Document

EX-99.D 2 artisanvariablelifeinsuran.htm ARTISAN FORM OF FLEXIBLE PREMIUM VARIABLE LIFE INSURANCE POLICY Document

ITT HARTFORD LIFE AND ANNUITY INSURANCE COMPANY

HARTFORD, CONNECTICUT 06104-2999

(A STOCK INSURANCE COMPANY)

(THE "COMPANY")

NATIONAL SERVICE CENTER ADDRESS:

P.O. BOX 59179

MINNEAPOLIS, MINNESOTA 55459

Will pay the Death Proceeds to the Beneficiary, upon receipt at Our National

Service Center in Minneapolis, Minnesota, of due proof of the Insured's death

while the Policy was in force.

Signed for the Company

/s/ Lynda Godkin /s/ Lowndes A. Smith

Lynda Godkin, SECRETARY Lowndes A. Smith, PRESIDENT

READ YOUR POLICY CAREFULLY

This is a legal contract between You and Us

RIGHT TO EXAMINE POLICY

WE WANT YOU TO BE SATISFIED WITH THE POLICY YOU HAVE PURCHASED. WE URGE YOU TO

EXAMINE IT CLOSELY. IF, FOR ANY REASON YOU ARE NOT SATISFIED, YOU MAY DELIVER

OR MAIL THE POLICY TO US OR TO THE AGENT FROM WHOM IT WAS PURCHASED ANYTIME

DURING YOUR FREE LOOK PERIOD. YOUR FREE LOOK PERIOD BEGINS ON THE DAY YOU GET

YOUR POLICY AND ENDS ON THE LATEST OF: (A) TEN DAYS AFTER YOU GET IT, (B) 45

DAYS AFTER YOU SIGN THE APPLICATION, AND (C) TEN DAYS AFTER WE MAIL YOU THE

NOTICE OF WITHDRAWAL RIGHT. IN SUCH AN EVENT, THE POLICY WILL BE RESCINDED AND

WE WILL PAY AN AMOUNT EQUAL TO THE GREATER OF THE PREMIUMS PAID FOR THE POLICY

LESS ANY INDEBTEDNESS OR THE SUM OF: I) THE ACCOUNT VALUE LESS ANY INDEBTEDNESS, ON THE DATE THE RETURNED POLICY IS RECEIVED BY US OR TO THE AGENT FROM WHOM IT WAS PURCHASED; AND, II) ANY DEDUCTIONS UNDER THE POLICY OR CHARGES ASSOCIATED WITH THE SEPARATE ACCOUNT.

CASH SURRENDER VALUE PAYABLE ON THE SCHEDULED MATURITY DATE,

UNLESS EXTENDED BY RIDER

DEATH PROCEEDS PAYABLE AT DEATH

ADJUSTABLE DEATH BENEFIT

PREMIUMS PAYABLE AS SHOWN ON PAGE 3

NON-PARTICIPATING

THE PORTIONS OF THE ACCOUNT VALUES PROVIDED BY THIS CONTRACT THAT ARE IN THE

SUB-ACCOUNTS ARE BASED ON THE INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT. THEY ARE VARIABLE AND NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT. THE AMOUNT OF THE DEATH BENEFIT MAY BE FIXED OR VARIABLE DEPENDING ON THE INVESTMENT EXPERIENCE OF THAT SEPARATE ACCOUNT. THE FACE AMOUNT IS A GUARANTEED DEATH BENEFIT DURING THE FIRST TEN POLICY YEARS SUBJECT TO THE CONDITIONS DESCRIBED ON PAGE 13.

FLEXIBLE PREMIUM

VARIABLE LIFE INSURANCE POLICY

[logo]

TABLE OF CONTENTS

PAGE

Policy Specifications 3

Definitions 5

Death Benefit 7

Increases and Decreases in Face Amount 8

Premiums 8

Valuation Provisions 10

Account Value, Cash Value

and Cash Surrender Value 10

Transfers 11

Monthly Deduction Amount 12

Lapse and Policy Grace Period 13

Reinstatement 14

Policy Loans 15

Withdrawals 16

Surrenders 16

Payments By Us 16

Taxation 16

The Contract 17

Ownership and Beneficiary 18

Exchange Option 18

Termination and Maturity Date 19

Income Settlement Options 19

Any Riders follow page 21

The Registrant hereby amends this Registration Statement on such date as may

be necessary to delay its effective date until the Registrant shall file a

further amendment which specifically states that this Registration Statement

shall become effective in accordance with Section 8(a) of the Securities Act

of 1933 or until the Registration Statement shall become effective on such

date as the Commission, acting pursuant to said Section 8(a), may determine.

Page 2

POLICY SPECIFICATIONS

- ------------------------------------------------------------------------------

BASE POLICY INFORMATION

- ------------------------------------------------------------------------------

POLICY: FLEXIBLE PREMIUM VARIABLE LIFE

POLICY NUMBER: VL00001

INSURED: JOHN DOE

ISSUE AGE/SEX: 35, MALE

INSURANCE CLASS: PREFERRED

OWNER: JOHN DOE

BENEFICIARY: JANE DOE

INITIAL FACE AMOUNT: $100,000

DEATH BENEFIT OPTION: A (LEVEL OPTION)

DEATH BENEFIT GUARANTEE PERIOD: JANUARY 1, 1996 - DECEMBER 31, 2005

OPTION C LIMIT: NOT APPLICABLE

FIRST PLANNED PREMIUM: $700.00

PREMIUM MODE: ANNUAL

MONTHLY DEATH BENEFIT GUARANTEE PREMIUM: $ 84.39

POLICY DATE: JANUARY 1, 1996

DATE OF ISSUE: JANUARY 1, 1996

SCHEDULED MATURITY DATE: JANUARY 1, 2056*

* IT IS POSSIBLE THAT COVERAGE WILL EXPIRE PRIOR TO THE SCHEDULED MATURITY

DATE SHOWN WHERE PREMIUMS AND INVESTMENT EXPERIENCE ARE INSUFFICIENT TO

CONTINUE COVERAGE TO SUCH DATE. COVERAGE MAY ALSO BE AFFECTED BY CHANGES

IN THE MONTHLY DEDUCTION AMOUNT.

Page 3

POLICY NUMBER: VL0000001

POLICY SPECIFICATIONS

- ------------------------------------------------------------------------------

ADDITIONAL BENEFITS AND RIDERS

- ------------------------------------------------------------------------------

TERM INSURANCE

DESIGNATED INSURED: SALLY DOE

ISSUE AGE/SEX: 60/FEMALE

INSURANCE CLASS: PREFERRED

TERM INSURANCE AMOUNT: $50,000

ISSUE CHARGE: $31.00

FIRST YEAR MONTHLY TERM INSURANCE CHARGE: $ 4.09

DATE OF ISSUE: 01/01/1996

RIDER EFFECTIVE DATE: 01/01/1996

TERMINATION DATE: 01/01/2056

- ------------------------------------------------------------------------------

WAIVER OF SPECIFIED AMOUNT DISABILITY BENEFIT

INSURED: JOHN DOE

INSURANCE CLASS: PREFERRED

SPECIFIED AMOUNT: $58.33

FIRST YEAR MONTHLY CHARGE: $ 2.33

DATE OF ISSUE: 01/01/1996

RIDER EFFECTIVE DATE: 01/01/1996

TERMINATION DATE: 01/01/2026

Page 3 (cont'd)

POLICY NUMBER: VL0000001

POLICY SPECIFICATIONS

POLICY CHARGES

- ------------------------------------------------------------------------------

DEDUCTIONS FROM PREMIUM PAYMENTS

- ------------------------------------------------------------------------------

TYPE OF POLICY PERCENT OF

CHARGE YEARS PREMIUMS PAID

------ ----- -------------

GUARANTEED MAXIMUM ALL 2%

SALES CHARGES

DAC TAX CHARGE ALL [1.25%]

PREMIUM TAX CHARGE ALL [2.35%]

- ------------------------------------------------------------------------------

GUARANTEED MAXIMUM DEDUCTIONS FROM ACCOUNT VALUE

- ------------------------------------------------------------------------------

TYPE OF POLICY CHARGE OR

CHARGE YEARS PERCENT OF VALUE

------ ----- ----------------

MONTHLY ADMINISTRATIVE CHARGE 1 $25.00 PER MONTH

2-10 $10.00 PER MONTH

11+ $7.50 PER MONTH

MORTALITY AND EXPENSE 1-10 .067% PER MONTH (.80%

RISK CHARGE PER YEAR) OF SEPARATE

ACCOUNT VALUE

11+ .042% PER MONTH (.50%

PER YEAR) OF SEPARATE

ACCOUNT VALUE

TRANSFER CHARGE ALL $0.00 FOR THE FIRST

TRANSFER IN ANY

CALENDAR MONTH

ALL $25.00 PER TRANSFER IN

EXCESS OF 1 PER

CALENDAR MONTH

- ------------------------------------------------------------------------------

MAXIMUM SURRENDER CHARGES *

- ---------------------------

POLICY MAXIMUM POLICY MAXIMUM

YEAR CHARGE YEAR CHARGE

1 $1000.00 9 $636.00

2 1000.00 10 545.00

3 1000.00 11 455.00

4 1000.00 12 364.00

5 1000.00 13 273.00

6 909.00 14 182.00

7 818.00 15 91.00

8 727.00 16+ 0.00

* SURRENDER CHARGES WILL BE REDUCED AS THE RESULT OF ANY PRIOR SURRENDER

CHARGES ASSESSED.

Page 3A

POLICY NUMBER: VL0000001

POLICY SPECIFICATIONS

ACCOUNT VALUE INFORMATION

- ------------------------------------------------------------------------------

FIXED ACCOUNT

- ------------------------------------------------------------------------------

FIXED ACCOUNT MINIMUM CREDITED RATE: 4%

- ------------------------------------------------------------------------------

SUB-ACCOUNTS AND FUNDS

- ------------------------------------------------------------------------------

LISTED BELOW ARE THE SUB-ACCOUNTS OF THE HARTFORD LIFE INSURANCE COMPANY

SEPARATE [ACCOUNT VL I] AND THE FUNDS THEY INVEST IN.

SUB-ACCOUNT FUND

HARTFORD BOND HARTFORD BOND FUND, INC.

HARTFORD STOCK HARTFORD STOCK FUND, INC.

HARTFORD MONEY MARKET HVA MONEY MARKET FUND, INC.

HARTFORD ADVISERS HARTFORD ADVISERS FUND, INC.

HARTFORD CAPITAL APPRECIATION HARTFORD CAPITAL APPRECIATION FUND, INC.

HARTFORD MORTGAGE SECURITIES HARTFORD MORTGAGE SECURITIES FUND, INC.

HARTFORD INDEX HARTFORD INDEX FUND, INC.

HARTFORD INTERNATIONAL HARTFORD INTERNATIONAL

OPPORTUNITIES OPPORTUNITIES FUND, INC.

HARTFORD DIVIDEND & GROWTH HARTFORD DIVIDENDS & GROWTH FUND, INC.

PUTNAM GLOBAL GROWTH PCM GLOBAL GROWTH FUND

PUTNAM GROWTH AND INCOME PCM GROWTH AND INCOME FUND

PUTNAM HIGH YIELD PCM HIGH YIELD FUND

PUTNAM MONEY MARKET PCM MONEY MARKET FUND

PUTNAM GLOBAL ASSET ALLOCATION PCM GLOBAL ASSET ALLOCATION FUND

PUTNAM U.S. GOVERNMENT AND PCM U.S. GOVERNMENT AND

HIGH QUALITY BOND HIGH QUALITY FUND

PUTNAM VOYAGER PCM VOYAGER FUND

PUTNAM UTILITIES GROWTH AND INCOME PCM UTILITIES GROWTH AND INCOME FUND

PUTNAM DIVERSIFIED INCOME PCM DIVERSIFIED INCOME FUND

PUTNAM NEW OPPORTUNITIES PCM NEW OPPORTUNITIES FUND

FIDELITY ASSET MANAGER ASSET MANAGER PORTFOLIO OF VARIABLE

INSURANCE PRODUCTS FUND II

FIDELITY OVERSEAS OVERSEAS PORTFOLIO OF VARIABLE

INSURANCE PRODUCTS FUND

FIDELITY EQUITY INCOME EQUITY-INCOME PORTFOLIO OF VARIABLE

INSURANCE PRODUCTS FUND]

AND OTHER SUB-ACCOUNTS AND FUNDS AS MAY BE MADE AVAILABLE FROM TIME TO TIME.

INITIAL ALLOCATION

OF NET PREMIUMS: HARTFORD MONEY MARKET SUB-ACCOUNT 100%

Page 3B

POLICY NUMBER: VL0000001

POLICY SPECIFICATIONS

- ------------------------------------------------------------------------------

TABLE OF MINIMUM DEATH BENEFIT PERCENTAGES

AND MONTHLY MAXIMUM COST OF INSURANCE RATES PER $1,000

- ------------------------------------------------------------------------------

MINIMUM MAXIMUM COST MINIMUM MAXIMUM COST

ATTAINED DEATH BENEFIT OF INSURANCE ATTAINED DEATH BENEFIT OF INSURANCE

AGE PERCENTAGES RATE AGE PERCENTAGES RATE

36 250.00 0.1517 66 119.00 2.0517

37 250.00 0.1617 67 118.00 2.2633

38 250.00 0.1725 68 117.00 2.4933

39 250.00 0.1842 69 116.00 2.7483

40 250.00 0.1983 70 115.00 3.0367

41 243.00 0.2133 71 113.00 3.3658

42 236.00 0.2292 72 111.00 3.7458

43 229.00 0.2467 73 109.00 4.1758

44 222.00 0.2658 74 107.00 4.6483

45 215.00 0.2875 75 105.00 5.1533

46 209.00 0.3108 76 105.00 5.6867

47 203.00 0.3358 77 105.00 6.2442

48 197.00 0.3633 78 105.00 6.8292

49 191.00 0.3933 79 105.00 7.4600

50 185.00 0.4275 80 105.00 8.1567

51 178.00 0.4667 81 105.00 8.9375

52 171.00 0.5117 82 105.00 9.8183

53 164.00 0.5633 83 105.00 10.7950

54 157.00 0.6208 84 105.00 11.8483

55 150.00 0.6850 85 105.00 12.9542

56 146.00 0.7550 86 105.00 14.0983

57 142.00 0.8292 87 105.00 15.2633

58 138.00 0.9117 88 105.00 16.4442

59 134.00 1.0042 89 105.00 17.6575

60 130.00 1.1075 90 105.00 18.9208

61 128.00 1.2225 91 104.00 20.2633

62 126.00 1.3550 92 103.00 21.7350

63 124.00 1.5050 93 102.00 23.4792

64 122.00 1.6717 94 101.00 25.8192

65 120.00 1.8542

THE MINIMUM DEATH BENEFIT PERCENTAGES ARE DETERMINED TO COMPLY WITH SECTION 7702 OF THE INTERNAL REVENUE CODE, OR YOUR REQUESTED PERCENTAGES, IF GREATER. THE MAXIMUM COST OF INSURANCE RATES DO NOT EXCEED THE COST OF INSURANCE RATES BASED ON THE 1980 COMMISSIONERS STANDARD ORDINARY SMOKER OR NONSMOKER MORTALITY TABLE, AGE LAST BIRTHDAY.

Page 3C

POLICY NUMBER: VL0000001

RIDER SPECIFICATIONS

DESIGNATED INSURED: SALLY DOE

- ------------------------------------------------------------------------------

TERM INSURANCE

TABLE OF MONTHLY MAXIMUM RATES

(PER $1,000 OF RIDER BENEFIT)

- ------------------------------------------------------------------------------

ATTAINED MAXIMUM ATTAINED MAXIMUM

AGE RATE AGE RATE

61 $0.7975 81 $6.4175

62 0.8742 82 7.2050

63 0.9683 83 8.0933

64 1.0742 84 9.0725

65 1.1883 85 10.1317

66 1.3067 86 11.2633

67 1.4275 87 12.4658

68 1.5525 88 13.7400

69 1.6917 89 15.0958

70 1.8550 90 16.5442

71 2.0542 91 18.1183

72 2.2983 92 19.8775

73 2.5908 93 21.9458

74 2.9275 94 24.6025

75 3.3033

76 3.7100

77 4.1458

78 4.6175

79 5.1400

80 5.7342

THE MONTHLY MAXIMUM RATES DO NOT EXCEED THE COST OF INSURANCE RATES BASED ON THE

1980 COMMISSIONERS STANDARD ORDINARY SMOKER OR NONSMOKER MORTALITY TABLE, AGE

LAST BIRTHDAY.

Page 4

POLICY NUMBER: VL0000001

RIDER SPECIFICATIONS

- ------------------------------------------------------------------------------

WAIVER OF SPECIFIED AMOUNT DISABILITY

TABLE OF MONTHLY MAXIMUM RATES

(PER $1 OF MONTHLY BENEFIT)

- ------------------------------------------------------------------------------

ATTAINED MAXIMUM ATTAINED MAXIMUM

AGE RATE AGE RATE

36 0.040 51 0.070

37 0.041 52 0.075

38 0.041 53 0.079

39 0.042 54 0.084

40 0.043 55 0.088

41 0.044 56 0.103

42 0.044 57 0.120

43 0.045 58 0.137

44 0.046 59 0.157

45 0.046 60 0.069

46 0.050 61 0.063

47 0.053 62 0.051

48 0.057 63 0.055

49 0.061 64 0.058

50 0.066

THE MONTHLY MAXIMUM RATES DO NOT EXCEED THE COST OF INSURANCE RATES BASED ON THE

1980 COMMISSIONERS STANDARD ORDINARY SMOKER OR NONSMOKER MORTALITY TABLE, AGE

LAST BIRTHDAY.

Page 4A

DEFINITIONS The definitions in this section apply to the

following words and phrases whenever and wherever they appear in

the Policy.

ACCOUNT VALUE: the total of all amounts in the Fixed Account,

Loan Account and Sub-Accounts.

ACCUMULATION UNIT: an accounting unit used to calculate the

value of a Sub-Account.

ATTAINED AGE: the Issue Age plus the number of completed Policy

Years.

CASH SURRENDER VALUE: the Cash Value less all Indebtedness.

CASH VALUE: the Account Value less any applicable Surrender

Charges.

COMPANY, WE, US, OUR: the Company referred to on the first page

of the Policy.

CUMULATIVE DEATH BENEFIT GUARANTEE PREMIUM: the premium

required to maintain the Death Benefit Guarantee.

DATE OF ISSUE: the date shown on Page 3 from which Suicide and

Incontestability provisions are measured. The date may be

different from the Policy Date.

DEATH BENEFIT: on the Policy Date, the Death Benefit equals the

Face Amount. Thereafter, it may change in accordance with the

terms of the Death Benefit Option provision, the Minimum Death

Benefit provision, the Death Benefit Guarantee provision and the

Withdrawals provision.

DEATH BENEFIT OPTION: the Death Benefit Option in effect

determines how the Death Benefit is calculated. The three Death

Benefit Options provided are described in the Death Benefit

section.

DEATH PROCEEDS: the amount which We will pay on the death of

the Insured.

FACE AMOUNT: an amount We use to determine the Death Benefit.

On the Policy Date, the Face Amount equals the Initial Face

Amount shown on Page 3. Thereafter, it may change in accordance

with the terms of the Increases and Decreases in Face Amount

provision and the Withdrawals provision.

FIXED ACCOUNT: part of the Company's General Account to which

all or a portion of the Account Value may be allocated.

FUNDS: the registered open end management investment companies

in which the assets of the Separate Account may be invested.

GENERAL ACCOUNT: all Company assets other than those allocated

to the separate accounts.

GRACE PERIOD: The 61 day period between the day Your policy

goes into default and the day on which Your policy terminates.

INDEBTEDNESS: all loans taken on the Policy, plus any interest

due or accrued minus any loan repayments.

INSURED: the person whose life is insured under the Policy as

shown on Page 3.

IN WRITING: in a written form satisfactory to Us.

Page 5

DEFINITIONS ISSUE AGE: as of the Policy Date, the Insured's

(continued) age on his/her last birthday.

LOAN ACCOUNT: an account established for any amounts

transferred from the Fixed Account and Sub-Accounts as a result

of loans. The amounts in the Loan Account are credited with

interest and are not subject to the investment experience of any

Sub-Accounts.

MONTHLY ACTIVITY DATE: the Policy Date and the same date in

each succeeding month as the Policy Date. However, whenever the

Monthly Activity Date falls on a date other than a Valuation

Day, the Monthly Activity Date will be deemed to be the next

Valuation Day.

NET PREMIUM: the amount of premium credited to the Account

Value. It is the premium paid minus the deductions from premium

shown on Page 3A.

PLANNED PREMIUM: the amount that the Owner intends to pay. The

First Planned Premium is shown on Page 3.

POLICY ANNIVERSARY: an anniversary of the Policy Date.

POLICY GRACE PERIOD: the 61 day period between the day Your

policy goes into default and the day on which Your policy

terminates.

POLICY DATE: the date shown on Page 3 from which Policy

Anniversaries and Policy Years are determined.

POLICY YEARS: years as measured from the Policy Date.

PRO RATA BASIS: an allocation method based on the proportion of

the Account Value in the Fixed Account and each Sub-Account.

SCHEDULED MATURITY DATE: the date, shown on Page 3, on which

the Policy will mature, unless extended by rider.

SEPARATE ACCOUNT: an account entitled Separate Account VL I

which has been established by Us to separate the assets funding

the variable benefits for the class of contracts to which the

Policy belongs from the other assets of the Company. Separate

Account VL I will offer the Funds listed on Page 3B as its

underlying investments.

SUB-ACCOUNTS: the subdivisions of the Separate Account. These

are shown on Page 3B.

SURRENDER CHARGE: a charge that may be assessed if You

surrender the Policy or the Face Amount is decreased.

VALUATION DAY: the date on which a Sub-Account is valued. This

occurs everyday We are open and the New York Stock Exchange is

open for trading.

VALUATION PERIOD: the period of time between the close of

business on successive Valuation Days.

YOU, YOUR: the Owner of the Policy.

Page 6

DEATH BENEFIT GENERAL

Upon receipt of due proof of the Insured's death, We will pay

the Death Proceeds to the Beneficiary.

DEATH PROCEEDS

Death Proceeds equal the Death Benefit described below less

Indebtedness and less any due and unpaid Monthly Deduction

Amounts occurring during a Policy Grace Period.

However, if the Insured dies after We receive a request In

Writing from You to surrender the Policy, the Cash Surrender

Value will be paid in lieu of the Death Proceeds.

The Death Benefit is the greater of:

(a) the Death Benefit provided by the Death Benefit Option

chosen; and

(b) the Minimum Death Benefit described below.

DEATH BENEFIT OPTIONS

You have three Death Benefit Options.

1. Under Option A (Level Option), the Death Benefit is the

Face Amount on the date We receive due proof of the

Insured's death.

2. Under Option B (Return of Account Value Option), the

Death Benefit is the Face Amount, plus the Account Value

on the date We receive due proof of the Insured's death.

3. Under Option C (Return of Premium Option), the Death

Benefit is the Face Amount on the date of the Insured's

death, plus the lesser of: (a) the sum of the premiums

paid up to the date We receive due proof of the Insured's

death; and (b) the Option C Limit shown on Page 3.

DEATH BENEFIT OPTION CHANGES

You may change Your Death Benefit Option, subject to the

conditions described here. You must notify Us In Writing of the

change. Such change will be effective on the Monthly Activity

Date following the date We receive the request.

You may change Option C (Return of Premium Option) or Option B

(Return of Account Value Option) to Option A (Level Option). If

You do, the Face Amount will become that amount available as a

Death Benefit immediately prior to the option change. You may

change Option A (Level Option) or Option C (Return of Premium

Option) to Option B (Return of Account Value Option). If You

do, the Face Amount will become that amount available as a Death

Benefit immediately prior to the option change, reduced by the

then current Account Value. Any resulting decrease in the Face

Amount may be subject to a partial Surrender Charge as described

in the Decreases in Face Amount provision.

MINIMUM DEATH BENEFIT

We will automatically increase the Death Benefit so that it will

never be less than the Account Value multiplied by the Minimum

Death Benefit Percentage for the then current Policy Year. The

Table of Minimum Death Benefit Percentages is shown on Page 3C.

This is to ensure that:

(a) the Policy continues to qualify as life insurance under

the Internal Revenue Code; or

(b) the Policy maintains the relationship between the

Account Value and the Death Benefit You selected on Your

application, if greater.

Page 7

INCREASES AND GENERAL

DECREASES IN At any time after the first Policy Year, You may make a request

FACE AMOUNT In Writing to change the Face Amount.

The minimum amount by which the Face Amount can be increased or

decreased is based on Our rules then in effect.

We reserve the right to limit You to one increase or decrease in

any 12 month period.

DECREASES IN FACE AMOUNT

A decrease in the Face Amount will be effective on the Monthly

Activity Date following the date We receive Your request. The

remaining Face Amount must not be less than Our minimum rules

then in effect.

If You decrease Your Face Amount to an amount lower than it has

ever been, a partial Surrender Charge may be assessed.

The Surrender Charge assessed will be:

(a) the Surrender Charge applicable to the then current Policy

Year, if any; multiplied by

(b) the percentage described below.

The percentage will be determined by:

(i) subtracting the requested Face Amount from the lowest Face

Amount prior to the request; and

(ii) dividing that difference by the lowest Face Amount prior

to the request.

The Surrender Charge assessed will be deducted from Your Account

Value on the Monthly Activity Date on which the decrease becomes

effective. We will also reduce the Surrender Charges applicable

to future Policy Years and provide You a revised schedule of

Maximum Surrender Charges.

INCREASES IN FACE AMOUNT

All requests to increase the Face Amount must be applied for on

a new application and accompanied by the Policy. All requests

will be subject to evidence of insurability satisfactory to Us.

Any increase approved by Us will be effective on the date shown

on the new policy specifications page, provided that the Monthly

Deduction Amount for the first month after the effective date of

the increase is made.

PREMIUMS GENERAL

No insurance is effective until We receive premiums sufficient

to cover the Monthly Deduction Amount on the Policy Date. After

the first premium has been paid, subsequent premiums can be paid

at any time.

Checks must be made payable to the Company shown on the first

page of the Policy.

Checks may be sent to either:

(a) Us at the address shown on the premium notice; or

(b) Our authorized agent in exchange for a receipt signed by

Our President or Secretary and countersigned by such agent.

We will apply any amount received under the Policy as a premium

unless it is clearly marked otherwise. The premium will be

applied on the date We receive it at the address shown on the

premium notice.

Page 8

PREMIUMS PLANNED PREMIUM PAYMENTS

(continued) We will send You a premium notice for the Planned Premium

payment. The notices may be sent at 12, 6, or 3 month intervals.

The First Year Planned Premium payment and premium mode You

selected are shown on Page 3. You may change the Planned Premium

payment shown on the premium notices subject to Our minimum

amount rules then in effect.

FLEXIBLE PREMIUMS

After the first premium has been paid, Your subsequent premium

payments are flexible. The actual amount and frequency of

payment will affect the Account Value and could affect the

amount and duration of insurance provided by the Policy.

You may pay additional premiums at any time prior to the

Scheduled Maturity Date subject to the Premium Limitation

provision.

PREMIUM LIMITATIONS

You may pay premiums at any time prior to the Scheduled Maturity

Date subject to the following limitations:

(a) The minimum premium that We will accept is $50.

(b) If premiums are received which would cause the Policy

to fail to meet the definition of a life insurance

contract in accordance with the Internal Revenue Code, We

reserve the right to refund the excess premium payments.

Such refunds and interest thereon will be made within 60

days after the end of a Policy Year.

insurability for any premium payment that results in an

increase in the Death Benefit greater than the amount of

the premium.

(d) Any premium received in excess of $1,000,000 is

subject to Our approval.

INITIAL PREMIUM ALLOCATION

The initial Net Premium will be allocated to the Hartford Money

Market Sub-Account on the later of:

(a) the Policy Date; and

(b) the date We receive the premium.

The Accumulated Value in the Hartford Money Market Sub-Account

will then be allocated to the Fixed Account and Sub-Accounts

according to the premium allocation You specified in the

application on the latest of:

(a) 45 days after the application is signed;

(b) 10 days after We receive the premium;

and

(d) the date We receive the final requirement to put the Policy

in force.

Any additional Net Premiums received by Us prior to such date

will be allocated to the Hartford Money Market Sub-Account.

SUBSEQUENT PREMIUM ALLOCATIONS

You may change how Your premiums are allocated by notifying Us

In Writing. Subsequent Net Premiums will be allocated to the

Fixed Account and Sub-Accounts according to Your most recent

instructions, subject to the following. The number of Sub-

Accounts that the Account Value may be allocated to will be

subject to Our rules then in effect. However, it will be

guaranteed to be no fewer than 9. If We receive a premium and

Your most recent allocation instructions would violate this

requirement, We will allocate the Net Premium to the Fixed

Account and Sub-Accounts on a Pro Rata Basis.

Page 9

VALUATION SUB-ACCOUNT ACCUMULATION UNITS

PROVISIONS Amounts allocated to each Sub-Account increase the number of

Accumulation Units in each Sub-Account. The number of

Accumulation Units added to each Sub-Account is determined by

dividing the amount allocated to the Sub-Account by the

dollar value of one Accumulation Unit for such Sub-Account.

Amounts taken from each Sub-Account decrease the number of

Accumulation Units in each Sub-Account. The number of

Accumulation Units subtracted from each Sub-Account is

determined by dividing the amount taken from the Sub-Account by

the dollar value of one Accumulation Unit for such Sub-Account.

The number of Your Accumulation Units will not be affected by

any subsequent change in the value of the units. The

Accumulation Unit Values in each Sub-Account may increase or

decrease daily as described below.

SUB-ACCOUNT ACCUMULATION UNIT VALUE

The Accumulation Unit Value for each Sub-Account will vary to

reflect the investment experience of the applicable Fund and

will be determined on each Valuation Day by multiplying the

Accumulation Unit Value of the particular Sub-Account on the

preceding Valuation Day by a Net Investment Factor for that Sub-

Account for the Valuation Period then ended. The Net Investment

Factor for each of the Sub-Accounts is equal to the net asset

value per share of the corresponding Fund at the end of the

Valuation Period (plus the per share amount of any dividend or

capital gain distributions paid by that Fund in the Valuation

Period then ended) divided by the net asset value per share of

the corresponding Fund at the beginning of the Valuation Period.

EMERGENCY PROCEDURE

If a national stock exchange is closed (except for holidays or

weekends) or trading is restricted due to an existing emergency

as defined by the Securities and Exchange Commission so that We

cannot value the Sub-Accounts, We may postpone all transactions

which require valuation of the Sub-Accounts until valuation is

possible. Any provision of the Policy which specifies a

Valuation Day will be superseded by the emergency procedure.

FIXED ACCOUNT

We will credit interest to amounts in the Fixed Account on a

monthly basis at rates We determine. The Fixed Account Minimum

Credited Rate is shown on Page 3B. The interest credited will

reflect the timing of amounts added to or withdrawn from the

Fixed Account.

ACCOUNT VALUE, ACCOUNT VALUE

CASH VALUE Your Account Value on the Policy Date equals the initial Net

AND CASH Premium less the Monthly Deduction Amount for the first policy

SURRENDER month.

VALUE

On each subsequent Monthly Activity Date, Your Account Value

equals:

(a) the sum of Your Accumulated Values in the Fixed Account and

Sub-Accounts; plus

(b) the value of Your Loan Account, if any; minus,

On each Valuation Day (other than a Monthly Activity Date), Your

Account Value equals:

(a) the sum of Your Accumulated Values in the Fixed Account and

Sub-Accounts; plus

(b) the value of Your Loan Account, if any.

Page 10

ACCOUNT VALUE, ACCUMULATED VALUE - FIXED ACCOUNT

CASH VALUE Your Accumulated Value in the Fixed Account equals:

SURRENDER (a) the Net Premiums allocated to it; plus

VALUE (b) amounts transferred to it from the Sub-Accounts or the Loan

(continued) Account; plus

(d) amounts transferred out of it to the Sub-Accounts or the

Loan Account; minus

(e) any transfer charges or Surrender Charges that have been

taken from it; minus

(f) any Monthly Deduction Amounts taken from it; minus

(g) any withdrawals taken from it.

ACCUMULATED VALUE - SUB-ACCOUNTS

Your Accumulated Value in any Sub-Account equals:

(a) the number of Your Accumulation Units in that

Sub-Account on the Valuation Day; multiplied by

(b) that Sub-Account's Accumulation Unit Value on the

Valuation Day.

The number of Accumulation Units in any Sub-Account is increased

when

(a) Net Premiums are allocated to it; or

(b) amounts are transferred to it from other

Sub-Accounts, the Fixed Account or the Loan Account.

The number of Accumulation Units in any Sub-Account is decreased

when

(a) amounts are transferred out of it to other

Sub-Accounts, the Fixed Account or the Loan Account; or

(b) any transfer charges or Surrender Charges have been

taken from it; or

(d) any withdrawals are taken from it.

CASH VALUE

Your Cash Value is equal to the Account Value less any

applicable Surrender Charges. The Maximum Surrender Charges and

the Policy Years during which they will be applied are shown on

Page 3A.

CASH SURRENDER VALUE

Your Cash Surrender Value is equal to Your Cash Value minus the

Indebtedness, if any.

TRANSFERS AMOUNT AND FREQUENCY OF TRANSFERS

Upon request and as long as the Policy is in effect, You may

transfer amounts among the Fixed Account and Sub-Accounts.

We reserve the right to limit the size of transfers and

remaining balances, and to limit the number and frequency of

transfers.

RESTRICTIONS ON TRANSFERS FROM THE FIXED ACCOUNT

In addition to the conditions above, transfers from the Fixed

Account are subject to the following:

(a) the transfer must occur during the 30 day period

following each Policy Anniversary; and

(b) if the Accumulated Value in Your Fixed Account

exceeds $1,000, the amount transferred in any Policy Year

may be no larger than 25% of the Accumulated Value in the

Fixed Account on the date of transfer.

TRANSFER CHARGE

After a transfer has occurred, the Transfer Charge, as specified

on Page 3A, if any, will be deducted on a Pro Rata Basis from

the Fixed Account and Sub-Accounts.

Page 11

MONTHLY GENERAL

DEDUCTION On each Monthly Activity Date, We will deduct an amount from

AMOUNT Your Account Value to pay for the benefits provided by the

Policy. This amount is called the Monthly Deduction Amount

and equals:

(a) the Cost of Insurance; plus

(b) the Monthly Administrative Charge; plus

(d) the charges for additional benefits provided by rider, if

any.

The Monthly Deduction Amount will be taken on a Pro Rata Basis

from the Fixed Account and Sub-Accounts on each Monthly Activity

Date.

COST OF INSURANCE

The Cost of Insurance for any Monthly Activity Date is equal to:

(a) the Cost of Insurance Rate per $1,000; multiplied by

(b) the amount at risk; divided by

On any Monthly Activity Date, the amount at risk equals the

Death Benefit less the Account Value on that date prior to

assessing the Monthly Deduction Amount.

COST OF INSURANCE RATE

The Cost of Insurance Rate is based on the then current Policy

Year as well as the sex, Issue Age and insurance class of the

Insured shown on the top of Page 3.

The Cost of Insurance Rates will not exceed those in the Table

of Monthly Maximum Cost of Insurance Rates shown on Page 4A.

We can use Cost of Insurance Rates that are lower than the

Monthly Maximum Cost of Insurance Rates shown on Page 4A. Rates

will be determined on each Policy Anniversary based on Our

future expectations of such factors as mortality, expenses,

interest, persistency and taxes. Any change We make will be on

a uniform basis for Insureds of the same Issue Age, sex and

insurance class and whose coverage has been in force for the

same length of time. No change in insurance class or cost will

occur on account of deterioration of the Insured's health.

MONTHLY ADMINISTRATIVE CHARGE

The Monthly Administrative Charge will not exceed the amounts

shown on Page 3A.

MORTALITY AND EXPENSE RISK CHARGE

The Mortality and Expense Risk Charge for any Monthly Activity

Date is equal to:

(a) the Mortality and Expense Risk Rate; multiplied by

(b) the sum of Your Accumulated Values in the Sub-Accounts

on the Monthly Activity Date, prior to assessing the Monthly

Deduction Amount.

Each month the Mortality and Expense Risk Rate will not exceed

that shown on Page 3A.

Page 12

LAPSE AND POLICY GRACE PERIOD

POLICY During the first Policy Year, the Policy will go into default

GRACE PERIOD on any Monthly Activity Date on which the Account Value less

Indebtedness is not sufficient to cover the Monthly Deduction

Amount.

During the second Policy Year, the Policy will go into default

on any Monthly Activity Date on which the Account Value less

Indebtedness less 1/2 of the Surrender Charge for the second

Policy Year is not sufficient to cover the Monthly Deduction

Amount. The Maximum Surrender Charges are shown on Page 3A.

During the third Policy Year and thereafter the Policy will go

into default on any Monthly Activity Date if the Cash Surrender

Value is not sufficient to cover the Monthly Deduction Amount.

If the Policy goes into default, We will send You a notice

warning You that the Policy is in danger of terminating. That

notice will tell You the premium required to keep the Policy

from terminating. The premiums required will be no greater than

the amount required to pay three Monthly Deduction Amounts as of

the day the Policy Grace Period began. That notice will be

mailed both to You on the first day the Policy goes into

default, at your last known address, and to any assignee of

record.

We will keep the Policy inforce for the 61 day period following

the date Your policy goes into default. We call that period the

Policy Grace Period. However, if We have not received the

required premiums (specified in Your warning notice) by the end

of the Policy Grace Period, the Policy will terminate unless the

Death Benefit Guarantee is in effect (see the Death Benefit

Guarantee provision which follows).

If the Insured dies during the Policy Grace Period, We will pay

the Death Proceeds.

DEATH BENEFIT GUARANTEE

The Policy will remain in force at the end of the Policy Grace

Period, as long as the Death Benefit Guarantee is in effect as

described below.

The Death Benefit Guarantee is available as long as:

(a) the Policy is in the first ten Policy Years; and

(b) on each Monthly Activity Date during that period, the

cumulative premiums paid into the Policy, less Indebtedness

less withdrawals from the Policy, equal or exceed an amount

known as the Cumulative Death Benefit Guarantee Premium. We

describe below how to calculate the Cumulative Death Benefit

Guarantee Premium.

If the Death Benefit Guarantee is available and the premium

required to keep the Policy from terminating has not been paid

by the end of the Policy Grace Period:

(a) all riders will terminate; and

(b) the Death Benefit Guarantee will be in effect.

While the Death Benefit Guarantee is in effect, the Death

Benefit will be the current Face Amount, regardless of the Death

Benefit Option previously selected.

The Death Benefit Guarantee will remain in effect on each

subsequent Monthly Activity Date provided:

(a) the Policy remains in default; and

(b) the Death Benefit Guarantee is available.

If the Account Value ever should be a negative amount while the

Death Benefit Guarantee is in effect, We guarantee that Your

Account Value will never be less than zero.

Page 13

LAPSE AND

POLICY CALCULATION OF THE CUMULATIVE DEATH BENEFIT GUARANTEE PREMIUM

GRACE PERIOD On the Policy Date, the Cumulative Death Benefit Guarantee

(continued) Premium is the Monthly Death Benefit Guarantee Premium shown

on Page 3.

On each Monthly Activity Date, the Cumulative Death Benefit

Guarantee Premium is:

(a) the Cumulative Death Benefit Guarantee Premium on the

previous Monthly Activity Date; plus

(b) the current Monthly Death Benefit Guarantee Premium. (The

initial Monthly Death Benefit Guarantee Premium is shown on

Page 3.)

If, during the Death Benefit Guarantee Period, the Face Amount

is increased or decreased, or if any riders are added, deleted

or changed, a new Monthly Death Benefit Guarantee Premium will

be calculated. We will send You notice of the new Monthly Death

Benefit Guarantee Premium which will be used in calculating the

Cumulative Death Benefit Guarantee Premium in subsequent months.

DEATH BENEFIT GUARANTEE GRACE PERIOD

If, on each Monthly Activity Date during the Death Benefit

Guarantee Period, the cumulative premiums paid into the Policy

less Indebtedness less withdrawals from the Policy, do not equal

or exceed the Cumulative Death Benefit Guarantee Premium on that

date, a Death Benefit Guarantee Grace Period of 61 days will

begin. We will mail the Owner and any assignee written notice

of the amount of premium required to continue the Death Benefit

Guarantee.

The Death Benefit Guarantee will be removed from the Policy if

the required premium is not paid by the end of the Death Benefit

Guarantee Grace Period. You will receive a written notification

of the change and the Death Benefit Guarantee will never again

be available or in effect on the Policy.

REINSTATEMENT Unless the Policy has been surrendered for its Cash Surrender

Value, the Policy may be reinstated prior to the Scheduled

Maturity Date provided:

(a) You make Your request In Writing within five years from

the Termination Date;

(b) satisfactory evidence of insurability is submitted;

repaid or carried over to the reinstated policy; and

(d) You pay sufficient premium to:

(i) cover all Monthly Deduction Amounts that are due

and unpaid during the Policy Grace Period; and

(ii) keep the Policy in force for 3 months after the

date of reinstatement.

The Account Value on the reinstatement date will equal:

(a) the Cash Value at the time of termination; plus

(b) Net Premiums attributable to premiums paid at the time

of reinstatement; minus

during the Policy Grace Period; plus

(d) the Surrender Charge at the time of reinstatement.

The Surrender Charge will be based on the duration from the

original Policy Date.

Page 14

POLICY LOANS GENERAL

At any time while the Policy is in force, You may borrow against

the Policy by assigning it as sole security to Us. We may defer

granting a loan, except to pay premiums to Us, for the period

permitted by law but not more than six months.

LOAN AMOUNTS

Any new loan taken together with any existing Indebtedness may

not exceed the Cash Surrender Value on the date We grant a loan.

The minimum loan amount that We will allow is $500. Before

advancing the loan amount, We may withhold an amount sufficient

to pay interest on total Indebtedness to the end of the Policy

Year and any Monthly Deduction Amounts due on or before the next

Policy Anniversary.

Unless you specify otherwise, all loan amounts will be

transferred from the Fixed Account and the Sub-Accounts to the

Loan Account on a Pro Rata Basis.

If total Indebtedness equals or exceeds the Cash Value on any

Monthly Activity Date, the Policy will then go into default.

See the Lapse and Policy Grace Period provision for details.

CREDITED INTEREST

Any amounts in the Loan Account will be credited with interest

at a rate equal to the Fixed Account Minimum Credited Rate shown

on Page 3B.

PREFERRED LOAN

If, any time after the 10th Policy Anniversary, the Account

Value exceeds the total of all premiums paid since issue, a

Preferred Loan is available. A lower interest rate is charged

to Preferred Loans than to the rest of Your Indebtedness, if

any. (Refer to the Interest Charged on Indebtedness provision

for details.) The amount available for a Preferred Loan is the

amount by which the Account Value exceeds the total premiums

paid. The amount of Indebtedness that qualifies as a Preferred

Loan is determined on each Monthly Activity Date.

LOAN REPAYMENTS

All or part of a loan may be repaid at any time that:

(a) the Policy is in force; and

(b) the Insured is alive.

However, each repayment must be at least $50 and clearly

identified In Writing as a loan repayment.

The amount of a loan repayment will be deducted from the Loan

Account and will be allocated among the Fixed Account and Sub-

Accounts in the same percentage as premiums are allocated.

INTEREST CHARGED ON INDEBTEDNESS

The table below shows the interest rates We will charge on Your

Indebtedness.

----------------------------------------------------------------

DURING POLICY PORTION OF INTEREST RATE CHARGED

YEARS INDEBTEDNESS EQUALS THE FIXED

ACCOUNT MINIMUM

CREDITED RATE PLUS:

----------------------------------------------------------------

1-10 All Indebtedness 2%

----------------------------------------------------------------

11 and later Preferred Loans, if any 0%

Rest of Indebtedness 1%

----------------------------------------------------------------

Page 15

POLICY LOANS Because the interest charged on Indebtedness may exceed the rate

(continued) credited to the Loan Account, the Indebtedness may grow faster

than the Loan Account. If this happens, any difference between

the value of the Loan Account and the Indebtedness will be

transferred on each Monthly Activity Date from the Fixed Account

and Sub-Accounts to the Loan Account on a Pro Rata Basis.

WITHDRAWALS GENERAL

You may request a withdrawal In Writing. The minimum withdrawal

allowed is $500. The maximum withdrawal is the Cash Surrender

Value less $1,000. A charge of up to $10 may be assessed for

each withdrawal. One withdrawal per calendar month is allowed.

Unless specified otherwise the withdrawal will be deducted on a

Pro Rata basis from the Fixed and Sub-Accounts.

If the Death Benefit Option then in effect is Option A (Level

Option) or Option C (Return of Premium Option), the Face Amount

will be reduced by the amount equal to the reduction in the

Account Value resulting from the withdrawal.

Any withdrawal that causes the Face Amount to fall below the

Initial Face Amount may be subject to a partial Surrender

Charge. Refer to the Decreases in Face Amount provision for an

explanation of the applicable partial Surrender Charge.

SURRENDERS GENERAL

While the Policy is in force, You may surrender the Policy to

Us. The Policy, and additional benefits provided by rider, are

then cancelled as of the day We receive Your request In Writing

or the date You request the surrender, whichever is later. We

will then pay You the Cash Surrender Value as of that date.

PAYMENTS GENERAL

BY US We will pay Death Proceeds, Cash Surrender Values,

withdrawals and loan amounts attributable to the Sub-Accounts

within 7 days after We receive all the information needed to

process the payment unless:

(a) the New York Stock Exchange is closed on other than

customary weekend and holiday closings or trading on the New

York Stock Exchange is restricted as determined by the

Securities and Exchange Commission (SEC); or

(b) an emergency exists, as determined by the SEC, as a

result of which disposal of securities is not reasonably

practicable to determine the value of the Sub-Accounts; or

protection of policy owners.

DEFERRAL OF PAYMENTS FROM THE FIXED ACCOUNT

We may defer payment of any Cash Surrender Values, withdrawals

and loan amounts which are not attributable to the Sub-Accounts

for up to six months from the date of the request. If We defer

payment for more than 30 days, We will pay interest at the Fixed

Account Minimum Credited Rate.

TAXATION We do not expect to incur any federal, state or local

income tax on the earnings or realized capital gains

attributable to the Separate Account. Based upon these

expectations, no charge is being made to the Separate Account

for federal, state or local income taxes. If We incur income

taxes attributable to the Separate Account or determine that

such taxes will be incurred, We may assess a charge for taxes

against the Policy in the future.

Page 16

THE CONTRACT ENTIRE CONTRACT

The Policy, the attached copy of the initial application, any

applications for reinstatement, all subsequent applications to

change the Policy, any endorsements or riders and all additional

policy information sections added to the Policy are the entire

contract. The contract is made in consideration of the

application and the payment of the initial premium. We will not

use any statement to cancel the Policy or to defend a claim

under it, unless that statement is contained in an attached

written application. All statements in the application will, in

the absence of fraud (as determined by a court of competent

jursidiction), be deemed representations and not warranties.

MODIFICATION

The only way this contract may be modified is by a written

agreement signed by Our President, or one of Our Vice

Presidents, Secretaries or Assistant Secretaries.

NON-PARTICIPATION

The Policy is non-participating. It does not share in Our

surplus earnings, so You will receive no policy dividends under

it.

MISSTATEMENT OF AGE AND/OR SEX

If on the date of death:

(a) the Issue Age of the Insured is understated; or

(b) the sex of the Insured is incorrectly stated such that

it resulted in lower Costs of Insurance,

the Death Benefit will be reduced to the Death Benefit that

would have been provided by the last Cost of Insurance charge at

the correct Issue Age and/or sex.

If on the date of death:

(a) the Issue Age of the Insured is overstated; or

(b) the sex of the Insured is incorrectly stated such that

it resulted in higher Costs of Insurance,

the Death Benefit will be adjusted by the return of all excess

Costs of Insurance prior to the date of the Insured's death.

SUICIDE

If, within 2 years from the Date of Issue, the Insured dies by

suicide, while sane or insane, Our liability will be limited to

the premiums paid less Indebtedness and less any withdrawals.

If, within 2 years from the effective date of any increase in

the Face Amount for which evidence of insurability was obtained,

the Insured dies by suicide, while sane or insane, Our liability

with respect to such increase, will be limited to the Cost of

Insurance for the increase.

INCONTESTABILITY

We cannot contest the Policy after it has been in force, during

the Insured's lifetime, for 2 years from its Date of Issue,

except for:

(a) non-payment of premium; and

(b) a rider that provides for an Incontestability period which

exceeds 2 years.

Any increase in the Face Amount for which evidence of

insurability was obtained, will be incontestable only after the

increase has been in force, during the Insured's lifetime, for 2

years from the effective date of the increase.

Page 17

THE CONTRACT SEPARATE ACCOUNTS

(continued) We will have exclusive and absolute ownership and control of the

assets of Our Separate Accounts. The assets of a Fund will be

available to cover the liabilities of Our General Account only to

the extent that those assets exceed the liabilities of that

Separate Account. The assets of a Fund will be valued on each

Valuation Day. Our determination of the value of an Accumulation

Unit by the method described in the Policy will be conclusive.

ANNUAL REPORT

We will send You a report at least once each Policy Year

showing:

(a) the current Account Value, Cash Surrender Value and Face

Amount;

(b) the premiums paid, Monthly Deduction Amounts and loans

since the last report;

(d) notifications required by the provisions of the Policy; and

(e) any other information required by the Insurance

Department of the state where the Policy was delivered.

OWNERSHIP AND CHANGE OF OWNER OR BENEFICIARY

BENEFICIARY The Owner and Beneficiary will be those named

in the application until You change them. To change the Owner

or Beneficiary, notify Us In Writing while the Insured is alive.

After We receive written notice, the change will be effective as

of the date You signed such notice, whether or not the Insured

is living when We receive it. However, the change will be

subject to any payment We made or actions We may have taken

before We received the request.

ASSIGNMENT

You may assign the Policy. Until You notify Us In Writing, no

assignment will be effective against Us. We are not responsible

for the validity of any assignment.

OWNER'S RIGHTS

While the Insured is alive and no Beneficiary is irrevocably

named, You may:

(a) exercise all the rights and options that the Policy provides

or that We permit;

(b) assign the Policy; and

NO NAMED BENEFICIARY

If no named Beneficiary survives the Insured, then, unless the

Policy provides otherwise:

(a) You will be the Beneficiary; or

(b) if You are the Insured, Your estate will be the Beneficiary.

EXCHANGE If the Policy is in effect, You may exchange it any time during

OPTION the 24 months following its Date of Issue for a non-variable life

insurance contract offered by Us on the life of the Insured

without evidence of insurability.

The new policy will be issued by Us with an amount at risk which

equals or is less than the amount at risk in effect on the

Exchange Date. The charges and/or premiums will be based on the

same Date of Issue, Issue Age and risk classification as the

Policy.

This exchange is subject to adjustments in payments and Account

Values to reflect variances, if any, in the payments and Account

Values under the Policy and the new policy.

Page 18

TERMINATION TERMINATION

AND MATURITY The Policy will terminate upon the earliest of the following

DATE events:

(a) Scheduled Maturity Date of the Policy unless extended by

rider; or

(b) surrender of the Policy; or

or exceeds the Cash Value, unless the Cash Value subsequently

exceeds the Indebtedness; or

(d) the end of the Policy Grace Period during which premiums

sufficient for the required deductions are not paid, provided

the Death Benefit Guarantee is not in effect; or

(e) the date We receive notification In Writing of the death of

the Insured. In this event, Your Death Benefit will not be

affected by any Monthly Deduction Amounts taken after the

date of the Insured's death and before We receive due proof

of death.

SCHEDULED MATURITY DATE

The Scheduled Maturity Date is the last date on which You may

elect to pay premium. Unless extended by rider, the Policy will

terminate on this date and any Cash Surrender Value will be paid

to You.

INCOME AVAILABILITY

SETTLEMENT All or parts of the proceeds of the Policy may, instead of

OPTIONS being paid in one sum, be left with Us under any one or a

combination of the following options, subject to Our minimum

amount requirements on the date of election.

We will pay interest of at least 3 1/2% per year (or higher, if

required by state law) on the Death Proceeds from the date of

the Insured's death to the date payment is made or an Income

Settlement Option is elected. These proceeds are then no longer

subject to the investment experience of a Separate Account.

If any payee is a corporation, partnership, association,

assignee, or fiduciary, an option may be chosen only with Our

consent. Option 4 is not available to any payee whose age

exceeds 90.

DESCRIPTION OF TABLES

The options shown below and on the next page are based on

interest at a guaranteed rate of 3 1/2% per year. Payments

under Option 4 are based on mortality according to the 1983a

Individual Annuity Mortality Table, with ages set back one year.

EXCESS INTEREST

We may pay or credit excess interest of such amount and in such

manner as We determine.

DEATH OF PAYEE

If the payee dies while receiving payments under one of the

options below, We will pay the following:

(a) Any principal and accrued interest remaining unpaid under

Option 1 or 2.

(b) The value of remaining unpaid guaranteed payments, if

any, under Option 3 or 4, commuted using interest of 3 1/2%

per year.

Any such amount will be paid in one sum to the payee's estate.

Page 19

INCOME OTHER OPTIONS

SETTLEMENT To convert the monthly payments shown in the tables for Options

OPTIONS 3 and 4 to quarterly, semi-annual or annual payments, multiply

(continued) by the following factors:

PAYMENT INTERVAL FACTOR

Quarterly 2.99

Semi-annual 5.96

Annual 11.81

Other options may be arranged with Our consent.

OPTION 1 - INTEREST INCOME

Payments of interest at the rate We declare, but not less than 3

1/2% per year, on the amount left under this option.

OPTION 2 - INCOME OF FIXED AMOUNT

Equal payments of the amount chosen until the amount left under

this option, with interest of not less than 3 1/2% per year, is

exhausted. The final payment will be for the balance only.

OPTION 3 - INCOME FOR FIXED PERIOD

Payments, determined from the table below, are guaranteed for

the number of years chosen. The first payment will be due on

the date proceeds are applied under this option.

MONTHLY PAYMENTS MONTHLY PAYMENTS

NUMBER PER $1,000 OF NUMBER PER $1,000 OF

OF YEARS PROCEEDS OF YEARS PROCEEDS

1 $84.65 10 $9.83

2 43.05 15 7.10

3 29.19 20 5.75

4 22.27 25 4.96

5 18.12 30 4.45

OPTION 4 - LIFE INCOME

Payments, determined from the table shown below for the option

elected, are based on the payee's sex and age nearest birthday

on the day the first payment becomes due. The first payment

will be due on the date proceeds are applied under this option.

The Life Income available are:

(a) Payments only while the payee is alive.

(b) Payment guaranteed for 10 years; then continuing while the

payee is alive.

Page 20

INCOME

SETTLEMENT

OPTIONS

(continued)

MONTHLY PAYMENTS PER $1,000 OF PROCEEDS

<TABLE>

OPTION 4A OPTION 4B OPTION 4A OPTION 4B

PAYEE'S LIFE ONLY 10 YRS. CERTAIN PAYEE'S LIFE ONLY 10 YRS. CERTAIN

AGE MALE FEMALE MALE FEMALE AGE MALE FEMALE MALE FEMALE

20 $3.34 $3.23 $3.34 $3.23 68 $6.79 $5.79 $6.38 $5.63

25 3.44 3.31 3.43 3.30 69 7.02 5.95 6.54 5.77

30 3.56 3.40 3.56 3.40 70 7.26 6.13 6.71 5.91

35 3.71 3.51 3.71 3.51 71 7.52 6.32 6.87 6.07

40 3.91 3.66 3.90 3.65 72 7.80 6.53 7.05 6.23

45 4.17 3.84 4.14 3.84 73 8.09 6.75 7.22 6.40

50 4.49 4.08 4.44 4.07 74 8.41 6.99 7.40 6.58

51 4.56 4.14 4.51 4.12 75 8.75 7.26 7.57 6.76

52 4.64 4.20 4.58 4.18 76 9.12 7.54 7.75 6.95

53 4.72 4.26 4.66 4.24 77 9.51 7.85 7.92 7.14

54 4.80 4.32 4.74 4.30 78 9.92 8.18 8.09 7.34

55 4.89 4.39 4.82 4.36 79 10.37 8.54 8.26 7.54

56 4.99 4.46 4.91 4.43 80 10.85 8.94 8.42 7.74

57 5.09 4.54 5.00 4.51 81 11.37 9.36 8.57 7.94

58 5.20 4.62 5.10 4.58 82 11.92 9.82 8.71 8.13

59 5.32 4.71 5.20 4.66 83 12.50 10.32 8.85 8.32

60 5.44 4.80 5.31 4.75 84 13.12 10.87 8.97 8.50

61 5.57 4.90 5.42 4.84 85 13.78 11.46 9.09 8.67

62 5.71 5.00 5.54 4.93 86 14.47 12.09 9.20 8.83

63 5.86 5.11 5.67 5.03 87 15.20 12.78 9.29 8.97

64 6.02 5.23 5.80 5.14 88 15.98 13.52 9.38 9.10

65 6.20 5.36 5.94 5.25 89 16.79 14.31 9.46 9.22

66 6.38 5.49 6.08 5.37 90 17.66 15.16 9.53 9.32

67 6.58 5.64 6.23 5.50

</TABLE>

Page 21

ITT HARTFORD LIFE AND ANNUITY INSURANCE COMPANY

HARTFORD, CONNECTICUT 06104-2999

(A STOCK INSURANCE COMPANY)

(THE "COMPANY")

NATIONAL SERVICE CENTER ADDRESS:

P.O. BOX 59179

MINNEAPOLIS, MINNESOTA 55459

CASH SURRENDER VALUE PAYABLE ON THE SCHEDULED MATURITY DATE,

UNLESS EXTENDED BY RIDER

DEATH PROCEEDS PAYABLE AT DEATH OF THE INSURED

ADJUSTABLE DEATH BENEFIT

PREMIUMS PAYABLE AS SHOWN ON PAGE 3

NON-PARTICIPATING

THE PORTIONS OF THE ACCOUNT VALUES PROVIDED BY THIS CONTRACT THAT ARE IN THE

SUB-ACCOUNTS ARE BASED ON THE INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT. THEY

ARE VARIABLE AND NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT. THE AMOUNT OF THE

DEATH BENEFIT MAY BE FIXED OR VARIABLE DEPENDING ON THE INVESTMENT EXPERIENCE OF

THAT SEPARATE ACCOUNT. THE FACE AMOUNT IS A GUARANTEED DEATH BENEFIT DURING THE

FIRST TEN POLICY YEARS SUBJECT TO THE CONDITIONS DESCRIBED ON PAGE 13.

[LOGO]

FLEXIBLE PREMIUM

VARIABLE LIFE INSURANCE POLICY

</TEXT>