations order (as defined in Section 414(p) of the Code). SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an initial designation of the beneficiary entitled to receive any death benefit payable pursuant to Section 2.12. You may change such designation from time to time during your lifetime, and while this Contract is in force. Any such designation or change must be made by written notice in a form satisfactory to us. A change will, upon receipt at the Processing Office, take effect as of the time the written notice was signed, whether or not you are living on the date of receipt, but without further liability as to any payment or other settlement made by us before receipt of such change. Beneficiary designations are subject to the rules of Section 3.06 if the Contract is issued pursuant to a Plan subject to Title I of ERISA. No. 92 TSAB Page 16 Unless otherwise specified in the designation, if you have designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive you, and if more than one survive, they will share equally. Any part of a death benefit payable pursuant to Section 2.12 for which there is no designated beneficiary living at the time of your death, will be payable in a single sum to your children who survive you, in equal shares, or should none survive, then to your estate. If you elect in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity previously elected by you, with respect to the beneficiary, subject to our rules then in effect. If, at your death, there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. Any such election must meet the minimum distribution requirements under the Code, as described in Section 3.05. SECTION 4.05 DISQUALIFICATION. In the event that the Plan fails to qualify as a Plan under Section 403(b) of the Code and applicable Treasury Regulations, we reserve the right, upon receiving notice of such fact, to transfer the Annuity Account Value under this Contract to another annuity contract issued by us, an affiliate subsidiary, on your life, or to terminate this Contract and pay to you the Annuity Account Value less deduction for applicable taxes, solely at our option. SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to the Employer, we reserve the right at our sole discretion to limit Contributions under this Contract. SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment of a death benefit and payment of any portion of your Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange has been closed or trading on it is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Securities and Exchange Commission, by order, permits us to defer payment in order to protect persons with interests in the Investment Divisions. We can defer payment of any portion of your Annuity Account Value in the Guaranteed Interest Division for up to six months while you are living. SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year we will furnish you with a notice showing the following: (1) the amount you have in the Guaranteed Interest Division, (2) the total number of Accumulation Units you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Values, (4) the amount you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the amount you have in the loan reserve account, (6) the Cash Value, and (7) the amount of death benefit payable with respect to you. We will also furnish annual calendar year reports concerning the status of the annuity and any other reports required by the Code or applicable Treasury Regulations. After the Retirement Date, we will notify you of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.09 AGE. If your age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by us will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. No. 92 TSAB Page 17 OWNER: JOHN DOE ANNUITANT: JOHN DOE CONTRACT NUMBER: 00 000 000 ISSUE DATE: FEB 28, 1992 CONTRACT DATE: FEB 28,1992 RETIREMENT DATE: JAN 1, 2020 THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York, New York 10116 AGREES o TO ALLOCATE the Contributions made to this Contract, after deduction of any applicable tax charge, to the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division of the Separate Account (referred to in this Contract as the "Investment Divisions") or to the Guaranteed Interest Division, in accordance with Sections 2,02, 2.03 and 2.04 or in part to any one, as directed by you, and o TO APPLY the Annuity Account Value at the Retirement Date to provide the Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant is then living, and o TO PROVIDE the Annuitant with the other rights and benefits of this Contract. This is the entire Contract. In this Contract "we", "our", and "us" mean The Equitable Life Assurance Society of the United States. "You" and "your" mean the Annuitant at the time a right is exercised by the Annuitant. TEN DAYS TO EXAMINE CONTRACT--You may cancel this Contract by returning it to us within ten days after receipt of it. Upon such cancellation, we will refund any Contribution made to us on your behalf under this Contract. /s/ Molly K. Heines /s/ Richard H. Jenrette Vice President and Secretary Chairman of the Board and Chief Executive Officer THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.26 IS 5% OR 3.5%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE NOT TO EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE TRUST. No. 92 TSUA The Contract is issued in consideration of the payment to us of the Contributions made under the terms of this Contract. The provisions on the following pages are part of this Contract. - ------------------------------------------------------------------------------- TABLE OF CONTENTS DEFINITIONS Page Section 1.00 - Agreement..........................................4 1.01 - Annuitant..........................................4 1.02 - Annuity............................................4 1.03 - Annuity Account Value..............................4 1.04 - Annuity Benefit....................................4 1.05 - Cash Value.........................................4 1.06 - Class of Contracts.................................5 1.07 - Code...............................................5 1.08 - Contract...........................................5 1.09 - Contract Date......................................5 1.10 - Contract Year......................................5 1.11 - Contribution.......................................5 1.12 - Divisions..........................................5 1.13 - Elective Deferrals.................................5 1.14 - Eligible Annuity Certain...........................5 1.15 - Employer...........................................5 1.16 - ERISA..............................................5 1.17 - Guaranteed Interest Rate...........................5 1.18 - Joint and Survivor Life Annuity Form....................................5 1.19 - Life Annuity Form..................................5 1.20 - Normal Form........................................5 1.21 - Period Certain Annuity.............................6 1.22 - Plan...............................................6 1.23 - Processing Office..................................6 1.24 - Retirement Date....................................6 1.25 - Separate Account...................................6 1.26 - Separate Account Definitions.......................7 1.27 - Transaction Date...................................7 1.28 - Trust..............................................7 ANNUITY ACCOUNT VALUE Section 2.01 - Contributions......................................8 2.02 - Separate Account Investment Divisions.......................................8 2.03 - Guaranteed Interest Division.......................8 2.04 - Allocation to Divisions............................8 2.05 - Transfers Among Divisions..........................8 2.06 - Termination of this Contract.......................9 2.07 - Partial Withdrawals................................9 2.08 - Charges for Partial Withdrawals....................9 2.09 - Free Corridor Amount..............................10 2.10 - Restrictions on Distributions.....................10 2.11 - Annual Administrative Charge......................10 2.12 - Death Benefit.....................................10 ANNUITY BENEFITS Section 3.01 - Fixed Annuity Benefit.............................11 3.02 - Variable Annuity Benefit..........................11 3.03 - Election and Commencement of Annuity Benefits...............................11 3.04 - Amount of Annuity Benefits........................11 3.05 - Payment of Annuity Benefits.......................12 3.06 - Special Annuity and Spousal Consent Provisions.............................14 GENERAL PROVISIONS Section 4.01 - Contract..........................................15 4.02 - Statutory Compliance..............................15 4.03 - Nontransferability and Assignments....................................15 4.04 - Beneficiary.......................................15 4.05 - Disqualification of Plan or Contract.......................................16 4.06 - Future Contributions..............................16 4.07 - Deferment.........................................16 4.08 - Annual Notice.....................................16 4.09 - Age...............................................16 No. 92 TSUA Page 2 OWNER: JOHN DOE ANNUITANT: JOHN DOE CONTRACT NUMBER: 00 000 000 ISSUE DATE: FEB 28, 1992 CONTRACT DATE: FEB 28,1992 RETIREMENT DATE: JAN 1, 2020 INITIAL GUARANTEED INTEREST RATE: 7.50% to MAR 31, 1992 MINIMUM GUARANTEED INTEREST RATE: 6.00% TO DEC 31, 1992 3.00% AFTER DEC 31, 1992 BENEFICIARY: JANE DOE FORM NUMBER: 92TSUA - ------------------------------------------------------------------------------- TABLE OF GUARANTEED VALUES ISSUE AGE 38 MALE $1000 ANNUAL CONTRIBUTION NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY SINCE FIRST CONTRIBUTION CASH VALUE ANNUITY AT AGE 65* ------------------------ ---------- ----------------- 1 977 6.63 2 1,946 16.20 3 2,944 26.67 4 3,998 36.84 5 5,064 46.70 6 6,220 56.28 7 7,362 65.59 8 8,538 74.62 9 9,841 83.38 10 11,204 91.90 11 12,629 100.16 12 14,118 108.18 13 15,673 115.97 14 17,144 123.54 15 18,658 131.18 16 20,218 138.64 17 21,824 145.90 18 23,479 152.80 19 25,213 159.70 20 27,000 166.03 24 (Age 62) 34,697 189.57 27 (Age 65) 41,098 205.49 THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000 CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE (SEE SECTION 2.11) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE ACCOUNT VALUE (SEE SECTION 1.05). THE TABLES ASSUME THAT 100% OF ALL CONTRIBUTIONS AND EARNINGS ARE ALLOCATED TO AND REMAIN IN THE GUARANTEED INTEREST DIVISION. YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS. THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A SETTLEMENT WILL BE SUBJECT TO A CHARGE (SEE SECTION 3.04). *ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO SURVIVOR) WITH JOINT ANNUITANT THE SAME AGE AS THE ANNUITANT. No. 92 TSUA Page 3 PART I--DEFINITIONS SECTION 1.00 AGREEMENT. The term "Agreement" means an agreement described in Treasury Regulation Section 1.403(b)-1(b)(3) between an Employer and an employee of the Employer, in which the Employer agrees to purchase an Annuity for the employee. If Employer contributions to purchase the Annuity result from the employee's agreement to take a reduction in future salary or forgo a future salary increase, such Agreement is referred to as a "Salary Reduction Agreement" within the meaning of Sections 402(g)(3)(C) and 3121(a)(5)(D) of the Code. SECTION 1.01 ANNUITANT. The term "Annuitant" means the owner of this Contract, as shown on page 3 and on whose behalf this Contract has been purchased and is maintained, and who exercises all rights under this Contract. SECTION 1.02 ANNUITY. The Term "Annuity" means an annuity contract purchased in accordance with the terms of the Plan or Agreement, which contract meets the requirements for qualification under Section 403(b) of the Code. SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts that you have in the Guaranteed Interest Division and the Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by us pursuant to Section 3.04 of this Contract. Various sections of this Contract (Sections 1.18, 1.19, 1.20, 3.01, and 3.02) refer to monthly payments to be made under an Annuity Benefit. You may wish to have your Annuity Benefit paid at other intervals, such as quarterly, semi-annually, or annually, instead of monthly. You may elect this at the time you elect the Annuity Benefit form as described in Section 3.03; in that event, all references in this Contract to monthly payments will be deemed to mean payments at the frequency you elect, subject to our rules at the time of election. SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value less any applicable withdrawal charge determined as follows: The withdrawal charge equals the lesser of (a) or (b) where (a) equals 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the excess of (i) the Annuity Account Value over (ii) the Free Corridor Amount defined in Section 2.09; and (b) is the excess, if any, of (i) 8% of the total Contributions made on your behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior charges for partial withdrawals made pursuant to Section 2.08. However, notwithstanding the above, if you are age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. A withdrawal charge will not apply, which means the Cash Value will equal the Annuity Account Value upon any of the following occurrences: (i) your attainment of age 59 and 6 months and your completion of at least five Contract Years, or (ii) you die and a distribution is made to your beneficiary, or (iii) your attainment of age 55, your completion of at least five Contract Years and the receipt by us of a properly completely settlement election form providing for the application of the Annuity Account Value to purchase an Eligible Annuity Certain, defined in Section 1.14, or (iv) your completion of at least three Contract Years and the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase a period certain Annuity, defined in Section 1.21, where the certain period of such annuity is at least ten years, or (v) the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase a Life Annuity distribution option, or (vi) the attainment of age 55, your completion of at least five Contract Years, and separation from service, or (vii) your completion of at least twelve Contract Years. No. 92 TSUA Page 4 SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all Contracts with a Contract Date in the same calendar year. SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.08 CONTRACT. The term "Contract" means this Contract. SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt by us of both an application for this Contract, properly signed and completed, and a Contribution. SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month period beginning on (i) the Contract Date, and (ii) each anniversary thereafter, unless otherwise agreed to in writing by us. SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us for you with respect to an Annuity purchased for you under the Plan. We are under no obligation to accept any Contribution less than $20.00. Contributions may be either Elective Deferrals or Employer Contributions pursuant to the Plan. The Employer shall indicate to us the amount and type of each Contribution. SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or severally as the case may be, the following Divisions described in this Contract: (a) the Guaranteed Interest Division, and (b) the Investment Division of the Separate Account. SECTION 1.13 ELECTIVE DEFERRALS. The term "Elective Deferrals" means Contributions made pursuant to a Salary Reduction Agreement as defined in Section 1.00. SECTION 1.14 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by us which extends beyond your attainment of age 59 and 6 months and does not permit any prepayment of the unpaid principal (that is, no withdrawal or single sum payment) prior to your attainment of age 59 and 6 months. SECTION 1.15 EMPLOYER. The term "Employer" means (i) an organization described in Section 501(c)(3) of the Code which is exempt from Federal income tax under Section 501(a) of the Code; or (ii) a State, political subdivision of a State, or an agency or instrumentality of any one or more of the foregoing, in connection with services performed by an employee for an educational organization described in Section 170(b)(1)(A)(ii) of the Code. SECTION 1.16 ERISA. The term ERISA means the Employee Retirement Income Security Act as amended. SECTION 1.17 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in the Guaranteed Interest Division. The initial rate to apply is shown on page 3 of this Contract. Section 2.03 describes the determination of the Rate to apply thereafter. SECTION 1.18 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by you. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.19 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity issued by us or one of our affiliated or subsidiary life insurance companies, providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.20 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under this Contract means (i) if you have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (with 100% of the monthly amount payable to your spouse), and (ii) if you do not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. No. 92TSUA Page 5 SECTION 1.21 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by us or one of our affiliated or subsidiary live insurance companies which does not permit any prepayment of the unpaid principal (that is, you cannot elect to receive part of your payments as a single sum payment with the remainder paid in monthly annuity payments). SECTION 1.22 PLAN. The term "Plan" means a program established by an Employer for the purchase of Annuities on behalf of employees. The Employer shall be the "Plan Administrator" within the meaning of Section 414(g) of the Code and applicable Treasury Regulations. SECTION 1.23 PROCESSING OFFICE. The term "Processing Office" means our Individual Annuity Center, P.O. Box 2996, G.P.O., New York, New York 10116, or such other location as we shall designate by advance written notice to the Employer, or the Plan's Trustee, as applicable, and to you. SECTION 1.24 RETIREMENT DATE. The term "Retirement Date" means the date on which you attain the retirement age as shown on page 3 of this Contract. Before the Retirement Date you may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month), either initially or by later change, must be in accordance with the terms of the Plan. No Retirement Date shall be later than the date of your attainment of age 70 and 6 months. Any election for such change must be made in writing by you and shall not take effect until received by us at our Processing Office. SECTION 1.25 SEPARATE ACCOUNT. The term "Separate Account" means Separate Account A which is organized as a unit investment trust (a type of investment company). We have established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited to or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities and variable life insurance. The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to these Contracts will not be chargeable with liabilities arising out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to our General Account. The Separate Account consists of "Investment Divisions". Each Investment Division may invest its assets in a separate class (or series) of shares of a designated Trust where each class (or series) represents a separate portfolio in the Trust. We reserve the right to change the designated trust or investment company or to add designated trusts or investment companies. The Investment Divisions available are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. The Guaranteed Interest Division is not a party of the Separate Account, but rather is an asset of our General Account. We will value the assets of each Investment Division on each business day. A business day is any day on which we are open, the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio of the securities in which an Investment Division is invested to materially affect the Accumulation Unit Value. We may, at our discretion, invest the assets of any Investment Division in any investment permitted by applicable law. We may rely conclusively on the opinion of counsel (including attorneys in our employ) as to what investments we are permitted by law to make. We reserve the right to (i) cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such committee at any time; (iii) restrict or eliminate any voting rights as to the Separate Account; (iv) operate the Separate Account by making direct investments, or in any other form; (v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or remove Investment Divisions (or sub-divisions of Investment Divisions) from the Separate Account (the term "Investment Division" in this Contract shall then refer to any other Investment Division in which the asset of a Class of Contracts to which this Contract belongs, were placed); (vi) combine any two or more Investment Divisions (or sub-divisions of Investment Divisions) of the Separate Account; and No. 92TSUA Page 6 (vii) withdraw from any Investment Division and to allocate to another Investment Division assets determined by us to be associated with the Class of Contracts to which this Contract belongs. If the exercise of these rights results in a material change in the underlying investments of an Investment Division, you will be notified of such exercise, as required by law. Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for any applicable tax charges) at a rate not to exceed 1.49% per year for the Stock, Money Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock Division, for financial accounting, death benefits, mortality risk, expenses and expense risk. The charge shall be made in accordance with Subsection (c) of the Net Investment Factor provision in Section 1.25. The relative proportion of these charges may be modified. The daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust shall not exceed a total annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to this Contract. The maximum rate may not be altered without your approval. SECTION 1.26 SEPARATE ACCOUNT DEFINITIONS. VALUATION PERIOD: Each business day together with any preceding consecutive non-business days. NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b), minus (c), where (a) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the Valuation Period before giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period. For this purpose, we use the share value reported to us by the Trust. (b) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the preceding Valuation Period (after any amounts allocated to or withdrawn for that Valuation period). (c) is the daily asset charge for the expenses of this Contract, times the number of calendar days in the Valuation Period. ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an Investment Division where your Contributions are invested and which is used in determining the amount you have in an Investment Division. ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of each Accumulation Unit in an Investment Division on a given date. The Accumulation Unit Value for a Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such Valuation Period. ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable from the Stock Division of the Separate Account under a Variable Annuity Benefit as defined in Section 3.02. ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1, 1968. On August 27, 1981, the date the first Contribution was put into the Stock Division, the Annuity Account Value was $1.26 and $1.52 for contracts with Assumed Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE ANNUITY UNIT VALUE: The Average Annuity Unit Value for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods ending in such month. SECTION 1.27 TRANSACTION DATE. The Transaction Date is the business day we receive a Contribution or a written contract transaction request providing the information we need at the Processing Office. In the case of a transfer request initiated through the use of a touch tone telephone as described in Section 2.05, the Transaction Date is the business day the telephone transaction is received. SECTION 1.28 TRUST. The term "Trust" means the designated trust or investment company in which Separate Account assets are invested. No. 92 TSUA Page 7 - ------------------------------------------------------------------------------- PART II-ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. The Employer is to make Contributions, from time to time on such dates and in such amounts as determined by the Employer pursuant to the terms of the Plan or Agreement. You are to specify the amount to be allocated to each Division. Each Contribution received by us with respect to you will, before its allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. Pursuant to the terms of the Plan, if applicable, you may, with our agreement, (i) transfer to this Contract any amount held under a contract or account that meets the requirements of Section 403(b) of the Code ("Transferred Funds"), or (ii) roll over contributions from a contract or account that meets the requirements of Section 403(b) of the Code, or from a conduit individual retirement arrangement described in Section 408(d)(3)(A)(iii) of the Code. If you do not provide to us at the time of such transfer as described in (i) above, as to what portion, if any, of the amounts of the Transferred Funds which are exempt from the distribution restrictions described in Section 2.10, and the minimum distribution rules described in Section 3.05, we will treat all such amounts as being subject to such restrictions. Any Transferred Funds from a contract not issued by us will, before allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when an amount is allocated to or withdrawn or transferred from an Investment Division, the Annuity Account Value will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units you have in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Sections 2.07, 2.08 or 2.13, or transferred from the Investment Division pursuant to Section 2.05. The amount you have in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units in the Investment Division on that date, and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under this Contract terminates on the earliest of (i) your election and commencement of annuity benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii) Termination of this Contract pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division becomes part of our general assets, which support the guarantees of this Contract and other contracts. The amount in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 or 2.13, plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Section 2.07, 2.08 or 2.13 or transferred from the Guaranteed Interest Division, pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division on a Transaction Date pursuant to Section 2.04. We will credit the amount you have in the Guaranteed Interest Division with interest at effective annual rates that we determine. For each Class of Contracts we determine a yearly guaranteed interest rate that will remain in effect throughout the next year. We guarantee that this yearly guaranteed interest rate will never be less than 3%. Participation in the Guaranteed Interest Division under the terms of this Contract terminates on the earliest of (i) election and commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, and (iii) Termination of this Contract pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section 2.01 is allocated (after deduction of any applicable tax charge) to one or more Divisions, at your sole direction as specified to us. Allocation percentages must be in whole numbers and the sum must equal 100. The allocation is made as of the Transaction Date on which we have received both such Contribution and such direction. Contributions made to an Investment Division purchase Accumulation Units in that Investment Division, using the Accumulation Unit Value next computed after the Transaction Date. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the Transaction Date with respect to each transfer from the Division pursuant to Section 2.05, (iii) on the Transaction Date with respect to each withdrawal pursuant to Section 2.07, (iv) at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, (v) upon Termination of this Contract, pursuant to Section 2.06, and (vi) upon your death pursuant to Section 2.12. SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request or through the use of a touch tone telephone, transfer all of part of the amount you have in a Division to one or more of the Divisions as follows: (i) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; (2) amounts in the Money Market Division may be transferred to other Divisions. Written authorization for touch tone telephone initiated transfers is only required when authorization for telephone transfers is requested. Upon advance written notice to you, we reserve the right to discontinue the acceptance of transfer requests through the use of a touch tone telephone. All transfers will be effective on the Trans- No. 92TSUA Page 8 action Date and will be subject to our rules in effect at the time of transfer. With respect to the Investment Division, the transfer will be made at the Accumulation Unit Value next computed after the Transfer Date. No transfers are permitted to the Money Market Division from the other Divisions. SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the terms of the Plan, including, for Plans subject to Title I of ERISA, if applicable, the spousal consent rules set forth in Section 3.06, you may elect, by written notice, to terminate this Contract. In addition, termination of this Contract is subject to the restrictions on distributions set forth in Section 2.10 of this Contract. We will determine the Cash Value as of the Transaction Date we receive your written election. The payment of such Cash Value to you may be deferred by us in accordance with the provisions of Section 4.07. Subject to the terms of the Plan, and the restrictions on distributions set forth in Section 2.10, we reserve the right to pay the Annuity Account Value under this Contract and terminate this Contract. This right may be exercised only if both (i) you made no Contributions during the last three completed Contract Years, and the Annuity Account Value is less than $500, or (ii) a partial withdrawal is made that would result in your Annuity Account Value falling below $500. We also reserve the right to terminate this Contract if no Contributions have been made within 120 months of the Contract Date shown on page 3 of this Contract. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. If this Contract is terminated, surrendered or exchanged prior to your Retirement Date, any applicable tax charges we have paid may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on terminations, unless a change in applicable law has occurred with respect to your Contract. SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under the terms of the Plan, and the restrictions on distributions set forth in Section 2.10, you may elect, by written notice to us, to make a partial withdrawal from the Divisions. For Plans subject to Title I of ERISA, partial withdrawals may be subject to the spousal consent rules, if applicable, set forth in Section 3.06. Following receipt of your written notice, we will pay the lesser of the Cash Value, or the amount of partial withdrawal requested to the person entitled to receive such payment as you designate to us in writing. The amount paid plus any withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the amounts you have in the Divisions. Unless instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts that you have in such Divisions. Upon any partial withdrawal payment, we will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by us in accordance with the provisions of Section 4.07. We may decline to accept a request for a partial withdrawal of less than $300, or where the request violates the provisions of Sections 2.07 or 3.06. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, we will so advise you and reserve the right to pay the Annuity Account Value to you and terminate this Contract. SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity Account Value, pursuant to Section 1.05. WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than the Free Corridor Amount, we will (i) first withdraw from the Divisions an amount equal to the Free Corridor Amount, in proportion to the amount you have in them, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a partial withdrawal charge. Such partial withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 0% thereafter of the amount withdrawn in excess of the Free Corridor Amount (including such charge) pursuant to (ii) of the preceding sentence. No. 92TSUA Page 9 (b) is the excess, if any, of (i) 8% of the total Contributions made on your behalf during the Current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to this Section. However, notwithstanding the above, if your are age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. If withdrawals are made from this Contract prior to the Retirement Date, any applicable tax charges we have paid with respect to this Contract may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on withdrawals, unless a change in applicable law has occurred with respect to your Contract. SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means if you have completed three Contract Years or attained age 59 and six months an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the current Contract Year. If you have not completed three Contract years or attained age 59 and six months, the Free Corridor Amount is zero. SECTION 2.10 RESTRICTIONS ON DISTRIBUTIONS. Notwithstanding anything in this Contract to the contrary, payments of Cash Value pursuant to the termination of this Contract under Section 2.06, partial withdrawals under Section 2.07, death benefits under Section 2.12, or Annuity Benefits under Section 3.03 may be limited as provided in Section 403(b)(11) of the Code and in this Section, to the extent they are attributable to Elective Deferral Contributions made to this Contract after December 31, 1988 and earnings credited after December 31, 1988 on Elective Deferral Contributions made before and after December 31, 1988 (collectively, "Restricted Amounts"). Distributions of Restricted Amounts may not be made until you attain age 59 years and six months, separate from service, die, or become disabled (within the meaning of Section 72(m)(7) of the Code). Distributions of Elective Deferral Contributions made after December 31, 1988 - (but not any earnings credited after December 31, 1988 attributable to Elective Deferral Contributions made before or after December 31, 1988) may also be made in the case of hardship (within the meaning of Section 403(b)(11) of the Code and applicable Treasury Regulations). If you request payment of Restricted Amounts on the grounds of disability or hardship you must furnish to us proof of such disability or hardship as may be required by the Plan, the Code, and applicable Treasury Regulations in a form satisfactory to us. SECTION 2.11 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract Year, if the Annuity Account Value on that date is less than $25,000, we will withdraw from the Divisions an Annual Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account Value including the amount of any withdrawals pursuant to Section 2.07 during that Contract Year. The charge will be allocated among the Divisions in proportion to the amounts that you have in the Divisions. If the Annuity Account Value is less than $25,000, on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03, or (b) the date of Termination of this Contract pursuant to Section 2.06 or 2.12, we will prorate the Annual Administrative Charge applicable to the completed portion of the Current Contract Year and withdraw such amount in lieu of the Annual Administrative Charge described in this Section for the applicable part of that Contract Year. If the Annuity Account Value is $25,000 or greater at the end of a Contract Year, the Annual Administrative Charge is zero. SECTION 2.12 DEATH BENEFIT. Upon receipt of due proof of your death , we will pay to the beneficiary designated to receive such payment, pursuant to Section 4.04 of this Contract, the amount of death benefit payable. The amount of the death benefit is equal to the greater of (i) the Annuity Account Value and (ii) the minimum death benefit. Such minimum death benefit is the sum of all Contributions made pursuant to Section 2.01 (before reduction for any applicable tax charge) less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount that was withdrawn is to the Annuity Account Value. If, in accordance with the provisions of Section 2.01, the Cash Value of another Annuity Contract issued by us, or one of our affiliated or subsidiary Life Insurance Companies, which provides for a death benefit before retirement is equal to the greater of the contract Cash Value or alternate amount based on premiums paid or Contributions made under the Annuity Contract, is transferred to this Contract, such Cash Value or an alternative amount as of the date of transfer, will be included in the "sum of all Contributions" in lieu of the amount of Cash Value transferred for purposes of the death benefit under this Contract. No. 92TSUA Page 10 We will pay the death benefit to the beneficiary in the form of an Annuity Benefit if you have made the election described in the last paragraph of Section 4.04. Also in accordance with the last paragraph of Section 4.04, if no such election is in effect at your death, we will pay the death benefit to the beneficiary in a single sum, unless the beneficiary elects, before we pay the death benefit, to apply the death benefit to an Annuity Benefit, for Plans subject to Title I of ERISA. Distributions pursuant to this Section are subject to the terms of the Plan and the Spousal Consent Rules set forth in Section 3.06 for Plans subject to Title I of ERISA. Upon payment of the death benefit, the amount you have in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. - ------------------------------------------------------------------------------- PART III-ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under this Contract with respect to a payee is the amount provided pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Stock Division of the Separate Account. Such Variable Annuity Benefit will increase if the average daily rate of investment return in the Stock Division is equivalent to more than 6.75% or 5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25% annually, depending on whether the applicable assumed base rate of net investment return referred to in Section 1.26 is 5% or 3.5%, respectively. The daily rate of investment return is before deduction of charges, as described in Section 1.25, not to exceed the maximum rate of 1.75% after any deductions to provide for any applicable tax charge. These charges include a daily charge for financial accounting, death benefits, mortality risk, expenses and expense risk, plus the investment advisory fee charges and direct operating expense charges of the Trust. The amount of the first, second and third payments under any Variable Annuity Benefit provided under the terms of this Contract with respect to a payee is the monthly amount provided pursuant to the fifth paragraph of Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. As described in Section 3.05, we will notify the payee how each Variable Annuity Benefit is determined. SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your Retirement Date, provided you are then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless you elect (i) to receive the Cash Value in a single sum or (ii) to apply the Annuity Account Value, or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by us, or one of our affiliated or subsidiary life insurance companies as elected by you, or (iii) to take partial withdrawals in amounts and at times as required by the Code, pursuant to Sections 2.07 and 3.05, subject to our rules then in effect and any other applicable requirements under the Code. We will provide notice and election forms to you not more than six months before your Retirement Date. If you elect to terminate this Contract, prior to the Retirement Date, pursuant to Section 2.06, an election may be made to receive an Annuity Benefit in lieu of the Cash Value, unless restricted by the Plan. We will have the right to require that you furnish pertinent information to provide an Annuity Benefit, and we will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. We may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary life insurance companies. If the issuance of this Contract is pursuant to a Plan subject to Title I of ERISA, the rules set forth in Section 3.06 shall apply to your election and the commencement of annuity benefits. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value if the payments under the annuity form involves life contingencies, or (ii) the Cash Value if the Annuity Form elected does not involve life contingencies. No. 92TSUA Page 11 The amount applied to provide an Annuity Benefit may be reduced by any applicable tax charge on annuity considerations, as we determine. If we have previously deducted any applicable tax charge from Contributions as provided in Section 2.01, we will not again deduct charges for the same taxes before application to provide an Annuity Benefit, unless a change in applicable law has occurred with respect to your Contract. The balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below, or (ii) our current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, your Contract will be governed by our supplementary contract then in effect. The amount to be applied to provide an Annuity Benefit will, in addition to any tax charge reduction, be reduced by an administrative charge. The amount of such charge will be determined from time to time in accordance with our general practices applicable on a uniform basis to all contracts of the same type as this Contract. After the application of an amount to provide an Annuity Benefit, the amounts you have in the Divisions and the Annuity Account Value shall be zero. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the terms of this Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (with 100% of the amount of your payment continued to your spouse). The amount of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Mortality Form, are based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females, at age zero. The amount of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on a 50-50 split of males and females, at age zero and an Assumed Base Rate of Net Investment Return of 3.5% or 5%, whichever applies pursuant to Section 1.26. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females, at age zero, if such annuity form provides for a Fixed Annuity Benefit, and on the projected 1983 Basic Table "a" adjusted to a unisex basis based on a 50-50 split of males and females, at age zero and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section 1.26, if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Distributions attributed to Contributions of Transferred Funds pursuant to Section 2.01 (where you have provided to us written evidence of such balance as of December 31, 1986) must commence no later than age 75. Such distributions will be made in the normal form of Annuity Benefit, unless you elect to take payments in a single sum or another form of Annuity Benefit then offered by us. Your entire interest in this Contract attributable to all other Contributions made, and earnings credited thereon must be distributed, or begin to be distributed no later than the first day of April following the calendar year in which you attain age 70 and 6 months ("Required Beginning Date"). Your entire interest may be distributed, as you elect, over (a) your life, or the lives of you and your designated beneficiary, or (b) a period certain not extending beyond your life expectancy, or the joint and last survivor expectancy of you and your designated beneficiary. Distributions must be made in periodic payments at intervals of no longer than one year. In addition, payments must be either nonincreasing or they may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the proposed Treasury Regulations, or any successor Regulation thereto. All distributions made hereunder shall be made in accordance with the requirements of Section 403(b)(10) and 401(a)(9) of the Code, including the incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and applicable Treasury Regulations, including the minimum distribution incidental benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or any successor Regulation thereto. Notwithstanding the above paragraphs and the following paragraphs of this Section 3.05, while any distribution shall be subject to such requirements of the Code and regulations, any distribution shall also be subject to the terms of this Contract. That is, the forms of distribution shall be those which are made available by us at the time of your election. For purposes of determining the "period certain" referred to in the first paragraph of this Section, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9 unless you otherwise elect prior to the time distributions are required to begin, those life expectancies shall be recalculated annually. Such election shall be irrevocable and shall apply to all subsequent years. The life expectancy of a non-spouse beneficiary may not be recalculated. Instead, life expectancy will be calculated using the attained age of such beneficiary during the calendar year in which you attain age 70 and 6 months and payments for subsequent years shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. If you die after distribution of your interest in this Contract has begun, the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution being used prior to your death. If you die before distribution of your interest begins, distribution of your entire interest shall be completed no later than December 31 of the calendar year containing the fifth anniversary of your death, except to the extent that an election is made to receive death benefit distributions in accordance with (1) or (2) below: No. 92TSUA Page 12 (1) If your interest is payable to a designated beneficiary, then your entire interest may be distributed over the life of, or over a period certain not greater than the life expectancy of, the designated beneficiary. Such distributions must commence on or before December 31 of the calendar year immediately following the calendar year of your death. (2) If the designated beneficiary is your surviving spouse, the date distributions are required to begin in accordance with (1) above shall not be earlier than the later of (A) December 31 of the calendar year immediately following the calendar year of your death or (B) December 31 of the calendar year in which you would have attained age 70 and 6 months. For purposes of determining the "period certain" referred to in the immediately preceding paragraph, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of distributions beginning after your death, unless otherwise elected by the surviving spouse by the time distributions are required to begin, life expectancies shall be recalculated annually. Such election shall be irrevocable by the surviving spouse and shall apply to all subsequent years. In the case of any other designated beneficiary, life expectancies shall be calculated using the attained age of such beneficiary during the calendar year in which distributions are required to begin pursuant to this Section, and payments for any subsequent calendar year shall be calculated based on life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. Distributions under this Section are considered to have begun if distributions are made because you have reached your Required Beginning Date or if prior to the Required Beginning Date distributions irrevocably commence to you over a period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1 of the Proposed Treasury Regulations or any successor Regulation thereto. Evidence of each payee's survival must be furnished to us either by personal endorsement of the check drawn for payment or by other means satisfactory to us. If a benefit payment under this Contract was based on information that is subsequently found to be incorrect, your benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by us will be charged against and underpayments will be added to any payments thereafter falling due under the terms of this Contract with respect to the payee, affecting as many such payments as are necessary to correct the overpayment or underpayment. Our liability, with respect to a payee, is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under this Contract. If we receive evidence satisfactory to us that (i) a payee entitled to receive any payment under this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, we may make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If a variable annuity form made available by us provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Pursuant to Section 3.03, upon your election, pursuant to Section 3.03 of an annuity form providing payments for a period certain, you may designate (with the right to change such designation) a person or persons to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The Payee may designate (with the right to change such designation and without the concurrence of any other person) a payee to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's estate in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, we will pay in a single sum to such payee's estate the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis applicable in determining the annuity amount. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. We will require satisfactory evidence of the age of any person upon whose life an annuity form depends. No. 92TSUA Page 13
- -------------------------------------------------------------------------------- TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% OF PAYMENT TO CONTINUE TO SPOUSE (Minimum Monthly Income per $1,000 of Annuity Account Value) - --------------------------------------------------------------------------------------------------------------------------------- Age 60 61 62 63 64 65 66 67 68 69 70 - --------------------------------------------------------------------------------------------------------------------------------- 60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88 61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96 62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03 63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11 64 4.89 4.94 5.00 5.05 5.10 5.14 5.19 65 5.00 5.06 5.11 5.17 5.22 5.27 66 5.12 5.18 5.24 5.29 5.35 67 5.24 5.31 5.37 5.43 68 5.37 5.44 5.51 69 5.52 5.59 70 5.67 - ---------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1000 of Annuity Account Value) - ------------------------------------------------------------------------------- VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS: Age 3.5% 5.0% - ----------- ---------- --------- ---------- ---------- 60 5.27 6.16 61 5.39 6.28 62 5.52 6.41 63 5.66 6.55 64 5.81 6.70 65 5.97 6.86 66 6.15 7.03 67 6.33 7.21 68 6.53 7.41 69 6.74 7.62 70 6.97 7.85 - ----------- ---------- --------- ---------- ---------- We will notify the payee, with respect to each payment under a Variable Annuity Benefit, the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each variable payment. Such notice will be mailed with each payment. Any election, change, revocation or designation shall be made, and will take effect on the Transaction Date, in the same manner as a change of beneficiary, as described in Section 4.04. If a commutation right under an Annuity Benefit is exercised, we may defer payment in accordance with Section 4.07. SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS. If this Contract is issued pursuant to a Plan subject to Title I of ERISA, then the provisions of this Section shall supersede any contrary provisions in this Contract. If you are married, your interest in the Contract shall be paid in the Normal Form joint and survivor annuity, and if you are unmarried, your interest shall be paid in the Normal Form life annuity, unless you elect otherwise as described in this Section. If you are married and die before payment of your interest has commenced, your interest shall be paid to your surviving spouse in the form of a life annuity, unless at the time of your death there was a contrary election made pursuant to this Section. The foregoing notwithstanding, your surviving spouse may elect, before payment is to commence, to have payment made in any form permitted under the terms of this Contract. You may elect, at any time within the 90 consecutive day period before the first day of the first period for which your interest is paid as an annuity or in any other form, not to have your interest paid in the Normal Form, in which case it shall be paid in any other form elected under the terms of this Contract. If such interest is to be paid to your spouse upon your death, you may elect, during the period beginning on the first day of the plan year of the Plan in which you attain age 35 (or, if you separate from service prior to that plan year, beginning on the date of separation) and ending with your death, for a beneficiary other than your spouse to receive payment of the value of your interest. In addition, if you will not yet attain age 35 by the end of any current plan year, you may make a special qualified election to designate a beneficiary other than your spouse to receive payment of the value of your interest, which special qualified election shall be effective for the period beginning on the date of such election and ending on the first day of the plan year in which you will attain age 35. Amounts payable in accordance with this Section will be automatically reinstated as of the first day of the plan year in which you attain age 35 unless a new election designating a beneficiary other than the spouse is made in accordance with the requirements of this Section. Any election described in the foregoing paragraph must be consented to by your spouse in writing before a notary or a representative of the Plan unless you can prove that there is no spouse or that the spouse cannot be located. Also, if you have become legally separated from your spouse or have been abandoned (within the meaning of local law) and have a court order to such effect, spousal consent is not required unless a qualified domestic relations order provides otherwise. Your election must designate a specific beneficiary (including any class of beneficiaries or any contingent beneficiaries) that may not be changed without further consent of the spouse, unless the spouse's consent expressly permits designation by you without further consent of the spouse. The spouse's consent under No. 92TSUA Page 14 this section shall acknowledge the effect of the election. In addition, the spouse's consent (or establishment that the consent of the spouse may not be obtained) shall only be valid with respect to such spouse. Your waiver of the Normal Form joint and survivor annuity shall not be effective unless the election designates a form of benefit payment which may not be changed without spousal consent (or the spouse expressly permits designations by you without any further spousal consent). A consent that permits designations by you without any requirement of further consent by such spouse must acknowledge that the spouse has the right to limit consent to a specific beneficiary and a specific form of benefit where applicable, and that the spouse voluntarily elects to relinquish either or both of such rights. If you make an election under this Section, you may revoke that election, without spousal consent, at any time before the first day of the first period for which an amount is paid as an annuity or in any other form. The provisions requiring spousal consent in this Section shall also apply with regard to your election to terminate this Contract or make partial withdrawals pursuant to Sections 2.06 and 2.07, and with respect to a beneficiary designation set forth in Section 4.04. A spouse's written consent, witnessed by a representative of the Plan or a notary public, must be given on a form acceptable to the Employer and us, within the 90 consecutive day period prior to any such payment or withdrawal, or beneficiary designation, unless you can show that you have no spouse or that the spouse cannot be located. If the Annuity Account Value applied to provide the spousal benefits on the date payment is to commence is in the aggregate less than $3,500, we may choose to make payment in a single sum rather than in the form of a Qualified Joint and Survivor Annuity or Life Annuity as described herein. Upon any payment made pursuant to this Section, we will be released from any and all liability for payment with respect to the Contributions made for you. - ------------------------------------------------------------------------------- PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the parties and the terms of this Contract alone will govern with respect to our rights and obligations. A copy of the application is incorporated in and made part of this Contract. This Contract may not be modified, nor many any of our rights or requirements be waived, except in writing and by our authorized officer. The terms of this Contract may be changed by amendment or replacement upon agreement between you and us without the consent of any other person. SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the terms of this Contract to reflect changes in the Code, or applicable Treasury Regulations, or in regulations or published rulings of the Internal Revenue Service so that this Contract will continue to be an Annuity. SECTION 4.03 NONTRANSFERABILITY AND ASSIGNMENTS. Your entire interest under this Contract is nonforfeitable. No interest of yours (or of a beneficiary) under this Contract may be transferred to any person other than us upon the surrender of this Contract. Except as permitted under applicable law, no right or interest of you or any other payee or beneficiary in this Contract shall be (a) assignable; (b) subject to any lien; or (c) liable for, or subject to, any obligation or liability of any person. The preceding sentence shall not apply to any assignment, transfer or attachment pursuant to a qualified domestic relations order (as defined in Section 414(p) of the Code). SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an initial designation of the beneficiary entitled to receive any death benefit payable pursuant to Section 2.12. You may change such designation from time to time during your lifetime, and while this Contract is in force. Any such designation or change must be made by written notice in a form satisfactory to us. A change will, upon receipt at the Processing Office, take effect as of the time the written notice was signed, whether or not you are living on the date of receipt, but without further liability as to any payment or other settlement made by us before receipt of such change. Beneficiary designations are subject to the rules of Section 3.06 if the Contract is issued pursuant to a Plan subject to Title I of ERISA. Unless otherwise specified in the designation, if you have designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive you, and if more than one survive, they will share equally. Any part of a death benefit payable pursuant to Section 2.12 for which there is no designated beneficiary living at the time of your death, will be payable in a single sum to your children who survive you, in equal shares, or should none survive, then to your estate. No. 92TSUA Page 15 If you elect in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity previously elected by you, with respect to the beneficiary, subject to our rules then in effect. If, at your death, there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. Any such election must meet the minimum distribution requirements under the Code, as described in Section 3.05. SECTION 4.05 DISQUALIFICATION OF PLAN OR CONTRACT. In the event that the Plan fails to qualify as a Plan under Section 403(b) of the Code and applicable Treasury Regulations, we reserve the right, upon receiving notice of such fact, to transfer the Annuity Account Value under this Contract to another annuity contract issued by us, an affiliate subsidiary, on your life, or to terminate this Contract and pay to you the Annuity Account Value less deduction for applicable taxes, solely at our option. SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to the Employer, we reserve the right at our sole discretion to limit Contributions under this Contract. SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment of a death benefit and payment of any portion of your Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange has been closed or trading on it is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Securities and Exchange Commission, by order, permits us to defer payment in order to protect persons with interests in the Investment Divisions. We can defer payment of any portion of your Annuity Account Value in the Guaranteed Interest Division for up to six months while you are living. SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year we will furnish you with a notice showing the following: (1) the amount you have in the Guaranteed Interest Division, (2) the total number of Accumulation Units you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Values, (4) the amount you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the Cash Value, and (6) the amount of death benefit payable with respect to you. We will also furnish annual calendar year reports concerning the status of the annuity and any other reports required by the Code or applicable Treasury Regulations. After the Retirement Date, we will notify you of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.09 AGE. If your age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by us will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. No. 92TSUA Page 16 - -------------------------------------------------------------------------------- APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES PROCESSING OFFICE: INDIVIDUAL ANNUITY CENTER, P.O. BOX 2996, NEW YORK, NEW YORK 10116-2996 QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR: EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY - -------------------------------------------------------------------------------- TYPE OF PURCHASE (Complete One Plan Only) A. |_| TSA PUBLIC SCHOOL (GV-PS-I) B. |_| TSA 501(C)(3) ORGANIZATION (GV-501-I) C. |X| TSA University (GV-PS-U-I) D. |_| IRA Individual (Including IRA to IRA transfers) (GV-IRA 4971) E. |_| IRA Unit Billed (Including IRA to IRA transfers) (GV-IRA 4971) F. |_| IRA QUALIFIED PLAN ROLLOVER-- (QP IRA) (Distribution from a Qualified Plan) (GV-IRA 4971-71) G. |_| EDC (Public Employee Deferred Compensation) (GV-EDC 4991) H. |_| EDC (Tax Exempt Organization) (GV-EDC 4991-SU-080) I. |_| SEP (Simplified Employee Pension) (GV-SEP 4981) J. |_| SARSEP (Salary Reduction SEP) _________________________________________ K. |_| CORPORATE TRUSTEED (GV-CORP 4941-41) L. |_| KEOGH/HR-10 TRUSTEE (GV HR-10 4911-11) (trustee owned) M. |_| KEOGH/HR-10 (GV-HR-10 4911) (not trustee owned) (issued to existing units only) - -------------------------------------------------------------------------------- DO NOT COMPLETE THIS SECTION IF 1.D OR 1.F CHECKED ABOVE 2. EMPLOYER/PLAN NAME |A|B|C|_|C|O|M|P|A|N|Y|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| 3. |_| EXISTING UNIT NO. |_|_|_|_|_|_|-|_|_|_| |x| NEW UNIT |0|0|0|1|2|3|-|4|5|6| (FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP, OR TRUSTEED PLANS. FORM 983-135B IS REQUIRED) - -------------------------------------------------------------------------------- 4. PROPOSED ANNUITANT Print name to appear on Contract. |J|O|H|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|D|O|E|_|_|_|_|_| FIRST MIDDLE INITIAL LAST A. |X| MR. |_| MRS. |_| MS. |_| OTHER ____ B. Date of Birth: Year 1954 Month JANUARY Day 27 ---- ------- -- C. Age at Nearest Birthday: 38 D. |X| Male |_| Female ---- E. Annuitant's Mailing Address: F. State of Residence: N.J. ---- No., St. |1|7|_|E|L|M|_|S|T|R|E|E|T|_|_|_|_|_|_|_|_|_|_|_|_| City |A|N|Y|T|O|W|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1| G. Telephone Number (101) 222 - 3456 |X| Home |_| Work H. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9| I. Are you associated with or employed by a member of National Association of Securities Dealers, Inc.(NASD)? |_| Yes |X| No 5. OWNER (Print Name) -- If Trusteed or EDC Plan Print Name of Owner, for all other Markets Print Name of Annuitant. JOHN DOE ----------------------------------------------------------------------------- a. Title ____________________________________________________________________ 6. RETIREMENT AGE 65 --------------------------------------------------------------- 7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death Benefit upon Annuitant's death before Retirement Date.) (BENEFICIARY MUST BE THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS.) JANE DOE - WIFE ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- 8. CONTRIBUTION ALLOCATION Guaranteed Interest Division 20% ----- Stock Division 20% ----- Money Market Division 20% ----- Balanced Division 20% ----- Aggressive Stock Division 20% ----- (PERCENTAGES IN WHOLE NUMBERS) Total 100% 9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F) A. Reminder Notice (Billing) Required |_| Yes |X| No IF YES, COMPLETE B-C-D-E B. REMINDER DATE Required for Individual IRA or otherwise must agree with existing unit or attached 983-135B. MONTH _________ DAY __________ C. REMINDER FREQUENCY |_| Annual |_| Semi-Annual |_| Quarterly |_| Monthly Available for TSA, EDC, SARSEP AND CORPORATE TRUSTEED AND UNIT BILLED IRA ONLY: |_| Semi-Monthly |_| Bi-Weekly D. REMINDER AMOUNT $_________________________________ E. BILLING MONTHS TO BE EXCLUDED - TSA ONLY ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- 10.EXPECTED FIRST CONTRACT YEAR Contribution. $1000 ---------------------------------------------------------------- IF AN ADVANCED BILLING AND/OR CONTRACT DATE ARE REQUESTED, COMPLETE #9B AND #12. - -------------------------------------------------------------------------------- (FOR PROCESSING OFFICE USE) Unit Name ___________________________ Reminder Date ___________________________ Cert. or App# _______________________ Amendment Required_______________________ EDC Emp. Add. _______________________ Emp. Fed. ID# ___________________________ Frequency ___________________________ Contract Date ___________________________ - -------------------------------------------------------------------------------- Receipt Date Batch # Inquiry # Processor - -------------------------------------------------------------------------------- 180-1000 - -------------------------------------------------------------------------------- 10. Did you receive the Separate Account Prospectus? |X| Yes |_| No Date shown on Prospectus January 1, 1992 ---------------------------------------------------- Date of any supplement to Prospectus _______________________________________ 11. Items (a) through (f) are to be answered by the annuitant. We are required by the NASD to ask these questions. (a) Name of Employer: ABC Company ------------------------------------------------------ (b) Address of Employer: 10 Main Street --------------------------------------------------------------------------- Anytown, NJ --------------------------------------------------------------------------- (c) Occupation Sales ------------------------------------------------------------- (d) Assuming the contract applied for will be issued, will any existing insurance or annuity be replaced or changed (or has it been)? | | Yes |X| No (e) Estimated Family Annual Income $100,000 ---------------------------------------- (f) Estimated Net Worth $250,000 ----------------------------------------------------- (g) Investment Objective: |_| Income |X| Income & Growth |_| Aggressive Growth |_| Growth |_| Safety of Principal 12. SPECIAL INSTRUCTIONS ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- 13. Amount paid with this form: $1000 (If a check is submitted with this request, no advanced Contract Date is permitted.) BACKDATING IS NOT PERMITTED. NOTE: Amount paid will be credited upon receipt at Equitable's Processing Office, subject to return if the certificate is not issued. The Contract Date will be the date of receipt by Equitable of this application, properly signed and completed, and Contribution at Equitable's Processing Office. - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- AGREEMENT All information and statements furnished in this application are true and complete to the best of my knowledge and belief. I understand and acknowledge that no Agent has the authority to make or modify any contract on Equitable's behalf, or to waive or alter any of Equitable's rights and regulations. IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT. UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S) OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND COMPLETE. - -------------------------------------------------------------------------------- LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR ANNUITY APPLICATION WITH INFORMATION YOU KNOW IS FALSE OR TO LEAVE OUT MATERIAL FACTS. - -------------------------------------------------------------------------------- X__________________________________ Date_______ City __________ State __________ Signature of Annuitant X__________________________________ Date_______ City __________ State __________ Signature of Authorized Individual (REQUIRED FOR EDC AND TRUSTEED) OR OWNER - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- AGENT'S SECTION Will any existing insurance or annuity be replaced or changed (or has it been), assuming the Contract will be issued? | | Yes | | No |_| I (we) certify that a prospectus for the Contract has been given to the proposed Annuitant and that no written sales materials other than those approved by Equitable have been used. EQUI-VEST issues must adequately reflect the commission interest of all Agents on previous contracts. - -------------------------------------------------------------------------------- Print Agent's Name(s) Initial of Agent Agent Agency District Agent's (Service Agent first) Last Name Number % Code Manager Code Signature - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS___ Date ___ District EQS ___ Date ____ - -------------------------------------------------------------------------------- (FOR ASU USE) ASU Code and App. No. __________________________________________________________ ASU Rec'd. _____________________________________________________________________ Date to Proc. Off. ________________________________________________ Campaign |_| Agent(s) shown above is Equity Qualified and is licensed in the state where the request is signed. Above Agent information verified by ASM (Registered Rep) - -------------------------------------------------------------------------------- Application reviewed by ________________________________________________________ - -------------------------------------------------------------------------------- 180-1000 Owner: [THE EQUITABLE LOGO] Annuitant: Contract Number: Issue Date: Contract Date: Retirement Date: - -------------------------------------------------------------------------------- THE EQUITABLE LIFE ASSURANCE SOCIETY OP THE UNITED STATES Processing Office: Individual Annuity Center, P O Box 2996, New York, New York 10116-2996 AGREES o TO ALLOCATE the Contributions made to this Contract, after deduction of any applicable tax charge, to the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division of the Separate Account (referred to in this Contract as the "Investment Divisions") or to the Guaranteed Interest Division, in accordance with Sections 2.02, 2.03 and 2.04 or in part to any one, as directed by you, and o TO APPLY the Annuity Account Value at the Retirement Date to provide the Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant is then living, and o TO PROVIDE the Annuitant with the other rights and benefits of this Contract. This is the entire Contract. In this Contract, "we", "our" and "us" mean the Equitable Life Assurance Society of the United States. "You" and "your" mean the Annuitant at the time a right is exercised by the Annuitant. TEN DAYS TO EXAMINE CONTRACT -- may cancel this Contract by returning it to us within ten days after receipt of it. Upon such cancellation, we will refund any Contribution made to us on your behalf under this Contract, plus or minus any investment gain or loss experienced in the Investment Divisions of the Separate Account from the date such Contribution is allocated to such Investment Division to the date we receive the returned Contract. /S/Pauline Sherman /s/Edward D. Miller Pauline Sherman, Vice President, Edward D. Miller Secretary & Associate General Counsel President and Chief Executive Officer THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.26 IS 5% OR 3.5%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE NOT TO EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE TRUST. No. 92 TSUB This Contract is issued in consideration of the payment to us of the Contributions made under the terms of this Contract. The provisions on the following pages are part of this Contract. - -------------------------------------------------------------------------------- TABLE OF CONTENTS DEFINITIONS Page Section 1.00 - Agreement...............................4 1.01 - Annuitant...............................4 1.02 - Annuity.................................4 1.03 - Annuity Account Value...................4 1.04 - Annuity Benefit.........................4 1.05 - Cash Value..............................4 1.06 - Class of Contracts......................5 1.07 - Code....................................5 1.08 - Contract................................5 1.09 - Contract Date...........................5 1.10 - Contract Year...........................5 1.11 - Contribution............................5 1.12 - Divisions...............................5 1.13 - Elective Deferrals......................5 1.14 - Eligible Annuity Certain................5 1.15 - Employer................................5 1.16 - ERISA...................................5 1.17 - Guaranteed Interest Rate................5 1.18 - Joint and Survivor Life Annuity Form...........................5 1.19 - Life Annuity Form.......................5 1.20 - Normal Form.............................5 1.21 - Period Certain Annuity .................6 1.22 - Plan....................................6 1.23 - Processing Office.......................6 1.24 - Retirement Date.........................6 1.25 - Separate Account........................6 1.26 - Separate Account Definitions............................7 1.27 - Transaction Date .......................7 1.28 - Trust ..................................7 ANNUITY ACCOUNT VALUE Section 2.01 - Contributions...........................8 2.02 - Separate Account Investment Divisions...................8 2.03 - Guaranteed Interest Division...............................8 2.04 - Allocation to Divisions.................8 2.05 - Transfers Among Divisions...............8 2.06 - Termination of this Contract............9 2.07 - Partial Withdrawals.....................9 2.08 - Charges for Partial Withdrawals............................9 2.09 - Free Corridor Amount...................10 2.10 - Restrictions on Distributions..........10 2.11 - Annual Administrative Charge ..........10 2.12 - Death Benefit..........................10 ANNUITY BENEFITS Section 3.01 - Fixed Annuity Benefit .................11 3.02 - Variable Annuity Benefit...............11 3.03 - Election and Commencement of Annuity Benefits....................11 3.04 - Amount of Annuity Benefits.............11 3.05 - Payment of Annuity Benefits ...........12 3.06 - Special Annuity and Spousal Consent Provisions....................14 GENERAL PROVISIONS Section 4.01 - Contract...............................15 4.02 - Statutory Compliance...................15 4.03 - Nontransferability and Assignments...........................15 4.04 - Beneficiary ...........................15 4.05 - Disqualification of Plan or Contract...........................16 4.06 - Future Contributions ..................16 4.07 - Deferment .............................16 4.08 - Annual Notice..........................16 4.09 - Age....................................16 No. 92 TSUB Page 2 - -------------------------------------------------------------------------------- PART I - DEFINITIONS SECTION 1.00 AGREEMENT. The term "Agreement" means an agreement described in Treasury Regulation Section 1.403(b)-l(b)(3) between an Employer and an employee of the Employer, in which the Employer agrees to purchase an Annuity for the employee. If Employer contributions to purchase the Annuity result from the employee's agreement to take a reduction in future salary or forgo a future salary increase, such Agreement is referred to as a "Salary Reduction Agreement" within the meaning of Sections 402(g)(3)(C) and 3121(a)(5)D) of the Code. SECTION 1.01 ANNUITANT. The term "Annuitant" means the owner of this Contract, as shown on page 3 and on whose behalf this Contract has been purchased and is maintained, and who exercises all rights under this Contract. SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in accordance with the terms of the Plan or Agreement, which contract meets the requirements for qualification under Section 403(b) of the Code. SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts that you have in the Guaranteed Interest Division and the Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by us pursuant to Section 3.04 of this Contract. Various sections of this Contract (Sections 1.18, 1.19, 1.20, 3.01, and 3.02) refer to monthly payments to be made under an Annuity Benefit. You may wish to have your Annuity Benefit paid at other intervals, such as quarterly, semi-annually, or annually, instead of monthly. You may elect this at the time you elect the Annuity Benefit form as described in Section 3.03; in that event, all references in this Contract to monthly payments will be deemed to mean payments at the frequency you elect, subject to our rules at the time of election. SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value less any applicable withdrawal charge determined as follows: The withdrawal charge equals the lesser of (a) or (b) where (a) equals 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 O% thereafter of the excess of (i) the Annuity Account Value over (ii) the Free Corridor Amount defined in Section 2.09; and (b) is the excess, if any, of (i) 8% of the total Contributions made on your behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior charges for partial withdrawals made pursuant to Section 2.08. However, notwithstanding the above, if you are age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. A withdrawal charge will not apply, which means the Cash Value will equal the Annuity Account Value upon any of the following occurrences: (i) your attainment of age 59 and 6 months, and your completion of at least five Contract Years, or (ii) you die and a distribution is made to your beneficiary, or (iii) your attainment of age 55, your completion of at least five Contract Years and the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase an Eligible Annuity Certain, defined in Section 1.14, or (iv) your completion of at least three Contract Years and the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase a Period Certain Annuity, defined in Section 1.21, where the certain period of such annuity is at least ten years, or (v) the receipt by us of a properly completed settlement election form providing for the application of the Annuity Account Value to purchase a Life Annuity distribution option, or (vi) your attainment of age 55, your completion of at least five Contract Years, and separation from service, or (vii) your completion of at least twelve Contract Years. No. 92 TSUB Page 4 SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all Contracts with a Contract Date in the same Calendar Year. SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.08 CONTRACT. The term "Contract" means this Contract. SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt by us of both the application for this Contract, properly signed and completed, and a Contribution. SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month period beginning on (i) the Contract Date, and (ii) each anniversary thereafter, unless otherwise agreed to in writing by us. SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us for you with respect to an Annuity purchased for you under the Plan. We are under no obligation to accept any Contribution less than $20.00. Contributions may be either Elective Deferrals or Employer Contributions pursuant to the Plan. The Employer shall indicate to us the amount and type of each Contribution. SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or severally as the case may be, the following Divisions described in this Contract: (a) the Guaranteed Interest Division, and (b) the Investment Division of the Separate Account. SECTION 1.13 ELECTIVE DEFERRALS. The term "Elective Deferrals" means Contributions made pursuant to a Salary Reduction Agreement as defined in Section 1.00. SECTION 1.14 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by us which extends beyond your attainment of age 59 and 6 months and does not permit any prepayment of the unpaid principal (that is, no withdrawal or single sum payment) prior to your attainment of age 59 and 6 months. SECTION 1.15 EMPLOYER. The term "Employer" means (i) an organization described in Section 501(c)(3) of the Code which is exempt from Federal income tax under Section 501(a) of the Code; or (ii) a State, political subdivision of a State, or an agency or instrumentality of any one or more of the foregoing, in connection with services performed by an employee for an educational organization described in Section 170(b)(l)(A)(ii) of the Code. SECTION 1.16 ERISA. The term ERISA means the Employee Retirement Income Security Act as amended. SECTION 1.17 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in the Guaranteed Interest Division. The initial rate to apply is shown on page 3 of this Contract. Section 2.03 describes the determination of the Rate to apply thereafter. SECTION 1.18 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected by you. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.19 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity issued by us or one of our affiliated or subsidiary life insurance companies, providing fixed monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.20 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under this Contract means (i) if you have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with such spouse as the contingent annuitant (with 100% of the monthly amount payable to your spouse), and (ii) if you do not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. No. 92 TSUB Page 5 SECTION 1.21 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by us or one of our affiliated or subsidiary life insurance companies, which does not permit any prepayment of the unpaid principal (that is, you cannot elect to receive part of your payments as a single sum payment with the remainder paid in monthly annuity payments). SECTION 1.22 PLAN. The term "Plan" means a program established by an Employer for the purchase of Annuities on behalf of employees. The Employer shall be the "Plan Administrator" within the meaning of Section 414(g) of the Code and applicable Treasury Regulations. SECTION 1.23 PROCESSING OFFICE. The term "Processing Office" means our Individual Annuity Center, P O Box 2996, New York, New York 10116-2996, or such other location as we shall designate by advance written notice to the Employer, or the Plan's Trustee, as applicable, and to you. SECTION 1.24 RETIREMENT DATE. The term "Retirement Date" means the date on which you attain the retirement age as shown on page 3 of this Contract. Before the Retirement Date you may elect to change the Retirement Date to another Retirement Date, which may be any date after the filing of the election (other than the 29th, 30th, or 31st day of any month), either initially or by later change, must be in accordance with the terms of the Plan. No Retirement Date shall be later than the date of your attainment of age 70 and 6 months. Any election for such change must be made in writing by you and shall not take effect until received by us at our Processing Office. SECTION 1.25 SEPARATE ACCOUNT. The term "Separate Account" means Separate Account A, which is organized as a unit investment trust (a type of investment company). We have established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited to or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities and variable life insurance. The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to these Contracts will not be chargeable with liabilities arising out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to our General Account. The Separate Account consists of "Investment Divisions". Each Investment Division may invest its assets in a separate class (or series) of shares of a designated Trust where each class (or series) represents a separate portfolio in the Trust. We reserve the right to change the designated trust or investment company or to add designated trusts or investment companies. The Investment Divisions available are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. The Guaranteed Interest Division is not a part of the Separate Account, but rather is an asset of our General Account. We will value the assets of each Investment Division on each business day. A business day is any day on which we are open, the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio of the securities in which an Investment Division is invested to materially affect the Accumulation Unit Value. We may, at our discretion, invest the assets of any Investment Division in any investment permitted by applicable law. We may rely conclusively on the opinion of counsel (including attorneys in our employ) as to what investments we are permitted by law to make. We reserve the right to (i) cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such committee at any time; (iii) restrict or eliminate any voting rights as to the Separate Account; (iv) operate the Separate Account by making direct investments, or in any other form; (v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or remove Investment Divisions (or sub-divisions of Investment Divisions) from the Separate Account; (The term "Investment Division" in this Contract shall then refer to any other Investment Division in which the asset of a Class of Contracts to which this Contract belongs, were placed); (vi) combine any two or more Investment Divisions (or sub-divisions of Investment Divisions) of the Separate Account; and (vii) withdraw from any Investment Division and to allocate to another Investment Division assets determined by us to be associated with the Class of Contracts to which this Contract belongs. No. 92 TSUB Page 6 If the exercise of these rights results in a material change in the underlying investments of an Investment Division, you will be notified of such exercise, as required by law. Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for any applicable tax charges) at a rate not to exceed 1.49% per year for the Stock, Money Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock Division, for financial accounting, death benefits, mortality risk, expenses and expense risk. The charge shall be made in accordance with Subsection (c) of the Net Investment Factor provision in Section 1.26. The relative proportion of these charges may be modified. The daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust shall not exceed a total annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to this Contract. The maximum rate may not be altered without your approval. SECTION 1.26 SEPARATE ACCOUNT DEFINITIONS. VALUATION PERIOD: Each business day together with any preceding consecutive non-business days. NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b), minus (c), where (a) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the Valuation Period before giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period. For this purpose, we use the share value reported to us by the Trust. (b) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the preceding Valuation Period (after any amounts allocated to or withdrawn for that Valuation Period). (c) is the daily asset charge for the expenses of this Contract, times the number of calendar days in the Valuation Period. ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an Investment Division where your Contributions are invested and which is used in determining the amount you have in an Investment Division. ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of each Accumulation Unit in an Investment Division on a given date. The Accumulation Unit Value for a Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for such Valuation Period. ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable from the Stock Division of the Separate Account under a Variable Annuity Benefit as defined in Section 3.02. ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1, 1968. On August 27, 1981, the date the first Contribution was put into the Stock Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods ending in such month. SECTION 1.27 TRANSACTION DATE. The Transaction Date is the business day we receive a Contribution or a written contract transaction request providing the information we need at the Processing Office. In the case of a transfer request initiated through the use of a touch tone telephone as described in Section 2.05, the term Transaction Date is the business day the telephone transaction is received. SECTION 1.28 TRUST. The term "Trust" means the designated trust or investment company in which Separate Account assets are invested. No. 92 TSUB Page 7 - -------------------------------------------------------------------------------- PART II - ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. The Employer is to make Contributions, from time to time on such dates and in such amounts as determined by the Employer pursuant to the terms of the Plan or Agreement. You are to specify the amount to be allocated to each Division. Each Contribution received by us with respect to you will, before its allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. Pursuant to the terms of the Plan, if applicable, you may, with our agreement, (i) transfer to this Contract any amount held under a contract or account that meets the requirements of Section 403(b) of the Code ("Transferred Funds"), or (ii) roll over contributions from a contract or account that meets the requirements of Section 403(b) of the Code, or from a conduit individual retirement arrangement described in Section 408(d)(3)(A)(iii) of the Code. If you do not provide to us at the time of such transfer as described in (i) above, as to what portion, if any, of the amounts of the Transferred Funds which are exempt from the distribution restrictions described in Section 2.10, and the minimum distribution rules described in Section 3.05, we will treat all such amounts as being subject to such restrictions. Any Transferred Funds from a contract not issued by us will, before allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when an amount is allocated to or withdrawn or transferred from an Investment Division, the Annuity Account Value will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units you have in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Sections 2.07, 2.08 or 2.13, or transferred from the Investment Division pursuant to Section 2.05. The amount you have in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units in the Investment Division on that date, and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under this Contract terminates on the earliest of (i) your election and commencement of annuity benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii) Termination of this Contract pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division becomes part of our general assets, which support the guarantees of this Contract and other contracts. The amount in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 or 2.13, plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Section 2.07, 2.08 or 2.13 or transferred from the Guaranteed Interest Division, pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division on a Transaction Date pursuant to Section 2.04. We will credit the amount you have in the Guaranteed Interest Division with interest at effective annual rates that we determine. For each Class of Contracts we determine a yearly guaranteed interest rate that will remain in effect throughout the next year. We guarantee that this yearly guaranteed interest rate will never be less than 3%. Participation in the Guaranteed Interest Division under the terms of this Contract terminates on the earliest of (i) election and commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, and (iii) Termination of this Contract pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section 2.01 is allocated (after deduction of any applicable tax charge) to one or more Divisions, at your sole direction as specified to us. Allocation percentages must be in whole numbers and the sum must equal 100. The allocation is made as of the Transaction Date on which we have received both such Contribution and such direction. Contributions made to an Investment Division purchase Accumulation Units in that Investment Division, using the Accumulation Unit Value next computed after the Transaction Date. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the Transaction Date with respect to each transfer from the Division pursuant to Section 2.05, (iii) on the Transaction Date with respect to each withdrawal pursuant to Section 2.07, (iv) at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, (v) upon Termination of this Contract, pursuant to Section 2.06, and (vi) upon your death pursuant to Section 2.12. SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request or through the use of a touch tone telephone, transfer all or part of the amount you have in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; (2) amounts in the Money Market Division may be transferred to other Divisions. Written authorization for touch tone telephone initiated transfers is only required when authorization for telephone transfers is requested. Upon advance written notice to you, we reserve the right to No. 92 TSUB Page 8 discontinue the acceptance of transfer requests through the use of a touch tone telephone. All transfers will be effective on the Transaction Date and will be subject to our rules in effect at the time of transfer. With respect to the Investment Division, the transfer will be made at the Accumulation Unit Value next computed after the Transaction Date. No transfers are permitted to the Money Market Division from the other Divisions. SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the terms of the Plan, including, for Plans subject to Title I of ERISA, if applicable, the spousal consent rules set forth in Section 3.06, you may elect, by written notice, to terminate this Contract. In addition, termination of this Contract is subject to the restrictions on distributions set forth in Section 2.10 of this Contract. We will determine the Cash Value as of the Transaction Date we receive your written election. The payment of such Cash Value to you may be deferred by us in accordance with the provisions of Section 4.07. Subject to the terms of the Plan, and the restrictions on distributions set forth in Section 2.10, we reserve the right to pay the Annuity Account Value under this Contract and terminate this Contract. This right may be exercised only if both (i) you made no Contributions during the last three completed Contract Years, and the Annuity Account Value is less than $500, or (ii) a partial withdrawal is made that would result in your Annuity Account Value falling below $500. We also reserve the right to terminate this Contract if no Contributions have been made within 120 days of the Contract Date shown on page 3 of this Contract. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. If this Contract is terminated, surrendered or exchanged prior to your Retirement Date, any applicable tax charges we have paid may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on terminations, unless a change in applicable law has occurred with respect to your Contract. SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under the terms of the Plan, and the restrictions on distributions set forth in Section 2.10, you may elect, by written notice to us, to make a partial withdrawal from the Divisions. For Plans subject to Title I of ERISA, partial withdrawals may be subject to the spousal consent rules, if applicable, set forth in Section 3.06. Following receipt of your written notice, we will pay the lesser of the Cash Value, or the amount of partial withdrawal requested to the person entitled to receive such payment as you designate to us in writing. The amount paid plus any withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the amounts you have in the Divisions. Unless instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts that you have in such Divisions. Upon any partial withdrawal payment, we will be released from any and all liability for payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by us in accordance with the provisions of Section 4.07. We may decline to accept a request for a partial withdrawal of less than $300, or where the request violates the provisions of Sections 2.07 or 3.06. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, we will so advise you and reserve the right to pay the Annuity Account Value to you and terminate this Contract. SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the amount of partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity Account Value, pursuant to Section 1.05. WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than the Free Corridor Amount, we will (i) first withdraw from the Divisions an amount equal to the Free Corridor Amount, in proportion to the amount you have in them, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a partial withdrawal charge. Such partial withdrawal charge will be equal to the lesser of (a) or (b) where: (a) is an amount equal to 6% during Contract Years 1 through 5 5% during Contract Years 6 through 8 4% during Contract Year 9 3% during Contract Year 10 2% during Contract Year 11 1% during Contract Year 12 O% thereafter No. 92 TSUB Page 9 of the amount withdrawn in excess of the Free Corridor Amount (including such charge) pursuant to (ii) of the preceding sentence. (b) is the excess, if any, of (i) 8% of the total Contributions made on your behalf during the current Contract Year and the nine preceding Contract Years over (ii) the cumulative total of any prior partial withdrawal charges made pursuant to this Section. However, notwithstanding the above, if you are age 60 or older on the Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the excess of the Annuity Account Value over the Free Corridor Amount. If withdrawals are made from this Contract prior to the Retirement Date, any applicable tax charges we have paid with respect to this Contract may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on withdrawals, unless a change in applicable law has occurred with respect to your Contract. SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means if you have completed three Contract Years or attained age 59 and 6 months an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the current Contract Year. If you have not completed three Contract Years or attained age 59 and 6 months, the Free Corridor Amount is zero. SECTION 2.10 RESTRICTIONS ON DISTRIBUTIONS. Notwithstanding anything in this Contract to the contrary, payments of Cash Value pursuant to the termination of this Contract under Section 2.06, partial withdrawals under Section 2.07, death benefits under Section 2.12 or Annuity Benefits under Section 3.03 may be limited as provided in Section 403(b)(ll) of the Code and in this Section, to the extent they are attributable to Elective Deferral Contributions made to this Contract after December 31, 1988 and earnings credited after December 31, 1988 on Elective Deferral Contributions made before and after December 31, 1988 (collectively, "Restricted Amounts"). Distributions of Restricted Amounts may not be made until you attain age 59 years and six months, separate from service, die, or become disabled (within the meaning of Section 72(m)(7) of the Code). Distributions of Elective Deferral Contributions made after December 31, 1988-(but not any earnings credited after December 31, 1988 attributable to Elective Deferral Contributions made before or after December 31, 1988) may also be made in the case of hardship (within the meaning of Section 403(b)(l1) of the Code and applicable Treasury Regulations). If you request payment of Restricted Amounts on the grounds of disability or hardship you must furnish to us proof of such disability or hardship as may be required by the Plan, the Code, and applicable Treasury Regulations in a form satisfactory to us. SECTION 2.11 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract Year, if the Annuity Account Value on that date is less than $25,000, we will withdraw from the Divisions an Annual Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account Value including the amount of any withdrawals pursuant to Section 2.07 during that Contract Year. The charge will be allocated among the Divisions in proportion to the amounts that you have in the Divisions. If the Annuity Account Value is less than $25,000, on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03, or (b) the date of Termination of this Contract pursuant to Section 2.06 or 2.12, we will prorate the Annual Administrative Charge applicable to the completed portion of the Current Contract Year and withdraw such amount in lieu of the Annual Administrative Charge described in this Section for the applicable part of that Contract Year. If the Annuity Account Value is $25,000 or greater at the end of a Contract Year, the Annual Administrative Charge is zero. SECTION 2.12 DEATH BENEFIT. Upon receipt of due proof of your death, we will pay to the beneficiary designated to receive such payment, pursuant to Section 4.04 of this Contract, the amount of death benefit payable. The amount of the death benefit is equal to the greater of (i) the Annuity Account Value and (ii) the minimum death benefit. Such minimum death benefit is the sum of all Contributions made pursuant to Section 2.01 (before reduction for any applicable tax charge) less any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is in the same proportion as the amount that was withdrawn is to the Annuity Account Value. If, in accordance with the provisions of Section 2.01, the Cash Value of another Annuity Contract issued by us, or one of our affiliated or subsidiary Life Insurance Companies, which provides for a death benefit before retirement is equal to the greater of the contract Cash Value or alternate amount based on premiums paid or Contributions made under the Annuity Contract, is transferred to this Contract, such Cash Value or an alternative amount as of the date of transfer, will be included in the "sum of all Contributions" in lieu of the amount of Cash Value transferred for purposes of the death benefit under this Contract. No. 92 TSUB Page 10 We will pay the death benefit to the beneficiary in the form of an Annuity Benefit if you have made the election described in the last paragraph of Section 4.04. Also, in accordance with the last paragraph of Section 4.04, if no such election is in effect at your death, we will pay the death benefit to the beneficiary in a single sum, unless the beneficiary elects, before we pay the death benefit, to apply the death benefit to an Annuity Benefit, for Plans subject to Title I of ERISA. Distributions pursuant to this Section are subject to the terms of the Plan and the Spousal Consent Rules set forth in Section 3.06 for Plans subject to Title I of ERISA. Upon payment of the death benefit, the amount you have in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. - -------------------------------------------------------------------------------- PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments with respect to a payee are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the terms of this Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Stock Division of the Separate Account. Such Variable Annuity Benefit will increase if the average daily rate of investment return in the Stock Division is equivalent to more than 6.75% or 5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25% annually, depending on whether the applicable assumed base rate of net investment return referred to in Section 1.26 is 5% or 3.5%, respectively. The daily rate of investment return is before deduction of charges, as described in Section 1.25, not to exceed the maximum rate of 1.75% after any deductions to provide for any applicable tax charge. These charges include a daily charge for financial accounting, death benefits, mortality risk, expenses and expense risk, plus the investment advisory fee charges and direct operating expense charges of the Trust. The amount of the first, second and third payments under any Variable Annuity Benefit provided under the terms of this Contract with respect to a payee is the monthly amount provided pursuant to the fifth paragraph of Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment under such benefit by the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. As described in Section 3.05, we will notify the payee how each Variable Annuity Benefit is determined. SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your Retirement Date, provided you are then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless you elect (i) to receive the Cash Value in a single sum, or (ii) to apply the Annuity Account Value, or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by us, or one of our affiliated or subsidiary life insurance companies, as elected by you, or (iii) to take partial withdrawals in amounts and at times as required by the Code, pursuant to Sections 2.07 and 3.05, subject to our rules then in effect and any other applicable requirements under the Code. We will provide notice and election forms to you not more than six months before your Retirement Date. If you elect to terminate this Contract, prior to the Retirement Date, pursuant to Section 2.06, an election may be made to receive an Annuity Benefit in lieu of the Cash Value, unless restricted by the Plan. We will have the right to require that you furnish pertinent information to provide an Annuity Benefit, and we will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. We may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary life insurance companies. If the issuance of this Contract is pursuant to a Plan subject to Title I of ERISA, the rules set forth in Section 3.06 shall apply to your election and the commencement of annuity benefits. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value if the payments under the annuity form involves life contingencies, or (ii) the Cash Value if the Annuity Form elected does not involve life contingencies. No. 92 TSUB Page 11 The amount applied to provide an Annuity Benefit may be reduced by any applicable tax charge on annuity considerations, as we determine. If we have previously deducted any applicable tax charge from Contributions as provided in Section 2.01, we will not again deduct charges for the same taxes before application to provide an Annuity Benefit, unless a change in applicable law has occurred with respect to your Contract. The balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) our current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, your Contract will be governed by our supplementary contract then in effect. The amount to be applied to provide an Annuity Benefit will, in addition to any tax charge reduction, be reduced by an administrative charge. The amount of such charge will be determined from time to time in accordance with our general practices applicable on a uniform basis to all contracts of the same type as this Contract. After the application of an amount to provide an Annuity Benefit, the amounts you have in the Divisions and the Annuity Account Value shall be zero. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the terms of this Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (with 100% of the amount of your payment continued to your spouse). The amount of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Mortality Form, are based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females, at age zero. The amount of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and the Joint and Survivor Life Annuity Form are based on a 50-50 split of males and females, at age zero and an Assumed Base Rate of Net Investment Return of 3.5% or 5%, whichever applies pursuant to Section 1.26. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females, at age zero, if such annuity form provides for a Fixed Annuity Benefit, and on the projected 1983 Basic Table "a" adjusted to a unisex basis based on a 50-50 split of males and females, at age zero and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section 1.26, if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Distributions attributed to Contributions of Transferred Funds pursuant to Section 2.01 (where you have provided to us written evidence of such balance as of December 31, 1986) must commence no later than age 75. Such distributions will be made in the normal form of Annuity Benefit, unless you elect to take payments in a single sum or another form of Annuity Benefit then offered by us. Your entire interest in this Contract attributable to all other Contributions made, and earnings credited thereon must be distributed, or begin to be distributed no later than the first day of April following the calendar year in which you attain age 70 and 6 months ("Required Beginning Date"). Your entire interest may be distributed, as you elect, over (a) your life, or the lives of you and your designated beneficiary, or (b) a period certain not extending beyond your life expectancy, or the joint and last survivor expectancy of you and your designated beneficiary. Distributions must be made in periodic payments at intervals of no longer than one year. In addition, payments must be either nonincreasing or they may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the proposed Treasury Regulations, or any successor Regulation thereto. All distributions made hereunder shall be made in accordance with the requirements of Section 403(b)(10) and 401(a)(9) of the Code, including the incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and applicable Treasury Regulations, including the minimum distribution incidental benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or any successor Regulation thereto. Notwithstanding the above paragraphs and the following paragraphs of this Section 3.05, while any distribution shall be subject to such requirements of the Code and regulations, any distribution shall also be subject to the terms of this Contract. That is, the forms of distribution shall be those which are made available by us at the time of your election. For purposes of determining the "period certain" referred to in the first paragraph of this Section, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9 unless you otherwise elect prior to the time distributions are required to begin, those life expectancies shall be recalculated annually. Such election shall be irrevocable and shall apply to all subsequent years. The life expectancy of a non-spouse beneficiary may not be recalculated. Instead, life expectancy will be calculated using the attained age of such beneficiary during the calendar year in which you attain age 70 and 6 months, and payments for subsequent years shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. If you die after distribution of your interest in this Contract has begun, the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution being used prior to your death. If you die before distribution of your interest begins, distribution of your entire interest shall be completed no later than December 31 of the calendar year containing the fifth anniversary of your death, except to the extent that an election is made to receive death benefit distributions in accordance with (1) or (2) below: No. 92 TSUB Page 12 (1) If your entire interest is payable to a designated beneficiary, then your entire interest may be distributed over the life of, or over a period certain not greater than the life expectancy of, the designated beneficiary. Such distributions must commence on or before December 31 of the calendar year immediately following the calendar year of your death. (2) If the designated beneficiary is your surviving spouse, the date distributions are required to begin in accordance with (1) above shall not be earlier than the later of (A) December 31 of the calendar year immediately following the calendar year of your death or (B) December 31 of the calendar year in which you would have attained age 70 and 6 months. For purposes of determining the "period certain" referred to in the immediately preceding paragraph, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of distributions beginning after your death, unless otherwise elected by the surviving spouse by the time distributions are required to begin, life expectancies shall be recalculated annually. Such election shall be irrevocable by the surviving spouse and shall apply to all subsequent years. In the case of any other designated beneficiary, life expectancies shall be calculated using the attained age of such beneficiary during the calendar year in which distributions are required to begin pursuant to this Section, and payments for any subsequent calendar year shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. Distributions under this Section are considered to have begun if distributions are made because you have reached your Required Beginning Date or if prior to the Required Beginning Date distributions irrevocably commence to you over a period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1 of the Proposed Treasury Regulations or any successor Regulation thereto. Evidence of each payee's survival must be furnished to us either by personal endorsement of the check drawn for payment or by other means satisfactory to us. If a benefit payment under the terms of this Contract was based on information that is subsequently found to be incorrect, your benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by us will be charged against and underpayments will be added to any payments thereafter falling due under the terms of this Contract with respect to the payee, affecting as many such payments as are necessary to correct the overpayment or underpayment. Our liability, with respect to a payee, is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under this Contract. If we receive evidence satisfactory to us that (i) a payee entitled to receive any payment under the terms of this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, we may make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If a variable annuity form made available by us provides for payment for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Pursuant to Section 3.03, upon your election, pursuant to Section 3.03 of an annuity form providing payments for a period certain, you may designate (with the right to change such designation) a person or persons to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person) a payee to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's estate in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, we will pay in a single sum to such payee's estate the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis applicable in determining the annuity amount. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. We will require satisfactory evidence of the age of any person upon whose life an annuity form depends. No. 92 TSUB Page 13 - -------------------------------------------------------------------------------- TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% OF PAYMENT TO CONTINUE TO SPOUSE (Minimum Monthly Income Per $1,000 OF Annuity Account Value) - ---------------------------------------------------------------------------- Age 60 61 62 63 64 65 66 67 68 69 70 - ---------------------------------------------------------------------------- 60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88 61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96 62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03 63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11 64 4.89 4.94 5.00 5.05 5.10 5.14 5.19 65 5.00 5.06 5.11 5.17 5.22 5.27 66 5.12 5.18 5.24 5.29 5.35 67 5.24 5.31 5.37 5.43 68 5.37 5.44 5.51 69 5.52 5.59 70 5.67 - ---------------------------------------------------------------------------- ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Account Value) - ------------------------------------------------------------------- VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS Age 3.5% 5.0% - ------------------------------------------------------------------- 60 5.27 6.16 61 5.39 6.28 62 5.52 6.41 63 5.66 6.55 64 5.81 6.70 65 5.97 6.86 66 6.15 7.03 67 6.33 7.21 68 6.53 7.41 69 6.74 7.62 70 6.97 7.85 - ------------------------------------------------------------------- We will notify the payee, with respect to each payment under a Variable Annuity Benefit, the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each variable payment. Such notice will be mailed with each payment. Any election, change, revocation or designation shall be made, and will take effect on the Transaction Date, in the same manner as a change of beneficiary, as described in Section 4.04. If a commutation right under an Annuity Benefit is exercised, we may defer payment in accordance with Section 4.07. SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS. if this Contract is issued pursuant to a Plan subject to Title I of ERISA, then the provisions of this Section shall supersede any contrary provisions in this Contract. If you are married, your interest in the Contract shall be paid in the Normal Form joint and survivor annuity, and if you are unmarried, your interest shall be paid in the Normal Form life annuity, unless you elect otherwise as described in this Section. If you are married and die before payment of your interest has commenced, your interest shall be paid to your surviving spouse in the form of a life annuity, unless at the time of your death there was a contrary election made pursuant to this Section. The foregoing notwithstanding, your surviving spouse may elect, before payment is to commence, to have payment made in any form permitted under the terms of this Contract. You may elect, at any time within the 90 consecutive day period before the first day of the first period for which your interest is paid as an annuity or in any other form, not to have your interest paid in the Normal Form, in which case it shall be paid in any other form elected under the terms of this Contract. If such interest is to be paid to your spouse upon your death, you may elect, during the period beginning on the first day of the plan year of the Plan in which you attain age 35 (or, if you separate from service prior to that plan year, beginning on the date of separation) and ending with your death, for a beneficiary other than your spouse to receive payment of the value of your interest. In addition, if you will not yet attain age 35 by the end of any current plan year, you may make a special qualified election to designate a beneficiary other than your spouse to receive payment of the value of your interest, which special qualified election shall be effective for the period beginning on the date of such election and ending on the first day of the plan year in which you will attain age 35. Amounts payable in accordance with this Section will be automatically reinstated as of the first day of the plan year in which you attain age 35 unless a new election designating a beneficiary other than the spouse is made in accordance with the requirements of this Section. Any election described in the foregoing paragraph must be consented to by your spouse in writing before a notary or a representative of the Plan unless you can prove that there is no spouse or that the spouse cannot be located. Also, if you have become legally separated from your spouse or have been abandoned (within the meaning of local law) and have a court order to such effect, spousal consent is not required unless a qualified domestic relations order provides otherwise. Your election must designate a specific beneficiary (including any class of beneficiaries or any contingent beneficiaries) that may not be changed without further consent of the spouse, unless the No. 92 TSUB Page 14 spouse's consent expressly permits designation by you without further consent of the spouse. The spouse's consent under this section shall acknowledge the effect of the election. In addition, the spouse's consent (or the establishment that the consent of the spouse may not be obtained) shall only be valid with respect to such spouse. Your waiver of the Normal Form joint and survivor annuity shall not be effective unless the election designates a form of benefit payment which may not be changed without spousal consent (or the spouse expressly permits designations by you without any further spousal consent). A consent that permits designations by you without any requirement of further consent by such spouse must acknowledge that the spouse has the right to limit consent to a specific beneficiary and a specific form of benefit where applicable, and that the spouse voluntarily elects to relinquish either or both of such rights. If you make an election under this Section, you may revoke that election, without spousal consent, at any time before the first day of the first period for which an amount is paid as an annuity or in any other form. The provisions requiring spousal consent in this Section shall also apply with regard to your election to terminate this Contract or make partial withdrawals pursuant to Sections 2.06 and 2.07, and with respect to a beneficiary designation set forth in Section 4.04. A spouse's written consent, witnessed by a representative of the Plan or a notary public, must be given on a form acceptable to the Employer and us, within the 90 consecutive day period prior to any such payment or withdrawal, or beneficiary designation, unless you can show that you have no spouse or that the spouse cannot be located. If the Annuity Account Value applied to provide the spousal benefits on the date payment is to commence is in the aggregate less than $3,500, we may choose to make payment in a single sum rather than in the form of a Qualified Joint and Survivor Annuity or Life Annuity as described herein. Upon any payment made pursuant to this Section, we will be released from any and all liability for payment with respect to the Contributions made for you. - ---------------------------------------------------------------------------- PART IV - GENERAL PROVISIONS SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the parties and the terms of this Contract alone will govern with respect to our rights and obligations. A copy of the application is incorporated in and made part of this Contract. This Contract may not be modified, nor may any of our rights or requirements be waived, except in writing and by our authorized officer. The terms of this Contract may be changed by amendment or replacement upon agreement between you and us without the consent of any other person. SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform the terms of this Contract to reflect changes in the Code, or applicable Treasury Regulations, or in regulations or published rulings of the Internal Revenue Service so that this Contract will continue to be an Annuity. SECTION 4.03 NONTRANSFERABILITY AND ASSIGNMENTS. Your entire interest under this Contract is nonforfeitable. No interest of yours (or of a beneficiary) under this Contract may be transferred to any person other than us upon the surrender of this Contract. Except as permitted under applicable law, no right or interest of you or any other payee or beneficiary in this Contract shall be (a) assignable; (b) subject to any lien; or (c) liable for, or subject to, any obligation or liability of any person. The preceding sentence shall not apply to any assignment, transfer or attachment pursuant to a qualified domestic relations order (as defined in Section 414(p) of the Code). SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an initial designation of the beneficiary entitled to receive any death benefit payable pursuant to Section 2.12. You may change such designation from time to time during your lifetime, and while this Contract is in force. Any such designation or change must be made by written notice in a form satisfactory to us. A change will, upon receipt at the Processing Office, take effect as of the time the written notice was signed, whether or not you are living on the date of receipt, but without further liability as to any payment or other settlement made by us before receipt of such change. Beneficiary designations are subject to the rules of Section 3.06 if the Contract is issued pursuant to a Plan subject to Title I of ERISA. Unless otherwise specified in the designation, if you have designated two or more persons as beneficiary, the beneficiary will be the designated person or persons who survive you, and if more than one survive, they will share equally. Any part of a death benefit payable pursuant to Section 2.12 for which there is no designated beneficiary living at the time of your death, will be payable in a single sum to your children who survive you, in equal shares, or should none survive, then to your estate. No. 92 TSUB Page 15 If you elect in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity previously elected by you, with respect to the beneficiary, subject to our rules then in effect. If, at your death, there is no election in effect to apply the single sum death benefit to provide an Annuity Benefit, the beneficiary may make such an election. Any such election must meet the minimum distribution requirements under the Code, as described in Section 3.05. SECTION 4.05 DISQUALIFICATION OF PLAN OR CONTRACT. In the event that the Plan fails to qualify as a Plan under Section 403(b) of the Code and applicable Treasury Regulations, we reserve the right, upon receiving notice of such fact, to transfer the Annuity Account Value under this Contract to another annuity contract issued by us, an affiliate subsidiary, on your life, or to terminate this Contract and pay to you the Annuity Account Value less deduction for applicable taxes, solely at our option. SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to the Employer, we reserve the right at our sole discretion to limit Contributions under this Contract. SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment of a death benefit and payment of any portion of your Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange has been closed or trading on it is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicably because of an emergency, or (3) the Securities and Exchange Commission, by order, permits us to defer payment in order to protect persons with interests in the Investment Divisions. We can defer payment of any portion of your Annuity Account Value in the Guaranteed Interest Division for up to six months while you are living. SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year we will furnish you with a notice showing the following: (1) the amount you have in the Guaranteed Interest Division, (2) the total number of Accumulation Units you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulation Unit Values, (4) the amount you have in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the Cash Value, and (6) the amount of death benefit payable with respect to you. We will also furnish annual calendar year reports concerning the status of the annuity and any other reports required by the Code or applicable Treasury Regulations. After the Retirement Date, we will notify you of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.09 AGE. If your age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by us will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. No. 92 TSUB Page 16 OWNER: JOHN DOE ANNUITANT: JOHN DOE CONTRACT NUMBER: 00 000 000 ISSUE DATE: FEB 28, 1992 CONTRACT DATE: FEB 28, 1992 RETIREMENT DATE: JAN 1, 2020 THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O New York, New York 10116 AGREES o TO ALLOCATE the Contributions made to this Contract, after deduction of any applicable tax charge, to the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division of the Separate Account (referred to in this Contract as the "Investment Divisions") or to the Guaranteed Interest Division, in accordance with Sections 2.02, 2.03 and 2.04, as directed by the Owner, and o TO APPLY the Annuity Account Value at the Retirement Date to provide you with an Annuity Benefit or a Cash Value benefit if you are then living, and o TO PROVIDE the Owner with the other rights and benefits of this Contract. This is the entire Contract. In this Contract, "we" "our" and "us" mean The Equitable Life Assurance Society of the United States. "You" and "your" mean the Annuitant. TEN DAYS TO EXAMINE CONTRACT - The Owner may cancel this Contract by returning it to us within ten days after receipt of it. Upon such cancellation, we will refund any Contribution made to us under this Contract. /s/ Molly K. Heines /s/ Richard H. Jenrette Vice President and Secretary Chairman of the Board and Chief Executive Officer THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT. THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75% OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR 5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET INVESTMENT RETURN REFERRED TO IN SECTION 1.25 IS 5% OR 3.5%, RESPECTIVELY. THE DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE TRUST. No. 92UTRA This Contract is issued in consideration of the payment to us of the Contributions made under the terms of this Contract. The provisions on the following pages are part of this Contract. - ------------------------------------------------------------------------------ TABLE OF CONTENTS DEFINITIONS PAGE Section 1.01 - Annuitant.............................4 1.02 - Annuity...............................4 1.03 - Annuity Account Value.................4 1.04 - Annuity benefit.......................4 1.05 - Cash Value............................4 1.06 - Class of Contracts....................4 1.07 - Code..................................4 1.08 - Contract..............................4 1.09 - Contract Date.........................4 1.10 - Contract Year.........................4 1.11 - Contribution..........................4 1.12 - Divisions.............................4 1.13 - Eligible Annuity Certain..............5 1.14 - Employer..............................5 1.15 - Guaranteed Interest Rate..............5 1.16 - Joint and Survivor Life Annuity Form..........................5 1.17 - Life Annuity Form.....................5 1.18 - Normal Form...........................5 1.19 - Owner.................................5 1.20 - Period Certain Annuity................5 1.21 - Plan..................................5 1.22 - Processing Office.....................5 1.23 - Retirement Date.......................5 1.24 - Separate Account......................5 1.25 - Separate Account Definitions..........6 1.26 - Transaction Date......................7 1.27 - Trust.................................7 1.28 - Trustee...............................7 1.29 - Trusteed Plan.........................7 ANNUITY ACCOUNT VALUE Section 2.01 - Contributions.........................7 2.02 - Separate Account Investment Divisions.............................8 2.03 - Guaranteed Interest Division..........8 2.04 - Allocation to Divisions...............8 2.05 - Transfers Among Divisions.............8 2.06 - Termination of this Contract..........8 2.07 - Partial Withdrawals...................9 2.08 - Charges for Partial Withdrawals.......9 2.09 - Free Corridor Amount..................9 2.10 - Annual Administrative Charge..........9 2.11 - Death Benefit........................10 ANNUITY BENEFITS Section 3.01 - Fixed Annuity Benefit................10 3.02 - Variable Annuity Benefit.............10 3.03 - Election and Commencement of Annuity Benefits..................11 3.04 - Amount of Annuity Benefits...........11 3.05 - Payment of Annuity Benefits..........11 3.06 - Special Annuity and Spousal Consent Provisions...................14 GENERAL PROVISIONS Section 4.01 - Contract.............................14 4.02 - Statutory Compliance.................15 4.03 - Assignments and Nontransferability...................15 4.04 - Beneficiary..........................15 4.05 - Disqualification.....................15 4.06 - Future Contributions.................15 4.07 - Deferment............................15 4.08 - Annual Notice........................15 4.09 - Trustee's Responsibility.............16 4.10 - Age..................................16 No. 92UTRA Page 2 OWNER: JOHN DOE ANNUITANT: JOHN DOE CONTRACT NUMBER: 00 000 000 ISSUE DATE: FEB 28, 1992 CONTRACT DATE: FEB 28, 1992 RETIREMENT DATE: JAN 1, 2020 INITIAL GUARANTEED INTEREST RATE: 7.50% TO MAR 31, 1992 MINIMUM GUARANTEED INTEREST RATE: 6.00% TO DEC 31, 1992 3.00% AFTER DEC 31, 1992 BENEFICIARY: JANE DOE FORM NUMBER 92UTRA ******************************************************************************** TABLE OF GUARANTEED VALUES ISSUE AGE 38 MALE $1000 ANNUAL CONTRIBUTION NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY SINCE FIRST YEAR OF CONTRIBUTION CASH VALUE ANNUITY AT AGE 65 - -------------------------------- ---------- ----------------- 1 983 6.62 2 1,958 16.20 3 2,963 26.67 4 3,998 36.83 5 5,064 46.70 6 6,162 56.28 7 7,349 65.58 8 8,580 74.61 9 9,848 83.38 10 11,154 91.89 11 12,500 100.16 12 13,886 108.18 13 15,313 115.97 14 16,783 123.53 15 18,298 131.18 16 19,857 138.63 17 21,464 145.90 18 23,118 152.80 19 24,853 159.69 20 26,639 166.03 24 (Age 62) 34,697 189.57 27 (Age 65) 41,098 205.49 THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000 CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE (SEE SECTION 2.10) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE CONTRIBUTIONS MADE IN THE CURRENT AND 5 PRIOR CONTRACT YEARS (SEE SECTION 1.05). THE TABLES ASSUME THAT 100% OF ALL CONTRIBUTIONS AND EARNINGS ARE ALLOCATED TO AND REMAIN IN THE GUARANTEED INTEREST DIVISION. YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS. THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A SETTLEMENT WILL BE SUBJECT TO A CHARGE (SEE SECTION 3.04). * ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO SURVIVOR) WITH JOINT ANNUITANT THE SAME AS THE ANNUITANT. No. 92UTRA Page 3 - ------------------------------------------------------------------------------- PART I - DEFINITIONS SECTION 1.01 ANNUITANT. The term "Annuitant" means the individual shown on Page 3 of this Contract. SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in accordance with the terms of the Plan. SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the sum of the amounts in the Guaranteed Interest Division and the Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03. SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable by us pursuant to Section 3.04 of this Contract. Various sections of this Contract (Sections 1.16, 1.17, 3.01 and 3.02) refer to monthly payments to be made under an Annuity Benefit. You may wish to have your Annuity Benefit paid at other intervals, such as quarterly, semi-annually, or annually, instead of monthly. You may elect this at the time you elect the Annuity Benefit form as described in Section 3.03; in that event, all references in this Contract to monthly payments will be deemed to mean payments at the frequency you elect, subject to our rules at the time of election. SECTION 1.05 CASH VALUE. The term "Cash Value" means an amount equal to the greater of (i) or (ii) where: (i) is the Annuity Account Value less 6% of the Contributions made during the current and five prior Contract Years, which had not been previously withdrawn pursuant to Section 2.08. (ii) is the sum of (a) the Free Corridor Amount as defined in Section 2.09 and (b) 94% of the Annuity Account Value less the Free Corridor Amount. However, if the Annuitant is age 60 years or older on the Contract Date and it is Contract Year 5, item (ii)(b) above will be 95% of the Annuity Account Value less the Free Corridor Amount. NO WITHDRAWAL CHARGE: If you have attained the age of 59 years and 6 months, the term "Cash Value" means an amount equal to the Annuity Account Value for withdrawals due to retirement or termination of employment. Your retirement or termination of employment must be verified by the Trustee. Such verification should be in the form of a statement signed by the Trustee and accompanying the request for withdrawal. The request for withdrawal must be signed by both you and the Trustee. The withdrawal charge will be imposed if this verification is not received at our Processing Office together with the withdrawal request. SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all Contracts with a Contract Date in the same calendar year. SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.08 CONTRACT. The term "Contract" means this Contract. SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt by us of both the application for this Contract, properly signed and completed, and a Contribution. SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month period beginning on (i) the Contract Date, and (ii) each anniversary thereafter, unless otherwise agreed to in writing by us. SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us for you with respect to an Annuity purchased for you under the Plan. We are under no obligation to accept any Contribution less than $20.00. SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or severally as the case may be, the following divisions described in this contract: (i) the Guaranteed Interest Division, and (ii) the Investment Divisions of the Separate Account. No. 92UTRA Page 4 SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means an annuity not involving life contingencies issued by us, which extends beyond your attainment of age 59 years and 6 months and does not permit any prepayment of the unpaid principal (that is, no withdrawal or single sum payment prior to your attainment of age 59 years and 6 months). SECTION 1.14 EMPLOYER. The term "Employer" means the unincorporated employer adopting the Plan, or any such employer that assumes in writing the obligations of the Plan. A sole proprietor is deemed to be his own Employer and a partnership is deemed to be the Employer of each partner. SECTION 1.15 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means the effective annual rate at which interest accrues on the amount in the Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of this Contract. Section 2.03 describes determination of the rate to apply thereafter. SECTION 1.16 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor Life Annuity Form" means an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100% , as elected by the Owner. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. SECTION 1.17 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity issued by us providing monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. SECTION 1.18 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under this Contract means, (i) if you have a living spouse at your Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with your spouse as the contingent annuitant (with 100% of the monthly payment continued to your spouse), and (ii) if you do not have a living spouse at your Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. SECTION 1.19 OWNER. The Owner of this Contract is as stated on Page 3 of this Contract. Notwithstanding any provisions in this Contract to the contrary, only the Owner can exercise all the rights under this Contract while you are living. The Owner does not need the consent of anyone who has only a conditional or future interest in this Contract. While you are living, the Owner of this Contract on your behalf may change the Owner by written notice satisfactory to us. The change will take effect on the date the Owner signs the notice, except it will not apply to any payment we make or other actions we take before we receive the notice. SECTION 1.20 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an annuity not involving life contingencies issued by us which does not permit any prepayment of the unpaid principal (that is, you cannot elect to receive part of your payments as a single sum payment with the remainder paid in monthly annuity payments). SECTION 1.21 PLAN. The term "Plan" means a defined contribution plan adopted by the Employer that is intended to meet the requirements for qualification under Section 401(a) of the Code. SECTION 1.22 PROCESSING OFFICE. The term "Processing Office" means our Individual Annuity Center, P.O. Box 2996, G.P.O., New York, New York 10116, or such other location as we shall designate by advance written notice to the Owner, the Employer or the Plan's Trustee, as applicable, and to you. SECTION 1.23 RETIREMENT DATE. The term "Retirement Date" means the date on which you attain the retirement age as shown on Page 3 of this Contract, pursuant to the terms of the Plan. Before the Retirement Date the Owner may elect to change the Retirement Date to another Retirement Date permitted under the Plan, which may be any date after the filing of the election (other than the 29th, 30th or 31st day of any month). No Retirement Date shall be later than the date you attain age 70 years and 6 months. Any election for such change must be made in writing by the Owner and shall not take effect until received by us at our Processing Office. SECTION 1.24 SEPARATE ACCOUNT. The term "Separate Account" means our Separate Account A which is organized as a unit investment trust, a type of investment company. We have established the Separate Account and it is maintained in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited to or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts and certificates. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities and variable life insurance. No. 92UTRA Page 5 The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to these contracts will not be chargeable with liabilities arising out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Investment Division to another Investment Division or to our General Account. The Separate Account consists of "Investment Divisions". Each Investment Division may invest its assets in a separate class (or series) of shares of a designated Trust where each class (or series) represents a separate portfolio in the Trust. We reserve the right to change the designated trust or investment company or to add designated trusts or investment companies. The Investment Divisions available are the Stock Division, the Money Market Division, the Balanced Division and the Aggressive Stock Division. The Guaranteed Interest Division is not part of the Separate Account but rather is an asset of our General Account. We will value the assets of each Investment Division on each business day. A business day is any day on which we are open, the New York Stock Exchange is open for trading and there is a sufficient degree of trading in the portfolio securities in which an Investment Division is invested to materially affect the Accumulation Unit Value. We may, at our discretion, invest the assets of any Investment Division in any investment permitted by applicable law. We may rely conclusively on the opinion of counsel (including attorneys in our employ) as to what investments we are permitted by law to make. We reserve the right to: (i) cause the registration or deregistration of the Separate Account under the Investment Company Act of 1940, provided that such registration or deregistration is in conformity with the requirements of applicable law; (ii) run the Separate Account under the direction of a committee, and to discharge such committee at any time; (iii) restrict or eliminate any voting rights as to the Separate Account; (iv) operate the Separate Account by making direct investments, or in any other form; (v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or remove Investment Divisions (or sub-divisions of Investment Divisions) from the Separate Account (the term "Investment Division" in this Contract shall then refer to any other Investment Division in which the assets, of a Class of Contracts to which this Contract belongs, were placed); (vi) combine any two or more Investment Divisions (or sub-divisions of Investment Divisions) of the Separate Account; and (vii) withdraw from any Investment Division and to allocate to another Investment Division assets determined by us to be associated with the Class of Contracts to which this Contract belongs. If the exercise of these rights results in a material change in the underlying investments of an Investment Division, the Owner and you will be notified of such exercise, as required by law. Assets of the Investment Divisions attributable to this Contract shall be subject to a daily charge (after any deductions to provide for applicable tax charges) at a rate not to exceed 1.49% per year for each of the Stock, Money Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock Division, for financial accounting, death benefits, mortality risk, expenses and expense risk. The charge shall be made in accordance with Subsection (c) of the Net Investment Factor provision in Section 1.25. The relative proportion of these charges may be modified. This daily charge, plus the investment advisory fee charges and direct operating expense charges of the Trust, shall not exceed a total annual rate of 1.75% of the value of the assets of the Investment Divisions attributable to this Contract. SECTION 1.25 SEPARATE ACCOUNT DEFINITIONS. VALUATION PERIOD. Each business day together with any consecutive preceding nonbusiness days. NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each Investment Division of the Separate Account for a Valuation Period is (a) divided by (b) minus (c), where (a) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the Valuation Period before giving effect to any amounts allocated to or withdrawn from the Investment Division for the Valuation Period. For this purpose, we use the share value reported to us by the Trust. No. 92UTRA Page 6 (b) is the value of the Investment Division's shares of the corresponding portfolio of the Trust at the end of the preceding Valuation Period (after any amounts allocated or withdrawn for that Valuation Period). (c) is the daily Separate Account charge for the expenses of this Contract times the number of calendar days in the Valuation Period. The net asset value of the shares of a trust or investment company held by an Investment Division shall be the value reported to us by that trust or investment company. The value of the assets in the Investment Divisions, referred to above, shall be taken at their fair market value, or where there is no readily available market, their fair value, as determined in accordance with generally accepted accounting practices and applicable laws and regulations. ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an Investment Division where Contributions are invested and which is used in determining the amount in an Investment Division. ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of each Accumulation Unit in an Investment Division on a given date. The Accumulation Unit Value for a Valuation Period is the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the Net Investment Factor for that Investment Division for such Valuation Period. ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable from the Stock Division of the Separate Account under a Variable Annuity Benefit as defined in Section 3.02. ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1, 1968. On August 27, 1981, the date the first contribution was put into the Stock Division, the Annuity Unit Value was $1.26 and $1.52 for Contracts with Assumed Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor for such subsequent Valuation Period. The Adjusted Net Investment Factor for a Valuation Period is the Net Investment Factor for such period reduced for each calendar day in such subsequent Valuation Period by the Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall be 5%, except in states where the rate is not permitted by law. AVERAGE ANNUITY UNIT VALUE: The Average Annuity Unit Value for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods ending in such month. SECTION 1.26 TRANSACTION DATE. The term "Transaction Date" means the business day we receive a Contribution or a written contract transaction request providing the information we need at the Processing Office. In the case of a transfer request initiated through the use of a touch tone telephone as described in Section 2.05, the term Transaction Date means the business day the telephone transaction is received. SECTION 1.27 TRUST. The term "Trust" means the designated trust or investment company in which Separate Account assets are invested. SECTION 1.28 TRUSTEE. The term "Trustee" means the person or persons named as trustee under a Trusteed Plan and such trustee's successors. SECTION 1.29 TRUSTEED PLAN. The term "Trusteed Plan" means a plan under which there is maintained a trust forming a part of the Plan. - -------------------------------------------------------------------------------- PART II - ANNUITY ACCOUNT VALUE SECTION 2.01 CONTRIBUTIONS. The Employer or the Trustee as applicable is to make Contributions from time to time on such dates and in such amounts as determined by the Employer or the Trustee pursuant to the terms of the Plan. Each Contribution received by us will, before its allocation under this Contract, be reduced by the amount of any applicable tax charge, as determined by us. Contributions will be allocated to the Division in accordance with the instructions received on the application unless later changed. Pursuant to the terms of the Plan, we will accept rollover contributions and transfers made on your behalf from a plan qualified under Section 401(a) of the Code or from a conduit individual retirement arrangement as described in Section 408 of the Code. No. 92UTRA Page 7 SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when an amount is allocated to, or withdrawn or transferred from, an Investment Division, the Annuity Account Value will be credited or charged, as the case may be, with the number of Accumulation Units determined by dividing said amount by the Accumulation Unit Value for the appropriate Investment Division for the Valuation Period which includes that date. The number of units in an Investment Division on any date is equal to (i) the sum of any Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units that have been withdrawn pursuant to Section 2.07 or 2.10 or transferred from the Investment Division pursuant to Section 2.05. The amount in an Investment Division on any date is equal to the product of (i) the number of Accumulation Units in the Investment Division on that date, and (ii) the Accumulation Unit Value for the Investment Division for the Valuation Period which includes that date. Participation in the Separate Account under the terms of this Contract terminates on the earliest of (i) Election and Commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii) Termination of this Contract pursuant to Section 2.06. SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the Guaranteed Interest Division becomes part of our general assets, which support the guarantees of this Contract and other contracts. The amount in the Guaranteed Interest Division at any time is equal to the sum of all amounts that have been allocated to the Guaranteed Interest Division pursuant to Section 2.04 plus the amount of any interest accrued but not allocated, less the sum of all amounts that have been withdrawn from the Guaranteed Interest Division pursuant to Section 2.07, 2.10 or 2.11 or transferred from the Guaranteed Interest Division, pursuant to Section 2.05. Interest is allocated to the Guaranteed Interest Division on a Transaction Date pursuant to Section 2.04. We will credit the amount in the Guaranteed Interest Division with interest at effective annual rates that we determine. For each Class of Contracts we determine a yearly guaranteed interest rate that will remain in effect throughout the next year. We guarantee that this yearly guaranteed interest rate will never be less than 3%. Participation in the Guaranteed Interest Division under the terms of this Contract terminates on the earliest of (i) Election and Commencement of Annuity Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii) Termination of this Contract pursuant to Section 2.06. SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section 2.01 is allocated (after deduction of any applicable tax charge) to one or more Divisions, at the Owner's sole discretion as specified to us in writing. Allocation percentages must be in whole numbers and the sum must equal 100. The allocation is made as of the Transaction Date on which we have received both such Contribution and such direction. Contributions made to an Investment Division purchase Accumulation Units in that Investment Division, using the Accumulation Unit Value next computed after the Transaction Date. Interest determined at the Guaranteed Interest Rate is allocated to the Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the Transaction Date with respect to each transfer from the Division pursuant to Section 2.05, (iii) on the Transaction Date with respect to each withdrawal pursuant to Section 2.07, (iv) at the time of application of amounts in the Guaranteed Interest Division to provide Annuity Benefits pursuant to Section 3.04, (v) upon Termination of this Contract pursuant to Section 2.06, and (vi) upon your death pursuant to Section 2.11. SECTION 2.05 TRANSFERS AMONG DIVISIONS. The Owner, unless the Owner transfers to you the right to transfer all or part of the amounts in the Divisions under this Contract, upon written request or through the use of a touch tone telephone, may transfer all or part of the amount in a Division to one or more of the Divisions as follows: (1) amounts in the Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive Stock Division may be transferred among such Divisions; (2) amounts in the Money Market Division may be transferred to other Divisions. Written authorization for touch tone telephone initiated transfers is only required when authorization for telephone transfers is requested. Upon advance written notice to the Owner, we reserve the right to discontinue the acceptance of transfer requests through the use of a touch tone telephone. All transfers will be effective on the Transaction Date and will be subject to our rules in effect at the time of transfer. With respect to the Investment Division, the transfer will be made at the Accumulated Unit Value next computed after the Transaction Date. No transfers are permitted to the Money Market Division from the other Divisions. SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the terms of the Plan, including the spousal consent rules set forth in Section 3.06, the Owner may elect, by written notice, to terminate this Contract. We will determine the Cash Value under this Contract as of the Transaction Date. If this Contract is terminated, surrendered or exchanged prior to the Retirement Date, any applicable tax charges we have paid may be deducted. If we have previously deducted charges for applicable taxes form Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on terminations, unless a change in applicable law has occurred with respect to this Contract. No. 92UTRA Page 8 The payment of such Cash Value may be deferred by us in accordance with the provisions of Section 4.07. Subject to the terms of the Plan, we reserve the right to pay the Annuity Account Value under this Contract and terminate this Contract if (i) no Contributions are made on your behalf during the last three completed Contract Years, and the Annuity Account Value is less than $500 and (ii) a partial withdrawal is made that would result in your Annuity Account Value falling below $500. We also reserve the right to terminate this Contract if no Contributions have been made and at least 120 days have elapsed since the Contract Date shown on Page 3 of this Contract. Upon payment pursuant to this Section or the fourth paragraph of Section 2.07, the amount in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any restrictions under the terms of the Plan, the Owner may elect, by written notice to us, to make a partial withdrawal form the Divisions. Partial withdrawals are subject to the spousal consent rules set forth in Section 3.06. On the Transaction Date, we will pay the lesser of the Cash Value or the amount of partial withdrawal requested to the person entitled to such payment as designated in writing by the Owner. The amount paid plus any withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the amounts you have in the Divisions. Unless instructed otherwise, the amount withdrawn (including any withdrawal charge) will be allocated among the Divisions in proportion to the amounts that you have in such Divisions. Upon any partial withdrawal payment, we will be released from any and all liability payments with respect to the Contributions from which the amounts so withdrawn arose. Partial withdrawal payments may be deferred by us in accordance with the provisions of Section 4.07. We may decline to accept a request for a partial withdrawal of less than $300. If a withdrawal made under this Section would result in an Annuity Account Value of less than $500, we will so advise the Owner and you and reserve the right to pay the Annuity Account Value to the Owner, and terminate this Contract. SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. There will be no partial withdrawal charge if the amount of the partial withdrawal requested is not greater than the Free Corridor Amount defined in Section 2.09. However, if the amount of partial withdrawal requested is greater than the Free Corridor Amount, we will (i) first withdraw from such Divisions an amount equal to the Free Corridor Amount, and (ii) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a partial withdrawal charge. Such partial withdrawal charge will be calculated in the following manner: (a) Withdrawals of Contributions made on your behalf during the current and five prior Contract Years will be subject to a charge of 6% of the amount withdrawn (including such charge). (b) Withdrawals of other amounts will not be subject to any withdrawal charges. For purposes of determining withdrawal charges described in this Section, amounts withdrawn up to the Free Corridor Amount will not be considered a withdrawal of any Contributions. Any excess withdrawals, i.e., those pursuant to items (ii) above, shall be considered withdrawals of Contributions in the order received, with the older Contributions first. With respect to partial withdrawals requested by the Owner, there will be no partial withdrawal charge if you have completed at least five Contract Years and have attained the age of 59 years and 6 months. If withdrawals are made from this Contract prior to the Retirement Date, any applicable tax charges we have paid with respect to this Contract may be deducted. If we have previously deducted charges for applicable taxes from Contributions pursuant to Section 2.01, we will not again deduct charges for the same taxes on withdrawals, unless a change in applicable law has occurred with respect to this Contract. SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount", means an amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value of the Stock Division, Balanced Division, Aggressive Stock Division, Money Market Division and the Guaranteed Interest Division on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the current Contract Year. SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract Year, if the Annual Account Value on that date is less than $10,000, we will withdraw from the Divisions an Annual Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account Value including the amount of any withdrawals pursuant to Section 2.07 during that Contract Year. The charge will be allocated among the Divisions in proportion to the amounts in the Divisions. No. 92UTRA Page 9 If the Annuity Account Value is less than $10,000 on (a) the date of the application of the Annuity Account Value or Cash Value pursuant to Section 3.03 or (b) the date of Termination of this Contract pursuant to Section 2.06 or 2.11, we will prorate the Annual Administrative Charge applicable to the completed portion of the Current Contract Year and withdraw such amount in lieu of the full Annual Administrative Charge described in this Section for the applicable part of that Contract Year. If the Annuity Account Value is $10,000 or greater at the end of a Contract Year, the Annual Administrative Charge is zero. SECTION 2.11 DEATH BENEFIT. If the Owner reports to us, or if we otherwise ascertain, upon receipt of due proof of your death, and subject to the terms of the Plan, including the spousal survivor benefit rules set forth in Section 3.06 pay to the beneficiary designated to receive such payment, pursuant to Section 4.04 of this Contract, the amount of death benefit payable. If the beneficiary under this Contract is the Trustee, the Trustee may, subject to the terms of the Plan, change the beneficiary within 31 days after we receive due proof of your death. The change shall be made in the same manner and subject to the same provisions as apply to a change of beneficiary during your lifetime. If the Trustee changes the beneficiary of this Contract after your death according to the terms of the Plan, the Trustee may elect an Annuity Benefit on any annuity form offered by us, subject to our rules then in effect, for the benefit of your beneficiary. Your beneficiary may not revoke or change any election made by the Trustee. If the Trustee does not make an election, your beneficiary may make such election for your beneficiary's own benefit. Any election for an Annuity Benefit must meet the minimum distribution requirements under the Code as described in Section 3.05. The amount of the death benefit is equal to the greater of (i) the Annuity Account Value and (ii) the minimum death benefit. Such minimum death benefit is the sum of all of your Contributions made pursuant to Section 2.01 (before reduction for any applicable tax charge) less an adjustment for any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by any previous such withdrawal) by an amount which is the in the same proportion as the amount that was withdrawn is to the Annuity Account Value. Upon payment of the death benefit, the amount in the Divisions and the Annuity Account Value shall be zero. We will be released from any and all liability for payments with respect to the Contributions from which the Annuity Account Value arose. - ------------------------------------------------------------------------------- PART III - ANNUITY BENEFITS SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an Annuity Benefit under which the monthly payments are payable in a specified dollar amount. The amount of each monthly payment under any Fixed Annuity Benefit provided under the terms of this Contract with respect to a payee is the amount provided with respect to the payee pursuant to Section 3.03. SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means an Annuity Benefit under which the dollar amount of the monthly payments with respect to a payee may increase or decrease depending on the investment experience of the Stock Division of the Separate Account. Such Variable Annuity Benefit will increase if the average daily rate of investment return in the Stock Division is equivalent to more than 6.75% or 5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25% annually, depending on whether the applicable assumed base rate of Net Investment Return referred to in Section 1.25 is 5% or 3.5%, respectively. The daily rate of investment return is before deduction of charges, as described in Section 1.24, not to exceed the maximum rate of 1.75% after any deductions to provide for any applicable tax charges. These charges include a daily charge for financial accounting, death benefits, mortality risk, expenses and expense risk, plus the investment advisory fee charges and direct operating expense charges of the Trust. The amount of the first, second and third payments under any Variable Annuity Benefit provided under the terms of this Contract with respect to a payee is the monthly amount provided with respect to a payee pursuant to the fifth paragraph of Section 3.04. The amount of the fourth and each subsequent payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number determined by dividing the amount of the first monthly payment by the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. (As described in Section 3.05, we will notify the payee how each Variable Annuity Payment is determined.) No. 92UTRA Page 10 SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. Subject to the terms of the Plan including the spousal consent and survivor rules designated in Section 3.06, as of your Retirement Date, provided you are then living, the Annuity Account Value shall be applied to provide the Normal Form of Annuity Benefit, unless the Owner elects (i) to receive the Cash Value in a single sum or (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit on any other annuity form offered by us, or one of our affiliated or subsidiary life insurance companies, or (iii) to take partial withdrawals in amounts and at times as required by the minimum distribution rules of Section 401(a)(9) of the Code and applicable Treasury Regulations, pursuant to Sections 2.07 and 3.05, subject to our rules then in effect and any other applicable requirements under the Code. We will provide notice and election forms to the Owner not more than six months before your Retirement Date. If the Owner elects to terminate this Contract pursuant to Section 2.06, an election may be made to receive an Annuity Benefit in lieu of the Cash Value. We will have the right to require the Owner to furnish pertinent information to provide an Annuity Benefit, and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and 3.05. We may offer annuity forms other than the Life Annuity Form or Joint and Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary life insurance companies. We will make payment of the Annuity Benefit, Partial Withdrawals or Cash Value to a payee as the Owner designates in writing. SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If, pursuant to the first or third paragraph of Section 3.03, an election is made to have an Annuity Benefit in lieu of the Cash Value, the amount applied to provide the Annuity Benefit paid will be (i) the Annuity Account Value if the annuity form elected involves life contingencies or (ii) the Cash Value if the payments under the annuity form elected does not involve life contingencies. The amount applied to provide an Annuity Benefit may be reduced by any applicable tax charge on annuity considerations, as we determine. If we have previously deducted any applicable tax charges from Contributions as provided in Section 2.01, we will not again deduct charges for the same taxes before application to provide an Annuity Benefit, unless a change in applicable law has occurred with respect to this Contract. The balance shall purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown below or (ii) our current individual annuity rates for payment of proceeds, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, your Contract will be governed by our supplementary contract then in effect. The amount to be applied to provide an Annuity Benefit will, in addition to any tax charge reduction, be reduced by an administrative charge. The amount of such charge will be determined from time to time in accordance with our general practices applicable on a uniform basis to all contracts of the same type as this Contract. After the application of an amount to provide an Annuity Benefit the amounts in the Divisions and the Annuity Account Value shall be zero. The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the terms of this Contract, as indicated, on either the Life Annuity Form or the Joint and Survivor Life Annuity Form (with 100% of the amount of your payment continued to your spouse). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form is based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form is based on a 50-50 split of males and females and an Assumed Base Rate of Net Investment Return of 3.5% or 5%, whichever applies pursuant to Section 1.25. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us on 3.5% interest and the 1983 Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males and females at age zero if such annuity form provides for a Fixed Annuity Benefit, and on the projected 1983 Basic Table "a" adjusted to a unisex basis based on a 50-50 split of males and females at age zero and an Assumed Base Rate of Net Investment Income Return of 5% or 3.5%, whichever applies pursuant to Section 1.25, if such annuity form provides for a Variable Annuity Benefit. SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract will be distributed or begin to be distributed, no later than the first day of April following the calendar year in which you attain age 70 years and 6 months ("Required Beginning Date"). Your entire interest may be distributed, as you elect, over (a) the life, or the lives of you and or your designated beneficiary, or (b) a period certain not extending beyond your life expectancy, or the joint and last survivor expectancy of you and your designated beneficiary. Distributions No. 92UTRA Page 11 must be made in periodic payments at intervals of no longer than one year. In addition, payments must be either nonincreasing or they may increase only as provided in Q&A F-3 of Section 1.401(a)(9)-1 of the proposed Treasury Regulations, or any successor Regulation thereto. All distributions made hereunder shall be made in accordance with the requirements of Section 401(a)(9) of the Code, including the incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and applicable Treasury Regulations, including the minimum distribution incidental benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or any successor Regulation thereto. Notwithstanding the above paragraphs and the following paragraphs of this Section 3.05, while any distribution shall be subject to such requirements of the Code and regulations, any distribution shall also be subject to the terms of this Contract. This is, the forms of distribution shall be those which are made available by us at the time of your election. For purposes of determining the "period certain" referred to in the first paragraph of this Section, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless you otherwise elect prior to the time distributions are required to begin, those life expectancies shall be recalculated annually. Such election shall be irrevocable and shall apply to all subsequent years. The life expectancy of a non-spouse beneficiary may not be recalculated. Instead, life expectancy will be calculated using the attained age of such beneficiary during the calendar year in which you attain age 70 years and 6 months, and payments for subsequent years shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. If you die after distribution of your interest described in this Contract has begun, the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution being used prior to your death. If you die before distribution of your interest begins, distribution of your entire interest shall be completed no later than December 31 of the calendar year containing the fifth anniversary of your death, except to the extent that an election is made to receive death benefit distributions in accordance with (1) or (2) below: (1) If your interest is payable to a designated beneficiary, then your entire interest may be distributed over the life of, or over a period certain not greater than the life expectancy of, the designated beneficiary. Such distributions must commence on or before December 31 of the calendar year immediately following the calendar year of your death. (2) If the designated beneficiary is your surviving spouse, the date distributions that are required to begin in accordance with (1) above shall not be earlier than the later of (A) December 31 of the calendar year immediately following the calendar year of your death or (B) December 31 of the calendar year in which you would have attained age 70 years and 6 months. For purposes of determining the "period certain" referred to in the immediately preceding paragraph, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of distributions beginning after your death, unless otherwise elected by the surviving spouse by the time distributions are required to begin, life expectancies shall be recalculated annually. Such election shall be irrevocable by the surviving spouse and shall apply to all subsequent years. In the case of any other designated beneficiary, life expectancies shall be calculated using the attained age of such beneficiary during the calendar year in which distributions are required to begin pursuant to this Section, and payments for any subsequent calendar year shall be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. Distributions under this Section are considered to have begun if distributions are made because you have reached your Required Beginning Date or if prior to the Required Beginning Date distributions irrevocably commence to you over a period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1 of the Proposed Treasury Regulations or any successor Regulation thereto. Evidence of each payee's survival must be furnished to us either by personal endorsement of the check drawn for payment or by other means satisfactory to us. If a benefit payment under the terms of this Contract was based on information that is subsequently found to be incorrect, such benefit will not be invalidated, but an adjustment on the basis of the correct information will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination thereof. Overpayments by us will be charged against and underpayments will be added to any payment thereafter falling due under the terms of this Contract with respect to the payee, affecting as many such payments as are necessary to correct the overpayment or underpayment. Our liability, with respect to a payee, is limited to the correct information and the actual amounts used to provide the benefits then in force with respect to the payee under this Contract. No. 92UTRA Page 12 If we receive evidence satisfactory to us that (i) a payee entitled to receive any payment under the terms of this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee or other representative of the estate of such payee has been appointed, we may, unless the Plan provides to the contrary, make the payments (in the case of a minor, at a rate not exceeding $200 a month) to such other person or institution, and will thereupon be fully discharged from all liability with respect thereto. If a variable annuity form made available by us provides for a period certain, such as 120 or 180 months, and thereafter during the remaining lifetime of one person, or of at least one of two persons, a payee for payments thereunder may elect, without the concurrence of any other person, to receive the commuted value of any remaining payments, provided no person upon whose life the income depends is surviving. Pursuant to Section 3.03, upon election by the Owner, on your behalf and if applicable, your spouse, of an annuity form providing payments for a period certain, such Owner may designate (with the right to change such designation, in accordance with the terms of the Plan) a payee to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. The payee may designate (with the right to change such designation and without the concurrence of any other person, unless the Plan provides to the contrary) a person or persons to receive any payments or installments payable after such payee's death, if the absence of such a designation would result in a single sum payment to such payee's estate in accordance with the following paragraph. If at the death of any payee there is no designated person living entitled to receive any remaining payments or installments, we will pay in a single sum to such payee's estate the commuted value of any remaining payments or installments. The commuted value of any such remaining payments will be determined on the basis of compound interest at the rate utilized in the actuarial rate basis applicable in determining the annuity amount. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected pursuant to Section 3.03. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person or persons upon whose life the income depends or the end of the certain period, whichever is later. We will require satisfactory evidence of the age of any person upon whose life an annuity form depends.
- ------------------------------------------------------------------------------- TABLES OF GUARANTEED ANNUITY PAYMENTS (Based On Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM 100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE (Minimum Monthly Income per $1,000 of Annuity Account Value) - ----------------------------------------------------------------------------------------------------------------------- Age 60 61 62 63 64 65 66 67 68 69 70 - ----------------------------------------------------------------------------------------------------------------------- 60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88 61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96 62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03 63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11 64 4.89 4.94 5.00 5.05 5.10 5.14 5.19 65 5.00 5.06 5.11 5.17 5.22 5.27 66 5.12 5.18 5.24 5.29 5.35 67 5.24 5.31 5.37 5.43 68 5.37 5.44 5.51 69 5.52 5.59 70 5.67
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Account Value) --------------------------------------------- VARIABLE ANNUITY BENEFIT PAYABLE IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS AGE 3.5% 5.0% --------------------------------------------- 60 5.27 6.16 61 5.39 6.28 62 5.52 6.41 63 5.66 6.55 64 5.81 6.70 65 5.97 6.86 66 6.15 7.03 67 6.33 7.21 68 6.53 7.41 69 6.74 7.62 70 6.97 7.85 No. 92UTRA Page 13 We will, with respect to each payment under a Variable Annuity Benefit, notify the payee of the number of Annuity Unites and the Average Annuity Unit Value used in determining the amount of each variable payment. Such notice will be mailed with each payment. Any election, change, revocation or designation shall be made, and will take effect on the Transaction Date, in the same manner as a change of beneficiary, as described in Section 4.04. If a commutation right under an Annuity Benefit is exercised, we may defer payment in accordance with Section 4.07. SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS. If you are married, your interest in this Contract shall be paid in the Normal Form joint and survivor annuity, and if you are unmarried, your interest shall be paid in the Normal Form life annuity, unless you elect otherwise as described in this Section. If you are married and die before payment of your interest has commenced, your interest shall be paid to your surviving spouse in the form of a life annuity, unless at the time of your death there was a contrary election made pursuant to this Section. The foregoing notwithstanding, your surviving spouse may elect, before payment is to commence, to have payment made in any form permitted under the terms of this Contract. You may elect, at any time within the 90 consecutive day period before the first day of the first period for which your interest is paid as an annuity or in any other form, not to have your interest paid in the Normal Form, in which case it shall be paid in any other form elected under the terms of this Contract. If such interest is to be paid to your spouse upon your death, you may elect, during the period beginning on the first day of the plan year of the Plan in which you attain age 35 (or, if you separate from service prior to that plan year, beginning on the date of separation) and ending with your death, for a beneficiary other than your spouse to receive payment of the value of your interest. In addition, if you will not yet attain age 35 by the end of any current plan year, you may make a special qualified election to designate a beneficiary other than your spouse to receive payment of the value of your interest. Such special qualified election shall be effective for the period beginning on the date of such election and ending on the first day of the plan year in which you attain age 35. Amounts payable in accordance with this Section will be automatically reinstated as of the first day of the plan year in which you attain age 35 unless a new election designating a beneficiary other than the spouse is made in accordance with the requirements of this Section. Any election described in the foregoing paragraph must be consented to by your spouse in writing before a notary public or a representative of the Plan, unless you can prove that there is no spouse or that the spouse cannot be located. Also, if you have become legally separated from your spouse or have been abandoned (within the meaning of the local law) and have a court order to such effect, spousal consent is not required unless a qualified domestic relations order provides otherwise. Your election must designate a specific beneficiary (including any class of beneficiaries or any contingent beneficiaries) that may not be changed without further consent of the spouse, unless the spouse's consent expressly permits designation by you without further consent of the spouse. The spouse's consent under this Section shall acknowledge the effect of the election. In addition, the spouse's consent (or the establishment that the consent of the spouse may not be obtained) shall only be valid with respect to such spouse. Your waiver of the Normal Form joint and survivor annuity shall not be effective unless the election designates a form of benefit payment which may not be changed without spousal consent (or the spouse expressly permits designations by you without any further spousal consent). A consent that permits designations by you without any requirement of further consent by such spouse must acknowledge that the spouse has the right to limit consent to a specific beneficiary, and a specific form of benefit where applicable, and that the spouse voluntarily elects to relinquish either or both of such rights. If you make an election under this Section you may revoke that election, without spousal consent, at any time before the first day of the first period for which an amount is paid as an annuity or in any other form. The provision requiring spousal consent in this Section shall also apply with regard to your election to terminate this Contract or make partial withdrawals pursuant to Sections 2.06 and 2.07 and with respect to a beneficiary designation set forth in Section 4.04. If the Annuity Account Value applied to provide the spousal benefits on the date payment is to commence is in the aggregate less than $3,500, we may choose to make payment in a single sum rather than in the form of a Qualified Joint and Survivor Annuity or Life Annuity as described herein. Upon any payment made pursuant to this Section, we will be released from any and all liability for payment with respect to the Contributions made for you. - ------------------------------------------------------------------------------- PART IV - GENERAL PROVISIONS Section 4.01 CONTRACT. This Contract constitutes the entire Contract between the parties and the terms of this Contract alone will govern with respect to our rights and obligations. A copy of the application is incorporated in and made a part of this Contract. No. 92UTRA Page 14 This Contract may not be modified, nor may any of our rights or requirements be waived, except in writing and by our authorized officer. The terms of this Contract may be changed by amendment or replacement upon agreement between the Owner and us without the consent of any other person provided that such change does not reduce any Annuity Benefit. SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right shall include, but not be limited to, the right to conform this Contract to reflect changes in the Code, applicable Treasury Regulations, or regulations or published rulings of the Internal Revenue Service so that this Contract will continue to be an Annuity under a qualified plan. SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY. No interest of yours or a beneficiary under this Contract may be transferred to any person other than us upon the surrender of this Contract. Except as permitted under Section 401(a)(13) of the Code, no right or interest of you or any other payee or beneficiary in this Contract shall be (a) assignable; (b) subject to any lien; or (c) liable for, or subject to, any obligation or liability of any person. The preceding sentence shall not apply to any assignment, transfer or attachment pursuant to a qualified domestic relations order, as defined in Section 414(p) of the Code. SECTION 4.04 BENEFICIARY. The Owner, as of the Contract Date, is to provide us with an initial designation of your beneficiary entitled to receive any death benefit payable with respect to you pursuant to Section 2.11. Subject to the plan and the Spousal Consent and Survivor rules of Section 3.06, such designation may be changed from time to time during your lifetime and while this Contract is in force. If the Beneficiary is the Trustee, the Trustee will have the right within 31 days of the day we receive due proof of your death and pursuant to the provisions of the Plan, to change your beneficiary entitled to receive the death benefits. If the Trustee is not the beneficiary, the beneficiary will be your spouse as provided in Section 3.06 of this Contract. SECTION 4.05 DISQUALIFICATION. In the event that the Plan fails to qualify as a Plan under Section 401(a) of the Code and applicable Treasury Regulations, we reserve the right, upon receiving notice of such fact, to transfer the Annuity Account Value under this Contract to another annuity contract issued by us on your life, or one of our affiliated or subsidiary life insurance companies, or to terminate this Contract and pay to the Owner the Annuity Account Value less deduction for applicable taxes, solely at our option. In the event that this Contract fails to qualify as an Annuity as described in Section 1.02, we will have the right, upon receiving notice of such fact before your Retirement Date, to terminate this Contract and pay at the direction of the Owner the Annuity Account Value less a deduction for the appropriate part attributable to the Owner of any Federal income tax payable which would not have been payable if you had an Annuity. SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to the Owner, we reserve the right at our sole discretion to limit contributions to this Contract. SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment of a death benefit and payment of any portion of your Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange has been closed or trading on it is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Securities Exchange Commission, by order, permits us to defer payments in order to protect persons with interests in the Investment Divisions. We can defer payments of any portion of your Annuity Account Value in the Guaranteed Interest Division for up to six months while you are living. SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year, we will furnish the Owner and you with a notice showing the following: (1) The amount in the Guaranteed Interest Division, (2) the total number of Accumulation Units in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (3) the Accumulated Unit Values, (4) the amount in the Stock Division, Balanced Division, Aggressive Stock Division and Money Market Division, (5) the Cash Value and (6) the amount of the death benefit. No. 92UTRA Page 15 We will also furnish any other reports required by the Code or applicable Treasury Regulations. After your Retirement Date, we will notify you of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. SECTION 4.09 TRUSTEE'S RESPONSIBILITY. The Trustee shall hold this Contract on your behalf and your beneficiaries as an asset of the Trust, unless this Contract is distributed to you pursuant to the terms of the Plan. The Trustee shall be responsible for transferring all payments made under this Contract to you and your beneficiaries in accordance with the terms of the Plan and the applicable provisions of the Code. We shall make no payment hereunder without written instructions from the Trustee, and we shall be fully discharged of any liability therefor, to the extent such payments are made to and at the direction of the Trustee. SECTION 4.10 AGE. If your age has been misstated, any benefits will be those which would have been purchased at the correct age. Any overpayments or underpayments made by us will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to benefits falling due thereafter. No. 92UTRA Page 16 - -------------------------------------------------------------------------------- APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES PROCESSING OFFICE: INDIVIDUAL ANNUITY CENTER, P.O. BOX 2996, NEW YORK, NEW YORK 10116-2996 QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR: EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY - -------------------------------------------------------------------------------- TYPE OF PURCHASE (Complete One Plan Only) A. |_| TSA PUBLIC SCHOOL (GV-PS-I) B. |_| TSA 501(C)(3) ORGANIZATION (GV-501-I) C. |_| TSA University (GV-PS-U-I) D. |_| IRA Individual (Including IRA to IRA transfers) (GV-IRA 4971) E. |_| IRA Unit Billed (Including IRA to IRA transfers) (GV-IRA 4971) F. |_| IRA QUALIFIED PLAN ROLLOVER-- (QP IRA) (Distribution from a Qualified Plan) (GV-IRA 4971-71) G. |_| EDC (Public Employee Deferred Compensation) (GV-EDC 4991) H. |_| EDC (Tax Exempt Organization) (GV-EDC 4991-SU-080) I. |X| SEP (Simplified Employee Pension) (GV-SEP 4981) J. |_| SARSEP (Salary Reduction SEP) _________________________________________ K. |_| CORPORATE TRUSTEED (GV-CORP 4941-41) L. |_| KEOGH/HR-10 TRUSTEE (GV HR-10 4911-11) (trustee owned) M. |_| KEOGH/HR-10 (GV-HR-10 4911) (not trustee owned) (issued to existing units only) - -------------------------------------------------------------------------------- DO NOT COMPLETE THIS SECTION IF 1.D OR 1.F CHECKED ABOVE 2. EMPLOYER/PLAN NAME |A|B|C|_|C|O|M|P|A|N|Y|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| 3. |_| EXISTING UNIT NO. |_|_|_|_|_|_|-|_|_|_| |x| NEW UNIT |0|0|0|1|2|3|-|4|5|6| (FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP, OR TRUSTEED PLANS. FORM 983-135B IS REQUIRED) - -------------------------------------------------------------------------------- 4. PROPOSED ANNUITANT Print name to appear on Contract. |J|O|H|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|D|O|E|_|_|_|_|_| FIRST MIDDLE INITIAL LAST A. |X| MR. |_| MRS. |_| MS. |_| OTHER ____ B. Date of Birth: Year 1954 Month JANUARY Day 27 ---- ------- -- C. Age at Nearest Birthday: 38 D. |X| Male |_| Female ---- E. Annuitant's Mailing Address: F. State of Residence: N.J. ---- No., St. |1|7|_|E|L|M|_|S|T|R|E|E|T|_|_|_|_|_|_|_|_|_|_|_|_| City |A|N|Y|T|O|W|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1| G. Telephone Number (101) 222 - 3456 |X| Home |_| Work H. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9| I. Are you associated with or employed by a member of National Association of Securities Dealers, Inc.(NASD)? |_| Yes |X| No 5. OWNER (Print Name) -- If Trusteed or EDC Plan Print Name of Owner, for all other Markets Print Name of Annuitant. JOHN DOE ----------------------------------------------------------------------------- a. Title ____________________________________________________________________ 6. RETIREMENT AGE 65 --------------------------------------------------------------- 7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death Benefit upon Annuitant's death before Retirement Date.) (BENEFICIARY MUST BE THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS.) JANE DOE - WIFE ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- 8. CONTRIBUTION ALLOCATION Guaranteed Interest Division 20% ----- Stock Division 20% ----- Money Market Division 20% ----- Balanced Division 20% ----- Aggressive Stock Division 20% ----- (PERCENTAGES IN WHOLE NUMBERS) Total 100% 9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F) A. Reminder Notice (Billing) Required |_| Yes |X| No IF YES, COMPLETE B-C-D-E B. REMINDER DATE Required for Individual IRA or otherwise must agree with existing unit or attached 983-135B. MONTH _________ DAY __________ C. REMINDER FREQUENCY |_| Annual |_| Semi-Annual |_| Quarterly |_| Monthly Available for TSA, EDC, SARSEP AND CORPORATE TRUSTEED AND UNIT BILLED IRA ONLY: |_| Semi-Monthly |_| Bi-Weekly D. REMINDER AMOUNT $_________________________________ E. BILLING MONTHS TO BE EXCLUDED - TSA ONLY ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- 10.EXPECTED FIRST CONTRACT YEAR Contribution. $1000 ---------------------------------------------------------------- IF AN ADVANCED BILLING AND/OR CONTRACT DATE ARE REQUESTED, COMPLETE #9B AND #12. - -------------------------------------------------------------------------------- (FOR PROCESSING OFFICE USE) Unit Name ___________________________ Reminder Date ___________________________ Cert. or App# _______________________ Amendment Required_______________________ EDC Emp. Add. _______________________ Emp. Fed. ID# ___________________________ Frequency ___________________________ Contract Date ___________________________ - -------------------------------------------------------------------------------- Receipt Date Batch # Inquiry # Processor - -------------------------------------------------------------------------------- 180-1000 - -------------------------------------------------------------------------------- 10. Did you receive the Separate Account Prospectus? |X| Yes |_| No Date shown on Prospectus January 1, 1992 ---------------------------------------------------- Date of any supplement to Prospectus _______________________________________ 11. Items (a) through (f) are to be answered by the annuitant. We are required by the NASD to ask these questions. (a) Name of Employer: ABC Company ------------------------------------------------------ (b) Address of Employer: 10 Main Street --------------------------------------------------------------------------- Anytown, NJ --------------------------------------------------------------------------- (c) Occupation Sales ------------------------------------------------------------- (d) Assuming the contract applied for will be issued, will any existing insurance or annuity be replaced or changed (or has it been)? | | Yes |X| No (e) Estimated Family Annual Income $100,000 ---------------------------------------- (f) Estimated Net Worth $250,000 ----------------------------------------------------- (g) Investment Objective: |_| Income |X| Income & Growth |_| Aggressive Growth |_| Growth |_| Safety of Principal 12. SPECIAL INSTRUCTIONS ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- 13. Amount paid with this form: $1000 (If a check is submitted with this request, no advanced Contract Date is permitted.) BACKDATING IS NOT PERMITTED. NOTE: Amount paid will be credited upon receipt at Equitable's Processing Office, subject to return if the certificate is not issued. The Contract Date will be the date of receipt by Equitable of this application, properly signed and completed, and Contribution at Equitable's Processing Office. - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- AGREEMENT All information and statements furnished in this application are true and complete to the best of my knowledge and belief. I understand and acknowledge that no Agent has the authority to make or modify any contract on Equitable's behalf, or to waive or alter any of Equitable's rights and regulations. IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT. UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S) OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND COMPLETE. - -------------------------------------------------------------------------------- LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR ANNUITY APPLICATION WITH INFORMATION YOU KNOW IS FALSE OR TO LEAVE OUT MATERIAL FACTS. - -------------------------------------------------------------------------------- X__________________________________ Date_______ City __________ State __________ Signature of Annuitant X__________________________________ Date_______ City __________ State __________ Signature of Authorized Individual (REQUIRED FOR EDC AND TRUSTEED) OR OWNER - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- AGENT'S SECTION Will any existing insurance or annuity be replaced or changed (or has it been), assuming the Contract will be issued? | | Yes | | No |_| I (we) certify that a prospectus for the Contract has been given to the proposed Annuitant and that no written sales materials other than those approved by Equitable have been used. EQUI-VEST issues must adequately reflect the commission interest of all Agents on previous contracts. - -------------------------------------------------------------------------------- Print Agent's Name(s) Initial of Agent Agent Agency District Agent's (Service Agent first) Last Name Number % Code Manager Code Signature - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS___ Date ___ District EQS ___ Date ____ - -------------------------------------------------------------------------------- (FOR ASU USE) ASU Code and App. No. __________________________________________________________ ASU Rec'd. _____________________________________________________________________ Date to Proc. Off. ________________________________________________ Campaign |_| Agent(s) shown above is Equity Qualified and is licensed in the state where the request is signed. Above Agent information verified by ASM (Registered Rep) - -------------------------------------------------------------------------------- Application reviewed by ________________________________________________________ - -------------------------------------------------------------------------------- 180-1000 EX-99.4ECONTRACTS 13 FORM OF GROUP ANNUITY CONTRACT AND ENDORSEMENTS [EQUITABLE LOGO] THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES GROUP ANNUITY CONTRACT NO.: AC 0000 - ------------------------------------------------------------------------------- CONTRACT HOLDER: UNITED STATES TRUST COMPANY OF NEW YORK REGISTER DATE: March 1, 1993 ------------- This Contract is issued in consideration of payment of the Contributions under the terms of this Contract. The terms of this Contract, which include the following pages, are agreed to by the Contract Holder and The Equitable Life Assurance Society of the United States ("Equitable"). FOR THE CONTRACT HOLDER FOR EQUITABLE By_____________________ By /s/ Richard H. Jenrette Chairman of the Board Title__________________ By /s/ Joseph J. Melone Dated__________________ President and Chief Executive Officer By /s/ Molly K. Heines Vice President and Secretary At New York, New York By Assistant Registrar Date of Issue __________________ THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN PART II OF THIS CONTRACT. THE AMOUNT OF ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION AS DESCRIBED IN SECTION 7.02 OF THIS CONTRACT. INTEREST RATE GUARANTEE - FIXED AND VARIABLE ANNUITY BENEFITS - NON-PARTICIPATING No. 11993AC-C TABLE OF CONTENTS Page Part I - DEFINITIONS 3 Part II - DIVISIONS 5 Part III - CONTRIBUTIONS AND TRANSFERS 7 PART IV - WITHDRAWALS AND TERMINATIONS 8 Part V - DEATH BENEFITS 9 Part VI - CHARGES 11 Part VII - ANNUITY BENEFITS 12 Part VIII - GENERAL PROVISIONS 15 Appendix A-IRA Part I - APPLICABLE TO IRA CERTIFICATES for both periodic and rollover Contributions 20 Part II - APPLICABLE TO IRA CERTIFICATES 24 for rollover Contributions only Appendix A - SEP 28 Applicable to SEP CERTIFICATES Appendix B-IRA - APPLICABLE TO IRA CERTIFICATES 32 Appendix B-SEP APPLICABLE TO SEP CERTIFICATES 34 No.11993AC-C Page 2 PART I - DEFINITIONS SECTION 1.01 ACCUMULATION UNIT "Accumulation Unit" means a unit which is purchased in an Investment Division of the Separate Account. SECTION 1.02 ACCUMULATION UNIT VALUE "Accumulation Unit Value" means the dollar value of each Accumulation Unit in an Investment Division of the Separate Account on a given date. SECTION 1.03 ANNUITANT. "Annuitant" means a person who has been enrolled under the Contract or any successor annuitant. A person will become enrolled upon receipt by Equitable of an application form made available by Equitable and completed in a manner satisfactory to Equitable. A certificate will be issued with respect to each Annuitant, in a form defined in Section 1.15, Section 1.16, or Section 1.20, whichever applies to the Annuitant pursuant to the application form, setting forth the benefits applicable to the Annuitant and the rights which the Owner may exercise. SECTION 1.04 ANNUITY ACCOUNT VALUE. "Annuity Account Value" means the sum of the amounts held with respect to an Owner or Annuitant, as set forth in the applicable certificate, in the Guaranteed Interest Division and the Investment Divisions of the Separate Account. SECTION 1.05 ANNUITY BENEFIT. "Annuity Benefit" means a benefit payable by Equitable pursuant to Part VII of this Contract. SECTION 1.06 BUSINESS DAY. A "business day" is any day on which Equitable is open and the New York Stock Exchange is open for trading. SECTION 1.07 CASH VALUE. "Cash Value" means an amount equal to the Annuity Account Value, less any withdrawal charge that applies as described in Section 6.01. SECTION 1.08 CODE. "Code" means the Internal Revenue Code of 1986, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.09 CONTRACT. "Contract" means this Contract. Attached to and part of this Contract are: Appendix A-IRA and Appendix B-IRA applicable to Annuitants to whom an IRA Certificate is issued; and Appendix A-SEP and Appendix B-SEP applicable to Annuitants to whom a SEP Certificate is issued. The application form completed for such Annuitant as described in Section 1.03 will specify the type of Certificate issued (IRA, Non-Qualified, or SEP Certificate, defined in Section 1.15, 1.16, and 1.20, respectively) and this determines if any Appendix A and B apply. If a Non-Qualified Certificate applies to the Annuitant, then the terms of this Contract without any Appendix A and B will apply. No.11993AC-C Page 3 SECTION 1.10 CONTRACT DATE. "Contract Date" means, with respect to an Annuitant, the date on which the Annuitant is enrolled under the Contract. That is, it is the date Equitable has received both a Contribution and the completed application form which is supplied by Equitable. SECTION 1.11 CONTRACT YEAR. "Contract Year" means, with respect to an Annuitant, the twelve month period starting on (i) the Contract Date and (ii) each anniversary of the Contract Date, unless Equitable agrees to another period. SECTION 1.12 CONTRIBUTION. "Contribution" means a payment made to Equitable as described in Section 3.01. SECTION 1.13 DIVISION. "Division" means the Guaranteed Interest Division or an Investment Division of the Separate Account. Each Division is described in Part II of this Contract. SECTION 1.14 GUARANTEED INTEREST RATE. "Guaranteed Interest Rate" means the effective annual rates at which interest accrues on the amount in the Guaranteed Interest Division. An initial rate to apply with respect to each new Annuitant is determined by Equitable. Section 2.01 describes the determination of the rates to apply thereafter. SECTION 1.15 IRA CERTIFICATE. "IRA Certificate" means a certificate issued by Equitable with respect to an Annuitant who is enrolled under this Contract pursuant to an individual retirement annuity program meeting the requirements of Section 408(b) of the Code. SECTION 1.16 NON-QUALIFIED CERTIFICATE. "Non-Qualified Certificate" means a certificate issued by Equitable with respect to an Annuitant who is enrolled under this Contract but not pursuant to a "qualified plan." A qualified plan for this purpose is one which receives favorable tax treatment under Section 401, 403 or 408, and other applicable provisions, of the Code. SECTION 1.17 OWNER. "Owner" means the person who owns a certificate, as named on the certificate, or any successor owner. SECTION 1.18 PROCESSING OFFICE. "Processing Office" means Equitable Individual Annuity Center, P.O. Box 2996, New York, New York 10116, or such other location as Equitable may designate upon advance written notice to each Owner. SECTION 1.19 RETIREMENT DATE "Retirement Date" means the date on which the Annuitant attains the retirement age shown on the application form submitted for the Annuitant and on the applicable certificate. No.11993AC-C Page 4 Before the Retirement Date the Owner may elect to change such Date to another Retirement Date, which may be any date after the election is filed (other than the 29th, 30th or 31st day of any month). Any election for such change must be made in writing by the Owner and will not take effect until received and accepted by Equitable at its Processing Office. No Retirement Date will be later than the first of the month which follows the date the Annuitant attains Equitable's maximum maturity age (currently age 85) or, if later, the tenth anniversary of the Contract Date, unless changed by Equitable to conform to any law which applies. SECTION 1.20 SEP CERTIFICATE. "SEP Certificate" means a certificate issued by Equitable with respect to an Annuitant who is enrolled under this Contract in order to provide an Annuity Benefit in accordance with a written program constituting a "Simplified Employee Pension," as described in Section 408(k) of the Code. Such a program as adopted by the Annuitant's employer may provide for salary reductions, whereby the employer makes tax-deferred contributions for the Annuitant in lieu of salary, and must meet the requirements of Section 408(b) of the Code. SECTION 1.21 SEPARATE ACCOUNT. "Separate Account" means Separate Account A which is organized as a unit investment trust, a type of investment company. SECTION 1.22 TRANSACTION DATE. The Transaction Date is the Business Day Equitable receives at the Processing Office a Contribution or a transaction request providing the information Equitable needs. Transaction requests must be in a form acceptable to Equitable. Equitable's Business Day ends at 4:00 P.M., Eastern Time. PART II - DIVISIONS SECTION 2.01 GUARANTEED INTEREST DIVISION. Any amount held in the Guaranteed Interest Division, as described in Section 3.01, becomes part of Equitable's general assets, which support the guarantees of this Contract and other contracts. The amount in such Division at any time is equal to the sum of: o all amounts that have been allocated or transferred to such Division, plus o the amount of any interest accrued but not allocated, less o the sum of all amounts that have been withdrawn or transferred from such Division. Equitable will credit the amount held in the Guaranteed Interest Division with interest at effective annual rates that Equitable sets. Each calendar year Equitable also sets a yearly Guaranteed Interest Rate that will remain in effect throughout the next calendar year. Equitable guarantees that this yearly rate will never be less than 3%. SECTION 2.02 SEPARATE ACCOUNT. Equitable established the Separate Account and maintains it in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited to or charged against it without regard to Equitable's other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts and No.11993AC-C Page 5 certificates. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities and variable life insurance. The Separate Account consists of "Investment Divisions." (The Guaranteed Interest Division is not a part of Separate Account A.) Each Investment Division may invest its assets in a separate class (or series) of shares of a designated trust or investment company where each class (or series) represents a separate portfolio in the designated trust or investment company. The Investment Divisions are: (a) "Type A" Investment Divisions: the Stock Division; the Balanced Division; the Aggressive Stock Division; the Global Division; the Growth Investors Division; and (b) "Type B" Investment Divisions: the Conservative Investors Division; the Money Market Division. Divisions may be added or removed as described in Section 8.03. Equitable will value the assets of each Investment Division on each Business Day. The assets of the Separate Account are Equitable's property. The portion of Equitable's assets equal to the reserves and other liabilities with respect to certificates issued under the Contract will not be chargeable with liabilities which arise out of any other business Equitable conducts. Equitable may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Division to another Investment Division or to Equitable's General Account. Equitable may, at its discretion, invest the assets of any Investment Division in any investment which applicable law permits. Equitable may rely conclusively on the opinion of counsel (including counsel in its employ) as to what investments Equitable may make as law permits. SECTION 2.03 SEPARATE ACCOUNT INVESTMENT DIVISIONS. The amount in an Investment Division with respect to an Annuitant at any time is equal to the number of Accumulation Units in that Division with respect to the Annuitant multiplied by the Division's Accumulation Unit Value at that time. Amounts allocated or transferred to an Investment Division are used to purchase Accumulation Units of that Division. Units are redeemed when amounts are deducted, transferred or withdrawn. The number of Accumulation Units in an Investment Division at any time is equal to the number of Accumulation Units purchased minus the number of Units redeemed in that Division up to that time. The number of Accumulation Units purchased or redeemed in a transaction is equal to the dollar amount of the transaction divided by the Division's Accumulation Unit Value for that Transaction Date. Equitable determines Accumulation Unit Values for each Investment Division for each Valuation Period. A Valuation Period is each Business Day together with any consecutive preceding non-business days. For example, for each Monday which is a Business Day, the preceding Saturday and Sunday will be included to equal a three-day Valuation Period. The Accumulation Unit Value of an Investment Division for any Valuation Period is equal to the Accumulation Unit Value for that Division on the immediately preceding Valuation Period No.11993AC-C Page 6 multiplied by the Net Investment Factor for that Division for the current Valuation Period. The Net Investment Factor for a Valuation Period is (a) divided by (b) minus (c), where (a) is the value of the Investment Division's shares of the related portfolio of the specified trust or investment company at the end of the Valuation Period (before taking into account any amounts allocated to or withdrawn from the Investment Division for the Valuation Period and after deduction of investment advisory fees and direct operating expenses of the specified trust or investment company; for this purpose, Equitable uses the share value reported to Equitable by the specified trust or investment company); (b) is the value of the Investment Division's shares of the related portfolio of the specified trust or investment company at the end of the preceding Valuation Period (taking into account any amounts allocated or withdrawn for that Valuation Period); (c) is the daily Separate Account charge (see Section 6.04) for the expenses of the Contract, times the number of calendar days in the Valuation Period, plus any charge for taxes or amounts set aside as a reserve for taxes. PART III - CONTRIBUTIONS AND TRANSFERS SECTION 3.01 CONTRIBUTIONS. On the application form for coverage under this Contract the Owner chooses which Divisions will be available under the certificate issued to the Owner (the Guaranteed Interest Division is always available). Once this choice is made, the Owner may only allocate Contributions to, or transfer among, these Divisions. The Owner may add or subtract Divisions after the certificate is issued to the Owner by sending Equitable a written request, but Equitable has the right to decline such request. On the application form the Owner will also choose how to allocate Contributions among the Divisions chosen. The Owner need not allocate Contributions to each Division chosen. The Owner may change the allocation instruction at any time by sending Equitable the proper form. Allocation percentages must be in whole number (no fractions) and must equal 100%. Each Contribution is allocated (after deduction of any tax charge that applies) in accordance with the allocation instructions in effect. Contributions made to an Investment Division purchase Accumulation Units in that Division, using the Accumulation Unit Value next computed after the Transaction Date. Equitable has the right not to accept an initial Contribution of less than $1,000 or, for payroll deductions and any subsequent Contributions, a Contribution of less than $50. Equitable may refuse to accept any Contribution if such Annuitant's current age at last birthday was 80 or greater. In addition, Equitable may refuse to accept a Contribution if the total Contributions made with respect to an Annuitant would exceed the following: (a) $500,000, if the Annuitant's current age at last birthday is 75 or less. (b) $250,000, if the Annuitant's current age at last birthday is 76-79. Equitable reserves the right to further limit Contributions as described in Section 8.03. SECTION 3.02 TRANSFERS AMONG DIVISIONS. The Owner may upon written request transfer all or part of the amount held with respect to an Annuitant in a Division to one or more of the Divisions. A transfer request must be made in a form acceptable to Equitable. All transfers will be made on the Transaction Date and will be subject to No.11993AC-C Page 7 Equitable's rules in effect at the time of transfer. With respect to the Investment Divisions, the transfers will be made at the Accumulation Unit Value next computed after the Transaction Date. If the Owner has elected any combination of Divisions that include a Type B Investment Division described in Section 2.02 (whether or not amounts are actually held with respect to the Annuitant in any such Division), then the maximum amount which may be transferred in any Contract Year from the Guaranteed Interest Division to any other Division is: (a) 25% of the amount the Owner has in the Guaranteed Interest Division on the last day of the prior Contract Year of, if greater, (b) the total of all amounts transferred at the Owner's request from the Guaranteed Interest Division to any of the other Divisions in the prior Contract Year. A request for a transfer of less than $300 will not be accepted, unless the Annuity Account Value is less than $300. Equitable reserves the right, pursuant to the terms of Section 8.03, to impose further restrictions on transfers. PART IV WITHDRAWALS AND TERMINATION SECTION 4.01 PARTIAL WITHDRAWALS. The Owner may make a written request to Equitable for a partial withdrawal from the Divisions before the Retirement Date and while the Annuitant is alive. On the Transaction Date, Equitable will pay the amount of partial withdrawal requested by the Owner or, if less, the Cash Value. The amount to be paid plus any withdrawal charge applicable pursuant to Section 6.01 will be withdrawn on a pro-rata basis from the amounts held with respect to the Annuitant in the Divisions, unless the Owner elects to otherwise. A request for a partial withdrawal of less and $300 will not be accepted, unless the Annuity Account Value is less than $300. Also, if a withdrawal made under this Section would result in an Annuity Account Value of less than $500, Equitable will so advise the Owner and reserve the right to pay the Annuity Account Value to the Owner, and participation under this Contract will be terminated. SECTION 4.02 TERMINATION OF COVERAGE UNDER THE CONTRACT. On or before the Annuitant's Retirement Date, and while the Annuitant is alive, the Owner may elect to terminate coverage under the Contract. Such election must be made in writing. Equitable will determine the Cash Value to be paid as of the Transaction Date. No withdrawal charge will be applied if the amount withdrawn is used to provide a life annuity issued by Equitable or one of its affiliated or subsidiary life insurance companies. If coverage is terminated before the Retirement Date, a charge for taxes that Equitable has paid may be deducted. If Equitable has previously deducted charges for taxes from Contributions as described in Section 3.01, Equitable will not again deduct charges for the same taxes on termination. Before an Annuitant's Retirement Date, Equitable has the right to pay the Cash Value under the Contract and terminate coverage if (i) no Contributions are made with respect to the Annuitant during the last three completed Contract Years, or (ii) after three Contract Years the Annuity Account Value is less than $500. Equitable also has the right to terminate coverage under the Contract if no Contributions have been made with respect to the Annuitant within 120 days of the Contract Date. No.11993AC-C Page 8 PART V - DEATH BENEFITS SECTION 5.01 DEATH BENEFIT. Unless the Owner's surviving spouse becomes the Annuitant under Section 5.02, upon receipt by Equitable of due proof that the Annuitant has died, Equitable will pay a death benefit to the beneficiary named under Section 5.03. The amount of the death benefit under this Contract is equal to (a) the Annuity Account Value or, if more, (b) the minimum death benefit. The minimum death benefit is the sum of all Contributions made on behalf of the Annuitant (less any tax charge that applies), less the total of any withdrawals made pursuant to Section 4.01. Equitable will pay the death benefit to the beneficiary in the form of an Annuity Benefit if the Owner has chosen the form described in the last paragraph of Section 5.03. Also pursuant to the last paragraph of Section 5.03, if no such choice has been made at the Annuitant's death, Equitable will pay the death benefit to the beneficiary in a single sum. However, the beneficiary may instead choose before Equitable pays the death benefit to apply the death benefit to provide (i) a form of an Annuity Benefit, (ii) any other form of benefit payment, or (iii) any combination of forms of benefit payment. All such choices will be subject to the forms Equitable then offers, Equitable's rules then in effect, and any requirements under the Code. SECTION 5.02 OWNER DEATH DISTRIBUTION RULES. Upon the death of the Owner before the Retirement Date: (i) If the Owner is both the Owner and the Annuitant, Equitable will pay the death benefit described in Section 5.01. If the Owner is married as of the date of the Owner's death before the Retirement Date, and the Owner's spouse is the named beneficiary, the spouse will be the successor owner and Annuitant and no death benefit will be payable at such time. (ii) If the Owner is not the Annuitant, the named beneficiary (successor owner) described in Section 5.03 will succeed as Owner, even if any co-owner exists. The entire amount in the Divisions subject to any withdrawal charges which apply must be fully paid by the fifth anniversary of the Owner's death, or payments must begin within one year after the Owner's death as a life annuity or installment option, for a period of not longer than the life expectancy of the named beneficiary. If the Owner has not elected a form of payment as described in the last paragraph of Section 5.03, and if the beneficiary named under Section 5.03 does not elect to receive the payments required by this Section in a form of Annuity Benefit, a series of partial withdrawals, or any payout option acceptable under Section 72(s) of the Code and Equitable's rules at the time, Equitable will pay the amount in the Divisions in a single sum to the beneficiary on the fifth anniversary of the Owner's death. Subject to Equitable's rules at the time of payment and the completion of an application, the beneficiary may elect to apply such a single sum payment to a new nonqualified annuity contract to be owned by the beneficiary. However, if the named beneficiary is the Owner's spouse, full payments of amounts under the Contract must be made no later than five years after the spouse's death. If payments under an Annuity Benefit had begun before the Owner's death, such payments will continue to be made over a period not longer than the period for under the Annuity Benefit elected. If the Annuitant dies before the entire amount in the Divisions is paid, Equitable will pay the death benefit as described in Section 5.01. No.11993AC-C Page 9 SECTION 5.03 BENEFICIARY - SUCCESSOR OWNER On the application, the Owner is to provide Equitable with the name of the beneficiary who is to receive any death benefit payable on the death of the Annuitant. Unless the Owner directs otherwise, the person named as beneficiary on the death of the Annuitant will also be the person who succeeds as Owner on the Owner's death while the Annuitant is alive as described in Section 5.02. The Owner may change any beneficiary or successor Owner from time to time during the Annuitant's lifetime and while coverage under the Contract is in force. Any such change must be made in writing in a form Equitable accepts. A change will, upon receipt at the Processing Office, take effect as of the date the written form was signed, whether or not the Owner is living on the date of receipt. Equitable will not be liable as to any payment it may make before it receives any such change. On the application the Owner may name a person to be primary beneficiary on the death of the Annuitant under Section 5.01 and another person to be a contingent beneficiary if the primary beneficiary dies before the Annuitant. Also, if the Owner is not the Annuitant, on the application the Owner may name a person to be the successor Owner and to receive the amounts required to be paid under Section 5.02 (on the Owner's death before the Retirement Date while coverage under the Contract is in force) and another person to be successor Owner, if the first choice as successor Owner dies before the Owner. Unless the Owner directs otherwise, if the Owner has named two or more persons as death benefit beneficiary, the beneficiary will be the named person or persons who survive the Annuitant. If more than one survive they will share equally. If the Owner is not the Annuitant and the Owner has named two or more persons to succeed as Owner, the successor Owner will be the named person or persons who survive the Owner, unless the Owner directs otherwise. If more than one survive they will share equally, unless the Owner directs otherwise. If the Owner is the Annuitant, any part of a death benefit payable as described in Section 5.01 for which there is no named beneficiary living at the Owner's death will be payable in a single sum to the Owner's children who survive the Owner. The payments will be made in equal shares, or should none survive, then to the Owner's estate. If the Owner is not the Annuitant, and if no beneficiary named to receive the death benefit payable as described in Section 5.01 survives the Annuitant, Equitable will pay such death benefit in a single sum to the Owner. In the event of the Owner's death after the Annuitant, but before Equitable pays such death benefit, the death benefit will be payable in a single sum to the children who survive the Owner, in equal shares, or should none survive, to the Owner's estate. If Owner is not the Annuitant and the Owner dies before the Retirement Date while the Annuitant is still living, and if no person named as successor Owner to receive the amounts required to be paid as described in Section 5.02 is living at the Owner's death, such beneficiary will be presumed to be, in this order, (i) the Owner's surviving spouse, (ii) the Annuitant, (iii) the children who survive the Owner, in equal shares, or (iv) the Owner's estate. If the Owner so chooses in writing, any amount which would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on a form of annuity chosen by the Owner, subject to Equitable's rules then in effect. If at the Owner's death there is no choice in effect, the beneficiary may make such a choice. No. 11993AC-C Page 10 PART VI -- CHARGES SECTION 6.01 WITHDRAWAL CHARGES. If the amount of a withdrawal made under Section 4.01 or a termination payment made under Section 4.02 is more than the Free Corridor Amount (defined below), Equitable will (a) first withdraw from such Divisions an amount equal to the Free Corridor Amount, and (b) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge, if one applies. The withdrawal charge is equal to 6% of the withdrawn Contributions which have been made on behalf of the Annuitant in the current and five prior Contract Years. For the purposes of this Section, amounts withdrawn up to the Free Corridor Amount will not be deemed a withdrawal of any Contributions. Also, any excess withdrawals (those pursuant to item (b) in the first paragraph of this Section) will be deemed withdrawals of older Contributions first and more recent Contributions next; that is, Contributions will be withdrawn in the order they were made. "Free Corridor Amount" means an amount equal to 10% of the Annuity Account Value on the Transaction Date, minus the total of all prior withdrawals made as described in Section 4.01 in the current Contract Year. However, a withdrawal charge will not apply upon any of these events: (i) the Annuitant dies and a death benefit is payable to the beneficiary, or (ii) the receipt by Equitable of a properly completed election from providing for the Annuity Account Value to be used to buy a life annuity as described in Section 7.03, or (iii) the Annuitant has qualified to receive Social Security disability benefits as certified by the Social Security Administration, or (iv) the Owner gives Equitable proof which Equitable accepts that the Annuitant's life expectancy is six months or less (such proof must include, but is not limited to, certification by a licensed physician), or (v) the Annuitant has been confined to a nursing home for more than 90 days as verified by a licensed physician. A nursing home for this purpose means one which is (a) approved by Medicare as a provider of skilled nursing care service, or (b) licensed as a skilled nursing home by the state or territory in which it is located (it must be within the United States, Puerto Rico, U.S. Virgin Islands, or Guam) and meets all of the following: o its main function is to provide skilled, intermediate, or custodial nursing care; o it provides continuous room and board to three or more persons; o it is supervised by a registered nurse or licensed practical nurse; o it keeps daily medical records of each patient; o it controls and records all medications dispensed; and o its primary service is other than to provide housing for residents. Moreover, the withdrawal charge will be reduced if needed in order to comply with any state law that applies. No.11993AC-C Page 11 However, a charge for taxes that Equitable has paid may be deducted from amounts withdrawn. If Equitable has previously deducted charges for taxes from Contributions as described in Section 3.01, Equitable will not again deduct charges for the same taxes on withdrawals. SECTION 6.02 CHARGE ON TRANSFER TO THIRD PARTY OR EXCHANGE If the Owner requests that Equitable make a direct transfer to a third party of amounts under the Contract, or requests that the certificate issued to the Owner be exchanged for another contract or certificate issued by another insurance company, Equitable will impose both a withdrawal charge as described in Section 6.01 (if any) and a charge of $25 for any such direct transfer or exchange. SECTION 6.03 ADMINISTRATIVE CHARGE. As of the last Business Day of each calendar quarter, Equitable will deduct an administrative charge from the Annuity Account Value. Such charge is equal to: (i) for each calendar quarter during the first two Contract Years, $6.00 or, if less, 0.50% of the Annuity Account Value plus the amount of any withdrawals made pursuant to Section 4.01 during such quarter; (ii) for each calendar quarter during each Contract Year after the second Year, $6.00. The charge will be allocated among the Divisions in proportion to the amounts held with respect to the Annuitant in the Divisions. SECTION 6.04 DAILY SEPARATE ACCOUNT CHARGE. Assets of the Investment Divisions will be subject to a daily asset charge. This daily charge is for financial accounting and for death benefits, mortality risk, expenses and expense risk which Equitable assumes. Such charge will be applied after any deductions to provide for taxes and will be at a rate not to exceed a guaranteed annual rate of 1.35%. Equitable reserves the right to charge less on a current basis. The charge will be made pursuant to item (c) of "Net Investment Factor" as defined in Section 2.03. PART VII - ANNUITY BENEFITS SECTION 7.01 FIXED ANNUITY BENEFIT. A "Fixed Annuity Benefit" is an Annuity Benefit under which the periodic payments are paid in a stated dollar amount. Payment under a Fixed Annuity Benefit are typically made monthly. An election may be made by the Owner to have the Annuity Benefit paid at other intervals, such as every three months, six months, or twelve months, instead of monthly, subject to Equitable's rules at the time of election. This election may be made at the time the Annuity Benefit form as described in Section 7.03 is elected; in that event, all references in this Contract to monthly payments will, with respect to the Annuity Benefit of such an Annuitant to whom the election applies, be deemed to mean payments at the frequency elected. SECTION 7.02 VARIABLE ANNUITY BENEFIT. A "Variable Annuity Benefit" is an Annuity Benefit under which the dollar amount of the monthly payments may increase or decrease depending on the investment experience of the Stock Division of the Separate Account. The following terms apply to the determination of Variable Annuity Benefit payments: No.11993AC-C Page 12 ANNUITY UNIT: The "Annuity Unit" is a unit used in determining amounts payable from the Stock Division under a Variable Annuity Benefit. ANNUITY UNIT VALUE: The "Annuity Unit Value" on August 27, 1981, was fixed at $1.26 and $1.52 for contracts with assumed base rates of net investment return of 5% and 3.5% a year, respectively. For any Valuation Period after such date, it is the Annuity Unit Value for the immediately preceding Valuation Period multiplied by the Adjusted Net Investment Factor. ADJUSTED NET INVESTMENT FACTOR: The "Adjusted Net Investment Factor" for a Valuation Period is the Net Investment Factor for such Period reduced for each calendar day in the Valuation Period by: o .00013366 of the Net Investment Factor if the assumed base rate of net investment return is 5% a year; or o .00009425 of the Net Investment factor if the assumed base rate of net investment return is 3.5% a year. The assumed base rate of net investment return will be 5%, except in states where such rate is not permitted by law. AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods ending in such month. A Variable Annuity Benefit will increase if the average daily rate of investment return in the Stock Division is equivalent to more than 5% or 3.5% annually and will decrease if it is equivalent to less than 5% or 3.5% annually. The daily rate of investment return is after deduction of the Daily Separate Account Charge described in Section 6.04, investment advisory fees and direct operating expenses related to the Separate Account. The amount of the first three monthly payments under any Variable Annuity Benefit provided under this Contract is the amount provided with respect to a payee pursuant to the first paragraph of the Tables of Guaranteed Annuity Payments of this Contract. The amount of the fourth and each later monthly payment under a Variable Annuity Benefit will be equal to the number of Annuity Units with respect to such benefit, multiplied by the Average Annuity Unit Value for the second calendar month immediately preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number equal to: (a) the amount of the first monthly payment, divided by (b) the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. Equitable will notify the payee how each Variable Annuity Payment is determined. SECTION 7.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of the Annuitant's Retirement Date, provided the Annuitant is then living, the Annuity Account Value will be applied to provide the Normal Form of Annuity Benefit (described below). However, the Owner may instead elect (i) to receive the Cash Value in a single sum, (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 7.04, to provide an Annuity Benefit on any other form offered by Equitable or one of Equitable's affiliated or subsidiary life insurance companies, or (iii) to apply the Cash Value to provide any other form of benefit payment offered by Equitable, subject to Equitable's rules then in effect. At the time an Annuity Benefit is purchased, Equitable will issue a supplementary contract which reflects the Annuity Benefit terms. No.11993AC-C Page 13 Equitable will provide notice and election forms to the Owner not more than six months before the Retirement Date. If the Owner chooses to terminate coverage under this Contract pursuant to Section 4.02 before the Annuitant's Retirement Date, a choice may be made to receive any form of benefit payment offered by Equitable, subject to Equitable's rules then in effect and any other applicable requirements under the Code. Equitable will have the right to require the Owner to furnish any information Equitable needs to provide an Annuity Benefit and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. The following annuity forms will apply. Equitable may offer other annuity forms as available from Equitable or from one of Equitable's affiliated or subsidiary life insurance companies. NORMAL FORM. The term "Normal Form" of Annuity Benefit means the Fixed Annuity Benefit payable on the Life-Period Certain Annuity Form described below. LIFE ANNUITY FORM. The "Life Annuity Form" is an annuity providing monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and terminate with the last payment due before the death of such person. LIFE - PERIOD CERTAIN ANNUITY. The "Life - Period Certain Annuity" is an annuity payable on the Life Annuity Form, but with 10 years of payments guaranteed (10 years certain period). That is, if the Annuitant dies before the certain period has ended, payments will continue to the beneficiary designated to receive such payments for the balance of the certain period. JOINT AND SURVIVOR LIFE ANNUITY FORM. The "Joint and Survivor Life Annuity Form" is an annuity providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as elected. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and terminate with the last payment due before the death of the survivor. PERIOD CERTAIN ANNUITY. The "Period Certain Annuity" is an annuity issued by Equitable which does not involve life contingencies; it provides payments only for the period specified (usually 5, 10, 15, or 20 years, but other periods from 3 to 25 years are available from Equitable) when the annuity is selected. It does not permit any prepayment of the unpaid principal (that is, the Owner cannot elect to receive part of the payments as a single sum payment with the remainder paid in monthly annuity payments). SECTION 7.04 AMOUNT OF ANNUITY BENEFITS. If the Owner elects pursuant to the first or third paragraph of Section 7.03 to have an Annuity Benefit paid in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will be (i) the Annuity Account Value if the annuity form elected provides payments for a person's remaining lifetime) or (ii) the Cash Value if the annuity form elected does not provide such lifetime payments. The amount applied to provide an Annuity Benefit may be reduced by a charge for any taxes which apply on annuity purchase payments. If Equitable has previously deducted charges for applicable taxes from Contributions as provided in Section 3.01, Equitable will not again deduct charges for the same taxes before an Annuity Benefit is provided. The balance will be used to purchase the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments or (ii) Equitable's then current individual annuity rates, whichever rates would provide a larger benefit with respect to the No.11993AC-C Page 14 payee. Regardless of the basis used, the Annuity Benefit will be governed by Equitable's supplementary contract which will be issued to the Owner. After an Annuity Benefit is provided, the amounts held with respect to the Annuitant in the Divisions and the Annuity Account Value will be zero. SECTION 7.05 CONDITIONS. Equitable has the right to ask for proof acceptable to it that the person on whose life a benefit payment is based is alive when each payment is due. Equitable will require proof of the age of any person on whose life an annuity form is based. If a benefit was based on information that is later found not to be correct, such benefit will be adjusted on the basis of the correct information. The adjustment will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination. Overpayments by Equitable will be charged against future payments. Underpayments will be added to future payments. Equitable's liability is limited to the correct information and the actual amounts used to provide the benefits. If Equitable receives proof satisfactory to it that (i) a payee entitled to receive any payment under the terms of this Contract is physically or mentally incompetent to receive such payment or is a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may make the payments to such other person or institution. In the case of a minor, the payments will not exceed $200. Equitable will have no further liability with respect to the payments so made. With respect to an annuity form providing payments for a period certain, the Owner may designate (with the right to change such designation) a payee to receive any payments that may become due after the death of the person or persons upon whose life or lives the income may depend. If the amount to be applied hereunder is less than $2,000, or would result in an initial payment of less than $20, Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected. Payments under annuity forms with life contingencies terminate with the last payment due before the death of the person upon whose life the income depends or, if later, the end of the period certain. PART VIII - GENERAL PROVISIONS SECTION 8.01 CONTRACT. This Contract constitutes the entire Contract between the parties and the provisions of this Contract alone will govern with respect to Equitable's rights and obligations. This Contract may not be modified, nor may any of Equitable's rights or requirements be waived, except in writing and by an authorized officer of Equitable. The terms of this Contract may be changed by amendment or replacement upon agreement between the Contract Holder and Equitable without the consent of any other person. The benefits and values under this Contract are not less than the minimum benefits required by any statute of the State in which a certificate under this Contract is delivered. No.11993AC-C Page 15 SECTION 8.02 STATUTORY COMPLIANCE. Equitable reserves the right to amend this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right will include, but not be limited to, the right to conform this Contract and any certificate to reflect changes in the Code, applicable Treasury Regulations, or published rulings of the Internal Revenue Service in order that each such certificate will continue to be an "annuity" as described in Section 72, or other Section which applies, of the Code. SECTION 8.03 RIGHTS TO CHANGE. Equitable reserves the following rights to change certiain terms of this Contract: a. upon at least 90 days' advance notice to the Contract Holder and each Owner: (i) to establish or change minimum and maximum amounts which may apply to Contributions; (ii) to establish or change restrictions on transfers among Divisions; (iii) to change any charge described in Section 6.01, 6.02, or 6.03, such as withdrawal charges and those related to the administrative functions covered by such charge, at any time to reflect any change in Equitable's expenses, subject to any law that applies; however, no such change will result in (A) withdrawal charges which exceed the amount shown in Section 6.01, (B) charges made under Section 6.02 which exceed $65.00 per direct transfer or exchange, or (C) charges made under Section 6.03 which exceed $65.00 in any calendar year; (vi) to change at any time on and after the fifth anniversary of the Contract Date, at intervals of not less than five years, the actuarial basis used in the Tables of Guaranteed Annuity Payments shown in the attached Appendix; however, no such change will apply to (A) any Annuity Benefit provided before the change or (B) Contributions made before such change which are applied to provide a Fixed Annuity Benefit. b. with respect to the Separate Account: (i) to add Investment Divisions (or sub-divisions of Investment Divisions) to, or to remove Investment Divisions (or sub-divisions) from, the Separate Account, or to add other separate accounts or investment funds; (ii) to combine any two or more Investment Divisions or sub-divisions thereof; (iii) to transfer the assets Equitable determines to be the share of the class of contracts to which this Contract belongs from any Investment Division to another Investment Division; (iv) to operate the Separate Account or any Investment Division as a management investment company under the Investment Company Act of 1940; (v) to deregister the Separate Account under the Investment Company Act of 1940, provided that such action conforms with the requirements of applicable law; (vi) to restrict or eliminate any voting rights as to the Separate Account; (vii) to cause one or more Investment Divisions to invest some or all of their assets in one or more other trusts or investment companies. No.11993AC-C Page 16 If the exercise of these rights results in a material change in the underlying investments of an Investment Division, the Contract Holder and each Owner will be notified of such exercise, as required by law. SECTION 8.04 DEFERMENT. Application of proceeds to provide a variable annuity, payment of a death benefit under Section 5.01 or 5.02 and payment of any portion of the Annuity Account Value (less any applicable withdrawal charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange is closed or trading is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Securities and Exchange Commission, by order, permits Equitable to defer payment in order to protect persons with interests in the Investment Divisions. Equitable can defer payment or transfer of any portion of the Annuity Account Value in the Guaranteed Interest Division for up to six months while the Owner is living. SECTION 8.05 ANNUAL REPORTS. At the end of each Contract Year up to and including the Retirement Date, Equitable will furnish the Owner with a report showing the following: (1) the dollar amount in the Guaranteed Interest Division, (2) the total number of Accumulation Units in each Investment Division, (3) the Accumulation Unit Value, (4) the dollar amount in each Investment Division, (5) the Cash Value, and (6) the amount of the death benefit. Also, after the Retirement Date, Equitable will notify the Owner of the number of Annuity Units and the Average Annuity Unit Value used in determining the amount of each Variable Annuity Benefit payment, if any. Such report will be mailed with each payment. SECTION 8.06 CHANGE OF OWNER While the Annuitant is living, the Owner may name a new Owner in writing in a form acceptable to Equitable. The change will take effect on the date the Owner signs the written form, but it will not apply to any payment Equitable makes or other actions Equitable takes before it receives the form. SECTION 8.07 ASSIGNMENTS. The entire interest of anyone covered under this Contract may not be assigned as collateral or security for a loan. Otherwise, the Owner may assign this Contract before the Retirement Date but Equitable will not be bound by an assignment unless it is in writing and Equitable has received it. The Owner's rights and those of any other persons referred to in this Contract will be subject to the assignment. Equitable assumes no responsibility for the validity of any assignment. No amounts payable under this Contract to a payee other than the Owner may be assigned, unless permitted herein, by that payee, nor will they be subject to the claims of creditors or to legal process, except to the extent permitted by law. No.11993AC-C Page 17 SECTION 8.08 AGE AND SEX. If the age or sex of any person upon whose life an Annuity Benefit depends has been misstated, any benefits will be those which would have been purchased at the correct age and sex. Any overpayments or underpayments made by Equitable will be charged or credited with interest at the rate of 6% per year, and such interest will be deducted from or added to future payments. SECTION 8.09 CONTRACT HOLDER'S RESPONSIBILITY. The sole responsibility of the Contract Holder is to serve as party to this Contract. The Contract Holder will have no responsibility for Contributions or any payments or distributions hereunder. Equitable will deal with the Contract Holder in accordance with the terms and conditions of the trust agreement pursuant to which the Contract Holder agreed to act as such and in such manner as the Contract Holder and Equitable agree, without the consent of any other person. No.11993AC-C Page 18 TABLES OF GUARANTEED ANNUITY PAYMENTS The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the terms of the Contract on the Life Annuity Form with Ten Years Certain. The amount of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form with Ten Years Certain is based on 3.0% interest and the 1983 Individual Annuity Table "a" projected with modified Scale "G". The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form with Ten Years Certain is based on the 1983 Individual Annuity Table "a" projected with modified Scale "G" and a modified two year age set back, and on an Assumed Base Rate of Net Investment Return of 3.5% or 5%, whichever applies pursuant to Section 7.02. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on the same actuarial basis. TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM WITH TEN YEARS CERTAIN (Minimum Monthly Income per $1,000 of Annuity Account Value) Monthly Income Monthly Income Age Males Females Age Males Females --- ----- ------- --- ----- ------- 60 4.68 4.22 73 6.25 5.58 61 4.77 4.29 74 6.39 5.72 62 4.87 4.37 75 6.55 5.87 63 4.97 4.46 76 6.70 6.03 64 5.08 4.54 77 6.86 6.19 65 5.19 4.64 78 7.02 6.36 66 5.31 4.73 79 7.18 6.53 67 5.43 4.84 80 7.34 6.70 68 5.56 4.95 81 7.50 6.88 69 5.69 5.06 82 7.66 7.06 70 5.82 5.18 83 7.81 7.23 71 5.96 5.31 84 7.96 7.41 72 6.10 5.44 85 8.11 7.58 No.11993AC-C Page 19 ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Account Value) VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM WITH TEN YEARS CERTAIN IF ASSUMED BASE RATE OF RETURN IS: 3.5% 5.0% Age Males Females Males Females --- ----- ------- ----- ------- 60 4.80 4.37 5.69 5.28 61 4.88 4.44 5.77 5.34 62 4.97 4.51 5.86 5.41 63 5.06 4.59 5.94 5.48 64 5.16 4.66 6.04 5.55 65 5.26 4.75 6.14 5.63 66 5.37 4.83 6.24 5.71 67 5.48 4.93 6.34 5.80 68 5.59 5.02 6.46 5.89 69 5.71 5.13 6.57 5.99 70 5.84 5.23 6.69 6.10 No.11993AC-C Page 20 APPENDIX A-IRA PART I: APPLICABLE TO IRA CERTIFICATES under which both periodic Contributions and rollover Contributions, as described in this Appendix, may be made. The terms of this Appendix apply with respect to IRA Certificates under which both periodic and rollover Contributions are to be made. If an IRA Certificate applies, then it is established for the exclusive benefit of the Annuitant and the Annuitant's beneficiaries, and the terms below change, or are added to, the stated Sections of this Contract. SECTION 1.17 OWNER: The Owner of an IRA Certificate will be the Annuitant. SECTION 1.19 RETIREMENT DATE: Section 1.19 of this Contract defines the "Retirement Date." No initial choice of Retirement Date may be later than age 70-1/2. Before the Retirement Date, the Owner may change the Retirement Date to a later age (up to age 85). In such a case the Owner must withdraw at least the minimum distributions required under Sections 408(b) and 401(a)(9) of the Code and Treasury Regulations that apply. See Section 7.03 of this Appendix. SECTION 3.01 CONTRIBUTIONS: Section 3.01 states that an initial Contribution of less than $1,000 may not be accepted. This does not apply to IRA Certificates. The following will also apply: Contributions are not fixed and may be made at any time and in any amount which is at least $50. No Contributions will be accepted unless they are in cash. Except in the case of a rollover contribution (as permitted by Sections 402(c), 403(a)(4), 403(b)(8), or 408(d)(3) of the Code), the total of such Contributions will not exceed $2,000 for any taxable year. Amounts transferred to the Contract from an individual retirement account or annuity contract which meets the requirements of Section 408 of the Code are not subject to the $2,000 limit. If the Owner makes a Contribution which qualifies as an eligible retirement plan rollover within the meaning of Section 402(c) or 403(b)(8) of the Code and the Owner commingles such Contribution with other Contributions, the Owner may not be able to roll over the eligible retirement plan Contributions and earnings to another qualified plan or Code Section 403(b) arrangement at a future date, unless the Code permits. SECTION 4.02 TERMINATION OF COVERAGE UNDER THE CONTRACT: In the event that an annuity bought under the Contract fails to qualify as an annuity which meets the requirements of Section 408(b) of the Code, Equitable will have the right, upon receipt of notice of such fact, before the Retirement Date, to terminate coverage under the Contract. In that case, Equitable will pay the Annuity Account Value less a deduction for the part which applies to any Federal income tax payable by the Annuitant which would not have been payable with respect to an annuity which meets such requirements. SECTION 5.01 DEATH BENEFIT: If the Annuitant is married at the Annuitant's death before the Retirement Date, and the Annuitant's spouse is named as death beneficiary, the Annuitant's spouse will be treated as No.11993AC-C Page 21 the contingent annuitant (Annuitant and Owner) under the Certificate. Payment of the death benefit is subject to Section 7.03 of this Appendix. SECTION 5.02 OWNER DEATH DISTRIBUTION RULES: This Section does not apply to IRA Certificates. SECTION 5.03 BENEFICIARY - SUCCESSOR OWNER: Section 5.03 is deleted and the following inserted in its place. SECTION 5.03 BENEFICIARY On the application, the Owner gives Equitable the name of the beneficiary who is to receive any death benefit payable on the Annuitant's death. The Owner may change the beneficiary from time to time during the Annuitant's lifetime and while coverage under the Contract is in force. Any such change must be made in writing in a form Equitable accepts. A change will, upon receipt at the Processing Office, take effect as of the date the written form is signed, whether or not the Owner is living on the date of receipt. Equitable will not be liable as to any payments it made before it receives any such change. On the application the Owner may name a person to be primary beneficiary on the Annuitant's death and another person to be contingent beneficiary if the primary beneficiary dies before the Annuitant. Unless the Owner directs otherwise, if the Owner has named two or more persons as beneficiary, the beneficiary will be the named person or persons who survive the Annuitant. If more than one survive, they will share equally. Any part of a death benefit payable as described in Section 5.01 for which there is no named beneficiary living at the Annuitant's death will be payable in a single sum to the Annuitant's children who survive the Annuitant. The payments will be made in equal shares, or should none survive, then to the Annuitant's estate. If the Owner so chooses in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity chosen by the Owner, subject to Equitable's rules then in effect. If at the Annuitant's death there is no choice in effect, the beneficiary may make such a choice. SECTION 6.01 WITHDRAWAL CHARGES: Section 6.01 describes the events under which a withdrawal charge will not apply. The event below is added: (iv) a request is made for a refund of a Contribution in excess of amounts allowed to be contributed under Section 219 and/or Section 408 of the Code within one month of the date on which the Contribution is made. SECTION 7.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS: Section 7.03 of this Contract refers to the Normal Form of annuity which is payable. The Normal Form that applies under an IRA Certificate, in lieu of the form shown in said Section, is defined as follows: The term "Normal Form" of an Annuity Benefit means, (i) if the Annuitant has a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with the Annuitant's spouse as the contingent annuitant (with 100% of the Annuitant's monthly payment amount continued to the Annuitant's spouse), and (ii) if the Annuitant does not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. No.11993AC-C Page 22 Also, the payment of Annuity Benefits as described in Sectin 7.03 is subject to the terms which follow, in order to comply with Section 401(a)(9) of the Code and the Treasury Regulations which apply: The Annuitant's entire interest in the Certificate will be paid or begin to be paid no later than the April 1 which follows the calendar year in which the Annuitant attains age 70-1/2 ("Required Start Date"). The entire interest may be paid, as the Annuitant chooses, over (a) the Annuitant's life, or the lives of the Annuitant and the named beneficiary, or (b) a period certain which does not extend beyond the Annuitant's "life expectancy" (defined below), or the joint and last survivor expectancy of the Annuitant and the named beneficiary. Payments must be made in periodic payments at intervals no longer than one year. Also, payments must be either non-increasing or they may increase only as provided in Regulations (Q & A F-3 of Proposed Treasury Regulation Section 1.401(a)(9)-1 or successor). All payments made under the Certificate will be made in accordance with the requirements of Code Section 401(a)(9), including the incidental death benefit requirement of the Code (Section 401(a)(9)(G)) and Treasury Regulations which apply (Proposed Treasury Regulation Section 1.401(a)(9)-2). For purposes of the above, "life expectancy" is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless the Annuitant otherwise chooses before the time payments must begin, life expectancies will be recalculated each year. Such choice may never be changed and will apply to all years which follow. In the case of any named beneficiary other than the spouse, life expectancies will be calculated using the attained age of such beneficiary during the calendar year in which the Annuitant attains age 70 1/2 and payments for any calendar year which follows will be calculated based on life expectancy reduced by one for each calendar year which has passed since the calendar year life expectancy was first calculated. If the Annuitant dies after payment of the Annuitant's entire interest has begun, the remainder of such interest will continue to be paid at least as quickly as under the payment method of distribution being used before the Annuitant's death. If the Annuitant dies before payment of the Annuitant's entire interest begins, payment of the Annuitant's entire interest will be completed no later than December 31 of the calendar year in which the fifth anniversary of the Annuitant's death occurs, except to the extent that a choice is made to receive death benefit payments under (a) or (b) below: (a) If the Annuitant's interest is payable to a beneficiary, then the entire interest may be paid over the life of, or over a "period certain" not greater than the life expectancy of, the named beneficiary. Such payments must commence on or before December 31 of the calendar year which follows the year of the Annuitant's death. (b) If the named beneficiary is the Annuitant's surviving spouse, the date that payments must begin under (a) above will not be earlier than (i) December 31 of the calendar year which follows the year of the Annuitant's death or, if later, (ii) December 31 of the calendar year in which the Annuitant would have reached age 70-1/2. For purposes of the "period certain" used in (a) above, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of payments which begin after the Annuitant's death, unless the surviving spouse chooses otherwise by the time payments are required to begin, life expectancies will be recalculated each year. Such choice may never be changed by such spouse and will apply to all years which follow. In the case of any other named beneficiary, life expectancies will be calculated using the attained age of such beneficiary during the calendar year in which payments are required to begin, as described in this Section, and payments for any subsequent calendar year will be calculated based on life expectancy reduced by one for each calendar year which has passed since the calendar year life expectancy was first calculated. No.11993AC-C Page 23 Payments under this Section are deemed to have begun if payments are made because the Annuitant has reached the Required Start Date or if, before the Required Start Date, payments commence to the Annuitant over a period permitted and in an annuity form acceptable under proposed Treasury Regulation 1.401(a)(9)-1 or any successor. SECTION 8.05 ANNUAL REPORTS: Section 8.05 lists the reports Equitable will send the Annuitant. Equitable will also send a report as of the end of each calendar year showing the status of the annuity and any other reports required by the Code or Treasury Regulations. SECTION 8.06 CHANGE OF OWNER: The Owner may not name a new owner. SECTION 8.07 ASSIGNMENTS: In addition to the restrictions on assignments described in section 8.07, the Annuitant's entire interest under the Certificate is not transferable except by surrender to Equitable. Further, the Annuitant's interest under the Certificate is non-forfeitable. APPENDIX B In lieu of the Tables of Guaranteed Annuity Payments, the attached "Appendix B-IRA" applies. No.11993AC-C Page 24 APPENDIX A-IRA PART II: APPLICABLE TO IRA CERTIFICATES under which only rollover Contributions, as described in this Appendix, may be made. The terms of this Appendix apply with respect to IRA Certificates under which only rollover Contributions are to be made. If an IRA Certificate applies, then it is established for the exclusive benefit of the Annuitant and the Annuitant's beneficiaries, and the terms below change, or are added to, the stated Sections of this Contract. SECTION 1.17 OWNER: The Owner of an IRA Certificate will be the Annuitant. SECTION 1.19 RETIREMENT DATE: Section 1.19 of this Contract defines the "Retirement Date." No initial choice of Retirement Date may be later than age 70-1/2. Before the Retirement Date, the Owner may change the Retirement Date to a later age (up to age 85). In such a case the Owner must withdraw at least the minimum distributions required under Sections 408(b) and 401(a)(9) of the Code and Treasury Regulations that apply. See Section 7.03 of this Appendix. SECTION 3.01 CONTRIBUTIONS: The following will also apply: Equitable will only accept Contributions which qualify as "eligible rollover amounts" within the meaning of Section 402(c) or 403(b)(8) of the Code, or "rollover contributions" from a "conduit" individual retirement account or annuity described in Section 408(d)(3)(A)(ii) and (iii) of the Code, as the case may be. If the Owner makes a Contribution which qualifies as an eligible retirement plan rollover within the meaning of Section 402(c) or 403(b)(8) of the Code and the Owner commingles such Contribution with other Contributions, the Owner may not be able to roll over the eligible retirement plan Contributions and earnings to another qualified plan or Code Section 403(b) arrangement at a future date, unless the Code permits. SECTION 4.02 TERMINATION OF COVERAGE UNDER THE CONTRACT: In the event that an annuity bought under the Contract fails to qualify as an annuity which meets the requirements of Section 408(b) of the Code, Equitable will have the right, upon receipt of notice of such fact, before the Retirement Date, to terminate coverage under the Contract. In that case, Equitable will pay the Annuity Account Value less a deduction for the part which applies to any Federal income tax payable by the Annuitant which would not have been payable with respect to an annuity which meets such requirements. SECTION 5.01 DEATH BENEFIT: If the Annuitant is married at the Annuitant's death before the Retirement Date, and the Annuitant's spouse is named as death beneficiary, the Annuitant's spouse will be treated as the contingent annuitant (Annuitant and Owner) under the Certificate. Payment of the death benefit is subject to Section 7.03 of this Appendix. No.11993AC-C Page 25 SECTION 5.02 OWNER DEATH DISTRIBUTION RULES: This Section does not apply to IRA Certificates. SECTION 5.03 BENEFICIARY - SUCCESSOR OWNER: Section 5.03 is deleted and the following inserted in its place. SECTION 5.03 BENEFICIARY On the application, the Owner gives Equitable the name of the beneficiary who is to receive any death benefit payable on the Annuitant's death. The Owner may change the beneficiary from time to time during the Annuitant's lifetime and while coverage under the Contract is in force. Any such change must be made in writing in a form Equitable accepts. A change will, upon receipt at the Processing Office, take effect as of the date the written form is signed, whether or not the Owner is living on the date of receipt. Equitable will not be liable as to any payments it made before it receives any such change. On the application the Owner may name a person to be primary beneficiary on the Annuitant's death and another person to be contingent beneficiary if the primary beneficiary dies before the Annuitant. Unless the Owner directs otherwise, if the Owner has named two or more persons as beneficiary, the beneficiary will be the named person or persons who survive the Annuitant. If more than one survive, they will share equally. Any part of a death benefit payable as described in Section 5.01 for which there is no named beneficiary living at the Annuitant's death will be payable in a single sum to the Annuitant's children who survive the Annuitant. The payments will be made in equal shares, or should none survive, then to the Annuitant's estate. If the Owner so chooses in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity chosen by the Owner, subject to Equitable's rules then in effect. If at the Annuitant's death there is no choice in effect, the beneficiary may make such a choice. SECTION 6.01 WITHDRAWAL CHARGES: Section 6.01 describes the events under which a withdrawal charge will not apply. The event below is added: (vi) a request is made for a refund of a Contribution in excess of amounts allowed to be contributed under Section 219 and/or Section 408 of the Code within one month of the date on which the Contribution is made. SECTION 7.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS: Section 7.03 of this Contract refers to the Normal Form of annuity which is payable. The Normal Form that applies under an IRA Certificate, in lieu of the form shown in said Section, is defined as follows: The term "Normal Form" of an Annuity Benefit means, (i) if the Annuitant has a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with the Annuitant's spouse as the contingent annuitant (with 100% of the Annuitant's monthly payment amount continued to the Annuitant's spouse), and (ii) if the Annuitant does not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. Also, the payment of Annuity Benefits as described in Section 7.03 is subject to the terms which follow, in order to comply with Section 401(a)(9) of the Code and the Treasury Regulations which apply. No.11993AC-C Page 26 The Annuitant's entire interest in the Certificate will be paid or begin to be paid no later than the April 1 which follows the calendar year in which the Annuitant attains age 70-1/2 ("Required Start Date"). The entire interest may be paid, as the Annuitant chooses, over (a) the Annuitant's life, or the lives of the Annuitant and the named beneficiary, or (b) a period certain which does not extend beyond the Annuitant's "life expectancy" (defined below), or the joint and last survivor expectancy of the Annuitant and the named beneficiary. Payments must be made in periodic payments at intervals no longer than one year. Also, payments must be either non-increasing or they may increase only as provided in Regulations (Q & A F-3 of Proposed Treasury Regulation Section 1.401(a)(9)-1 or successor). All payments made under the Certificate will be made in accordance with the requirements of Code Section 401(a)(9), including the incidental death benefit requirement of the Code (Section 401(a)(9)(G)) and Treasury Regulations which apply (Proposed Treasury Regulation Section 1.401(a)(9)-2). For purposes of the above, "life expectancy" is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless the Annuitant otherwise chooses before the time payments must begin, life expectancies will be recalculated each year. Such choice may never be changed and will apply to all years which follow. In the case of any named beneficiary other than the spouse, life expectancies will be calculated using the attained age of such beneficiary during the calendar year in which the Annuitant attains age 70 1/2 and payments for any calendar year which follows will be calculated based on life expectancy reduced by one for each calendar year which has passed since the calendar year life expectancy was first calculated. If the Annuitant dies after payment of the Annuitant's entire interest has begun, the remainder of such interest will continue to be paid at least as quickly as under the payment method of distribution being used before the Annuitant's death. If the Annuitant dies before payment of the Annuitant's entire interest begins, payment of the Annuitant's entire interest will be completed no later than December 31 of the calendar year in which the fifth anniversary of the Annuitant's death occurs, except to the extent that a choice is made to receive death benefit payments under (a) or (b) below. (a) If the Annuitant's interest is payable to a beneficiary, then the entire interest may be paid over the life of, or over a "period certain" not greater than the life expectancy of, the named beneficiary. Such payments must commence on or before December 31 of the calendar year which follows the year of the Annuitant's death. (b) If the named beneficiary is the Annuitant's surviving spouse, the date that payments must begin under (a) above will not be earlier than (i) December 31 of the calendar year which follows the year of the Annuitant's death or, if later, (ii) December 31 of the calendar year in which the Annuitant would have reached age 70-1/2. For purposes of the "period certain" used in (a) above, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of payments which begin after the Annuitant's death, unless the surviving spouse chooses otherwise by the time payments are required to begin, life expectancies will be recalculated each year. Such choice may never be changed by such spouse and will apply to all years which follow. In the case of any other named beneficiary, life expectancies will be calculated using the attained age of such beneficiary during the calendar year in which payments are required to begin, as described in this Section, and payments for any subsequent calendar year will be calculated based on life expectancy reduced by one for each calendar year which has passed since the calendar year life expectancy was first calculated. Payments under this Section are deemed to have begun if payments are made because the Annuitant has reached the Required Start Date or if, before the Required Start Date, payments No.11993AC-C Page 27 commence to the Annuitant over a period permitted and in an annuity form acceptable under proposed Treasury Regulation 1.401(a)(9)-1 or any successor. SECTION 8.05 ANNUAL REPORTS: Section 8.05 lists the reports Equitable will send the Annuitant. Equitable will also send a report as of the end of each calendar year showing the status of the annuity and any other reports required by the Code or Treasury Regulations. SECTION 8.06 CHANGE OF OWNER: The Owner may not name a new owner. SECTION 8.07 ASSIGNMENTS: In addition to the restrictions on assignments described in Section 8.07, the Annuitant's entire interest under the Certificate is not transferable except by surrender to Equitable. Further, the Annuitant's interest under the Certificate is non-forfeitable. APPENDIX B In lieu of the Tables of Guaranteed Annuity Payments, the attached "Appendix B-IRA" applies. No.11993AC-C Page 28 APPENDIX A-SEP APPLICABLE TO SEP CERTIFICATES The terms of this Appendix apply with respect to SEP Certificates. If a SEP Certificate applies, then it is established for the exclusive benefit of the Annuitant and the Annuitant's beneficiaries, and the terms below change, or are added to, the stated Sections of this Contract. SECTION 1.17 OWNER: The Owner of a SEP Certificate will be the Annuitant. SECTION 1.19 RETIREMENT DATE: Section 1.19 of this Contract defines the "Retirement Date." No initial choice of Retirement Date may be later than age 70-1/2. Before the Retirement Date, the Owner may change the Retirement Date to a later age (up to age 85). In such a case the Owner must withdraw at least the minimum distributions required under Sections 408(b) and 401(a)(9) of the Code and Treasury Regulations that apply. See Section 7.03 of this Appendix. SECTION 3.01 CONTRIBUTIONS: Section 3.01 states that an initial Contribution of less than $1,000 may not be accepted. This does not apply to SEP Certificates. The following will also apply: Contributions are not fixed and may be made at any time and in any amount of at least $50. No contributions will be accepted unless thay are in cash. Except in the case of a rollover contribution (as permitted by Sections 402(c), 403(a)(4), 403(b)(8), or 408(d)(3) of the Code), or a Contribution made under the terms of a Simplified Employee Pension as contained in Section 408(k) of the Code, the total of such Contributions will not exceed $2,000 for any taxable years. Amounts transferred to the Contract from an individual retirement account or annuity contract which meets the requirements of Section 408 of the Code are not subject to the $2,000 limit. If the Owner makes a Contribution which qualifies as an eligible retirement plan rollover within the meaning of Section 402(c) or 403 (b)(8) of the Code and the Owner commingles such Contribution with other Contributions, the Owner may not be able to roll over the eligible retirement plan Contributions and earnings to another qualified plan or Code Section 403(b) arrangement at a future date, unless the Code permits. SECTION 4.02 TERMINATION OF COVERAGE UNDER THE CONTRACT: In the event that an annuity bought under the Contract fails to qualify as an annuity which meets the requirements of Section 408(b) of the Code, Equitable will have the right, upon receipt of notice of such fact, before the Retirement Date, to terminate coverage under the Contract. In that case, Equitable will pay the Annuity Account Value less a deduction for the part which applies to any Federal income tax payable by the Annuitant which would not have been payable with respect to an annuity which meets such requirements. SECTION 5.01 DEATH BENEFIT: If the Annuitant is married at the Annuitant's death before the Retirement Date, and the Annuitant's spouse is named as death beneficiary, the Annuitant's spouse will be treated as the contingent annuitant (Annuitant and Owner) under the Certificate. Payment of the death benefit is subject to Section 7.03 of this Appendix. No.11993AC-C Page 29 SECTION 5.02 OWNER DEATH DISTRIBUTION RULES: This Section does not apply to SEP Certificates. SECTION 5.03 BENEFICIARY - SUCCESSOR OWNER: Section 5.03 is deleted and the following inserted in its place. SECTION 5.03 BENEFICIARY On the application, the Owner gives Equitable the name of the beneficiary who is to receive any death benefit payable on the Annuitant's death. The Owner may change the beneficiary from time to time during the Annuitant's lifetime and while coverage under the Contract is in force. Any such change must be made in writing in a form Equitable accepts. A change will, upon receipt at the Processing Office, take effect as of the date the written form is signed, whether or not the Owner is living on the date of receipt. Equitable will not be liable as to any payments it made before it receives any such change. On the application the Owner may name a person to be primary beneficiary on the Annuitant's death and another person to be contingent beneficiary if the primary beneficiary dies before the Annuitant. Unless the Owner directs otherwise, if the Owner has named two or more persons as beneficiary, the beneficiary will be the named person or persons who survive the Annuitant. If more than one survive, they will share equally. Any part of a death benefit payable as described in Section 5.01 for which there is no named beneficiary living at the Annuitant's death will be payable in a single sum to the Annuitant's children who survive the Annuitant. The payments will be made in equal shares, or should none survive, then to the Annuitant's estate. If the Owner so chooses in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity chosen by the Owner, subject to Equitable's rules then in effect. If at the Annuitant's death there is no choice in effect, the beneficiary may make such a choice. SECTION 6.01 WITHDRAWAL CHARGES: Section 6.01 describes the events under which a withdrawal charge will not apply. The events below are added: (vi) a request is made for a refund of a Contribution which exceeds the amounts which may be contributed pursuant to Section 219 and/or 408 of the Code and the request for a refund is received within one month of the date on which such Contribution was made, or (vii) a distribution of deferrals disallowed by reason of failure to meet the requirements of Section 408(k)(6)(A)(ii) of the Code, including income thereon and less any loss allowable thereto, is made no later than April 15 following the calendar year of the notification by the Annuitant's employer of such disallowance, or (viii) a distribution of "excess contributions," as such term is defined in Section 408(k)(6)(C)(ii) of the Code, including the income thereon and less any loss allowable thereto, is made no later than the end of the plan year of the Simplified Employee Pension following the plan year in which such excess contributions were made, or (ix) a distribution of "excess deferrals" as such term is defined in Section 402(g)(2) of the Code, including income thereon and less any loss allowable thereto, is made no later than April 15 following the year in which such excess deferrals were made. No.11993AC-C Page 30 SECTION 7.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS: Section 7.03 of this Contract refers to the Normal Form of annuity which is payable. The Normal Form that applies under a SEP Certificate, in lieu of the form shown in said Section, is defined as follows: The term "Normal Form" of an Annuity Benefit means, (i) if the Annuitant has a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with the Annuitant's spouse as the contingent annuitant (with 100% of the Annuitant's monthly payment amount continued to the Annuitant's spouse), and (ii) if the Annuitant does not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. Also, the payment of Annuity Benefits as described in Section 7.03 is subject to the terms which follow, in order to comply with Section 401(a)(9) of the Code and the Treasury Regulations which apply: The Annuitant's entire interest in the Certificate will be paid or begin to be paid no later than the April 1 which follows the calendar year in which the Annuitant attains age 70-1/2 ("Required Start Date"). The entire interest may be paid, as the Annuitant chooses, over (a) the Annuitant's life, or the lives of the Annuitant and the named beneficiary, or (b) a period certain which does not extend beyond the Annuitant's "life expectancy" (defined below), or the joint and last survivor expectancy of the Annuitant and the named beneficiary. Payments must be made in periodic payments at intervals no longer than one year. Also, payments must be either non-increasing or they may increase only as provided in Regulations (Q & A F-3 of Proposed Treasury Regulation Section 1.401(a)(9)-1 or successor). All payments made under the Certificate will be made in accordance with the requirements of Code Section 401(a)(9), including the incidental death benefit requirement of the Code (Section 401(a)(9)(G)) and Treasury Regulations which apply (Proposed Treasury Regulation Section 1.401(a)(9)-2). For purposes of the above, "life expectancy" is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless the Annuitant otherwise chooses before the time payments must begin, life expectancies will be recalculated each year. Such choice may never be changed and will apply to all years which follow. In the case of any named beneficiary other than the spouse, life expectancies will be calculated using the attained age of such beneficiary during the calendar year in which the Annuitant attains age 70 1/2 and payments for any calendar year which follows will be calculated based on life expectancy reduced by one for each calendar year which has passed since the calendar year life expectancy was first calculated. If the Annuitant dies after payment of the Annuitant's entire interest has begun, the remainder of such interest will continue to be paid at least as quickly as under the payment method of distribution being used before the Annuitant's death. If the Annuitant dies before payment of the Annuitant's entire interest begins, payment of the Annuitant's entire interest will be completed no later than December 31 of the calendar year in which the fifth anniversary of the Annuitant's death occurs, except to the extent that a choice is made to receive death benefit payments under (a) or (b) below. (a) If the Annuitant's interest is payable to a beneficiary, then the entire interest may be paid over the life of, or over a "period certain" not greater than the life expectancy of, the named beneficiary. Such payments must commence on or before December 31 of the calendar year which follows the year of the Annuitant's death. (b) If the named beneficiary is the Annuitant's surviving spouse, the date that payments must begin under (a) above will not be earlier than (i) December 31 of the calendar year No. 11993AC-C Page 31 which follows the year of the Annuitant's death or, if later, (ii) December 31 of the calendar year in which the Annuitant would have reached age 70-1/2. For purposes of the "period certain" used in (a) above, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of payments which begin after the Annuitant's death, unless the surviving spouse chooses otherwise by the time payments are required to begin, life expectancies will be recalculated each year. Such choice may never be changed by such spouse and will apply to all years which follow. In the case of any other named beneficiary, life expectancies will be calculated using the attained age of such beneficiary during the calendar year in which payments are required to begin, as described in this Section, and payments for any subsequent calendar year will be calculated based on life expectancy reduced by one for each calendar year which has passed since the calendar year life expectancy was first calculated. Payments under this Section are deemed to have begun if payments are made because the Annuitant has reached the Required Start Date or if, before the Required Start Date, payments commence to the Annuitant over a period permitted and in an annuity form acceptable under proposed Treasury Regulation 1.401(a)(9)-1 or any successor. SECTION 8.05 ANNUAL REPORTS: Section 8.05 lists the reports Equitable will send the Annuitant. Equitable will also send a report as of the end of each calendar year showing the status of the annuity and any other reports required by the Code or Treasury Regulations. SECTION 8.06 CHANGE OF OWNER: The Owner may not name a new owner. SECTION 8.07 ASSIGNMENTS: In addition to the restrictions on assignments described in Section 8.07, the Annuitant's entire interest under the Certificate is not transferable except by surrender to Equitable. Further, the Annuitant's interest under the Certificate is non-forfeitable. SECTION 8.08 AGE AND SEX A misstatement of the sex of any person upon whose life an Annuity Benefit depends does not apply, since the Annuity Benefit tables which apply, as shown in "Appendix B-SEP", has the same values for both sexes. APPENDIX B In lieu of the Tables of Guaranteed Annuity Payments, the attached "Appendix B-SEP" applies. No.11993AC-C Page 32 APPENDIX B-IRA APPLICABLE TO IRA CERTIFICATES TABLES OF GUARANTEED ANNUITY PAYMENTS The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract on the Joint and Survivor Life Annuity Form (with 100% of the amount of the Annuitant's payment continued to the Annuitant's spouse). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on 3.0% interest and the 1983 Individual Annuity Table "a" projected with modified Scale "G." The amount of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and the Joint and Survivor Life Annuity Form are based on the 1983 Individual Annuity Table "a" projected with modified Scale "G" and a modified two year age set back, and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section 7.02. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on the same actuarial basis.
TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE (Minimum Monthly Income per $1,000 of Annuity Account Value) Female Ages ----------- Age 60 61 62 63 64 65 66 67 68 69 70 60 3.86 3.90 3.93 3.97 4.01 4.05 4.08 4.12 4.15 4.19 4.22 61 3.88 3.92 3.96 4.00 4.04 4.08 4.12 4.16 4.19 4.23 4.27 62 3.91 3.95 3.99 4.03 4.07 4.11 4.15 4.19 4.23 4.27 4.31 63 3.93 3.97 4.01 4.06 4.10 4.14 4.19 4.23 4.28 4.32 4.36 Male 64 3.95 3.99 4.04 4.08 4.13 4.18 4.22 4.27 4.32 4.36 4.41 Ages 65 3.97 4.02 4.06 4.11 4.16 4.21 4.26 4.31 4.35 4.40 4.45 ---- 66 3.99 4.04 4.09 4.14 4.19 4.24 4.29 4.34 4.39 4.45 4.50 67 4.01 4.06 4.11 4.16 4.21 4.27 4.32 4.38 4.43 4.49 4.54 68 4.02 4.08 4.13 4.18 4.24 4.30 4.35 4.41 4.47 4.53 4.59 69 4.04 4.10 4.15 4.21 4.26 4.32 4.38 4.44 4.51 4.57 4.63 70 4.06 4.11 4.17 4.23 4.29 4.35 4.41 4.48 4.54 4.61 4.67
No.11993AC-C Page 33 ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1000 of Annuity Value) VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM IF ASSUME BASE RATE OF NET INVESTMENT RETURN IS: 3.5% 5.0% ---- ---- Age Males Females Males Females --- ----- ------- ----- ------- 60 4.88 4.41 5.79 5.32 61 4.97 4.48 5.88 5.39 62 5.07 4.55 5.98 5.46 63 5.17 4.63 6.08 5.54 64 5.28 4.72 6.19 5.62 65 5.40 4.81 6.31 5.71 66 5.52 4.90 6.43 5.80 67 5.66 5.00 6.56 5.90 68 5.80 5.11 6.71 6.00 69 5.95 5.22 6.86 6.11 70 6.11 5.34 7.02 6.23 No.11993AC-C Page 34 APPENDIX B-SEP APPLICABLE TO SEP CERTIFICATES TABLES OF GUARANTEED ANNUITY PAYMENTS The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract on the Joint and Survivor Life Annuity form (with 100% of the amount of the Annuitant's payment continued to the Annuitant's spouse). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on 3.0% interest and the 1983 Individual Annuity Table "a" projected with modified Scale "G" and adjusted to a unisex basis based on a 20%-80% split of males and females, at age 55. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and the Joint and Survivor Life Annuity Form are based on the 1983 Individual Annuity Table "a" projected with modified Scale "G," adjusted with a modified two year age set back and a 20%-80% split of males and females, at age 55 and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section 7.02. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by Equitable on the same actuarial basis.
TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE (Minimum Monthly Income per $1,000 of Annuity Account Value) Age 60 61 62 63 64 65 66 67 68 69 70 60 3.79 3.82 3.84 3.87 3.90 3.92 3.95 3.97 4.00 4.02 4.04 61 3.85 3.87 3.90 3.93 3.96 3.99 4.02 4.04 4.07 4.09 62 3.91 3.94 3.97 4.00 4.03 4.06 4.09 4.11 4.14 63 3.97 4.00 4.04 4.07 4.10 4.13 4.16 4.19 64 4.04 4.07 4.11 4.14 4.18 4.21 4.24 65 4.11 4.15 4.19 4.22 4.26 4.29 66 4.19 4.23 4.27 4.30 4.34 67 4.27 4.31 4.35 4.39 68 4.36 4.40 4.44 69 4.45 4.50 70 4.55
No.11993AC-C Page 35 ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1000 of Annuity Value) VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS: --------------------------------- 3.5% 5.0% ---- ---- AGE --- 60 4.49 5.41 61 4.57 5.48 62 4.65 5.56 63 4.73 5.64 64 4.82 5.73 65 4.91 5.82 66 5.01 5.91 67 5.12 6.02 68 5.23 6.13 69 5.35 6.24 70 5.48 6.37 No.11993AC-C Page 36 (EQUITABLE LOGO) CERTIFICATE THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES ("Equitable") Processing Office: Individual Annuity Center, P.O. Box 2995, G.P.O. New York, New York 10116 This is the Certificate which is issued under the terms of the Contract defined in Section 1.10. This Certificate is issued in return for the application for coverage under the Contract and the Contributions to be made to us under the Contract. In this Certificate, "we", "our" and "us" mean Equitable. "You" and "your" mean the Owner. We will provide the benefits and other rights pursuant to the terms of the Certificate. TEN DAYS TO CANCEL - Not later than ten days after you receive this Certificate, you may return it to us. We will cancel it and refund any Contribution made to us, plus or minus any investment gain or loss which applies to the Investment Divisions of the Separate Account from the date such Contribution was allocated to such Division to the date of cancellation. /s/ Joseph J. Melone /s/ Richard H. Jenrette President and Chairman Joseph J. Melone Chief Executive Richard H. Jenrette of the Officer Board /s/ Molly K. Heines Vice President Molly K. Heines and Secretary THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE (SEE PART II OF THIS CERTIFICATE). THE AMOUNT OF ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY BENEFIT MAY INCREASE OR DECREASE, BASED ON THE INVESTMENT EXPERIENCE OF THE STOCK DIVISION (SEE SECTION 7.02). No. 11993AC CPA THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES NEW YORK, NEW YORK The provisions on the following pages are part of this Certificate. TABLE OF CONTENTS Page PART I - DEFINITIONS 4 PART II - DIVISIONS 6 PART III - CONTRIBUTIONS AND TRANSFERS 7 PART IV - WITHDRAWALS AND TERMINATIONS 8 PART V - DEATH BENEFITS 9 PART VI - CHARGES 11 PART VII - ANNUITY BENEFITS 12 PART VIII - GENERAL PROVISIONS 15 APPENDIX 18 No. 11993AC Page 2 Owner: Annuitant: Certificate Number: Issue Date: Contract Date: Retirement Date: Initial Guaranteed Interest Rate: Beneficiary: Endorsement: [None IRA QPIRA SEP] TABLES OF GUARANTEED VALUES Table A Table B ------- ------- Guaranteed Guaranteed Paid Up Cash Value Monthly Annuity At Age 65 ---------- ------------------------- The tables illustrate minimum guaranteed values. They assume a $1,000 Contribution made each year on the first of the month which follows the Contract Date. Table A reflects an administrative charge (see Section 6.03) and a withdrawal charge (see Section 6.01). The tables assume that 100% of all Contributions and earnings are in the Guaranteed Interest Division. Your actual values may differ from those shown above based on the level [and frequency] of your Contributions. The guaranteed paid-up monthly annuity shown in Table B will be reduced by any charge we make for any taxes (see Section 7.02). Other forms of Annuity Benefits may be available. No. 11993AC Page 3 PART I - DEFINITIONS SECTION 1.01 ACCUMULATION UNIT "Accumulation Unit" means a unit which is purchased in an Investment Division of the Separate Account. SECTION 1.02 ACCUMULATION UNIT VALUE "Accumulation Unit Value" means the dollar value of each Accumulation Unit in an Investment Division of the Separate Account on a given date. SECTION 1.03 ANNUITANT. "Annuitant" means the person shown as such on page 3 of this Certificate, and on whose life this Certificate is based, or any successor annuitant. SECTION 1.04 ANNUITY ACCOUNT VALUE. "Annuity Account Value" means the sum of the amounts held for you in the Guaranteed Interest Division and the Investment Divisions of the Separate Account. SECTION 1.05 ANNUITY BENEFIT. "Annuity Benefit" means a benefit payable by us as described in Part VII of this Certificate. SECTION 1.06 BUSINESS DAY. A "business day" is any day on which we are open and the New York Stock Exchange is open for trading. SECTION 1.07 CASH VALUE. "Cash Value" means an amount equal to the Annuity Account Value, less any withdrawal charge that applies as described in Section 6.01. SECTION 1.08 CERTIFICATE. "Certificate" means this Certificate, including any Endorsements. SECTION 1.09 CODE. "Code" means the Internal Revenue Code of 1986, as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.10 CONTRACT. "Contract" means Group Annuity Contract No. AC 0000 issued by us to United States Trust Company of New York. This Certificate reflects the terms of the Contract. SECTION 1.11 CONTRACT DATE. "Contract Date" means the date on which the Annuitant is enrolled under the Contract. That is, it is the date we have received both a Contribution and the completed application form which is provided by us. No. 11993AC Page 4 SECTION 1.12 CONTRACT YEAR. "Contract Year" means the twelve month period starting on (i) the Contract Date and (ii) each anniversary of the Contract Date, unless we agree to another period. SECTION 1.13 CONTRIBUTION. "Contribution" means a payment made to us under the Contract. See Section 3.01. SECTION 1.14 DIVISION. "Division" means the Guaranteed Interest Division or an Investment Division of the Separate Account. Each Division is described in Part II of this Certificate. SECTION 1.15 GUARANTEED INTEREST RATE. "Guaranteed Interest Rate" means the effective annual rates at which interest accrues on the amount in the Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of this Certificate. Section 2.01 describes how the rates are set after the initial rate. SECTION 1.16 OWNER. "Owner" means the person shown as such on page 3 of this Certificate or any successor owner. SECTION 1.17 PROCESSING OFFICE. "Processing Office" means Equitable Individual Annuity Center, P.O. Box 2996, New York, New York 10116, or such other location as we may designate upon advance written notice to you. SECTION 1.18 RETIREMENT DATE. "Retirement Date" means the date on which the Annuitant attains the retirement age shown on page 3 of this Certificate. Before the Retirement Date you may choose to change such Date to another Retirement Date. The changed Date may be any date after your choice is filed (other than the 29th, 30th or 31st day of any month). You must do this in writing. The change will not take effect until your written choice is received and accepted at our Processing Office. No Retirement Date will be later than the first of the month which follows the date the Annuitant attains our maximum maturity age (currently age 85) or, if later, the tenth anniversary of the Contract Date, unless changed by us to conform to any law which applies. SECTION 1.19 SEPARATE ACCOUNT. "Separate Account" means Separate Account A which is organized as a unit investment trust, a type of investment company. SECTION 2.20 TRANSACTION DATE. The Transaction Date is the Business Day we receive at the Processing Office a Contribution or a transaction request (in writing or by telephone) providing the information we need. (A request by telephone may be made subject to our requirements for telephone transactions.) Our Business Day ends at 4:00 P.M. Eastern Time. No. 11993AC Page 5 PART II - DIVISIONS SECTION 2.01 GUARANTEED INTEREST DIVISION. Any amount held in the Guaranteed Interest Division (see Section 3.01) becomes part of our general assets, which support the guarantees of the Contract and other contracts. The amount in such Division at any time is equal to: o all amounts that have been allocated or transferred to such Division, plus o the amount of any interest accrued but not allocated, less o the sum of all amounts that have been withdrawn or transferred from such Division. We will credit the amount you have in such Division with interest at effective annual rates that we set. Each calendar year we also set a yearly Guaranteed Interest Rate that will remain in effect through the next calendar year. We guarantee that this yearly rate will never be less than 3%. SECTION 2.20 SEPARATE ACCOUNT. We established the Separate Account and maintain it in accordance with the laws of New York State. Realized and unrealized gains and losses from the assets of the Separate Account are credited or charged against it without regard to our other income, gains or losses. Assets are put in the Separate Account to support this Contract and other variable annuity contracts and certificates. Assets may be put in the Separate Account for other purposes, but not to support contracts or policies other than variable annuities and variable life insurance. The Separate Account consists of "Investment Divisions." (The Guaranteed Interest Division is not a part of Separate Account A.) Each Investment Division may invest its assets in a separate class (or series) of shares of a specified trust or investment company where each class (or series) represents a separate portfolio in the specified trust or investment company. The Investment Divisions are: (a) "Type A" Investment Divisions: the Stock Division; the Balanced Division; the Aggressive Division; the Global Division; the Growth Investors Division; and (b) "Type B" Investment Divisions: the Conservative Investors Division; the Money Market Division; Divisions may be added or removed as described in Section 8.03 We will value the assets of each Investment Division on each Business Day. The assets of the Separate Account are our property. The portion of its assets equal to the reserves and other liabilities with respect to Certificates issued under the Contract will not be chargeable with liabilities which arise out of any other business we conduct. We may transfer assets of an Investment Division in excess of the reserves and other liabilities with respect to such Division to another Investment Division or to our General Account. No. 11993AC Page 6 We may, at our discretion, invest the assets of any Investment Division in any investment which applicable law permits. We may rely conclusively on the opinion of counsel (including counsel in our employ) as to what investments we may make as law permits. SECTION 2.03 SEPARATE ACCOUNT INVESTMENT DIVISIONS. The amount you have in an Investment Division at any time is equal to the number of Accumulation Units you have in that Division multiplied by the Division's Accumulation Unit Value at that time. Amounts allocated or transferred to an Investment Division are used to purchase Accumulation Units of that Division. Units are redeemed when amounts are deducted, transferred or withdrawn. The number of Accumulation Units you have in an Investment Division at any time is equal to the number of Accumulation Units purchased minus the number of Units redeemed in that Division up to that time. The number of Accumulation Units purchased or redeemed in a transaction is equal to the dollar amount of the transaction divided by the Division's Accumulation Unit Value for that Transaction Date. We determine Accumulation Unit Values for each Investment Division for each Valuation Period. A Valuation Period is each Business day together with any consecutive preceding non-business days. For example, for each Monday which is a Business day, the preceding Saturday and Sunday will be included to equal a three-day Valuation Period. The Accumulation Unit Value of an Investment Division for any Valuation Period is equal to the Accumulation Unit Value for that Division on the immediately preceding Valuation Period multiplied by the Net Investment Factor for that Division for the current Valuation Period. The Net Investment Factor for a Valuation Period is (a) divided by (b) minus (c), where (a) is the value of the Investment Division's shares of the related portfolio of the specified trust or investment company at the end of the Valuation Period (before taking into account any amounts allocated to or withdrawn from the Investment Division for the Valuation Period and after deduction of investment advisory fees and direct operating expenses of the specified trust or investment company; for this purpose, we use the share value reported to us by the specified trust or investment company); (b) is the value of the Investment Division's shares of the related portfolio of the specified trust or investment company at the end of the preceding Valuation Period (taking into account any amounts allocated or withdrawn for that Valuation Period); (c) is the daily Separate Account charge (see Section 6.04) for the expenses of the Contract, times the number of calendar days in the Valuation Period, plus any charge for taxes or amounts set aside as a reserve for taxes. PART III - CONTRIBUTIONS AND TRANSFERS SECTION 3.01 CONTRIBUTIONS. On the application form you choose which Divisions will be available under your Certificate (the Guaranteed Interest Division is always available). Once this choice is made, you may only allocate Contributions to, or transfer among, these Divisions. You may add or subtract Divisions after the Certificate is issued to you by sending us a written request, but we have the right to decline your request. On the application form you will also choose how to allocate your Contributions among the Divisions you have chosen. You need not allocate Contributions to each Division that you have chosen. You No. 11993AC Page 7 may change your allocation instruction at any time by sending us the proper form. Allocation percentages must be in whole numbers (no fractions) and must equal 100%. Each Contribution is allocated (after deduction of any tax charge that applies) in accordance with the allocation instructions in effect. Contributions made to an Investment Division purchase Accumulation Units in that Division, using the Accumulation Unit Value next computed after the Transaction Date. We have the right not to accept an initial Contribution of less than [$1,000] or, for payroll deductions and any subsequent Contributions, a Contribution of less than [$50]. We may refuse to accept any Contribution if such Annuitant's current age at last birthday is 80 or greater. In addition, we may refuse to accept a Contribution if the total Contributions would exceed: (a) [$500,000,] if the Annuitant's current age at last birthday is 75 or less. (b) [$250,000,] if the Annuitant's current age at last birthday is 76-79. We have the right to further limit Contributions as described in Section 8.03. SECTION 3.03 TRANSFERS AMONG DIVISIONS. You may request a transfer of all or part of the amount you have in a Division to one or more of the Divisions. A transfer request may be made in writing. It may also be made by telephone, subject to our requirements for telephone requests. All transfers will be made on the Transaction Date and will be subject to our rules. With respect to the Investment Divisions, the transfers will be made at the Accumulation Unit value next computed after the Transaction Date. If you have chosen any combination of Divisions that include a Type B Investment Division described in Section 2.02 (whether or not amounts have actually been placed in any such Division), then the maximum amount which may be transferred in any Contract Year from the Guaranteed Interest Division to any other Division is: (a) [25%] of the amount you have in the Guaranteed Interest Division on the last day of the prior Contract Year or, if greater, (b) the total of all amounts transferred at your request from the Guaranteed Interest Division to any of the other Divisions in the prior Contract Year. We will to accept a request for a transfer of less than [$300], unless the Annuity Account Value is less than [$300]. We have the right to impose further restrictions on transfers. See Section 8.03. PART IV WITHDRAWALS AND TERMINATION SECTION 4.01 PARTIAL WITHDRAWALS. You may make a written request to us for a partial withdrawal from the Divisions before the Retirement Date and while the Annuitant is alive. On the Transaction Date, we will pay the amount requested or, if less, the Cash Value. The amount to be paid plus any withdrawal charge that applies (see Section 6.01) will be withdrawn on a pro-rate basis from the amounts you have in the Divisions, unless you choose otherwise. We will not accept a request for a partial withdrawal of less than $300, unless the Annuity Account Value is less than $300. Also, if a withdrawal made under this Section would result in an Annuity Account Value of less than $500, we will so advise you and have the right to pay the Annuity Account Value to you, and coverage under the Contract will be terminated. No. 11993AC Page 8 SECTION 4.02 TERMINATION OF COVERAGE UNDER THE CONTRACT. On or before the Annuitant's Retirement Date, and while the Annuitant is alive, you may choose to terminate coverage under the Contract. You must do so in writing. We will determine the Cash Value to be paid as of the Transaction Date. No withdrawal charge will be applied if the amount withdrawn is used to provide a life annuity offered by us or one of our affiliated or subsidiary life insurance companies. If coverage is terminated before the Retirement Date, a charge for any taxes that we have paid may be deducted. If we have previously deducted charges for taxes from Contributions as described in Section 3.01, we will not again deduct charges for the same taxes on termination. Before the Retirement Date, we have the right to pay the Cash Value under the Contract and terminate coverage if (i) no Contributions are made during the last three completed Contract Years, or (ii) after three Contract Years the Annuity Account Value is less than $500. We also have the right to terminate coverage under the Contract if no Contributions have been made within 120 days of the Contract Date shown on page 3 of this Certificate. PART V - DEATH BENEFITS SECTION 5.01 DEATH BENEFIT. Unless your surviving spouse becomes the Annuitant under Section 5.02, upon receipt of due proof of the Annuitant's death we will pay a death benefit to the beneficiary named under Section 5.03. The amount of the death benefit payable is equal to (a) the Annuity Account Value or, if more, (b) the minimum death benefit. The minimum death benefit is the sum of all Contributions made (less any tax charges that apply) and less the total of any withdrawals made as described in Section 4.01. We will pay the death benefit to the beneficiary in the form of an Annuity Benefit if you have chosen the form described in the last paragraph of Section 5.03. Also pursuant to the last paragraph of Section 5.03, if no such choice has been made at the Annuitant's death, we will pay the death benefit to the beneficiary in a single sum. However, the beneficiary may instead choose before we pay the death benefit to apply the death benefit to provide (i) a form of an Annuity Benefit, (ii) any other form of benefit payment, (iii) any combination of forms of benefit payment. All choices will be subject to the forms we then offer, our rules then in effect, and any requirements under the Code. SECTION 5.02 OWNER DEATH DISTRIBUTION RULES. Upon the death of the Owner before the Retirement Date: (i) If you are both the Owner and the Annuitant, we will pay the death benefit described in Section 5.01. If you are married at the date of your death before the Retirement Date and your spouse is the named beneficiary, your spouse will be the successor Owner and Annuitant and no death benefit will be payable at such time. (ii) If you are not the Annuitant, the named beneficiary (successor owner) described in Section 5.03 will succeed as Owner, even if any co-owner exists. The entire amount in the Divisions (subject to any withdrawal charges which apply) must be fully paid by the fifth anniversary of your death, or payments must begin within one year after your death as a life annuity or installment option, for a period of not longer than the life expectancy of the named beneficiary. If you have not chosen a form of payment described in the last paragraph of Section 5.03, and if the beneficiary named under Section 5.03 does not choose to receive the payments required by this Section in a form of Annuity Benefit, a series of No. 11993AC Page 9 partial withdrawals, or any payout option acceptable under Section 72(s) of the Code and our rules at the time, we will pay the amount in the Divisions in a single sum to the beneficiary on the fifth anniversary of your death. Subject to our rules at the time of payment and the completion of an application, the beneficiary may choose to apply such a single sum payment to a new nonqualified annuity contract to be owned by the beneficiary. However, if the named beneficiary is your spouse, full payments of amounts under the Contract must be made no later than five years after the spouse's death. If payments under an Annuity Benefit had begun before your death, such payments will continue to be made over a period not longer than the period provided for under the Annuity Benefit chosen. If the Annuitant dies before the entire amount in the Divisions is paid, we will pay the death benefit as described in Section 5.01. SECTION 5.03 BENEFICIARY - SUCCESSOR OWNER. On the application, you give us the name of the beneficiary who is to receive any death benefit payable on the death of the Annuitant. Unless you direct otherwise, the person named as beneficiary on the death of the Annuitant will also be the person who succeeds as Owner on your death while the Annuitant is alive as described in Section 5.02. You may change any beneficiary or successor Owner from time to time during the Annuitant's lifetime and while coverage under the Contract is in force. Any such change must be made in writing in a form we accept. A change will, upon receipt at the Processing Office, take effect as of the date the written form was signed, whether or not you are living on the date of receipt. We will not be liable as to any payment we may make before we receive any such change. On the application you may name a person to be primary beneficiary on the death of the Annuitant under Section 5.01 and another person to be a contingent beneficiary if the primary beneficiary dies before the Annuitant. Also, if you are not the Annuitant, on the application you may name a person to be your successor Owner and to receive the amounts required to be paid under Section 5.02 (on your death before the Retirement Date while coverage under the Contract is in force) and another person to be successor Owner, if your first choice as successor Owner dies before you. Unless you direct otherwise, if you have named two or more persons as death benefit beneficiary, the beneficiary will be the named person or persons who survive the Annuitant. If more than one survive they will share equally. If you are not the Annuitant and you name two or more persons to succeed as Owner, the successor Owner will be the named person or persons who survive you, unless you direct otherwise. If more than one survive they will share equally, unless you direct otherwise. If you are the Annuitant, any part of a death benefit payable as described in Section 5.01 for which there is no named beneficiary living at your death will be payable in a single sum to your children who survive you. The payments will be made in equal shares, or should none survive then to your estate. If you are not the Annuitant, and if no beneficiary named to receive the death benefit payable as described in Section 5.01 survives the Annuitant, we will pay such death benefit in a single sum to you. In the event of your death after the Annuitant, but before we pay such death benefit, the death benefit will be payable in a single sum to your children who survive you, in equal shares, or should none survive, to your estate. If you are not the Annuitant and you die before the Retirement Date while the Annuitant is still living, and if no person is named as successor Owner to receive the amounts required to be paid as described in Section 5.02 is living at your death, such beneficiary will be presumed to be, in this order, (i) your surviving spouse, (ii) the Annuitant, (iii) your children who survive you, in equal shares, or (iv) your estate. No. 11993AC Page 10 If you so choose in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on a form of annuity chosen by you, subject to our rules then in effect. If at your death there is no choice in effect, the beneficiary may make such a choice. PART VI -- CHARGES SECTION 6.01 WITHDRAWAL CHARGES. If the amount of a withdrawal made under Section 4.01 or a termination payment made under Section 4.02 is more than the Free Corridor Amount (defined below), we will (a) first withdraw from such Divisions an amount equal to the Free Corridor Amount, and (b) then withdraw an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a withdrawal charge, if one applies. The withdrawal charge is equal to [6%] of the withdrawn Contributions which have been made in the current and five prior Contract Years. For the purposes of this Section, amounts withdrawn up to the Free Corridor Amount will not be deemed a withdrawal of any Contributions. Also, any excess withdrawals (those pursuant to item (b) in the first paragraph of this Section) will be deemed withdrawals of older Contributions first and more recent Contributions next: that is, Contributions will be withdrawn in the order they were made. "Free Corridor Amount" means an amount equal to 10% of the Annuity Account Value on the Transaction Date, minus the total of all prior withdrawals made as described in Section 4.01 in the current Contract Year. However, a withdrawal charge will not apply upon any of these events: (i) the Annuitant dies and a death benefit is payable to the beneficiary, or (ii) the receipt by us of a properly completed election form providing for the Annuity Account Value to be used to buy a life annuity as described in Section 7.03, or (iii) the Annuitant has qualified to receive Social Security disability benefits as certified by the Social Security Administration, or (iv) you give us proof which we accept that the Annuitant's life expectancy is six months or less (such proof must include, but is not limited to, certification by a licensed physician), or (v) the Annuitant has been confined to a nursing home for more than 90 days as verified by a licensed physician. A nursing home for this purpose means one which is (a) approved by Medicare as a provider of skilled nursing care service, or (b) licensed as a skilled nursing home by the state or territory in which it is located (it must be within the United States, Puerto Rico, U.S. Virgin Islands, or Guam) and it meets all of the following: o its main function is to provide skilled, intermediate, or custodial nursing care; o it provides continuous room and board to three or more persons; o it is supervised by a registered nurse or a licensed practical nurse; o it keeps daily medical records of each patient; o it controls and records all medications dispensed; and No 11993AC Page 11 o its primary service is other than to provide housing for residents. Moreover, the withdrawal charge will be reduced if needed in order to comply with any state law that applies. However, a charge for taxes that we have paid may be deducted from amounts withdrawn. If we have previously deducted charges for taxes from Contributions as described in Section 3.01, we will not again deduct charges for the same taxes on withdrawals. SECTION 6.02 CHARGE ON TRANSFER TO THIRD PARTY OR EXCHANGE. If you request us to make a direct transfer to a third party of amounts under your Certificate, or request that your Certificate be exchanged for another contract or certificate issued by another insurance company, we deduct both a withdrawal charge as described in Section 6.01 (if any) and a charge of [$25] for any such direct transfer or exchange. SECTION 6.03 ADMINISTRATIVE CHARGE. As of the last Business Day of each calendar quarter, we will deduct an administrative charge from the Annuity Account Value. Such charge is equal to: (i) for each calendar quarter during the first two Contract Years, [$6.00] or, if less, [0.50%] of the Annuity Account Value at the end of such quarter plus the amount of any withdrawals made as described in Section 4.01 during such quarter; (ii) for each calendar quarter during each Contract Year after the second Year, [$6.00.] The charge will be allocated among the Divisions pro-rata based on the amounts that you have in the Divisions. SECTION 6.04 DAILY SEPARATE ACCOUNT CHARGE. Assets of the Investment Divisions will be subject to a daily asset charge. This daily charge is for financial accounting and for death benefits, mortality risk, expenses and expense risk which we assume. Such charge will be applied after any deductions to provide for taxes and will be at a rate not to exceed a guaranteed annual rate of 1.35%. We have the right to charge less on a current basis. The charge will be made pursuant to item (c) of "Net Investment Factor" as defined in Section 2.03. PART VII - ANNUITY BENEFITS SECTION 7.01 FIXED ANNUITY BENEFIT. A "Fixed Annuity Benefit" is an Annuity Benefit under which the periodic payments are paid in a stated dollar amount. Payments under a Fixed Annuity Benefit are typically made monthly. You may choose to have the Annuity Benefit paid at other intervals, such as every three months, six months, or twelve months, instead of monthly, subject to our rules at the time you make the choice. This choice may be made at the time the Annuity Benefit form as described in Section 7.03 is chosen; in that event, all references in this Certificate to monthly payments will be deemed to mean payments at the frequency chosen. SECTION 7.02 VARIABLE ANNUITY BENEFIT. A "Variable Annuity Benefit" is an Annuity Benefit under which the dollar amount of the monthly payments may go up or down based on the investment experience of the Stock Division of the Separate Account. No. 11993AC Page 12 These terms apply to Variable Annuity Benefit payments: ANNUITY UNIT: The "Annuity Unit" is a unit used to determine amounts payable from the Stock Division under a Variable Annuity Benefit. ANNUITY UNIT VALUE: The "Annuity Unit Value" on August 27, 1981, was fixed at $1.26 and $1.52 for contracts with assumed base rates of net investment return of 5% and 3.5% a year, respectively. For any Valuation Period after such date, it is the Annuity Unit Value for the preceding Valuation Period times the Adjusted Net Investment Factor. ADJUSTED NET INVESTMENT FACTOR: The "Adjusted Net Investment Factor" for a Valuation Period is the Net Investment Factor for such Period reduced for each calendar day in the Valuation Period by: o .00013366 of the Net Investment Factor if the assumed base rate of net investment return is 5% a year; or o .00009425 of the Net Investment factor if the assumed base rate of net investment return is 3.5% a year. The assumed base rate of net investment return will be 5%, except in states where the laws that apply do not permit such rate. AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar month is equal to the average of the Annuity Unit Values for all Valuation Periods which end in such month. A Variable Annuity Benefit amount will go up if the average daily rate of investment return in the Stock Division is equivalent to more than 5% or 3.5% a year and will go down if such rate is equivalent to less than 5% or 3.5% a year. The daily rate of investment return is after deduction of charges described in Section 6.04, investment advisory fees and direct operating expenses related to the Separate Account. The amount of the first three monthly payments under any Variable Annuity Benefit is the amount that applies as described in the first paragraph of the attached Appendix. The amount of the fourth and each later monthly payment will be equal to the number of Annuity Units with respect to such benefit, times the Average Annuity Unit Value for the second calendar month preceding the due date of the payment. The number of Annuity Units with respect to a benefit is the number equal to: (a) the amount of the first monthly payment, divided by (b) the Annuity Unit Value for the Valuation Period which includes the due date of the first monthly payment. We will notify the payee how each Variable Annuity Payment is determined. SECTION 7.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of the Annuitant's Retirement Date, if the Annuitant is then living, the Annuity Account Value will be used to provide the Normal Form of Annuity Benefit (described below). However, you may instead choose (i) to receive the Cash Value in a single sum, (ii) to apply the Annuity Account Value or Cash Value, whichever applies as described in the first paragraph of Section 7.04, to provide an Annuity Benefit or any other form offered by us or one of our affiliated or subsidiary life insurance companies, or (iii) to apply the Cash Value to provide any other form of benefit payment offered by us, subject to our rules then in effect. At the time an Annuity Benefit is purchased, we will issue a supplementary contract which reflects the Annuity Benefit terms. We will provide notice and election forms to you not more than six months before the Retirement Date. No. 11993AC Page 13 If you choose to terminate coverage under the Contract as described in Section 4.02 before the Retirement Date, a choice may be made to receive any form of benefit payment offered by us, subject to our rules then in effect and any requirements of the Code which apply. We will have the right to require you to give us any information we need to provide an Annuity Benefit. We will be fully protected in relying on such information and need not inquire as to the accuracy or completeness of it. The following annuity forms will apply. We may offer other annuity forms as available from us or from one of our affiliated or subsidiary life insurance companies. NORMAL FORM. The term "Normal Form" of an Annuity Benefit means the Fixed Annuity Benefit payable on the Life - Period Certain Annuity Form, defined below. LIFE - PERIOD CERTAIN ANNUITY. The "Life - Period Certain Annuity" is an annuity payable on the Life Annuity Form, but with 10 years of payments guaranteed (10 years certain period). That is, if the Annuitant dies before the certain period has ended, payments will be paid to the beneficiary named to receive such payments for the balance of the certain period. JOINT AND SURVIVOR LIFE ANNUITY FORM. The "Joint and Survivor Life Annuity Form" is an annuity which provides monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be paid when only one of the persons is living will be equal to a percentage of the monthly amount that was paid while both were living. This percentage may be 50% or any higher percentage up to and including 100%, as chosen. The payments commence on the date as of which the Joint and Survivor Life Annuity Form is purchased and end with the last payment due before the death of the survivor. LIFE ANNUITY FORM. The "Life Annuity Form" is an annuity which provides monthly payments during the lifetime of the person upon whose life such payments depend. The payments commence on the date as of which the Life Annuity Form is purchased and end with the last payment due before the death of such person. PERIOD CERTAIN ANNUITY. The "Period Certain Annuity" is an annuity which does not involve life contingencies. It provides payments only for the period specified (usually 5, 10, 15, or 20 years, but other periods form 3 to 25 years are available from us) when the annuity is chosen. It does not permit any prepayment of the unpaid principal (that is, you cannot elect to receive part of the payments as a single sum payment with the rest paid in monthly annuity payments). SECTION 7.04 AMOUNT OF ANNUITY BENEFITS. If you choose as described in the first or third paragraph of Section 7.03 to have an Annuity Benefit paid in lieu of the Cash Value, the amount used to provide the Annuity Benefit will be (i) the Annuity Account Value if the annuity form chosen provides payments for a person's remaining lifetime or (ii) the Cash Value if the annuity form chosen does not provide such lifetime payments. The amount used to provide an Annuity Benefit may be reduced by a charge for any taxes which apply on annuity purchase payments. If we have previously deducted charges for taxes from Contributions as provided in Section 3.01, we will not again deduct charges for the same taxes before an Annuity Benefit is provided. The balance will be used to buy the Annuity Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments shown in the attached Appendix or (ii) our then current individual annuity rates, whichever rates would provide a larger benefit with respect to the payee. Regardless of the basis used, the Benefit will be governed by our supplementary contract which will be issued to you. After an Annuity Benefit is provided, the amounts you have in the Divisions and the Annuity Account Value will be zero. No. 11993AC Page 14 SECTION 7.05 CONDITIONS. We have the right to ask for proof acceptable to us that the person on whose life a benefit payment is based is alive when each payment is due. We will require proof of the age of any person on whose life an annuity form is based. If a benefit was based on information that is later found not to be correct, such benefit will be adjusted on the basis of the correct information. The adjustment will be made in the amount of the benefit payments, or any amount used to provide the benefit, or any combination. Overpayments by us will be charged against future payments. Underpayments will be added to future payments. Our liability is limited to the correct information and the actual amounts used to provide the benefits. If we receive proof acceptable to us that (i) a payee is not physically or mentally competent to receive such payment or is a minor, (ii) another person or an institution has custody of such payee, and (iii) no guardian, committee, or anyone else for the payee's estate has been appointed, we may make the payments to such other person or institution. In the case of a minor, the payments will not exceed $200. We will then have no further liability with respect to the payments so made. With respect to an annuity form providing payments for a period certain, you may name, and later change, a payee to receive future payments that fall due after the death of the person on whose life the payments are based. If the amount to be applied to provide payments is less than $2,000, or would result in an initial payment of less than $20, we may pay the amount to the payee in a single sum instead of as payments under the annuity form chosen. Payments under annuity forms with lifetime payments end with the last payment due before the death of the person on whose life the payments are based or the end of the period certain if later. PART VIII - GENERAL SECTION 8.01 CONTRACT. The Contract is the entire Contract between the parties. The terms of the Contract will govern with respect to our rights and obligations. The Contract may not be changed, nor may any of our rights or rules be waived, except in writing and by our authorized officer. The terms of the Contract may be changed by amendment or replacement upon agreement between the Contract holder and us without the consent of any other person. The benefits and values under the Contract will not be less than the minimum benefits required by any statute of the State in which a Certificate is delivered. SECTION 8.02 STATUTORY COMPLIANCE. We have the right to change the Contract without the consent of any other person in order to comply with laws and regulations which apply. Such right will include, but not be limited to, the right to conform the Contract and any Certificate to reflect changes in the Code, applicable Treasury Regulations, or published rulings of the Internal Revenue Service in order that each Certificate issued under the Contract will continue to be an "annuity" as described in Section 72, or other Section which applies, of the Code. No. 11993AC Page 15 SECTION 8.03 RIGHTS TO CHANGE. We have the following rights to change certain terms of the Contract and this Certificate: a. upon at least 90 advance notice to you: (i) to establish or change minimum and maximum amounts which may apply to Contributions; (ii) to establish or change restrictions on transfers among Divisions; (iii) to change any charge described in Section 6.01, 6.02 or 6.03, such as withdrawal charges and those related to the administrative functions covered by such charges, at any time to reflect any change in our expenses, subject to any law that applies; (iv) to change at any time on and after the fifth anniversary of the Contract Date, at intervals of not less than five years, the actuarial basis used in the Tables of Guaranteed Annuity Payments shown in the attached Appendix (no such change will apply to any Annuity Benefit provided before the change). b. with respect to the Separate Account: (i) to add Investment Divisions (or sub-divisions) to, or to remove Divisions (or sub-divisions) from, the Separate Account, or to add other separate accounts or investment funds; (ii) to combine any two or more Investment Divisions or sub-divisions; (iii) to transfer the assets we determine to be the share of the class of contracts to which the Certificates issued under the Contract belong from any Investment Division to another Investment Division; (iv) to operate the Separate Account or any Investment Division as a management investment company under the Investment Company Act of 1940 (the "Act"); (v) to deregister the Separate Account under the Act, provided that such action conforms with the terms of any law which applies; (vi) to restrict or eliminate any voting rights as to the Separate Account; (vii) to cause one or more Investment Divisions to invest some or all of their assets in one or more other trusts or investment companies. If the exercise of these rights results in a material change in the underlying investments of an Investment Division, you will be notified of such exercise, as required by law. Any such change will be made only if we are doing so under all Certificates issued under the Contract. SECTION 8.04 DEFERMENT. The use of proceeds to provide a Variable Annuity, payment of a death benefit under Section 5.01 or 5.02 and payment of any portion of your Annuity Account Value (less any withdrawal charge) will be made within seven days after the Transaction Date. Payments or use of proceeds from the Investment Divisions can be deferred for any period during which (1) the New York Stock Exchange is closed or trading is restricted, (2) sales of securities or determination of the fair value of an Investment Division's assets is not reasonably practicable because of an emergency, or (3) the Securities and Exchange Commission, by order, permits us to defer payment in order to protect persons with interests in the Investment Divisions. We can defer payment or transfer of any portion No. 11993AC Page 16 of the Annuity Account Value in the Guaranteed Interest Division for up to six months while you are living. SECTION 8.05 ANNUAL REPORTS. At the end of each Contract Year until the Retirement Date, we will send you a report showing: (1) the dollar amount in the Guaranteed Interest Division, (2) the total number of Accumulation Units in each Investment Division, (3) the Accumulation Unit Value, (4) the dollar amount in each Investment Division, (5) the Cash Value, and (6) the amount of the death benefit. Also, after the Retirement Date, we will notify you of the number of Annuity Units and the Average Annuity Unit Value used to determine the amount of each Variable Annuity Benefit payment, if any. Such report will be mailed with each payment. SECTION 8.06 CHANGE OF OWNER. While the Annuitant is living, you may name a new Owner in writing in a form we accept. The change will take effect on the date you sign the written form, but it will not apply to any payment we make or other actions we take before we receive the form. SECTION 8.07 ASSIGNMENTS. The interest of anyone covered under the Contract may not be assigned as collateral or security for a loan. Otherwise, you may assign this Certificate and the rights described in it before the Retirement Date. We will not be bound by an assignment unless it is in writing and we have received it. Your rights and those of any other persons referred to in this Certificate will be subject to the assignment. We assume no responsibility for the validity of any assignment. No amounts payable to a payee other than you may be assigned, unless permitted in this Certificate by that payee, nor will they be subject to the claims of creditors or to legal process, except to the extent permitted by law. SECTION 8.08 AGE AND SEX. If the age or sex on whose life an Annuity Benefit is based has been misstated, any benefits will be those which would have been purchased at the correct age and sex. Any overpayments or underpayments made by us will be charged or credited with interest at the rate which then applies. Such interest will be deducted from or added to future payments. No. 11993AC Page 17 APPENDIX The Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly income that $1,000 of Annuity Value will provide under the terms of the Contract on the Life Annuity Form with Ten Years Certain. The amount of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form with Ten Years Certain is based on 3.0% interest and the 1983 Individual Annuity Table "a" projected with modified Scale "G". The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form with Ten Years Certain is based on the 1983 Individual Annuity Table "a" projected with modified Scale "G" and a modified two year age set back, and on an Assumed Base Rate of Net Investment Return of 3.5% or 5%, whichever applies pursuant to Section 7.02 Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us on the same actuarial basis. TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM WITH TEN YEARS CERTAIN (Minimum Monthly Income per $1,000 of Annuity Account Value) Monthly Income Monthly Income Age Males Females Age Males Females - --- ----- ------- --- ----- ------- 60 4.68 4.22 73 6.25 5.58 61 4.77 4.29 74 6.39 5.72 62 4.87 4.37 75 6.55 5.87 63 4.97 4.46 76 6.70 6.03 64 5.08 4.54 77 6.86 6.19 65 5.19 4.64 78 7.02 6.36 66 5.31 4.73 79 7.18 6.53 67 5.43 4.84 80 7.34 6.70 68 5.56 4.95 81 7.50 6.88 69 5.69 5.06 82 7.66 7.06 70 5.82 5.18 83 7.81 7.23 71 5.96 5.31 84 7.96 7.41 72 6.10 5.44 85 8.11 7.58 No. 11993AC Page 18 ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1,000 of Annuity Account Value) VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM WITH TEN YEARS CERTAIN IF ASSUMED BASE RATE OF RETURN IS: 3.5% 5.0% Age Males Females Males Females - --- ----- ------- ----- ------- 60 4.80 4.37 5.69 5.28 61 4.88 4.44 5.77 5.34 62 4.97 4.51 5.86 5.41 63 5.06 4.59 5.94 5.48 64 5.16 4.66 6.04 5.55 65 5.26 4.75 6.14 5.63 66 5.37 4.83 6.24 5.71 67 5.48 4.93 6.34 5.80 68 5.59 5.02 6.46 5.89 69 5.71 5.13 6.57 5.99 70 5.84 5.23 6.69 6.10 No. 11993AC Page 19 [THE EQUITABLE LOGO] ENDORSEMENT APPLICABLE TO IRA CERTIFICATES under which both periodic Contributions and rollover Contributions, as described in this Endorsement, may be made. This Certificate is deemed an "IRA Certificate" if it is issued as an individual retirement annuity contract which meets the requirements of Section 408(b) of the Code. If this Certificate is to be so deemed, this will be specified in the application and on page 3 of this Certificate. If so, then it is established for the exclusive benefit of you and your beneficiaries, and the terms below change, or are added to, the stated Sections of this Certificate. SECTION 1.16 OWNER: The Owner of an IRA Certificate will be the Annuitant. So both "the Owner" and "the Annuitant" as used in this Certificate mean you. SECTION 1.18 RETIREMENT DATE: Section 1.18 of this Certificate defines the "Retirement Date." No initial choice of Retirement Date may be later than age 70-1/2. Before your Retirement Date, you may change your Retirement Date to a later age (up to age 85). In such a case you must withdraw at least the minimum distributions required under Sections 408(b) and 401(a) (9) of the Code and Treasury Regulations that apply. See Section 7.03 of this Endorsement. SECTION 3.01 CONTRIBUTIONS: Section 3.01 states that an initial contribution of less than[$1,000] may not be accepted. This does not apply to IRA Certificates. The following will also apply: Contributions are not fixed and may be made at any time and in any amount which is at least [$50.] No Contributions will be accepted unless they are in cash. Except in the case of a rollover contribution (as permitted by Sections 402(c), 403(a)(4, 403(b)(8), or 408(d)(3) of the Code), the total of such Contributions will not exceed $2,000 for any taxable year. Amounts transferred to the Contract from an individual retirement account or annuity contract which meets the requirements of Section 408 of the Code are not subject to the $2,000 limit. If you make a Contribution which qualifies as an eligible retirement plan rollover within the meaning of Section 402(c) or 403(b)(8) of the Code and you commingle such Contribution with other Contributions, you may not be able to roll over the eligible retirement plan Contributions and earnings to another qualified plan or Code Section 403(b) arrangement at a future date, unless the Code permits. SECTION 4.02 TERMINATION OF COVERAGE UNDER THE CONTRACT: In the event that an annuity bought under the contract fails to qualify as an annuity which meets the requirements of Section 408(b) of the Code, we will have the right, upon receipt of notice of such fact, before the Retirement Date, to terminate coverage under the Contract. In that case, we will pay to you the Annuity Account Value less a deduction for the part which applies to any Federal income tax payable by you which would not have been payable with respect to an annuity which meets such requirements. PF11993IRA Page 1 SECTION 5.01 DEATH BENEFIT: If you married at you death before the Retirement Date, and your spouse is named as death beneficiary, you spouse will be treated as the contingent annuitant (Annuitant and Owner) under this Certificate. Payment of the death benefit is subject to Section 7.03 of this Endorsement. SECTION 5.02 OWNER DEATH DISTRIBUTION RULES: This Section does not apply to IRA Certificates. SECTION 5.03 BENEFICIARY - SUCCESSOR OWNER: Section 5.03 is deleted and the following inserted in its place. SECTION 5.03 BENEFICIARY On the application, you give us the name of the beneficiary who is to receive any death benefit payable on your death. You may change the beneficiary from time to time during your lifetime and while coverage under the Contract is in force. Any such change must be made in writing in a form we accept. A change will, upon receipt at the Processing Office, take effect as of the date the written form was signed, whether or not you are living on the date of receipt. We will not be liable as to any payment we may make before we receive any such change. On the application you may name a person to be primary beneficiary on your death and another person to be contingent beneficiary if the primary beneficiary dies before you. Unless you direct otherwise, if you have named two or more persons as beneficiary, the beneficiary will be the named person or persons who survive you. If more than one survive, they will share equally. Any part of a death benefit payable as described in Section 5.01 for which there is no named beneficiary living at your death will be payable in a single sum to your children who survive you. The payments will be made in equal shares, or should none survive, then to your estate. If you so choose in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on a form of annuity chosen by you, subject to our rules then in effect. If at your death there is no choice in effect, the beneficiary may make such a choice. SECTION 6.01 WITHDRAWAL CHARGES: Section 6.01 describes the events under which a withdrawal charge will not apply. The event below is added: (vi) a request is made for a refund of a Contribution in excess of amounts allowed to be contributed under Section 219 and/or Section 408 of the Code within one month of the date on which the Contribution is made. SECTION 7.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS: Section 7.03 of this Certificate refers to the Normal Form of annuity which is payable. The Normal Form that applies under an IRA Certificate, in lieu of the form shown in said Section, is defined as follows: The term "Normal Form of an Annuity Benefit means, (i) if you have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with your spouse as the contingent annuitant (with 100% of your monthly payment PF11993IRA Page 2 amount continued to your spouse), and (ii) if you do not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. Also, the payment of Annuity Benefits as described in Section 7.03 is subject to the terms which follow, in order to comply with Section 401(a)(9) of the Code and the Treasury Regulations which apply: Your entire interest in the Certificate will be paid or begin to be paid no later than the April 1 which follows the calendar year in which you attain age 70-1/2 ("Required Start Date"). The entire interest may be paid, as you choose, over (a) your life, or the lives of you and the named beneficiary, or (b) a period certain which does not extend beyond your "life expectancy" (defined below), or the joint and last survivor expectancy of you and the named beneficiary. Payments must be made in periodic payments at intervals no longer than one year. Also, payments must be either non-increasing or they may increase only as provided in Regulations (Q&A F-3 of Proposed Treasury Regulation Section 1.401 (a) (9)-1 or successor). All payments made under the Certificate will be made in accordance with the requirements of Code Section 401(a)(9), including the incidental death benefit requirements of the Code (Section 401(a)(9)(G)) and Treasury Regulations which apply (Proposed Treasury Regulation Section 1.401(a)(9)-2). For purposes of the above, "life expectancy" is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless you otherwise choose before the time payments must begin, life expectancies will be recalculated each year. Such choice may never be changed and will apply to all years which follow. In the case of any named beneficiary other than the spouse, life expectancies will be calculated using the attained age of such beneficiary during the calendar year in which you attain age 70 1/2 and payments for any calendar year which follows will be calculated based on life expectancy reduced by one for each calendar year which has passed since the calendar year life expectancy was first calculated. If you die after payment of your entire interest has begun, the remainder of such interest will continue to be paid at least as quickly as under the payment method of distribution being used before your death. If you die before payment of your entire interest begins, payment of your entire interest will be completed no later than December 31 of the calendar year in which the fifth anniversary of your death occurs, except to the extent that a choice is made to receive death benefit payments under (a) or (b) below: (a) If your interest is payable to a beneficiary, then the entire interest may be paid over the life of, or over a "period certain" not greater than the life expectancy of, the named beneficiary. Such payments must commence on or before December 31 of the calendar year which follows the year of your death. (b) If the named beneficiary is your surviving spouse, the date that payments must begin under (a) above will not be earlier than (i) December 31 of the calendar year which follows the year of your death or, if later, (ii) December 31 of the calendar year in which you would have reached age 70-1/2. For purposes of the "period certain" used in (a) above, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of payments which begin after your death, unless the surviving spouse chooses otherwise by the time payments are required to begin, life expectancies will be recalculated each year. Such choice may never be changed by such spouse and will apply to all years which follow. In the case of any other named beneficiary, life expectancies will be calculated using the attained age of such beneficiary during the calendar year in which payments are required to begin, as described in this Section, and payments for any subsequent calendar year will be calculated based on life expectancy reduced by one for each calendar year which has passed since the calendar year life expectancy was first calculated. PF11993IRA Page 3 Payments under this Section are deemed to have begun if payments are made because you have reached the Required Start Date or if, before the Required Start Date, payments commence to you over a period permitted and in an annuity form acceptable under proposed Treasury Regulation 1.401(a)(9)-1 or any successor. SECTION 8.05 ANNUAL REPORTS: Section 8.05 lists the reports we will send you. We will also send a report as of the end of each calendar year showing the status of the annuity and any other reports required by the Code or Treasury Regulations. SECTION 8.06 CHANGE OF OWNER: You may not name a new owner. SECTION 8.07 ASSIGNMENTS: In addition to the restrictions on assignments described in section 8.07, your entire interest under this Certificate is not transferable except by surrender to us. Further, your interest under this Certificate in non-forfeitable. APPENDIX In lieu of the Appendix, the attached "Appendix IRA" applies. PF11993IRA Page 4 APPENDIX IRA APPLICABLE TO IRA CERTIFICATES The Tables of Guaranteed Annuity Payments set forth this minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract on the Joint and Survivor Life Annuity Form (with 100% of the amount of your payment continued to your spouse). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on 3.0% interest and the 1983 Individual Annuity Table "a" projected with modified Scale "G." The amount of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and the Joint and Survivor Life Annuity Form are based on the 1983 Individual Annuity Table "a" projected with modified Scale "G" and a modified two year age set back, and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section 7.02. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us on the same actuarial basis. TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE (Minimum Monthly Income per $1,000 of Annuity Account Value)
Female Ages ----------- Age 60 61 62 63 64 65 66 67 68 69 70 60 3.86 3.90 3.93 3.97 4.01 4.05 4.08 4.12 4.15 4.19 4.22 61 3.88 3.92 3.96 4.00 4.04 4.08 4.12 4.16 4.19 4.23 4.27 62 3.91 3.95 3.99 4.03 4.07 4.11 4.15 4.19 4.23 4.27 4.31 63 3.93 3.97 4.01 4.06 4.10 4.14 4.19 4.23 4.28 4.32 4.36 Male 64 3.95 3.99 4.04 4.08 4.13 4.18 4.22 4.27 4.32 4.36 4.41 Ages 65 3.97 4.02 4.06 4.11 4.16 4.21 4.26 4.31 4.35 4.40 4.45 66 3.99 4.04 4.09 4.14 4.19 4.24 4.29 4.34 4.39 4.45 4.50 67 4.01 4.06 4.11 4.16 4.21 4.27 4.32 4.38 4.43 4.49 4.54 68 4.02 4.08 4.13 4.18 4.24 4.30 4.35 4.41 4.47 4.53 4.59 69 4.04 4.10 4.15 4.21 4.26 4.32 4.38 4.44 4.51 4.57 4.63 70 4.06 4.11 4.17 4.23 4.29 4.35 4.41 4.48 4.54 4.61 4.67
PF11993IRA Page 5 ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1000 of Annuity Value) VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS: 3.5% 5.0% ---- ---- AGE MALES FEMALES MALES FEMALES --- ----- ------ ----- ------- 60 4.88 4.41 5.79 5.32 61 4.97 4.48 5.88 5.39 62 5.07 4.55 5.98 5.46 63 5.17 4.63 6.08 5.54 64 5.28 4.72 6.19 5.62 65 5.40 4.81 6.31 5.71 66 5.52 4.90 6.43 5.80 67 5.66 5.00 6.56 5.90 68 5.80 5.11 6.71 6.00 69 5.95 5.22 6.86 6.11 70 6.11 5.34 7.02 6.23 PF11993IRA Page 6 [THE EQUITABLE LOGO] ENDORSEMENT APPLICABLE TO IRA CERTIFICATES under which only rollover Contributions, as described in this Endorsement, may be made. This Certificate is deemed an "IRA Certificate" if it is issued as an individual retirement annuity contract which meets the requirements of Section 408(b) of the Code. If this Certificate is to be so deemed, this will be specified in the application to enroll under the Contract and on page 3 of this Certificate. If so, then it is established for the exclusive benefit of you and your beneficiaries, and the terms below change, or are added to, the stated Sections of this Certificate. SECTION 1.16 OWNER: The Owner of an IRA Certificate will be the Annuitant. So both "the Owner" and "the Annuitant" as used in this Certificate mean you. SECTION 1.18 RETIREMENT DATE: Section 1.18 of this Certificate defines the "Retirement Date." No initial choice of Retirement Date may be later than age 70-1/2. Before your Retirement Date, you may change your Retirement Date to a later age (up to age 85). In such case you must withdraw at least the minimum distributions required under Sections 408(b) and 401(a)(9) of the Code and Treasury Regulations that apply. See Section 7.03 of this Endorsement. SECTION 3.01 CONTRIBUTIONS: The following will also apply: We will only accept Contributions which qualify as "eligible rollover amounts" within the meaning of Section 402(c) or 403(b)(8) of the Code, or "rollover contributions" from a "conduit" individual retirement account or annuity described in Section 408(d)(3)(A)(ii) and (iii) of the Code, as the case may be. If you make a Contribution which qualifies as an eligible retirement plan rollover within the meaning of Section 402(c) or 403(b)(8) of the Code and you commingle such Contribution with other Contributions, you may not be able to roll over the eligible retirement plan Contributions and earnings to another qualified plan or Code Section 403(b) arrangement at a future date, unless the Code permits. SECTION 4.02 TERMINATION OF COVERAGE UNDER THE CONTRACT: In the event that an annuity bought under the Contract fails to qualify as an annuity which meets the requirements of Section 408(b) of the Code, we will have the right, upon receipt of notice of such fact, before the Retirement Date, to terminate coverage under the Contract. In that case, we will pay to you the Annuity Account Value less a deduction for the part which applies to any Federal income tax payable by you which would not have been payable with respect to an annuity which meets such requirements. PF 11993QPI Page 1 THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES SECTION 5.01 DEATH BENEFIT: If you are married at your death before the Retirement Date, and your spouse is named as death beneficiary, your spouse will be treated as the contingent annuitant (Annuitant and Owner) under this Certificate. Payment of the death benefit is subject to Section 7.03 of this Endorsement. SECTION 5.02 OWNER DEATH DISTRIBUTION RULES: This Section does not apply to IRA Certificates. SECTION 5.03 BENEFICIARY -- SUCCESSOR OWNER: Section 5.03 is deleted and the following inserted in its place. SECTION 5.03 BENEFICIARY On the application, you give us the name of the beneficiary who is to receive any death benefit payable on your death. You may change the beneficiary from time to time during your lifetime and while coverage under the Contract is in force. Any such change must be made in writing in a form we accept. A change will, upon receipt at the Processing Office, take effect as of the date the written form was signed, whether or not you are living on the date of receipt. We will not be liable as to any payment we may make before we receive any such change. On the application you may name a person to be primary beneficiary on your death and another person to be contingent beneficiary if the primary beneficiary dies before you. Unless you direct otherwise, if you have named two or more persons as beneficiary, the beneficiary will be the named person or persons who survive you. If more than one survive, they will share equally. Any part of a death benefit payable as described in Section 5.01 for which there is no named beneficiary living at your death will be payable in a single sum to your children who survive you. The payments will be made in equal shares, or should none survive, then to your estate. If you so choose in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on a form of annuity chosen by you, subject to our rules then in effect. If at your death there is no choice in effect, the beneficiary may make such a choice. SECTION 6.01 WITHDRAWAL CHARGES: Section 6.01 describes the events under which a withdrawal charge will not apply. The event below is added: (vi) a request is made for a refund of a Contribution in excess of amounts allowed to be contributed under Section 219 and/or Section 408 of the Code within one month of the date on which the Contribution is made. SECTION 7.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS: Section 7.03 of this Certificate refers to the Normal Form of annuity which is payable. The Normal Form that applies under an IRA Certificate, in lieu of the form shown in said Section, is defined as follows: PF 11993QPI Page 2 The term Normal Form of an Annuity Benefit means, (i) if you have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with your spouse as the contingent annuitant (with 100% of your monthly payment amount continued to your spouse), and (ii) if you do not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. Also, the payment of Annuity Benefits as described in Section 7.03 is subject to the terms which follow, in order to comply with Section 401(a)(9) of the Code and the Treasury Regulations which apply: Your entire interest in the Certificate will be paid or begin to be paid no later than the April 1 which follows the calendar year in which you attain age 70-1/2 ("Required Start Date"). The entire interest may be paid, as you choose, over (a) your life, or the lives of you and the named beneficiary, or (b) a period certain which does not extend beyond your "life expectancy" (defined below), or the joint and last survivor expectancy of you and the named beneficiary. Payments must be made in periodic payments at intervals no longer than one year. Also, payments must be either non-increasing or they may increase only as provided in Regulations (Q & A F-3 of Proposed Treasury Regulation Section 1.401(a)(9)-1 or successor). All payments made under the Certificate will be made in accordance with the requirements of Code Section 401(a)(9), including the incidental death benefit requirements of the Code (Section 401(a)(9)(G)) and Treasury Regulations which apply (Proposed Treasury Regulation Section 1.401(a)(9)-2). For purposes of the above, "life expectancy" is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless you otherwise choose before the time payments must begin, life expectancies will be recalculated each year. Such choice may never be changed and will apply to all years which follow. In the case of any named beneficiary other than the spouse, life expectancies will be calculated using the attained age of such beneficiary during the calendar year in which you attain age 70 1/2 and payments for any calendar year which follows will be calculated based on life expectancy reduced by one for each calendar year which has passed since the calendar year life expectancy was first calculated. If you die after payment of your entire interest has begun, the remainder of such interest will continue to be paid at least as quickly as under the payment method of distribution being used before your death. If you die before payment of your entire interest begins, payment of your entire interest will be completed no later than December 31 of the calendar year in which the fifth anniversary of your death occurs, except to the extent that a choice is made to receive death benefit payments under (a) or (b) below: (a) If your interest is payable to a beneficiary, then the entire interest may be paid over the life of, or over a "period certain" not greater than the life expectancy of, the named beneficiary. Such payments must commence on or before December 31 of the calendar year which follows the year of your death. (b) If the named beneficiary is your surviving spouse, the date that payments must begin under (a) above will not be earlier than (i) December 31 of the PF 11993QPI Page 3 calendar year which follows the year of your death or, if later, (ii) December 31 of the calendar year in which you would have reached age 70-1/2. For purposes of the "period certain" used in (a) above, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of payments which begin after your death, unless the surviving spouse chooses otherwise by the time payments are required to begin, life expectancies will be recalculated each year. Such choice may never be changed by such spouse and will apply to all years which follow. In the case of any other named beneficiary, life expectancies will be calculated using the attained age of such beneficiary during the calendar year in which payments are required to begin, as described in this Section, and payments for any subsequent calendar year will be calculated based on life expectancy reduced by one for each calendar year which has passed since the calendar year life expectancy was first calculated. Payments under this Section are deemed to have begun if payments are made because you have reached the Required Start Date or if, before the Required Start Date, payments commence to you over a period permitted and in an annuity form acceptable under proposed Treasury Regulation 1.401(a)(9)-1 or any successor. SECTION 8.05 ANNUAL REPORTS: Section 8.05 lists the reports we will send you. We will also send a report as of the end of each calendar year showing the status of the annuity and any other reports required by the Code or Treasury Regulations. SECTION 8.06 CHANGE OF OWNER: You may not name a new owner. SECTION 8.07 ASSIGNMENTS: In addition to the restrictions on assignments described in section 8.07, your entire interest under this Certificate is not transferable except by surrender to us. Further, your interest under this Certificate is non-forfeitable. APPENDIX In lieu of the Appendix, the attached "Appendix IRA" applies. PF 11993QPI Page 4 APPENDIX IRA APPLICABLE TO IRA CERTIFICATES The Tables of Guaranteed Annuity Payments set forth this minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract on the Joint and Survivor Life Annuity Form (with 100% of the amount of your payment continued to your spouse). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on 3.0% interest and the 1983 Individual Annuity Table "a" projected with modified Scale "G." The amount of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and the Joint and Survivor Life Annuity Form are based on the 1983 Individual Annuity Table "a" projected with modified Scale "G" and a modified two year age set back, and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section 7.02. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us on the same actuarial basis. TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE (Minimum Monthly Income per $1,000 of Annuity Account Value)
Female Ages ----------- Age 60 61 62 63 64 65 66 67 68 69 70 60 3.86 3.90 3.93 3.97 4.01 4.05 4.08 4.12 4.15 4.19 4.22 61 3.88 3.92 3.96 4.00 4.04 4.08 4.12 4.16 4.19 4.23 4.27 62 3.91 3.95 3.99 4.03 4.07 4.11 4.15 4.19 4.23 4.27 4.31 63 3.93 3.97 4.01 4.06 4.10 4.14 4.19 4.23 4.28 4.32 4.36 Male 64 3.95 3.99 4.04 4.08 4.13 4.18 4.22 4.27 4.32 4.36 4.41 Ages 65 3.97 4.02 4.06 4.11 4.16 4.21 4.26 4.31 4.35 4.40 4.45 ---- 66 3.99 4.04 4.09 4.14 4.19 4.24 4.29 4.34 4.39 4.45 4.50 67 4.01 4.06 4.11 4.16 4.21 4.27 4.32 4.38 4.43 4.49 4.54 68 4.02 4.08 4.13 4.18 4.24 4.30 4.35 4.41 4.47 4.53 4.59 69 4.04 4.10 4.15 4.21 4.26 4.32 4.38 4.44 4.51 4.57 4.63 70 4.06 4.11 4.17 4.23 4.29 4.35 4.41 4.48 4.54 4.61 4.67
PF 11993QPI Page 5 ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1000 of Annuity Value) VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS: --------------------------------- 3.5% 5.0% ---- ---- AGE MALES FEMALES MALES FEMALES --- ----- ------- ----- ------- 60 4.88 4.41 5.79 5.32 61 4.97 4.48 5.88 5.39 62 5.07 4.55 5.98 5.46 63 5.17 4.63 6.08 5.54 64 5.28 4.72 6.19 5.62 65 5.40 4.81 6.31 5.71 66 5.52 4.90 6.43 5.80 67 5.66 5.00 6.56 5.90 68 5.80 5.11 6.71 6.00 69 5.95 5.22 6.86 6.11 70 6.11 5.34 7.02 6.23 PF 11993QPI Page 6 [THE EQUITABLE LOGO] ENDORSEMENT APPLICABLE TO SEP CERTIFICATES This Certificate is deemed a "SEP Certificate" if it is purchased under a written program which is a "Simplified Employee Pension," as described in Section 408(k) of the Code. Such a program as adopted by the Annuitant's employer may provide for salary reductions, whereby the employer makes tax-deferred contributions for the Annuitant in lieu of salary, and must meet the requirements of Section 408(b) of the Code. If this Certificate is to be so deemed, this will be specified in the application to enroll under the Contract and on page 3 of this Certificate. If so, then it is established for the exclusive benefit of you and your beneficiaries, and the terms below change, or are added to, the stated Sections of this Certificate. SECTION 1.16 OWNER: The Owner of a SEP Certificate will be the Annuitant. So both "the Owner" and "the Annuitant" as used in this Certificate mean you. SECTION 1.18 RETIREMENT DATE: Section 1.18 of this Certificate defines the "Retirement Date." No initial choice of Retirement Date may be later than age 70-1/2. Before your Retirement Date, you may change your Retirement Date to a later age (up to age 85). In such a case you must withdraw at least the minimum distributions required under Sections 408(b) and 401(a)(9) of the Code and Treasury Regulations that apply. See Section 7.03 of this Endorsement. SECTION 3.01 CONTRIBUTIONS: Section 3.01 states that an initial contribution of less than [$1,000] may not be accepted. This does not apply to SEP Certificates. The following will also apply: Contributions are not fixed and may be made at any time and in any amount of at least [$50.] No Contributions will be accepted unless they are in cash. Except in the case of a rollover contribution (as permitted by Sections 402(c), 403(a)(4), 403(b)(8), or 408(d)(3) of the Code), or a Contribution made under the terms of a Simplified Employee Pension as contained in Section 408(k) of the Code, the total of such Contributions will not exceed $2,000 for any taxable year. Amounts transferred to the Contract from an individual retirement account or annuity contract which meets the requirements of Section 408 of the Code are not subject to the $2,000 limit. If you make a Contribution which qualifies as an eligible retirement plan rollover within the meaning of Section 402(c) or 403(b)(8) of the Code and you commingle such Contribution with other Contributions, you may not be able to roll over the eligible retirement plan Contributions and earnings to another qualified plan or Code Section 403(b) arrangement at a future date, unless the Code permits. PF11993SEP Page 1 SECTION 4.02 TERMINATION OF COVERAGE UNDER THE CONTRACT: In the event that an annuity bought under the Contract fails to qualify as an annuity which meets the requirements of Section 408(b) of the Code, we will have the right, upon receipt of notice of such fact, before the Retirement Date, to terminate coverage under the Contract. In that case, we will pay to you the Annuity Account Value less a deduction for the part which applies to any Federal income tax payable by you which would not have been payable with respect to an annuity which meets such requirements. SECTION 5.01 DEATH BENEFIT: If you are married at your death before the Retirement Date, and your spouse is named as death beneficiary, your spouse will be treated as the contingent annuitant (Annuitant and Owner) under this Certificate. Payment of the death benefit is subject to Section 7.03 of this Endorsement. SECTION 5.02 OWNER DEATH DISTRIBUTION RULES: This Section does not apply to SEP Certificates. SECTION 5.03 BENEFICIARY - SUCCESSOR OWNER: Section 5.03 is deleted and the following inserted in its place. SECTION 5.03 BENEFICIARY On the application, you give us the name of the beneficiary who is to receive any death benefit payable on your death. You may change the beneficiary from time to time during your lifetime and while coverage under the Contract is in force. Any such change must be made in writing in a form we accept. A change will, upon receipt at the Processing Office, take effect as of the date the written form was signed, whether or not you are living on the date of receipt. We will not be liable as to any payment we may make before we receive any such change. On the application you may name a person to be primary beneficiary on your death and another person to be contingent beneficiary if the primary beneficiary dies before you. Unless you direct otherwise, if you have named two or more persons as beneficiary, the beneficiary will be the named person or persons who survive you. If more than one survive, they will share equally. Any part of a death benefit payable as described in Section 5.01 for which there is no named beneficiary living at your death will be payable in a single sum to your children who survive you. The payments will be made in equal shares, or should none survive, then to your estate. If you so choose in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on a form of annuity chosen by you, subject to our rules then in effect. If at your death there is no choice in effect, the beneficiary may make such a choice. PF11993SEP Page 2 SECTION 6.01 WITHDRAWAL CHARGES: Section 6.01 describes the events under which a withdrawal charge will not apply. The events below are added: (vi) a request is made for a refund of a Contribution in excess of amounts allowed to be contributed under Section 219 and/or Section 408 of the Code within one month of the date on which the Contribution is made, or (vii) a distribution of deferrals disallowed by reason of failure to meet the requirements of Section 408(k)(6)(A)(ii) of the Code, including income thereon and less any loss allowable thereto, is made no later than April 15 which follows the calendar year of the notification by your employer of such disallowance, or (viii) a distribution of "excess contributions," as such term is defined in Section 408(k)(6)(C)(ii) of the Code, including the income thereon and less any loss allowable thereto, is made no later than the end of the plan year of the Simplified Employee Pension which follows the plan year in which such excess contributions were made, or (ix) a distribution of "excess deferrals" as such term is defined in Section 402(g)(2) of the Code, including income thereon and less any loss allowable thereto, is made no later than April 15 which follows the year in which such excess deferrals were made. SECTION 7.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS: Section 7.03 of this Certificate refers to the Normal Form of annuity which is payable. The Normal Form that applies under a SEP Certificate, in lieu of the form shown in said Section, is defined as follows: The term "Normal Form" of an Annuity Benefit means, (i) if you have a living spouse at the retirement Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity form with your spouse as the contingent annuitant (with 100% of your monthly payment amount continued to your spouse), and (ii) if you do not have a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form. Also, the payment of Annuity Benefits as described in Section 7.03 is subject to the terms which follow, in order to comply with Section 401(a)(9) of the Code and the Treasury Regulations which apply: Your entire interest in the Certificate will be paid or begin to be paid no later than the April 1 which follows the calendar year in which you attain age 70-1/2 ("Required Start Date"). The entire interest may be paid, as you choose, over (a) your life, or the lives of you and the named beneficiary, or (b) a period certain which does not extend beyond your "life expectancy" (defined below), or the joint and last survivor expectancy of you and the named beneficiary. Payments must be made in periodic payments at intervals no longer than one year. Also, payments must be either non-increasing or they may increase only as provided in Regulations (Q & A F-3 of Proposed Treasury Regulation Section 1.401 (a)(9)-1 or successor). PF11993SEP Page 3 All payments made under the Certificate will be made in accordance with the requirements of Code Section 401(a)(9), including the incidental death benefit requirements of the Code (Section 401(a)(9)(G)) and Treasury Regulations which apply (Proposed Treasury Regulation Section 1.401(a)(9)-2). For purposes of the above, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless you otherwise choose before the time payments must begin, life expectancies will be recalculated each year. Such choice may never be changed and will apply to all years which follow. In the case of any named beneficiary other than the spouse, life expectancies will be calculated using the attained age of such beneficiary during the calendar year in which you attain age 70 1/2 and payments for any calendar year which follows will be calculated based on life expectancy reduced by one for each calendar year which has passed since the calendar year life expectancy was first calculated. If you die after payment of your entire interest has begun, the remainder of such interest will continue to be paid at least as quickly as under the payment method of distribution being used before your death. If you die before payment of your entire interest begins, payment of your entire interest will be completed no later than December 31 of the calendar year in which the fifth anniversary of your death occurs, except to the extent that a choice is made to receive death benefit payments under (a) or (b) below: (a) If your interest is payable to a beneficiary, then the entire interest may be paid over the life of, or over a "period certain" not greater than the life expectancy of, the named beneficiary. Such payments must commence on or before December 31 of the calendar year which follows the year of your death. (b) If the named beneficiary is your surviving spouse, the date that payments must begin under (a) above will not be earlier than (i) December 31 of the calendar year which follows the year of your death or, if later, (ii) December 31 of the calendar year in which you would have reached age 70-1/2. For purposes of the "period certain" used in (a) above, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of payments which begin after your death, unless the surviving spouse chooses otherwise by the time payments are required to begin, life expectancies will be recalculated each year. Such choice may never be changed by such spouse and will apply to all years which follow. In the case of any other named beneficiary, life expectancies will be calculated using the attained age of such beneficiary during the calendar year in which payments are required to begin, as described in this Section, and payments for any subsequent calendar year will be calculated based on life expectancy reduced by one for each calendar year which has passed since the calendar year life expectancy was first calculated. Payments under this Section are deemed to have begun if payments are made because you have reached the Required Start Date or if, before the Required Start Date, payments commence to you over a period permitted and in an annuity form acceptable under proposed Treasury Regulation 1.401(a)(9)-1 or any successor. PF11993SEP Page 4 SECTION 8.05 ANNUAL REPORTS: Section 8.05 lists the reports we will send you. We will also send a report as of the end of each calendar year showing the status of the annuity and any other reports required by the Code or Treasury Regulations. SECTION 8.06 CHANGE OF OWNER: You may not name a new owner. SECTION 8.07 ASSIGNMENTS: In addition to the restrictions on assignments described in section 8.07, your entire interest under this Certificate is not transferable except by surrender to us. Further, your interest under this Certificate is non-forefeitable. SECTION 8.08 AGE AND SEX: A misstatement of the sex of any person upon whose life an Annuity Benefit depends does not apply, since the Annuity Benefit tables which apply, as shown in the Appendix for SEP Certificates, has the same values for both sexes. APPENDIX In lieu of the Appendix, the attached "Appendix SEP" applies. PF11993SEP Page 5 APPENDIX SEP APPLICABLE TO SEP CERTIFICATES The Tables of Guaranteed Annuity Payments set forth this minimum amount of monthly income that $1,000 of Annuity Value will provide under the Contract on the Joint and Survivor Life Annuity Form (with 100% of the amount of your payment continued to your spouse). The amounts of income provided under the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on 3.0% interest and the 1983 Individual Annuity Table "a" projected with modified Scale "G" and adjusted to a unisex basis based on a 20%-80% split of males and females, at age 55. The amounts of income initially provided under the Variable Annuity Benefit payable on the Life Annuity Form and the Joint and Survivor Life Annuity Form are based on the 1983 Individual Annuity Table "a" projected with modified Scale "G", adjusted with a modified two year age set back and a 20%-80% split of males and females, at age 55 and an Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section 7.02. Amounts required for ages or for annuity forms not shown in the Tables will be calculated by us on the same actuarial basis. TABLES OF GUARANTEED ANNUITY PAYMENTS (Based on Age Nearest Birthday on Due Date of First Payment) FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM -- 100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE (Minimum Monthly Income per $1,000 of Annuity Account Value)
Age 60 61 62 63 64 65 66 67 68 69 70 60 3.79 3.82 3.84 3.87 3.90 3.92 3.95 3.97 4.00 4.02 4.04 61 3.85 3.87 3.90 3.93 3.96 3.99 4.02 4.04 4.07 4.09 62 3.91 3.94 3.97 4.00 4.03 4.06 4.09 4.11 4.14 63 3.97 4.00 4.04 4.07 4.10 4.13 4.16 4.19 64 4.04 4.07 4.11 4.14 4.18 4.21 4.24 65 4.11 4.15 4.19 4.22 4.26 4.29 66 4.19 4.23 4.27 4.30 4.34 67 4.27 4.31 4.35 4.39 68 4.36 4.40 4.44 69 4.45 4.50 70 4.55
PF11993SEP Page 6 ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM (Minimum Monthly Income per $1000 of Annuity Value) VARIABLE ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM IF ASSUMED BASE RATE OF NET INVESTMENT RETURN IS: 3.5% 5.0% ---- ---- AGE 60 4.49 5.41 61 4.57 5.48 62 4.65 5.56 63 4.73 5.64 64 4.82 5.73 65 4.91 5.82 66 5.01 5.91 67 5.12 6.02 68 5.23 6.13 69 5.35 6.24 70 5.48 6.37 PF11993SEP Page 7 EX-99.4FCONTRACT 14 FORM OF GROUP ANNUITY CERTIFICATE GROUP ANNUITY CONTRACT NO.: [AC 0000] ------- CONTRACT HOLDER: [UNITED STATES TRUST COMPANY OF NEW YORK] - -------------------------------------------------------------------------------- REGISTER DATE: [September 1, 1994] ISSUED IN: [New York] This Contract is issued in consideration of payment of the Contributions under the terms of this Contract. The terms of this Contract, which include the following pages, are agreed to by the Contract Holder and The Equitable Life Assurance Society of the United States ("Equitable"). FOR THE CONTRACT HOLDER FOR EQUITABLE Title By /s/ Joseph J. Melone ---------------------- ------------------------------------ Chairman and Chief Executive Officer By By /s/ James M. Benson ---------------------- ------------------------------------ President and Chief Operating Officer Dated By /s/ Molly K. Heines ---------------------- ------------------------------------ Vice President and Secretary At [New York, New York] By ------------------------------------ Assistant Registrar Date of Issue ------------------------- THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE AS DESCRIBED IN PART II OF THIS CONTRACT. No. 1050-94IC INTEREST RATE GUARANTEE -- NON-PARTICIPATING TABLE OF CONTENTS Page Part I - DEFINITIONS 3 Part II - INVESTMENT OPTIONS 6 Part III - CONTRIBUTIONS AND ALLOCATIONS 10 Part IV - TRANSFERS AMONG INVESTMENT OPTIONS 11 Part V - WITHDRAWALS AND TERMINATION 12 Part VI - DEATH BENEFITS 13 Part VII - ANNUITY BENEFITS 14 Part VIII - CHARGES 17 Part IX - GENERAL PROVISIONS 20 TABLE OF GUARANTEED ANNUITY PAYMENTS 22 APPENDIX A 24 APPENDIX B 28 APPENDIX C 30 APPENDIX D 33 No. 1050-94IC Page 2 PART I - DEFINITIONS SECTION 1.01 ANNUITANT "Annuitant" means the individual shown as such in the Certificate who has been enrolled under the Contract according to Equitable's enrollment procedures, or any successor annuitant. If a Certificate uses the term "Participant" to refer to the Annuitant, then any reference in this Contract to the Annuitant will be deemed to mean the "Participant" shown in such Certificate. SECTION 1.02 ANNUITY ACCOUNT VALUE "Annuity Account Value" means the sum of the amounts held with respect to a Certificate in the Investment Options. SECTION 1.03 ANNUITY BENEFIT "Annuity Benefit" means a benefit payable by Equitable pursuant to Part VII of this Contract. SECTION 1.04 ANNUITY COMMENCEMENT DATE "Annuity Commencement Date" means the date on which annuity payments are to commence pursuant to Section 7.03. The Annuity Commencement Date is shown on the Certificate and is subject to change as described in Section 7.03. SECTION 1.05 BUSINESS DAY A "Business Day" is any day on which Equitable is open and the New York Stock Exchange is open for trading, or any other day specified in the Certificate. Equitable's Business Day ends at 4:00 p.m., Eastern Time, or such other time as Equitable designates in writing to each Owner. SECTION 1.06 CASH VALUE "Cash Value" means an amount equal to the Annuity Account Value, less any charges that apply as described in Part VIII and any charges that may apply as described in any applicable Appendix hereto. SECTION 1.07 CERTIFICATE "Certificate" means the certificate which will be issued by Equitable with respect to each Annuitant, setting forth the benefits and the rights which the Owner may exercise. The Certificate will also reflect the terms of this Contract which may differ based on the type of Certificate issued. Some provisions of this Contract refer to specific requirements related to certain types of retirement programs, and the Certificate issued with respect to such types of programs will reflect said provisions; to distinguish among Certificate versions which may thus be issued under this Contract, the following terms are sometimes used herein. (These terms represent the Certificate forms which may be available as of the No. 1050-94IC Page 3 Register Date; variations of such form and other forms may be made available by Equitable at any time on or after the Register Date.) "IRA Certificate," which applies to a Certificate issued as an individual retirement annuity meeting the requirements of Section [408(b)] of the Code; "Non-Qualified Certificate," which applies to a Certificate which is an annuity issued other than pursuant to a qualified plan. SECTION 1.08 CODE "Code" means the Internal Revenue Code of [1986], as now or hereafter amended, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.09 CONTRACT "Contract" means this contract including each Appendix, if any, attached hereto. SECTION 1.10 CONTRACT DATE "Contract Date" means, with respect to a Certificate, the earlier of (a) the date on which the Annuitant is enrolled under the Contract, according to Equitable's enrollment procedures, and (b) the date on which the Annuitant was enrolled under a Prior Contract, if applicable. SECTION 1.11 CONTRACT YEAR "Contract Year" means, with respect to a Certificate, the twelve month period starting on (i) the Contract Date and (ii) each anniversary of the Contract Date, unless Equitable agrees to another period. SECTION 1.12 CONTRIBUTION "Contribution" means a payment made to Equitable as described in Section 3.01. SECTION 1.13 EMPLOYER "Employer" means, if applicable, an employer defined in an Appendix hereto. SECTION 1.14 GUARANTEED INTEREST RATE "Guaranteed Interest Rate" means the effective annual rate(s) at which interest accrues on amounts in the Guaranteed Interest Account as described in Section 2.01. (If a Certificate uses the term "Guaranteed Rate Account" to refer to the Guaranteed Interest Account, then any reference in this Contract to the Guaranteed Interest Account will be deemed to mean the "Guaranteed Rate Account" described in such Certificate.) No. 1050-94IC Page 4 SECTION 1.15 INVESTMENT FUND "Investment Fund" means a sub-fund of a Separate Account. An Investment Fund may invest its assets in a separate class (or series) or shares of a specified trust or investment company where each class (or series) represents a separate portfolio in the specified trust or investment company. SECTION 1.16 INVESTMENT OPTION "Investment Option" means the Guaranteed Interest Account, a Separate Account, or an Investment Fund of a Separate Account or each Guarantee Period in the Guaranteed Period Account (Separate Account No. 46). SECTION 1.17 OWNER "Owner" means the person or entity which owns a Certificate on behalf of the Annuitant, as named on the Certificate, or any successor owner. SECTION 1.18 PLAN "Plan" means, if applicable, the annuity program sponsored by the Employer of the Annuitant and as may be defined in any Appendix hereto. SECTION 1.19 PRIOR CONTRACT "Prior Contract" means another contract or certificate issued by Equitable and from which the Owner and Equitable have agreed to transfer amounts with respect to the Annuitant to this Contract. SECTION 1.20 PROCESSING DATE "Processing Date" means the day(s) Equitable deducts charges from the Annuity Account Value. The Certificate shows how often a Processing Date will occur. SECTION 1.21 PROCESSING OFFICE "Processing Office" means the Equitable administrative office specified in the Certificate, or such other location as Equitable may designate upon written notice to each Owner. SECTION 1.22 SEPARATE ACCOUNT "Separate Account" means any of the Separate Accounts (except Equitable's Separate Account No. 46) described or referred to in Sections 2.02 and 2.05. SECTION 1.23 TRANSACTION DATE The Transaction Date is the Business Day Equitable receives at the Processing Office a Contribution or a transaction request providing the information Equitable needs. Transaction requests must be in a form acceptable to Equitable. No. 1050-94IC Page 5 PART II - INVESTMENT OPTIONS SECTION 2.01 GUARANTEED INTEREST ACCOUNT Any amount held in the Guaranteed Interest Account becomes part of Equitable's general assets, which support the guarantees of this Contract as well as other obligations of Equitable. The amount in such Account at any time with respect to a Certificate is equal to the sum of: o all amounts that have been allocated or transferred to such Account, plus o the amount of any interest credited, less o all amounts that have been withdrawn (including charges) or transferred from such Account. Equitable will credit the amount held in the Guaranteed Interest Account with interest at effective annual rates that Equitable determines. Equitable will also determine a minimum Guaranteed Interest Rate that will remain in effect throughout a stated twelve-month period or a calendar year. The Certificate will describe the initial Rate(s) to apply for a stated period or periods starting with the Contract Date. Equitable guarantees that any rate so determined after a Contract Date will never be less than the minimum rate shown in the Certificate. SECTION 2.02 SEPARATE ACCOUNT Equitable has established the Separate Account(s) and maintains such Account(s) in accordance with the laws of New York State. Income, realized and unrealized gains and losses from the assets of the Separate Account(s) are credited to or charged against it without regard to Equitable's other income, gains or losses. Assets are placed in the Separate Account(s) to support this Contract and other variable annuity contracts and certificates. Assets may be placed in the Separate Account(s) for other purposes, but not to support contracts or policies other than variable annuities and variable life insurance. The Certificate sets forth the Separate Account(s) available under this Contract. A Separate Account may be subdivided into Investment Funds. The assets of a Separate Account are Equitable's property. The portion of such assets equal to the reserves and other contract liabilities will not be chargeable with liabilities which arise out of any other business Equitable conducts. Equitable may transfer assets of a Separate Account in excess of the reserves and other liabilities with respect to such Account to another Separate Account or to Equitable's general account. No. 1050-94IC Page 6 Equitable may, in its discretion, invest Separate Account assets in any investment permitted by applicable law. Equitable may rely conclusively on the opinion of counsel (including counsel in its employ) as to what investments Equitable may make as law permits. SECTION 2.03 SEPARATE ACCOUNT ACCUMULATION UNITS AND UNIT VALUES The amount in a Separate Account with respect to an Annuitant at any time is equal to the number of Accumulation Units in that Account with respect to the Annuitant multiplied by the Accumulation Unit Value which applies at that time. For the purposes of this Contract, "Accumulation Unit" means a unit which is purchased in a Separate Account, and "Accumulation Unit Value" means the dollar value of each Accumulation Unit in a Separate Account on a given date. (If Investment Funds apply as described in Section 2.02, then the terms of this Section 2.03 apply separately to each Fund, unless otherwise stated.) Amounts allocated or transferred to a Separate Account are used to purchase Accumulation Units of that Account. Units are redeemed when amounts are deducted, transferred or withdrawn. The number of Accumulation Units in a Separate Account at any time is equal to the number of Accumulation Units purchased minus the number of Units redeemed in that Account up to that time. The number of Accumulation Units purchased or redeemed in a transaction is equal to the dollar amount of the transaction divided by the Account's Accumulation Unit Value for that Transaction Date. Equitable determines Accumulation Unit Values for each Separate Account for each Valuation Period. A "Valuation Period" is each Business Day together with any consecutive preceding non-business days. For example, for each Monday which is a Business Day, the preceding Saturday and Sunday will be included to equal a three-day Valuation Period. Unless the following paragraph applies, the Accumulation Unit Value for a Separate Account for any Valuation Period is equal to the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the ratio of (i) the value of the Separate Account at the close of business at the end of the current Valuation Period, before any amounts are allocated to or withdrawn from the Separate Account in that Period, to (ii) the value of the Separate Account at the close of business at the end of the preceding Valuation Period, after all allocations and withdrawals were made for that Period. For this purpose, "value of the Separate Account" means the market value or, where there is no readily available market, the fair value of the assets allocated to the Separate Account, as determined in accordance with Equitable's rules, accepted accounting practices, and applicable laws and regulations. To the extent the Separate Account invests in Investment Funds, and the assets of the Funds are invested in a class or series of shares of a specified trust or investment company, then the Accumulation Unit Value of an Investment Fund for any Valuation Period is equal to the Accumulation Unit Value for that Fund on the immediately No. 1050-94IC Page 7 preceding Valuation Period multiplied by the Net Investment Factor of that Fund for the current Valuation Period. The Net Investment Factor for a Valuation Period is (a) divided by (b) minus (c), where (a) is the value of the Investment Fund's shares of the related portfolio of the specified trust or investment company at the end of the Valuation Period (before taking into account any amounts allocated to or withdrawn from the Investment Fund for the Valuation Period and after deduction of investment advisory fees and direct operating expenses of the specified trust or investment company; for this purpose, Equitable uses the share value reported to Equitable by the specified trust or investment company); (b) is the value of the Investment Fund's shares of the related portfolio of the specified trust or investment company at the end of the preceding Valuation Period (taking into account any amounts allocated or withdrawn for that Valuation Period); (c) is the daily Separate Account charges (see Section 8.04) for the expenses and risks of the Contract, times the number of calendar days in the Valuation Period, plus any charge for taxes or amounts set aside as a reserve for taxes. SECTION 2.04 AVAILABILITY OF INVESTMENT OPTIONS Section 3.01 of this Contract describes the allocation of Contributions among Investment Options pursuant to the Owner's election. Such election is subject to the following: (a) If the Contributions made under this Contract with respect to a Certificate are made pursuant to the terms of a Plan, then the availability of Investment Options may be subject to the terms of such Plan, as reported to Equitable by the Owner. (b) Equitable reserves the right to limit the number of Options which an Owner may elect. The Certificate will list which Options are available. SECTION 2.05 CHANGES WITH RESPECT TO SEPARATE ACCOUNTS In addition to the right reserved pursuant to subsection (b) of Section 2.04, Equitable reserves the right, subject to compliance with applicable law, including approval of Owners if required: (a) to add Investment Funds (or sub-funds of Investment Funds) to, or to remove Investment Funds (or sub-funds) from, a Separate Account, or to add or remove Separate Accounts; (b) to combine any two or more Investment Funds or sub-funds thereof; No. 1050-94IC Page 8 (c) to transfer the assets Equitable determines to be the share of the class of contracts to which this Contract belongs from any Separate Account or Investment Fund to another Separate Account or Investment Fund; (d) to operate the Separate Account or any Investment Fund as a management investment company under the Investment Company Act of 1940, in which case charges and expenses that otherwise would be assessed against an underlying Mutual Fund would be assessed against the Separate Account; (e) to operate the Separate Account or any Investment Fund as a unit investment trust under the Investment Company Act of 1940; (f) to deregister the Separate Account or any Investment Fund under the Investment Company Act of 1940, provided that such action conforms with the requirements of applicable law; (g) to restrict or eliminate any voting rights as to the Separate Account; (h) to cause one or more Separate Accounts or Investment Funds to invest some or all of their assets in one or more other trusts or investment companies. If the exercise of these rights results in a material change in the underlying investments of a Separate Account, the Contract Holder and each Owner will be notified of such exercise, as required by law. A Separate Account or Investment Fund which may be added by Equitable as described above may be one with respect to which (i) there may be periods during which contributions are restricted pursuant to the maturity terms of such Account, (ii) amounts therein may be automatically liquidated according to the investment policy of the Account, and (iii) investments therein may mature. Equitable will have the right to reallocate amounts arising from liquidation or maturity according to the Owner's allocation instructions then in effect unless the Owner specifies other instructions with respect to said amounts. If no such allocation instructions have been made, the reallocation will be made to a designated Investment Option, or to the next established Account or Fund of the same type as described in this paragraph, if applicable, as specified in the Certificate. No. 1050-94IC Page 9 PART III - CONTRIBUTIONS AND ALLOCATIONS SECTION 3.01 CONTRIBUTIONS, ALLOCATIONS Contributions will be remitted on behalf of an Annuitant from the Owner (who may also be the Annuitant, if so stated in the Certificate.) The Owner will elect which Investment Options will be available under the Certificate issued to the Owner, subject to the terms of Section 2.04. Once this election is made, the Owner may only allocate Contributions to, or transfer among, these Options. The Owner may add or subtract Options after the Certificate is issued by sending Equitable a written request, but Equitable has the right to decline such request. The Owner will also elect how to allocate Contributions among the Options elected. If the Owner is not the Annuitant, the Owner may delegate to the Annuitant authority to allocate Contributions. The Owner need not allocate Contributions to each Option elected. The Owner may change the allocation instruction at any time by sending Equitable the proper form. Allocation percentages must be in whole numbers (no fractions) and must equal 100%. Each Contribution is allocated (after deduction of any charges that may apply) in accordance with the allocation instructions in effect on the Transaction Date. Contributions made to a Separate Account purchase Accumulation Units in that Account, using the Accumulation Unit Value for that Transaction Date. SECTION 3.02 LIMITS ON CONTRIBUTIONS Equitable reserves the right not to accept any Contribution which is less than the amount shown in the Certificate. The applicable Appendix to this Contract indicates other minimum and maximum Contribution requirements which may apply. Equitable also reserves the right, upon advance notice to the Contract Holder and each Owner, to (a) change such requirements to apply to Contributions made after the date of such change, and (b) discontinue acceptance of Contributions under this Contract (i) with respect to all Owners or (ii) with respect to all Owners to whom the same type of Certificate applies (as described in Section 1.07). No. 1050-94IC Page 10 PART IV - TRANSFERS AMONG INVESTMENT OPTIONS SECTION 4.01 TRANSFER REQUESTS The Owner may upon request transfer all or part of the amount held with respect to a Certificate in an Investment Option to one or more of the other Options. A transfer request must be made in a form acceptable to Equitable. All transfers will be made on the Transaction Date and will be subject to the terms of Section 4.02 and to Equitable's rules in effect at the time of transfer. With respect to a Separate Account, the transfers will be made at the Accumulation Unit Value for that Transaction Date. SECTION 4.02 TRANSFER RULES The transfer rules which apply are stated in the Certificate. A transfer request will not be accepted by Equitable if it involves less than the minimum amount, if any, stated in the Certificate (unless the Annuity Account Value is less than such amount). Equitable has the right to change transfer rules. Any change will be made upon advance notice to the Contract Holder and to each Owner. The Investment Funds may consist of funds which are classified as "Type A" Investment Options or "Type B" Investment Options or any other type which may be specified in the Certificate, as Equitable designates in its discretion for purposes of the transfer rules described in the Certificate. The Certificate will specify whether such Investment Options are designated Type A or Type B, or another type as well as the minimum or maximum limits on transfers which apply. No. 1050-94IC Page 11 PART V - WITHDRAWALS AND TERMINATION SECTION 5.01 WITHDRAWALS Unless otherwise stated in the Certificate, the Owner may make a request to Equitable, pursuant to Equitable's procedures then in effect, for a withdrawal from the Investment Options before the Annuity Commencement Date and while the Annuitant is alive. On the Transaction Date, Equitable will pay the amount of the withdrawal requested by the Owner or, if less, the Cash Value. The amount to be paid plus any Withdrawal Charge applicable pursuant to Section 8.01 will be withdrawn on a pro-rata basis from the amounts held with respect to the Certificate in the Investment Options, unless the Owner elects otherwise or unless otherwise stated in the Certificate. A withdrawal request will not be accepted by Equitable if it involves less than the minimum amount, if any, stated in the Certificate (unless the Annuity Account Value is less than such amount). Further conditions or restrictions on distributions may apply if stated in the Certificate. SECTION 5.02 TERMINATION The Certificate will terminate if one or more of the following events occurs, unless otherwise specified in the Certificate: (a) If a withdrawal made under Section 5.01 would result in an Annuity Account Value of an amount less than the minimum amount stated in the Certificate, Equitable will so advise the Owner and reserve the right to pay such Value to the Owner, in which case the Certificate will be terminated. (b) Before an Annuitant's Annuity Commencement Date, Equitable has the right to pay the Cash Value and terminate the Certificate if no Contributions are made during the last three completed Contract Years (or such other number of years stated in the Certificate and permitted under applicable law), and the Annuity Account Value is less than the amount described in subsection (a) above. (c) Equitable also has the right to terminate the Certificate if no Contributions have been made with respect to the Annuitant within 120 days of the Contract Date. No. 1050-94IC Page 12 PART VI - DEATH BENEFITS SECTION 6.01 DEATH BENEFIT Upon receipt by Equitable of due proof that the Annuitant has died prior to the Annuity Commencement Date, Equitable will pay a death benefit to the beneficiary named under Section 6.02. Payment of the death benefit is subject to the terms of Section 6.02 and any special rules which may apply as stated in an Appendix hereto and the Certificate. The amount of the death benefit under this Contract will be determined by Equitable as specified in the Certificate. The death benefit will be paid as an Annuity Benefit or in a single sum, as described in Section 6.02. SECTION 6.02 BENEFICIARY The Owner will give Equitable the name of the beneficiary who is to receive any death benefit payable on the Annuitant's death. The Owner may change the beneficiary from time to time during the Annuitant's lifetime and while coverage under this Contract is in force. Any such change must be made in writing in a form Equitable accepts. A change will, upon receipt at the Processing Office, take effect as of the date the written form is executed, whether or not the Owner is living on the date of receipt. Equitable will not be liable as to any payments it made before it receives any such change. The Owner may name one or more persons to be primary beneficiary on the Annuitant's death and one or more persons to be successor beneficiary if the primary beneficiary dies before the Annuitant. Unless the Owner directs otherwise, if the Owner has named two or more persons as beneficiary, the beneficiary will be the named person or persons who survive the Annuitant and payments will be made to such persons in equal shares or the survivor. Any part of a death benefit payable as described in Section 6.01 for which there is no named beneficiary living at the Annuitant's death will be payable in a single sum to the Annuitant's children who survive the Annuitant, in equal shares, or should none survive or should there be none, then to the Annuitant's estate. If the Owner so elects in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by the Owner, subject to Equitable's rules then in effect. If at the Annuitant's death there is no election in effect, the beneficiary may make such an election. In the absence of any election by either the Owner or the beneficiary, Equitable will pay the death benefit in a single sum. The naming of a beneficiary is subject to the terms of the Plan, if applicable, including any terms requiring spousal consent. No. 1050-94IC Page 13 PART VII ANNUITY BENEFITS SECTION 7.01 ANNUITY BENEFIT Payments under an Annuity Benefit will be made monthly. An election may be made by the Owner instead to have the Annuity Benefit paid at other intervals, such as every three months, six months, or twelve months, instead of monthly, subject to Equitable's rules at the time of election or as stated in the Certificate. This election may be made at the time the Annuity Benefit form as described in Section 7.02 is elected; in that event, all references in this Contract to monthly payments will, with respect to the Annuity Benefit of such an Annuitant to whom the election applies, be deemed to mean payments at the frequency elected. SECTION 7.02 ELECTION OF ANNUITY BENEFITS As of the Annuitant's Annuity Commencement Date, provided the Annuitant is then living, the Annuity Account Value will be applied to provide the Normal Form of Annuity Benefit (described in Section 7.04). However, the Owner may instead elect (i) to have the Cash Value paid in a single sum, (ii) to apply the Annuity Account Value or Cash Value, whichever is applicable pursuant to the first paragraph of Section 7.05 to provide an Annuity Benefit of any form offered by Equitable or one of Equitable's subsidiary life insurance companies, or (iii) to apply the Cash Value to provide any other form of benefit payment offered by Equitable, subject to Equitable's rules then in effect and applicable laws and regulations. At the time an Annuity Benefit is purchased, Equitable will issue a supplementary contract which reflects the Annuity Benefit terms. Equitable will provide notice and election forms to the Owner within six months before the Annuity Commencement Date. Equitable will have the right to require the Owner to furnish any information Equitable needs to provide an Annuity Benefit and will be fully protected in relying on such information and need not inquire as to the accuracy or completeness thereof. SECTION 7.03 COMMENCEMENT OF ANNUITY BENEFITS Before the Annuity Commencement Date, the Owner may elect to change such Date. The changed Date may be any date after the election is filed (other than the 29th, 30th, or 31st day of any month). Any election for such change must be made in writing by the Owner and will not take effect until received and accepted by Equitable at its Processing Office. However, unless provided otherwise in any Appendix of this Contract, no Annuity Commencement Date will be later than the first day of the month which follows the date the Annuitant attains the "maximum maturity age" or, if later, the tenth anniversary of the Contract Date. The current maximum maturity age is specified in the Certificate; such age may be changed by Equitable in conformance with applicable law. No. 1050-94IC Page 14 SECTION 7.04 ANNUITY BENEFIT FORMS The "Normal Form" of Annuity Benefit is an Annuity Benefit payable on the Life-Period Certain Annuity Form described below, unless another form is to apply pursuant to the terms of the Plan, if applicable, the requirements of the Employee Retirement Income Security Act of 1974 (ERISA), as amended, or any other law that applies. The Certificate will specify the Normal Form which applies. Equitable may offer other annuity forms as available from Equitable or from one of Equitable's affiliated or subsidiary life insurance companies. Such a form may include the Joint and Survivor Life Annuity Form providing monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage, as elected, of the monthly amount that was paid while both were living. The Life-Period Certain Annuity is an annuity payable during the lifetime of the person upon whose life the payments depend, but with 10 years of payments guaranteed (10 years certain period). That is, if the Annuitant dies before the certain period has ended, payments will continue to the beneficiary named to receive such payments for the balance of the certain period. SECTION 7.05 AMOUNT OF ANNUITY BENEFITS If the Owner elects pursuant to Section 7.02 to have an Annuity Benefit paid in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will, unless otherwise specified in the Certificate or required by applicable laws and regulations, be (i) the Annuity Account Value if the annuity form elected provides payments for a person's remaining lifetime or (ii) the Cash Value if the annuity form elected does not provide such lifetime payments. The amount applied to provide an Annuity Benefit may be reduced by a charge for any taxes which apply on annuity purchase payments. If Equitable has previously deducted charges for applicable taxes from Contributions, Equitable will not again deduct charges for the same taxes before an Annuity Benefit is provided. The balance will be used to purchase the Annuity Benefit on the basis of either (i) the Tables of Guaranteed Annuity Payments or (ii) Equitable's then current individual annuity rates, whichever rates would provide a larger benefit with respect to the payee. SECTION 7.06 CONDITIONS Equitable may require proof acceptable to it that the person on whose life a benefit payment is based is alive when each payment is due. Equitable will require proof of the age of any person on whose life an Annuity Benefit is based. If a benefit was based on information that is later found not to be correct, such benefit will be adjusted on the basis of the correct information. The adjustment will be made in the number or amount of the benefit payments, or any amount used to provide the benefit, or any combination. Overpayments by Equitable will be charged against future payments. Underpayments will be added to future payments. Equitable's liability is limited to the correct information and the actual amounts used to provide the benefits. No. 1050-94IC Page 15 If the age (or sex, if applicable as stated in the Tables of Guaranteed Annuity Payments) of any person upon whose life an Annuity Benefit depends has been misstated, any benefits will be those which would have been purchased at the correct age (or sex). Any overpayments or underpayments made by Equitable will be charged or credited with interest at (a) the rate shown in the Certificate or (b) the then current Guaranteed Interest Rate; Equitable will determine which rate will apply, on a uniform and nondiscriminatory manner, for similar Certificates. Such interest will be deducted from or added to future payments. If Equitable receives proof satisfactory to it that (i) a payee entitled to receive any payment under the terms of this Contract is physically or mentally incompetent to receive such payment or a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, Equitable may make the payments to such other person or institution. In the case of a minor, the payments will not exceed [$200] or such other amount shown in the Certificate. Equitable will have no further liability with respect to the payments so made. If the amount to be applied hereunder is less than [$2,000] or would result in an initial payment of less than [$20], Equitable may pay the amount to the payee in a single sum instead of applying it under the annuity form elected. SECTION 7.07 CHANGES Equitable reserves the right, upon advance notice to the Contract Holder and each Owner, to change at any time on and after the fifth anniversary of the Register Date of this Contract, at intervals of not less than five years, the actuarial basis used in the Tables of Guaranteed Annuity Payments; however, no such change will apply to (A) any Annuity Benefit provided before the change or (B) Contributions made before such change which are applied to provide an Annuity Benefit. No. 1050-94IC Page 16 PART VIII - CHARGES SECTION 8.01 WITHDRAWAL CHARGES The amount of the Withdrawal Charge, if applicable, will be specified in the Certificate issued with respect to the Annuitant. Equitable reserves the right to change such Charge with respect to future Contributions, subject to any maximum amount specified in the Certificate. If specified in the Certificate, a "Free Corridor Amount" will apply as follows: "Free Corridor Amount" means an amount equal to a percentage of the Annuity Account Value, minus the total of all prior withdrawals (and associated Withdrawal Charges) made as described in Section 5.01 in the current Contract Year. Such percentage for this purpose will be (a) determined by Equitable with respect to each Annuitant on a uniform and nondiscriminatory basis and (b) specified in the Certificate; it will be any percentage between [0% and 30%] if so provided in the Certificate. If the amount of a withdrawal made under Part V is more than the Free Corridor Amount (defined above), Equitable will (a) first withdraw from the Investment Options, on the basis described in Section 5.01, an amount equal to the Free Corridor Amount, and (b) then withdraw from the Investment Options an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a Withdrawal Charge as specified in the Certificate. For purposes of this Section, amounts withdrawn up to the Free Corridor Amount will not be deemed a withdrawal of any Contributions. Equitable reserves the right to carry forward the Free Corridor Amount into a future Contract Year, if not used in any Year with respect to an Annuitant, as specified in the Certificate. Any withdrawals in excess of the Free Corridor Amount will be deemed withdrawals of Contributions in the reverse order in which they were made; that is, Contributions will be withdrawn on a last-in, first-out basis. However, Equitable reserves the right instead to deem Contributions withdrawn on a first-in, first-out basis. If Equitable exercises this right, it will do so with respect to Certificates for which the Contract Date occurs after the effective date of the change, and the first-in, first-out basis will be specified in the Certificate. In addition, the Annuitant's years of participation under the Prior Contract, if applicable, will be included for purposes of determining the Withdrawal Charge, if so specified in the Certificate in accordance with Equitable's rules then in effect. If specified in the Certificate, Equitable reserves the right to reduce or waive the Withdrawal Charge in such circumstances as it determines. The Certificate issued with respect to the Annuitant will specify the circumstances, if any, by which a waiver will apply. No. 1050-94IC Page 17 Moreover, the Withdrawal Charge will be reduced if needed in order to comply with any applicable state or federal law. SECTION 8.02 ADMINISTRATIVE AND OTHER CHARGES DEDUCTED FROM ANNUITY ACCOUNT VALUE As of each Processing Date, Equitable will deduct Administrative Charges, a charge for the minimum guaranteed death benefit, if applicable, or other Charges related to the administration and/or distribution of certificates under this Contract from the Annuity Account Value. Such Charges are specified in the Certificate. If specified in the Certificate, the Charges will be deducted in full or prorated for the Contract Year, or portion thereof, in which the Contract Date occurs or in which the Annuity Account Value is withdrawn or applied to provide an Annuity Benefit or death benefit. If so, the Charges will be deducted when withdrawn or so applied. The amount of any such Charge for any Contract Year will in no event exceed any maximum amount stated in the Certificate subject to the maximum amount permitted under any applicable law. Equitable reserves the right to reduce or waive said Charges in such circumstances as it determines. SECTION 8.03 TRANSFER CHARGES Equitable reserves the right to impose a charge with respect to any transfer among Investment Options after the number of free transfers, as specified in the Certificate, made on behalf of an Annuitant. The amount of such charge will be set forth in a notice from Equitable to the Contract Holder and each Owner and in no event will exceed any maximum amount stated in the Certificate. SECTION 8.04 DAILY SEPARATE ACCOUNT CHARGE Assets of the Separate Account will be subject to a daily asset charge. This daily asset charge is for mortality risk, expenses and expense risk which Equitable assumes, as well as for financial accounting and death benefits if specified in the Certificate. The charge will be made pursuant to item (c) of "Net Investment Factor" as defined in Section 2.03. Such charge will be applied after any deductions to provide for taxes. It will be at a rate not to exceed the maximum annual rate stated in the Certificate. Equitable reserves the right to charge less on a current basis; the actual charge to apply will be specified in the Certificate. SECTION 8.05 CHANGES In addition to the right of Equitable to reduce or waive charges as described in this Part VIII, Equitable reserves the right, upon advance notice to the Contract Holder and each Owner, to increase the amount of any charge stated in the Certificate issued with respect to each Annuitant, subject to (a) any maximum amount provided in this Part VIII and (b) No. 1050-94IC Page 18 with respect to Withdrawal Charges and Administrative or other Charges deducted from the Annuity Account Value, the application of any increase only to Contributions made after the date of the change. Equitable also reserves the right, upon advance written notice to the Contract Holder, to increase the maximum amount of any charge provided in this Part VIII or the Certificate, only with respect to Annuitants whose Contract Date occurs after the effective date of the increase, but not to exceed the maximum amount then permitted by any law that applies or, with respect to the daily Separate Account charge described in Section 8.04, by the Securities and Exchange Commission. No. 1050-94IC Page 19 PART IX - GENERAL PROVISIONS SECTION 9.01 CONTRACT This Contract constitutes the entire contract between the parties and will govern with respect to the rights and obligations of Equitable. This Contract may not be modified, nor may any of Equitable's rights or requirements be waived, except in writing and by an authorized officer of Equitable. In addition to the rights of change reserved by Equitable as provided in this Contract, the Contract may be changed by amendment or replacement without the consent of any other person provided that such change does not reduce any Annuity Benefit provided before such change and provided that no rights, privileges or benefits under the Contract with respect to Contributions made hereunder prior to the effective date of such change may be adversely affected by an amendment to the Contract without the consent of the Contract Holder and each Owner. SECTION 9.02 STATUTORY COMPLIANCE Equitable reserves the right to amend this Contract without the consent of any other person in order to comply with applicable laws and regulations. Such right will include, but not be limited to, the right to conform the Contract to reflect changes in the Code, in Treasury regulations or published rulings of the Internal Revenue Service, ERISA, and in Department of Labor regulations. The benefits and values available under this Contract will not be less than the minimum benefits required by any applicable state law. SECTION 9.03 DEFERMENT Application of proceeds to provide a payment of a death benefit under Part VI and payment of any portion of the Annuity Account Value (less any applicable Withdrawal Charge) will be made within seven days after the Transaction Date. Payments or applications of proceeds from a Separate Account may be deferred for any period during which (1) the New York Stock Exchange is closed or trading is restricted, (2) sales of securities or determination of the fair value of the Account's assets is not reasonably practicable because of an emergency, or (3) the Securities and Exchange Commission, by order, permits Equitable to defer payment in order to protect persons with interests in the Separate Account. Equitable may defer payment or transfer of any portion of the Annuity Account Value in the Guaranteed Interest Account for up to six months while the Owner is living. SECTION 9.04 REPORTS AND NOTICES With respect to each Certificate, at least once each year until the Annuity Commencement Date, Equitable will furnish the Owner with a report showing the following: (a) the dollar amount in the Guaranteed Interest Account, No. 1050-94IC Page 20 (b) the total number of Accumulation Units in each Separate Account or Investment Fund, (c) the Accumulation Unit Value, (d) the dollar amount in each Separate Account or Investment Fund, (e) the Cash Value, and (f) the amount of the death benefit. The terms of this Contract which require Equitable to send a report as described above or any written notice as described in any other Section will be satisfied by Equitable mailing any such report or notice to the Owner's last known address as shown in Equitable's records. All written notices sent to Equitable will not be effective until received in good order at the Processing Office. SECTION 9.05 ASSIGNMENTS No amounts payable under this Contract to a payee other than the Owner may be assigned by that payee unless permitted herein, nor will they be subject to the claims of creditors or to legal process, except to the extent permitted by law. The Certificate will describe any other restrictions or assignments which may apply. SECTION 9.06 CONTRACT HOLDER'S RESPONSIBILITY The sole responsibility of the Contract Holder is to serve as party to the Contract. The Contract Holder will have no responsibility for the administration of any Plan or agreement, or for Contributions or any payments or other distributions hereunder. Equitable will deal with the Contract Holder in accordance with the terms and conditions of the trust agreement pursuant to which the Contract Holder agreed to act as such and in such manner as the Contract Holder and Equitable agree, without the consent of any other person. SECTION 9.07 MANNER OF PAYMENT Equitable will pay all amounts payable under this Contract by check (in United States dollars) or, if so agreed upon by an Owner and Equitable, by wire transfer. All amounts payable by the Owner will be paid by check payable to Equitable (in United States dollars) or by any other method acceptable to Equitable. No. 1050-94IC Page 21 TABLE OF GUARANTEED ANNUITY PAYMENTS ------------------------------------ [APPLICABLE TO IRA CERTIFICATES] ------------------------------ [AMOUNT OF ANNUITY BENEFIT PAYABLE MONTHLY ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM (WITH 100% OF THE AMOUNT OF THE ANNUITANT'S PAYMENT CONTINUED TO THE ANNUITANT'S SPOUSE) PROVIDED BY AN APPLICATION OF $1,000. FEMALE AGES
AGE 60 61 62 63 64 65 66 67 68 69 70 60 3.39 3.42 3.46 3.49 3.52 3.55 3.58 3.61 3.64 3.67 3.70 61 3.41 3.45 3.48 3.51 3.55 3.58 3.61 3.64 3.68 3.71 3.74 62 3.43 3.47 3.50 3.54 3.57 3.61 3.64 3.68 3.71 3.74 3.78 63 3.45 3.49 3.52 3.56 3.60 3.63 3.67 3.71 3.74 3.78 3.82 MALE 64 3.47 3.51 3.54 3.58 3.62 3.66 3.70 3.74 3.78 3.82 3.86 AGES 65 3.48 3.52 3.56 3.61 3.65 3.69 3.73 3.77 3.81 3.85 3.89 66 3.50 3.54 3.58 3.63 3.67 3.71 3.76 3.80 3.84 3.89 3.93 67 3.52 3.56 3.60 3.65 3.69 3.74 3.78 3.83 3.88 3.92 3.97 68 3.53 3.57 3.62 3.67 3.71 3.76 3.81 3.86 3.91 3.96 4.00 69 3.54 3.59 3.64 3.69 3.73 3.78 3.83 3.88 3.94 3.99 4.04 70 3.56 3.60 3.65 3.70 3.75 3.81 3.86 3.91 3.96 4.02 4.07
The amount of income provided under an Annuity Benefit payable on the Joint and Survivor Life Annuity form is based on 2.5% interest and the 1983 Individual Annuity Mortality Table "a" projected with modified Scale G. Amounts required for ages or for annuity forms not shown in the above Table will be calculated by Equitable on the same actuarial basis. If a variable annuity form is available from Equitable and elected pursuant to Section 7.02, then the amounts required will be calculated by Equitable based on the 1983 Individual Annuity Mortality Table "a" projected with modified Scale "G" and a modified two year age setback and on an Assumed Base Rate of Net Investment Return of 3.5%/5.0%.] No. 1050-94IC Page 22 TABLE OF GUARANTEED ANNUITY PAYMENTS [APPLICABLE TO NON-QUALIFIED CERTIFICATES] [AMOUNT OF ANNUITY BENEFIT PAYABLE MONTHLY ON THE LIFE ANNUITY FORM WITH TEN YEARS CERTAIN PROVIDED BY APPLICATION OF $1,000. Monthly Income Monthly Income [Ages Males Females Age Males Females ---- ----- ------- --- ----- ------- 60 4.12 3.70 73 5.52 4.87 61 4.20 3.76 74 5.66 4.99 62 4.29 3.83 75 5.80 5.12 63 4.38 3.90 76 5.95 5.26 64 4.48 3.98 77 6.10 5.40 65 4.58 4.06 78 6.25 5.55 66 4.68 4.14 79 6.40 5.70 67 4.79 4.23 80 6.56 5.85 68 4.90 4.32 81 6.72 6.01 69 5.02 4.42 82 6.88 6.18 70 5.14 4.52 83 7.04 6.34 71 5.26 4.63 84 7.20 6.51 72 5.39 4.75 85 7.36 6.67 The amount of income provided under an Annuity Benefit payable on the Joint and Survivor Life Annuity form is based on 2.5% interest and the 1983 Individual Annuity Mortality Table "a" projected with modified Scale G, adjusted to a unisex basis, reflecting a 20%-80% split of males and females at pivotal age 55. Amounts required for ages not shown in the above Table or for other annuity forms will be calculated by Equitable on the same actuarial basis. If a variable annuity form is available from Equitable and elected pursuant to Section 7.02, then the amounts required will be calculated by Equitable based on the 1983 Individual Annuity Mortality Table "a" projected with modified Scale "G" and a modified two year age setback and a 20%-80% split of males and females at age 55 and on an Assumed Base Rate of Net Investment Return of 3.5%/5.0%.] No. 1050-94IC Page 23 APPENDIX A ---------- APPLICABLE TO IRA CERTIFICATES 1. OWNER: The Annuitant is the Owner. 2. ANNUITY COMMENCEMENT DATE: The Owner may not choose Annuity Commencement Date later than the maximum maturity age specified in the Certificate. If the Owner chooses a date later than the Annuitant's age [70 1/2], the Owner must withdraw at least the minimum distributions required under Section [408(b)] and [401(a)(9)] of the Code and Treasury regulations that apply. See Item 4 of this Appendix. 3. CONTRIBUTIONS: No Contributions will be accepted unless they are in cash (or check or other form as Equitable may require). Except in the case of a rollover contribution (as permitted by Sections [402(c), 403(a)(4), 403(b)(8), or 408(d)(3)] of the Code), the total of such Contributions will not exceed [$2,000] for any taxable year. Amounts transferred to the Contract from an individual retirement account or annuity contract which meets the requirements of Section [408] of the Code are not subject to the [$2,000] limit. If the Owner makes a Contribution which qualifies as an eligible retirement plan rollover as defined in Section [402(c) or 403(b)(8)] of the Code and the Owner commingles such Contribution with other Contributions, the Owner may not be able to roll over the eligible retirement plan Contributions and earnings to another qualified plan or Code Section [403(b)] arrangement at a future date, unless the Code permits. Equitable may agree, if requested, to maintain records with respect to each source of Contributions. For example, a source may arise as follows: [(a) Salary Deferral Contributions: Contributions made pursuant to an individual retirement annuity program in accordance with the requirements of Section 408(b) of the Code and applicable Treasury regulations; (b) Rollover Contributions: Contributions which qualify as eligible retirement plan rollovers within the meaning of Section 402(c) of the Code and applicable Treasury regulations.] The Owner, or Employer if applicable, will determine and report each Source to Equitable, in a form acceptable to Equitable, and will specify as part of each withdrawal and transfer request the Source(s) from which each individual or transfer is to be made. No. 1050-94IC Page 24 4. DEATH BENEFITS: Under the following circumstances, the death benefit described in Section 6.01 will not be paid at the Annuitant's death before the Annuity Commencement Date, and the coverage under this Contract will continue with the Annuitant's surviving spouse as Successor Annuitant and Owner: a. the Annuitant is married at death; b. the person named as beneficiary under Section 6.02 is the Annuitant's surviving spouse; and c. the Annuitant has requested that the spouse become "Successor Annuitant and Owner" of the Certificate if the spouse survives the Annuitant. 5. REQUIRED DISTRIBUTIONS: [The Annuitant's entire interest in the Certificate will be distributed or begin to be distributed no later than the April 1 which follows the calendar year in which the Annuitant attains age 70 1/2 ("Required Beginning Date"). The entire interest may be distributed, as the Annuitant elects, over (a) the Annuitant's life, or the lives of the Annuitant and the named beneficiary, or (b) a period which does not extend beyond the Annuitant's "life expectancy" (defined below), or the joint and last survivor expectancy of the Annuitant and the named beneficiary. Distributions must be made in periodic payments at intervals no longer than one year. Also, payments must be either non-increasing or they may increase only as provided in Regulations (Q & A F-3 of Proposed Treasury Regulation Section 1.401(a)(9)-1 or successor thereto). All distributions made under the Certificate will be made in accordance with the requirements of Code Sections [408(b) and 401(a)(9), including the incidental death benefit requirement of the Code (Section 401(a)(9)(G)) and Treasury Regulations which apply (including minimum distribution incidental benefit requirements of Proposed Treasury Regulation Section 1.401(a)(9)-2) or any successor thereto.] [For purposes of determining the "period certain" referred to in the first paragraph of this item 5, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless the Annuitant otherwise elects before the time distributions are required to begin, life expectancies will be recalculated annually. Such election will be irrevocable and will apply to all subsequent years. In the case of any named beneficiary other than the spouse, if permitted under Equitable's rules then in effect, life expectancies may not be recalculated. Instead, life expectancy will be calculated using the attained age of such beneficiary during the calendar year in which the Annuitant attains age 70 1/2 and payment for any subsequent calendar year will be calculated based on life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated.] No. 1050-94IC Page 25 [If the Annuitant dies after distribution of the Annuitant's entire interest has begun, the remainder of such interest will continue to be distributed at least as rapidly as under the payment method of distribution being used before the Annuitant's death. If the Annuitant dies before distribution of the Annuitant's entire interest begins, distribution of the Annuitant's entire interest will be completed no later than December 31 of the calendar year in which the fifth anniversary of the Annuitant's death occurs, except to the extent that a choice is made to receive death benefit distributions under (a) or (b) below: (a) If the Annuitant's interest is payable to a beneficiary, then the entire interest may be distributed over the life of, or over a period certain not greater than the life expectancy of, the named beneficiary. Such distributions must commence on or before December 31 of the calendar year which follows the calendar year of the Annuitant's death. (b) If the named beneficiary is the Annuitant's surviving spouse, the date that distributions must begin under (a) above will not be earlier than the later of (i) December 31 of the calendar year which follows the year of the Annuitant's death or, (ii) December 31 of the calendar year in which the Annuitant would have reached age 70 1/2. If the designated beneficiary is the Annuitant's surviving spouse, and a Successor Annuitant and Owner option (described in item 4 preceding) is in effect, the distribution of the Annuitant's interest need not be made until after the spouse's death. For purposes of the "period certain" used in (a) above, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes of distributions which begin after the Annuitant's death, unless the surviving spouse elects otherwise by the time distributions are required to begin, life expectancies will be recalculated annually. Such election will be irrevocable by such surviving spouse and will apply to all subsequent years. In the case of any other designated beneficiary, life expectancies will be calculated using the attained age of such beneficiary during the calendar year in which distributions are required to begin, pursuant to this item, and payments for any subsequent calendar year will be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. Distributions under this item are considered to have begun if distributions are made because the Annuitant has reached the Required Beginning Date or if, before the Required Beginning Date, distributions irrevocably commence to the Annuitant over a period permitted and in an annuity form acceptable under Proposed Treasury Regulation 1.401(a)(9)-1 or any successor thereto.] No. 1050-94IC Page 26 6. REPORTS - NOTICES: In addition to the reports described in Section 9.04, Equitable will send the Annuitant a report as of the end of each calendar year showing the status of the annuity and any other reports required by the Code or Treasury regulations. 7. ASSIGNMENTS, NONTRANSFERABILITY, NONFORFEITABILITY: The Owner's rights may not be assigned, pledged, or otherwise transferred except as permitted by law. The Owner may not name a new Owner, except as described in item 4 above. The interest under the Certificate is nonforfeitable. 8. TERMINATION: In the event that an annuity bought under the Contract fails to qualify as an annuity under Section [408(b)] of the Code, Equitable will have the right, upon receipt of notice of such fact, before the Annuity Commencement Date, to terminate the Certificate. In that case, Equitable will pay the Annuity Account Value less a deduction for the part which applies to any Federal income tax payable by the Annuitant which would not have been payable with respect to an annuity which meets the terms of the Code. No. 1050-94IC Page 27 APPENDIX B ---------- APPLICABLE TO NON-QUALIFIED CERTIFICATES 1. CONTRIBUTIONS: Equitable has the right not to accept a Contribution less than the amount(s) shown in the Certificate. 2. OWNER DEATH DISTRIBUTION RULES: Upon the death of an Owner before the Annuity Commencement Date: (a) If the Owner is both the Owner and the Annuitant, Equitable will pay the death benefit described in Section 6.01. Any part of a death benefit payable as described in Section 6.01 for which there is no named beneficiary living at the Owner's death will be payable in a single sum to the Owner's children who survive the Owner in equal shares, or should none survive, then to the Owner's estate. Under the following circumstances, the death benefit described in Section 6.01 will not be paid at the Owner's death before the Annuity Commencement Date, and the coverage under the Contract will continue with the Owner's surviving spouse as Successor Annuitant and Owner: (i) the Owner is married at his or her death; (ii) the person named as the beneficiary who is to receive any death benefit payable on the Owner's death under Section 6.02 is the surviving spouse; and (iii) the Owner has additionally requested that the spouse become "Successor Annuitant and Owner" of the Certificate if such spouse survives the Owner. (b) If the Owner is not the Annuitant, the named beneficiary (successor Owner) will succeed as Owner. The entire amount in the Investment Options subject to any Withdrawal Charge which applies must be fully paid by the fifth anniversary of the Owner's death, or payments must begin within one year after the Owner's death as a life annuity or installment option, for a period of not longer than the life expectancy of the named beneficiary. If the Owner has not elected a form of payment as described in the next to last paragraph of Section 6.02, and if the beneficiary named under Section 6.02 does not elect to receive the payments required by this Section in a form of Annuity Benefit, a series of partial withdrawals, or any payout option acceptable under Section [72(s)] of the Code and Equitable's rules at the time, Equitable No. 1050-94IC Page 28 will pay the amount in the Options in a single sum to the beneficiary on the fifth anniversary of the Owner's death. Subject to Equitable's rules at the time of payment and the completion of an application, the beneficiary may elect to apply such a single sum payment to a new non qualified annuity contract to be owned by the beneficiary. However, if the named beneficiary is the Owner's spouse, full payments of amounts under this Contract must be made not later than five years after the spouse's death. If payments under an Annuity Benefit had begun before the Owner's death, such payments will continue to be made over a period not longer than the period provided for under the Annuity Benefit elected. If the Annuitant dies before the entire amount in the Investment Options is paid, Equitable will pay the death benefit as described in Section 6.01. (c) Unless the Owner directs otherwise, the named beneficiary will also be the person who succeeds as Owner on the Owner's death while the Annuitant is alive as described in Section 6.02. The Owner may change any beneficiary or successor Owner from time to time during the Annuitant's lifetime and while coverage under this Contract is in force, also as described in item (b) above. (d) If the Owner is not the Annuitant, the Owner may name another person to be the successor Owner and to receive the amounts to be paid under item (b) above and another person to be successor Owner if the first choice as successor Owner dies before the Owner. If the Owner has named two or more persons as successor Owner, and more than one survive, they will share equally unless the Owner directs otherwise. If no person named as beneficiary to receive the death benefit survives the Annuitant, Equitable will pay such death benefit in a single sum to the Owner. In the event of the Owner's death after the Annuitant, but before Equitable pays such death benefit, the death benefit will be payable in a single sum to the children who survive the Owner, in equal shares, or should none survive, to the Owner's estate. If the Owner dies before the Annuity Commencement Date while the Annuitant is still living, and if no person named as successor Owner is living at the Owner's death, the beneficiary will be presumed to be, in this order, (i) the Owner's surviving spouse, (ii) the Annuitant, (iii) the children who survive the Owner, in equal shares, or (iv) the Owner's estate. 3. ASSIGNMENTS: Notwithstanding the terms of Section 9.05, the Owner may assign the Certificate and the rights described therein before the Annuity Commencement Date. Equitable will not be bound by an assignment unless Equitable has received it and No. 1050-94IC Page 29 it is in writing. The Owner's rights and those of any other persons referred to in the Certificate will be subject to the assignment. Equitable assumes no responsibility for the validity of any assignment. No. 1050-94IC Page 30 APPENDIX C ---------- MARKET VALUE ADJUSTMENT PROVISIONS The terms of this Appendix will become operative only upon advance notice from Equitable to the Contract Holder and to each Owner affected by such terms. If this Appendix becomes operative, the terms herein will be included in each Certificate issued thereafter. THE TERMS OF THIS APPENDIX CONTAIN A MARKET VALUE ADJUSTMENT ("MVA") FORMULA WHICH MAY RESULT IN ADJUSTMENTS, POSITIVE OR NEGATIVE, IN BENEFITS. AN MVA WILL NOT APPLY UPON TRANSFER TO A NEW GUARANTEE PERIOD OR OTHER INVESTMENT OPTION ON THE EXPIRATION DATE OR PURSUANT TO ITEM 1 BELOW. 1. GUARANTEED PERIOD ACCOUNT Under the terms of this Appendix, Equitable will specify one or more Guarantee Periods in the Guaranteed Period Account. For each such Guarantee Period, Equitable guarantees to credit an interest rate (called the "Guaranteed Rate"). Interest will be credited daily to amounts in the Guaranteed Period Account. The duration of each Guarantee Period provided at any time and the Guaranteed Rate that applies to each Period will be furnished by Equitable upon request. The Guarantee Period(s) and the Rate for each such Period the Owner initially elects are shown in the Certificate. One or more Guarantee Period(s) may be elected by the Owner, according to Equitable's rules then in effect. Contributions and transfers to be made to the Guaranteed Period Account pursuant to Section 3.01 will be allocated to the Guarantee Period(s) according to the Owner's election. Contributions and transfers into the Guaranteed Period Account will receive the Guaranteed Rate applicable to the elected Guarantee Period as of the Business Day Equitable receives such Contribution or transfer request at the Processing Office. The amount held with respect to a given Guarantee Period is referred to as the Guaranteed Period Amount which reflects Contributions and transfers made to the Guaranteed Period Account, plus interest at the Guaranteed Rate(s), minus any withdrawals, transfers and charges, if any, deducted from the Guaranteed Period Account. The last day of a Guarantee Period is the Expiration Date. Equitable will notify the Owner at least [15 but not more 45] days before the Expiration Date of each Period. The Owner may elect one of the following three options effective at the Expiration Date, none of which will result in a market value adjustment: a) to transfer the Guaranteed Period Amount into a Guarantee Period of any duration which Equitable then offers; b) to transfer the Guarantee Period Amount to another Investment Option; No. 1050-94IC Page 31 c) to make a withdrawal of the Guaranteed Period Amount (subject to any Withdrawal Charges which apply pursuant to section 8.01). If no such election is made on or prior to the Expiration Date, the Guaranteed Period Amount (without any market value adjustment) will be transferred into the Investment Option described in the Certificate. During the 30 days following the Expiration Date, the full Guaranteed Period Amount (less any withdrawals and transfers made or charges deducted during that 30 day period) may be transferred into a new Guarantee Period or other Investment Option. In no event can the Owner elect a Guarantee Period which extends beyond the Annuity Commencement Date. The "Guaranteed Period Account" is Equitable's Separate Account No. 46 that Equitable uses to account for amounts allocated to Guarantee Periods under the Contract. All amounts allocated to a Guarantee Period, whether Contributions or transfers, become part of the Guaranteed Period Account. 2. TRANSFERS, WITHDRAWALS, DEATH AND ANNUITY BENEFITS If the Owner requests, other than as described in item 1 above, a transfer to another Investment Option pursuant to Section 4.01 or a withdrawal pursuant to Section 5.01, any such transfer or withdrawal from a Guaranteed Period Amount will be subject to a market value adjustment described below. For this purpose, the Annuity Account Value in Separate Account No. 46 will be after the market value adjustment. The market value adjustment will be in addition to any other charges which apply pursuant to Section 8.01. In addition, amounts applied from a Guaranteed Period Amount to provide a death benefit pursuant to Section 6.01, an annuity pursuant to Section 7.02 or any other annuity form offered by Equitable, will be subject to a market value adjustment, unless otherwise specified in the Certificate. Payment or transfers from a Guaranteed Period Amount may be deferred for up to six months while the Owner is living. 3. MARKET VALUE ADJUSTMENT The market value adjustment with respect to each Guarantee Period that applies to a Certificate Owner is determined as follows: (a) Equitable determines the Guaranteed Period Amount that will be payable on the Expiration Date, using the Guaranteed Rate for such Guarantee Period. (b) Equitable determines the period remaining in the Guarantee Period (based on the Business Day Equitable received the Owner's transaction request at the Processing Office) and converts it to fractional years based on a 365 day year. For example, three years and 12 days, becomes 3.0329. No. 1050-94IC Page 32 (c) Equitable determines the current Guaranteed Rate which applies to new Contributions for the same class of Certificates under a Guarantee Period with the same Expiration Date as the Owner's Guarantee Period. Equitable adds to such current rate a percentage which is no greater than that shown in the Certificate. (d) Equitable determines the present value of the Guaranteed Period Amount payable at the Expiration Date, using the period determined in (b) and the rate determined in (c). (e) Equitable subtracts the current Guaranteed Period Amount from the result in (d). The result is the Market Value Adjustment, which may be positive or negative, applicable to such Guarantee Period. If Equitable is not offering a Guarantee Period to which the "current Guaranteed Rate" would apply, Equitable will use the Rate at the closest Expiration Date. If Equitable is no longer offering new Guarantee Periods, Equitable will use a procedure for determining such current Rate which will be stated in the Certificate or which Equitable will develop and file with the insurance supervisory official of the appropriate jurisdiction. 4. REPORTS AND NOTICES Equitable will report the values under this Appendix with the reports sent out as described in Section 9.04. It will include the Guaranteed Period Amount, market value adjustment, and Annuity Account Value in Separate Account No. 46. No. 1050-94IC Page 33 APPENDIX D ---------- APPLICABLE TO LIFE CONTINGENT ANNUITY DESCRIBED HEREIN The terms of this Appendix apply, notwithstanding any terms to the contrary contained in the Contract and Certificate, if the Owner has elected the Life Contingent Annuity described herein. Under the terms of this Appendix, Equitable provides this Annuity Benefit in consideration of the purchase payment(s) made. The effective date of this Endorsement is the date Equitable receives the initial purchase payment. Equitable pays an Annuity Benefit during the lifetime of the Annuitant(s). The Annuity Benefit ends upon the death of the Annuitant(s). IF THE DEATH OF THE ANNUITANT(S) OCCURS BEFORE THE FIRST ANNUITY BENEFIT PAYMENT IS DUE, EQUITABLE WILL NOT MAKE ANY PAYMENTS NOR WILL EQUITABLE REFUND ANY PURCHASE PAYMENT. THE TERMS HEREIN DO NOT CREATE A CASH VALUE BENEFIT. 1. ANNUITANT(S) The Annuitant is named in the Certificate. If this Annuity Benefit is purchased on a survivorship basis as described below, then more than one Annuitant may be named. 2. PURCHASE PAYMENTS Purchase payments may be made on a flexible basis; the amount, frequency and other conditions are shown in the Certificate. Purchase payments may be paid by check, withdrawn from the Annuity Account Value under the Certificate or from another Equitable contract that the Owner owns. No purchase payments may be paid after the Initial Benefit Payment Date. Purchase payments do not create a cash value under the Certificate. Each purchase payment (less any charges shown in the Data pages) will provide a guaranteed amount of annuity which, when added to all other guaranteed amounts of annuity so purchased with respect to the Annuitant, equals the guaranteed Annuity Benefit to be provided under the terms of this Appendix. 3. ANNUITY BENEFIT PAYMENTS Annuity Benefit payments under the Life Contingent Annuity begin at the Initial Benefit Payment Date stated in the Certificate and continue (a) for the lifetime of the Annuitant or (b) if the Annuity Benefit is purchased on a survivorship basis as elected by the Owner, for as long as at least one of the Annuitants named in the No. 1050-94IC Page 34 Certificate is living. The Annuity Benefit form elected by the Owner at issue will be set forth in the Certificate. The form of the Annuity Benefit may not be changed. Annuity Benefit payments will be made as set forth in the Certificate. They may be made monthly, quarterly or annually. If Equitable does not receive written notice from the Owner, the payments will be made annually. Equitable reserves the right to change the frequency to meet its minimum payment rules, as described in the Certificate. 4. AMOUNT OF ANNUITY BENEFIT Guaranteed Annuity Benefit payments will be based on [4% interest and the 1983 "a" Individual Annuity Mortality table, projected with modified Scale "G"]. The schedule in the Certificate shows the guaranteed purchase rates for the Initial Benefit Payment Date selected. Before the Initial Benefit Payment Date, Equitable will report annually the amount of payments to be provided at such Date. In addition, Equitable may from time to time increase the amount of the Annuity Benefit payments based on changes in its expectations as to future mortality and interest. Any such increase will be made on a uniform and non-discriminatory basis. 5. INITIAL BENEFIT PAYMENT DATE The Owner may elect to change the Initial Benefit Payment Date subject to conditions shown in the Certificate. The Annuity Benefit will be determined by applying the present value of Annuity Benefits as of the prior Initial Benefit Payment Date using the guaranteed mortality and interest (see item 4). If the Owner wishes to change such Date, the Owner must do this in writing. The change will not take effect until written election is received and accepted by Equitable at its Processing Office. If this Appendix applies in connection with an IRA Certificate, the recalculation of life expectancies as described in item 5, the third paragraph, of Appendix A will apply in determining the required distributions. 6. TRANSFERS/WITHDRAWALS This Appendix provides no Annuity Account Value. No transfers or withdrawals, described in Parts IV and V of the Certificate, will apply to purchase payments made under this Appendix. 7. DEATH BENEFITS Payments will continue as long as an Annuitant survives. There will be no death benefits payable to any beneficiary under this Appendix. No. 1050-94IC Page 35 If the death of the Annuitant(s) occurs before the due date of the first Annuity Benefit payment, Equitable will not make any payments under the Annuity Benefit nor will Equitable refund any part of the purchase payments paid for it. 8. ASSIGNMENT This Annuity may not be sold, assigned, discounted or pledged as collateral for a loan or as security for the performance of an obligation or for any other purpose, and except as otherwise permitted by law, no sum payable under this Annuity may be transferred, assigned or encumbered, or will in any way be subject to any legal process to subject the same to the payment of any claim against the person to whom any sum is payable. 9. PAYMENT All payments by Equitable under this Annuity will be made by check (in United States dollars) and will be payable at the Processing Office. 10. CONDITIONS Equitable may require proof acceptable to it that the person(s) on whose life the Annuity Benefit payment is based is alive when each payment is due. Equitable will require proof of the age of any such person. If the Annuity Benefit was based on information that is later found not to be correct, such Benefit will be adjusted on the basis of the correct information. The adjustment will be made in the amount of the Annuity Benefit payments, or any amount used to provide the Annuity Benefit, or any combination. Overpayments by Equitable will be charged against future payments. Underpayments will be added to future payments. Equitable's liability is limited to the correct information and the actual amounts used to provide the Annuity Benefit. If the age or sex of any person upon whose life the Annuity Benefit depends has been misstated, the Annuity Benefit payments will be those which would have been purchased at the correct age or sex. Any overpayments or underpayments made by Equitable will be charged or credited with interest at the rate shown in the Certificate; Equitable will choose which rate will apply on a uniform basis for like Certificates. Such interest will be deducted from or added to future payments. 11. STATUTORY COMPLIANCE The benefits under this Appendix have been determined without regard to other benefits provided under the Certificate. They will not be less than the minimum benefits required by any applicable state law. No. 1050-94IC Page 36 EX-99.4GCERTIFICATE 15 FORMS OF GROUP ANNUITY CERTIFICATE CERTIFICATE THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES ("Equitable") Processing Office: [Individual Annuity Center, P.O. Box XXXX, G.P.O. New York, New York, 10016] This is the Certificate which is issued under the terms of the Contract defined in Section 1.09. This Certificate is issued in return for the application for coverage under the Contract and the Contributions to be made to us under the Contract. In this Certificate, "we", "our" and "us" mean Equitable. "You" and "your" mean the Owner. We will provide the benefits and other rights pursuant to the terms of this Certificate. [TEN DAYS TO CANCEL - Not later than ten days after you receive this Certificate, you may return it to us. We will cancel it and refund any Contribution made to us.] NEW YORK, THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES /s/ Joseph J. Melone /s/ James M. Benson /s/ Molly K. Heines Chairman and Chief Executive Officer President and Chief Operating Officer Vice President and Secretary
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE (SEE PART II OF THIS CERTIFICATE). No. 94ICA [Cover Page "A"] CERTIFICATE THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES ("Equitable") Processing Office: [Individual Annuity Center, P.O. Box XXXX, G.P.O. New York, New York, 10016] This is the Certificate which is issued under the terms of the Contract defined in Section 1.09. This Certificate is issued in return for the application for coverage under the Contract and the Contributions to be made to us under the Contract. In this Certificate, "we", "our" and "us" mean Equitable. "You" and "your" mean the Owner. We will provide the benefits and other rights pursuant to the terms of this Certificate. [TEN DAYS TO CANCEL - Not later than ten days after you receive this Certificate, you may return it to us. We will cancel it and refund any Contribution made to us, plus or minus any investment gain or loss which applies to the Investment Funds of the Separate Account from the date such Contribution was allocated to such Fund to the date of cancellation.] NEW YORK, THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES /s/ Joseph J. Melone /s/ James M. Benson /s/ Molly K. Heines Chairman and Chief Executive Officer President and Chief Operating Officer Vice President and Secretary
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE IN VALUE (SEE PART II OF THIS CERTIFICATE). No. 94ICB [Cover Page "B"] TABLE OF CONTENTS Page ---- Part I - DEFINITIONS 3 Part II - INVESTMENT OPTIONS 6 Part III - CONTRIBUTIONS AND ALLOCATIONS 10 Part IV - TRANSFERS AMONG INVESTMENT OPTIONS 11 Part V - WITHDRAWALS AND TERMINATION 12 Part VI - DEATH BENEFITS 13 Part VII - ANNUITY BENEFITS 14 Part VIII - CHARGES 17 Part IX - GENERAL PROVISIONS 19 TABLE OF GUARANTEED ANNUITY PAYMENTS 21 DATA No. 94ICA/B Page 2 PART I - DEFINITIONS SECTION 1.01 [ANNUITANT] ["Annuitant"] means the individual shown as such in the Data pages, or any successor [Annuitant]. SECTION 1.02 ANNUITY ACCOUNT VALUE "Annuity Account Value" means the sum of the amounts held for you in the Investment Options. SECTION 1.03 ANNUITY BENEFIT "Annuity Benefit" means a benefit payable by us as described in Part VII. SECTION 1.04 ANNUITY COMMENCEMENT DATE "Annuity Commencement Date" means the date on which annuity payments are to commence as described in Section 7.03. Such date is the date shown in the Data pages and is subject to change as described in Section 7.03. SECTION 1.05 BUSINESS DAY A "Business Day" is any day on which we are open and the New York Stock Exchange is open for trading, or any other day specified in the Data pages. Our Business Day ends at 4:00 p.m., Eastern time, or such other time as we state in writing to you. SECTION 1.06 CASH VALUE "Cash Value" means an amount equal to the Annuity Account Value, less any charges that apply as described in Part VIII and any charges that may apply as described in any applicable Endorsement(s). SECTION 1.07 CERTIFICATE "Certificate" means this certificate including the Data pages and any endorsement(s). It is a summary of the Contract terms which affect you. SECTION 1.08 CODE "Code" means the Internal Revenue Code of [1986], as amended at any time, or any corresponding provisions of prior or subsequent United States revenue laws. SECTION 1.09 CONTRACT "Contract" means the Group Annuity Contract named in the Data pages. A copy of the contract is on file with us. You may ask to see it at any reasonable time. No. 94ICA/B Page 3 SECTION 1.10 CONTRACT DATE "Contract Date" means the earlier of (a) the date on which the [Annuitant] is enrolled under the Contract according to our enrollment procedures and (b) the date of enrollment under a prior Contract. Such date is shown in the Data pages. SECTION 1.11 CONTRACT YEAR "Contract Year" means the twelve month period starting on (i) the Contract Date and (ii) each anniversary of the Contract Date, unless we agree to another period. SECTION 1.12 CONTRIBUTION "Contribution" means a payment made to us under the Contract. See Section 3.01. SECTION 1.13 EMPLOYER "Employer" means, if applicable, an employer as defined in an endorsement hereto. SECTION 1.14 GUARANTEED INTEREST RATE "Guaranteed Interest Rate" means the effective annual rate(s) at which interest accrues on amounts in the [Guaranteed Interest Account]. SECTION 1.15 INVESTMENT FUND "Investment Fund" means a sub-fund of a Separate Account. An Investment Fund may invest its assets in a separate class (or series) or shares of a specified trust or investment company where each class (or series) represents a separate portfolio in such trust or investment company. SECTION 1.16 INVESTMENT OPTION "Investment Option" means the [Guaranteed Interest Account], a Separate Account, or an Investment Fund of a Separate Account [or each Guarantee Period in the Guaranteed Period Account (Separate Account No. 46)]. SECTION 1.17 OWNER "Owner" means the person or entity shown as such in the Data pages, or any successor owner. SECTION 1.18 PLAN "Plan" means, if applicable, the annuity program sponsored by the Employer and as may be defined in an endorsement hereto. SECTION 1.19 PRIOR CONTRACT "Prior Contract" means another contract or certificate issued by us and from which the Owner and we have agreed to transfer amounts to this Contract. No. 94ICA/B Page 4 SECTION 1.20 PROCESSING DATE "Processing Date" means the day(s) we deduct charges from the Annuity Account Value. The Data pages show how often a Processing Date will occur. SECTION 1.21 PROCESSING OFFICE "Processing Office" means the Equitable administrative office shown on the cover page of this Certificate, or such other location we may state upon written notice to you. SECTION 1.22 SEPARATE ACCOUNT "Separate Account" means any of the Separate Accounts [(except our Separate Account No. 46)] described or referred to in Sections 2.02 and 2.05. SECTION 1.23 TRANSACTION DATE The Transaction Date is the Business Day we receive at the Processing Office a Contribution or a transaction request providing the information we need. Transaction requests must be in a form acceptable to us. No. 94ICA/B Page 5 PART II - INVESTMENT OPTIONS SECTION 2.01 [GUARANTEED INTEREST ACCOUNT] Any amount held in the [Guaranteed Interest Account] becomes part of our general assets, which support the guarantees of the Contract and other contracts. The amount in such Account at any time is equal to: o all amounts that have been allocated or transferred to such Account, plus o the amount of any interest credited, less o all amounts that have been withdrawn (including charges) or transferred from such Account. We will credit the amount held in such Account with interest at effective annual rates that we set. We will also set a minimum Guaranteed Interest Rate that will remain in effect through a stated twelve-month period or a calendar year. The Data pages show the initial Rate(s) to apply. We guarantee that any rate so set after your Contract Date will never be less than the minimum rate shown in the Data pages. SECTION 2.02 SEPARATE ACCOUNT We have established the Separate Account(s) and maintain such Account(s) in accordance with the laws of New York State. Income, realized and unrealized gains and losses from the assets of the Separate Account(s) are credited to or charged against it without regard to our other income, gains or losses. Assets are placed in the Separate Account(s) to support the Contract and other variable annuity contracts and certificates. Assets may be placed in the Separate Account(s) for other purposes, but not to support contracts or policies other than variable annuities and variable life insurance. The Data pages set forth the Separate Account(s). A Separate Account may be subdivided into Investment Funds. The assets of a Separate Account are our property. The portion of such assets equal to the reserves and other contract liabilities will not be chargeable with liabilities which arise out of any other business we conduct. We may transfer assets of a Separate Account in excess of the reserves and other liabilities with respect to such Account to another Separate Account or to our general account. We may, at our discretion, invest Separate Account assets in any investment permitted by applicable law. We may rely conclusively on the opinion of counsel (including counsel in our employ) as to what investments we may make as law permits. No. 94ICA/B Page 6 SECTION 2.03 SEPARATE ACCOUNT ACCUMULATION UNITS AND UNIT VALUES The amount you have in an Investment Fund at any time is equal to the number of Accumulation Units you have in that Fund multiplied by the Fund's Accumulation Unit Value at that time. "Accumulation Unit" means a unit which is purchased in a Separate Account. "Accumulation Unit Value" means the dollar value of each Accumulation unit in a Separate Account on a given date. (If Investment Funds apply as described in Section 2.02, then the terms of this Section 2.03 apply separately to each Fund, unless otherwise stated.) Amounts allocated or transferred to a Separate Account are used to purchase Accumulation Units of that Account. Units are redeemed when amounts are deducted, transferred or withdrawn. The number of Accumulation Units you have in a Separate Account at any time is equal to the number of Accumulation Units purchased minus the number of Units redeemed in that Account up to that time. The number of Accumulation Units purchased or redeemed in a transaction is equal to the dollar amount of the transaction divided by the Account's Accumulation Unit Value for that Transaction Date. We determine Accumulation Unit Values for each Separate Account for each Valuation Period. A "Valuation Period" is each Business Day together with any consecutive preceding non-business days. For example, for each Monday which is a Business Day, the preceding Saturday and Sunday will be included to equal a three-day Valuation Period. Unless the following paragraph applies, the Accumulation Unit Value for a Separate Account for any Valuation Period is equal to the Accumulation Unit Value for the immediately preceding Valuation Period multiplied by the ratio of values "(i) " and "(ii) ". Value "(i) " is the value of the Separate Account at the close of business at the end of the current Valuation Period, before any amounts are allocated to or withdrawn from the Separate Account in that Period. Value "(ii)" is the value of the Separate Account at the close of business at the end of the preceding Valuation Period, after all allocations and withdrawals were made for that Period. For this purpose, "value of the Separate Account" means the market value or, where there is no readily available market, the fair value of the assets allocated to the Separate Account, as determined in accordance with our rules, accepted accounting practices, and applicable laws and regulations. To the extent the Separate Account invests in Investment Funds, and the assets of the Funds are invested in a class or series of shares of a specified trust or investment company, the Accumulation Unit Value of an Investment Fund for any Valuation Period is equal to the Accumulation Unit Value for that Fund on the immediately preceding Valuation Period multiplied by the Net Investment Factor for that Fund for the current Valuation Period. The Net Investment Factor for a Valuation Period is (a) divided by (b) minus (c), where (a) is the value of the Investment Fund's shares of the related portfolio of the specified trust or investment company at the end of the Valuation Period (before taking into account any amounts allocated to or withdrawn from the Investment Fund for the Valuation Period and after deduction of investment advisory fees and direct operating expenses of the specified trust or investment No. 94ICA/B Page 7 company; for this purpose, we use the share value reported to us by the specified trust or investment company); (b) is the value of the Investment Fund's shares of the related portfolio of the specified trust or investment company at the end of the preceding Valuation Period (taking into account any amounts allocated or withdrawn for that Valuation Period); (c) is the daily Separate Account charges (see Section 8.04) for the expenses and risks of the Contract, times the number of calendar days in the Valuation Period, plus any charge for taxes or amounts set aside as a reserve for taxes. SECTION 2.04 AVAILABILITY OF INVESTMENT OPTIONS Section 3.01 describes how Contributions are allocated among Investment Options based on your election. Your election is subject to the following: (a) If the Contributions are made pursuant to the terms of a Plan, then Investment Options available may be subject to the terms of such Plan, as reported to us by the Owner. (b) We have the right to limit the number of Options which you may elect. The Data pages list which Options are available as of the Contract Date. SECTION 2.05 CHANGES WITH RESPECT TO SEPARATE ACCOUNT In addition to the right reserved pursuant to subsection (b) of Section 2.04, we have the right, subject to compliance with applicable law, including approval of Certificate owners if required: (a) to add Investment Funds (or sub-funds of Investment Funds) to, or to remove Investment Funds (or sub-funds) from, the Separate Account, or to add other separate accounts; (b) to combine any two or more Investment Funds or sub-funds thereof; (c) to transfer the assets we determine to be the share of the class of contracts to which the Contract belongs from any Investment Fund to another Investment Fund; (d) to operate the Separate Account or any Investment Fund as a management investment company under the Investment Company Act of 1940, in which case charges and expenses that otherwise would be assessed against an underlying mutual fund would be assessed against the Separate Account; (e) to operate the Separate Account or any Investment Fund as a unit investment trust under the Investment Company Act of 1940; (f) to deregister the Separate Account under the Investment Company Act of 1940, provided that such action conforms with the requirements of applicable law; No. 94ICA/B Page 8 (g) to restrict or eliminate any voting rights as to the Separate Account; (h) to cause one or more Investment Funds to invest some or all of their assets in one or more other trusts or investment companies. If the exercise of these rights results in a material change in the underlying investment of a Separate Account, you will be notified of such exercise, as required by law. A Separate Account or Investment Fund which may be added by us as described above may be one with respect to which (i) there may be periods during which Contributions may be restricted pursuant to the maturity terms of such Account or Fund, (ii) amounts therein may be automatically liquidated pursuant to the investment policy of the Account, and (iii) investments therein may mature. We will have the right to reallocate amounts arising from liquidation or maturity according to your allocation instructions then in effect unless you specify other instructions with respect to such amounts. If no such allocation instructions have been made, the reallocation will be made to a designated Investment Option, or to the next established Account or Fund of the same type as described in this paragraph, if applicable, as specified in the Data pages. No. 94ICA/B Page 9 PART III - CONTRIBUTIONS AND ALLOCATIONS SECTION 3.01 CONTRIBUTIONS, ALLOCATIONS You elect which Investment Options will be available under the Certificate subject to the terms of Section 2.04. Once this election is made, you may allocate Contributions to, or transfer among, only these Options. You may add or subtract Options by sending us a written request, but we have the right to decline your request. You also elect how to allocate Contributions among the Options chosen. If you are not the Annuitant, you may delegate to the Annuitant authority to allocate Contributions. You need not allocate Contributions to each Option you have chosen. You may change the allocation election at any time by sending us the proper form. Allocation percentages must be in whole numbers (no fractions) and must equal 100%. Each Contribution is allocated (after deduction of any charges that may apply) in accordance with the allocation election in effect on the Transaction Date. Contributions made to a Separate Account purchase Accumulation Units in that Account, using the Accumulation Unit Value for that Transaction Date. SECTION 3.02 LIMITS ON CONTRIBUTIONS We have the right not to accept any Contribution which is less than the amount shown in the Data pages. The Data pages indicate other minimum and maximum Contribution requirements which may apply. We also have the right, upon advance notice to you, to: (a) change such requirements to apply to Contributions made after the date of such change, and (b) discontinue acceptance of Contributions under the Contract with respect to all Owners or with respect to all Owners to whom the same type of Certificate applies. No. 94ICA/B Page 10 PART IV - TRANSFERS AMONG INVESTMENT OPTIONS SECTION 4.01 TRANSFER REQUESTS You may request to transfer all or part of the amount held in an Investment Option to one or more of the other Options. The request must be in a form we accept. All transfers will be made on the Transaction Date. Transfers are subject to the terms of Section 4.02 and to our rules in effect at the time of transfer. With respect to a Separate Account, the transfers will be made at the Accumulation Unit Value for that Transaction Date. SECTION 4.02 TRANSFER RULES The transfer rules which apply are described in the Data pages. A transfer request will not be accepted if it involves less than the minimum amount, if any, stated in the Data pages (unless the Annuity Account Value is less than such amount). We have the right to change our transfer rules. Any change will be made upon advance notice to you. The Investment Funds may consist of funds which are classified as "Type A" Investment Options or "Type B" Investment Options or any other type which may be specified in the Data pages, as we designate in our discretion for purposes of the transfer rules described in the Data pages. The Data pages specify whether such Investment Options are designated Type A or Type B or another type as well as the minimum or maximum limits on transfers which apply. No. 94ICA/B Page 11 PART V - WITHDRAWALS AND TERMINATION SECTION 5.01 WITHDRAWALS Unless otherwise stated in the Data pages, you may request, pursuant to our procedures then in effect, a withdrawal from the Investment Options before the Annuity Commencement Date and while the [Annuitant] is alive. The request must be in a form we accept. On the Transaction Date, we will pay the amount of the withdrawal requested or, if less, the Cash Value. The amount to be paid plus any Withdrawal Charge which applies (see Section 8.01) will be withdrawn on a pro rata basis from the amounts held for you in the Investment Options, unless you elect otherwise and unless otherwise stated in the Data pages. We will not accept a withdrawal request if it involves less than the minimum amount, if any, stated in the Data pages. Further conditions or restrictions may apply if stated in the Data pages or in an endorsement hereto. SECTION 5.02 TERMINATION This Certificate will terminate if one or more of the following events occurs, unless otherwise specified in the Data pages: (a) If a withdrawal made under Section 5.01 would result in an Annuity Account Value of an amount less than the minimum amount stated in the Data pages, we will so advise you and have the right to pay you such Value. In that case this Certificate will be terminated. (b) Before the Annuity Commencement Date, we have the right to pay the Cash Value and terminate this Certificate if no Contributions are made during the last [three] completed Contract Years, and the Annuity Account Value is less than the amount described in item (a) above. (c) We also have the right to terminate this Certificate if no Contributions have been made within 120 days of the Contract Date. No. 94ICA/B Page 12 PART VI - DEATH BENEFITS SECTION 6.01 DEATH BENEFIT Upon receipt of due proof that the [Annuitant] has died before the Annuity Commencement Date, we will pay a death benefit to the beneficiary named under Section 6.02. Payment may be subject to the terms of Section 6.02 and any special rules which may apply as described in any endorsement hereto. The amount of the death benefit is described in the Data pages. The death benefit will be paid as an Annuity Benefit or in a single sum, as described in Section 6.02. SECTION 6.02 BENEFICIARY You give us the name of the beneficiary who is to receive any death benefit payable on the [Annuitant]'s death. You may change the beneficiary from time to time during the [Annuitant]'s lifetime and while coverage under the Contract is in force. Any such change must be made in writing in a form we accept. A change will, upon receipt at the Processing Office, take effect as of the date the written form is executed, whether or not you are living on the date of receipt. We will not be liable as to any payments we made before we receive any such change. You may name one or more persons to be primary beneficiary on the [Annuitant]'s death and one or more other persons to be successor beneficiary if the primary beneficiary dies before the [Annuitant]. Unless you direct otherwise, if you have named two or more persons as beneficiary, the beneficiary will be the named person or persons who survive the [Annuitant] and payments will be made to such persons in equal shares or to the survivor. Any part of a death benefit payable as described in Section 6.01 for which there is no named beneficiary living at the [Annuitant]'s death will be payable in a single sum to the [Annuitant]'s surviving children. The payments will be made in equal shares, or should none survive or should there be none, then to the [Annuitant]'s estate. If you so elect in writing, any amount that would otherwise be payable to a beneficiary in a single sum may be applied to provide an Annuity Benefit, on the form of annuity elected by you, subject to our rules then in effect. If at the [Annuitant]'s death there is no election in effect, the beneficiary may make such an election. In the absence of any election by either you or the beneficiary, we will pay the death benefit in a single sum. Any naming of a beneficiary is subject to the terms of the Plan, if one applies, including any terms requiring spousal consent. No. 94ICA/B Page 13 PART VII ANNUITY BENEFITS SECTION 7.01 ANNUITY BENEFIT Payments under an Annuity Benefit will be made monthly. You may elect instead to have the Annuity Benefit paid at other intervals, such as every three months, six months, or twelve months, instead of monthly, subject to our rules at the time of your election or as otherwise stated in the Data pages or any endorsement hereto. This election may be made at the time the Annuity Benefit form as described in Section 7.02 is elected. In that event, all references in this Certificate to monthly payments will, with respect to the Annuity Benefit to which the election applies, be deemed to mean payments at the frequency elected. SECTION 7.02 ELECTION OF ANNUITY BENEFITS As of the Annuity Commencement Date, provided the [Annuitant] is then living, the Annuity Account Value will be applied to provide the Normal Form of Annuity Benefit (described below). However, you may instead elect (i) to have the Cash Value paid in a single sum, (ii) to apply the Annuity Account Value or Cash Value, whichever applies pursuant to the first paragraph of Section 7.05, to provide an Annuity Benefit of any form offered by us or one of our subsidiary life insurance companies , or (iii) to apply the Cash Value to provide any other form of benefit payment we offer, subject to our rules then in effect and applicable laws and regulations. At the time an Annuity Benefit is purchased, we will issue a supplementary contract which reflects the Annuity Benefit terms. We will provide notice and election forms to you not more than six months before the Annuity Commencement Date. We will have the right to require you to furnish any information we need to provide an Annuity Benefit. We will be fully protected in relying on such information and need not inquire as to its accuracy or completeness. SECTION 7.03 COMMENCEMENT OF ANNUITY BENEFITS Before the Annuity Commencement Date, you may elect to change such Date to any date after your election is filed (other than the 29th, 30th, or 31st of any month). You must do this in writing. The change will not take effect until your written election is received and accepted by us at our Processing Office. However, no Annuity Commencement Date will be later than the first day of the month which follows the date the [Annuitant] attains the "maximum maturity age" or, if later, the tenth anniversary of the Contract Date. The current maximum maturity age is shown in the Data pages, but may be changed by us in conformance with applicable law. SECTION 7.04 ANNUITY BENEFIT FORMS The "Normal Form" of Annuity Benefit is an Annuity Benefit payable on the Life-Period Certain Annuity Form described below, unless another Form is to apply pursuant to the terms of the Plan, if applicable, the requirements of the Employee Retirement Income No. 94ICA/B Page 14 Security Act of 1974 (ERISA), as amended, or any other law that applies. The Data pages will state the Normal Form which applies. We may offer other annuity forms as available from us or from one of our affiliated or subsidiary life insurance companies. Such a form may, for example, include the Joint and Survivor Life Annuity Form which provides monthly payments while either of two persons upon whose lives such payments depend is living. The monthly amount to be continued when only one of the persons is living will be equal to a percentage, as elected, of the monthly amount that was paid while both were living. The Life-Period Certain Annuity is an annuity payable during the lifetime of the person upon whose life the payments depend, but with 10 years of payments guaranteed (10 years certain period). That is, if the original payee dies before the certain period has ended, payments will continue to the beneficiary named to receive such payments for the balance of the certain period. SECTION 7.05 AMOUNT OF ANNUITY BENEFITS If you elect pursuant to Section 7.02 to have an Annuity Benefit paid in lieu of the Cash Value, the amount applied to provide the Annuity Benefit will, unless otherwise stated in the Data pages or required by applicable laws or regulations, be (i) the Annuity Account Value if the annuity form elected provides payments for a person's remaining lifetime or (ii) the Cash Value if the annuity form elected does not provide such lifetime payments. The amount applied to provide an Annuity Benefit may be reduced by a charge for any taxes which apply on annuity purchase payments. If we have previously deducted charges for taxes from Contributions, we will not again deduct charges for the same taxes before an Annuity Benefit is provided. The balance will be used to purchase the Annuity Benefit on the basis of either (i) the Tables of Guaranteed Annuity Payments or (ii) our then current individual annuity rates, whichever rates would provide a larger benefit with respect to the payee. SECTION 7.06 CONDITIONS We may require proof acceptable to us that the person on whose life a benefit payment is based is alive when each payment is due. We will require proof of the age of any such person on whose life an Annuity Benefit is based. If a benefit was based on information that is later found not to be correct, such benefit will be adjusted on the basis of the correct information. The adjustment will be made in the number or amount of the benefit payments, or any amount used to provide the benefit, or any combination. Overpayments by us will be charged against future payments. Underpayments will be added to future payments. Our liability is limited to the correct information and the actual amounts used to provide the benefits. If the age (or sex, if applicable as stated in the Tables of Guaranteed Annuity Payments) of any person upon whose life an Annuity Benefit depends has been misstated, any benefits will be those which would have been purchased at the correct age (or sex). Any overpayments or underpayments made by us will be charged or credited with interest at (a) the rate shown in the Data pages or (b) the then current Guaranteed Interest Rate; we will choose which rate will apply on a uniform basis for like Certificates. Such interest will be deducted from or added to future payments. No. 94ICA/B Page 15 If we receive acceptable proof that (i) a payee entitled to receive any payment under the terms of the Contract is physically or mentally incompetent to receive such payment or a minor, (ii) another person or an institution is then maintaining or has custody of such payee, and (iii) no guardian, committee, or other representative of the estate of such payee has been appointed, we may make the payments to such other person or institution. In the case of a minor, the payments will not exceed [$200,] or such other amount as may be shown in the Data pages. We will have no further liability with respect to the payments so made. If the amount to be applied hereunder is less than the minimum amount stated in the Data pages, we may pay the amount to the payee in a single sum instead of applying it under the annuity form elected. SECTION 7.07 CHANGES We have the right, upon advance notice to you, to change at any time after the fifth anniversary of the Contract's register date and at intervals of not less than five years, the actuarial basis used in the Tables of Guaranteed Annuity Payments. However, no such change will apply to (a) any Annuity Benefit provided before the change or (b) Contributions made before such change which are applied to provide an Annuity Benefit. No. 94ICA/B Page 16 PART VIII - CHARGES SECTION 8.01 WITHDRAWAL CHARGES The amount of the Withdrawal Charge is stated in the Data pages. We have the right to change the Charge shown in the Data pages with respect to future Contributions, subject to any maximum stated in the Data pages. We will give you notice of any change. If specified in the Data pages, a "Free Corridor Amount" will apply as follows: "Free Corridor Amount" means an amount equal to the percentage, stated in the Data pages, of the Annuity Account Value, minus the total of all prior withdrawals (and associated Withdrawal Charges) made as described in Section 5.01 in the current Contract Year. We have the right to change the Free Corridor Amount, but it will always be a percentage between [0% and 30%] if so provided in the Data pages. If the amount of a withdrawal made under Part V is more than the Free Corridor Amount (defined above), we will (a) first withdraw from the Investment Options, on the basis described in Section 5.01, an amount equal to the Free Corridor Amount, and (b) then withdraw from the Investment Options an amount equal to the excess of the amount requested over the Free Corridor Amount, plus a Withdrawal Charge if one applies. For purposes of this Section, amounts withdrawn up to the Free Corridor Amount will not be deemed a withdrawal of any Contributions. We have the right to carry forward the Free Corridor Amount into a future Contract Year, if not used in any Year, if so stated in the Data pages. Any withdrawals in excess of the Free Corridor Amount will be deemed withdrawals of Contributions in the reverse order in which they were made. That is, Contributions will be withdrawn on a last-in, first-out basis unless the Data pages state that a first-in, first-out basis will apply. In addition, the [Annuitant]'s years of participation under the Prior Contract, if applicable, will be included for purposes of determining the Withdrawal Charge, if so specified in the Data pages in accordance with our rules then in effect. If specified in the Data pages we have the right to reduce or waive the Withdrawal Charge upon such events as stated in the Data pages. Moreover, the Withdrawal Charge will be reduced if needed in order to comply with any applicable state or federal law. SECTION 8.02 ADMINISTRATIVE AND OTHER CHARGES DEDUCTED FROM ANNUITY ACCOUNT VALUE As of each Processing Date, we will deduct Administrative Charges or other Charges related to the administration and/or distribution of this Certificate from the Annuity Account Value. Such Charges are shown in the Data pages. No. 94ICA/B Page 17 If specified in the Data pages, the Charges will be deducted in full or prorated for the Contract Year, or portion thereof, in which the Contract Date occurs or in which the Annuity Account Value is withdrawn or applied to provide an Annuity Benefit or death benefit. If so, the Charges will be deducted when withdrawn or so applied. The amount of any such Charge will in no event exceed any maximum amount shown in the Data pages, subject to any maximum amount permitted under any applicable law. We have the right to change the amount of the Charges with respect to future Contributions. We will give you advance notice of any such change. SECTION 8.03 TRANSFER CHARGES We have the right to impose a charge with respect to any transfer among Investment Options after the number of free transfers, shown in the Data pages, made on behalf of an [Annuitant]. The amount of such charge will be set forth in a notice from us to you and will in no event exceed any maximum amount stated in the Data pages. SECTION 8.04 DAILY SEPARATE ACCOUNT CHARGE Assets of the Investment Funds will be subject to a daily asset charge. This daily asset charge is for mortality risk, expenses and expense risk that we assume, as well as for financial accounting and death benefits if specified in the Data pages. The charge will be made pursuant to item (c) of "Net Investment Factor" as defined in Section 2.03. Such charge will be applied after any deductions to provide for taxes. It will be at a rate not to exceed the maximum annual rate stated in the Data pages. We have the right to charge less on a current basis; the actual charge to apply, for at least the first Contract Year, is also stated in the Data pages. SECTION 8.05 CHANGES In addition to our right to reduce or waive charges as described in this Part VIII, we have the right, upon advance notice to you, to increase the amount of any charge stated in the Data pages, subject to (a) any maximum amount provided in this Part VIII or the Data pages and (b) with respect to Withdrawal Charges and Administrative or Other Charges deducted from the Annuity Account Value, the application of any increase only to Contributions made after the date of the change. No. 94ICA/B Page 18 PART IX - GENERAL PROVISIONS SECTION 9.01 CONTRACT The Contract is the entire contract between the parties. It will govern with respect to our rights and obligations. The Contract may not be changed, nor may any of our rights or rules be waived, except in writing and by our authorized officer. In addition to the rights of change reserved by us as provided in this Certificate, the Contract may be changed by amendment or replacement upon agreement between the Contract Holder and us without the consent of any other person provided that any such change does not reduce any Annuity Benefit provided before such change and provided that no rights, privileges or benefits under the Contract and this Certificate with respect to Contributions made hereunder prior to the effective date of such change may be adversely affected by an amendment without the consent of the Contract Holder and each Certificate Owner. SECTION 9.02 STATUTORY COMPLIANCE We have the right to change the Contract without the consent of any other person in order to comply with any laws and regulations that apply. Such right will include, but not be limited to, the right to conform the Contract to reflect changes in the Code, in Treasury regulations or published rulings of the Internal Revenue Service, ERISA, and in Department of Labor regulations. The benefits and values available under the Contract will not be less than the minimum benefits required by any state law that applies. SECTION 9.03 DEFERMENT The use of proceeds to provide a payment of a death benefit and payment of any portion of the Annuity Account Value (less any Withdrawal Charge that applies) will be made within seven days after the Transaction Date. Payments or use of proceeds from the Investment Funds can be deferred for any period during which (1) the New York Stock Exchange is closed or trading is restricted, (2) sales of securities or determination of the fair value of an Investment Fund's assets is not reasonably practicable because of an emergency, or (3) the Securities and Exchange Commission, by order, permits us to defer payment in order to protect persons with interests in the Investment Funds. We can defer payment or transfer of any portion of the Annuity Account Value in the [Guaranteed Interest Account] for up to six months while you are living. SECTION 9.04 REPORTS AND NOTICES At least once each year until the Annuity Commencement Date, we will send you a report showing: (a) the dollar amount in the [Guaranteed Interest Account]; (b) the total number of Accumulation Units in each Separate Account or Investment Fund; No. 94ICA/B Page 19 (c) the Accumulation Unit Value; (d) the dollar amount in each Separate Account or Investment Fund; (e) the Cash Value; and (f) the amount of the death benefit. The terms which require us to send you a report as described above or any written notice as described in any other Section will be satisfied by our mailing any such report or notice to your last known address as shown in our records. All written notices sent to us will not be effective until received at the Processing Office. Your Certificate Number should be included in all correspondence. SECTION 9.05 ASSIGNMENTS, NONTRANSFERABILITY, NONFORFEITABILITY No amounts payable under the Contract to a payee other than you may be assigned by that payee unless permitted herein, nor will they be subject to the claims of creditors or to legal process, except to the extent permitted by law. Other restrictions may apply if stated in any endorsement hereto. SECTION 9.06 MANNER OF PAYMENT We will pay all amounts hereunder by check (in United States dollars) or, if so agreed by you and us, by wire transfer. All amounts payable by you must be paid by check payable to us (in United States dollars) or by any other method acceptable to us. No. 94ICA/B Page 20 TABLE OF GUARANTEED ANNUITY PAYMENTS ------------------------------------ [APPLICABLE TO IRA CERTIFICATES] -------------------------------- [AMOUNT OF ANNUITY BENEFIT PAYABLE MONTHLY ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM (WITH 100% OF THE AMOUNT OF THE ANNUITANT'S PAYMENT CONTINUED TO THE ANNUITANT'S SPOUSE) PROVIDED BY AN APPLICATION OF $1,000. FEMALE AGES
AGE 60 61 62 63 64 65 66 67 68 69 70 60 3.39 3.42 3.46 3.49 3.52 3.55 3.58 3.61 3.64 3.67 3.70 61 3.41 3.45 3.48 3.51 3.55 3.58 3.61 3.64 3.68 3.71 3.74 62 3.43 3.47 3.50 3.54 3.57 3.61 3.64 3.68 3.71 3.74 3.78 63 3.45 3.49 3.52 3.56 3.60 3.63 3.67 3.71 3.74 3.78 3.82 MALE 64 3.47 3.51 3.54 3.58 3.62 3.66 3.70 3.74 3.78 3.82 3.86 AGES 65 3.48 3.52 3.56 3.61 3.65 3.69 3.73 3.77 3.81 3.85 3.89 66 3.50 3.54 3.58 3.63 3.67 3.71 3.76 3.80 3.84 3.89 3.93 67 3.52 3.56 3.60 3.65 3.69 3.74 3.78 3.83 3.88 3.92 3.97 68 3.53 3.57 3.62 3.67 3.71 3.76 3.81 3.86 3.91 3.96 4.00 69 3.54 3.59 3.64 3.69 3.73 3.78 3.83 3.88 3.94 3.99 4.04 70 3.56 3.60 3.65 3.70 3.75 3.81 3.86 3.91 3.96 4.02 4.07
The amount of income provided under an Annuity Benefit payable on the Joint and Survivor Life Annuity form is based on 2.5% interest and the 1983 Individual Annuity Mortality Table "a" projected with modified Scale "G" . Amounts required for ages or for annuity forms not shown in the above Table will be calculated by us on the same actuarial basis. If a variable annuity form is available from us and elected pursuant to Section 7.02, then the amounts required will be calculated by us based on the 1983 Individual Annuity Mortality Table "a" projected with modified Scale "G" and a modified two year age setback and on an Assumed Base Rate of Net Investment Return of 3.5%/5.0%.] No. 94ICA/B Page 21 TABLE OF GUARANTEED ANNUITY PAYMENTS ------------------------------------ [APPLICABLE TO NON-QUALIFIED CERTIFICATES] ------------------------------------------ [AMOUNT OF ANNUITY BENEFIT PAYABLE MONTHLY ON THE LIFE ANNUITY FORM WITH TEN YEARS CERTAIN PROVIDED BY APPLICATION OF $1,000. Monthly Income Monthly Income Ages Males Females Age Males Females ---- ----- ------- --- ----- ------- 60 4.12 3.70 73 5.52 4.87 61 4.20 3.76 74 5.66 4.99 62 4.29 3.83 75 5.80 5.12 63 4.38 3.90 76 5.95 5.26 64 4.48 3.98 77 6.10 5.40 65 4.58 4.06 78 6.25 5.55 66 4.68 4.14 79 6.40 5.70 67 4.79 4.23 80 6.56 5.85 68 4.90 4.32 81 6.72 6.01 69 5.02 4.42 82 6.88 6.18 70 5.14 4.52 83 7.04 6.34 71 5.26 4.63 84 7.20 6.51 72 5.39 4.75 85 7.36 6.67 The amount of income provided under an Annuity Benefit payable on the Joint and Survivor Life Annuity form is based on 2.5% interest and the 1983 Individual Annuity Mortality Table "a" projected with modified Scale "G", adjusted to a unisex basis, reflecting a 20%-80% split of males and females at pivotal age 55. Amounts required for ages not shown in the above Table or for other annuity forms will be calculated by us on the same actuarial basis. If a variable annuity form is available from us and elected pursuant to Section 7.02, then the amounts required will be calculated by us based on the 1983 Individual Annuity Mortality Table "a" projected with modified Scale "G" and a modified two year age setback and a 20%-80% split of males and females at age 55 and on an Assumed Base Rate of Net Investment Return of 3.5%/5.0%.] No. 94ICA/B Page 22 EX-99.4HCERTIFICATE 16 FORMS OF ENDORSEMENT ENDORSEMENT APPLICABLE TO IRA CERTIFICATES As specified in the Data pages, this Certificate is an "IRA Certificate" which is issued as an individual retirement annuity contract which meets the requirements of Section [408(b)] of the Code. It is established for the exclusive benefit of you and your beneficiaries, and the terms below change, or are added to, applicable sections of this Certificate. Also, your rights under the Contract are not forfeitable. 1. OWNER (SECTION 1.17): You must be both the Owner and the Annuitant. 2. ANNUITY COMMENCEMENT DATE (SECTION 1.04): You may not choose an Annuity Commencement Date later than the maximum maturity age stated in the Data pages. If you choose a Date later than age [70 1/2], you must withdraw at least the minimum payments required under Sections [408(b) and 401(a)(9)] of the Code and applicable Treasury regulations. See Section 5.01 of the Certificate and item 5 below. 3. CONTRIBUTIONS (SECTION 3.01 AND 3.02): No Contributions will be accepted unless they are in cash (or check or other form if we require). Except in the case of a "rollover contribution," the total of such Contributions will not exceed [$2,000] for any taxable year. A "rollover contribution" is one permitted by Sections [402(c), 403(a)(4), 403(b)(8), or 408(d)(3)] of the Code. Amounts transferred to the Contract from an individual retirement account or annuity contract which meets the requirements of Section [408] of the Code are not subject to the [$2,000] limit. If you make a Contribution which is an "eligible retirement plan rollover" as defined in Section [402(c) or 403(b)(8)] of the Code, and you commingle such Contribution with other Contributions, you may not be able to roll over the eligible retirement plan Contributions and earnings to another qualified plan or Code Section [403(b)] arrangement at a future date, unless the Code permits. 4. DEATH BENEFITS (SECTION 6.01): Under the following circumstances, the death benefit described in Section 6.01 of the Certificate will not be paid at your death before the Annuity Commencement Date and the coverage under the Contract will continue with your surviving spouse as Successor Annuitant and Owner: a. you are married at your death; b. the person named as death beneficiary under Section 6.02 of the Certificate is your surviving spouse; and No. 94ENIRAI Page 1 c. you have additionally requested that your spouse become "Successor Annuitant and Owner" of your Certificate if your spouse survives you. 5. REQUIRED PAYMENTS: This Certificate is subject to these "Required Payment" or "Minimum Distribution" rules of Sections [408(b) and 401(a)(9)] of the Code and the Treasury Regulations which apply. MINIMUM DISTRIBUTION RULES -- REQUIRED PAYMENTS DURING YOUR LIFE -- [Your entire interest in this Certificate will be distributed or begin to be distributed no later than the first day of April following the calendar year in which you attain age 70 1/2 ("Required Beginning Date"). Your entire interest may be distributed, as you elect, over (a) your life, or the lives of you and your designated beneficiary, or (b) a period certain not extending beyond your life expectancy, or the joint and last survivor expectancy for you and your designated beneficiary. Distributions must be made in periodic payments at intervals of no longer than one year. In addition, payments must be either non-increasing or they may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the Proposed Treasury Regulations, or any successor Regulation thereto. All distributions made under this Certificate must be made in accordance with the requirements of Sections 408(b) and 401(a)(9) of the Code, including the incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and applicable Treasury Regulations, including the minimum distribution incidental benefit requirements of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or any successor Regulation thereto. For purposes of determining the "period certain" referred to in the first paragraph of this Section, life expectancy is computed by use of the expected return multiples in Tables V and VI of Treasury Regulation Section 1.72-9. Unless you otherwise elect prior to the time distributions are required to begin, life expectancies will be recalculated annually. Such election will be irrevocable and will apply to all subsequent years. The life expectancy of a non-spouse beneficiary, if the naming of such a beneficiary is permitted by our rules then in effect, may not be recalculated. Instead, life expectancy will be calculated using the attained age of such beneficiary during the calendar year in which you attain age 70 1/2, and payments of subsequent years will be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. MINIMUM DISTRIBUTION RULES -- DEATH BENEFIT - If you die after distribution of your interest in this Certificate has begun, the remaining portion of such interest will continue to be distributed at least as rapidly as under the method of distribution being used prior to your death. If you die before distribution of your interest in this Certificate begins, distribution of your entire interest will be completed no later than December 31 of the calendar year containing the fifth anniversary of your death, except to the extent that an election is made to receive death benefit distributions in accordance with (a) or (b) below: No. 94ENIRAI Page 2 (a) If your interest is payable to a designated beneficiary, then your entire interest may be distributed over the life of, or over a period certain not greater than the life expectancy of, the designated beneficiary. Such distributions must commence on or before December 31 of the calendar year immediately following the calendar year of your death. (b) If the designated beneficiary is your surviving spouse, the date that distributions are required to begin in accordance with (a) above shall not be earlier than the later of (1) December 31 of the calendar year immediately following the calendar year of your death or (2) December 31 of the calendar year in which you would have attained age 70 1/2. If the designated beneficiary is your surviving spouse, and a Successor Annuitant and Owner option (described in item 4 above of this Endorsement) is in effect, the distribution of your interest need not be made until after your spouse's death. For purposes of determining the "period certain" referred to in the immediately preceding paragraph, life expectancy is computed by use of the expected return multiples in Table V and VI of Treasury Regulation Section 1.72-9. For purposes of distributions beginning after your death, unless otherwise elected by the surviving spouse by the time distributions are required to begin, life expectancies will be recalculated annually. Such election will be irrevocable by the surviving spouse and will apply to all subsequent years. In the case of any other designated beneficiary, life expectancies will be calculated using the attained age of such beneficiary during the calendar year in which distributions are required to begin, pursuant to this item, and payments for any subsequent calendar year will be calculated based on such life expectancy reduced by one for each calendar year which has elapsed since the calendar year life expectancy was first calculated. Distributions under this item are considered to have begun if distributions are made because you have reached your Required Beginning Date, or if prior to the Required Beginning Date, distributions irrevocably commence to you over a period permitted and in any annuity form acceptable under Section 1.401(a)(9)-1 of the Proposed Treasury Regulations or any successor Regulation thereto.] 6. REPORTS - NOTICES (SECTION 9.04): We will send you a report as of the end of each calendar year showing the status of the annuity and any other reports required by the Code or Treasury Regulations. 7. ASSIGNMENTS (SECTION 9.05): Your rights may not be assigned, pledged or transferred except as permitted by law. You may not name a new Owner, except as described in item 4 of this Endorsement. 8. TERMINATION OF CERTIFICATE: If an annuity under the Contract fails to qualify as an annuity under Section [408(b)] of the Code, we will have the right to terminate the Certificate. We may do so, upon receipt of notice of such fact, before the Annuity Commencement Date. In that case, we will pay the Annuity Account Value less a deduction for the part No. 94ENIRAI Page 3 which applies to any Federal income tax payable by you which would not have been payable with respect to an annuity which meets the terms of the Code. No. 94ENIRAI Page 4 ENDORSEMENT APPLICABLE TO NON-QUALIFIED CERTIFICATES This Endorsement applies only to the Owner of a Non-Qualified Certificate. 1. CONTRIBUTIONS (SECTION 3.01): We have the right not to accept any Contribution which is less than the amount(s) stated in the Data pages. 2. OWNER DEATH DISTRIBUTION RULES (SECTION 6.01): Upon the death of you, as Owner, before the Annuity Commencement Date: (a) If you are both the Owner and the Annuitant, we will pay the death benefit described in Section 6.01. Any part of a death benefit for which there is no named beneficiary living at your death will be payable in a single sum to your children who survive you in equal shares, or should none survive, then to your estate. Under the following circumstances, the death benefit described in Section 6.01 of the Certificate will not be paid at your death before the Annuity Commencement Date and the coverage under the Contract will continue with your surviving spouse as Successor Annuitant and Owner: (i) you are married at your death; (ii) the person named as death beneficiary under Section 6.02 of the Certificate is your surviving spouse; and (iii) you have additionally requested that your spouse become "Successor Annuitant and Owner" of your Certificate if your spouse survives you. (b) If you are not the Annuitant, the named beneficiary will succeed as Owner. The entire amount in the Investment Options (after any Withdrawal Charge) must be fully paid within five years after your death, or payments must begin within one year after your death as a life annuity or installment option for a period of not longer than the life expectancy of the named beneficiary. If you have not elected a form of payment as described in Section 6.02, we will make a single sum payment to the beneficiary on the fifth anniversary of your death. Subject to our rules at the time of payment, the beneficiary may elect to apply such a single sum payment to a new non-qualified annuity contract to be owned by the beneficiary. Instead of a single sum payment, the beneficiary may elect to receive an Annuity Benefit or a payout option which satisfies the terms of Section [72(s)] of the Code and our rules at the time. However, if the named beneficiary is your spouse, full payment of amounts No. 94ENNQI Page 1 under the Certificate must be made not later than five years after the spouse's death. If payments under an Annuity Benefit had begun before your death, such payments will continue to be made pursuant to the terms of such Benefit. If the Annuitant dies before the entire amount under the Certificate is paid, we will pay the death benefit as described in Section 6.01. (c) Unless you direct otherwise, the named beneficiary will also be the person who succeeds as Owner on your death while the Annuitant is alive as described in Section 6.02. You may change any beneficiary or successor Owner from time to time during the Annuitant's lifetime and while the Certificate is in force, as described in item (a) above. (d) If you are not the Annuitant, you may name another person to be the successor Owner and to receive the amounts to be paid under (b) above. You may also name another person to be successor Owner if the first choice as successor Owner dies before you. If you have so named two or more persons to succeed as Owner and more than one survive, they will share equally unless you direct otherwise. If no person named as beneficiary to receive the death benefit survives the Annuitant, we will pay the death benefit in a single sum to you. In the event of your death after the Annuitant, but before we pay such death benefit, the benefit will be payable in a single sum to the children who survive you, in equal shares, or should none survive, to your estate. If you die before the Annuity Commencement Date while the Annuitant is still living, and if no person named as successor Owner is living at the Owner's death, the beneficiary will be deemed to be, in this order, (i) your surviving spouse, (ii) the Annuitant, (iii) the children who survive you, in equal shares, or (iv) your estate. 3. ASSIGNMENTS (SECTION 9.05): Notwithstanding the terms of Section 9.05, you may assign the Certificate and the rights described therein before the Annuity Commencement Date. We will not be bound by an assignment unless we have received it and it is in writing. Your rights and those of any other persons referred to in the Certificate and this Endorsement will be subject to the assignment. We assume no responsibility for the validity of any assignment. No. 94ENNQI Page 2 ENDORSEMENT APPLICABLE TO MARKET VALUE ADJUSTMENT TERMS ******************************************************************************** THE TERMS OF THIS ENDORSEMENT CONTAIN A MARKET VALUE ADJUSTMENT ("MVA") FORMULA WHICH MAY RESULT IN ADJUSTMENTS, POSITIVE OR NEGATIVE, IN BENEFITS. AN MVA WILL NOT APPLY UPON TRANSFER TO A NEW GUARANTEE PERIOD OR OTHER INVESTMENT OPTION ON THE EXPIRATION DATE OR PURSUANT TO ITEM 1 BELOW. ******************************************************************************** 1. GUARANTEED PERIOD ACCOUNT We will specify one or more Guarantee Periods in the Guaranteed Period Account. For each such Guarantee Period, we guarantee to credit an interest rate (called the Guaranteed Rate). Interest will be credited daily to amounts in the Guaranteed Period Account. The duration of each Guarantee Period provided at any time and the Guaranteed Rate that applies to each Period will be furnished by us upon request. The Guarantee Period(s) and the Rate for each such Period you initially elect are shown in the Data pages. You may elect one or more Guarantee Period(s), according to our rules then in effect. Contributions and transfers to be made to the Guaranteed Period Account as described in Section 3.01 will be allocated to the Guarantee Period(s) according to your election. Contributions and transfers into the Guaranteed Period Account will receive the Guaranteed Rate applicable to the elected Guarantee Period as of the Business Day we receive your Contribution or transfer request at our Processing Office. The amount held with respect to a given Guarantee Period is called the Guaranteed Period Amount which reflects Contributions and transfers made to the Guaranteed Period Account, plus interest at the Guaranteed Rate(s), minus any withdrawals, transfers and charges, if any, deducted from the Guaranteed Period Account. The last day of a Guarantee Period is the Expiration Date. We will notify you at least [15 but not more than 45] days before the Expiration Date of each Period. You may elect one of the following three options effective at the Expiration Date, none of which will result in a market value adjustment: (a) to transfer the Guaranteed Period Amount into a Guarantee Period of any duration which we then offer; (b) to transfer the Guaranteed Period Amount to another Investment Option; (c) to make a withdrawal of the Guaranteed Period Amount (subject to any Withdrawal Charges which apply pursuant to Section 8.01). No. 94ENMVAI Page 1 If no election is made on or prior to the Expiration Date, the Guaranteed Period Amount (without any market value adjustment) will be transferred into the Investment Option described in the Data pages. During the 30 days following the Expiration Date, the full Guaranteed Period Amount (less any withdrawals or transfers made or charges deducted during such 30 day period) may be transferred into a new Guarantee Period or other Investment Option. In no event may you elect a Guarantee Period which extends beyond the Annuity Commencement Date. The "Guaranteed Period Account" is our Separate Account No. 46 that we use to account for amounts allocated to Guarantee Periods under this Certificate. All amounts allocated to a Guarantee Period, whether Contributions or transfers, become part of the Guaranteed Period Account. 2. TRANSFERS, WITHDRAWALS, DEATH AND ANNUITY BENEFITS If you request, other than as described in item 1 above, a transfer to another Investment Option as described in Section 4.01 or a withdrawal as described in Section 5.01, any such transfer or withdrawal from a Guaranteed Period Amount will be subject to a market value adjustment described below. For this purpose, the Annuity Account Value in Separate Account No. 46 will be after the market value adjustment. The market value adjustment will be in addition to any charges which apply as described in Section 8.01. In addition, amounts applied from a Guaranteed Period Amount to provide a death benefit as described in Section 6.01, an annuity as described in Section 7.02, or any other annuity form offered by us, will be subject to a market value adjustment, unless otherwise provided in the Data pages. Payment or transfers from the Guaranteed Period Account may be deferred for up to six months while you are living. 3. MARKET VALUE ADJUSTMENT The market value adjustment with respect to each Guarantee Period that applies to you is determined as follows: (a) We determine the Guaranteed Period Amount that will be payable on the Expiration Date, using the Guaranteed Rate for such Guarantee Period. (b) We determine the period remaining in your Guarantee Period (based on the Business Day we receive your transaction request at our Processing Office or effective date for such determination) and convert it to fractional years based on a 365 day year. For example, three years and 12 days becomes 3.0329. (c) We determine the current Guaranteed Rate which applies to new Contributions, for the same class of Certificates as yours, under a Guarantee Period with the same Expiration Date as your Guarantee Period. We add to such current Rate a percentage which is no greater than that shown in the Data pages. No. 94ENMVAI Page 2 (d) We determine the present value of the Guaranteed Period Amount payable at the Expiration Date, using the period determined in (b) and the rate determined in (c). (e) We subtract the current Guaranteed Period Amount from the result in (d). The result is the Market Value Adjustment, which may be positive or negative, applicable to such Guarantee Period. If we are not offering a Guarantee Period to which the "current Guaranteed Rate" would apply, we will use the Rate at the closest Expiration Date. If we are no longer offering new Guarantee Periods, we will use a procedure for determining such current Rate that is stated in the Data pages or which we will develop and file with insurance supervisory officials of the appropriate jurisdiction. 4. REPORTS AND NOTICES We will report the values under this Endorsement with the reports sent out as described in Section 9.04. Such report will include the Guaranteed Period Amount, market value adjustment, and Annuity Account Value in Separate Account No. 46. No. 94ENMVAI Page 3 EX-99.4IDATAPAGES 17 FORMS OF DATA PAGES TO ENDORSEMENT DATA PART A -- THIS PART LISTS YOUR PERSONAL DATA - ------ OWNER: [John Doe] [Add for Non-Qualified Certificates if Owner is not Annuitant] Age: [45] Sex: [Male] ANNUITANT: [Annuitant is same as Owner for IRA Certificates] [John Doe] Age: [45] Sex: [Male] Certificate Number: [00000] Endorsements Attached: [IRA Certificate Endorsement] [Non-Qualified Certificate Endorsement] [Market Value Adjustment Terms] CONTRACT: GROUP ANNUITY CONTRACT NO. AC [0000] ISSUE DATE: [JANUARY 1, 1994] CONTRACT DATE: [JANUARY 1, 1994] ANNUITY COMMENCEMENT DATE: THE MAXIMUM MATURITY AGE IS AGE [85] -- SEE SECTION 7.03. The Annuity Commencement Date may not be later than the month which follows the date the Annuitant attains the maximum maturity age. [Add for IRA Certificates] However, if you choose a date later than age 70 1/2, you must withdraw at least the minimum payments required (see item 2 of the Endorsement) BENEFICIARY: [Jane Doe] No. 94ICA/BIM Data Page 1 DATA PAGES (CONT'D). PART B -- THIS PART LISTS THE CONTRACT TERMS WHICH AFFECT THE TYPE OF - ------ CERTIFICATE YOU HAVE. INITIAL CONTRIBUTION RECEIVED (SEE SECTION 3.02): [$10,000] INVESTMENT OPTIONS AVAILABLE (SEE PART II); YOUR ALLOCATION PERCENTAGE IS ALSO SHOWN. INVESTMENT OPTIONS ALLOCATION PERCENTAGE (SEE SECTION 3.O1) - ------------------ ---------------------------------------- O [CONSERVATIVE INVESTORS FUND O GROWTH INVESTORS FUND O GROWTH AND INCOME FUND O COMMON STOCK FUND O GLOBAL FUND O AGGRESSIVE STOCK O MONEY MARKET FUND O INTERMEDIATE GOVERNMENT SECURITIES FUND GUARANTEED PERIOD ACCOUNT O GUARANTEE PERIODS EXPIRATION DATE AND GUARANTEED RATE MAY 15, 1995 - 6.0% MAY 15, 1996 - 7.0% MAY 15, 1997 - 8.0% MAY 15, 1998 - 9.0% MAY 15, 1999 - 9.0% MAY 15, 2000 - 9.0% MAY 15, 2001 - 9.0% MAY 15, 2002 - 9.0% MAY 15, 2003 - 9.0% MAY 15, 2004 - 9.0%] ------------------------ TOTAL: 100% Investment Options shown are Investment Funds of our Separate Account No. 45 and Guarantee Periods shown are in the Guaranteed Period Account. See Endorsement for Market Value Adjustment Terms. "Types" of Investment Options - see Section 4.02 -- are not applicable. Guaranteed Interest Account (see Section 2.01): Not available under this Certificate. GUARANTEED INTEREST ACCOUNT (SEE SECTION 2.01): Not available under this Certificate. No. 94ICA/BIM Data Page 2 DATA PAGES (CONT'D). BUSINESS DAY (SEE SECTION 1.05): A Business Day for this Certificate will mean any day on which the New York Stock Exchange is open for trading. PROCESSING DATES (SEE SECTION 1.20): A Processing Date is each Contract Date anniversary. AVAILABILITY OF INVESTMENT OPTIONS (SEE SECTION 2.04): Section 2.04(b) will not apply, that is, we will not limit the number of Options available. DESIGNATED INVESTMENT OPTION (SEE THE SECOND TO LAST PARAGRAPH OF SECTION 2.05): The designated Investment Option to which amounts will be transferred upon maturity of amounts in Guarantee Periods is the Money Market Fund. ALLOCATION OF CONTRIBUTIONS (SEE SECTION 3.01): If we do not receive instructions from you, additional Contributions will be allocated only among the Investment Funds in proportion to the Annuity Account Value in each Investment Fund as of the Transaction Date. CONTRIBUTION LIMITS (SEE SECTION 3.02): [VERSION 1 - APPLICABLE TO IRA CERTIFICATES] Initial Contribution minimum $1,500. Rollover Initial Contribution minimum $10,000. Additional Contribution minimum $250. Total Contributions must not exceed $2,000 for any taxable year, except for rollover Contributions. Additional Contributions can be made until the year in which you reach age 70 1/2, except for rollover Contributions. Also, we may refuse to accept any Contribution if the sum of all Contributions totals more than $1,500,000. [VERSION 2 - APPLICABLE TO NON-QUALIFIED CERTIFICATES] Initial Contribution minimum: $10,000. Additional Contribution minimum: $500, $250 for preauthorized bank withdrawal. Additional Contributions can be made until the Annuitant reaches age 80. Also, we may refuse to accept any Contribution if the sum of all Contributions totals more than $1,500,000. TRANSFER RULES (SEE SECTION 4.02): (See Data Pages, Part C) MINIMUM TRANSFER AMOUNT (SEE SECTION 4.02): (See Data Pages, Part C) NUMBER OF FREE TRANSFERS IN A CONTRACT YEAR (SEE SECTION 4.03): 5 ALLOCATION OF WITHDRAWALS (SEE SECTION 5.01): Unless you elect otherwise, withdrawals plus any withdrawal charges will be withdrawn on a pro rata basis from amounts in the Investment Funds. No. 94ICA/BIM Data Page 3 DATA PAGES (CONT'D). MINIMUM WITHDRAWAL AMOUNT (SEE SECTION 5.01): $1,000, except for withdrawals under the flexible payment withdrawal options where the minimum is $100. MINIMUM AMOUNT OF ANNUITY ACCOUNT VALUE AFTER A WITHDRAWAL (SEE SECTION 5.02): Requests for a withdrawal must be for either (a) 90% or less of the Cash Value or (b) 100% of the Cash Value (surrender of the Certificate). We will not exercise our rights, described in Sections 5.02(b) and 5.02(c), to terminate the Certificate. DEATH BENEFIT AMOUNT (SEE SECTION 6.01): The sum of: (1) The Annuity Account Value in the Investment Funds or, if greater, the guaranteed minimum death benefit defined below; and (2) The death benefit amount provided by the Endorsement Applicable to Market Value Adjustment Terms. [VERSION 1 -NON NY] Guaranteed Minimum Death Benefit On the Contract Date, the guaranteed minimum death benefit is equal to the portion of the initial Contribution allocated to the Investment Funds. Thereafter(except as adjusted at the end of the sixth Contract Year, see (1) below) it is equal to (a) the prior guaranteed minimum death benefit,(b) plus any additional Contributions and transfers into the Investment Funds, (c) less any transfers out of such Funds, less any withdrawals from such Funds, (d) plus interest (see (2) below) that is credited on each Processing Date. (1) At the end of the sixth Contract Year, the guaranteed minimum death benefit calculated on such date will be set at the then guaranteed minimum death benefit determined above or, if greater, the current Annuity Account Value in the Investment Funds. (2) Interest will be calculated at the applicable effective annual guaranteed minimum death benefit interest rate (see table below) taking into account Contributions, transfers and withdrawals during the Contract Year, except with respect to amounts in the Money Market Fund where the rate will be based on the lesser of the actual rate of return and the guaranteed minimum death benefit interest rate below. Annuitant's Age on Contract Date Rate ---------------- ---- up to and including 69 6% 70 through 74 3% 75 through 79 0% No. 94ICA/BIM Data Page 4 DATA PAGES (CONT'D). [VERSION 2 - NY] Guaranteed Minimum Death Benefit On the Contract Date, the guaranteed minimum death benefit is equal to the portion of the initial Contribution allocated to the Investment Funds. Thereafter, on each Processing Date (except as adjusted at the end of the sixth Contract Year, see (1) below), the guaranteed minimum death benefit is reset at the greater of the prior guaranteed minimum death benefit and the Annuity Account Value in the Investment Funds as of such Date. In no event, however, will the guaranteed minimum death benefit on any date be greater than (a) the initial contribution, (b) plus any additional Contributions and transfers into the Investment Funds, (c) less any transfers out of such Funds, less any withdrawals from such Funds, (d) plus interest (see (2) below) that is credited on each Processing Date. (1) At the end of the sixth Contract Year, the guaranteed minimum death benefit calculated on such date will be set at the then guaranteed minimum death benefit determined above or, if greater, the current Annuity Account Value in the Investment Funds. (2) Interest will be calculated at the applicable effective annual guaranteed minimum death benefit interest rate (see table below) taking into account Contributions, transfers and withdrawals during the Contract Year, except with respect to amounts in the Money Market Fund where the rate will be based on the lesser of the actual rate of return and the guaranteed minimum death benefit interest rate below. Annuitant's Age on Contract Date Rate ---------------- ---- up to and including 69 6% 70 through 74 3% 75 through 79 0% NORMAL FORM OF ANNUITY (SEE SECTION 7.02): Life Period Certain Annuity Form AMOUNT OF ANNUITY BENEFIT (SEE SECTION 7.05): The amount applied to provide the Annuity Benefit will be the Cash Value. MINIMUM AMOUNT TO BE APPLIED FOR AN ANNUITY (SEE SECTION 7.06): $2,000, as well as minimum of $20 for initial monthly annuity payment. No. 94ICA/BIM Data Page 5 DATA PAGES (CONT'D). INTEREST RATE TO BE APPLIED IN ADJUSTING FOR MISSTATEMENT OF AGE OR SEX (SEE SECTION 7.06): 6% per year WITHDRAWAL CHARGES (SECTION 8.01): (a) A withdrawal charge will be imposed as a percentage of the initial and each additional Contribution made to the extent that a withdrawal exceeds the Free Corridor Amount as discussed in Section 8.01 or, if the Certificate is surrendered to receive the Cash Value. We determine the withdrawal charge separately for each Contribution in accordance with the table below. Current and Maximum Percentage of Contract Year Contributions ------------- ------------- 1 6.00% 2 5.00% 3 4.00% 4 3.00% 5 2.00% 6 1.00% 7 and later 0.00% The applicable withdrawal charge percentage is determined by the Contract Year in which the withdrawal is made or the Certificate is surrendered, beginning with "Contract Year 1" with respect to each Contribution withdrawn or surrendered. For purposes of the table, for each Contribution, the Contract Year in which we receive that Contribution is "Contract Year 1." (b) A withdrawal processing charge of the lesser of $25 and 2% of the amount withdrawn is assessed for each withdrawal (other than under the flexible payment withdrawal options) after the first during a Contract Year. Both the charges in (a) and (b) will be deducted from the Annuity Account Value in the Investment Options from which each withdrawal is made in proportion to the amount being withdrawn from each Investment Option. No. 94ICA/BIM Data Page 6 DATA PAGES (CONT'D) FREE CORRIDOR AMOUNT (SEE SECTION 8.01) 15% of Annuity Account Value at the beginning of the Contract Year, minus any amount previously withdrawn during the Contract Year. Amounts withdrawn up to the Free Corridor Amount will not be deemed a withdrawal of Contributions. Withdrawals in excess of the Free Corridor Amount will be deemed withdrawals of Contributions in the order in which they were made (that is, the first-in, first-out basis will apply). The Free Corridor Amount does not apply when calculating the withdrawal charge applicable upon a surrender. CHARGES DEDUCTED FROM ANNUITY ACCOUNT VALUE (SEE SECTION 8.02): (a) Distribution Fee: A distribution fee currently in an amount of 0.65% of the initial and each additional Contribution made within the prior six years that have not been withdrawn, is deducted on the six Processing Dates (so long as the Certificate is in force) following receipt of each Contribution. 0.65% is the maximum we will charge. (b) Annual Contract Fee: An annual contract fee of $30 per Contract Year is incurred at the beginning of each Contract Year and deducted on each Processing Date. $30 is the maximum amount we will charge. If total Contributions received in the first Contract Year equal $100,000 or more, this charge will be zero. (c) Transfer Charge: For each transfer in excess of five free transfers, we will currently charge $25 at the time each transfer is processed. $25 is the maximum amount we will charge. We will also deduct $25 per occurrence for a direct transfer to a third party of amounts under the Certificate or an exchange for another contract of another issuer. $25 is the maximum amount we will charge. (d) Guaranteed Minimum Death Benefit Charge: For the guaranteed minimum death benefit we will deduct on each Processing Date an amount equal to 0.35% of the guaranteed minimum death benefit in effect on such Processing Date. 0.35% is the maximum we will charge. No. 94ICA/BIM Data Page 7 DATA PAGES (CONT'D) (e) Premium Taxes: Premium taxes are generally incurred on the Annuity Commencement Date and a charge for such premium taxes will then be deducted from the Annuity Account Value. Some jurisdictions impose a premium tax at the time the initial Contribution and each additional Contribution are paid, regardless of the Annuity Commencement Date. In those states we will recover the tax in equal installments on each of the six Processing Dates following receipt of each Contribution. Unless you specify otherwise, the charges in (a), (b), (d) and (e) will be deducted from the Investment Funds in which your Annuity Account Value is allocated on a pro rata basis. The transfer charges in (c) will be deducted from the Investment Options from which each transfer is made on a pro rata basis. Also, if you surrender the Certificate or it is terminated during a Contract Year before the next Processing Date, we will deduct any administrative charge in (b) incurred but not deducted, and deduct any remaining unrecovered premium tax charge in (e). Also, if a withdrawal exceeds the Free Corridor Amount, we will recover a pro rata portion of the premium tax charge. If there is insufficient value in the Investment Funds, all or a portion of the charges in (a), (b) (c) (d) and (e) will be deducted from the Annuity Account Value in the Guaranteed Period Account. DAILY SEPARATE ACCOUNT CHARGES (SEE SECTION 8.04) Current and Maximum Mortality Annual rate of 0.90% (equivalent to and Expense Risk Charge: a daily rate of 0.002477%). Current and Maximum Asset Based Annual rate of 0.10% (equivalent to Administrative Charge: a daily rate of 0.000276%). No. 94ICA/BIM Data Page 8 DATA PAGES (CONT'D) PART C -- THIS PART LISTS THE TERMS WHICH APPLY TO THE MARKET VALUE ADJUSTMENT - ------ TERMS ENDORSEMENT. ALLOCATION RESTRICTIONS: No more than 60% of any Contribution may be allocated to the Guaranteed Period Account. You must provide specific instructions as to how each Contribution will be allocated among the Guarantee Periods. MARKET VALUE ADJUSTMENT ON TRANSFERS AND WITHDRAWALS (SEE ITEM 2 OF ENDORSEMENT): The market value adjustment (positive or negative) applicable to a withdrawal or transfer of a portion of the amount in a Guarantee Period will be a percentage of the market value adjustment that would be applicable upon a surrender. This percentage is determined by (i) dividing the amount of the withdrawal or transfer from the Guarantee Period by (ii) the Annuity Account Value in such Guarantee Period prior to the withdrawal or transfer. Upon a withdrawal or transfer, the market value adjustment will be deducted from or added to the Guaranteed Period Amount. DEATH BENEFIT AMOUNT: The larger of (a) the Annuity Account Value in the Guaranteed Period Account and (b) the sum of the Guaranteed Period Amounts in each Guarantee Period. DEATH BENEFIT (SEE ITEM 2 OF ENDORSEMENT): No market value adjustment will be made to amounts applied from the Guaranteed Period Account to provide a death benefit. TRANSFER RULES (SEE SECTION 4.02): No transfers are permitted to or from the Guaranteed Period Account during the first Contract Year and only one transfer per Contract Year may be made thereafter. MINIMUM TRANSFER AMOUNT: (SEE SECTION 4.02): The amount transferred to or from the Guaranteed Period Account must be at Least $2,000 or, if less, the entire Annuity Account Value may be transferred from the Guaranteed Period Account. Similarly, the entire Annuity Account Value in the Investment Funds may be transferred to the Guaranteed Period Account. WITHDRAWALS (SEE SECTION 5.01): If you choose to have withdrawals allocated to the Guaranteed Period Account, or a withdrawal is greater than the Annuity Account Value in the Investment Funds, you must specify the Guarantee Period(s) from which the withdrawal plus any withdrawal charge will be taken. TRANSFERS AT EXPIRATION DATE (SEE ITEM 1 OF ENDORSEMENT): If no election is made with respect to amounts in the Guaranteed Period Account as of the Expiration Date, such amounts will be transferred into the Money Market Fund. MVA FORMULA (SEE ITEM 3 OF ENDORSEMENT): The current rate percentage we use in item (e) of the formula is 0.00%. We reserve the right to increase the rate percentage to 0.25%. No. 94ICA/BMVA Data Page 9 EX-99.5AAPPLICATION 18 FORM OF APPLICATION FOR EQUI-VEST APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O., New York, New York 10116 FOR A VARIABLE ANNUITY CONTRACT: EQUITABLE'S NON-QUALIFIED EQUI-VEST CONTRACT - -------------------------------------------------------------------------------- UNIT SECTION (complete only if Salary Allotment is used) 1. EMPLOYER / UNIT NAME ------------------------------------------------------- 2. |_| EXISTING UNIT NO. |_|_|_|_|_|_| - |_|_|_| |_| NEW UNIT |_|_|_|_|_|_| - |_|_|_| FORM 983-2357 REQUIRED - -------------------------------------------------------------------------------- PARTICIPANT SECTION 3. PROPOSED PARTICIPANT - Print name to appear on Contract. ---------------------------------------------------------------------------- First Middle Initial Last a. |_| Mr. |_| Mrs. |_| Miss |_| Ms. Other --------- b. Date of Birth: Year Month Day ------- ------- -------- c. Age at Nearest Birthday: ----------------------------- d. State of Residence: ---------------------------------- e. Participant's Mailing Address: 1. |_| Male |_| Female No. St. |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| City |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| State |_|_| Zip Code |_|_|_|_|_| - |_|_|_|_| g. Social Security Number (Required): |_|_|_| - |_|_| - |_|_|_|_| h. Are you associated with or employed by a member of National Association of Securities Dealers, Inc. (NASD)? |_| Yes |_| No 4. RETIREMENT AGE (maximum: 85) ------------------ 5. BENEFICIARY--Include FULL NAME and RELATIONSHIP to Participant. FOR DEATH BENEFIT UPON PARTICIPANT'S DEATH BEFORE RETIREMENT DATE, AND FOR OWNERSHIP RIGHTS UPON DEATH OF OWNER. ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- 6. OWNER--ONLY IF OTHER THAN PARTICIPANT: |_| Individual |_| Executor |_| Guardian |_| Custodian (SEE #14) |_| Trustee (For natural person) The following owner types will incur annual tax liability |_| Corporation |_| Partnership |_| Deferred Compensation |_| Trustee (NOT for natural person) Name |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| No. St. |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| City |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| State |_|_| Zip Code |_|_|_|_|_| - |_|_|_|_| Relationship to Participant --------------------------------- Owner SSN # |_|_|_| - |_|_| - |_|_|_|_| (IF CUSTODIAN USE PARTICIPANT'S SSN #) Are you associated with or employed by a member of National Association of Securities Dealers, Inc. (NASD)? |_| Yes |_| No ABOVE NAMED OWNER WILL RECEIVE ALL COMMUNICATIONS. SPECIFY ANY CO-OWNERS IN SPECIAL INSTRUCTIONS (#13) 7. CONTRIBUTION ALLOCATION Fixed Income Account ______% Stock Account ______% Money Market Account ______% Balanced Account ______% Aggressive Stock Account ______% ---------------------------- (PERCENTAGES IN WHOLE NUMBERS) Total 100% 8. Will any existing insurance or annuity be replaced or changed (or has it been), assuming the contract applied for will be issued? |_| Yes |_| No IF YES, answer the questions below: a. Year Issued: Plan: ---------- ---------- Company: ---------------------------------------------------------------- b. Contribution Basis: (CHECK ONE ONLY): |_| pre-August 14, 1982 |_| post-August 13, 1982 (SEPARATE APPLICATION REQUIRED FOR EACH BASIS.) c. Net Cost: $ ------------------------------------------------------------- (NET COST ILLUSTRATION MUST BE SUBMITTED) 9. CONTRIBUTIONS (COMPLETE ONLY IF CONTRIBUTION BASIS POST-AUGUST 13, 1982 AND FURTHER CONTRIBUTIONS ANTICIPATED) a. Reminder Notice (Billing) Required |_| Yes |_| No IF YES, complete B-C-D b. Reminder Frequency: |_| Annual |_| Semi-Annual |_| Quarterly For Salary Allotment Only: |_| Monthly |_| Semi-Monthly |_| Bi-Weekly c. First Reminder Date (IF SALARY ALLOTMENT, MUST AGREE WITH EXISTING UNIT OR ATTACHED 983-2357 FORM): Mo. Day ------------- ------------- d. REMINDER AMOUNT $ ------------------------------------------------------- (CONTRIBUTIONS MUST BE AT LEAST $50.) 10. EXPECTED FIRST PARTICIPATION YEAR CONTRIBUTION $ ---------------------------- (MUST BE AT LEAST $1,000 OR $600 IF SALARY ALLOTMENT) FOR SALARY ALLOTMENT ONLY: IF AN ADVANCED PARTICIPATION DATE IS REQUESTED, COMPLETE #9C AND #13. - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- (FOR PROCESSING OFFICE USE) Unit Name Cert or App. # --------------------------- ------------------------ Frequency Reminder Date --------------------------- ------------------------- Amendment Required Participation Date ------------------ -------------------- ---------------------------------------------------------------------------- Receipt Date | Batch # | Inquiry # | Processor ---------------------------------------------------------------------------- - -------------------------------------------------------------------------------- 983-2356A-PA (8-87) Cat. #121442 - -------------------------------------------------------------------------------- 11. Did you receive the Separate Accounts Prospectus? |_| Yes |_| No Date on Prospectus ---------------------------------------------------------- Date of any supplement to Prospectus ---------------------------------------- 12. ITEMS (A) THROUGH (G) ARE TO BE ANSWERED COMPLETELY OR NOT AT ALL. If Participant does not wish to provide information requested, check here |_|. (Show amounts before this purchase.) NOTE: In NJ and MD by law item (A) MUST be answered (a) Sources of Retirement Income (other than Soc. Security) ---------------------------------------------------------------------- ---------------------------------------------------------------------- (b) Debts: $ --------------------------------------------------------------- --------------------------------------------------------------- --------------------------------------------------------------- (c) (i) Savings (Checking and Savings accounts) $ --------------------------------------------------------------- (ii) Securities: $ ---------------------------------------------------- (iii) Value of home, less mortgage: $ ---------------------------------- (iv) Other Assets (specify sources and amounts): ----------------------------------------------------------------- ----------------------------------------------------------------- (d) Ages of dependents: ---------------------------------------------------- (e) Amount of Life Insurance: $ -------------------------------------------- (f) Cash available for investment or retirement: (i) $ annually, or (ii) $ single sum -------- -------- (g) Annual income including spouse's: $ ------------------------------------ 13. SPECIAL INSTRUCTIONS ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- 14. CUSTODIAN DESIGNATION: (Fill in) THE OWNER IS ------------------------------------ -------------------------- (name) (Relationship) as custodian for ------------------------------------------------------------ (participant) under the Uniform Gifts to Minors Act ---------------- (state) 15. Amount paid with this form: $ ----------------------------------------------- (must be at least $1,000 for other than Salary Allotment) (If a check is submitted with this request, no advanced participation date is permitted.) BACKDATING IS NOT PERMITTED. - -------------------------------------------------------------------------------- NOTE: Amount paid will be credited upon receipt at Equitable's Processing Office, subject to return if the contract is not issued; the Participation Date of the contract will be the date of receipt by Equitable of all completed requirements at Equitable's Processing Office. The Normal Form of annuity benefit is a Life With 10 Years Certain Annuity. At retirement, you will be given a choice of this form or any of several other available forms. AGREEMENT All information and statements furnished in this request are true and complete to the best of my (our) knowledge and belief. I (We) understand and acknowledge that no Agent has the authority to make or modify any contract on Equitable's behalf, or to waive or alter any of Equitable's rights and regulations. Under the penalties of perjury I (we) certify that the Social Security Number(s) or Tax Identification Number(s) provided on this form is (are) true, correct, and complete. IT IS UNDERSTOOD THAT THE ACCOUNT VALUES ATTRIBUTABLE TO ALLOCATIONS TO THE SEPARATE ACCOUNTS AND VARIABLE ANNUITY BENEFIT PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT. Signature of Proposed Participant X --------------------------------------------- Date City State ------------------- ------------------------------ ------------------ Signature of Owner X ------------------------------------------------------------ (if other than the Proposed Participant) - -------------------------------------------------------------------------------- AGENT SECTION Will any existing insurance or annuity be replaced or changed (or has it been), assuming the contract applied for will be issued? |_| Yes |_| No I (we) certify that a prospectus for the contract applied for has been given to the proposed Participant and that no written sales materials other than those approved by The Equitable have been used. Non-Qualifed Equi-Vest issues must adequately reflect the commission interest of all Agents on previous certificates or contract.
- ------------------------------------------------------------------------------------------------------------------------------------ Agents's Name(s) (Print) Initial of Agent Agent Agency District Agent's (Service Agent first) Last Name Number % Code Manager Code Signature - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------- FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS Date District EQS Date -------- -------- ------ ------------- - -------------------------------------------------------------------------------- (FOR ASU USE) ASU Code and App. No. ----------------------------------------------------------- ASU Rec'd. ---------------------------------------------------------------------- Date to Proc. Off. -------------------------------------------------------------- Campaign ------------------------------------------------------------------------ Agent(s) shown above is Equity Qualified and is licensed in the state where the request is signed. Above Agent information verified by ASM (Registered Rep) ------------------------ - -------------------------------------------------------------------------------- 983-2356A-PA (8-87) Cat. #121442 THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O., New York, New York 10116 REQUEST FOR ENROLLMENT UNDER EQUITABLE'S NON-QUALIFIED EQUI-VEST CONTRACT - -------------------------------------------------------------------------------- UNIT SECTION (complete only if Salary Allotment is used) 1. EMPLOYER/UNIT NAME __________________________________________________________ 2. |_| Existing Unit No.|_|_|_|_|_|_|-|_|_|_| |_| NEW UNIT |_|_|_|_|_|_|-|_|_|_| Form 983-2357 Required - -------------------------------------------------------------------------------- PARTICIPANT SECTION 3. PROPOSED PARTICIPANT a. Print name to appear on Certificate. ______________________________________________________________ First Middle Initial Last b. |_| Mr. |_| Mrs. |_| Miss |_| Ms. |_| Other ______ c. Date of Birth: Year ____________ Month __________ Day ________ d. Age at Nearest Birthday ______________________________________ e. State of Residence ___________________________________________ f. |_| Male |_| Female g. Social Security Number |_|_|_|-|_|_|-|_|_|_|_| h. Are you associated with or employed by a member of National Association of Securities Dealers, Inc. (NASD)? |_| Yes |_| No 4. RETIREMENT AGE (maximum: 85) ________________ 5. BENEFICIARY--Include FULL NAME and RELATIONSHIP to Participant. (For Death Benefit upon Participant's death before Retirement Date, and for Ownership Rights upon death of Owner) ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ 6. OWNER--Specify: Full Name and Address Relationship to Participant _____________________________ ________________________________ _____________________________ Social Security or Tax I.D. No. _____________________________ ________________________________ Above named Owner will receive all communications. Specify any co-owners or secondary owners in Special Instructions (#12). 7. CONTRIBUTION ALLOCATION (PERCENTAGES IN WHOLE NUMBERS) Fixed Income Account _______% Stock Account (Sep Acct A) _______% Money Market Acct (Sep Acct E) _______% Balanced Acct (Sep Acct J) _______% Aggressive Stock Acct (Sep Acct K _______% ------------------ Total 100 % 8. Will any existing insurance or annuity be replaced or changed (or has it been), assuming the certificate applied for will be issued? |_| Yes |_| No If yes, answer the questions below: Contribution Basis |_| pre-August 14, 1982 (check one) |_| post-August 13, 1982 Note that a separate enrollment form must be submitted for each basis. _______________________________________________________________ Year Issued, Company, and Plan _______________________________________________________________ Net Cost (Net Cost Illustration msut be submitted.) 9. CONTRIBUTIONS (complete only if the Contribution Basis is post-August 13, 1982 and further contributions are anticipated) a. Reminder Frequency If no reminders are desired, check here: |_| |_| Annual |_| Semi-Annual |_| Quarterly For Salary Allotment Only: |_| Monthly |_| Semi-Monthly |_| Bi-Weekly b. First Reminder Date (if Salary Allotment, must agree with existing unit or attached 983-2357 form): Mo.____________ Day____________ c. REMINDER AMOUNT $_____________ (contributions must be at least $50.) - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- (FOR PROCESSING Unit Name ___________________ Cert. or App. # ____________________ OFFICE Frequency ___________________ Reminder Date ______________________ USE) Amendment Required __________ Participation Date _________________ -------------------------------------------------------------------------- Receipt Date Batch# Inquiry # Processor -------------------------------------------------------------------------- - -------------------------------------------------------------------------------- 983-2356 CAT.#115075 d. EXPECTED FIRST PARTICIPATION YEAR CONTRIBUTION $ __________________________________________ (must be at least $1,000, for Individual billing or $600. for Salary Allotment) For Salary Allotment only: If an advanced participation date is requested, complete #9b and #12. 10. Did you receive the Separate Accounts Prospectus? |_| Yes |_| No Date on Prospectus __________________________________________ Date of any supplement to Prospectus ________________________ 11. Items (a) through (g) are to be answered completely or not at all. If Participant does not wish to provide information requested, check here |_|. (Show amounts before this purchase.) Note: In NJ and MD by law item (a) must be answered. (a) Sources of Retirement Income (other than Soc. Security) _______________________________________________________ _______________________________________________________ (b) Debts: $_______________________________________________ _______________________________________________ (c) (i) Savings (Checking and Savings accounts): $________________________________________________ (ii) Securities: $____________________________________ (iii) Value of home, less mortgage: $__________________ (iv) Other Assets (specify sources and amounts): _________________________________________________ _________________________________________________ (d) Ages of dependents:____________________________________ (e) Amount of Life Insurance: $____________________________ (f) Cash available for investment or retirement: (i) $___________________________________ annually, or (ii) $___________________________________ single sum (g) Annual income including spouse's: $____________________ 12. SPECIAL INSTRUCTIONS ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ 13. Amount paid with this form: $______________________________ (must be at least $1,000. for other than Salary Allotment) (If a check is submitted with this request, no advanced participation date is permitted.) Backdating is not permitted. - -------------------------------------------------------------------------------- NOTE: Amount paid will be credited upon receipt at Equitable's Processing Office, subject to return if the certificate is not issued; the Participation Date of the certificate will be the date of receipt by Equitable of all completed requirements at Equitable's Processing Office. The Normal Form of annuity benefit is a Life With 10 Years Certain Annuity. At retirement, you will be given a choice of this form or any of several other available forms. AGREEMENT All information and statements furnished in this request are true and complete to the best of my (our) knowledge and belief. I (We) understand and acknowledge that no Agent has the authority to make or modify any contract on Equitable's behalf, or to waive or alter any of Equitable's rights and regulations. Under the penalties of perjury I (we) certify that the Social Security Number(s) or Tax Identification Number(s) provided on this form is (are) true, correct, and complete. IT IS UNDERSTOOD THAT THE ACCOUNT VALUES ATTRIBUTABLE TO ALLOCATIONS TO THE SEPARATE ACCOUNTS AND VARIABLE ANNUITY BENEFIT PAYMENTS MAY INCREASE OR DECREASE AND NOT ARE GUARANTEED AS TO DOLLAR AMOUNT. Signature of Proposed Participant Date: City State: ----------------------------------------------- Signature of Owner (if other than the Proposed Participant) --------------------- - -------------------------------------------------------------------------------- AGENT SECTION Will any existing insurance or annuity be replaced or changed (or has it been), assuming the certificate applied for will be issued? |_| Yes |_| No I (We) certify that a prospectus for the certificate applied for has been given to the proposed Particpant and that no written sales materials other than those approved by The Equitable have been used. Non-Qualified Equi-Vest issues must adequately reflect the commission interest of all Agents on previous contracts or certificates. ___________________________________________________________________________
Agent's Name(s) (Print Initial of Agent Agent Agency District Agent's (Service Agent first) Last Name Number % Code Manager Code Signature ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________
- -------------------------------------------------------------------------------- FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS__________ Date__________ District EQS_____________ Date_____________ - -------------------------------------------------------------------------------- (FOR ASU USE) ASU Code and App. No.____________ ASU Rec'd._____________ Date to Proc. Off.____ __________________ Campaign |_| Agent(s)shown above is Equity Qualified and is licensed in the state where the request is signed. Above Agent information verified by ASM (Registered Rep)__________________ - -------------------------------------------------------------------------------- 983-2356 CAT.#115075 APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O., New York, New York 10116 REQUEST FOR ENROLLMENT UNDER EQUITABLE'S QUALIFIED EQUI-VEST CONTRACT - -------------------------------------------------------------------------------- PLAN/UNIT SECTION 1. TYPE OF PURCHASE Complete One Plan Only A. |_| TSA Public School (GV-PS 4931) B. |_| TSA 501(c)(3) Organization (GV-501 4921) C. |_| TSA University (GV-PS 4931-31) D. |_| IRA Individual (GV-IRA 4971) E. |_| IRA Unit Billed (GV-IRA 4971) F. |_| IRA QUALIFIED PLAN ROLLOVER-Distribution from a Qualified Plan (GV-IRA 4971-71) G. |_| PEDC (Public Employee Deferred Compensation) )GV-PEDC 4991) H. |_| IRC-457 (Tax Exempt Organization) (GV-PEDC 4991-SU-080) I. |_| SEP (Simplified Employee Pension) (GV-SEP 4981) J. |_| CORPORATE TRUSTEED (GV-Corp 4941-41) Type of contributions |_| Required |_| Voluntary (After Tax) K. |_| KEOGH/HR-10 TRUSTEE (GV HR-10 4911-11) (trustee owned) (9) Type of contributions |_| Required |_| Voluntary (After Tax) L. |_| KEOGH/HR-10 (GV - HR-10 4911) (not trustee owned) (9) Type of contributions |_| Required |_| Voluntary (After Tax) - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- DO NOT COMPLETE THIS SECTION IF BOX 1.D OR 1.F CHECKED ABOVE 2. EMPLOYER / PLAN NAME ------------------------------------------------------- 3. |_| EXISTING UNIT NO. |_|_|_|_|_|_| - |_|_|_| |_| NEW UNIT |_|_|_|_|_|_| - |_|_|_| (FOR NEW TRUSTEED OWNER PLAN OR TWO OR MORE LIVES FORM 983-135B REQUIRED) ================================================================================ PARTICIPANT SECTION 4. PROPOSED PARTICIPANT - Print name to appear on Certificate. ---------------------------------------------------------------------------- First Middle Initial Last A. |_| Mr. |_| Mrs. |_| Miss |_| Ms. Other --------- B. Date of Birth: Year Month Day ------- ------- -------- C. Age at Nearest Birthday ----------------------------- D. |_| Male |_| Female E. Participant's Mailing Address No., St. |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| City |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| State |_|_| Zip Code |_|_|_|_|_| - |_|_|_|_| F. State of Residence --------------------------------------- G. Social Security No. (Required) |_|_|_| - |_|_| - |_|_|_|_| H. Are you associated with or employed by a member of National Association of Securities Dealers, Inc. (NASD)? |_| Yes |_| No 5. RETIREMENT AGE ------------------ 6. BENEFICIARY--Include FULL NAME and RELATIONSHIP to Participant. (BENEFICIARY MUST BE THE OWNER FOR PEDC/IRC-457 PURCHASES AND FOR MOST TRUSTEED PLANS.) ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- 7. CONTRIBUTION ALLOCATION (PERCENTAGES IN WHOLE NUMBERS) Fixed Income Account ______% Stock Account ______% Money Market Account ______% Balanced Account ______% Aggressive Stock Account ______% ------------------ Total 100% 8. CONTRIBUTIONS (NOT REQUIRED FOR 1.F) A. Reminder Notice (Billing) Required |_| Yes |_| No IF YES, complete b-c-d-e B. REMINDER DATE Required for Individual IRA or otherwise must agree with existing unit or attached 983-135B Month Day ------------- ------------- C. REMINDER FREQUENCY |_| Annual |_| Semi-Annual |_| Quarterly |_| Monthly Available for TSA, PEDC/IRC-457 AND UNIT BILLED IRA ONLY: |_| Semi-Monthly |_| Bi-Weekly D. REMINDER AMOUNT $ ------------------------------------------------------- E. BILLING MONTHS TO BE EXCLUDED - TSA ONLY ------------------------------------------------------------------------ ------------------------------------------------------------------------ 9. EXPECTED FIRST PARTICIPATION YEAR CONTRIBUTION $ ---------------------------- If an advanced billing and/ or participation date are requested, complete #8b and #13. ================================================================================ (FOR PROCESSING OFFICE USE) Unit Name Reminder Date --------------------------- ------------------------- Cert or App. # Amendment Required ---------------------- ------------------ PEDC Emp. Add. Emp. Fed. ID# ---------------------- ------------------------ Frequency Participation Date --------------------------- -------------------- ---------------------------------------------------------------------------- Receipt Date | Batch # | Inquiry # | Processor ---------------------------------------------------------------------------- ================================================================================ 983-136D (1-87) Cat. #120764 - -------------------------------------------------------------------------------- 10. Did you receive the Separate Accounts Prospectus? |_| Yes |_| No Date shown on Prospectus ---------------------------------------------------- Date of any supplement to Prospectus ---------------------------------------- 11. ITEMS (A) THROUGH (G) ARE TO BE ANSWERED COMPLETELY OR NOT AT ALL. If Annuitant does not wish to provide information requested, check here |_|. (Show amounts before this purchase.) NOTE: In NJ and MD by law item (A) MUST be answered. (a) Sources of Retirement Income (other than Soc. Security) ------------------------------------------------------------------------ ------------------------------------------------------------------------ (b) Debts: $ --------------------------------------------------------------- --------------------------------------------------------------- --------------------------------------------------------------- (c) (I) Savings (Checking and Savings accounts) $ --------------------------------------------------------------- (II) Securities: $ ---------------------------------------------------- (III) Value of home, less mortgage: $ ---------------------------------- (IV) Other Assets (specify sources and amounts): ----------------------------------------------------------------- ----------------------------------------------------------------- (d) Ages of dependents: ---------------------------------------------------- (e) Amount of Life Insurance: $ -------------------------------------------- (f) Cash available for investment or retirement: (I) $ annually, or ---------------------------------------------------- (II) $ single sum ------------------------------------------------------- (g) Annual income including spouse's: $ ------------------------------------ 12. Will any existing insurance or annuity be replaced or changed (or has it been), assuming the certificate applied for will be issued? |_| Yes |_| No 13. SPECIAL INSTRUCTIONS ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- 14. Amount paid with this form: $ ----------------------------------------------- (If a check is submitted with this request, no advanced participation date is permitted.) BACKDATING IS NOT PERMITTED. NOTE: Amount paid will be credited upon receipt at Equitable's Processing Office, subject to return if the certificate is not issued; the Participation Date of the certificate will be the date of receipt by Equitable of all completed requirements at Equitable's Processing Office. ================================================================================ AGREEMENT All information and statements furnished in this request are true and complete to the best of my knowledge and belief. I understand and acknowledge that no Agent has the authority to make or modify any contract on Equitable's behalf, or to waive or alter any of Equitable's rights and regulations. IT IS UNDERSTOOD THAT THE ACCOUNT VALUES ATTRIBUTABLE TO ALLOCATIONS TO THE SEPARATE ACCOUNTS AND VARIABLE ANNUITY BENEFIT PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT. Signature of Participant X Date City State ------------------------ ------ ----- ------ Signature of Owner (REQUIRED FOR PEDC/IRC 457/HR-10 TRUSTEE/CORP. TRUSTEED) X ------------------------------------------------------------------------------- ================================================================================ AGENT SECTION Will any existing insurance or annuity be replaced or changed (or has it been), assuming the certificate applied for will be issued? |_| Yes |_| No I (we) certify that a prospectus for the certificate applied for has been given to the proposed Annuitant and that no written sales materials other than those approved by The Equitable have been used. Equi-Vest issues must adequately reflect the commission interest of all Agents on previous contracts or certificates. - -------------------------------------------------------------------------------- Initial (Print) of Agents's Name(s) Last Agent Agent Agency District Agent's (Service Agent first) Name Number % Code Manager Code Signature - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- ================================================================================ FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS Date District EQS Date --- --- -- -- ================================================================================ (FOR ASU USE) ASU Code and App. No. ----------------------------------------------------------- ASU Rec'd. ---------------------------------------------------------------------- Date to Proc. Off. Campaign |_| -------------------------------------------------- AGENT(S) SHOWN ABOVE IS EQUITY QUALIFIED AND IS LICENSED IN THE STATE WHERE THE REQUEST IS SIGNED. Above Agent information verified by ASM (Registered Rep) - -------------------------------------------------------------------------------- Application reviewed by -------------------------------------------------------- .=============================================================================== 983-136D Cat. #120764 - -------------------------------------------------------------------------------- THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES APPLICATION FOR ESTABLISHMENT OF NEW QUALIFIED EQUI-VEST PLAN - -------------------------------------------------------------------------------- 1. TYPE OF QUALIFIED PLAN ESTABLISHED: a) |_| TSA 403(b) (Public School) (3-30) b) |_| TSA 501 (c) (3) Organization (2-20) c) |_| TSA University (3-31) d) |_| IRA Unit Billed (7-70) e) |_| SEP (Simplified Employee Pension) (8-80) f) |_| PEDC (Public Employee Deferred Compensation) (9-90) g) |_| IRC-457 (Tax Exempt Organization) (9-90 SU 080) h) |_| KEOGH/HR-10 TRUSTEE (1-11) i) |_| KEOGH/HR-10 (1-10) j) |_| CORPORATE TRUSTEED (4-41) 2. NAME OF PLAN: |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| 3. EFFECTIVE DATE OF PLAN: Year___________ Month__________ Day___________ 4. FISCAL YEAR END (FOR KEOGH, SEP, PEDC/IRC-457): Month___________________ Day_______________ 5. REMINDER NOTICE REQUIRED: |_| YES |_| NO 6. UNIT REMINDER DUE DATE: Month___________________ Day_______________ 7. REMINDER FREQUENCY: |_| Annual (1) |_| Semi-Annual (2) |_| Quarterly (3) |_| Monthly (4) Available for TSA, PEDC/IRC-457 and Unit Billed IRA only: |_| Semi-Monthly (5) |_| Bi-Weekly (7) 8. ORDER IN WHICH PARTICIPANTS TO APPEAR ON STATEMENT REMINDER: |_| Alphabetical (3) |_| Certificate Number (2) 9. EMPLOYER FEDERAL IDENTIFICATION NUMBER: |_|_|-|_|_|_|_|_|_|_| 10. BILLING NAME: |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| Plan Mailing and Billing Address: |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| No. & Street: |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| City or Town: |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| State: |_|_|_|_|_|_|_|_| Zip Code: |_|_|_|_|_|-|_|_|_|_| 11. TSA UNIVERSITY PLANS ONLY: (A) Does the University Plan Document AUTHORIZE Participants to make Loans: |_| Yes |_| No (B) Maximum % of cash at maturity |_|_|_|% (C) Surrenders, Withdrawals or Loans (if allowed) will be processed only with employer approval at the time the request is made. (D) Please describe any other plan restrictions on reverse of this form. Acceptance of any other plan provisions or restrictions detailed on the back is subject to Equitable approval. 12. PEDC/IRC-457, HR-10 TRUSTEE, AND CORPORATE TRUSTEED PLANS ONLY: A) Should all correspondence (except Billing & Proxies) be sent to participant? |_| Yes |_| No B) Does Owner/Employer authorize Participants to make transfers between accounts and change the allocation percentages for future allocations? |_| Yes |_| No 13. ERISA INFORMATION STATEMENT SUBMITTED (Required if Box 1(C)(D)(E)(G)(H) (I) or (J) checked): |_| Yes |_| No 14. IS EQUITABLE ADOPTION STATEMENT BEING SUBMITTED (Answer Required if Box 1(H)(I) or (J) checked): |_| Yes |_| No - -------------------------------------------------------------------------------- UPON ESTABLISHMENT OF PLAN, THE EQUITABLE IS AUTHORIZED TO SOLICIT PROSPECTIVE APPLICANTS FOR THE PLAN. X_____________________________________________ Date at _____________ on __ 19 __ Signature and Title of Authorized Officer City State or Purchaser - -------------------------------------------------------------------------------- Key Agent (Please Print) ___________________________________________ ASU (Alpha) _______ (Numeric) ______ (First) (Middle Initial) (Last) (Code) Agency__________________________________________________________________________ (Name) (Numeric Code) Key Agent Signature ___________________________________________ - -------------------------------------------------------------------------------- (PROC. OFFICE USE ONLY) |_|_|_|_|_|_|_|_|_|_|_| Analyst Code |_|_|_| - -------------------------------------------------------------------------------- 983-135B (1-87) Cat. #120755 EX-99.5BAPPLICATION 19 FORM OF APPLICATION USED UNDER EQUI-VEST This Application Kit contains the necessary forms to successfully complete an EQUI-VEST Deferred Variable Annuity Personal Retirement Program sale. Please complete all required forms. Please note: o No Application will be processed without an Agent's Report o All checks must be made payable to: The Equitable APPLICATION COMPLETION INSTRUCTIONS Print neatly or type (except signatures). Do not abbreviate. Any corrections must be initialed by the Owner. Unless otherwise indicated, complete in all cases. 1. EQUI-VEST PROGRAM TYPE. Please elect only one program. 2. PROPOSED ANNUITANT -- Individual on whose life annuity benefits are determined. 3. BENEFICIARY. The individual who will receive any death benefit payable upon the death of the Annuitant. For the NQ certificate where the Owner and the Annuitant are not the same, the beneficiary will succeed as new Owner upon the death of the Owner while the Annuitant is alive unless another person is named as Successor Owner. 4. SUCCESSOR ANNUITANT AND OWNER. If the Annuitant and Owner are the same person and designates their spouse to be the beneficiary, the Annuitant/Owner can elect their spouse to become the Successor Annuitant and Owner. If elected, no death benefit is payable upon the death of the Annuitant/Owner. The surviving spouse of the Annuitant/Owner automatically becomes the Successor Annuitant/Owner and the certificate remains in force. 5. OWNER. Complete this section only for NQ certificates where the Owner and Annuitant are different. For IRA and QP-IRA certificates, the Annuitant and Owner must be the same individual. The Owner exercises all the rights of the certificate. 6. SUCCESSOR OWNER. This is a feature which is only available for NQ certificates and only if the Owner is other than the Annuitant. By indicating a Successor Owner, the Owner is advising us that the beneficiary will not succeed as Owner upon the death of the original Owner. 7. RETIREMENT AGE. Indicate the age at which the Annuitant plans to retire. Maximum Retirement Age is 85. 8. INVESTMENT FUND CHOICES. The Owner may elect the Maximum Choice option. If the Owner elects Maximum Choice transfer restrictions out of the GIA will apply even if no monies are invested in any of the Income Funds of the Conservative Investors Fund. 9. CURRENT INVESTMENT ALLOCATION. Indicate how and in what percentage the Owner wishes to have contributions allocated among the Investment Fund Options. The Owner may not allocate contributions to a Fund within the Income Funds or to the Conservative Investors Fund unless the Owner has elected the Maximum Choice option. Also, the Owner need not allocate contributions to every Fund with an Investment Fund elected. 10. REPLACEMENT/EXCHANGE QUESTIONS. Please answer these questions if the Owner is establishing an EQUI-VEST certificate by replacing an existing annuity or insurance contract. 11. PROSPECTUS REQUIREMENT. Please indicate the date of the Prospectus and any Supplements delivered to the Owner. 12. NASD INFORMATION. These questions are required by the NASD for suitability purposes. 13. SPECIAL INSTRUCTIONS. Please use this for any additional details regarding beneficiary, replacement or transfer information. 14. CONTRIBUTIONS. Please indicate the amount remitted with the application and whether or not the Owner plans on having monies automatically contributed through the Automatic Investment Program. If the Annuitant is establishing a QP-IRA, only Qualified Plan TSA or conduit IRA rollover monies can be remitted to the certificate. 15. REMINDER NOTICE. Please complete if the Owner wishes to receive a contribution Reminder Notice. Application must be signed by both the Annuitant and Owner.
- ---------------------------------------------------------------------------------------------------------------------------------- SAMPLE FEATURE ELECTIONS EXAMPLE A. IRA B. QP-IRA C. NQ D. NQ E. NQ ANNUITANT.................................. Husband Wife Husband Wife Husband OWNER...................................... Husband Wife Wife Husband Husband BENEFICIARY................................ Children Husband Son Son Wife SUCCESSOR ANNUITANT AND OWNER.............. Not Applicable Husband Elected Not Applicable Not Applicable Not Elected SUCCESSOR OWNER............................ Not Available Not Available Daughter Not Elected Not Available
A. IRA--The Annuitant and Owner must be the same individual. Upon the death of the husband (Annuitant and Owner),the children as beneficiary will receive the death benefit proceeds. B. QP-IRA--The Annuitant and Owner must be the same individual. Upon the death of the wife (Annuitant and Owner), the husband as beneficiary and Successor Annuitant and Owner becomes the Annuitant and Owner. No death benefit will be paid at this time. C. NQ--The Annuitant is the husband and the Owner is the Wife. The wife (Owner) selects their son to be the beneficiary and their daughter to be the Successor Owner. If the husband (Annuitant) dies prior to the wife (Owner), the son (beneficiary) receives the death benefit. If the wife (Owner) dies first, the daughter (Successor Owner) now becomes the Owner of the certificate and can exercise all rights of the certificate, such as change the beneficiary, make withdrawals, etc. D. NQ--The Annuitant is the wife and the Owner is the husband. The husband, as Owner has designated the son to be the beneficiary. The husband (Owner) dies. The son (beneficiary) will succeed as Owner and receive the death benefit proceeds. E. NQ--The Annuitant and Owner is the husband. The wife is the beneficiary. The husband dies. The wife receives the death benefit proceeds. - -------------------------------------------------------------------------------- THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES P.O. Box 2996, New York, New York 10116-2996 APPLICATION FOR EQUI-VEST(R) DEFERRED VARIABLE ANNUITY PERSONAL RETIREMENT PROGRAMS - -------------------------------------------------------------------------------- 1. EQUI-VEST PROGRAM TYPE (Check One) a. |_| IRA (including IRA to IRA transfers) b. |_| IRA QUALIFIED PLAN ROLLOVER (Distribution from a Qualified Plan) c. |_| NQ (non-qualified) - -------------------------------------------------------------------------------- 2. PROPOSED ANNUITANT Print name to appear on Certificate. a. |_| Mr. |_| Mrs. |_| Ms. |_| Other ________________ b. |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| First Middle Initial Last c. Date of Birth: Year |_|_|_|_| Month |_|_| Day |_|_| d. Age at Nearest Birthday: |_|_| E. |_| Male |_| Female f. Annuitant's Mailing Address: No., St.|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| City |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| State |_|_| Zip Code |_|_|_|_|_|-|_|_|_|_| G. State of Residence:|_|_| h. Social Security No. (Required): |_|_|_|-|_|_|-|_|_|_|_| i. Telephone Number |_|_|_|-|_|_|_|-|_|_|_|_| |_| Home |_| Work 3. BENEFICIARY of Annuitant (upon death of last Annuitant) a. Full Name |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| b. Relationship __________________________________________________ 4. SUCCESSOR ANNUITANT AND OWNER Available only if Annuitant/Owner elects spouse to be beneficiary and to succeed as Annuitant/Owner upon death. |_| No, I do not elect the Successor Annuitant and Owner Option. |_| Yes, I elect the Successor Annuitant and Owner Option. If yes, complete a and b. a. Spouse's SSN# |_|_|_|-|_|_|-|_|_|_|_| b. Spouse's Date of Birth: Yr. |_|_|_|_| Month |_|_| Day |_|_| 5. OWNER Complete for NQ only if Annuitant will not also be Owner. (IF IRA, OWNER AND ANNUITANT MUST BE THE SAME.) a. |_| Individual |_| Guardian |_| Custodian (SEE BELOW)* |_| Trustee (For natural person) b. Name |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| c. No., St.|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| City |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| State|_|_| Zip Code |_|_|_|_|_|-|_|_|_|_| d. Tax ID or Owner SSN # |_|_|_|-|_|_|-|_|_|_|_| (If Custodian Use Minor's SSN#) e. Date of Birth: Yr. |_|_|_|_| Month |_|_| Day |_|_| f. Relationship to Annuitant _____________________________________________ |_| Uniform Gifts to Minors Act g. *As custodian under the _____________ |_| Uniform Transfer to Minors Act (State) 6. SUCCESSOR OWNER Complete for NQ only if Owner is not the Annuitant and you do not want the beneficiary to succeed as Owner at Owner's death. a. Name |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| b. No., St.|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| City |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| State |_|_| Zip Code |_|_|_|_|_|-|_|_|_|_| c. SSN # |_|_|_|-|_|_|-|_|_|_|_| Date of Birth: Yr. |_|_|_|_| Month |_|_| Day |_|_| 7. RETIREMENT AGE Maximum 85: _____________________ 8. INVESTMENT FUND CHOICES You can customize your program for current and future use by choosing one of the following categories: a. |_| Maximum Transfer Flexibility. Only those Investment Funds that will NOT result in GIA transfer restrictions. (Funds in #9 with no asterisk). b. |_| Maximum Choice. All available Investment Funds. (GIA transfer restrictions will apply). Requests to elect "Maximum Choice" after issue are subject to our rules than in effect. 9. CURRENT INVESTMENT ALLOCATION You can allocate your contribution below by entering percentages in whole numbers totaling 100%. You can only allocate percentages into funds marked with an asterisk (*) if you checked "b" in #8 above. GUARANTEED Guaranteed Interest Account (GIA) ________________ % EQUITY Balanced ________________ % Growth & Income ________________ % Stock ________________ % Global ________________ % Aggressive Stock ________________ % INCOME Money Market* ________________ % Quality Bond* ________________ % High Yield* ________________ % ASSET ALLOCATION Conservative Investors*________________ % Growth Investors ________________ % TOTAL 100 10. REPLACEMENT/EXCHANGE QUESTIONS -- Will any existing insurance or annuity be replaced or changed (or has it been), assuming the contract applied for will be issued? |_| Yes |_| No. If yes, answer the questions below: A. Year Issued:_________ Plan: ___________ Company: ______________________________ Contract Number: ______________________ B. Contribution Basis: -- NQ only |_| pre-August 14, 1982 |_| post-August 13, 1982 C. Net Cost: $_______________________________________ (Net Cost Illustration must be submitted) - -------------------------------------------------------------------------------- 180-2000 (9/93) - -------------------------------------------------------------------------------- 11. PROSPECTUS REQUIREMENT Did you receive the Prospectus for the EQUI-VEST Deferred Variable Annuity Personal Retirement Programs? |_| Yes |_| No Date of Prospectus ________________________________________________________ Date of any supplement to Prospectus ______________________________________ 12. NASD INFORMATION Items (a) through (f) are to be answered by the Annuitant. We are required by the NASD to ask these questions. (A) Name of Employer: ____________________________________________________ (B) Address of Employer: ---------------------------------------------------------------------- ---------------------------------------------------------------------- (C) Occupation ___________________________________________________________ (D) Estimated Family Annual Income _______________________________________ (E) Estimated Net Worth __________________________________________________ (f) Investment Objective: |_| Income |_| Income & Growth |_| Growth |_| Aggressive Growth |_| Safety of Principal (G) Is Owner or Annuitant associated with or employed by a member of National Association of Securities Dealers, Inc.(NASD)? |_| Yes |_| No - -------------------------------------------------------------------------------- 13. SPECIAL INSTRUCTIONS --------------------------------------------------------------------------- --------------------------------------------------------------------------- --------------------------------------------------------------------------- --------------------------------------------------------------------------- --------------------------------------------------------------------------- --------------------------------------------------------------------------- - -------------------------------------------------------------------------------- 14. CONTRIBUTIONS (QP-IRA is for Qualified Plan Rollovers only) A. Amount paid with this Application: $_______________________ B. Automatic Investment Program |_| Yes (Complete Form 180-1005) |_| No 15. CONTRIBUTION REMINDER NOTICE A. Reminder Notice (Billing) Requested |_| Yes |_| NO B. Reminder Date: Month _________ Day _____________ C. Reminder Frequency: |_| Annual |_| Semi-Annual |_| Quarterly |_| Monthly D. Reminder Amount $_______________________________________________________ NOTE: Amount paid will be credited upon receipt at Equitable's Processing Office, subject to return if the certificate is not issued; the Contract Date will be the date of receipt by Equitable of all completed requirements at Equitable's Processing Office. - -------------------------------------------------------------------------------- AGREEMENT All information and statements furnished in this application are true and complete to the best of my knowledge and belief. I understand and acknowledge that no Agent has the authority to make or modify any contract on Equitable's behalf, or to waive or alter any of Equitable's rights and regulations. It is understood that the Annuity Account Value attributable to allocations to the investment funds of the Separate Account and Variable Annuity Benefit payments may increase or decrease and are not guaranteed as to dollar amount. - -------------------------------------------------------------------------------- LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR ANNUITY APPLICATION WITH INFORMATION YOU KNOW IS FALSE OR TO LEAVE OUT MATERIAL FACTS. - -------------------------------------------------------------------------------- X__________________________________ Date_______ City __________ State __________ Signature of Proposed Annuitant X__________________________________ Date_______ City __________ State _________ Signature of Owner (for NQ only, if owner other than Proposed Annuitant) - -------------------------------------------------------------------------------- 180-2000 (9/93) EX-99.9AOPINION 20 OPINION AND CONSENT OF JONATHAN E. GAINES, ESQ. HERBERT P. SHYER [EQUITABLE LOGO - 1987 VERSION] EXECUTIVE VICE PRESIDENT AND GENERAL COUNSEL December 15, 1987 The Equitable Life Assurance Society of the United States 787 Seventh Avenue New York, New York 10019 Dear Sirs: This opinion is furnished in connection with the filing by The Equitable Life Assurance Society of the United States ("Equitable") and Separate Account A of Equitable ("Separate Account A") under the Securities Act of 1933 and the Investment Company Act of 1940 ("1940 Act") of amendments on Form N-4 to Registration Statement Nos. 2-50547 and 811-1705 ("Registration Statement"), previously filed on Form N-3. Prior to this filing, the Registration Statement's registrant has been Separate Account E of Equitable rather than Separate Account A, and its 1940 Act file number has been 811-2469. The change in registrant and 1940 Act file number, and the use of Form N-4, anticipate the restructuring of Separate Accounts A, E, C, D, J, and K of Equitable ("Separate Accounts") as a unit investment trust, in which Separate Account A will be the continuing account. The restructuring will occur pursuant to an Agreement and Plan of Reorganization, to be entered into on or about December 18, 1987 ("Agreement"), by and among Equitable, each of the Separate Accounts, and The Equitable Trust. The Registration Statement covers an indefinite number of units of interest ("Units") in Separate Account A, including Units which will be issued subsequent to the restructuring of the Separate Accounts. The Units are purchased with contributions received under individual variable annuity contracts ("Contracts"). As described in the prospectus included in the Registration Statement ("Prospectus"), the Contracts are designed to provide fixed and variable retirement benefits. I have examined all such corporate records of Equitable and such other documents and laws as I consider appropriate as a basis for the opinion hereinafter expressed. On the basis of such examination, it is my opinion that: 1. Equitable is a corporation duly organized and validly existing under the laws of the State of New York. THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES 787 Seventh Avenue, New York, NY 10019 - 2 - 2. Separate Account A was duly created pursuant to the provisions of the New York Insurance Law. 3. The assets of Separate Account A are owned by Equitable; Equitable is not a trustee with respect thereto. Under New York law, the income, gains and losses, whether or not realized, from assets allocated to Separate Account A must be credited to or charged against such account, without regard to the other income, gains or losses of Equitable. Although contractual obligations with respect to funds of Separate Account A constitute corporate obligations of Equitable, the specific amounts payable from accumulations in Separate Account A in accordance with the Contracts will bepend upon the investment experience of Separate Account A. 4. The Contracts provide that the portion of the assets of Separate Account A equal to the reserves and other contract liabilities with respect to Separate Account A shall not be chargeable with liabilities arising out of any other business Equitable may conduct and that Equitable reserves the right to transfer assets of Separate Account A in excess of such reserves and contract liabilities to the general account of Equitable. 5. The Contracts, as proposed to be amended to reflect changes contemplated by the Agreement (including any Units duly credited under the Contracts), will have been duly authorized, and each of the Contracts, as thus amended (including any such Units), will constitute a validly issued and binding obligation of Equitable in accordance with its terms. Purchasers of the Contracts described in the Prospectus will be subject only to the deductions, charges and fees set forth in the Prospectus. I hereby consent to the use of this opinion as an exhibit to the Registration Statement. Very truly yours, /s/ Herbert P. Shyer ----------------------- Herbert P. Shyer N-4/Ex.9 3600i EX-99.9BOPINION 21 JONATHAN GAINES 7-16-92 JONATHAN E. GAINES Vice President and Associate General Counsel [EQUITABLE LOGO] (212) 554-3169 Fax (212) 554-1266 LAW DEPARTMENT July 16, 1992 The Equitable Life Assurance Society of the United States 787 Seventh Avenue New York, New York 10019 Dear Sirs: This opinion is furnished in connection with the filing by The Equitable Life Assurance Society of the United States ("Equitable") and Separate Account A of Equitable ("Separate Account A") under the Securities Act of 1933 and the Investment Company Act of 1940 of amendments on Form N-4 to Registration Statement Nos. 2-30070 and 811-1705 ("Registration Statement"). The Registration Statement covers an indefinite number of units of interest ("Units") in Separate Account A. The Units to which this opinion relates are purchased with contributions received under individual variable annuity contracts, the form numbers of which are listed in Appendix A attached hereto (collectively, "Contracts"). As described in the prospectus included in the Registration Statement, the Contracts are designed to provide fixed and variable retirement benefits. I have examined all such corporate records of Equitable and such other documents and laws as I consider appropriate as a basis for the opinion hereinafter expressed. On the basis of such examination, it is my opinion that: 1. Equitable is a corporation duly organized and validly existing under the laws of the State of New York. 2. Separate Account A was duly created pursuant to the provisions of the New York Insurance Law. THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES 787 SEVENTH AVENUE, NEW YORK, NEW YORK 10019 - 2 - 3. The assets of Separate Account A are owned by Equitable; Equitable is not a trustee with respect thereto. Under New York law, the income, gains and losses, whether or not realized, from assets allocated to Separate Account A must be credited to or charged against such account, without regard to the other income, gains or losses of Equitable. 4. The Contracts provide that the portion of the assets of Separate Account A equal to the reserves and other contract liabilities with respect to Separate Account A shall not be chargeable with liabilities arising out of any other business Equitable may conduct and that Equitable reserves the right to transfer assets of Separate Account A in excess of such reserves and contract liabilities to the general account of Equitable. 5. The Contracts and the Units thereunder have been duly authorized, and each of the Contracts (including the Units duly credited thereunder), when duly issued, will constitute a validly issued and binding obligation of Equitable in accordance with its terms. I hereby consent to the use of this opinion as an exhibit to the Registration Statement. Very truly yours, /s/ Jonathan E. Gaines ------------------------- Jonathan E. Gaines LMR:bw:9791j EX-99.9COPINION 22 OPINION AND CONSENT OF JONATHAN E. GAINES November 3, 1993 The Equitable Life Assurance Society Jonathan E. Gaines of the United States Vice President 787 Seventh Avenue and Associate General Counsel New York, New York 10019 (212) 554-3169 (212) 554-1266 Dear Sirs: This opinion is furnished in connection with the filing by The Equitable Life Assurance Society of the United States ("Equitable") and Separate Account A of Equitable ("Separate Account A") of a Form N-4 Registration Statement of Equitable and Separate Account A under the Securities Act of 1993 (File No. 33-63890) and Amendment No. 39 of the Registration Statement of Separate Account A under the Investment Company Act of 1940 included with the same Form N-4. The Registration Statement covers an indefinite number of units of interest ("Units") in Separate Account A. The Units are purchased with contributions received under certificates (the "Certificates") Equitable offers under a group variable annuity contract. As described in the prospectus included in the Registration Statement ("Prospectus"), the Certificates are designed to provide fixed retirement benefits. I have examined all such corporate records of Equitable and such other documents and laws as I consider appropriate as a basis for the opinion hereinafter expressed. On the basis of such examination, it is my opinion that: 1. Equitable is a corporation duly organized and validly existing under the laws of the State of New York; 2. Separate Account A was duly established pursuant to the provisions of the New York Insurance Law; 3. The assets of Separate Account A are owned by Equitable; Equitable is not a trustee with respect thereto. Under New York law, the income, gains and losses, whether or not realized, from assets allocated to Separate Account A must be credited to or charged against such account, without regard to the other income, gains or losses of Equitable; 4. The Certificates provide that the portion of the assets of Separate Account A equal to the reserves and other contract liabilities with respect to Separate Account A shall not be chargeable with liabilities arising out of any other business Equitable may conduct and that Equitable reserves the right to transfer assets of Separate Account A in excess of such reserves and contract liabilities to the general account of Equitable; and 5. The Certificates (including any Units credited thereunder) have been duly authorized and constitute a validly issued and binding obligation of Equitable in accordance with their terms. I hereby consent to the use of this opinion as an exhibit to the Registration Statement. Very truly yours /s/ Jonathan E. Gaines ---------------------- Jonathan E. Gaines 2287 2 EX-99.10(B)NOTICE 23 NOTICE CONCERNING REGULATORY RELIEF NOTICE CONCERNING REGULATORY RELIEF ----------------------------------- The following regulatory relief has been granted by the Commission and its staff to The Equitable Life Assurance Society of the United States (the "Company") and Separate Account A of the Company, (the "Separate Account") among other applicants, named in an Application dated December 18, 1986, File No. 812-6572, as amended and restated on June 15, 1987 (the "Application"): Commission Exemptive Order Release No. IC-15908 (August 5, 1987) SEC Docket, Vol. 38, No. 18 at 1328 (August 18, 1987) The Application, among other things, sought relief from Sections 26(a) (2) (C) and 27(c) (2) for the deduction of certain mortality and expense risk charges from the Separate Account in connection with group variable annuity contracts referred to in the Application as "EQUI-VEST Contracts". The deductions and charges under the group variable annuity contracts filed as Exhibit 4(d) to this Registration Statement are identical in all material respects to the EQUI-VEST Contracts referred to in the Application. Under these circumstances, the Company and the Separate Account intend to rely on the relief granted pursuant to the aforesaid Commission Exemptive Order to the extent applicable, in connection with this Registration Statement. 5395i EX-99.13ASCHEDULES 24 SCHEDULES FOR COMPUTATION OF MONEY MARKET FUND EQUI-VEST The following is an example of the calculation of the Money Market Division's yield for the seven-day period ended December 31, 1993. Yields may fluctuate substantially from the example shown. 1. The value of one Unit in a hypothetical account (excluding capital changes) at the beginning of the seven-day period (December 24, 1993) $ 25.412950 2. The value of one Unit in the same hypothetical account (excluding capital changes) at the end of the seven-day period (December 31, 1993) 25.420946 3. Net change in Unit Value [(1) subtracted from (2)] .007996 4. Adjustment to the net change in the Unit Value to reflect the average annual administrative expense charge .0001977 5. Adjusted net change in the Unit Value [(4) subtracted from (3)] .007798 6. Base period return [(5) divided by (1)] .000307 7. Current yield [(6) annualized (multiplied by 365/7)] 1.60% 8. Effective Yield 1.62% EX-99.13BFORMULAE 25 30 - DAY YIELDS 12/31/94 FORMULAE FOR DETERMINING "30-DAY YIELDS" FOR EQUI-VEST SERIES CONTRACTS AS OF DECEMBER 31, 1994 Invested in One Investment Fund (Intermediate Government Securities Quality Bond, or High Yield) of the Hudson River Trust MOR[superscript: HRT][subscript: 12-31-94] = [(YTD[supercript: HRT][subscript: 12-31-94]) / (YTD[superscript: HRT][subscript: 11-30-94])] - 1 MOR[superscript: SA][subscript: 12-31-94] = [(UV [superscript: SA][subscript: 12-31-94]) / (UV[superscript: SA][subscript 11-30-94])] - 1 SAC[superscript: SA][subscript: 12-31-94] = 1 - [(1 + MOR[superscript: SA[subscript: 12-31-94) / (1 + MOR[superscript: HRT][subscript: 12-31-94])][superscript: 365/(number of Days in Month Ending 12-31-94) YIELD[superscript: SA[subscript: 12-31-94]= (YIELD[superscript: HRT][subscript: 12-31-94]) - (SAC[superscript: SA][subscript: 12-31-94]) - (AC[superscript: SA][subscript: 12-31-94]) YIELD[superscript: MIN][subscript: 12-31-94]= MIN {(YIELD[superscript: SAEQV][subscript: 12-31-94), (YIELD[superscript: SAPRP][subscript: 12-31-94]) }
where UV[subscript: t] is the separate account unit value at time t. YTDR[subscript: t] is the year-to-date return as of time t. MOR[subscript: t] is the unannualized return for the month ending at time t. YIELD[subscript: t] is the annual yield rate based on month ending at time t. SAC[subscript: t] is the annual rate of separate account daily asset-based charge for month ending at time t. AC[subscript: t] is the average annual administrative charge as of time t. HRT denotes Hudson River Trust. SA denotes either separate account, SAEQV or SAPRP, as defined below. SAEQV denotes the SA specific TO "EQUI-VEST" (Series 100 & 200) contracts SAPRP denotes the SA specific to "EQUI-VEST PRP" (Series 300 & 400) contracts. MIN denotes the lower, or worse, of the SAEQV and SAPRP rates.
Intermediate Intermediate Government Quality High Government Quality High Securities Bond Yield Securities Bond Yield ------------ ------- ----- ---------- ---- ----- Year to date returns (unannualized): Income Yields unannualized: --------------------------- 1 10/31/94 1 -4.47% -4.83% -1.53% 2 11/30/94 2 -4.72% -4.98% -3.59% 5.400% 6.718% 9.442% 3 12/31/94 3 -4.37% -5.10% -2.79% 6.345% 6.365% 10.534% 4 1/31/95 4 1.56% 1.49% 0.98% 0.000% 0.000% 0.000% 5 2/28/95 5 3.29% 3.44% 3.96% 0.000% 0.000% 0.000% 6 3/31/95 6 7 4/30/95 7 1 1 1 1 1 1
- ----------------------------- SA YIELD CALCULATIONS: 12/31/94 - ----------------------------- ------------------------------------------------------------- HUDSON RIVER TRUST EQUI-VEST EQUI-VEST PRP -------------------------------------------------------------
Intermediate Intermediate Intermediate Government Quality High Government Quality High Government Quality High Securities Bond Yield Securities Bond Yield Securities Bond Yield ---------- ---- ----- ---------- ---- ----- ---------- ---- ----- Year-to-date returns (unannualized): 11/30/94 -4.72% -4.98% -3.59% 12/31/94 -4.37% -5.10% -2.79% Accumulation unit values: 11/30/94 97.948050 94.084989 95.194461 97.946050 94.084989 95.194461 12/31/94 98.193986 93.866039 95.882880 98.193986 93.866039 95.882880 Monthly returns (unannualized): 12/31/94 0.37% -0.13% 0.83% 0.25% -0.23% 0.72% 0.25% -0.23% 0.72% Separate Account daily asset charge (unannualized): 0.0134 0.0134 0.0134 0.0134 0.0134 0.0134 11/30/94 12/31/94 1.332% 1.247% 1.238% 1.332% 1.247% 1.238% Average annual SA administrative 0.00113 0.00113 0.00113 0.00113 0.00113 0.00113 charges (in %): 12/31/94 0.113% 0.113% 0.113% 0.113% 0.113% 0.113% Yields (annualized): 12/31/94 6.345% 6.365% 10.534% 4.900% 5.005% 9.183% 4.900% 5.005% 9.183% "Worpe" Yields (EQUI-VEST vs. EQUI-VEST PRP): 12/31/94 4.900% 5.005% 9.183%
Table 2 SA Yields as of December 31, 1994 Intermediate Government Quality High Securities Bond Yield ------------ ------- ----- EQUI-VEST series 4.900% 5.005% 9.183% EX-99.13CPERFVALUE 26 SEPARATE ACCOUNT A PERFORMANCE VALUES WORKSHEETS FORMULAE FOR DETERMINING CUMULATIVE AND ANNUALIZED RATES OF RETURN FOR EQUI-VEST THROUGH DECEMBER 31, 1993 CRR = (UV[subscript: 12-31-93]/UV[subscript: (12-31-93)-B) - 1 ARR = [(UV[subscript: 12-31-93]/UV[subscript: (12-31-93)-B] [superscript: 1/B - 1] x 100 where: B is the total time of the investment, in years or fraction thereof. UV[subscript: 12-31-93 is the separate account unit value at 12-31-93. UV[subscript: (12-31-93)-B is the separate account unit value at time B year prior to 12-31-93. CRR is the cumulative rate of return over the period of B years. ARR is the annualized rate of return over the period of B years.
CUMULATIVE AND ANNUALIZED RATES OF RETURN FOR EQUI-VEST AND MOMENTUM ACCUMULATION UNIT VALUES [subscript: UV(12-31-83)-B] Division 12/31/93 12/31/92 12/31/90 12/31/88 12/31/83 12/31/73 - -------- -------- -------- -------- -------- -------- -------- B = 1 B = 3 B = 5 B = 10 B = 20 Since Inception* ----- ----- ----- ------ ------ ---------------- Stock 128.807492 104.627091 75.665624 67.220229 35.203215 13.930000 10.030000 Money Market 25.412953 25.014473 23.381166 20.319365 14.813059 12.879414 Balanced 28.853651 26.038399 19.401129 15.801712 10.000000 Aggressive 55.683075 48.301505 27.355194 18.092816 10.000000 Quality Bond 98.779000 99.616600 High Yield 100.037700 82.338600 60.515300 59.788900 53.471900 Growth & Income 100.782900 101.380100 101.380100 Global 100.353500 76.983600 60.890200 52.544800 55.637600 Conservative Inv. 100.548800 92.010700 74.555300 69.119900 Growth Investors 100.827100 88.663900 58.293400 51.533100 Intermediate Govt 100.470400 92.091600 79.676917
CUMULATIVE RATES OF RETURN (CRR)
Division B = 1 B = 3 B = 5 B = 10 B = 20 Since Inception* - -------- ----- ----- ----- ------ ------ ---------------- Stock 23.11% 70.23% 91.62% 265.90% 824.68% 1184.22% Money Market 1.59% 8.69% 25.07% 71.56% 97.31% Balanced 10.81% 48.72% 82.60% 188.54% Aggressive 15.28% 103.56% 207.76% 456.83% Quality Bond -0.84% High Yield 21.50% 65.31% 67.32% 87.08% Growth & Income -0.59% Global 30.36% 64.81% 90.99% 80.37% Conservative Inv. 9.28% 34.86% 45.47% Growth Investors 13.72% 72.96% 95.66% Intermediate Govt 9.10% 26.10%
ANNUALIZED RATES OF RETURN (ARR)
Division B = 1 B = 3 B = 5 B = 10 B = 20 Since Inception* - -------- ----- ----- ----- ------ ------ ---------------- Stock 23.11% 19.40% 13.89% 13.85% 11.76% 10.57% Money Market 1.59% 2.82% 4.58% 5.55% 6.01% Balanced 10.81% 14.15% 12.80% 11.58% Aggressive 15.28% 26.73% 25.21% 19.44% Quality Bond -0.84%** High Yield 21.50% 18.24% 10.84% 9.37% Growth & Income -0.59%** Global 30.36% 18.12% 13.82% 9.74% Conservative Inv. 9.28% 10.48% 9.23% Growth Investors 13.72% 20.04% 17.12% Intermediate Govt 9.10% 8.79%
- ---------------- *Number of years since inception, or fraction thereof, where inception dates are: Stock 08/01/68 Quality Bond 10/01/93 Conservative Inv. 10/02/89 Money Market 05/11/82 High Yield 01/02/87 Growth Investors 10/02/89 Balanced 05/01/84 Growth & Income 10/01/93 Intermediate Govt 04/01/91 Aggressive 05/01/84 Global 08/27/87 - ---------------- **Unannualized. FORMULAE FOR DETERMINING CUMULATIVE AND ANNUALIZED RATES OF RETURN FOR EQUI-VEST CERTIFICATES Invested in One Investment Fund of the Hudson River Trust and Terminated on December 31, 1993 AV[subscript: 0] = $1,000.00 AC[subscript: t] = min[$30.00,2% x AV[subscript: t] AV[subscript: t] = (AV[subscript: t-1] - AC[subscript: t-1]) x (UV[subscript: t]/UV[subscript: t-1]) Acct = AVsubscript: 12-31-93 - ACsubscript: 12-31-93 CV = Acct - SC AAR = [(CV/AV[subscript: 0])[superscript:1/B] - 1] x 100 where: AV[subscript: 0] is the amount invested on the inception date. t is the anniversary date of the EQUI-VEST certificate, which is from 1 to B years after the date of inception (t=0). B is the total time of the investment, in years or fraction thereof, from the date of inception AC[subscript: t] is the administration charge at time t. AV[subscript: t] is the accumulated value at time t of AV[subscript: 0] UV[subscript: t] is the separate account unit value at time t. Acct is the account value of the EQUI-VEST certificate on the termination date. CV is the cash value of the EQUI-VEST certificate on the termination date. SC is the applicable surrender charge for the EQUI-VEST certificate on the termination date. AAR is the average annual return over the period of B years. Standardized Performance for the Period Ending December 31, 1993 Investment Fund: Stock
B = One Year B = Three Years B = Five Years B = Ten Years ------------------------ ------------------------- --------------------------- ------------------------- Accum. Admin. Accum. Admin. Accum. Admin. Accum. Admin. Date Unit Value t Value Charge t Value Charge t Value Charge t Value Charge - ---------- ------------- ----- ----------- ------ ----- ----------- ------- ---- ------------ --------- ----- ----------- ------- 12/31/83 35.203215 0 1,000.00 12/31/84 34.028544 1 966.63 19.33 12/31/85 45.113988 2 1,255.90 25.12 12/31/86 52.103759 3 1,421.47 28.43 12/31/87 55.302407 4 1,478.56 29.57 12/31/88 67.220229 0 1,000.00 5 1,761.25 30.00 12/31/89 83.400518 1 1,240.71 24.81 6 2,147.98 30.00 12/31/90 75.665624 0 1,000.00 2 1,103.12 22.06 7 1,921.55 30.00 12/31/91 102.761532 1 1,358.10 27.16 3 1,468.19 29.36 8 2,568.91 30.00 12/31/92 104.627091 0 1,000.00 2 1,355.10 27.10 4 1,464.95 29.30 9 2,585.00 30.00 12/31/93 128.807492 1 1,231.11 24.62 3 16,34.91 30.00 5 1,767.44 30.00 10 3,145.49 30.00 Account Value (Acct): 1,206.49 1,604.91 1,737.44 3,115.49 TSA, IRA*, SEP, EDC Plan and Participant-Owned HR-10 Plan Certificates: Surrender Charge (SC): 72.39 80.00 80.00 80.00 Cash Value (CV): 1,134.10 1,524.91 1,657.44 3,035.49 Average Annual Return (AAR): 13.41% 15.10% 10.63% 11.74% Trusteed and NQ Contracts: Surrender Charge (SC): 60.00 60.00 60.00 0.00 Cash Value (CV): 1,146.49 1,544.91 1,677.44 3,115.49 Average Annual Return (AAR): 14.65% 15.60% 10.90% 12.03% QP IRA Contracts (Individual): Surrender Charge (SC): 65.15 80.00 80.00 80.00 Cash Value (CV): 1,141.34 1,524.91 1,657.44 3,035.49 Average Annual Return (AAR): 14.13% 15.10% 10.63% 11.74%
- --------------- * Includes QP IRA group certificates. 3/30/94 [EQV93PRF.XLW]Stock Standardized Performance for the Period Ending December 31, 1993 Investment Fund: Money Market
B = One Year B = Three Years B = Five Years B = Ten Years ------------------------- ------------------------- --------------------------- -------------------------- Accum. Admin. Accum. Admin. Accum. Admin. Accum. Admin. Date Unit Value t Value Charge t Value Charge t Value Charge t Value Charge - ----------- ------------- ----- ----------- ------- ----- ----------- ------- ---- ------------ --------- ----- ----------- -------- 12/31/83 14.813059 0 1,000.00 12/31/84 16.215445 1 1,094.67 21.89 12/31/85 17.308762 2 1,145.11 22.90 12/31/86 18.220373 3 1,181.31 23.63 12/31/87 19.180943 4 1,218.72 24.37 12/31/88 20.319365 0 1,000.00 5 1,265.23 25.30 12/31/89 21.887910 1 1,077.19 21.54 6 1,335.64 26.71 12/31/90 23.381166 0 1,000.00 2 1,127.67 22.55 7 1,398.23 27.96 12/31/91 24.478278 1 1,046.92 20.94 3 1,156.97 23.14 8 1,434.56 28.69 12/31/92 25.014473 0 1,000.00 2 1,048.46 20.97 4 1,158.67 23.17 9 1,436.66 28.73 12/31/93 25.412953 1 1,015.93 20.32 3 1,043.86 20.88 5 1,153.58 23.07 10 1,430.36 28.61 Account Value (Acct): 995.61 1,022.98 1,130.51 1,401.75 TSA, IRA*, SEP, EDC Plan and Participant-Owned HR-10 Plan Certificates: Surrender Charge (SC): 59.74 61.38 61.05 37.85 Cash Value (CV): 935.87 961.60 1,069.46 1,363.90 Average Annual Return (AAR): -6.41% -1.30% 1.35% 3.15% Trusteed and NQ Contracts: Surrender Charge (SC): 53.76 55.24 60.00 0.00 Cash Value (CV): 941.85 967.74 1,070.51 1,401.75 Average Annual Return (AAR): -5.82% -1.09% 1.37% 3.43% QP IRA Contracts (Individual): Surrender Charge (SC): 53.76 55.24 61.05 37.85 Cash Value (CV): 941.85 967.74 1,069.46 1,363.90 Average Annual Return (AAR): -5.82% -1.09% 1.35% 3.15%
- --------------- * Includes QP IRA group certificates. 3/30/94 [EQV93PRF.XLW] Money Market Standardized Performance for the Period Ending December 31, 1993 Investment Fund: Balanced
B = One Year B = Three Years B = Five Years --------------------------- ---------------------------- --------------------------- Accum. Admin. Accum. Admin. Accum. Admin. Date Unit Value t Value Charge t Value Charge t Value Charge - --------------- ------------- ----- ----------- --------- ----- ----------- ---------- ---- ------------ --------- 12/31/88 15.801712 0 1,000.00 12/31/89 19.688488 1 1,245.97 24.92 12/31/90 19.401129 0 1,000.00 2 1,203.23 24.06 12/31/91 27.165865 1 1,400.22 28.00 3 1,651.09 30.00 12/31/92 26.038399 0 1,000.00 2 1,315.27 26.31 4 1,553.81 30.00 12/31/93 28.853651 1 1,108.12 22.16 3 1,428.32 28.57 5 1,688.57 30.00 Account Value (Acct): 1,085.96 1,399.75 1,658.57 TSA, IRA*, SEP, EDC Plan and Participant-Owned HR-10 Plan Certificates: Surrender Charge (SC): 65.16 80.00 80.00 Cash Value (CV): 1,020.80 1,319.75 1,578.57 Average Annual Return (AAR): 2.08% 9.69% 9.56% Trusteed and NQ Contracts: Surrender Charge (SC): 58.64 60.00 60.00 Cash Value (CV): 1,027.32 1,339.75 1,598.57 Average Annual Return (AAR): 2.73% 10.24% 9.84% QP IRA Contracts (Individual): Surrender Charge (SC): 58.64 75.59 80.00 Cash Value (CV): 1,027.32 1,324.16 1,578.57 Average Annual Return (AAR): 2.73% 9.81% 9.56%
- --------------- * Includes QP IRA group certificates. 3/30/94 [EQV93PRF.XLW] Balanced Standardized Performance for the Period Ending December 31, 1993 Investment Fund: Aggressive Stock
B = One Year B = Three Years B = Five Years --------------------------- ---------------------------- --------------------------- Accum. Admin. Accum. Admin. Accum. Admin. Date Unit Value t Value Charge t Value Charge t Value Charge - ----------- ------------- ----- ----------- --------- ----- ----------- ---------- ---- ------------ --------- 12/31/88 18.092816 0 1,000.00 12/31/89 25.864365 1 1,429.54 28.59 12/31/90 27.355194 0 1,000.00 2 1,481.70 29.63 12/31/91 50.511325 1 1,846.50 30.00 3 2,681.23 30.00 12/31/92 48.301505 0 1,000.00 2 1,737.03 30.00 4 2,535.25 30.00 12/31/93 55.683075 1 1,152.82 23.06 3 1,967.90 30.00 5 2,888.10 30.00 Account Value (Acct): 1,129.76 1,937.90 2,858.10 TSA, IRA*, SEP, EDC Plan and Participant-Owned HR-10 Plan Certificates: Surrender Charge (SC): 67.79 80.00 80.00 Cash Value (CV): 1,061.97 1,857.90 2,778.10 Average Annual Return (AAR): 6.20% 22.93% 22.67% Trusteed and NQ Contracts: Surrender Charge (SC): 60.00 60.00 60.00 Cash Value (CV): 1,069.76 1,877.90 2,798.10 Average Annual Return (AAR): 6.98% 23.37% 22.85% QP IRA Contracts (Individual): Surrender Charge (SC): 61.01 80.00 80.00 Cash Value (CV): 1,068.75 1,857.90 2,778.10 Average Annual Return (AAR): 6.88% 22.93% 22.67%
- --------------- * Includes QP IRA group certificates. 3/30/94 [EQV93PRF.XLW] Aggressive Stock Standardized Performance for the Period Ending December 31, 1993 B = Since Inception ---------------------------
Investment Fund: Balanced Investment Fund: Aggressive Stock Accum. Admin. Accum. Admin. Date Unit Value t Value Charge Unit Value t Value Charge - --------- -------------- ------- ----------- --------- -------------- ------ ---------- ---------- 5/1/84 10.000000 0.00 1,000.00 10.000000 0.00 1,000.00 4/30/85 11.322949 1.00 1,132.29 22.65 12.162050 1.00 1,216.21 24.32 4/30/86 15.169983 2.00 1,486.66 29.73 17.906847 2.00 1,754.87 30.00 4/30/87 16.439187 3.00 1,578.82 30.00 23.155393 3.00 2,230.44 30.00 4/30/88 14.685893 4.00 1,383.63 27.67 19.679475 4.00 1,870.12 30.00 4/30/89 17.015587 5.00 1,571.06 30.00 21.856608 5.00 2,043.69 30.00 4/30/90 18.601026 6.00 1,684.65 30.00 25.019351 6.00 2,305.08 30.00 4/30/91 21.148296 7.00 1,881.24 30.00 38.258256 7.00 3,478.94 30.00 4/30/92 24.898643 8.00 2,179.51 30.00 45.986648 8.00 4,145.64 30.00 4/30/93 26.386400 9.00 2,277.98 30.00 45.883488 9.00 4,106.41 30.00 12/31/93 28.853651 9.67 2,458.17 20.02 55.683075 9.67 4,947.03 20.02 Account Value (Acct): 2,438.15 4,927.01 TSA, IRA*, SEP, EDC Plan and Participant-Owned HR-10 Plan Certificates: Surrender Charge (SC): 65.83 80.00 Cash Value (CV): 2,372.32 4,847.01 Average Annual Return (AAR): 9.35% 17.74% Trusteed and NQ Contracts: Surrender Charge (SC): 0.00 0.00 Cash Value (CV): 2,438.15 4,927.01 Average Annual Return (AAR): 9.66% 17.93% QP IRA Contracts (Individual): Surrender Charge (SC): 65.83 80.00 Cash Value (CV): 2,372.32 4,847.01 Average Annual Return (AAR): 9.35% 17.74%
- --------------- * Includes QP IRA group certificates. 4/5/94 [EQV93PRF.XLW] Since inception (RevBalAgg) Standardized Performance for the Period Ending December 31, 1993 Investment Fund: Quality Bond Since Inception -------------------------- Accum. Admin. Date Unit Value t Value Charge ---- ---------- - ----- ------ 12/31/88 12/31/89 12/31/90 12/31/91 10/1/93 99.616618 0 1,000.00 12/31/93 98.778977 1 991.59 7.47 Account Value (Acct): 984.12 TSA, IRA*, SEP, EDC Plan and Participant-Owned HR-10 Plan Certificates: Surrender Charge (SC): 59.05 Cash Value (CV): 925.07 Average Annual Return (AAR): -26.85% Trusteed and NQ Contracts: Surrender Charge (SC): 53.14 Cash Value (CV): 930.98 Average Annual Return (AAR): -24.95% QP IRA Contracts (Individual): Surrender Charge (SC): 53.14 Cash Value (CV): 930.98 Average Annual Return (AAR): -24.95% * Includes QP IRA group certificates. 4/6/94 EQUI-VEST [EQV93PRF.XLW]Quality Bond Standardized Performance for the Period Ending December 31, 1993 Investment Fund: High Yield
B = One Year B = Three Years B = Five Years Since Inception --------------------------- ------------------------- --------------------------- --------------------------- Accum. Admin. Accum. Admin. Accum. Admin. Accum. Admin. Date Unit Value t Value Charge t Value Charge t Value Charge t Value Charge - -------- ------------- ----- ----------- --------- ----- ----------- ------- ---- ------------ --------- ----- ----------- --------- 1/2/87 53.471871 0 1,000.00 12/31/87 55.225461 1 1,032.79 20.66 12/31/88 59.788945 0 1,000.00 2 1,095.78 21.92 12/31/89 62.016058 1 1,037.25 20.74 3 1,113.86 22.28 12/31/90 60.515262 0 1,000.00 2 991.91 19.84 4 1,065.17 21.30 12/31/91 74.308235 1 1,227.93 24.56 3 1,193.63 23.87 5 1,281.79 25.64 12/31/92 82.338588 0 1,000.00 2 1,333.41 26.67 4 1,296.17 25.92 6 1,391.90 27.84 12/31/93 100.037653 1 1,214.95 24.30 3 1,587.64 30.00 5 1,543.29 30.00 7 1,657.27 30.00 Account Value (Acct): 1,190.65 1,557.64 1,513.29 1,627.27 TSA, IRA*, SEP, EDC Plan and Participant-Owned HR-10 Plan Certificates: Surrender Charge (SC): 71.44 80.00 80.00 73.23 Cash Value (CV): 1,119.21 1,477.64 1,433.29 1,554.04 Average Annual Return (AAR): 11.92% 13.90% 7.46% 6.51% Trusteed and NQ Contracts: Surrender Charge (SC): 60.00 60.00 60.00 0.00 Cash Value (CV): 1,130.65 1,497.64 1,453.29 1,627.27 Average Annual Return (AAR): 13.07% 14.41% 7.76% 7.21% QP IRA Contracts (Individual): Surrender Charge (SC): 64.30 80.00 80.00 73.23 Cash Value (CV): 1,126.35 1,477.64 1,433.29 1,554.04 Average Annual Return (AAR): 12.64% 13.90% 7.46% 6.51%
* Includes QP IRA group certificates. 4/6/94 EQUI-VEST [EQV93PRF.XLW]High Yield Standardized Performance for the Period Ending December 31, 1993 Investment Fund: Growth & Income Since Inception ------------------------- Accum. Admin. Date Unit Value t Value Charge ---- ---------- - ----- ------ 12/31/88 12/31/89 12/31/90 12/31/91 10/1/93 101.380093 0 1,000.00 12/31/93 100.782857 1 994.11 7.47 Account Value (Acct): 986.64 TSA, IRA*, SEP, EDC Plan and Participant-Owned HR-10 Plan Certificates: Surrender Charge (SC): 59.20 Cash Value (CV): 927.44 Average Annual Return (AAR): -26.09% Trusteed and NQ Contracts: Surrender Charge (SC): 53.28 Cash Value (CV): 933.36 Average Annual Return (AAR): -24.18% QP IRA Contracts (Individual): Surrender Charge (SC): 53.28 Cash Value (CV): 933.36 Average Annual Return (AAR): -24.18% * Includes QP IRA group certificates. 4/6/94 [EQV93PRF.XLW]Growth & Income Standardized Performance for the Period Ending December 31, 1993 Investment Fund: Conservative Investors
B = One Year B = Three Years Since Inception --------------------------- ---------------------------- --------------------------- Accum. Admin. Accum. Admin. Accum. Admin. Date Unit Value t Value Charge t Value Charge t Value Charge - --------------- ------------- ----- ----------- --------- ----- ----------- ---------- ---- ------------ --------- 10/2/89 69.119928 0 1,000.00 12/31/89 71.019416 1 1,027.48 7.39 12/31/90 74.555332 0 1,000.00 2 1,070.88 21.42 12/31/91 88.156628 1 1,182.43 23.65 3 1,240.91 24.82 12/31/92 92.010728 0 1,000.00 2 1,209.44 24.19 4 1,269.26 25.39 12/31/93 100.548785 1 1,092.79 21.86 3 1,295.24 25.90 5 1,359.30 27.19 Account Value (Acct): 1,070.93 1,269.34 1,332.11 TSA, IRA*, SEP, EDC Plan and Participant-Owned HR-10 Plan Certificates: Surrender Charge (SC): 64.26 76.16 71.93 Cash Value (CV): 1,006.67 1,193.18 1,260.18 Average Annual Return (AAR): 0.67% 6.06% 5.60% Trusteed and NQ Contracts: Surrender Charge (SC): 57.83 60.00 60.00 Cash Value (CV): 1,013.10 1,209.34 1,272.11 Average Annual Return (AAR): 1.31% 6.54% 5.83% QP IRA Contracts (Individual): Surrender Charge (SC): 57.83 68.54 71.93 Cash Value (CV): 1,013.10 1,200.80 1,260.18 Average Annual Return (AAR): 1.31% 6.29% 5.60%
* Includes QP IRA group certificates. 4/6/94 EQUI-VEST [EQV93PRF.XLW]Conservative Investors Standardized Performance for the Period Ending December 31, 1993 Investment Fund: Growth Investors
B = One Year B = Three Years Since Inception --------------------------- ---------------------------- --------------------------- Accum. Admin. Accum. Admin. Accum. Admin. Date Unit Value t Value Charge t Value Charge t Value Charge - --------------- ------------- ----- ----------- --------- ----- ----------- ---------- ---- ------------ --------- 10/2/89 51.533137 0 1,000.00 12/31/89 53.415454 1 1,036.53 7.39 12/31/90 58.293444 0 1,000.00 2 1,123.12 22.46 12/31/91 85.642190 1 1,469.16 29.38 3 1,617.03 30.00 12/31/92 88.663930 0 1,000.00 2 1,490.57 29.81 4 1,643.03 30.00 12/31/93 100.827148 1 1,137.18 22.74 3 1,661.15 30.00 5 1,834.31 30.00 Account Value (Acct): 1,114.44 1,631.15 1,804.31 TSA, IRA*, SEP, EDC Plan and Participant-Owned HR-10 Plan Certificates: Surrender Charge (SC): 66.87 80.00 80.00 Cash Value (CV): 1,047.57 1,551.15 1,724.31 Average Annual Return (AAR): 4.76% 15.76% 13.69% Trusteed and NQ Contracts: Surrender Charge (SC): 60.00 60.00 60.00 Cash Value (CV): 1,054.44 1,571.15 1,744.31 Average Annual Return (AAR): 5.44% 16.25% 14.00% QP IRA Contracts (Individual): Surrender Charge (SC): 60.18 80.00 80.00 Cash Value (CV): 1,054.26 1,551.15 1,724.31 Average Annual Return (AAR): 5.43% 15.76% 13.69%
* Includes QP IRA group certificates. 4/6/94 EQUI-VEST [EQV93PRF.XLW]Growth Investors Standardized Performance for the Period Ending December 31, 1993 Investment Fund: Intermediate Gov't Security
B = One Year Since Inception --------------------------------- --------------------------------- Accum. Admin. Accum. Admin. Date Unit Value t Value Charge t Value Charge - --------------- -------------- ---- ------------ --------- ---- ------------ --------- 4/1/91 79.676917 0 1,000.00 12/31/91 88.397370 1 1,109.45 22.19 12/31/92 92.091607 0 1,000.00 2 1,132.70 22.65 12/31/93 100.470450 1 1,090.98 21.82 3 1,211.04 24.22 Account Value (Acct): 1,069.16 1,186.82 TSA, IRA*, SEP, EDC Plan and Participant-Owned HR-10 Plan Certificates: Surrender Charge (SC): 64.15 71.21 Cash Value (CV): 1,005.01 1,115.61 Average Annual Return (AAR): 0.50% 4.06% Trusteed and NQ Contracts: Surrender Charge (SC): 57.73 60.00 Cash Value (CV): 1,011.43 1,126.82 Average Annual Return (AAR): 1.14% 4.43% QP IRA Contracts (Individual): Surrender Charge (SC): 57.73 64.09 Cash Value (CV): 1,011.43 1,122.73 Average Annual Return (AAR): 1.14% 4.30%
* Includes QP IRA group certificates. 4/6/94 EQUI-VEST [EQV93PRF.XLW]Intermediate Gov't Security Standardized Performance for the Period Ending December 31, 1993 Investment Fund: Global
B = One Year B = Three Years B = Five Years Since Inception --------------------------- -------------------------- --------------------------- ------------------------- Accum. Admin. Accum. Admin. Accum. Admin. Accum. Admin. Date Unit Value t Value Charge t Value Charge t Value Charge t Value Charge - --------- ------------- ----- ----------- --------- ----- ----------- -------- ---- ------------ --------- ----- ----------- ------- 8/28/87 55.637589 0 1,000.00 12/31/87 48.032208 1 863.30 10.27 12/31/88 52.544826 0 1,000.00 2 933.18 18.66 12/31/89 65.700058 1 1,250.36 25.01 3 1,143.48 22.87 12/31/90 60.890182 0 1,000.00 2 1,135.65 22.71 4 1,038.57 20.77 12/31/91 78.431030 1 1,288.07 25.76 3 1,433.54 28.67 5 1,311.00 26.22 12/31/92 76.983608 0 1,000.00 2 1,239.02 24.78 4 1,378.94 27.58 6 1,261.07 25.22 12/31/93 100.353483 1 1,303.57 26.07 3 1,582.84 30.00 5 1,761.60 30.00 7 1,611.01 30.00 Account Value (Acct): 1,277.50 1,552.84 1,731.60 1,581.01 TSA, IRA*, SEP, EDC Plan and Participant-Owned HR-10 Plan Certificates: Surrender Charge (SC): 76.65 80.00 80.00 71.15 Cash Value (CV): 1,200.85 1,472.84 1,651.60 1,509.86 Average Annual Return (AAR): 20.09% 13.78% 10.56% 6.71% Trusteed and NQ Contracts: Surrender Charge (SC): 60.00 60.00 60.00 0.00 Cash Value (CV): 1,217.50 1,492.84 1,671.60 1,581.01 Average Annual Return (AAR): 21.75% 14.29% 10.82% 7.49% QP IRA Contracts (Individual): Surrender Charge (SC): 68.99 80.00 80.00 71.15 Cash Value (CV): 1,208.52 1,472.84 1,651.60 1,509.86 Average Annual Return (AAR): 20.85% 13.78% 10.56% 6.71%
* Includes QP IRA group certificates. 4/6/94 EQUI-VEST [EQV93PRF.XLW]Global -----END PRIVACY-ENHANCED MESSAGE-----