Attached files
| file | filename |
|---|---|
| S-1 - S-1 - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICA | contingents1oct122010.htm |
| EX-99 - RIDER - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICA | ex99a4c.htm |
| EX-99 - ARTICLES - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICA | ex99a3a.htm |
| EX-99 - BYLAWS - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICA | ex99a3b.htm |
| EX-99 - CONRACT - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICA | ex99a4a.htm |
| EX-99 - POA - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICA | ex99a24a.htm |
| EX-99 - RESOLUTION - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICA | ex99a24b.htm |
Contract Schedule
Contract Number: [12345]
Contract Date: [01/01/2008] Maturity Date: [01/01/2058]
Contract Owner: [John Doe]
[Joint Contract Owner:] [Jane Doe]
Covered Person: [John Doe] Covered Person’s DOB: [01/01/1958]
[Joint Covered Person:] [Jane Doe] [Joint Covered Person’s DOB:] [01/01/1958]
Annuitant: [John Doe] Annuitant’s DOB: [01/01/1958]
Maximum Issue Age: [80]
Minimum Annuity Payment Amount: $[100] per month
Maximum Birthday: [91st] birthday
Program Sponsor: [XYZ Trust/Broker-Dealer]
Designated Account
Account Number: [8675309]
Maximum Coverage Amount: [$1,000,000.00]
Program Rule(s): [0 to 100% PIMCO Global Multi-Asset Fund]
[0 to 100% PIMCO Total Return Fund]
[0 to 100% PIMCO Money Market Fund]
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Required Reallocation Period:
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[30 days from the date of the written notice or the next Business Day if the 30th day is not a Business Day. ]
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Allocation Correction Period:
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[10 days from the date of the written notice or the next Business Day if the 10th day is not a Business Day.]
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Addition Reversal Period:
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[60 days from the date of the written notice or the next Business Day if the 60th day is not a Business Day.]
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Minimum Value: [$5,000]
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Benefit Grace Period:
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[10 days from the date of the written notice or the next Business Day if the 10th day is not a Business Day]
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Benefit Base
Initial Investment: [$75,000]
Withdrawals
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Withdrawal Reversal Period:
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[10 days from the date of withdrawal or the next Business Day if the 10th day is not a Business Day]
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Exercise Ages: On the Withdrawal Start Date, all Covered Persons must be atleast age [65].
Withdrawal Percentage Table
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Current Ten-year U.S. Constant Maturity Treasury rate
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Payment percentage
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[Less than 3.50%
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4%]
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[3.50% to 4.99%
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5%]
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[5.00% to 6.49%
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6%]
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[6.50% and above
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7%]
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CS1000 3
Contract Schedule continued from the previous page
Total Contract Charges
Grace Period: [30] days
Due Dates: [Contract Date and the first Business Day in January, April, July and October]
[Contract Date and each quarterly anniversary of the Contract Date or the next BusinessDay if such day is not a Business Day]
Contract Maintenance
Charge Due Date: [First Business Day in January]
[Contract Anniversary]
Insurance Charge
[Initial Annual Insurance Charge Rate for a Sole Covered Person]
Allocation 1: [PIMCO Global Multi-Asset Fund] [1.05%]
Allocation 2: [PIMCO Total Return Fund] [1.05%]
Allocation 3: [PIMCO Money Market Fund ] [1.05%]
[Initial Annual Insurance Charge Rate for Joint Covered Persons]
Allocation 1: [PIMCO Global Multi-Asset Fund] [1.05%]
Allocation 2: [PIMCO Total Return Fund] [1.05%]
Allocation 3: [PIMCO Money Market Fund ] [1.05%]
Maximum Annual Insurance Charge Rate: [1.75]%
Administrative Charge
The Annual Administrative Charge Rate is [0.20]%.
Contract Maintenance Charge
The Annual Contract Maintenance Charge is $[75.00].
The Designated Amount is $[100,000].
Reinstatement and Reapplication
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Reinstatement Period:
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[90 days or the next Business Day if the 90th day is not a Business Day] after Contract Termination
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Reapplication Wait Period: [24 months] after Contract Termination
[Optional Riders:]
CS1000 [3A]
Contract Schedule continued from the previous page
Guaranteed Purchase Rate Tables are based on [1]% interest and the [Annuity 2000 Mortality Tables]. Values for ages not shown will be furnished upon request.
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TABLE 1, LIFE ONLY ANNUITY
Monthly Installments, per $1,000, payable during the lifetime of the Annuitant.
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Age on
Annuity Date
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Male Female
Annuitant Annuitant
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[50
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3.02
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2.78
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51
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3.09
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2.84
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52
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3.17
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2.90
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53
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3.25
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2.97
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54
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3.33
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3.04
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55
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3.42
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3.12
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56
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3.51
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3.20
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57
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3.61
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3.29
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58
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3.72
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3.38
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59
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3.83
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3.47
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60
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3.95
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3.57
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61
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4.07
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3.68
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62
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4.21
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3.79
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63
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4.35
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3.91
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64
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4.50
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4.04
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65
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4.67
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4.18
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66
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4.84
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4.33
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67
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5.03
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4.48
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68
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5.22
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4.65
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69
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5.43
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4.83
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70
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5.66
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5.03
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71
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5.90
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5.24
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72
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6.15
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5.47
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73
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6.42
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5.71
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74
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6.71
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5.98
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75
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7.02
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6.26
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76
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7.36
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6.57
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77
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7.71
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6.91
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78
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8.09
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7.27
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79
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8.50
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7.66
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80
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8.93
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8.09]
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TABLE 2, JOINT AND SURVIVOR ANNUITY
Monthly installment per $1,000, payable as long as either Annuitant is living.
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Age of Male on
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Age of Female on Annuity Date
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Annuity Date
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50
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55
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60
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65
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70
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75
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80
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[50
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2.49
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2.63
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2.74
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2.84
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2.90
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2.95
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2.98
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55
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2.58
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2.76
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2.94
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3.09
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3.21
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3.29
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3.35
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60
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2.65
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2.88
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3.12
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3.34
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3.54
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3.69
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3.80
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65
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2.70
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2.97
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3.27
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3.58
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3.89
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4.15
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4.36
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70
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2.73
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3.03
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3.38
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3.78
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4.22
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4.64
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5.00
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75
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2.75
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3.06
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3.46
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3.93
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4.49
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5.11
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5.70
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80
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2.76
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3.09
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3.51
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4.04
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4.70
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5.50
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6.37]
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CS1000 [3A]