ALLIANZ LIFE INSURANCE CO OF NORTH AMERICA - FORM S-1 - EX-99.4BII - S40877 INDEX OPTIONS SCHEDULE - April 20, 2021

Attached files

file filename
S-1 - INDEX ADVANTAGE INCOME ADV S-1 4-20-21 - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICAiaiadvs1apr202021.htm
EX-99.B - APPENDIX B EXHIBIT - DAILY ADJUSTMENT CALCULATION - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICAex99b.htm
EX-99.24C - POWERS OF ATTORNEY - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICAex24c.htm
EX-99.4KII - S40906 INCOME MULT BENEFIT RIDER SCHED - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICAex4kii.htm
EX-99.4KI - S40905 INCOME MULT BENEFIT RIDER - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICAex4ki.htm
EX-99.4JII - S40898-IADV MAX ANNIV DEATH BENEFIT RIDER SCHED - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICAex4jii.htm
EX-99.4JI - S40897-IADV MAX ANNIV DEATH BENEFIT RIDER - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICAex4ji.htm
EX-99.4II - S40880-IADV TRADITIONAL DEATH BENEFIT RIDER - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICAex4ii.htm
EX-99.4HII - S40902-01-IADV INCOME BENEFIT RIDER SCHEDULE - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICAex4hii.htm
EX-99.4HI - S40901-02-IADV INCOME BENEFIT RIDER - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICAex4hi.htm
EX-99.4G - S40891-01-IADV INDEX PRECISION STRATEGY CREDITING RIDER - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICAex4g.htm
EX-99.4F - S40889-02-IADV INDEX GUARD STRATEGY CREDITING RIDER - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICAex4f.htm
EX-99.4EII - S40899-01-IADV INDEX PROTECTON STATEGY WITH CAP RIDER - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICAex4eii.htm
EX-99.4EI - S40879-01-IADV INDEX PROTECTION STRATEGY CREDITING RIDER - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICAex4ei.htm
EX-99.4DII - S40904-IADV INDEX PERF STRATEGY RIDER III - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICAex4dii.htm
EX-99.4DI - S40903 INDEX PERF STRATEGY RIDER II - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICAex4di.htm
EX-99.4C - ICC21-IAI-APP-ADV APPLICATION - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICAex4c.htm
EX-99.4BI - S40875 BASE CONTRACT SCHEDULE - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICAex4bi.htm
EX-99.4A - L40538 ANNUITY CONTRACT - ALLIANZ LIFE INSURANCE CO OF NORTH AMERICAex4a.htm



Index Options Contract Schedule

Owner:   [John Doe]  Contract Number:    [??687456]
Owner’s Age     Issue Date:    [04/15/10]
and gender:  [35 Male]  Annuitant:    [John Doe]
[Joint Owner:      [Jane Doe]]       Annuitant’s Age
[Joint Owner’s     and gender:  [35 Male]
Age and gender:    [35 Female]]
 

Allocation Guidelines: 
[1. Currently, you can select up to [5] of the Index Protection Strategy with Declared Protection Strategy Credit Index Options.
2. Currently, you can select up to [5] of the Index Protection Strategy with Cap Index Options.
3. Currently, you can select up to [5] of the Index Performance Strategy II Index Options.
4. Currently, you can select up to [5] of the Index Performance Strategy III Index Options.
5. Currently, you can select up to [5] of the Index Guard Strategy Index Options.
6. Currently, you can select up to [5] of the Index Precision Strategy Index Options.
7. Currently, you can select up to a maximum of [15] Index Options.
8. Allocations must be made in whole percentages.]

Index Options:
[On the Income Benefit Date, for any Index Option that has not reached a Term End Date, we will lock the Index Option Value before we calculate Income Payments.]
[Part [A] Index Option Rider(s):]
 [Index Performance Strategy II Index Options
Index
Buffer for all Terms
 
Minimum Cap for all Terms
 
 
Term
 
[S&P 500® Index
[10.00]%
[3.00]%
[1 Index Year]]
[Nasdaq-100® Index
[10.00]%
[3.00]%
[1 Index Year]]
[Russell 2000® Index
[10.00]%
[3.00]%
[1 Index Year]]
[EURO STOXX 50®
[10.00]%
[3.00]%
[1 Index Year]]
[iShares® MSCI Emerging Markets ETF
[10.00]%
[3.00]%
[1 Index Year]]]

 
S40877-IADV                                                                            [Admin. Tracking Identifier]


Index Options Contract Schedule continued from the previous page
[Index Performance Strategy III Index Options
Index
Buffer for all Terms
 
Minimum Cap for all Terms
 
 
Minimum Participation Rate for all Terms
 
 
Term
 
[S&P 500® Index
[10.00]%
[1.50]%
[100.00]%
[3 Index Years]]
[Nasdaq-100® Index
[10.00]%
[1.50]%
[100.00]%
[3 Index Years]]
[Russell 2000® Index
[10.00]%
[1.50]%
[100.00]%
[3 Index Years]]
[EURO STOXX 50®
[10.00]%
[1.50]%
[100.00]%
[3 Index Years]]
[iShares® MSCI Emerging Markets ETF
[10.00]%
[1.50]%
[100.00]%
[3 Index Years]]
[S&P 500® Index
[20.00]%
[1.50]%
[100.00]%
[3 Index Years]]
[Nasdaq-100® Index
[20.00]%
[1.50]%
[100.00]%
[3 Index Years]]
[Russell 2000® Index
[20.00]%
[1.50]%
[100.00]%
[3 Index Years]]
[EURO STOXX 50®
[20.00]%
[1.50]%
[100.00]%
[3 Index Years]]
[iShares® MSCI Emerging Markets ETF
[20.00]%
[1.50]%
[100.00]%
[3 Index Years]]
[S&P 500® Index
[10.00]%
[1.50]%
[100.00]%
[6 Index Years]]
[Nasdaq-100® Index
[10.00]%
[1.50]%
[100.00]%
[6 Index Years]]
[Russell 2000® Index
[10.00]%
[1.50]%
[100.00]%
[6 Index Years]]
[EURO STOXX 50®
[10.00]%
[1.50]%
[100.00]%
[6 Index Years]]
[iShares® MSCI Emerging Markets ETF
[10.00]%
[1.50]%
[100.00]%
[6 Index Years]]]

 [Index Guard Strategy Index Options
Index
Floor for all Index Years
 
Minimum Cap for all Index Years
 
 
Term
 
[S&P 500® Index
[-10.00]%
[3.00]%
[1 Index Year]]
[Nasdaq-100® Index
[-10.00]%
[3.00]%
[1 Index Year]]
[Russell 2000® Index
[-10.00]%
[3.00]%
[1 Index Year]]
[EURO STOXX 50®
[-10.00]%
[3.00]%
[1 Index Year]]
[iShares® MSCI Emerging Markets ETF
[-10.00]%
[3.00]%
[1 Index Year]]]


















Index Options Contract Schedule continued from the previous page

[Index Precision Strategy Index Options
Index
Buffer for all Index Years
 
Minimum Precision Rate for all Index Years
 
 
Term
 
[S&P 500® Index
[10.00]%
[3.00]%
[1 Index Year]]
[Nasdaq-100® Index
[10.00]%
[3.00]%
[1 Index Year]]
[Russell 2000® Index
[10.00]%
[3.00]%
[1 Index Year]]
[EURO STOXX 50®
[10.00]%
[3.00]%
[1 Index Year]]
[iShares® MSCI Emerging Markets ETF
[10.00]%
[3.00]%
[1 Index Year]]]

 
[Part [B] Index Option Rider(s):]
[Index Protection Strategy with Declared Protection Strategy
 Credit Index Options
Index
Minimum Declared Protection Strategy Credit for all Index Years
Term
[S&P 500® Index
[0.50]%
[1 Index Year]]
[Nasdaq-100® Index
[0.50]%
[1 Index Year]]
[Russell 2000® Index
[0.50]%
[1 Index Year]]
[EURO STOXX 50®
[0.50]%
[1 Index Year]]
[iShares® MSCI Emerging Markets ETF
[0.50]%
[1 Index Year]]]

[Index Protection Strategy with Cap Index Options
Index
Minimum Cap for all Index Years
Term
[S&P 500® Index
[0.50]%
[1 Index Year]]
[Nasdaq-100® Index
[0.50]%
[1 Index Year]]
[Russell 2000® Index
[0.50]%
[1 Index Year]]
[EURO STOXX 50®
[0.50]%
[1 Index Year]]
[iShares® MSCI Emerging Markets ETF
[0.50]%
[1 Index Year]]]

The indexes do not reflect the dividends paid on the stocks underlying the market indexes.


Index Options Contract Schedule continued from the previous page

[Index disclosure language will be populated here.]
S40877-IADV                                                                            [Admin. Tracking Identifier]