Scudder DestinationsSM Variable Annuity
Guaranteed Retirement Income Benefit

Illustration of Income Options & Commutable Values

The Guaranteed Retirement Income Benefit ("GRIB") in your deferred annuity contract converts upon annuitization to provide fixed lifetime income payments under a supplementary agreement. The level of lifetime income will depend upon the Annuity Option and guaranteed installment period ("Period Certain") selected.

The GRIB may be exercised beginning with the 7th contract anniversary once age 60 is attained, or, for an Annuitant age 44 or younger at issue, the 15th contract anniversary. In any case, it must be exercised prior to attaining age 91.

The GRIB Illustration Tool provided below may be used to illustrate GRIB annuity payment amounts. GRIB annuity payments are paid for the life of a single Annuitant or the lifetimes of two Annuitants. If paid for the lifetimes of two Annuitants, the age of the older Annuitant is used to determine the GRIB base.

Please do not use the GRIB Illustration Tool provided below to illustrate a Joint and Survivor Annuity if the Joint Annuitant will have reached age 80 before GRIB is exercised and the Joint Annuitant is older that the primary Annuitant. The GRIB Illustration Tool will not illustrate properly under these circumstances. Please contact the Annuity Service Center at 1-800-449-0523 for assistance. If you wish to have the GRIB base calculated for illustration purposes under these circumstances.

In addition, the GRIB Illustration Tool only functions to calculate the effect of currently exercising the GRIB rider using a known GRIB base or an assumed GRIB base that the contract owner may input. The GRIB Illustration Tool does not calculate GRIB base into the future and is not useful for other purposes, such as evaluating a buy back offer.


Please enter the following information:


Annuitant:

Name


Gender
Male Female


Date of birth
(mm/dd/yyyy)

Joint Annuitant(leave blank if not applicable):

Gender
Male Female


Date of birth
(mm/dd/yyyy)


Is the joint annuitant the annuitant's spouse?
Yes No


Survivor %

Destinations Contract Data:

Policy number


Issue date
(mm/dd/yyyy)


Plan type


Issue State


Contract value
$


GRIB Base/GRIB Value
$

GRIB Election Data:

GRIB Election Date
(mm/dd/yyyy) Must be within one month of Contract Anniversary


First Payment Date
(mm/dd/yyyy) Must be 1st or 15th day of the month

        


Scudder Destinations is a variable, fixed, and market value-adjusted deferred annuity contract (policy form series L-8166 and L-1550) issued by Zurich American Life Insurance Company, administrative office: 2000 Wade Hampton Blvd., Greenville, SC 29615-1

For additional information please contact our Annuity Service Center at (800) 449-0523.