EX-99.24(B)(4) 2 d19418dex9924b4.htm THE FORM OF THE VARIABLE ANNUITY CONTRACT The form of the variable annuity contract
LOGO   

NATIONWIDE LIFE INSURANCE COMPANY

[ONE NATIONWIDE PLAZA

COLUMBUS, OH 43215

1-800-848-6331] (For any inquiries)

 

www.nationwide.com

NATIONWIDE LIFE INSURANCE COMPANY (“Nationwide”) is a stock life insurance company organized under the laws of the State of Ohio. Nationwide will provide the benefits described in the Contract, including making annuity payments to the Annuitant beginning on the Annuitization Date. The Contract is provided in return for the Purchase Payment(s) made by the Contract Owner.

RIGHT TO EXAMINE AND CANCEL

THE CONTRACT OWNER HAS THE “RIGHT TO EXAMINE AND CANCEL” THE CONTRACT. THE CONTRACT OWNER MAY RETURN THE CONTRACT WITHIN TEN DAYS (THIRTY DAYS IF THE CONTRACT IS A REPLACEMENT) OF THE DATE IT IS RECEIVED BY THE CONTRACT OWNER TO THE HOME OFFICE OF NATIONWIDE OR THE AGENT THROUGH WHOM IT WAS PURCHASED. WHEN NATIONWIDE RECEIVES THE CONTRACT, IT WILL CANCEL THE CONTRACT AND REFUND THE CONTRACT VALUE IN FULL, PLUS ANY CHARGES DEDUCTED.

 

THIS IS A LEGAL CONTRACT BETWEEN NATIONWIDE AND THE CONTRACT OWNER, PLEASE READ IT CAREFULLY. IF THE CONTRACT IS NOT RETURNED DURING THE “RIGHT TO EXAMINE AND CANCEL” PERIOD, THE CONTRACT OWNER WILL BE BOUND BY THE TERMS OF THE CONTRACT.

Executed for Nationwide on the Date of Issue by:

 

LOGO    LOGO
Secretary    President

Individual Flexible Purchase Payment Variable Deferred Annuity Contract, Non-Participating

For early withdrawal: Please consult a tax advisor about your individual circumstances.

ANNUITY PAYMENTS, DEATH BENEFITS, SURRENDER VALUES, AND OTHER VALUES PROVIDED BY THE CONTRACT ARE BASED ON THE INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT. THESE VALUES ARE VARIABLE AND MAY INCREASE OR DECREASE WITH THE FLUCTUATIONS OF THE NET INVESTMENT FACTOR AND ARE NOT GUARANTEED AS TO FIXED-DOLLAR AMOUNT, UNLESS OTHERWISE SPECIFIED.

NOTICE: Details of the variable provisions of this Contract

are on pages 7, 9 and 14.

TABLE OF CONTENTS

 

CONTRACT SPECIFICATIONS PAGE

      Insert  

DEFINITIONS

      4  

GENERAL PROVISIONS

      5  

Entire Contract

   

Non-Participating

   

Incontestability

   

Contract Settlement

   

Minimum Benefits

   

Evidence of Survival

   

Alteration or Modification

   

Conformity with Interstate Insurance Product Regulation Commission Standards

   

Assignment

   

Protection of Proceeds

   

Misstatement of Age or Sex

   

Reports

   

CONTRACT EXPENSES

      7  

Variable Account Charges

   

PARTIES TO THE CONTRACT

      7  

Nationwide

   

Contract Owner

   

Joint Owner

   

Contingent Owner

   

Annuitant

   

Beneficiaries and Contingent Beneficiaries

   

CONTRACT INVESTMENT OPTIONS

      9  

Variable Accounts

   

OPERATION OF THE CONTRACT

      10  

Purchase Payments

   

Transfers

   

Surrenders

   

Surrenders Required by the Internal Revenue Code

   

Additional Tax Information

   

CONTRACT OWNER SERVICES

      14  

Asset Rebalancing Program

   

Systematic Surrenders

   

SUCCESSION OF RIGHTS AND THE DEATH BENEFIT

      15  

Death of the Contract Owner

   

Death of Annuitant

   

Death Benefit Payment

   

Payment of Interest on the Death Benefit

   

Standard Death Benefit

   

 

2

ANNUITIZATION

      17  

Annuity Commencement Date

   

Annuitization Process

   

Calculation of Fixed Annuity Payments

   

Frequency and Amount of Payments

   

Large Size Annuity Contracts

   

ANNUITY PAYMENT OPTIONS

      18  

Selection of Annuity Payment Option

   

Single Life Annuity

   

Standard Joint and Survivor Annuity

   

Single Life Annuity with 10 or 20 Year Term Certain

   

Any Other Option

   

Confirmation of Annuity Payments

   

TABLES

      20  

 

3

DEFINITIONS

Accumulation Unit - An accounting unit of measure used to calculate the Variable Accounts’ value before the Annuitization Date.

Annuitant - The natural person(s) on whose life annuity payments involving life contingencies depends.

Annuitization - The period during which annuity payments are received by the Annuitant.

Annuitization Date - The date annuity payments begin.

Annuity Commencement Date - The date annuity payments are scheduled to begin.

Beneficiary - The person designated by the Contract Owner to receive certain benefits under the Contract if the Contract Owner dies before the Annuitization Date and there is no surviving Joint Owner.

Contingent Annuitant – The person designated by the Contract Owner to be the recipient of certain rights or benefits under the Contract if the Annuitant dies before the Annuitization Date.

Contingent Beneficiary - The person designated by the Contract Owner to receive the benefits accorded the Beneficiary if the Beneficiary is not living when the Annuitant dies.

Contingent Owner – The person designated by the Contract Owner to succeed to the rights of a Contract Owner if the Contract Owner dies before the Annuitization and there is no joint owner.

Contract - The terms, conditions, benefits, and rights of the annuity described in this document, as well as any documents describing elected options, endorsements, or attached application form.

Contract Anniversary - Beginning with the Date of Issue, each recurring one-year anniversary of the Date of Issue during which the Contract remains in force.

Contract Owner(s) - The person possessing all rights under the Contract prior to the Annuitization Date.

Contract Value - The value of the Variable Accounts.

Date of Issue - The date the first Purchase Payment is applied to the Contract.

Death Benefit - The benefit payable when an Annuitant dies before the Annuitization Date, unless a Contingent Annuitant has been named.

Joint Owner - The person possessing an undivided interest in the entire Contract with the Contract Owner. If there is a Joint Owner, references to Contract Owner and Joint Owner will apply to both of them, or either of them, unless the context requires otherwise.

Nationwide - Nationwide Life Insurance Company.

Non-Qualified Contract - A Contract that does not qualify for favorable tax treatment under Internal Revenue Code Sections 408, 408A, or 401(a).

Quarterly Contract Anniversary – Each recurring three-month anniversary of the Date of Issue during which the Contract remains in force. In any month where such day does not exist (e.g. 29th, 30th, and 31st), the Quarterly Contract Anniversary will be the last day of that calendar month.

Purchase Payment(s) - New money deposited into the Contract by the Contract Owner.

 

4

State of Issue - The jurisdiction where this Contract has been issued for delivery. For purposes of this Contract, the term includes the District of Columbia, Puerto Rico and any state, territory, or possession of the United States of America.

Sub-Account Daily Net Assets - A figure that is calculated at the end of each Valuation Date and represents the sum of the Contract Owners’ interests in a specific Sub-Account after the deduction of underlying mutual fund expenses.

Sub-Accounts - Divisions of the Variable Accounts where Accumulation Units are maintained separately. Each Sub-Account corresponds to a different underlying mutual fund.

Surrender - A withdrawal of part or all of the Contract Value from the Contract.

Surrender Value - The value of amounts Surrendered from the Contract. This is the Contract Value minus any applicable charges described in the Contract and any applicable premium taxes.

Valuation Date - Each day the New York Stock Exchange and Nationwide’s home office are open for business or any other day during which there is a sufficient degree of trading in the Sub-Accounts of the Variable Accounts that the current net asset value of its Accumulation Units might be materially affected. Values of the Variable Accounts are determined as of the close of regular trading on the New York Stock Exchange which generally closes at 4:00 pm Eastern Time, but may close earlier on certain days and as conditions warrant.

Valuation Period - The period of time commencing at the close of a Valuation Date and ending at the close of business for the next succeeding Valuation Date.

Variable Accounts - Separate investment accounts of Nationwide into which Purchase Payments may be allocated.

GENERAL PROVISIONS

Entire Contract

The Contract and a copy of any attached application, including any attached supplemental applications, together with any amendments, endorsements, or elected options, make up the entire agreement between Nationwide and the Contract Owner.

All statements made by the applicant for the issuance of the Contract shall, in the absence of fraud, be deemed representations and not warranties.

Non-Participating

The Contract is non-participating. It does not share in the surplus of Nationwide.

Incontestability

Except for fraud in the procurement of the Contract, where permitted by law in the State of Issue, after this Contract has been in force during the lifetime of the Annuitant for two years from the Date of Issue, or effective date of any Contract change requiring underwriting, Nationwide will not contest it.

The Contract may only be contested on the basis of statements material to risks intended to be accepted by Nationwide contained in any attached application.

Contract Settlement

Nationwide may require that the Contract be returned before making any annuity payments or processing a Surrender of the entire Surrender Value.

 

5

Minimum Benefits

Any paid-up annuity, cash Surrender Value or Death Benefit that may be available under the Contract will never be less than the minimum benefits required by Section 7B of the National Association of Insurance Commissioners Model Variable Annuity Regulation, model #250, or applicable successor provision, as amended.

Evidence of Survival

If annuity payments depend on a person being alive, then Nationwide may require proof that person is still living before making annuity payments.

Alteration or Modification

Changes to the Contract must be made in writing and signed by Nationwide’s President or Secretary. The Contract may be modified or superseded by applicable law. Other changes to the Contract will be made only with the mutual agreement of Nationwide and the Contract Owner. A copy of the amendment will be furnished to the Contract Owner if required.

Conformity with Interstate Insurance Product Regulation Commission Standards

This Contract was approved under the authority of the Interstate Insurance Product Regulation Commission and issued under the Commission standards. Any provision of this Contract that on the provision’s effective date is in conflict with the applicable Interstate Insurance Product Regulation Commission standards in effect as of the provision’s effective date for this product type is hereby amended to conform to the applicable Interstate Insurance Product Regulation Commission standards in effect as of the provision’s effective date.

Assignment

In some cases, a Contract Owner may assign some or all rights under the Contract. An assignment has to be made in writing and signed by the Contract Owner during the lifetime of the Annuitant and before the Annuitization Date.

The assignment takes effect on the date it is signed, unless otherwise specified by the Contract Owner. Nationwide is not responsible for the validity or tax consequences of any assignment or for any payment or other settlement made prior to Nationwide’s receipt of the assignment.

An assignment will not be considered received until Nationwide has received sufficient direction from the Contract Owner and assignee as to how rights under the Contract will be allocated.

Protection of Proceeds

Proceeds under the Contract are not assignable by any Beneficiary prior to the time they become payable. To the extent permitted by applicable law, proceeds are not subject to the claims of creditors or to legal process.

Misstatement of Age or Sex

If the age or sex of the Contract Owner, Joint Owner, Annuitant, Beneficiary or Contingent Beneficiary is misstated, all payments and benefits under the Contract will be adjusted. Payments and benefits will be based on the correct age or sex. Proof of age may be required at any time, in a form satisfactory to Nationwide. When age or sex has been misstated, the dollar amount of any overpayment will be deducted from the next payment or payments due under the Contract. The dollar amount of any underpayment made by Nationwide as a result of an age or sex misstatement will be paid in full with the next payment due under the Contract.

Any adjustment for overpayment or underpayment will include interest charged or credited, as applicable, at a rate not exceeding 6% per annum.

 

6

Reports

Before Annuitization, a report will be sent to the Contract Owner at his or her last known address at least once a year. The information provided in the report will be as of a date no more than four months prior to the date of mailing.

The report will contain at least the following information:

 

  (1)

the beginning and ending dates of the report period;

 

  (2)

the Contract Value at the beginning and ending of the report period;

 

  (3)

amounts credited to and deducted from the Contract Value during the report period, including Purchase Payments, Surrenders, and other Contract charges;

 

  (4)

the Surrender Value at the end of the report period and any other information required by federal law or law in the State of Issue; and

 

  (5)

the Death Benefit amount at the end of the report period.

Additional reports are available upon request for no additional charge.

CONTRACT EXPENSES

Variable Account Charges

Mortality and Expense Risk Charge - Nationwide deducts a Mortality and Expense Risk Charge. The Mortality and Expense Risk Charge is shown on the Contract Specifications Page and is assessed as an annualized rate of the daily net assets of the Variable Accounts. Nationwide reserves the right to charge less than the rate shown on the Contract Specifications Page.

Administrative Charge - Nationwide deducts an Administrative Charge. The Administrative Charge is shown on the Contract Specifications Page and is assessed as an annualized rate of the daily net assets of the Variable Accounts. If the Contract Value is greater than or equal to $1,000,000 on the later of the Date of Issue or the most recent Quarterly Contract Anniversary, then the Administrative Charge is waived for that quarter. Nationwide will determine on each Quarterly Contract Anniversary if the Contract is eligible for a waiver of the Administrative Charge. If the Contract Value subsequently falls to less than $1,000,000 on the most recent Quarterly Contract Anniversary, the Administrative Charge will be reinstated for that quarter.

These charges compensate Nationwide for expenses it incurs including administrative and distribution costs, insurance benefit expenses, as well as expenses associated with issuing, maintaining, and assuming certain risks in connection with the Contract. The election of any available options may increase the Variable Account charges. Nationwide deducts the Variable Account charges from the Variable Accounts each Valuation Date based on the value of the Variable Accounts.

PARTIES TO THE CONTRACT

Nationwide and the Contract Owner (including any Joint Owner) are the primary parties to the Contract. Additional parties listed in the Contract may be entitled to certain rights, but only under specific conditions, as described in the Contract.

The Contract Owner may change a party named in the Contract, except a Joint Owner, if the change request is made to Nationwide in writing. Changes are effective as of the date the change request is signed, unless otherwise specified by the Contract Owner. Nationwide, however, is not responsible for payment or other actions taken before the change request is received. Changes to the Annuitant require Nationwide’s written consent and may only be done prior to the Annuitization Date. Nationwide is not responsible for the tax implications of any changes to the named parties.

 

7

A change of Contract Owner may require a signature guarantee and must be signed by the Contract Owner and the person designated as the new Contract Owner.

Changes to the Annuitant or Contingent Annuitant are subject to underwriting and approval by Nationwide. If any Contract Owner is not a natural person, the change of the Annuitant will be treated as the death of the Contract Owner.

Nationwide

Nationwide is a stock life insurance company organized under Ohio law. In exchange for the Purchase Payment(s) made under this Contract, Nationwide issues the Contract to the Contract Owner, assumes certain risks and promises to make certain payments.

In issuing this Contract, Nationwide intends to offer only annuity and related benefits (including death benefits) to single individuals and their beneficiaries. These benefits result in Nationwide assuming certain risks. This Contract is not intended for use by institutional investors, people trying to cover risks involving multiple lives with a single contract, or by someone trying to cover a single life with multiple Nationwide contracts.

Nationwide’s failure to detect, mitigate, or eliminate altered risk does not act as a waiver of its rights and does not bar Nationwide from asserting its rights at a future date.

Contract Owner

The Contract Owner has all rights under the Contract before the Annuitization Date, unless a Joint Owner is named. If the person purchasing the Contract names someone else as the Contract Owner, then the purchaser will have no rights under the Contract.

The Annuitant becomes the Contract Owner on the Annuitization Date.

Joint Owner

Joint Owners must be spouses at the time joint ownership is requested. Joint Owners have an undivided interest in the Contract and any exercise of ownership rights in the Contract must be in writing and signed by both Joint Owners.

Contingent Owner

The Contingent Owner may receive benefits under the Contract, but only if the Contract Owner is not named as the Annuitant, dies prior to the Annuitization Date, and there is no surviving Joint Owner. If more than one Contingent Owner survives the Contract Owner, each will share equally unless otherwise specified in the Contingent Owner designation.

If a Contract Owner is named as the Annuitant and dies before the Annuitization Date, then the Contingent Owner does not have any rights in the Contract. If a surviving Contingent Owner is also named as a Beneficiary, then the surviving Contingent Owner will have all the rights of a Beneficiary.

Annuitant

The Annuitant is the person who will receive annuity payments upon Annuitization. The Annuitant must be no older than the Maximum Annuitant Age shown on the Contract Specifications Page at the time of Contract issuance unless Nationwide approves a request for the Annuitant to be older. The Annuitant may not be changed prior to the Annuitization Date without Nationwide’s written consent.

Contingent Annuitant

If the Annuitant dies before the Annuitization Date, the Contingent Annuitant becomes the Annuitant. The Contingent Annuitant must be no older than the Maximum Contingent Annuitant Age shown on the Contract Specifications Page at the time of Contract issuance unless Nationwide approves a request for the Contingent Annuitant to be older. All provisions of the Contract that are based on the death of the Annuitant prior to the Annuitization Date will be based on the death of the last survivor of the Annuitant and Contingent Annuitant.

 

8

Beneficiaries and Contingent Beneficiaries

The Beneficiary may be entitled to certain rights under the Contract. Whether these rights actually vest depends on several conditions. The Contingent Beneficiary has no rights unless the Contingent Beneficiary survives all Beneficiaries and such Beneficiaries (had they survived) would be entitled to receive payments under the Contract. The right to receive payments under the Contract, including the Death Benefit, is described in detail in the Succession of Rights and the Death Benefit section of the Contract.

Unless otherwise directed by the Contract Owner, the following will apply:

 

  (1)

after the death of the Contract Owner (assuming all rights vest with the Beneficiary as described in the preceding paragraphs), the Beneficiary may name a successor beneficiary. A successor beneficiary will have the right to receive any Contract proceeds remaining after the Beneficiary dies;

 

  (2)

if there is more than one Beneficiary, each will share equally in any right to receive payment;

 

  (3)

if there is more than one Contingent Beneficiary, each will share equally in any right to receive payment.

CONTRACT INVESTMENT OPTIONS

Variable Accounts

Nationwide may make available one or more Variable Accounts in which Contract Owners may elect to invest.

Variable Accounts are segregated investment accounts of Nationwide. All assets of the Variable Accounts remain the property of Nationwide, but are not charged with the liabilities from any other of its businesses. Income, gains and losses of the Variable Accounts reflect their own investment experience and not the investment experience of Nationwide. Although the assets in the Variable Accounts are the property of Nationwide, it is obligated to make payments to the parties of the Contract.

Each Variable Account may offer various underlying investment options, each being a Sub-Account of the Variable Account. The Contract Owner may allocate Purchase Payments to any of the available Sub-Accounts of each Variable Account.

Purchase Payments allocated to Sub-Accounts may be subject to terms or conditions established by the corresponding underlying investment option.

The underlying investment options available in the Variable Accounts are not publicly traded investment options or publicly traded mutual funds.

The value of amounts allocated to each Sub-Account is determined by multiplying the number of Accumulation Units in the Sub-Account by the Accumulation Unit value. Charges assessed by the underlying investment options, as well as the Variable Account charge are deducted each day when calculating the Accumulation Unit value. Charges associated with any elected options (if applicable) may also be deducted each day when calculating the Accumulation Unit value. When a Sub-Account is established, the Accumulation Unit value is initially set at $10 per unit.

The Accumulation Unit value of the Sub-Account fluctuates based on the investment performance of the corresponding underlying investment option.

Investment experience is not tied to the number of Accumulation Units, but the value of the Accumulation Units. Accumulation Units of a Sub-Account are added by Purchase Payment or transfer allocations.

Accumulation Units of a Sub-Account are subtracted by any Surrenders and transfers to other Sub-Accounts.

 

9

The investment performance of a Sub-Account is determined by the net investment factor. The net investment factor is determined by dividing (a) by (b) and subtracting (c) from the result where:

 

  (a)

is the net asset value for the current Valuation Period of the underlying investment option corresponding to the Sub-Account (plus any dividend or income distributions made by such underlying investment option);

 

  (b)

is the net asset value of the underlying investment option determined as of the preceding Valuation Period; and

 

  (c)

is a factor representing the daily Variable Account charge plus any charges associated with any elected options, as applicable (each is determined by taking the annual charge and dividing it by the number of days in the current calendar year).

If the net investment factor is multiplied by the preceding Valuation Period’s Accumulation Unit value, the result will be the current Valuation Period’s Accumulation Unit value. If the net investment factor is greater than 1, the Accumulation Unit value increases. If the net investment factor is less than 1, the Accumulation Unit value decreases.

If an underlying investment option is no longer available for investment by a Variable Account or if, in the judgment of Nationwide’s management, further investment in such underlying investment option would be inappropriate in view of the purposes of the Contract, Nationwide may substitute another underlying investment option for an underlying investment option already purchased or to be purchased in the future by Purchase Payments under the Contract.

In the event of a substitution or change, Nationwide may make changes to the Contract and other contracts of this class as may be necessary to reflect the substitution or change. Nothing contained in the Contract will prevent the Variable Accounts from purchasing other securities for other series or classes of contracts or from effecting a conversion between series or classes of contracts on the basis of requests made individually by owners of such contracts.

OPERATION OF THE CONTRACT

Purchase Payments

All purchase payments must be in the currency of the United States of America.

The Contract is issued in consideration of the Purchase Payment(s) made by the Contract Owner. Purchase Payments are accepted by Nationwide at its office in Columbus, Ohio. The Minimum Initial Purchase Payment shown on the Contract Specifications Page is required before the first Contract Anniversary. Nationwide does not require any additional Purchase Payments after the Minimum Initial Purchase Payment has been satisfied and the Contract will not lapse or otherwise be cancelled for failure to make additional Purchase Payments. However, failure to submit additional Purchase Payments, together with partial Surrenders as described in the Surrenders section of the Contract, may result in a full Surrender of the Contract. Nationwide accepts additional Purchase Payments of at least the Minimum Subsequent Purchase Payment shown on the Contract Specifications Page. If additional Purchase Payments are made via automated clearinghouse, the Minimum Subsequent Purchase Payment amount is reduced to the Minimum Subsequent Purchase Payment by ACH shown on the Contract Specifications Page.

Notwithstanding the preceding paragraph, total cumulative Purchase Payments under the Contract and any other annuity contract issued by Nationwide or any of its subsidiaries or affiliates with the same Contract Owner, Joint Owner, or Annuitant may not exceed $1,000,000 (and will be returned to the Contract Owner), unless Nationwide agrees in writing to accept Purchase Payments exceeding $1,000,000.

 

10

Transfers

Prior to the Annuitization Date, transfers among the investment options available under the Contract are permitted 24 times in two consecutive calendar quarters or 40 times per calendar year. Nationwide accepts transfers in excess of the transfer limits set forth above, but only if they are sent via ordinary U.S. Mail on a Nationwide provided form. For purposes of determining the number of transfers, the following will apply:

 

  (1)

a transfer is considered to be one or more allocations of Contract Value among available investment options on a single business day;

 

  (2)

the transfer limits set forth above will be set (or re-set) every calendar year beginning January 1st;

 

  (3)

transfers not exercised during a given calendar year cannot be “banked” or otherwise accumulated and used in subsequent calendar years (transfer limits are non-cumulative in nature); and

 

  (4)

asset rebalancing transactions, as described in the Contract Owner Services section of the Contract, are not considered transfers except as otherwise provided in the Asset Rebalancing Program subsection of the Contract Owner Services section of the Contract.

There are certain transfer restrictions, prohibitions or fees that may be imposed by underlying mutual funds.

Subject to state and federal securities law and Securities and Exchange Commission rules, Nationwide may refuse, limit or otherwise restrict transfer requests, or take any other reasonable action it deems necessary to protect Contract Owners, Annuitants, and/or Beneficiaries from short-term trading strategies or other harmful investment practices that negatively impact underlying mutual fund performance. Nationwide may restrict a Contract Owner engaged in such a practice or strategy or a third-party acting on behalf of a Contract Owner(s).

Nationwide’s failure to take action in any one or more instances with respect to the preceding restrictions is not, nor is it to be construed or deemed as, a further or continuing waiver of its right to enforce them.

Some underlying mutual funds require Nationwide to stop accepting daily transfer requests prior to the close of the New York Stock Exchange. Transfer requests involving Sub-Accounts that invest in these underlying mutual funds will receive the Accumulation Unit value next determined at the end of the current Valuation Period if the request and all necessary information is received by Nationwide prior to the applicable cut-off times. All transfer requests received by Nationwide at or after the applicable cut-off time will receive the Accumulation Unit value next determined at the end of the following Valuation Period.

Surrenders

The Contract Owner may Surrender part or all of the Contract Value on or before the earlier of:

 

  (1)

the death of the Annuitant and any Contingent Annuitant; or

 

  (2)

the Annuitization Date.

Nationwide requires that Surrender requests be made to Nationwide in writing and may require the return of the Contract if the entire Contract Value is being Surrendered.

Nationwide may treat a request for a partial Surrender as a request for a full Surrender of the Contract if: (a) the partial Surrender would reduce the Contract Value to an amount less than the Minimum Contract Value Amount specified on the Contract Specifications Page; (b) cumulative Purchase Payments (minus any Surrenders) are less than the Minimum Contract Value Amount specified on the Contract Specifications Page; and (c) no additional Purchase Payments have been submitted for the preceding two consecutive years (as measured from a Contract Anniversary date or the Date of Issue, as applicable).

 

11

To insure Surrenders are being requested properly, Nationwide may require the signature(s) on a Surrender request be guaranteed by a member firm of a major stock exchange or other depository institution qualified to do so.

Unless the Contract Owner provides specific direction to Nationwide as to how amounts from the Contract are to be Surrendered, Nationwide will process requests for Surrender in the following manner:

 

  (1)

Proportional Surrender - Surrenders will be taken proportionally from the Sub-Accounts and/or Variable Accounts in which the Contract Owner is invested based on the value in each Sub-Account at the time of the request.

 

  (2)

Surrender Amount Received - The amount received by the Contract Owner will be equal to the amount of the Surrender requested by the Contract Owner minus any adjustments and any applicable premium taxes.

The Surrender Value will be paid to the Contract Owner within seven days of the date Nationwide receives, at its office in Columbus, Ohio, the properly executed Surrender request from the Contract Owner.

The Surrender Value is equal to:

 

  (1)

the Contract Value; minus

 

  (2)

any charges associated with any elected options; minus

 

  (3)

any state premium taxes.

Any applicable federal income taxes are not included in calculating the Surrender Value.

Nationwide has the right to suspend or delay the date of any Surrender from the Variable Accounts for any period when;

 

  (1)

the New York Stock Exchange is closed,

 

  (2)

when trading on the New York Stock Exchange is restricted,

 

  (3)

when an emergency exists and as a result the disposal of securities in the Variable Accounts is not reasonably practicable or it is not reasonably practicable to fairly determine the value of the net assets in the Variable Accounts, or

 

  (4)

during any other period when the Securities and Exchange Commission by order permits a suspension of Surrender for the protection of security holders.

Rules and regulations of the Securities and Exchange Commission may govern as to whether certain conditions set forth in the preceding paragraphs exist. Federal tax law may impose additional restrictions on Nationwide’s right to Surrender the Contract.

Partial Surrenders to Pay Investment Advisory Fees

To the extent permitted by applicable law, the Contract Owner may take one or more partial Surrenders to pay investment advisory fees. To do so, the investment adviser and Contract Owner must complete an authorization form specified by Nationwide.

The fees for investment advisory services are specified in the respective account agreements and are separate from and in addition to the fees and expenses described in this Contract. Partial Surrenders to pay investment advisory fees will reduce the Contract Value and may have a negative impact on certain elected options. Partial Surrenders taken from this Contract to pay advisory fees may also be subject to income tax and/or tax penalties.

 

12

Surrenders Required by the Internal Revenue Code

Certain Surrenders may be required by the Internal Revenue Code (the “Code”). For purposes of this section, a Surrender may also be termed a “distribution” or a “required distribution.” In no case may a Surrender be delayed beyond the time specified by Code Section 72(s).

If any Contract Owner or Joint Owner dies (including an Annuitant who becomes the Contract Owner of the Contract on the Annuitization Date), certain distributions are required by Section 72(s) of the Code. The following distributions will be made in accordance with these requirements (regardless of any other provisions in the Contract):

 

  (1)

If any Contract Owner dies on or after the Annuitization Date and before the entire interest under the Contract has been distributed, then the remaining portion of such interest shall be distributed at least as rapidly as under the method of distribution in effect as of the date of such Contract Owner’s death.

 

  (2)

If any Contract Owner dies before the Annuitization Date, then the entire interest in the Contract (consisting of either the Death Benefit or the Contract Value reduced by certain charges as set forth elsewhere in the Contract) shall be distributed within 5 years of the death of the deceased Contract Owner, provided however:

 

  (a)

If any portion of such interest is payable to or for the benefit of a natural person who is a surviving Contract Owner, Contingent Owner, Joint Owner, Annuitant, Contingent Annuitant, Beneficiary, or Contingent Beneficiary as the case may be (each a “designated beneficiary”), such portion may, at the election of the designated beneficiary, be distributed over the life of such designated beneficiary, or over a period not extending beyond the life expectancy of such designated beneficiary, provided that payments begin within one year of the date of the deceased Contract Owner’s death (or such longer period as may be permitted by federal income tax regulations). Life expectancy and the amount of each payment will be determined as prescribed by federal income tax regulations.

 

  (b)

If the designated beneficiary is the surviving spouse of the deceased Contract Owner, such spouse may elect, in lieu of the Death Benefit, to become the Contract Owner of this Contract, and the distributions required under the Required Distribution Provisions will be made upon the death of such spouse.

In the event that the Contract Owner is not a natural person (e.g., a trust or corporation), then, for purposes of these distribution provisions, (i) the death of the Annuitant shall be treated as the death of any Contract Owner, (ii) any change of the Annuitant shall be treated as the death of any Contract Owner, and (iii) in either case the appropriate distribution required under these distribution rules shall be made upon such death or change, as the case may be. The Annuitant is the primary annuitant as defined in Section 72(s)(6)(B) of the Code.

These distribution provisions shall not be applicable to any Contract that is not required to be subject to the provisions of Section 72(s) of the Code by reason of Section 72(s)(5) or any other law or rule. Such Contracts include, but are not limited to, any Contract: (i) which is provided under a plan described in Section 401(a) of the Code which includes a trust exempt from tax under Section 501 of the Code; (ii) which is provided under a plan described in Section 403(a) of the Code; (iii) which is described in Section 403(b) of the Code; (iv) which is an individual retirement annuity or provided under an individual retirement account or annuity as described in Section 408 of the Code; or (v) which is qualified funding asset (as defined in Section 130(d) of the Code, but without regard to whether there is a qualified assignment).

Additional Tax Information

The Contract is subject to requirements found in the Code. It is intended that the Contract be treated as an “annuity contract” for federal income tax purposes.

Nationwide will interpret and administer all sections of the Contract in accordance with Code Section 72(s). Nationwide reserves the right to amend this Contract to comply with requirements set out in the Code and regulations and rulings thereunder, as they may exist from time to time.

 

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Surrenders are calculated by use of the expected return multiples specified in Tables V and VI of Section 1.72-9 of the Treasury Regulations and calculated in accordance with the calculation methods made available by Nationwide, prescribed by the regulations and elected by the Contract Owner.

If the Contract is issued other than as a Non-Qualified Contract, the Contract Owner will receive an endorsement describing the Contract requirements for the type of Contract issued.

Nationwide will deduct against the Contract Value the amount of any premium taxes levied by a state or any other government entity on Purchase Payments. The method used to recoup premium taxes will be determined by Nationwide at its sole discretion and in compliance with applicable state law. Nationwide currently deducts premium taxes from a Contract Value at one of the following times:

 

  (1)

when the Contract is Surrendered;

 

  (2)

on the Annuitization Date; or

 

  (3)

when Nationwide is subject to the premium tax.

CONTRACT OWNER SERVICES

Listed in this section are descriptions of certain services Nationwide may make available under the Contract. The services described in this section are not available on or after the Annuitization Date.

Asset Rebalancing Program

Please note that terms and conditions imposed by underlying mutual funds may restrict the ability to do asset rebalancing with certain Sub-Accounts.

Nationwide permits the Contract Owner to elect, on a form provided by Nationwide, to periodically have the part of the Contract Value held in the Sub-Accounts of the Variable Accounts automatically re-allocated on a predetermined percentage basis (“the portfolio percentages”).

The Contract Owner may elect to have periodic automatic reallocations as set forth above occur on an annual basis on the Contract Anniversary or on another frequency if permitted by Nationwide. If the last day of any of these periods falls on a date other than a Valuation Date, Nationwide will process the asset rebalancing on the next available Valuation Date.

Nationwide may, on a prospective basis, assess a processing fee not to exceed $25 for this service or discontinue the Asset Rebalancing Program at any time.

Systematic Surrenders

The Contract Owner may elect, on a form provided by Nationwide, to take systematic Surrenders of $100 or more on a quarterly basis or on another frequency if permitted by Nationwide. Nationwide will process the Surrenders on pro-rata basis from each Sub-Account of the Variable Accounts. Systematic Surrenders may be subject to any applicable state premium taxes. Unless otherwise directed by the Contract Owner, Nationwide will withhold federal income taxes from each systematic Surrender.

Unless the Contract Owner has made an irrevocable election of Surrenders of substantially equal periodic payments, the systematic Surrenders may be discontinued at any time by written notification to Nationwide. Nationwide may discontinue prospective systematic Surrender programs. If systematic Surrenders reduce the Contract Value to zero, Nationwide will terminate the Contract.

 

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SUCCESSION OF RIGHTS AND THE DEATH BENEFIT

Whether a party to the Contract has certain rights (including the right to receive the Death Benefit) depends on whether certain parties (such as a Contingent Annuitant or Joint Owner) have been named and whether the Contract Owner and the Annuitant is the same person.

Death of the Contract Owner

If the Contract Owner (or any Joint Owner) and the Annuitant are not the same person and such Contract Owner dies before the Annuitization Date, the Standard Death Benefit section does not apply and contract rights succeed in the following order:

 

  (1)

If there is a surviving Joint Owner, they become the new Contract Owner.

 

  (2)

If there is no surviving Joint Owner, the Contingent Owner becomes the new Contract Owner;

 

  (3)

If there is no surviving Joint Owner or Contingent Owner, the Beneficiary(ies) becomes the new Contract Owner.

 

  (4)

If there is no surviving Beneficiary(ies), then the last surviving Contract Owner’s estate becomes a new Contract Owner.

Death of Contract Owner/Annuitant

If the Contract Owner (or any Joint Owner) and the Annuitant are the same person, and that person dies before the Annuitization Date, the Death Benefit becomes payable. Rights to the Death Benefit are determined in the following order:

 

  (1)

If there is a surviving Joint Owner, the surviving Joint Owner is entitled to the Death Benefit.

 

  (2)

If there is no surviving Joint Owner, the Beneficiary(ies) are entitled to the Death Benefit.

 

  (3)

If there is no surviving Joint Owner or Beneficiary(ies), then the Contingent Beneficiary(ies) are entitled to the Death Benefit.

 

  (4)

If there is no surviving Contingent Beneficiary(ies), then the last surviving Contract Owner’s estate is entitled to the Death Benefit.

Death of Annuitant

If there is no Contingent Annuitant, the Contract Owner and the Annuitant are not the same person, and the Annuitant dies before the Annuitization Date, then rights to the Death Benefit are determined in the following order:

 

  (1)

the Beneficiary(ies), if they survive the Annuitant;

 

  (2)

the Contingent Beneficiary(ies), if they survive the Annuitant;

 

  (3)

the last surviving Contract Owner’s estate.

Death Benefit Payment

The Death Benefit is only payable if the Annuitant dies before the Annuitization Date. The value of each component comprising the calculation of the amount of the Death Benefit is determined as of the date of the Annuitant’s death, except for the Contract Value component which is valued as of the date Nationwide receives the information necessary to pay a Death Benefit claim as described below.

 

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Prior to paying the Death Benefit, Nationwide must receive in writing at its office in Columbus, Ohio the following three items: (1) proper proof of the Annuitant’s death; (2) an election specifying the method of Surrender; and (3) state required forms, if any.

Nationwide will accept any one of the following as proper proof of the Contract Owner‘s death:

 

  (1)

a certified copy of the death certificate;

 

  (2)

a copy of a certified decree of a court of competent jurisdiction as to the finding of death;

 

  (3)

a written statement by a medical doctor who attended the deceased Annuitant; or

 

  (4)

any other proof Nationwide finds acceptable.

The Beneficiary must elect a method of Surrender that complies with any applicable Internal Revenue Code requirements. The Beneficiary may elect to receive the Death Benefit in the form of:

 

  (1)

a lump sum distribution;

 

  (2)

an annuity payment; or

 

  (3)

any distribution that is permitted by state and federal regulations and is acceptable to Nationwide.

The Death Benefit payment will be made upon receipt of proof of death, which includes proper proof of death and notification of the election on how to receive the Death Benefit.

Payment of Interest on the Death Benefit

The Death Benefit payment will include interest accrued from the eighth day following the date that acceptable proof of death is received by Nationwide.

Interest will accrue at the Two-Year Treasury Constant Maturity Rate as published by the Federal Reserve, based upon the rate in effect on the date that due proof of death is received by Nationwide.

Beginning with the date that is 31 calendar days from the latest of (1), (2), and (3) below to the date the Death Benefit is paid, interest will accrue at the rate described above plus additional interest at a rate of 10% annually, where:

 

  (1)

is the date that due proof of death is received by Nationwide;

 

  (2)

is the date Nationwide receives sufficient information to determine its liability, the extent of the liability, and the appropriate payee legally entitled to the proceeds; and

 

  (3)

is the date that legal impediments to payment of proceeds that depend on the action of parties other than Nationwide are resolved and sufficient evidence of the same is provided to Nationwide. Legal impediments to payment include but are not limited to: (a) the establishment of guardianships and conservatorships; (b) the appointment and qualification of trustees, executors, and administrators; and (c) the submission of information required to satisfy state and federal reporting requirements.

Standard Death Benefit

The dollar amount of the Death Benefit is equal to the Contract Value.

 

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ANNUITIZATION

The other sections within the Contract primarily deal with provisions involving the accumulation of amounts in the various contract investment options, certain contractual benefits and rights that occur prior to receiving any annuity payments.

This Annuitization section primarily describes the right to receive certain payments upon Annuitization, including guarantees with respect to certain life contingent payment options.

Annuity Commencement Date

The Annuity Commencement Date is selected by the Contract Owner. The date must be at least two years after the Date of Issue. If an Annuity Commencement Date is not selected, it will be the date the Annuitant reaches age 90.

The Contract Owner may change the Annuity Commencement Date if the following requirements are met:

 

  (1)

the requested change is before the Annuitization Date;

 

  (2)

the change is made in writing and approved by Nationwide;

 

  (3)

the new Annuity Commencement Date is not later than the first day of the first calendar month after the Annuitant’s 90th birthday, unless Nationwide agrees to a later date in writing.

A change will become effective as of the date requested but will not apply to any action taken by Nationwide before it is recorded at Nationwide’s office in Columbus, Ohio.

Annuitization Process

Annuitization is irrevocable once payments have begun. To annuitize the Contract, the Contract Owner must notify Nationwide in writing of the Contract Owner’s election of an Annuity Payment Option, as described in the Annuity Payment Options section of the Contract.

Actual purchase rates used to determine annuity payments will be those in effect on the Annuitization Date. Annuity benefits at the time of commencement will not be less than those that would be provided by the application of the Surrender Value to purchase a single premium immediate annuity contract at purchase rates offered by Nationwide at the time to the same class of annuitants.

Calculation of Fixed Annuity Payments

The first payment of a fixed payment annuity is determined by applying the Contract Value specified by the Contract Owner, less applicable premium tax, to the fixed annuity table in effect on the Annuitization Date for the Annuity Payment Option elected.

The purchase rates for any options guaranteed to be available will be determined on a basis not less favorable than 0.5% minimum interest. The purchase rate tables are based on the sex-distinct Annuity 2012 Basic Mortality table (Age Last Birthday) using a ten-year age setback with Projection Scale G2 with Conservatism (ALB) at 0.5% interest.

For purposes of the purchase rate tables, the payees’ actual ages as of their respective last birthdays are used. Other combinations are available upon request.

 

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Frequency and Amount of Payments

All annuity payments will be mailed within 10 (ten) business days of the scheduled payment date. Payments will be made based on the Annuity Payment Option selected and frequency selected.

However, if any annuity payment would be or becomes less than the Minimum Annuity Payment Amount, Nationwide may change the frequency of payments to an interval that results in payments of at least the Minimum Annuity Payment Amount. The Minimum Annuity Payment Amount is shown on the Contract Specifications Page. In no event will Nationwide make payments under an annuity option less frequently than annually. If any annuity payment would be or becomes less than the Minimum Annuity Payment Amount, and no additional Purchase Payments have been submitted for the preceding two consecutive years, Nationwide has the right to pay this amount in one lump sum instead of periodic annuity payments.

Large Size Annuity Contracts

Any references in this Contract to Purchase Payment amounts in excess of $1,000,000 are assumed to have been approved by Nationwide as described in the Purchase Payments subsection of the Operation of the Contract section of the Contract.

Notwithstanding any other provision in the Contract, the following will apply to all issued Contracts for which cumulative Purchase Payments received, and/or the Contract Value annuitized, exceed $2,000,000. Nationwide may limit the available Annuity Payment Option to a fixed Single Life Annuity with a guaranteed period of payments through age 95 or 20 years (whichever is greater).

In addition, Nationwide may limit the amount of the Contract Value applied to an Annuity Payment Option to $5,000,000 per Contract and/or for all Nationwide issued annuity contracts with the same Annuitant. For amounts in excess of $5,000,000, the Contract Owner must:

 

  (1)

reduce the amount to be annuitized to $5,000,000 or less by taking a partial Surrender from the Contract;

 

  (2)

reduce the amount to be annuitized to $5,000,000 or less by exchanging the portion of the Contract Value in excess of $5,000,000 to another annuity contract; or

 

  (3)

annuitize the portion of the Contract Value in excess of $5,000,000 under an Annuity Payment Option with a term certain, if available.

ANNUITY PAYMENT OPTIONS

Selection of Annuity Payment Option

The Contract Owner may select an Annuity Payment Option prior to Annuitization. The following applies to the selection of an Annuity Payment Option:

 

  (1)

if no Annuity Payment Option is selected, Nationwide will automatically set it as a fixed payment life annuity with a guaranteed period of 240 months;

 

  (2)

whether the Annuity Payment Option is selected by the Contract Owner or established automatically by Nationwide, the Annuity Payment Option may not be changed;

 

  (3)

Annuity Payment Options available may be limited based on age of the Annuitant (and any designated second person upon whose continuation of life any lifetime payments may depend); and

 

  (4)

Annuity Payment Options may also be limited based on requirements under the Internal Revenue Code.

 

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The Annuity Payment Options found in the Contract are guaranteed to be available by Nationwide subject to the restrictions set forth in the preceding paragraphs and the Large Size Annuity Contracts subsection of the Annuitization section of the Contract.

Single Life Annuity

The amount to be paid under this option will be paid during the lifetime of the Annuitant. Payments will cease with the last payment due prior to the death of the Annuitant. This option is not available for Annuitants who are 86 or older on the Annuitization Date.

No withdrawals other than the scheduled annuity payments are permitted. No Death Benefit will be paid.

Standard Joint and Survivor Annuity

The amount to be paid under this option will be paid during the joint lifetimes of the Annuitant and a designated second person. Payments will continue as long as either is living. Payments will cease with the last payment due prior to the death of the last survivor of the Annuitant and the designated second person. This option is not available for Annuitants or designated second persons who are 86 or older on the Annuitization Date.

No withdrawals other than the scheduled annuity payments are permitted. No Death Benefit will be paid.

Single Life Annuity With 10 or 20 Year Term Certain

The amount to be paid under this option will be paid monthly during the lifetime of the Annuitant. A guaranteed term of 10 or 20 years may be selected. If the Annuitant dies prior to the end of this guaranteed period, the recipient chosen by the Contract Owner will receive the remaining monthly guaranteed payments.

No withdrawals other than the scheduled annuity payments are permitted.

Any Other Option

Payment options not set forth in the Contract are available only if they are approved by Nationwide.

Confirmation of Annuity Payments

Nationwide will issue within 30 days of the Annuitization Date a confirmation of the elected Annuity Payment Option.

 

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GUARANTEED ANNUITY TABLES

FIXED MONTHLY BENEFITS PER $1,000 APPLIED

LIFE ANNUITY: MONTHLY ANNUITY PAYMENTS

 

Male Guaranteed Period

   

Female Guaranteed Period

ANNUITANT’S
AGE		    NONE    120
MONTHS		    240
MONTHS		    ANNUITANT’S
AGE		    NONE    120
MONTHS		    240
MONTHS
50    2.00    1.99    1.98    50    1.92    1.92    1.91
51    2.04    2.04    2.02    51    1.96    1.96    1.95
52    2.08    2.08    2.06    52    2.00    2.00    1.99
53    2.13    2.12    2.10    53    2.04    2.04    2.03
54    2.17    2.17    2.15    54    2.08    2.08    2.07
55    2.22    2.22    2.19    55    2.13    2.12    2.11
56    2.27    2.27    2.24    56    2.17    2.17    2.15
57    2.33    2.32    2.29    57    2.22    2.22    2.20
58    2.38    2.37    2.34    58    2.27    2.27    2.25
59    2.44    2.43    2.39    59    2.33    2.32    2.30
60    2.50    2.49    2.45    60    2.38    2.38    2.35
61    2.57    2.56    2.51    61    2.44    2.43    2.40
62    2.64    2.62    2.57    62    2.50    2.49    2.46
63    2.71    2.69    2.63    63    2.57    2.56    2.52
64    2.79    2.77    2.69    64    2.64    2.63    2.58
65    2.87    2.84    2.76    65    2.71    2.70    2.64
66    2.95    2.93    2.83    66    2.79    2.77    2.71
67    3.04    3.01    2.90    67    2.87    2.85    2.77
68    3.14    3.10    2.98    68    2.95    2.93    2.84
69    3.24    3.20    3.05    69    3.05    3.02    2.92
70    3.34    3.30    3.13    70    3.14    3.11    2.99
71    3.46    3.40    3.21    71    3.24    3.21    3.07
72    3.58    3.52    3.30    72    3.35    3.31    3.15
73    3.70    3.63    3.38    73    3.46    3.42    3.23
74    3.84    3.76    3.46    74    3.59    3.53    3.32
75    3.99    3.89    3.55    75    3.71    3.65    3.40
76    4.14    4.03    3.63    76    3.85    3.77    3.49
77    4.31    4.18    3.72    77    4.00    3.91    3.57
78    4.49    4.34    3.80    78    4.16    4.05    3.66
79    4.69    4.51    3.88    79    4.33    4.20    3.74
80    4.90    4.69    3.95    80    4.51    4.36    3.82
81    5.13    4.87    4.02    81    4.71    4.53    3.90
82    5.39    5.07    4.09    82    4.92    4.71    3.97
83    5.66    5.28    4.14    83    5.16    4.90    4.03
84    5.96    5.49    4.19    84    5.41    5.10    4.09
85    6.28    5.71    4.23    85    5.69    5.31    4.15
86         5.94    4.27    86         5.53    4.20
87         6.17    4.30    87         5.75    4.24
88         6.41    4.32    88         5.98    4.27
89         6.64    4.34    89         6.22    4.30
90         6.87    4.35    90         6.45    4.32

 

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GUARANTEED ANNUITY TABLES

FIXED MONTHLY BENEFITS PER $1,000 APPLIED

JOINT AND SURVIVOR MONTHLY ANNUITY PAYMENTS

 

          Age of Female Annuitant
          50    55    60    65    70    80
     50    1.75    1.83    1.88    1.92    1.95     
     55    1.81    1.92    2.01    2.08    2.13     
     60    1.85    1.99    2.12    2.24    2.33    2.43

Age of Male Annuitant

    65         2.04    2.21    2.38    2.53    2.73
     70              2.28    2.50    2.72    3.07
     80                   2.63    2.98    3.78

 

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Individual Flexible Purchase Payment Variable Deferred Annuity Contract, Non-Participating