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AMENDMENT <br />TO <br />GROUP ANNUITY CONTRACT <br />NUMBER G XX,XXX <br />(THE CONTRACT) <br />UE <br />AMERICAN L N E'Cl* <br />P Y (ATM <br />TO I <br />SA E O N r <br />( CQT DE ) <br />This Amendment is effective as of XXX, XX, XXXX. <br />AUL and the Contractholder hereby amend the Contract by adding the following Contract <br />termination payment option to the "TERMINATION OF CONTRACT" Section of the Contract: <br />If you terminate the contract, you may elect to have us pay you your FIA Withdrawal <br />Value in a lump -sum upon contract termination. Payment is made on the termination <br />effective date, unless you and we agree to another date. Calculation of the amount to be <br />paid is made on the Business Day preceding the payment date. Notwithstanding the <br />definition of "Withdrawal Charge" in contract "SECTION 1 — DEFINITIONS," and <br />solely for purposes of determining the FIA Withdrawal Value under this payment option, <br />the Withdrawal Charge is equal to 5% of the FIA Account Value withdrawn under this <br />payment option. <br />CONTRACTHOLDER AUL <br />Title <br />Date <br />I0 <br />Title <br />Date <br />GB8.uFIAlumpsum (3121 SpPport) <br />