EX-99.24(B)4(III) 5 b69027a1exv99w24xby4xiiiy.txt SPECIFICATIONS PAGES FOR VENTURE 200.08 FOR TRADITIONAL IRA . . . SPECIFICATIONS PAGE TYPE OF CONTRACT: [QUALIFIED] INITIAL PAYMENT: [$100,000.00] OWNER: [JOHN X. SMITH] ANNUITANT: [JOHN X. SMITH] CO-ANNUITANT: [MARY. SMITH] CONTRACT DATE: [1/1/2008] CONTRACT NUMBER: [000000005] GOVERNING LAW: [YS] ANNUITANT'S AGE [55] CO-ANNUITANT'S AGE [53] PLAN [Marketing Name] FEES AND CHARGES CONTRACT ASSET FEE [0.35%] ANNUAL CONTRACT FEE [$30.00](1) (1) Prior to the Annuity Commencement Date, when the Annual Administration Fee is to be assessed, if the Contract Value equals or exceeds [$25,000], the Annual Administration Fee will be waived. LIFETIME INCOME BENEFIT FEE [0.40%] MAXIMUM LIFETIME INCOME [0.65%] BENEFIT FEE LIFETIME INCOME BENEFIT MINIMUM HOLDING PERIOD EXPIRATION [1/1/2011] MINIMUM HOLDING PERIOD DURATION [5 years] LIFETIME INCOME AGE [59 1/2] SINGLE LIFETIME INCOME PERCENTAGE [5.0%] SPOUSAL LIFETIME INCOME PERCENTAGE [4.5%] BENEFIT BASE PERCENTAGE [100%] TRANSFERRED BENEFIT BASE [$125,000] PAYMENT LIMIT PERCENTAGE [20%] STEP-UP DATES Every [Contract Anniversary] up to the anniversary on or after the earlier of the Annuitant's or any co-Annuitant's [85th] birthday.
SP.VEN200.08-IRA S.1 LIMITS - PAYMENTS & TRANSFERS PAYMENT LIMITS The initial Payment is shown above. No Additional Payment will be accepted without our prior approval that either (a) exceeds $[25,000], or (b) causes the total of all Additional Payments received to exceed $[25,000]. No Additional Payment will be accepted after the older of the Annuitant or any co-Annuitant attains age [81]. IRA PAYMENT LIMITS Payments may not include any amounts other than a rollover contribution (as permitted by IRC Sections 402(c), 402(e)(6), 403(a)(4), 403(b)(8), 403(b)(10), 408(d)(3) and 457(e)(16)), a nontaxable transfer from an individual retirement plan under IRC Section 7701(a)(37), a contribution made in accordance with the terms of a Simplified Employee Pension as described in IRC Section 408(k), and a contribution in cash not to exceed the amount permitted under IRC Sections 219(b) and 408(b), (or such other amount provided by applicable federal tax law). In particular, unless otherwise provided by applicable federal tax law: A. The total cash contributions shall not exceed $4,000 for any taxable year beginning in 2007 and $5,000 for any taxable year beginning in 2008 and years thereafter. After 2008, the limit will be adjusted by the Secretary of the Treasury for cost-of-living increases under IRC Section 219(b)(5)(C). Such adjustments will be in multiples of $500. B. In the case of an individual who is 50 or older, the annual cash contribution limit is increased by $1,000 for any taxable year beginning in 2006 and years thereafter. C. In addition to the amounts described in paragraphs A and B above, an individual may make a repayment of a qualified reservist distribution described in IRC section 72(t)(2)(G) during the 2-year period beginning on the day after the end of the active duty period or by August 17, 2008, if later. D. In addition to the amounts described in paragraphs A and C above, an individual who was a participant in a IRC section 401(k) plan of a certain employer in bankruptcy described in IRC section 219(b)(5)(C) may contribute up to $ 3,000 for taxable years beginning after 2006 and before 2010 only. An individual who makes contributions under this paragraph D may not also make contributions under paragraph B. E. No contribution will be accepted under a SIMPLE IRA plan established by any employer pursuant to IRC Section 408(p). No transfer or rollover of funds attributable to contributions made by a particular employer under its SIMPLE IRA plan will be accepted from a SIMPLE IRA, that is, an individual retirement account under IRC Section 408(a) or an individual retirement annuity under IRC Section 408(b) used in conjunction with a SIMPLE IRA plan, prior to the expiration of the two-year period beginning on the date the Owner first participated in that employer's SIMPLE IRA plan.
SP.VEN200.08-IRA S.2 TRANSFER CHARGES AND We reserve the right to impose a transaction charge for transfers. LIMITATIONS - BEFORE In the event a charge is imposed, it will not exceed the lesser of MATURITY DATE [$25.00] or [2%] of the amount of each transfer. \[We reserve the right to limit the amount of the transfer and the maximum number of transfers that can be made. You must transfer at least [$300] or, if less, the entire amount in the Investment Option each time you make a transfer. If, after the transfer, the amount remaining in the Investment Option from which the transfer is made is less than [$100], then we will transfer the entire amount instead of the requested amount. Should we limit the maximum number of transfers that can be made per Contract Year, that limit will be no less than [one] per [month] or [six] at any time within a Contract Year. TRANSFER CHARGES AND We reserve the right to limit the maximum number of transfers you LIMITATIONS - ON OR AFTER may make per Contract Year after variable annuity payments have MATURITY DATE begun. If we limit the maximum number of transfers that can be made after variable annuity payments have begun, the maximum number of transfers you may make per Contract Year shall be no less than [4.]
SP.VEN200.08-IRA S.3 INITIAL ALLOCATION OF NET PAYMENT (SEE FOLLOWING PAGE FOR ALL AVAILABLE OPTIONS) VARIABLE INVESTMENT OPTIONS: [LIFESTYLE BALANCED] [100.00%] TOTAL 100.00% THIS PLAN IS INTENDED TO QUALIFY UNDER THE INTERNAL REVENUE CODE FOR TAX-FAVORED STATUS. LANGUAGE CONTAINED IN THIS CONTRACT REFERRING TO FEDERAL TAX STATUS OR RULES IS INFORMATIONAL AND INSTRUCTIONAL AND THIS LANGUAGE IS NOT SUBJECT TO APPROVAL OR DISAPPROVAL BY THE STATE IN WHICH THE CONTRACT IS ISSUED FOR DELIVERY. PLEASE SEEK THE ADVICE OF YOUR OWN TAX ADVISOR REGARDING YOUR INDIVIDUAL TAX TREATMENT.
SP.VEN200.08-IRA S.4 AVAILABLE INVESTMENT OPTIONS VARIABLE ACCOUNT: [JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) SEPARATE ACCOUNT H] VARIABLE INVESTMENT OPTIONS [LIFESTYLE PORTFOLIOS: Growth Balanced Moderate Conservative Money Market] SP.VEN200.08-IRA S.5 ANNUITY BENEFITS MATURITY DATE: [1/1/2048] ANNUITY COMMENCEMENT DATE [1/1/2043] ANNUITY OPTION: [Life 5-Year Certain] [The guarantee period for the Annuity Option may be reduced to comply with the period permitted under Section 1.401(a)(9)-6 of the Income Tax Regulations, except as otherwise provided by applicable federal tax law.] ANNUITY PAYMENTS - GENERAL The rates for Annuity Payments are determined based on: INFORMATION - Mortality Table: [Annuity 2000 Table projected at Scale G from January 1, 2000] - Fixed Annuity Payment Interest Rate: [3% interest per year] - Variable Annuity Payment Assumed Interest Rate: [3.00%] The amount of each Annuity Payment will depend upon the sex and age of the Annuitant, the Co-Annuitant, if any, or other payee. For variable annuity payments, the smallest annual rate of investment return that is required to be earned on the assets of the Separate Account so that the dollar amount of such payments will not decrease is: [3.31%] BENEFICIARY INFORMATION [Mary Smith]
SP.VEN200.08-IRA S.6