EX-99.4BI 4 ex4bi.htm S40875 BASE CONTRACT SCHEDULE



Contract Schedule

Owner:   [John Doe]  Contract Number:    [??687456]
Owner’s Age    Issue Date:    [04/15/10]
and gender:  [35 Male]  Maximum Issue Age:  [80]
[Joint Owner:  [Jane Doe]]  Annuitant:    [John Doe]
[Joint Owner’s Age    Annuitant’s Age
and gender:  [35 Female]]  and gender:  [35 Male]
Determining Life (Lives):  [John Doe]
[Jane Doe]


Purchase Payments
Interim Fund(s):    [AZL Government Money Market Fund]
Initial Purchase Payment:  $[10,000.00]
Minimum Additional Purchase Payment:    $[50.00]
Maximum Total Purchase Payments:  $[1 million; higher amounts may be accepted with our approval, on a non-discriminatory basis]

Variable Account:  [Allianz Life Variable Account B]    


Contract Charges
Product Fee:  [0.25]%
Contract Maintenance Charge:    $[50.00] each Contract Year
Contract Maintenance Charge Waiver Minimum:    $[100,000.00]
Maximum Annual Advisory Fee Percentage:  [1.50%]


Market Value Adjustment
MVA Period:  [7 Index Years]
MVA Reference Rate Index:  [Bloomberg Barclays US Long Corporate Bond Index]
MVA Limit:  [10%]


Withdrawals
Minimum Partial Withdrawal:   $[100.00]
Minimum Required Value:    $[2,000.00]
Free Withdrawal Amount:  [10]% of total Annual Contribution Amounts


Annuity Payments
Maximum Annuity Date:  [Index Anniversary on or after the day the Annuitant attains age 100]
Minimum Annuity Payment:  $[100.00]
Annuity Mortality Table:  [2012 Individual Annuity Reserve Table]
Minimum Annual Annuity Payment Rate:    [0.10]%

S40875-IADV  [3]  [Admin Tracking Number]


Contract Schedule continued from the previous page

Guaranteed Purchase Rate Tables
The tables below are examples of Guaranteed Purchase Rates for a representative set of ages in certain calendar years.  Guaranteed Purchase Rates are based on the Annuity Mortality Table and Minimum Annual Annuity Payment Rate shown in the Annuity Payments section of the Contract Schedule.  Guaranteed Purchase Rates will vary by Age on Annuity Date, Annuity Option, and the calendar year in which Annuity Payments begin. 

The Guaranteed Purchase Rates shown below in Tables 2, 3, and 4 are only applicable if Annuity Payments begin for the designated Age on Annuity Date in the designated calendar year.

Upon request, we will furnish rates for ages and guaranteed periods not shown. Guaranteed Purchase Rates change based on the calendar year in which annuitization occurs.

TABLE 1: GUARANTEED PERIOD
Monthly installments per $1,000, payable for the guaranteed period
Guaranteed
Monthly
Period
Installments
10
$[8.37]

Guaranteed Purchase Rates for the Life, Life with Guaranteed Period, Joint and Survivor, and Joint and 2/3 Survivor change based on the calendar year in which annuitization occurs.
TABLE 2: LIFE
Monthly installments per $1,000 payable while the Annuitant is living
 
Guaranteed Rates for [2025]
Guaranteed Rates for [2035]
Guaranteed Rates for [2045]
Age of Annuitant on Annuity Date
Male Annuitant
Female Annuitant
Male Annuitant
Female Annuitant
Male Annuitant
Female Annuitant
[60
$[2.91
2.76
2.83
2.70
2.76
2.65
70
4.26
3.97
4.11
3.86
3.98
3.76
80]
7.26
6.58
6.95
6.36
6.68
6.16]
LIFE WITH A GUARANTEED PERIOD - Male Annuitant
Monthly installments per $1,000, payable for the
guaranteed period and thereafter while the Annuitant is living
 
Guaranteed Rates for [2025]
Guaranteed Rates for [2035]
Guaranteed Rates for [2045]
Age of Annuitant on Annuity Date 
Guaranteed Period
Guaranteed Period
Guaranteed Period
5 years
10 years
5 years
10 years
5 years
10 years
[60
$[2.91
2.89
2.83
2.81
2.75
2.74
70
4.24
4.14
4.09
4.01
3.96
3.89
80]
7.02
6.26
6.76
6.12
6.52
5.98]
S40875-IADV   [3A]                                               [Admin. Tracking Identifier]


Contract Schedule continued from the previous page

LIFE WITH A GUARANTEED PERIOD - Female Annuitant
Monthly installments per $1,000, payable for the
guaranteed period and thereafter while the Annuitant is living
 
Guaranteed Rates for [2025]
Guaranteed Rates for [2035]
Guaranteed Rates for [2045]
Age of Annuitant on Annuity Date
Guaranteed Period
Guaranteed Period
Guaranteed Period
5 years
10 years
5 years
10 years
5 years
10 years
[60
$[2.76
2.75
2.70
2.69
2.64
2.63
70
3.95
3.88
3.84
3.78
3.75
3.70
80]
6.42
5.87
6.23
5.75
6.05
5.64]


TABLE 3: JOINT AND SURVIVOR
Monthly installments per $1,000, payable while either Annuitant is living
Age of Annuitant on Annuity Date
Guaranteed Rates for [2025]
Guaranteed Rates for [2035]
Guaranteed Rates for [2045]
Age of Annuitant on Annuity Date
Age of Annuitant on Annuity Date
Age of Annuitant on Annuity Date
[60
70
80
60
70
80
60
70
80]
[60
$[2.35
2.60
2.72
2.31
2.56
2.66
2.28
2.51
2.61
70
2.60
3.25
3.73
2.56
3.18
3.64
2.51
3.12
3.55
80]
2.72
3.73
5.09
2.66
3.64
4.96
2.61
3.55
4.84]


TABLE 4: JOINT AND 2/3 SURVIVOR
Monthly installments per $1,000, payable while both Annuitants are living.  After the death of one Annuitant, 2/3 of the original installment amount will continue while the surviving Annuitant is living
Age of Annuitant on Annuity Date
Guaranteed Rates for [2025]
Guaranteed Rates for [2035]
Guaranteed Rates for [2045]
 
Age of Annuitant on Annuity Date
Age of Annuitant on Annuity Date
Age of Annuitant on Annuity Date
[60
70
80
60
70
80
60
70
80]
[60
$[2.61
3.01
3.40
2.56
2.94
3.32
2.51
2.88
3.25
70
3.01
3.70
4.46
2.94
3.60
4.34
2.88
3.52
4.23
80]
3.40
4.46
5.99
3.32
4.34
5.81
3.25
4.23
5.65]


S40875-IADV   [3B]                       [Admin. Tracking Identifier]