Attached files
file | filename |
---|---|
EX-24.A - POWERS OF ATTORNEY - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICA | powersofattorney.htm |
EX-4.D - INDEX ADVANTAGE ADV APPLICATION IXA-APP-ADV - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICA | application.htm |
S-1 - INDEX ADVANTAGE ADV S-1 8-15-16 - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICA | indadvadvaug152016.htm |
EX-4c. Contract Schedule Page (Base)-S40875-ADV
Contract Schedule
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Owner:
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[John Doe]
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Contract Number:
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[??687456]
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[Joint Owner:
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[Jane Doe]]
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Issue Date:
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[04/15/10]
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Annuitant:
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[John Doe]
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Scheduled Annuity Date:
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[04/01/65]
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Determining Life (Lives):
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[John Doe]
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Maximum Issue Age:
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[80]
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[Jane Doe]
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Purchase Payments
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Initial Purchase Payment:
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$[10,000.00]
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Minimum Additional Purchase Payment:
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$[50.00]
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Maximum Total Purchase Payments:
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$[1 million; higher amounts may be accepted with our approval]
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Transfers
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Number of Free Transfers Permitted:
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[12] each Contract Year
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Transfer Fee:
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$[25.00] for each transfer in excess of the free transfers permitted
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Transfer Index Anniversary:
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Every [Sixth] Index Anniversary
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Contract Charges
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Product Fee:
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[0.25]%
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Contract Maintenance Charge:
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$[50.00] each Contract Year
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Designated Amount:
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Contract Value must be $[100,000.00] to waive the Contract Maintenance Charge
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Withdrawals
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Minimum Partial Withdrawal:
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$[100.00]
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Minimum Required Value:
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$[2,000.00]
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Free Withdrawal Amount:
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[10]% of total Purchase Payments
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Withdrawal Charge Percentages Table
Number of Complete Years Since Receipt of Purchase Payment
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Charge
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[0
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6.50%
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1
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6.00%
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2
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5.00%
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3
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4.00%
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4
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3.00%
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5
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2.00%
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6 years or more
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0%]
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Annuity Payments
Minimum Annuity Payment:
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$[100.00]
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Annuity Mortality Table:
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[Annuity 2000 Mortality Table]
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Minimum Annual Annuity Payment Rate:
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[1.00]%
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Riders:
[The applicable riders based on the information from the application will populate this area.]
Guaranteed Purchase Rate Table
Upon request, we will furnish rates for ages and guaranteed periods not shown.
Annuity Options - Guaranteed monthly annuity payments per $1,000
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||||||||||
Option 1
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Option 2
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Option 3
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Option 4
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Option 5
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||||||
10-year guaranteed period
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20-year guaranteed period
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100% joint and survivor
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10-year guaranteed period
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|||||||
Age on
Annuity Date
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Male
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Female
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Male
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Female
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Male
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Female
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Male & Female
Same Age
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Male & Female
Same Age
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Male
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Female
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30
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[2.08
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1.97
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2.08
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1.97
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2.07
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1.97
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1.84
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1.84
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2.00
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1.92
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40
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2.45
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2.29
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2.45
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2.29
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2.42
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2.28
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2.10
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2.10
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2.29
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2.19
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50
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3.02
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2.78
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3.00
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2.77
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2.92
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2.73
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2.49
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2.49
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2.70
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2.57
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60
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3.95
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3.57
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3.87
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3.53
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3.59
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3.37
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3.12
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3.11
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3.29
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3.14
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70
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5.66
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5.03
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5.28
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4.83
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4.24
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4.13
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4.22
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4.20
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4.18
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4.00
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80
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8.93
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8.09
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7.07
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6.79
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4.55
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4.53
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6.37
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6.04
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5.54
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5.38
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90
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15.24
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14.64
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8.36
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8.30
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4.59
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4.59
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10.68
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7.98
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7.66
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7.50]
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