EX-4.B
from S-3/A
5 pages
Rila-Sch-B(5/21) Annuity Schedule Page Annuity Number: [001-00001] Issue Date: [March 1, 2013] Type of Business: [Non-Qualified] Owner: [John Doe] Date of Birth: [October 21, 1972] Sex: [Male] Owner: [Mary Doe] Date of Birth: [October 15, 1972] Sex: [Female] Annuitant: [John Doe] Date of Birth: [October 21,1972] Sex: [Male] [Joint Annuitant: [Mary Doe] Date of Birth: [January 15, 1952] Sex: [Female]] [Contingent Annuitant: [Mary Doe] Date of Birth: [January 15, 1952] Sex: [Female]] Purchase Payment Allocation Purchase Payment: [$100,000.00] Index Strategy Allocation Percentage(s): [Point to Point With Cap Index Strategy XX% [Index Name] [Index Term] [$XXXX.XX] [XX.XX% Buffer] [Index Name] [Index Term] [$XXXX.XX] [XX.XX% Buffer] Tiered Participation Rate Index Strategy XX% [Index Name] [Index Term] [$XXXX.XX] [XX.XX% Buffer] [Index Name] [Index Term] [$XXXX.XX] [XX.XX% Buffer] Step Rate Plus Index Strategy XX% [Index Name] [Index Term] [$XXXX.XX] [XX.XX% Buffer] [Index Name] [Index Term] [$XXXX.XX] [XX.XX% Buffer]] Withdrawals Maximum Free Withdrawal Percentage: [10%] of the Purchase Payment During the First Annuity Year. Thereafter [10%] of the Prior Contract Anniversary Account Value During the Contingent Deferred Sales Charge Period. Minimum Withdrawal Amount: [$100] Minimum Surrender Value After a Partial Withdrawal: [$2,000] Account Value Allocation Minimum Variable Sub-Account Amount: [$20] Minimum Index Strategy Amount: [$2,000]
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