<PAGE>
<TABLE>
<CAPTION>
<S><C>
ANCHOR NATIONAL NEW BUSINESS DOCUMENTS OVERNIGHT WITH CHECKS
LIFE INSURANCE COMPANY WITH CHECKS BONPC
1 SunAmerica Center P.O. Box 100330 1111 Arroyo Parkway
Los Angeles, CA 90067-6022 Pasadena, CA 91189-0001 Suite 150
WITHOUT CHECKS Lock Box 10330
P.O. Box 54299 Pasadena, CA 91105
Los Angeles, CA 90054-0299
-----------------------------------------------------------------------------------------------------------------------------------
DEFERRED ANNUITY APPLICATION ANA-543 (6/00)
DO NOT USE HIGHLIGHTER. Please print or type.
-----------------------------------------------------------------------------------------------------------------------------------
A. OWNER
-----------------------------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------------------------
Last Name First Name Middle Initial
-----------------------------------------------------------------------------------------------------------------------------------
Street Address
-----------------------------------------------------------------------------------------------------------------------------------
City State Zip Code
Mo. Day Year / / M / / F ( )
------------------------------------ -------------- --------------------- ------------------------
Date of Birth Sex SSN or TIN Telephone Number
JOINT OWNER: (If Applicable)
-----------------------------------------------------------------------------------------------------
Last Name First Name Middle Initial
Mo. Day Year / / M / / F ( )
------------------------------------ -------------- ---------------- ----------------------- ------------------------
Date of Birth Sex SSN Relationship to Owner Telephone Number
-----------------------------------------------------------------------------------------------------------------------------------
B. ANNUITANT (Complete only if different from Owner)
-----------------------------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------------------------
Last Name First Name Middle Initial
-----------------------------------------------------------------------------------------------------------------------------------
Street Address
-----------------------------------------------------------------------------------------------------------------------------------
City State Zip Code
Mo. Day Year / / M / / F ( )
------------------------------------ -------------- ----------------- ------------------------------------
Date of Birth Sex SSN Telephone Number
JOINT ANNUITANT (If Applicable):
--------------------------------------------------------------------------------------------------
Last Name First Name Middle Initial
Mo. Day Year / / M / / F
------------------------------------ -------------- ----------------- ------------------------------------
Date of Birth Sex SSN Telephone Number
--------------------------------------------------------------------- -------------------------------------------------------------
C. REQUIRED ELECTION: Owners must choose a Withdrawal Charge D. OPTIONAL ENHANCED DEATH BENEFIT: The optional benefit may
Period. Once elected, this cannot be changed. (Please see your only be chosen at the time of application. Optional death
financial representative and the prospectus for information about benefits are offered as an enhancement to the standard Death
these options.) Benefit described in the prospectus. If an optional death
benefit is not chosen, the standard death benefit will be
paid. Once elected, the option cannot be terminated or
changed.
--------------------------------------------------------------------- -------------------------------------------------------------
I.WITHDRAWAL CHARGE PERIOD II. OPTIONAL ENHANCED DEATH BENEFIT
/ / Option 1: 7 Years (with DCA Fixed Accounts) / / [Purchase Payment Accumulation]
/ / Option 2: 9 Years (with Payment Enhancement Provisions) / / [Maximum Anniversary Value]
--------------------------------------------------------------------- -------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------------------------
E. BENEFICIARY (Please list additional beneficiaries, if any, in the special instructions section)
-----------------------------------------------------------------------------------------------------------------------------------
/X/ Primary
--------------------------------------------------------------- ------------------ -------------
Last Name First Name M I Relationship Percentage
/ / Primary / / Contingent
--------------------------------------------------------------- ------------------ -------------
Last Name First Name M I Relationship Percentage
/ / Primary / / Contingent
--------------------------------------------------------------- ------------------ -------------
Last Name First Name M I Relationship Percentage
ANA-543 (6/00) 1
<PAGE>
-----------------------------------------------------------------------------------------------------------------------------------
F. TYPE OF CONTRACT (If this is a transfer or 1035 Exchange, please complete form [SA2500RL] and submit it with this application)
-----------------------------------------------------------------------------------------------------------------------------------
/ / NON-QUALIFIED PLAN (Minimum $5,000) / / QUALIFIED PLANS (MINIMUM $2,000)
/ / IRA (tax year _________) / / IRA TRANSFER
/ / IRA ROLLOVER / / ROTH IRA / / 401(k) / / KEOGH
/ / SEP / / 457 / / OTHER_______________
/ / Check included with this application for $_______________________
-----------------------------------------------------------------------------------------------------------------------------------
G. ANNUITY DATE: Date annuity payments ("income payments") begin. Must be at least 2 years after the Contract Date. Maximum
annuitization age is the later of the Owner's age 90 or 10 years after Contract Date. NOTE: If left blank, the Annuity Date will
default to the maximum for nonqualified and to 70 1/2 for qualified contracts.
-----------------------------------------------------------------------------------------------------------------------------------
Month Day Year
---------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------------------------
H. SPECIAL FEATURES (OPTIONAL)
-----------------------------------------------------------------------------------------------------------------------------------
/ / SYSTEMATIC WITHDRAWAL: Include Form Number [SA-5550SW] with this application.
/ / PRINCIPAL ADVANTAGE: Check the appropriate fixed account below and specify the other allocations as percentages in section L.
/ / 1 Year Fixed / / 3 Year MVA Fixed / / 5 Year MVA Fixed / / 7 Year MVA Fixed / / 10 Year MVA Fixed
/ / AUTOMATIC ASSET REBALANCING: I request the accounts to be REBALANCED as designated in section L at the frequency initialed
below:
(Select only one) __________ Monthly ___________ Quarterly __________Semiannually ________Annually
-----------------------------------------------------------------------------------------------------------------------------------
I. TELEPHONE TRANSFERS AUTHORIZATION
-----------------------------------------------------------------------------------------------------------------------------------
I / / DO / / DO NOT authorize telephone transfers, subject to the conditions set forth below. If no election is made, the Company
will assume that you do authorize telephone transfers. (North Dakota: If no election is made, the Company will assume you do NOT
wish to authorize telephone transfers)
I authorize the Company to accept telephone instructions for transfers in any amount among investment options from anyone providing
proper identification subject to restrictions and limitations contained in the Contract and related prospectus, if any. I
understand that I bear the risk of loss in the event of a telephone instruction not authorized by me. The company will not be
responsible for any losses resulting from unauthorized transactions if it follows reasonable procedures designed to verify the
identity of the requestor and therefore, the Company will record telephone conversations containing transaction instructions,
request personal identification information before acting upon telephone instructions and send written confirmation statements of
transactions to the address of record.
-----------------------------------------------------------------------------------------------------------------------------------
J. ADDITIONAL INSTRUCTIONS (Additional Beneficiaries, Transfer Company Information etc.)
-----------------------------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------------------------
K. DISCLOSURE NOTICES
-----------------------------------------------------------------------------------------------------------------------------------
FRAUD WARNING: Any Person who with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an
application or files a claim containing a false or deceptive statement may be guilty of insurance fraud.
FOR APPLICANTS IN MAINE AND PENNSYLVANIA: FRAUD WARNING: Any person, who knowingly and with intent to defraud any insurance company
or other person, files an application for insurance containing any materially false information or conceals, for the purpose of
misleading, information concerning any fact hereto commits a fraudulent act, which is a crime and subjects such person to criminal
and civil penalties.
FOR APPLICANTS IN FLORIDA: FRAUD WARNING: Any person who knowingly and with intent to injure, defraud, or deceive any insurer files
a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the
third degree.
FOR APPLICANTS IN ARIZONA: Upon your written request, we will provide you within a reasonable period of time, reasonable, factual
information regarding the benefits and provisions of the annuity contract for which you are applying. If for any reason you are not
satisfied with the contract, you may return the contract within ten days after you receive it. If the contract you are applying
for is a variable annuity, you will receive an amount equal to the sum of (1) the difference between the premiums paid and the
amounts allocated to any account under the contract and (2) the Contract Value on the date the returned contract is received by our
company or agent.
FOR APPLICANTS IN TEXAS: FRAUD WARNING: Any Person who with intent to defraud or knowing that he is facilitating a fraud against an
insurer, submits an application or files a claim containing a false or deceptive statement may be guilty of fraud.
ANA-543 (6/00) 2
<PAGE>
Page 3 of 3 ANA-543 (6/00)
-----------------------------------------------------------------------------------------------------------------------------------
L. INVESTMENT & DCA INSTRUCTIONS: (Allocations must be expressed in whole percentages and total allocation must equal 100%)
-----------------------------------------------------------------------------------------------------------------------------------
PAYMENT DCA TARGET
ALLOCATIONS ALLOCATIONS PORTFOLIO FIXED ACCOUNT OPTIONS
STRATEGIES NON-MVA FIXED OPTION
_________% ______% Growth Strategy _______% 1 yr.
_________% ______% Moderate Growth Strategy
_________% ______% Balanced Growth Strategy MVA FIXED OPTIONS
_________% ______% Conservative Growth Strategy ________% 3 yr.
________% 5 yr
PORTFOLIOS ________% 7 yr.
_________% ______% Large Cap Growth Portfolio ________% 10 yr.
_________% ______% Large Cap Composite Portfolio
_________% ______% Large Cap Value Portfolio
_________% ______% Mid Cap Growth Portfolio
_________% ______% Mid Cap Value Portfolio DCA OPTIONS AND PROGRAM* *These DCA Options are only available if
_________% ______% Small Cap Portfolio Option 1 (the 7 year withdrawal charge
_________% ______% International Equity Portfolio ________% 6 Month DCA Account period) in Section C was selected.
_________% ______% Diversified Equity Portfolio (Monthly DCA Only) The DCA Program will begin 30 days (if
_________% ______% Cash Management Portfolio monthly) or 90 days (if quarterly) from
the date of deposit. Please indicate the
target account(s) in the spaces provided
to the left. The total must equal 100%.
The minimum transfer amount in $100.
FOCUSED ________% 1 yr. DCA Account We reserve the right to adjust the
PORTFOLIOS Frequency (Select one below) number of transfers in order to meet the
_________% ______% Focus Growth Portfolio / / Monthly / / Quarterly minimum transfer amount.
--------------------------------------------------------------------------------------------------------------------
M. STATEMENT OF OWNER
--------------------------------------------------------------------------------------------------------------------
Will this Contract replace an existing life insurance or annuity contract. / / Yes / / No (If yes, please attached transfer forms,
replacement forms and indicate the name and contract number of the issuing company below.)
--------------------------------------------------------------------------------------------------------------------
Company Name Contract Number
I hereby represent my answers to the above questions to be correct and true to the best of my knowledge and belief and agree that
this Deferred Annuity Application Form shall be a part of any Contract issued by the Company. I VERIFY MY UNDERSTANDING THAT THE
VALUE OF PURCHASE PAYMENTS DIRECTED INTO THE VARIABLE INVESTMENT OPTIONS ARE VARIABLE AND NOT GUARANTEED AS TO DOLLAR AMOUNT. IF
THE RETURN OF PURCHASE PAYMENTS IS REQUIRED UNDER THE RIGHT TO EXAMINE PROVISION OF THE CONTRACT, I UNDERSTAND THAT THE COMPANY
RESERVES THE RIGHT TO ALLOCATE MY PURCHASE PAYMENT(S) AND ANY INITIAL PAYMENT ENHANCEMENT(S), IF APPLICABLE, TO THE CASH MANAGEMENT
PORTFOLIO UNTIL THE END OF THE RIGHT TO EXAMINE PERIOD. I FURTHER UNDERSTAND THAT AT THE END OF THE RIGHT TO EXAMINE PERIOD, THE
COMPANY WILL ALLOCATE MY FUNDS ACCORDING TO MY INVESTMENT INSTRUCTIONS. I UNDERSTAND THAT ALL PAYMENTS AND VALUES BASED ON THE
MULTI-YEAR FIXED ACCOUNT OPTIONS ARE SUBJECT TO A MARKET VALUE ADJUSTMENT FORMULA, WHICH MAY RESULT IN UPWARD AND DOWNWARD
ADJUSTMENTS IN AMOUNTS AVAILABLE FOR WITHDRAWAL. I UNDERSTAND THE TERMS OF THE WITHDRAWAL CHARGE PERIOD THAT I SELECTED. I
ACKNOWLEDGE RECEIPT OF THE CURRENT PROSPECTUSES FOR [SEASONS SELECT], INCLUDING THE [SEASONS SERIES TRUST] PROSPECTUSES. I HAVE
READ THEM CAREFULLY AND UNDERSTAND THEIR CONTENTS. I FURTHER VERIFY MY UNDERSTANDING THAT THIS VARIABLE ANNUITY IS SUITABLE TO MY
OBJECTIVES AND NEEDS.
Signed at
----------------------------------------------------------------- --------------------
City State Date
---------------------------------------------- -----------------------------------------------
Owner's Signature Joint Owner's Signature (If Applicable)
----------------------------------------------
Registered Representative's Signature
-----------------------------------------------------------------------------------------------------------------------------------
N. LICENSED/REGISTERED REPRESENTATIVE INFORMATION
-----------------------------------------------------------------------------------------------------------------------------------
Will this Contract replace in whole or in part any existing life insurance or annuity contract? / / Yes / / No
-------------------------------------------------------- ------------------------------
Printed Name of Registered Representative Social Security Number
----------------------------------------------------------------------------------------------- --------------
Representative's Street Address City State Zip
( )
------------------------------------------------ -------------------------------- -------------------------------
Broker/Dealer Firm Name Representative's Phone Number Agent's License ID Number
/ / Option 1 / / Option 2 / / Option 3 / / Option 4 (Check your home office for availability)
-----------------------------------------------------------------------------------------------------------------------------------
FOR OFFICE USE ONLY
-----------------------------------------------------------------------------------------------------------------------------------
</TABLE>
ANA-543 (6/00) 3
