EX-4.(V)
from S-1/A
6 pages
This Completed Document Is for Restricted Use Only. No Part May Be Copied Nor Disclosed Without Prior Consent of Principal®. Icc23 Aa 4971 Sample Page 1 of 6 Principal® Strategic Income Index-Linked Deferred Annuity Application Principal Life Insurance Company Ris Annuity Services 711 High Street Des Moines, Ia 50392-1770 a Member of Principal Financial Group® a Single Premium Deferred Individual Annuity 1. Owner(s) Primary Owner: Owner Is a/An: Individual Trust Custodian/Poa Utma/Ugma Full Name (First, Middle, Last) Trust Date (If Applicable) Street Address City State Zip Email Address M F Date of Birth Gender Social Security or Tax Id # Telephone Number Joint Owner: Not Applicable for Qualified Contracts Full Name (First, Middle, Last) M F Date of Birth Gender Social Security or Tax Id # Telephone Number 2. Annuitant(s) Primary Annuitant: Complete Only if Different Than Owner Full Name (First, Middle, Last) Street Address City State Zip M F Date of Birth Gender Social Security or Tax Id # Telephone Number Joint Annuitant: Not Applicable for Qualified Contracts Full Name (First, Middle, Last) M F Date of Birth Gender Social Security or Tax Id # Telephone Number 3. Type of Contract Tax Status: Nonqualified (Nq) Traditional Ira Ira Transfer Ira Rollover Roth Ira Pension Trust Sep Ira Simple Ira if Qualified, Date of the Contribution Year: If Roth Ira, Date of the First Contribution to Any Roth Ira: Premium Details Amount Personal Check Nq Transfer Transfer From Ira Rollover From Eligible Qualified Plan Initial Premium: $ Initial Premium: $ Initial Premium: $ Minimum Premium $10,000 Nonqualified or $10,000 Qualified Make Checks Payable to Principal Life Insurance Company Form Always Required
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EX-4.(IV)
from S-1/A
6 pages
Data Page Single Premium Index-Linked Deferred Annuity Contract Data Contract Number: {1234567} Annuitant/Age: {John Doe/45} Owner: {Jane Doe} {Joint Annuitant/Age:} {Jane Doe/45} {Joint Owner:} {John Doe} Contract Date: {May 1, 2024} Annuitization Date: {May 1, 2074} Premium Payment: {$10,000.00} Contract Charges and Limits Transaction Fee: For Unscheduled Partial Surrenders: Currently {$00.00}, Not to Exceed the Lesser of $25 or 2% of Each Unscheduled Partial Surrender After the 12th Unscheduled Partial Surrender in a Contract Year. Maximum Total Premium Payment: [$2,000,000.00.] Segment Minimums: [$1,000] Minimum Partial Surrender: [$100.00] Minimum Accumulated Value After [$2,000.00] a Partial Surrender: Minimum Accumulated Value to Initiate a [$5,000.00] Scheduled Partial Surrender: Guaranteed Minimum Interest Rate for Initial Holding [0.25%] Account: Current Interest Rate for Initial Holding Account: [1.00%] Sf 1027-3 3
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EX-4.(I)
from S-1/A
13 pages
Single Premium Index-Linked Deferred Annuity Contract. We Agree to Provide the Benefits and Other Rights of This Contract. Payment Is Subject to the Provisions, Terms, and Conditions of This Contract. This Contract Contains Benefits Waiving Surrender Charges. Non-Participating. the Accumulated Value of This Contract May Increase or Decrease Each Valuation Day Depending on the Investment Experience of the External Index That You Select, and Are Not Guaranteed as to a Fixed Dollar Amount. This Contract Does Not Directly Participate in Any Stock, Index, or Equity Investments. This Contract Is a Legal Contract Between You, as Owner, and US, Principal Life Insurance Company, a Stock Company and Member of the Principal Financial Group®. Your Contract Is Issued Based on the Information You Give US and Payment of the Premium Payment as Shown on the Data Page
12/34/56
EX-4.5
from S-1
6 pages
This Completed Document Is for Restricted Use Only. No Part May Be Copied Nor Disclosed Without Prior Consent of Principal®. Icc22 Aa 4950-1 Sample Page 1 of 5 a Single Premium Deferred Individual Annuity 1. Owner(s) Primary Owner: Owner Is a/An: Individual Trust Custodian/Poa Utma/Ugma Full Name (First, Middle, Last) Trust Date (If Applicable) Street Address City State Zip Email Address M F Date of Birth Gender Social Security or Tax Id # Telephone Number Joint Owner: Not Applicable for Qualified Contracts Full Name (First, Middle, Last) M F Date of Birth Gender Social Security or Tax Id # Telephone Number 2. Annuitant(s) Primary Annuitant: Complete Only if Different Than Owner Full Name (First, Middle, Last) Street Address City State Zip M F Date of Birth Gender Social Security or Tax Id # Telephone Number Joint Annuitant: Not Applicable for Qualified Contracts Full Name (First, Middle, Last) M F Date of Birth Gender Social Security or Tax Id # Telephone Number 3. Type of Contract Tax Status: Nonqualified (Nq) Traditional Ira Ira Transfer Ira Rollover Roth Ira Pension Trust Sep Ira Simple Ira if Qualified, Date of the Contribution Year: If Roth Ira, Date of the First Contribution to Any Roth Ira: Premium Details Amount Personal Check Nq Transfer Transfer From Ira Rollover From Eligible Qualified Plan Initial Premium: $ Initial Premium: $ Initial Premium: $ Minimum Premium $10,000 Nonqualified or $10,000 Qualified Make Checks Payable to Principal Life Insurance Company Form Always Required Principal Life Insurance Company Attn: Ris Annuity Services 711 High Street Des Moines, Ia 50392-1770 Principal Rila Annuity Application
12/34/56
EX-4.1
from S-1
19 pages
Single Premium Index-Linked Deferred Annuity Contract. We Agree to Provide the Benefits and Other Rights of This Contract. Payment Is Subject to the Provisions, Terms, and Conditions of This Contract. This Contract Contains Benefits Waiving Surrender Charges. Non-Participating. the Accumulated Value of This Contract May Increase or Decrease Each Valuation Day Depending on the Investment Experience of the External Index That You Select, and Are Not Guaranteed as to a Fixed Dollar Amount. This Contract Does Not Directly Participate in Any Stock, Index, or Equity Investments. This Contract Is a Legal Contract Between You, as Owner, and US, Principal Life Insurance Company, a Stock Company and Member of the Principal Financial Group®. Your Contract Is Issued Based on the Information You Give US and Payment of the Premium Payment as Shown on the Data Page
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