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SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM N-4
REGISTRATION STATEMENT UNDER THE SECURITIES ACT OF 1933
Post-Effective Amendment No. 9 (File No. 33-4174) X
and/or
REGISTRATION STATEMENT UNDER THE INVESTMENT COMPANY ACT OF 1940
Amendment No. 11 (File No. 811-3500) X
IDS LIFE OF NEW YORK ACCOUNT 4
IDS LIFE OF NEW YORK ACCOUNT 5
IDS LIFE OF NEW YORK ACCOUNT 6
IDS LIFE OF NEW YORK ACCOUNT 9
IDS LIFE OF NEW YORK ACCOUNT 10
IDS LIFE OF NEW YORK ACCOUNT 11
___________________________________________________________________
(Exact Name of Registrant)
IDS Life Insurance Company of New York
___________________________________________________________________
(Name of Depositor)
20 Madison Avenue Extension, Albany, NY 12203
___________________________________________________________________
(Address of Depositor's Principal Executive Offices) (Zip Code)
Depositor's Telephone Number, including Area Code (612) 671-3678
Mary Ellyn Minenko, IDS Tower 10, Minneapolis, MN 55440-0010
___________________________________________________________________
(Name and Address of Agent for Service)
It is proposed that this filing will become effective:
immediately upon filing pursuant to paragraph (b) of Rule 486
on (date) pursuant to paragraph (b) of Rule 486
60 days after filing pursuant to paragraph (a) of Rule 486
X on April 29, 1994, pursuant to paragraph (a) of Rule 486
The Registrant has registered an indefinite number or amount of
securities under the Securities Act of 1933 pursuant to Section
24-f of the Investment Company Act of 1940. Registrant's Rule
24f-2 Notice for its most recent fiscal year was filed on or about
February 25, 1994.
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CROSS REFERENCE SHEET
Cross reference sheet showing location in the prospectus of the information
called for by the items enumerated in Part A and B of Form N-4.
Negative answers omitted from prospectus are so indicated.
<TABLE>
<CAPTION>
PART A PART B
Page Number in
Page Number Statement of
Item No. in Prospectus Item No. Additional Information
<C> <C> <C> <C>
1 3 15 31
2 5-6 16 32
3(a) 8-9 17(a) NA
(b) 6-8 (b) NA
(c) 29*
4(a) 9
(b) 10-11 18(a) NA
(c) 9-10 (b) NA
(c) 39
5(a) 3,29 (d) NA
(b) 11 (e) NA
(c) 11-12 (f) 39
(d) 3,12
(e) 28-29 19(a) 39*
(f) NA (b) 16-17*
6(a) 15-17 20(a) 39
(b) 16-17 (b) 39
(c) 17 (c) 39
(d) NA (d) NA
(e) 12
(f) NA 21 34-35
7(a) 13 22 NA
(b) 11,19-21,28
(c) 12,17 23(a) NA
(d) 3 (b) NA
8(a) 24
(b) 13-14
(c) 24-25
(d) 37
(e) 25
(f) 26
9(a) 23-24
(b) 23-24
10(a) 13,14-15,17-18
(b) 17-18
(c) 13,14-15,17-18
(d) NA
11(a) 21-23
(b) NA
(c) 21-22
(d) 14
(e) 6
12(a) 26-28
(b) 6
(c) NA
13 NA
14 30
*Designates page number in the prospectus, which is hereby incorporated by
reference in this Statement of Additional Information.
</TABLE>
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IDS Life of New York Flexible Annuity
Prospectus
April 29, 1994
The Flexible Annuity is an individual deferred fixed/variable
annuity contract offered by IDS Life Insurance Company of New York
(IDS Life of New York), a subsidiary of IDS Life Insurance Company
(IDS Life), which is a subsidiary of IDS Financial Corporation
(IDS). Purchase payments may be allocated among different
accounts, providing variable and/or fixed returns and payouts. The
annuity is available for qualified and non-qualified retirement
plans.
IDS Life Accounts 4, 5, 6, 9, 10 and 11
Sold by: IDS Life Insurance Company of New York
20 Madison Avenue Extension
Albany, NY 12203
Telephone: 518-869-8613
THIS PROSPECTUS CONTAINS THE INFORMATION ABOUT THE VARIABLE
ACCOUNTS THAT YOU SHOULD KNOW BEFORE INVESTING. Refer to "The
variable accounts" in this prospectus.
THE PROSPECTUS IS ACCOMPANIED OR PRECEDED BY THE RETIREMENT ANNUITY
MUTUAL FUND PROSPECTUS FOR IDS LIFE AGGRESSIVE GROWTH FUND, IDS
LIFE INTERNATIONAL EQUITY FUND, IDS LIFE CAPITAL RESOURCE FUND, IDS
LIFE MANAGED FUND, INC., IDS LIFE SPECIAL INCOME FUND, INC. AND IDS
LIFE MONEYSHARE FUND, INC. PLEASE KEEP THESE PROSPECTUSES FOR
FUTURE REFERENCE.
THESE SECURITIES HAVE NOT BEEN APPROVED OR DISAPPROVED BY THE
SECURITIES AND EXCHANGE COMMISSION, OR ANY STATE SECURITIES
COMMISSION, NOR HAS THE SECURITIES AND EXCHANGE COMMISSION OR
ANY STATE SECURITIES COMMISSION PASSED UPON THE ACCURACY OR
ADEQUACY OF THIS PROSPECTUS. ANY REPRESENTATION TO THE CONTRARY
IS A CRIMINAL OFFENSE.
IDS LIFE OF NEW YORK IS NOT A BANK AND THE SECURITIES IT OFFERS ARE
NOT DEPOSITS OR OBLIGATIONS OF, OR GUARANTEED OR ENDORSED BY ANY
BANK NOR ARE THEY INSURED BY THE FEDERAL DEPOSIT INSURANCE
CORPORATION, THE FEDERAL RESERVE BOARD OR ANY OTHER AGENCY.
A Statement of Additional Information (SAI) dated April 29, 1994
(incorporated by reference into this prospectus) has been filed
with the Securities and Exchange Commission (SEC), and is available
without charge by contacting IDS Life of New York at the telephone
number above or by completing and sending the order form on the
last page of this prospectus. The table of contents of the SAI is
on the last page of this prospectus.
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Contents
Key Terms.....................................................p.
The Flexible Annuity in brief.................................p.
Expense summary...............................................p.
Condensed financial information...............................p.
Financial statements..........................................p.
Performance information.......................................p.
The variable accounts.........................................p.
The funds.....................................................p.
Aggressive Growth Fund...................................p.
International Equity Fund................................p.
Capital Resource Fund....................................p.
Managed Fund.............................................p.
Special Income Fund......................................p.
Moneyshare Fund..........................................p.
The fixed account.............................................p.
Buying your annuity...........................................p.
Setting the retirement date...................................p.
Beneficiary...................................................p.
Two ways to make purchase payments............................p.
Charges.......................................................p.
Contract administrative charge...........................p.
Mortality and expense risk fee...........................p.
Surrender charge.........................................p.
Other information on charges.............................p.
Valuing your investment.......................................p.
Number of units..........................................p.
Accumulation unit value..................................p.
Net investment factor................ ...................p.
Factors that affect variable account
accumulation units.......................................p.
Making the most of your annuity...............................p.
Automated dollar - cost averaging during
the accumulation period..................................p.
How dollar - cost averaging works........................p.
Transferring money between accounts......................p.
Transfer policies........................................p.
Two ways to request a transfer or a surrender............p.
Surrendering your contract....................................p.
Surrender policies.......................................p.
Receiving payment when you request a surrender...........p.
Special surrender provisions.............................p.
Changing ownership............................................p.
Benefits in case of death.....................................p.
The annuity payout period.....................................p.
Annuity payout plans.....................................p.
Death after annuity payouts begin........................p.
Transfers between accounts after annuity
payouts begin............................................p.
Taxes.........................................................p.
Voting Rights.................................................p.
About IDS Life of New York....................................p.
Regular and special reports...................................p.
Table of contents of the Statement of Additional
Information...................................................p.
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Key terms
These terms can help you understand details about your annuity.
Annuity - A contract purchased from an insurance company that
offers tax-deferred growth of the contract owner's investment until
earnings are withdrawn, and that can be tailored to meet the
specific needs of the individual during retirement.
Accumulation unit - A measure of the value of each variable account
before annuity payouts begin.
Annuitant - The person on whose life or life expectancy the payouts
are based.
Annuity payouts - An amount paid at regular intervals under one of
several plans available to the owner and/or any other payee. This
amount may be on a variable or fixed basis.
Annuity unit - A measure of the value of each variable account used
to calculate the annuity payouts you receive.
Beneficiary - The person designated to receive annuity benefits in
case of the owner's or annuitant's death.
Close of business - When the New York Stock Exchange (NYSE) closes,
normally 4:00 p.m. Eastern time.
Code - Internal Revenue Code of 1986, as amended.
Contract value - The total value of your annuity before any
applicable surrender charge and any contract administration charge
have been deducted.
Contract year - A period of 12 months, starting on the effective
date of your contract and on each anniversary of the effective
date.
Fixed account - An account to which you may allocate purchase
payments. Amounts allocated to this account earn interest at rates
that are declared periodically by IDS Life of New York.
IDS Life of New York - In this prospectus, "we," "us," "our," and
"IDS Life of New York" refer to IDS Life Insurance Company of New
York.
Mutual funds (funds) - Six IDS Life Retirement Annuity mutual
funds, each with a different investment objective. (See "The
funds.") You may allocate your purchase payments into variable
accounts investing in shares of any or all of these funds.
Owner (you, your) - The person who controls the annuity (decides on
investment allocations, transfers, payout options, etc.). Usually,
but not always, the owner is also the annuitant. The owner is
responsible for taxes, regardless of whether he or she receives the
annuity's benefits.
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Purchase payments - Payments made to IDS Life of New York for an
annuity.
Qualified annuity - An annuity purchased for a retirement plan that
is subject to applicable federal law and any rules of the plan
itself. These plans include:
o Individual Retirement Annuities (IRAs)
o Simplified Employee Pension Plans (SEPs)
o Section 401(k) plans
o Custodial and trusteed pension and profit sharing plans
o Tax Sheltered Annuities (TSAs)
o Section 457 plans.
All other annuities are considered non-qualified annuities.
Retirement date - The date when annuity payouts are scheduled to
begin. You select this date when you start your contract. It can
be changed in the future.
Surrender charge - A deferred sales charge that may be applied if
you surrender your annuity before the retirement date.
Surrender value - The amount you are entitled to receive if you
surrender your annuity. It is the contract value minus any
applicable surrender charge and contract charge.
Valuation date - Any normal business day, Monday through Friday,
that the NYSE is open. The value of each variable account is
calculated at the close of business on each valuation date.
Variable accounts - Six separate accounts to which you may allocate
purchase payments; each invests in shares of one mutual fund. (See
"The variable accounts.") The value of your investment in each
variable account changes with the performance of the particular
fund.
The Flexible Annuity in brief
Purpose: The Flexible Annuity is designed to allow you to build up
funds for retirement. You do this by making one or more investments
(purchase payments) that may earn returns that increase the value
of the annuity. Beginning at a specified future date (the
retirement date), the annuity provides lifetime or other forms of
payouts to you or to anyone you designate.
Ten-day free look: You may return your annuity to your financial
planner or our Albany office within 10 days after it is delivered
to you and receive a full refund of the contract value. No charges
will be deducted. However, you bear the investment risk from the
time of purchase until return of the contract; the refund amount
may be more or less than the payment you made. (Exception: If the
law so requires, all of your purchase payment will be refunded.)
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Accounts: You may allocate your purchase payments among any or all
of:
o six variable accounts, each of which invests in mutual funds
with a particular investment objective. The value of each
variable account varies with the performance of the particular
fund. We cannot guarantee that the value at the retirement date
will equal or exceed the total of purchase payments allocated to
the variable accounts. (p.)
o one fixed account, which earns interest at rates that are
adjusted periodically by IDS Life of New York. (p.)
Buying the annuity: Your IDS personal financial planner will help
you complete and submit an application. Applications are subject
to acceptance at our Albany office. You may buy a non-qualified
annuity or a qualified annuity including an IRA. Payment may be
made either in a lump sum or installments:
o Minimum purchase payment - $2,000 ($1,000 for qualified
annuities) unless you pay in installments by means of a bank
authorization or under a group billing arrangement such as a
payroll deduction.
o Minimum installment payment - $50 monthly; $23.08 bi-weekly
payroll deductions.
o Maximum first-year payment(s) - $50,000 to $1,000,000 depending
on your age.
o Maximum payment for each subsequent year - $50,000. (p.)
Transfers: You may redistribute your money among accounts without
charge at any time until annuity payouts begin, and once per
contract year thereafter. You may establish automated transfers
among the fixed and variable account(s), subject to certain
restrictions. (p.)
Surrenders: You may surrender all or part of your contract value at
any time before the retirement date. You also may establish
automated partial surrenders. Surrenders may be subject to charges
and tax penalties and may have other tax consequences; also,
certain restrictions apply. (p.)
Changing ownership: You may change ownership of a non-qualified
annuity by written instruction, however, such changes of non-
qualified annuities may have federal income tax consequences.
Certain restrictions apply concerning change of ownership of a
qualified annuity. (p.)
Payment in case of death: If you or the annuitant dies before
annuity payouts begin, we will pay the beneficiary an amount at
least equal to the contract value. (p.)
Annuity payouts: The contract value of your investment can be
applied to an annuity payout plan that begins on your retirement
date. You may choose from a variety of plans to make sure that
payouts continue as long as they are needed. If you purchased a
qualified annuity, the payout schedule must meet requirements of
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PAGE 8
the qualified plan. Payouts may be made on a fixed or variable
basis, or both. Total monthly payouts include amounts from each
variable account and the fixed account. (p.)
Taxes: Generally your annuity grows tax deferred until you
surrender it or begin to receive payouts. (Under certain
circumstances, IRS penalty taxes may apply.) Even if you direct
payouts to someone else, you will still be taxed on the income if
you are the owner. Certain state and local governments impose
premium taxes. (p.)
Charges: Your Flexible Annuity is subject to a $6 quarterly ($24
annual) contract administrative charge, a 1% mortality and expense
risk charge, and a 7% surrender charge on purchase payments up to
six contract years old. (p.)
Expense summary
The purpose of this summary is to help you understand the various
costs and expenses associated with the Flexible Annuity.
You pay no sales charge when you purchase the annuity. All costs
that you bear directly or indirectly for the variable accounts and
underlying mutual funds are shown below. Some expenses may vary as
explained under "Contract charges."
Direct charges. These are deducted directly from the contract
value. They include:
o Surrender charge - 7% of purchase payments up to six contract
years old; no charge on earnings and purchase payments six years
old or more.
o Annual contract administrative charge - $24 ($6 per quarter).
Indirect charges. The variable account pays these expenses out of
its assets. They are reflected in the variable account's daily
accumulation unit value and are not charged directly to your
account. They include:
o Mortality and expense risk fee - 1% per year, deducted from the
variable account as a percentage of the average daily net assets
of the underlying fund.
o Operating expenses of underlying mutual funds - management fees
and other expenses deducted as a percentage of average net
assets as follows: *
<TABLE>
<CAPTION>
Aggressive International Capital Special
Growth Equity Resource Managed Income Moneyshare
<S> <C> <C> <C> <C> <C> <C>
Management fees .__% .__% .__% .__% .__% .__%
Other expenses .__ .__ .__ .__ .__ .__
Total** .__% .__% .__% .__% .__% .__%
</TABLE>
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* Premium taxes imposed by some state and local governments are not
reflected in this table.
** Annualized operating expenses of underlying mutual funds at Dec.
31, 1993.
Example*
You would pay the following expenses on a $1,000 investment,
assuming 5% annual return and surrender at the end of each time
period:
1 year $_____ $_____ $_____ $_____ $_____ $_____
3 years _____ _____ _____ _____ _____ _____
5 years _____ _____ _____ _____ _____ _____
10 years _____ _____ _____ _____ _____ _____
You would pay the following expenses on the same investment
assuming no surrender:
1 year $_____ $_____ $_____ $_____ $_____ $_____
3 years _____ _____ _____ _____ _____ _____
5 years _____ _____ _____ _____ _____ _____
10 years _____ _____ _____ _____ _____ _____
This example should not be considered a representation of past or
future expenses. Actual expenses may be more or less than those
shown.
* In this example, the $24 annual contract administrative charge is
approximated as a .___% charge based on our average contract size.
Condensed financial information
(unaudited)
The following tables give per-unit information about the financial
history of each variable account.
Financial statements
The SAI dated April 29, 1994, contains:
o complete audited financial statements of the variable accounts
including:
- statements of net assets as of Dec. 31, 1993;
- statements of operations for the year ended Dec. 31, 1993;
and
- statements of changes in net assets for the years ended
Dec. 31, 1993 and Dec. 31, 1992 (for Accounts 10 and
11, the period from Jan. 13, 1992 when they commenced
operations, to Dec. 31, 1992).
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o complete audited financial statements for IDS Life of New York,
including:
- consolidated balance sheets as of Dec. 31, 1993 and Dec.
31, 1992; and
- related consolidated statements of income and cash flows
for each of three years in the period ended Dec. 31, 1993.
Performance information
Performance information for the variable accounts may appear from
time to time in advertisements or sales literature. In all cases,
such information reflects the performance of a hypothetical
investment in a particular account during a particular time period.
Calculations are performed as follows:
Simple yield - Account 6 (investing in Moneyshare Fund): Income
over a given seven-day period (not counting any change in the
capital value of the investment) is annualized (multiplied by 52)
by assuming that the same income is received for 52 weeks. This
annual income is then stated as an annual percentage return on the
investment.
Compound yield - Account 6: Calculated like simple yield, except
that, when annualized, the income is assumed to be reinvested.
Compounding of reinvested returns increases the yield as compared
to a simple yield.
Yield - all other accounts: Net investment income (income less
expenses) per accumulation unit during a given 30-day period is
divided by the value of the unit on the last day of the period.
The result is converted to an annual percentage.
Average annual total return: Expressed as an average annual
compounded rate of return of a hypothetical investment over a
period of one, five and ten years (or up to the life of the account
if it is less than ten years old). This figure reflects deduction
of all applicable charges, including the contract administrative
charge, mortality and expense risk fee and surrender charge,
assuming a surrender at the end of the illustrated period.
Optional total return quotations may be made that do not reflect a
surrender charge deduction (assuming no surrender).
Aggregate total return: Represents the cumulative change in value
of an investment for a given period (reflecting change in an
account's accumulation unit value). The calculation assumes
reinvestment of investment earnings. Aggregate total return may be
shown by means of schedules, charts or graphs.
Performance information should be considered in light of the
investment objectives and policies, characteristics and quality of
the fund in which the account invests, and the market conditions
during the given time period. Such information is not intended to
indicate future performance. Because advertised yields and total
return figures include all charges attributable to the annuity,
which has the effect of decreasing advertised performance, account
performance should not be compared to that of mutual funds that
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sell their shares directly to the public. (See the SAI for a
further description of methods used to determine yield and total
return for the accounts.)
If you would like additional information about actual performance,
contact your financial planner.
The variable accounts
Purchase payments can be allocated to any or all of the variable
accounts that invest in shares of the following funds:
IDS Life Account Established
Aggressive Growth Fund 11 Oct. 8, 1991
International Equity Fund 10 Oct. 8, 1991
Capital Resource Fund 4 Nov. 12, 1981
Managed Fund 9 Feb. 12, 1986
Special Income Fund 5 Nov. 12, 1981
Moneyshare Fund 6 Nov. 12, 1981
Each variable account meets the definition of a separate account
under federal securities laws. Income, capital gains and capital
losses of each account are credited or charged to that account
alone. No variable account will be charged with liabilities of any
other account or of our general business.
All variable accounts were established under New York law and are
registered together as a single unit investment trust under the
Investment Company Act of 1940 (the 1940 Act). This registration
does not involve any supervision of our management or investment
practices and policies by the SEC.
The funds
Aggressive Growth Fund
Objective: capital appreciation. Invests primarily in common stock
of small and medium-size companies. The fund also may invest in
warrants or debt securities or in large well-established companies
when the portfolio manager believes such investments offer the best
opportunity for capital appreciation.
International Equity Fund
Objective: capital appreciation. Invests primarily in common stock
of foreign issuers and foreign securities convertible into common
stock. The fund also may invest in certain international bonds if
the portfolio manager believes they have a greater potential for
capital appreciation than equities.
Capital Resource Fund
Objective: capital appreciation. Invests primarily in U.S. common
stocks listed on national securities exchanges and other securities
convertible into common stock, diversified over many different
companies in a variety of industries.
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Managed Fund
Objective: maximum total investment return. Invests primarily in
U.S. common stocks listed on national securities exchanges,
securities convertible into common stock, warrants, fixed income
securities (primarily high-quality corporate bonds), and
money-market instruments. The fund invests in many different
companies in a variety of industries.
Special Income Fund
Objective: to provide a high level of current income while
conserving the value of the investment for the longest time period.
Invests primarily in high-quality, lower-risk corporate bonds
issued by many different companies in a variety of industries, and
in government bonds.
Moneyshare Fund
Objective: maximum current income consistent with liquidity and
conservation of capital. Invests in high-quality money market
securities with remaining maturities of 13 months or less. The
fund also will maintain a dollar-weighted average portfolio
maturity not exceeding 90 days. The fund attempts to maintain a
constant net asset value of $1 per share.
The Internal Revenue Service (IRS) has issued final regulations
relating to the diversification requirements under section 817(h)
of the Code. Each mutual fund intends to comply with these
requirements.
The U.S. Treasury and the IRS have indicated they may provide
additional guidance concerning how many variable accounts may be
offered and how many exchanges among variable accounts may be
allowed before the owner is considered to have investment control,
and thus is currently taxed on income earned within variable
account assets. We do not know at this time what the additional
guidance will be or when action will be taken. We reserve the
right to modify the contract, as necessary, to ensure that the
owner will not be subject to current taxation as the owner of the
variable account assets.
We intend to comply with all federal tax laws to ensure that the
contract continues to qualify as an annuity for federal income tax
purposes. We reserve the right to modify the contract as necessary
to comply with any new tax laws.
IDS Life is the investment adviser for each of the funds. IDS Life
cannot guarantee that the funds will meet their investment
objectives. Please read the Retirement Annuity Mutual Fund
prospectus for complete information on investment risks,
deductions, expenses and other facts you should know before
investing. It is available by contacting IDS Life of New York at
the address or telephone number on the front of this publication,
or from your financial planner.
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PAGE 13
The fixed account
Purchase payments can also be allocated to the fixed account. The
cash value of the fixed account increases as interest is credited
to the account. Purchase payments and transfers to the fixed
account become part of the general account of IDS Life of New York,
the company's main portfolio of investments. Interest is credited
daily and compounded annually. We may change the interest rates
from time to time.
Because of exemptive and exclusionary provisions, interests in the
fixed account have not been registered under the Securities Act of
1933 (1933 Act), nor is the fixed account registered as an
investment company under the 1940 Act. Accordingly, neither the
fixed account nor any interests in it are generally subject to the
provisions of the 1933 or 1940 Acts, and we have been advised that
the staff of the SEC has not reviewed the disclosures in this
prospectus that relate to the fixed account. Disclosures regarding
the fixed account, however, may be subject to certain generally
applicable provisions of the federal securities laws relating to
the accuracy and completeness of statements made in prospectuses.
Buying your annuity
Your financial planner will help you prepare and submit your
application, and send it along with your initial purchase payment
to our Albany office. As the owner, you have all rights and may
receive all benefits under the contract. Annuities cannot be owned
in joint tenancy. You cannot buy an annuity or be an annuitant if
you are 91 or older.
When you apply, you can select:
o the account(s) in which you want to invest;
o how you want to make purchase payments;
o the date you want to start receiving annuity payouts (the
retirement date); and
o a beneficiary.
If your application is complete, we will process it and apply your
purchase payment to your account(s) within two days after we
receive it. If your application is accepted, we will send you a
contract. If we cannot accept your application within five days,
we will decline it and return your payment. We will credit
additional purchase payments to your account(s) at the next close
of business.
Setting the retirement date
You'll start receiving annuity payouts on the retirement date you
select. This date can be aligned with your actual retirement from
a job, or it can be a different future date, depending on your
needs and goals and on certain restrictions. You can also change
the date, provided you send us written instructions at least 30
days before the change.
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PAGE 14
For non-qualified annuities, the retirement date you select must
be:
o no earlier than the 60th day after the contract's effective
date; and
o no later than the annuitant's 85th birthday (or before the 10th
contract anniversary, if purchased after age 75).
For qualified annuities, to avoid IRS penalty taxes, the retirement
date generally must be:
o on or after the annuitant reaches age 59 1/2; and
o by April 1 of the year following the calendar year when the
annuitant reaches age 70 1/2.
If you are taking the minimum IRA or TSA distributions as required
by the Code from another tax-qualified investment, or in the form
of partial surrenders from this annuity, annuity payouts can start
as late as the annuitant's 85th birthday or the 10th contract
anniversary.
Beneficiary
If death benefits become payable before the retirement date, your
named beneficiary will receive all or part of the contract value.
If there is no named beneficiary, then you or your estate will be
the beneficiary. (See "Payment in case of death" for more about
beneficiaries.)
Minimum purchase payment
If Single payment:
Non-qualified: $2,000
Qualified: $1,000
If installment payments
$50 monthly; $23.08 bi-weekly
Installments must total at least $600 in the first year**
**If you make no purchase payments for 36 months, and your previous
payments total $600 or less, we have the right to give you 30 days'
written notice and pay you the total value of your annuity in a
lump sum.
Minimum additional purchase payment(s): $50
Maximum first-year payment(s)
This maximum is based on your age or age of the annuitant (whomever
is older) on the effective date of the contract.
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PAGE 15
Up to age 75 $1 million
76 to 85 $500,000
86 to 90 $50,000
Maximum payment each subsequent year $50,000*
*These limits apply in total to all IDS Life of New York annuities
you own. We reserve the right to increase maximum limits or reduce
age limits. For qualified annuities the qualified plan's limits on
annual contribution also apply.
Two ways to make purchase payments
1 By letter
Send your check along with your name and account number to:
Regular mail:
IDS Life Insurance Company of New York
P.O. Box 5144
Albany, NY 12205
Express mail:
IDS Life Insurance Company of New York
20 Madison Avenue Extension
Albany, NY 12203
2 By scheduled payment plan
Your financial planner can help you set up:
o an automatic payroll deduction, salary reduction, or other group
billing arrangement;
o a bank authorization.
Charges
Contract administrative charge
This fee is for establishing and maintaining your records. We
deduct $6 from the contract value at the end of each contract
quarter (each three-month period measured from the effective date
of your contract). Annual charge: $24.
If you surrender your contract, the quarterly charge will be
deducted at the time of surrender. The quarterly charge cannot be
increased and does not apply after annuity payouts begin.
Mortality and expense risk fee
This fee is to cover the annuity mortality risk and annuity expense
risk and is applied daily to the variable accounts and reflected in
the unit values of the accounts. Annually it totals 1% of their
average daily net assets. Approximately two-thirds of this amount
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is for our assumption of mortality risk, and one-third is for our
assumption of expense risk. This fee does not apply to the fixed
account.
Mortality risk arises because of our guarantee to make annuity
payouts according to the terms of the contract, no matter how long
a specific annuitant lives and no matter how long the entire group
of IDS Life of New York annuitants live. If, as a group, IDS Life
of New York annuitants outlive the life expectancy we have assumed
in our actuarial tables, then we must take money from our general
assets to meet our obligations. If, as a group, IDS Life of New
York annuitants do not live as long as expected, we could profit
from the mortality risk fee.
Expense risk arises because the contract administrative charge
cannot be increased and may not cover our expenses. Any deficit
would have to be made up from our general assets. We could profit
from the expense risk fee if the annual contract administrative
charge is more than sufficient to meet expenses.
We do not plan to profit from the contract administrative charge.
However, we hope to profit from the mortality and expense risk fee.
We may use any profits realized from this fee for any proper
corporate purpose, including, among others, payment of distribution
(selling) expenses. We do not expect that the surrender charge,
discussed in the following paragraphs, will cover sales and
distribution expenses.
Surrender charge
If you surrender part or all of your contract, you may be subject
to a surrender charge. The surrender amount you request is
determined by drawing from your total contract value in the
following order:
1. First we surrender any contract earnings (contract value minus
all purchase payments received and not previously surrendered).
There is no surrender charge on contract earnings.
2. Next, if necessary, we surrender purchase payments six contract
years old or more and not previously surrendered. There is no
surrender charge on these old purchase payments.
3. Finally, if necessary, we surrender purchase payments up to six
contract years old and not previously surrendered. A surrender
charge of 7% applies to any amount surrendered from these new
purchase payments.
The surrender charge is calculated so that the total amount
surrendered, minus any surrender charge, equals the amount you
request for:
o a total surrender, the surrender charge equals the amount
withdrawn from new purchase payments times 7%; and
o a partial surrender, the surrender charge equals the amount
withdrawn from new purchase payments divided by 0.93 times 7%.
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Example of surrender charge on new purchase payments
you request..............$1,000 partial surrender = $1,075.27
.93
Total amount surrendered.........$1,075.27
X 0.07
Total surrender charge...........$ 75.27
There are no surrender charges for:
o amounts surrendered after the later of the annuitant attaining
age 65, or the 10th contract anniversary;
o contracts settled using an annuity payout plan; and
o death benefits.
Other information on charges
IDS Financial Corporation (IDS) makes certain custodial services
available to some custodial and trusteed pension and profit sharing
plans and 401(k) plans funded by IDS Life of New York annuities.
Fees for these services start at $30 per calendar year per
participant. A termination fee for owners under 59 1/2 will be
charged (fee waived in case of death or disability).
Possible group reductions - In some cases (for example an employer
making the annuity available to employees) lower sales and
administrative expenses may be incurred due to the size of the
group, the average contribution and the use of group enrollment
procedures. In such cases, we may be able to reduce or eliminate
the contract administrative and surrender charges. However, we
expect this to occur infrequently.
Valuing your investment
Here is how your accounts are valued:
Fixed account: The amounts allocated to the fixed account are
valued directly in dollars and equal the sum of your purchase
payments, plus interest earned, less any amounts surrendered or
transferred.
Variable accounts: Amounts allocated to the variable accounts are
converted into accumulation units. Each time you make a purchase
payment or transfer amounts into one of the variable accounts, a
certain number of accumulation units are credited to your contract
for that account. Conversely, each time you take a partial
surrender, transfer amounts out of a variable account, or are
assessed a contract administrative charge, a certain number of
accumulation units are subtracted from your contract.
The accumulation units are the true measure of investment value in
each account during the accumulation period. They are related to,
but not the same as, the net asset value of the underlying fund.
The dollar value of each accumulation unit can rise or fall daily
depending on the performance of the underlying mutual fund and on
certain fund expenses. Here is how unit values are calculated:
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Number of units:
To calculate the number of accumulation units for a particular
account, we divide your investment by the current accumulation unit
value.
Accumulation unit value:
The current accumulation unit value for each variable account
equals the last value times the account's current net investment
factor.
Net investment factor:
o Determined each business day by adding the underlying mutual
fund's current net asset value per share plus per share amount
of any current dividend or capital gain distribution; then
o dividing that sum by the previous net asset value per share; and
o subtracting the percentage factor representing the mortality and
expense risk fee from the result.
Because the net asset value of the underlying mutual fund may
fluctuate, the net investment factor may be greater or less than
one, and the accumulation unit value may increase or decrease. You
bear this investment risk in a variable account.
Factors that affect variable account accumulation units
Accumulation units may change in two ways: in number and in value.
Here are the factors that influence those changes:
The number of accumulation units you own may fluctuate due to:
o additional purchase payments allocated to the variable accounts;
o transfers into or out of the account(s);
o partial surrenders;
o surrender charges; and/or
o contract administrative charges.
Accumulation unit values may fluctuate due to:
o changes in underlying mutual fund(s) net asset value;
o dividends distributed to the variable account(s);
o capital gains or losses of underlying mutual funds;
o mutual fund operating expenses; and/or
o mortality and expense risk fees.
Making the most of your annuity
Automated dollar-cost averaging during the accumulation period
You can use automated transfers to take advantage of dollar-cost
averaging (investing a fixed amount at regular intervals). For
example, you might have a set amount transferred monthly from a
relatively conservative variable account to a more aggressive one,
or to several others.
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This systematic approach can help you benefit from fluctuations in
accumulation unit values caused by fluctuations in the market
value(s) of the underlying mutual fund(s). Since you invest the
same amount each period, you automatically acquire more units when
the market value falls, fewer units when it rises. The potential
effect is to lower your average cost per unit and increase your
long-term return. For specific features contact your financial
planner.
How dollar-cost averaging works
Amount Accumulation Number of units
Month invested unit value purchased
Jan $100 $20 5.00
Feb 100 16 6.25
Mar 100 9 11.11
Apr 100 5 20.00
May 100 7 14.29
June 100 10 10.00
July 100 15 6.67
Aug 100 20 5.00
Sept 100 17 5.88
Oct 100 12 8.33
(footnotes to table) By investing an equal number of dollars each
month...
(arrow in table pointing to April) you automatically buy more units
when the per unit market price is low
(arrow in table pointing to August) and fewer units when the per
unit market price is high.
You have paid an average price of only $10.81 per unit over the 10
months, while the average market price actually was $13.10.
Dollar-cost averaging does not guarantee that any variable account
will gain in value, nor will it protect against a decline in value
if market prices fall. However, if you can continue to invest
regularly throughout changing market conditions, it can be an
effective strategy to help meet your long term goals.
Transferring money between accounts
You may transfer money from one account, including the fixed
account, to another before the annuity payouts begin. If we
receive your request before the close of business, we will process
it that day. Requests received after the close of business will be
processed the next business day. There is no charge for transfers.
Before making a transfer, you should consider the risks involved in
switching investments.
We may suspend or modify transfer privileges at any time. Certain
restrictions apply to transfers involving the fixed account. (For
information on transfers after annuity payouts begin, see "The
annuity payout period.")
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Transfer policies
o You may transfer contract values between the variable accounts,
or from the variable account(s) to the fixed account at any
time. However, if you have made a transfer from the fixed
account to the variable account(s), you may not make a transfer
from any variable account back to the fixed account until the
next contract anniversary.
o You may transfer contract values from the fixed account to the
variable account(s) once a year during a 31-day transfer period
starting on each contract anniversary (except for automated
transfers, which can be set up for transfer periods of your
choosing subject to certain minimums.)
o If we receive your transfer request within 30 days before the
contract anniversary date, the transfer from the fixed account
to the variable account(s) will be effective on the anniversary.
o If we receive your request on or within 30 days after the
contract anniversary date, the transfer from the fixed account
to the variable account(s) will be effective on the day we
receive it.
o We will not accept requests for transfers from the fixed account
at any other time.
o No transfers may be made to or from the fixed account once
annuity payouts begin.
Two ways to request a transfer or surrender
1 By letter
Send your name, account number, Social Security number or Taxpayer
Identification number and signed request for a transfer or
surrender to:
Regular mail:
IDS Life Insurance Company of New York
P.O. Box 5144
Albany, NY 12205
Express mail:
IDS Life Insurance Company of New York
20 Madison Avenue Extension
Albany, NY 12203
Minimum amount
Mail transfers: $250 or entire account balance
Mail surrenders: none
Maximum amount
Mail transfers: none-up to contract value
Mail surrenders: none-up to contract value
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2 By automated transfers and automated partial surrenders
o Your financial planner can help you set up automated transfers
among your accounts or partial surrenders from the accounts.
Start or stop this service by written request or other method
acceptable to IDS Life of New York. You must allow 30 days for IDS
Life of New York to change any instructions that are currently in
place.
o Automated transfers from the fixed to variable account(s) may
not exceed an amount that, if continued, would deplete the fixed
account within 12 months.
o Automated transfers and automated partial surrenders are subject
to all of the contract provisions and terms, including transfer
of contract values between accounts. Automated surrenders may
be restricted by applicable law under some contracts.
o You may not make additional purchase payments if automated
partial surrenders are in effect.
o Automated partial surrenders may result in IRS taxes and
penalties on all or part of the amount surrendered.
Minimum amount
Automated transfers or surrenders: $50
Maximum amount
Automated transfers or surrenders: None - except for automated
transfers from the fixed
account
Surrendering your contract
As owner, you may surrender all or part of your contract at any
time before annuity payouts begin by sending a written request or
calling IDS Life of New York. For total surrenders we will compute
the value of your contract at the close of business after we
receive your request. We may ask you to return the contract. You
may have to pay surrender charges (see "Surrender charge") and IRS
taxes and penalties (see "Taxes"). No surrenders may be made after
annuity payouts begin.
Surrender policies
If you have a balance in more than one account and request a
partial surrender, we will withdraw money from all your accounts in
the same proportion as your value in each account correlates to
your total contract value, unless you request otherwise.
Receiving payment when you request a surrender
By regular or express mail:
o Payable to owner.
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o Normally mailed to address of record within seven days after
receiving your request. However, we may postpone the payment
if:
-the surrender amount includes a purchase payment check that
has not cleared;
-the NYSE is closed, except for normal holiday and weekend
closings;
-trading on the NYSE is restricted, according to SEC rules;
-an emergency, as defined by SEC rules, makes it impractical
to sell securities or value the net assets of the accounts;
or
-the SEC permits us to delay payment for the protection of
security holders.
Note: The express mail delivery charges you pay will vary. The
express mailing cost for partial surrenders is deducted from the
remaining balance, whereas the express mailing cost for full
surrenders is deducted from the proceeds.
Special surrender provisions
Participants in Tax-Sheltered Annuities: The Code imposes certain
restrictions on your right as owner to receive early distributions
from a TSA:
o Distributions attributable to salary reduction contributions
made after Dec. 31, 1988, plus the earnings on them, or to
transfers or rollovers of such amounts from other contracts, may
be made from the TSA only if:
-you have attained age 59 1/2;
-you have become disabled as defined in the Code;
-you have separated from the service of the employer who
purchased the annuity; or
-the distribution is made to your beneficiary because of your
death.
o If you encounter a financial hardship (within the meaning of the
Code), you may receive a distribution of all contract values
attributable to salary reduction contributions made after Dec.
31, 1988, but not the earnings on them.
o Even though a distribution may be permitted under the above
rules, it still may be subject to IRS taxes and penalties. (See
"Taxes.")
o The above restrictions on the right to receive a distribution do
not affect the availability of the amount credited to the
contract as of Dec. 31, 1988. The restrictions do not apply to
transfers or exchanges of contract value within the annuity, or
to another registered variable annuity contract or investment
vehicle available through the employer.
o If the contract has a loan provision, the right to receive a
loan from your fixed account continues to exist and is described
in detail in your contract. You may borrow from the contract
value allocated to the fixed account.
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o For certain types of contributions under a TSA contract to be
excluded from taxable income, the employer must comply with
certain nondiscrimination requirements. You should consult your
employer to determine whether the nondiscrimination rules apply
to you.
Changing ownership
You may change ownership of your non-qualified annuity at any time
by filing a change of ownership with us at our Albany office. The
change will become binding upon us when we receive and record it.
We take no responsibility for the validity of the change.
If you have a non-qualified annuity, you may lose your tax
advantages by transferring, assigning or pledging any part of it.
(See "Taxes.")
If you have a qualified annuity, you may not sell, assign,
transfer, discount or pledge your contract as collateral for a
loan, or as security for the performance of an obligation or for
any other purpose to any person except IDS Life of New York.
However, if the owner is a trust or custodian, or an employer
acting in a similar capacity, ownership of a contract may be
transferred to the annuitant.
Benefits in case of death
If you or the annuitant dies (or, for qualified annuities, if the
annuitant dies) before annuity payouts begin, we will pay the
beneficiary as follows.
If death occurs before the annuitant's 75th birthday, the
beneficiary receives the greatest of:
o the contract value; or
o the contract value as of the most recent 6th contract
anniversary, minus any surrenders since that anniversary; or
o purchase payments, minus any surrenders.
If death occurs on or after the annuitant's 75th birthday, the
beneficiary receives the greater of:
o the contract value; or
o the contract value as of the most recent 6th contract
anniversary, minus any surrenders since that anniversary.
If your spouse is sole beneficiary under a non-qualified annuity
and you die before the retirement date, your spouse may keep the
annuity as owner. To do this your spouse must, within 60 days
after we receive proof of death, give us written instructions to
keep the contract in force.
Under a qualified annuity, if the annuitant dies before reaching
age 70 1/2 and before the retirement date, and the spouse is the
only beneficiary, the spouse may keep the annuity in force until
the date on which the annuitant would have reached age 70 1/2. To
do this, the spouse must give us written instructions within 60
days after we receive proof of death.
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Payments: We will pay the beneficiary in a single sum unless you
have given us other written instructions, or the beneficiary may
receive payouts under any annuity payout plan available under this
contract if:
o the beneficiary asks us in writing within 60 days after we
receive proof of death;
o payouts begin no later than one year after death; and
o the payout period does not extend beyond the beneficiary's life
or life expectancy.
When paying the beneficiary, we will determine the contract's value
at the next close of business after our death claim requirements
are fulfilled. Interest, if any, will be paid from the date of
death at a rate no less than required by law. We will mail payment
to the beneficiary within seven days after our death claim
requirements are fulfilled. (See "Taxes.")
The annuity payout period
As owner of the contract, you have the right to decide how and to
whom annuity payouts will be made starting at the retirement date.
You may select one of the annuity payout plans outlined below, or
we will mutually agree on other payout arrangements. The amount
available for payouts under the plan you select is the contract
value on your retirement date. No surrender charges are deducted
under the payout plans listed below.
You also decide whether annuity payouts are to be made on a fixed
or variable basis, or a combination of fixed and variable. Amounts
of fixed and variable payouts depend on:
o the annuity payout plan you select;
o the annuitant's age and, in most cases, sex;
o the annuity table in the contract;
o the amounts you allocated to the account(s) at settlement.
In addition, for variable payouts only, amounts depend on the
investment performance of the account(s) you select. These payouts
will vary from month to month because the performance of the
underlying mutual funds will fluctuate. (In the case of fixed
annuities, payouts remain the same from month to month.)
Annuity payout plans
You may choose any one of these annuity payout plans by giving us
written instructions at least 30 days before contract values are to
be used to purchase the payout plan:
o Plan A - Life annuity - no refund: Monthly payouts are made
until the annuitant's death. Payouts end with the last payout
before the annuitant's death; no further payouts will be made.
This means that if the annuitant dies after only one monthly payout
has been made, no more payouts will be made.
o Plan B - Life annuity with five, ten or fifteen years certain:
With this payout plan the annuitant will choose a guaranteed payout
period of five, ten or fifteen years. This election will determine
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PAGE 25
the length of the payout period to the beneficiary if the annuitant
should die before the elected period has expired. The guaranteed
payout period is calculated from the annuitant's retirement date.
If the annuitant outlives the elected guaranteed payout period,
payouts will continue until the annuitant's death.
o Plan C - Life annuity - installment refund: Monthly payouts are
made until the annuitant's death, with our guarantee that payouts
will continue for some period of time. Payouts will be made for at
least the number of months determined by dividing the amount
applied under this option by the first monthly payout, whether or
not the annuitant is living.
o Plan D - Joint and last survivor life annuity - no refund:
Monthly payouts are made to the annuitant and a joint annuitant
while both are living. If either annuitant dies, monthly payouts
continue at the full amount until the death of the surviving
annuitant. Payouts end with the death of the second annuitant.
o Plan E - Payouts for a specified period (available as a fixed
payout only): The annuitant can choose between a specific payout
period of 10 to 30 years. Payouts will only be made for the number
of years specified whether the annuitant is living or not.
Depending on the time period selected, it is foreseeable that an
annuitant can outlive the payout period selected. In addition, a
10% IRS penalty tax could apply under this payout plan. (See
"Taxes".)
Retrictions for some qualified plans: If you purchased a qualified
annuity, you must select a payout plan that provides for payouts:
o over the life of the annuitant;
o over the joint lives of the annuitant and a designated
beneficiary;
o for a period not exceeding the life expectancy of the
annuitant; or
o for a period not exceeding the joint life expectancies
of the annuitant and a designated beneficiary.
If we do not receive instructions: You must give us written
instructions for the annuity payouts at least 30 days before the
annuitant's retirement date. If you do not, we will make payouts
under Plan B, with 120 monthly payouts guaranteed.
If monthly payouts would be less than $20: We will calculate the
amount of monthly payouts at the time the contract value is used to
purchase a payout plan. If the calculations show that monthly
payouts would be less than $20, we have the right to pay the
contract value to the owner in a lump sum.
Death after annuity payouts begin
If you or the annuitant dies after annuity payouts begin, any
amount payable to the beneficiary will be provided in the annuity
payout plan in effect.
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Transfers between accounts after annuity payouts begin
After the annuity payouts begin, you may transfer the value of your
annuity from one variable account to another once each contract
year. You must send us written instructions to do this. We will
make the transfer at the next close of business after we receive
your instructions.
Taxes
Generally, under current law, any increase in your contract value
is not taxable until you receive a payout or surrender. (See
detailed discussion below.) Any portion of the annuity payouts and
any surrenders you request that represent ordinary income are
normally taxable. You will receive a 1099 tax information form for
any year in which a taxable distribution was made.
Annuity payouts under non-qualified annuities: A portion of each
payout will be ordinary income and subject to tax, and a portion of
each payout will be considered a return of part of your investment
and will not be taxed. All amounts received after your investment
in the annuity is fully recovered will be subject to tax.
Tax law requires that all non-qualified deferred annuity contracts
issued by the same company to the same owner during a calendar year
are to be taxed as a single, unified contract when distributions
are taken from any one of such contracts.
Annuity payouts under qualified annuities: Under a qualified
annuity, the entire payout generally will be includable as ordinary
income and subject to tax except to the extent that contributions
were made with after-tax dollars. If you or your employer invested
in your contract with pre-tax dollars as part of a qualified
retirement plan, such amounts are not considered to be part of your
investment in the contract and will be taxed when paid to you.
Surrenders: If you surrender part or all of your contract before
your annuity payouts begin, your surrender payment will be taxed to
the extent that the value of your contract exceeds your investment.
You also may have to pay a 10% IRS penalty for surrenders before
reaching age 59 1/2. For qualified annuities, other penalties may
apply if you surrender your annuity before your plan specifies that
you can receive payouts.
Death benefits to beneficiaries: The death benefit under an
annuity is not tax exempt. Any amount received by the beneficiary
that represents previously deferred earnings within the contract,
is taxable as ordinary income to the beneficiary in the year(s) he
or she receives the payment.
Annuities owned by corporations, partnerships or trusts: Any
annual increase in the value of annuities held by such entities
generally will be treated as ordinary income received during that
year. This provision is effective for purchase payments made after
Feb. 28, 1986. However, if the trust was set up for the benefit of
a natural person only, the income will continue to be tax-deferred.
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Penalties: If you receive amounts from your contract before
reaching age 59 1/2, you may have to pay a 10% IRS penalty on the
amount includable in your ordinary income. However, this penalty
will not apply to any amount received by you or your beneficiary:
o because of your death;
o because you become disabled (as defined in the Code);
o if the distribution is part of a series of substantially equal
periodic payments, made at least annually, over your life or
life expectancy (or joint lives or life expectancies of you and
your beneficiary); or
o if it is allocable to an investment before Aug. 14, 1982 (except
for qualified annuities).
For a qualified annuity, other penalties or exceptions may apply if
you surrender your annuity before your plan specifies that payouts
can be made.
Withholding, generally: If you receive all or part of the contract
value from an annuity, withholding may be imposed against the
taxable income portion of the payout. Any withholding that is done
represents a prepayment of your tax due for the year. You take
credit for such amounts on the annual tax return that you file.
If the payout is part of an annuity payout plan, the amount of
withholding generally is computed using payroll tables. You can
provide us with a statement of how many exemptions to use in
calculating the withholding. As long as you've provided us with a
valid Social Security number or Taxpayer Identification number, you
can elect not to have any withholding occur.
If the distribution is any other type of payment (such as a partial
or full surrender) withholding is computed using 10% of the taxable
portion. Similar to above, as long as you've provided us with a
valid Social Security number or Taxpayer Identification number, you
can elect not to have this withholding occur.
Some states also impose withholding requirements similar to the
federal withholding described above.
Withholding from qualified annuities: If you receive directly all
or part of the contract value from a qualified annuity (except an
IRA), mandatory 20% income tax withholding generally will be
imposed at the time the payout is made. This mandatory withholding
is in place of the elective withholding discussed above. This
mandatory withholding will not be imposed if:
o instead of receiving the distribution check, you elect to have
the distribution rolled over directly to an IRA or another
eligible plan;
o the payout is one in a series of substantially equal periodic
payouts, made at least annually, over your life or life
expectancy (or the joint lives or life expectancies of you and
your beneficiary) or over a specified period of 10 years or
more; or
o the payment is a minimum distribution required under the Code.
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Payments made to a surviving spouse instead of being directly
rolled over to an IRA may also be subject to 20% mandatory income
tax withholding.
State withholding also may be imposed on taxable distributions.
Transfer of ownership of a non-qualified annuity: If you make such
a transfer without receiving adequate consideration, the transfer
is considered a gift, and also may be considered a surrender for
federal income tax purposes. If the gift is a currently taxable
event, the amount of the earnings at the time of the transfer will
be taxed to the original owner, who also may be subject to a 10%
IRS penalty as discussed earlier. In this case, the new owner's
investment in the annuity will be the value of the annuity at the
time of the transfer.
Exchanges: Code section 1035 generally provides that no gain or
loss is recognized on the exchange of one annuity contract for
another annuity contract. If the old contract contained premium
payments made prior to Aug. 14, 1982, the tax rules which
previously applied to that investment will continue to apply.
However, not all characteristics of the old contract carry forward
to your new contract. The IRS 10% penalty and required
distribution-at-death rules may apply to your new contract.
Special rules and procedures must be followed in order to take
advantage of Code section 1035. If you consider such a
transaction, you should consult your tax advisor before preceeding.
Collateral assignment of a non-qualified annuity: If you
collaterally assign or pledge your contract, earnings on purchase
payments you made on or after Aug. 13, 1982 will be taxed to you
like a surrender.
Important: Our discussion of federal tax laws is based upon our
understanding of these laws as they are currently interpreted.
Federal tax laws or current interpretations of them may change.
For this reason and because tax consequences are complex and highly
individual and cannot always be anticipated, you should consult a
tax adviser if you have any questions about taxation of your
contract.
Voting rights
As a contract owner with investments in the variable account(s),
you may vote on important mutual fund policies until annuity
payouts begin. Once they begin, the person receiving them has
voting rights. We will vote fund shares according to the
instructions of the person with voting rights.
Before annuity payouts begin, the number of votes you have is
determined by applying your percentage interest in each variable
account to the total number of votes allowed to the account.
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After payouts begin, the number of votes you have is equal to:
o the reserve held in each account for your contract, divided by
o the net asset value of one share of the applicable underlying
mutual fund.
As we make annuity payouts, the reserve for your contract
decreases; therefore, the number of votes also will decrease.
We calculate votes separately for each account not more than 60
days before a shareholders' meeting. Notice of these meetings,
proxy materials and a statement of the number of votes to which the
voter is entitled, will be sent.
We will vote shares for which we have not received instructions in
the same proportion as the votes for which we have received
instructions. We also will vote the shares for which we have
voting rights in the same proportion as the votes for which we have
received instructions.
About IDS Life of New York
The Flexible Annuity is issued by IDS Life of New York. IDS Life
of New York is a wholly owned subsidiary of IDS Life, which is a
wholly owned subsidiary of IDS. IDS is a wholly owned subsidiary
of the American Express Company (American Express). American
Express is a financial services company principally engaged through
subsidiaries (in addition to IDS) in travel related services,
investment services and international banking services. IDS Life
of New York is a stock life insurance company organized in 1972
under the laws of the State of New York and is located at 20
Madison Avenue Extension, Albany, New York. IDS Life of New York
is licensed in New York and North Dakota and conducts a
conventional life insurance business in the state of New York.
IDS Financial Services Inc. is the principal underwriter for the
Accounts. Its home office is IDS Tower 10, Minneapolis, MN 55440-
0010. IDS Financial Services Inc. is a wholly owned subsidiary of
IDS.
The IDS family of companies offers not only insurance and
annuities, but also mutual funds, investment certificates and a
broad range of financial management services.
As a subsidiary of IDS, IDS Life of New York is part of a 100-year
tradition of excellent service and responsible financial
management. Today, the IDS group of companies owns or manages
assets of more than __ billion.
IDS Financial Services Inc., serves over __ individuals and
businesses through its nationwide network of more than ___ offices
and more than _____ planners.
Other subsidiaries provide investment management and related
services for pension, profit-sharing, employee savings and
endowment funds of businesses and institutions.
<PAGE>
PAGE 30
Regular and special reports
Services
To help you track and evaluate the performance of your annuity, IDS
Life of New York provides:
Quarterly statements showing the value of your investment.
Annual reports containing required information on the annuity and
its underlying investments.
A personalized annuity progress report detailing the cumulative
return since the contract was purchased and the average annual rate
of return on your investments. This report, which is unique in the
industry, is available upon request from your financial planner.
Table of contents of the Statement of Additional Information
IDS Preferred Retirement Account..............p.
Performance information.......................p.
Rating agencies...............................p.
Principal underwriter.........................p.
Independent auditors..........................p.
Prospectus....................................p.
Financial statements -
IDS Life of New York Accounts 4, 5, 6, 9, 10 and 11........p.
IDS Life Insurance Company of New York.....................p.
___________________________________________________________________
Please check the appropriate box to receive a copy of the Statement
of Additional Information for:
_____ IDS Life of New York Flexible Annuity
_____ IDS Life Retirement Annuity Mutual Funds
Please return this request to:
IDS Life of New York Annuity Service
IDS Life Insurance Company of New York
P.O. Box 5144
Albany, NY 12205
Your name _______________________________________________________
Address _________________________________________________________
City ______________________ State ______________ Zip ___________
<PAGE>
PAGE 31
STATEMENT OF ADDITIONAL INFORMATION
for
FLEXIBLE ANNUITY
IDS LIFE OF NEW YORK ACCOUNTS 4, 5, 6, 9, 10 AND 11
April 29, 1994
IDS Life of New York Accounts 4, 5, 6, 9, 10 and 11 are separate
accounts established and maintained by IDS Life Insurance Company
of New York (IDS Life of New York).
This Statement of Additional Information, dated April 29, 1994, is
not a prospectus. It should be read together with the accounts'
prospectus, dated April 29, 1994, which may be obtained from your
IDS personal financial planner, or by writing or calling IDS Life
of New York Annuity Service at the address or telephone number
below.
IDS Life of New York Annuity Service
20 Madison Avenue Extension
Albany, NY 12203
(518) 869-8613
<PAGE>
PAGE 32
TABLE OF CONTENTS
IDS Preferred Retirement Account..............................p. 3
Performance Information.......................................p. 4
Calculating Annuity Payouts...................................p. 6
Rating Agencies...............................................p. 8
Principal Underwriter.........................................p. 9
Independent Auditors..........................................p. 9
Prospectus....................................................p. 9
Financial Statements
- IDS Life of New York Accounts 4, 5, 6, 9, 10
and 11............................................p.
- IDS Life Insurance Company of New York............p.
<PAGE>
PAGE 33
IDS PREFERRED RETIREMENT ACCOUNT
The Flexible Annuity may be used to fund the IDS Preferred
Retirement Account (PRA) as a way to build tax-deferred retirement
income. The PRA can be used to supplement, or as an alternative
to, a non-deductible IRA or other retirement plan.
The advantages of the IDS Preferred Retirement Account over a non-
deductible IRA are shown below:
IDS Preferred Non-deductible
Retirement IRA
Account
_____________________________________________________________
Maximum $1 million initially, $2,000 per year
amount you then $50,000 per (only $250 for
can year (spouse can non-working spouse)
contribute have own plan and
also contribute
$50,000, whether
or not employed)
______________________________________________________________
Highest age The later of age 85 70 1/2 years old
you can or the 10th contract
contribute anniversary
______________________________________________________________
Types of Any type: wages, Generally limited
income you investment income, to income from
can gifts, inheritance, employment
contribute etc.
______________________________________________________________
Records None required, but You must keep all
you must IDS furnishes you records yourself
keep regular reports
for your files
______________________________________________________________
Reports you None You must report all
must file contributions and
with the withdrawals each
IRS year
______________________________________________________________
Age at which The later of age 85 70 1/2 years old
you must or the 10th contract
begin anniversary
withdrawals
______________________________________________________________
<PAGE>
PAGE 34
PERFORMANCE INFORMATION
Calculation of yield for Account 6
IDS Life of New York Account 6, which invests in IDS Life
Moneyshare Fund, Inc., calculates an annualized simple yield and
compound yield based on a seven-day period.
The simple yield is calculated by determining the net change in the
value of a hypothetical account having the balance of one
accumulation unit at the beginning of the seven-day period. (The
net change does not include capital change, but does include a pro
rata share of the annual contract charges, including the annual
contract administrative charge and the mortality and expense risk
fee.) The net change in the account value is divided by the value
of the account at the beginning of the period to obtain the return
for the period. That return is then multiplied by 365/7 to obtain
an annualized figure. The value of the hypothetical account
includes the amount of any declared dividends, the value of any
shares purchased with any dividend paid during the period and any
dividends declared for such shares. The variable account's
(account) yield does not include any realized or unrealized gains
or losses, nor does it include the effect of any applicable
surrender charge.
The account calculates its compound yield according to the
following formula:
Compound Yield = [(return for seven-day period +1) 365/7 ] - 1
On Dec. 31, 1993, the account's annualized yield was ___% percent
and its compound yield was ___% percent.
The rate of return, or yield, on the account's accumulation unit
may fluctuate daily and does not provide a basis for determining
future yields. Investors must consider, when comparing an
investment in Account 6 with fixed annuities, that fixed annuities
often provide an agreed-to or guaranteed fixed yield for a stated
period of time, whereas the account's yield fluctuates. In
comparing the yield of Account 6 to a money market fund, you should
consider the different services that the annuity provides.
Calculation of yield for non-money market accounts
For an account other than the money market account, quotations of
yield will be based on all investment income earned during a
particular 30-day period, less expenses accrued during the period
(net investment income) and will be computed by dividing net
investment income per accumulation unit by the value of an
accumulation unit on the last day of the period, according to the
following formula:
YIELD = 2[(a-b + 1)6 - 1]
cd
<PAGE>
PAGE 35
where: a = dividends and investment income earned during the
period.
b = expenses accrued for the period (net of
reimbursements).
c = the average daily number of accumulation units
outstanding during the period that were entitled to
receive dividends.
d = the maximum offering price per accumulation unit on
the last day of the period.
Yield on the account is earned from the increase in the net asset
value of shares of the fund in which the account invests and from
dividends declared and paid by the fund, which are automatically
invested in shares of the fund.
Calculation of average annual total return
Quotations of average annual total return for an account will be
expressed in terms of the average annual compounded rate of return
of a hypothetical investment in the annuity contract over a period
of one, five and 10 years (or, if less, up to the life of the
Account), calculated according to the following formula:
P(1+T)n = ERV
where: P = a hypothetical initial payment of $1,000.
T = average annual total return.
n = number of years.
ERV = Ending Redeemable Value of a hypothetical $1,000
payment made at the beginning of the one, five,
or ten year (or other) period at the end of the
one, five, or ten year (or other) period (or
fractional portion thereof).
Account total return figures reflect the deduction of the contract
administrative charge and mortality and expense risk fee.
Performance figures will be shown with and may be shown without the
deduction of a surrender charge. The Securities and Exchange
Commission requires that an assumption be made that the contract
owner surrenders the entire contract at the end of the one, five
and ten year periods (or, if less, up to the life of the account)
for which performance is required to be calculated.
Aggregate total return
Aggregate total return represents the cumulative change in the net
asset value of shares of the fund in which the account invests over
a specified period of time and is computed by the following
formula:
ERV - P
P
<PAGE>
PAGE 36
where: P = a hypothetical initial payment of $1,000.
ERV = Ending Redeemable Value of a hypothetical $1,000
payment made at the beginning of the one, five, or
ten year (or other) period at the end of the one,
five, or ten year (or other) period (or fractional
portion thereof).
Performance of the accounts may be quoted or compared to rankings,
yields, or returns as published or prepared by independent rating
or statistical services or publishers or publications such as The
Bank Rate Monitor National Index, Barron's, Business Week,
Donoghue's Money Market Fund Report, Financial Services Week,
Financial Times, Financial World, Forbes, Fortune, Global Investor,
Institutional Investor, Investor's Daily, Kiplinger's Personal
Finance, Lipper Analytical Services, Money, Mutual Fund Forecaster,
Newsweek, The New York Times, Personal Investor, Stanger Report,
Sylvia Porter's Personal Finance, USA Today, U.S. News and World
Report, The Wall Street Journal and Wiesenberger Investment
Companies Service.
CALCULATING ANNUITY PAYOUTS
The Variable Account
The following calculations are done separately for each of the
variable accounts. The separate monthly payouts, added together,
make up your total variable annuity payout.
Initial Payout: To compute your first monthly payment, we:
o determine the dollar value of your annuity as of the valuation
date seven days before the retirement date.
o apply the result to the annuity table contained in the contract
or another table at least as favorable. The annuity table shows
the amount of the first monthly payment for each $1,000 of value
which depends on factors built into the table, as described below.
Annuity Units: The value of your account is then converted to
annuity units. To compute the number credited to you, we divide
the first monthly payment by the annuity unit value (see below) on
the valuation date on (or next day preceding) the seventh calendar
day before the retirement date. The number of units in your
account is fixed. The value of the units fluctuate with the
performance of the underlying mutual fund.
Subsequent Payouts: To compute later payouts, we multiply:
o the annuity unit value on the valuation date on or immediately
preceding the seventh calendar day before the payout is due; by
o the fixed number of annuity units credited to you.
<PAGE>
PAGE 37
Annuity Table: The table shows the amount of the first monthly
payment for each $1,000 of contract value according to the age and,
when applicable, the sex of the annuitant. (Where required by law,
we will use a unisex table of settlement rates.) The table assumes
that the contract value is invested at the beginning of the annuity
payout period and earns a 3.5% rate of return, which is reinvested
and helps to support future payouts.
Annuity Unit Values: This value was originally set at $1 for each
variable account. To calculate later values we multiply the last
annuity value by the product of:
o the net investment factor; and
o the neutralizing factor. The purpose of the neutralizing factor
is to offset the effect of the assumed investment rate built into
the annuity table. With an assumed investment rate of 5%, the
neutralizing factor is 0.999866 for a one day valuation period.
Net Investment Factor:
o Determined each business day by adding the underlying mutual
fund's current net asset value per share plus per share amount of
any current dividend or capital gain distribution; then
o dividing that sum by the previous net asset value per share; and
o subtracting the percentage factor representing the mortality and
expense risk fee from the result.
Because the net asset value of the underlying mutual fund may
fluctuate, the net investment factor may be greater or less than
one, and the accumulation unit value may increase or decrease. You
bear this investment risk in a variable account.
The Fixed Account
Your fixed annuity payout amounts are guaranteed. Once calculated,
your payout will remain the same and never change. To calculate
your annuity payouts we:
o take the value of your fixed account at the retirement date or
the date you have selected to begin receiving your annuity payouts;
then
o using an annuity payout table we apply the value according to
the annuity payout plan you select; and
o the annuity payout table we use will be the one in effect at the
time you choose to begin your annuity payouts. The table will be
equal to or greater than the table in your contract.
<PAGE>
PAGE 38
RATING AGENCIES
The following chart provides information on ratings* given to IDS
Life of New York by independent rating agencies that evaluate the
financial soundness of insurance companies. IDS Life of New York
has one of the most liquid and highest quality balance sheets of
the largest insurance companies in the industry.**
Rating Agency Rating Relevance of Rating
A.M. Best A+ Reflects A.M. Best's opinion
(Superior) regarding IDS Life of New York's
strong distribution network,
favorable overall balance sheet
profile, consistently improving
profitability, adequate level of
capitalization and asset-liability
management expertise.
Duff & Phelps AAA Reflects Duff & Phelps' opinion
regarding IDS Life of New York's
consistently excellent
profitability record, stable
operating leverage, leadership
position in chosen markets and
effective use of asset/liability
management techniques.
Moody's Aa2 Reflects Moody's opinion regarding
IDS Life of New York's leadership
position in financial planning,
strong asset/liability management
and good capitalization. IDS Life
of New York has a strong market
focus and it greatly emphasizes
quality service.
A.M. Best rates over 1,600 insurance companies on a 15 level scale
with letters ranging from A++ to F to "NA" ratings based on a
company's financial strength and claims paying ability.
Duff & Phelps rates over 125 companies for claims-paying ability
with 19 rating categories from AAA to CCC-.
Moody's rates over 80 companies for financial strength with 19
rating categories ranging from Aaa to C.
* Ratings relate to IDS Life of New York's ability to fulfill its
obligations under its contracts and not to the management or
performance of the separate accounts.
** Measured by comparing the 15 largest life insurance companies'
investments in below investment grade (junk) bonds, mortgages and
real estate to a percentage of those companies' total assets.
<PAGE>
PAGE 39
PRINCIPAL UNDERWRITER
The principal underwriter for the accounts is IDS Financial
Services Inc. which offers the variable annuities on a continuous
basis.
Surrender charges received by IDS Life of New York for 1993, 1992
and 1991, aggregated ________, $136,471, and $117,959,
respectively. Commissions paid by IDS Life of New York for 1993,
1992 and 1991, aggregated _______, $631,691 and $220,527,
respectively. The surrender charges were applied toward payment of
commissions.
INDEPENDENT AUDITORS
The Financial Statements of the accounts and of IDS Life of New
York appearing in this Statement of Additional Information have
been audited by Ernst & Young, independent auditors, 1400 Pillsbury
Center, Minneapolis, MN 55402, to the extent indicated in their
reports. Ernst & Young are experts in accounting and auditing.
PROSPECTUS
The prospectus dated April 29, 1994, is hereby incorporated in this
Statement of Additional Information by reference.
<PAGE>
PAGE 40
PART C.
Item 24. Financial Statements and Exhibits
(a) To be filed by amendment.
(b) Exhibits:
1.1 Resolution of the Executive Committee of the Board of
Directors of IDS Life of New York dated November 12, 1981,
filed electronically herewith.
1.2 Resolution of the Executive Committee of the Board of
Directors of IDS Life of New York establishing Account 9 on
Feb. 12, 1986, filed electronically herewith.
1.3 Resolution of the Board of Directors of IDS Life Insurance
Company of New York establishing Accounts 10 and 11 on Oct. 8,
1991, filed as Exhibit 1(b) to Registrant's Post-Effective
Amendment No. 7 is incorporated herein by reference.
2. Not applicable.
3. Form of Variable Annuity and Life Insurance Distribution
Agreement filed electronically herewith.
4.1 Copy of form of Qualified Deferred Annuity Contract (form
39192) filed electronically herewith.
4.2 Copy of form of Non-Qualified Deferred Annuity Contract (form
39191) filed electronically herewith.
4.3 Copy of form of Deferred Annuity Contract (IRA) (form 39192
IRA) filed electronically herewith.
5.1 Application form for the Contracts filed as Exhibit 10 to the
IDS Life of New York Accounts 4, 5 and 6 Registration
Statement 2-78194, is incorporated herein by reference.
5.2 Copy of Form of Application for IDS Flexible Annuity Contract
of New York, filed electronically herewith.
6.1 Amendment to Articles of Incorporation of IDS Life of New York
filed as Exhibit 6(a) to Post-Effective Amendment No. 6 to
Registration Statement No. 2-78194, is incorporated herein by
reference.
6.2 By-Laws of IDS Life of New York, filed as Exhibit 6(b) to the
IDS Life of New York Accounts 4, 5 and 6 Registration
Statement No. 2-78194, are incorporated herein by reference.
7. Not applicable.
8. Not applicable.
<PAGE>
PAGE 41
9. Opinion of counsel as to the legality of the securities being
registered and consent to its use was filed with Registrant's
24f-2 Notice on or about Feb. 25, 1994.
10. Consent of Independent Auditors to be filed by amendment.
11. Not applicable.
12. Not applicable.
13. Not applicable.
14.1 Financial Data Schedule to be filed by amendment.
14.2 Powers of Attorney to sign Amendments to this Registration
Statement filed as Exhibit (14) to Post-Effective Amendment
No. 5 to Registration Statement No. 33-4174 are incorporated
herein by reference.
<PAGE>
PAGE 42
Item 25. Directors and Officers of the Depositor
<TABLE>
<CAPTION>
Positions and Positions and
Name & Principal Offices with Name & Principal Offices with
Business Address Depositor Business Address Depositor
<S> <C> <C> <C>
Gary A. Beller Director James A. Mitchell Chairman of the
American Express Plaza IDS Tower 10 Board, President
New York, NY Minneapolis, MN and Director
John C. Boeder Director, Michael P. Monaco Director
Box 5144 Vice President, Box 5144
Albany, NY 12205 Chief Operating Albany, NY 12205
Officer
Stephen P. Norman Director
Paul V. Bruce Qualified American Express
IDS Tower 10 Actuary Plaza
Minneapolis, MN New York, NY
Michael B. Carlin Claims Officer, Gordon H. Ritz Director
Box 5144 Secretary and 404 WCCO Radio Bldg.
Albany, NY General Counsel Minneapolis, MN
Roger C. Corea Director Michael R. Woodward Director
345 Woodcliff Drive 45 Liberty St.
Fairport, NY 14450 Batavia, NY 14020
Charles A. Cuccinello Director
25 Dogwood Drive
Scarsdale, NY
Francis M. Ellis Director
90 Greene St.
New York, NY 10012
Milton Fenster Director
540 Madison Ave.
New York, NY
Donna Gaglione Treasurer
Box 5144
Albany, NY 12205
Margaret Grogan, M.D. Medical
Bethlehem Terrace Apts Director
Slingerland, NY
David R. Hubers Director
IDS Tower 10
Minneapolis, MN
Richard W. Kling Director
IDS Tower 10
Minneapolis, MN
<PAGE>
PAGE 43
Item 25. Directors and Officers of the Depositor (continued)
Edward Landes Director
30 South 9th Street
Minneapolis, MN
</TABLE>
<PAGE>
PAGE 44
Item 26. Persons Controlled by or Under Common Control with the
Depositor or Registrant
IDS Life Insurance Company of New York is a wholly owned
subsidiary of IDS Life Insurance Company which is a
wholly owned subsidiary of IDS Financial Corporation.
IDS Financial Corporation is a wholly owned subsidiary of
American Express Company (American Express).
The following list includes the names of major
subsidiaries of American Express.
Jurisdiction
Name of Subsidiary of Incorporation
I. Travel Related Services
American Express Travel Related New York
Services Company, Inc.
II. International Banking Services
American Express Bank Ltd. Connecticut
III. Investment Services
Shearson Lehman Brothers Holdings Inc. Delaware
IV. Companies engaged in Investors Diversified
Financial Services
IDS Financial Corporation Delaware
IDS Certificate Company Delaware
Investors Syndicate Development Corp. Nevada
IDS Financial Services Inc. Delaware
IDS Securities Corporation Delaware
IDS Bank & Trust Minnesota
IDS Real Estate Services, Inc. Delaware
IDS Life Insurance Company Minnesota
IDS Life Insurance Company of New York New York
American Enterprise Life Insurance Company Indiana
IDS International, Inc. Delaware
IDS Fund Management Limited U.K.
IDS Insurance Agency of North
Carolina Inc. North Carolina
IDS Insurance Agency of Arkansas Inc. Arkansas
IDS Insurance Agency of Alabama Inc. Alabama
IDS Insurance Agency of Massachusetts Inc. Massachusetts
IDS Insurance Agency of Nevada Inc. Nevada
IDS Insurance Agency of New Mexico Inc. New Mexico
IDS Insurance Agency of Utah Inc. Utah
IDS Insurance Agency of Wyoming Inc. Wyoming
IDS Advisory Group Inc. Minnesota
IDS Property Casualty Insurance Company Wisconsin
IDS Management Corporation Minnesota
IDS Futures Corporation Minnesota
<PAGE>
PAGE 45
Item 26. Persons Controlled by or Under Common Control with the
Depositor or Registrant (Continued)
Jurisdiction
Name of Subsidiary of Incorporation
IDS Cable Corporation Minnesota
IDS Realty Corporation Minnesota
IDS Partnership Services Corporation Minnesota
IDS Futures III Corporation Minnesota
IDS Cable II Corporation Minnesota
American Express Minnesota Foundation Minnesota
IDS Deposit Corp. Utah
IDS Sales Support Inc. Minnesota
IDS Plan Services of California, Inc. Minnesota
American Enterprise Investment
Services, Inc. Minnesota
IDS Aircraft Services Corporation Minnesota
IDS Capital Holdings Inc. Minnesota
Mankato Ventures
Item 27. Number of Contractowners
On Jan. 31, 1994, there were 16,260 contract owners of
qualified Flexible Annuity contracts. There were 8,910
owners of non-qualified contracts.
Item 28. Indemnification
The By-Laws of the depositor provide that it shall
indemnify any person made a party to an action or
proceeding by or in the right of the depositor to procure
a judgment in its favor, by reason of the fact that he,
his testator or intestate, is or was a director or
officer or employee of the depositor against the
reasonable expenses, including attorneys' fees, actually
and necessarily incurred by him in connection with the
defense of such action or proceeding, or in connection
with the appeal therein, except in relation to matters as
to which such person is adjudged to have breached his
duty to the depositor; and
The depositor shall indemnify any person made, or
threatened to be made a party to an action or proceeding
other than one by or in the right of the depositor to
procure a judgment in its favor, whether civil or
criminal, including an action by or in the right of any
other corporation of any type or kind domestic or
foreign, which any director or officer or employee of the
depositor served in any capacity at the request of the
depositor, by reason of the fact that he, his testator or
intestate, was a director or officer or employee of the
depositor, or served such other corporation in any
capacity, against judgments, fines, amounts paid in
settlement and reasonable expenses, including attorneys'
fees, actually and necessarily incurred as a result of
such action or proceeding, or any appeal therein, if such
<PAGE>
PAGE 46
person acted in good faith, for a purpose which he
reasonably believed to be in the best interests of the
depositor and, in criminal actions or proceedings, in
addition had no reasonable cause to believe that his
conduct was unlawful.
Item 29. Principal Underwriters.
(a) IDS Financial Services Inc. acts as principal underwriter for
the following investment companies:
IDS Blue Chip Advantage Fund; IDS Bond Fund, Inc.; IDS
California Tax-Exempt Fund; IDS Cash Management Fund, Inc.;
IDS Discovery Fund, Inc,; IDS Diversified Equity Income Fund;
IDS Equity Plus Fund, Inc.; IDS Extra Income Fund, Inc.; IDS
Federal Income Fund, Inc.; IDS Global Bond Fund, Inc.; IDS
Global Growth Fund; IDS Growth Fund, Inc.; IDS High Yield Tax-
Exempt Fund, Inc.; IDS Insured Tax-Exempt Fund; IDS
International Fund, Inc.; IDS Managed Retirement Fund, Inc.;
IDS Massachusetts Tax-Exempt Fund; IDS Michigan Tax-Exempt
Fund; IDS Minnesota Tax-Exempt Fund; IDS Mutual; IDS New
Dimensions Fund, Inc.; IDS New York Tax-Exempt Fund; IDS Ohio
Tax-Exempt Fund; IDS Planned Investment Account; IDS Precious
Metals Fund, Inc.; IDS Progressive Fund, Inc.; IDS Selective
Fund, Inc.; IDS Stock Fund, Inc.; IDS Strategy Fund, Inc.; IDS
Tax-Exempt Bond Fund, Inc.; IDS Tax-Free Money Fund, Inc.; IDS
Utilities Income Fund, Inc. and IDS Certificate Company.
(b) As to each director, officer or partner of the principal
underwriter:
Positions and
Name and Principal Position and Offices Offices with
Business Address with Underwriter Registrant
Ronald G. Abrahamson Vice President- None
IDS Tower 10 Field Administration
Minneapolis, MN 55440
Douglas A. Alger Vice President- None
IDS Tower 10 Total Compensation
Minneapolis, MN 55440
Jerome R. Amundson Vice President and None
IDS Tower 10 Controller-Mutual Funds
Minneapolis, MN 55440 Operations
Peter J. Anderson Senior Vice President- None
IDS Tower 10 Advisory Group and
Minneapolis, MN 55440 Equity Management
Alvan D. Arthur Region Vice President- None
IDS Tower 10 Pacific Region
Minneapolis, MN 55440
Kent L. Ashton Vice President-Group None
IDS Tower 10 Management Office,
Minneapolis, MN 55440 Banking and Certificates<PAGE>
PAGE 47
Item 29. (Continued)
Positions and
Name and Principal Position and Offices Offices with
Business Address with Underwriter Registrant
Timothy V. Bechtold Vice President-Insurance None
IDS Tower 10 Product Development
Minneapolis, MN 55440
John D. Begley Region Vice President- None
Olentangy Valley Center Mid-Central Region
Suite 300
7870 Olentangy River Rd.
Columbus, OH 43235
Carl E. Beihl Vice President- None
IDS Tower 10 Strategic Technology
Minneapolis, MN 55440 Planning
Alan F. Bignall Vice President- None
IDS Tower 10 Financial Planning
Minneapolis, MN 55440 Systems
Brent L. Bisson Region Vice President- None
Seafirst Financial Northwest Region
Center, Suite 1730
601 W. Riverside Ave.
Spokane, WA 99201
Karl J. Breyer Senior Vice President None
IDS Tower 10 and Special Counsel
Minneapolis, MN 55440
Thomas J. Brakke Vice President-
IDS Tower 10 Investment Services and
Minneapolis, MN 55440 Investment Research
John L. Burbidge Vice President- None
IDS Tower 10 Government Relations
Minneapolis, MN 55440
Harold E. Burke Vice President None
IDS Tower 10 and Assistant
Minneapolis, MN 55440 General Counsel
Orison Y. Chaffee III Vice President-Field None
IDS Tower 10 Real Estate
Minneapolis, MN 55440
James E. Choat Senior Vice President- None
Suite 124 Central Region
6210 Campbell Rd.
Dallas, TX 75248
Kenneth J. Ciak Vice President and None
IDS Tower 10 General Manager-
Minneapolis, MN 55440 IDS Property Casualty<PAGE>
PAGE 48
Item 29. (Continued)
Positions and
Name and Principal Position and Offices Offices with
Business Address with Underwriter Registrant
Roger C. Corea Region Vice President- None
345 Woodcliff Drive Northeast Region
Fairport, NY 14450
Kevin F. Crowe Region ice President-
IDS Tower 10 Atlantic Region
Minneapolis, MN 55440
Alan R. Dakay Vice President- None
IDS Tower 10 Institutional Insurance
Minneapolis, MN 55440 Marketing
William F. Darland Region Vice President- None
Suite 108C South Central Region
301 Sovereign Court
Manchester, MO 63011
William H. Dudley Director, Executive None
IDS Tower 10 Vice President and
Minneapolis MN 55440 Investment and Brokerage
Operations
Roger S. Edgar Senior Vice President- None
IDS Tower 10 Information Systems
Minneapolis, MN 55440
Gordon L. Eid Senior Vice President None
IDS Tower 10 and General Counsel
Minneapolis, MN 55440
Edwin W. Elder III Vice President-
IDS Tower 10 Operations/IDS Property
Minneapolis, MN 55440 Casualty
Mark A. Ernst Vice President- None
IDS Tower 10 Tax and Business Services
Minneapolis, MN 55440
Gordon M. Fines Vice President- None
IDS Tower 10 Mutual Fund Equity
Minneapolis MN 55440 Investments
Louis C. Fornetti Senior Vice President- None
IDS Tower 10 Corporate Controller
Minneapolis, MN 55440
Douglas L. Forsberg Vice President- None
IDS Tower 10 Securities Services
Minneapolis, MN 55440
<PAGE>
PAGE 49
Item 29. (Continued)
Positions and
Name and Principal Position and Offices Offices with
Business Address with Underwriter Registrant
Carl W. Gans Region Vice President-
IDS Tower 10 North Central Region
Minneapolis, MN 55440
Robert G. Gilbert Vice President- None
IDS Tower 10 Real Estate
Minneapolis, MN 55440
John J. Golden Vice President- None
IDS Tower 10 Field Compensation
Minneapolis, MN 55440 Development
Morris Goodwin Jr. Vice President and None
IDS Tower 10 Corporate Treasurer
Minneapolis, MN 55440
David A. Hammer Vice President None
IDS Tower 10 and Marketing
Minneapolis, MN 55440 Controller
Robert L. Harden Region Vice President None
Suite 403 Mid-Atlantic Region
8500 Leesburg Pike
Vienna, VA 22180
Lorraine R. Hart Vice President- None
IDS Tower 10 Insurance Investments
Minneapolis, MN 55440
Mark S. Hays Vice President-Senior None
IDS Tower 10 Portfolio Manager, IDS
Minneapolis, MN 55440 International
Robert H. Healy Vice President- None
IDS Tower 10 Senior Portfolio
Minneapolis, MN 55440 Manager
Brian M. Heath Region Vice President-
IDS Tower 10 Southwest Region
Minneapolis, MN 55440
James G. Hirsh Vice President and None
IDS Tower 10 Assistant General
Minneapolis, MN 55440 Counsel
Raymond E. Hirsch Vice President-Senior None
IDS Tower 10 Portfolio Manager
Minneapolis, MN 55440
Kevin P. Howe Vice President- None
IDS Tower 10 Government and
Minneapolis, MN 55440 Customer Relations<PAGE>
PAGE 50
Item 29. (Continued)
Positions and
Name and Principal Position and Offices Offices with
Business Address with Underwriter Registrant
David R. Hubers Senior Vice President- None
IDS Tower 10 Finance and Chief
Minneapolis, MN 55440 Financial Officer
Marietta Johns Senior Vice President- None
IDS Tower 10 Acuma Ltd.
Minneapolis, MN 55440
Douglas R. Jordal Vice President-Taxes None
IDS Tower 10
Minneapolis, MN 55440
Craig A. Junkins Vice President-
IDS Tower 10 IDS 1994 Implementation
Minneapolis, MN 55440 Planning and Financial
Planning Development
Susan D. Kinder Senior Vice President- None
IDS Tower 10 Human Resources
Minneapolis, MN 55440
Richard W. Kling Vice President- None
IDS Tower 10 Insurance Marketing
Minneapolis, MN 55440 and Products
Harold Knutson Vice President- None
IDS Tower 10 System Services
Minneapolis, MN 55440
Paul F. Kolkman Vice President- None
IDS Tower 10 Corporate Actuary
Minneapolis, MN 55440
Claire Kolmodin Vice President- None
IDS Tower 10 Service Quality
Minneapolis, MN 55440
David S. Kreager Vice President-
IDS Tower 10 Field Management
Minneapolis, MN 55440 Development
Christopher Kudrna Vice President- None
IDS Tower 10 Systems and Technology
Minneapolis, MN 55440 Development
Steven C. Kumagai Director, Senior Vice None
IDS Tower 10 President- Associate
Minneapolis, MN 55440 General Sales Manager
Mitre Kutanouski Region Vice President-
IDS Tower 10 Midwest Region
Minneapolis, MN 55440<PAGE>
PAGE 51
Item 29. (Continued)
Positions and
Name and Principal Position and Offices Offices with
Business Address with Underwriter Registrant
Edward Labenski Vice President- None
IDS Tower 10 Senior Portfolio
Minneapolis, MN 55440 Manager
Peter L. Lamaison Vice President- None
One Broadgate IDS International
London, England Division
Kurt A. Larson Vice President- None
IDS Tower 10 Senior Portfolio
Minneapolis, MN 55440 Manager
Ryan R. Larson Vice President- None
IDS Tower 10 Annuity Product
Minneapolis, MN 55440 Development
Douglas A. Lennick Director, Senior Vice None
IDS Tower 10 President and General
Minneapolis, MN 55440 Sales Manager
Mary J. Malevich Vice President- None
IDS Tower 10 Senior Portfolio
Minneapolis, MN 55440 Manager
William J. McKinney Vice President- None
IDS Tower 10 Field Management
Minneapolis, MN 55440 Support
Thomas Medcalf Vice President- None
IDS Tower 10 Senior Portfolio Manager
Minneapolis, MN 55440
William C. Melton Vice President- None
IDS Tower 10 Chief Economist
Minneapolis, MN 55440
Janis E. Miller Vice President-Mutual None
IDS Tower 10 Funds Products and
Minneapolis, MN 55440 Marketing
James A. Mitchell Senior Vice President- None
IDS Tower 10 Insurance Operations
Minneapolis, MN 55440
Pamela J. Moret Vice President and None
IDS Tower 10 Assistant General
Minneapolis, MN 55440 Counsel
Robert J. Neis Vice President- None
IDS Tower 10 EDP Services
Minneapolis, MN 55440
<PAGE>
PAGE 52
Item 29. (Continued)
Positions and
Name and Principal Position and Offices Offices with
Business Address with Underwriter Registrant
Vernon F. Palen Region Vice President- None
Suite D-222 Rocky Mountain Region
7100 E. Lincoln Drive
Scottsdale, AZ 85253
James R. Palmer Vice President- None
IDS Tower 10 Insurance Operations
Minneapolis, MN 55440
George M. Perry Vice President- None
IDS Tower 10 Corporate Strategy
Minneapolis, MN 55440 and Development
Susan B. Plimpton Vice President- None
IDS Tower 10 American Express
Minneapolis, MN 55440 Marketing
Ronald W. Powell Vice President and None
IDS Tower 10 Assistant General
Minneapolis, MN 55440 Counsel
James M. Punch Vice President- None
IDS Tower 10 TransAction Services
Minneapolis, MN 55440
Frederick C. Quirsfeld Vice President-Taxable None
IDS Tower 10 Mutual Fund Investments
Minneapolis, MN 55440
Roger B. Rogos Region Vice President- None
Suite 15, Parkside
Place Great Lakes
945 Boardman-Canfield
Rd Region
Youngstown, Ohio 44512
ReBecca K. Roloff Vice President- None
IDS Tower 10 Insurance
Minneapolis, MN 55440 Operations
Stephen W. Roszell Vice President-
IDS Tower 10 Advisory Institutional
Minneapolis, MN 55440 Marketing
Robert A. Rudell Vice President- None
IDS Tower 10 Sales and Marketing,
Minneapolis, MN 55440 IDS Institutional
Marketing
John P. Ryan Vice President and None
IDS Tower 10 General Auditor
Minneapolis, MN 55440<PAGE>
PAGE 53
Item 29. (Continued)
Positions and
Name and Principal Position and Offices Offices with
Business Address with Underwriter Registrant
Erven A. Samsel Senior Vice President- None
45 Braintree Hill Park Eastern Region
Braintree, MA 02184
R. Reed Saunders Director and Senior None
IDS Tower 10 Vice President-
Minneapolis, MN 55440 Chief Marketing Officer
Stuart A. Sedlacek Vice President- None
IDS Tower 10 Quantitative
Minneapolis, MN 55440 Investment Management
F. Dale Simmons Vice President-Senior None
IDS Tower 10 Portfolio Manager
Minneapolis, MN 55440 Insurance Investments
Judy P. Skoglund Vice President-Human
IDS Tower 10 Resources and Organization
Minneapolis, MN 55440 Development
Julian W. Sloter Region Vice President- None
9040 Roswell Rd. Southeast Region
River Ridge-Suite 600
Atlanta, GA 30350
William A. Smith Vice President- None
IDS Tower 10 Finance and CFO/UK
Minneapolis, MN 55440
James B. Solberg Vice President- None
IDS Tower 10 Advanced Financial
Minneapolis, MN 55440 Planning
James W. Sowles Vice President- None
IDS Tower 10 Certificate
Minneapolis, MN 55440 Administration
Bridget Sperl Vice President-
IDS Tower 10 Human Resources Management
Minneapolis, MN 55440 Services
Jeffrey E. Stiefler Director, Chairman, None
IDS Tower 10 Chief Executive Officer
Minneapolis, MN 55440 and President
Lois Stilwell Vice President- None
IDS Tower 10 Sales Training and
Minneapolis, MN 55440 Communications
William A. Stoltzmann Vice President and None
IDS Tower 10 Assistant General
Minneapolis, MN 55440 Counsel<PAGE>
PAGE 54
Item 29. (Continued)
Positions and
Name and Principal Position and Offices Offices with
Business Address with Underwriter Registrant
James J. Strauss Vice President- None
IDS Tower 10 Corporate Planning
Minneapolis, MN 55440 and Analysis
Jeffrey J. Stremcha Vice President-
IDS Tower 10 Information Resource
Minneapolis, MN 55440 Management/ISD
Neil Taylor Vice President-
IDS Tower 10 IDS 1994
Minneapolis, MN 55440
John R. Thomas Senior Vice President- Director/
IDS Tower 10 Mutual Funds Operations Trustee
Minneapolis, MN 55440
Melinda S. Urion Vice President-
IDS Tower 10 Insurance Controller
Minneapolis, MN 55440
Charles R. Utoft Vice President-
IDS Tower 10 Equity and Fixed Income
Minneapolis, MN 55440 Trading
Wesley W. Wadman Vice President- None
IDS Tower 10 Senior Portfolio
Minneapolis, MN 55440 Manager
Norman Weaver Jr. Senior Vice President- None
Suite 215 Western Region
1501 Westcliff Drive
Newport Beach, CA 92660
Michael L. Weiner Vice President- None
IDS Tower 10 Corporate Tax
Minneapolis, MN 55440 Operations
William N. Westhoff Senior Vice None
IDS Tower 10 President-Fixed
Minneapolis, MN 55440 Income Management
Edwin Wistrand Vice President and None
IDS Tower 10 Assistant General
Minneapolis, MN 55440 Counsel
Michael Woodward Senior Vice President- None
45 Liberty St. North Region
Batavia, NY 14020
<PAGE>
PAGE 55
<TABLE>
<CAPTION>
(c) Name of Net Underwriting
Principal Discounts and Compensation on Brokerage Other
Underwriter Commissions Redemption Commissions Compensation
<S> <C> <C> <C> <C>
IDS Financial
Services Inc. None $151,536* None None
</TABLE>
Item 30. Location of Accounts and Records
IDS Life Insurance Company of New York
20 Madison Avenue Extension
Albany, NY 12203
Item 31. Management Services
Not applicable.
Item 32. Undertakings
(a) (b) & (c) These undertakings were filed with the
Registrant's initial Registration Statements,
File Nos. 33-4174 and 811-3500.
(d) Registrant represents that it is relying upon
the no-action assurance given to the American
Council of Life Insurance (pub. avail. Nov. 28,
1989). Further, Registrant represents that it
has complied with the provisions of paragraphs
(1)-(4) of that no-action letter.
<PAGE>
PAGE 56
SIGNATURES
As required by the Securities Act of 1933 and the Investment
Company Act of 1940, IDS Life Insurance Company of New York, on
behalf of the Registrant has caused this Registration Statement to
be signed on its behalf, in the City of Minneapolis, and State of
Minnesota, on the 25th day of February, 1994.
IDS LIFE ACCOUNT 4
IDS LIFE ACCOUNT 5
IDS LIFE ACCOUNT 6
IDS LIFE ACCOUNT 9
IDS LIFE ACCOUNT 10
IDS LIFE ACCOUNT 11
(Registrant)
By IDS Life Insurance Company of New York
(Sponsor)
By /s/ James A. Mitchell*
James A. Mitchell
President
As required by the Securities Act of 1933, this Registration
Statement has been signed by the following persons in the
capacities indicated on the 25th day of February, 1994.
Signature Title
/s/ James A. Mitchell* Director, Chairman of the
James A. Mitchell Board and Chief Executive
Officer
Director
Gary A. Beller
/s/ John C. Boeder* Director, President,
John C. Boeder* Chief Operating Officer
/s/ Paul V. Bruce* Qualified Actuary
Paul V. Bruce
/s/ Michael Carlin* General Counsel and
Michael Carlin Secretary
/s/ Roger C. Corea* Director
Roger C. Corea
/s/ Charles A. Cuccinello* Director
Charles A. Cuccinello
Director
Francis M. Ellis
<PAGE>
PAGE 57
Signature Title
/s/ Milton Fenster* Director
Milton Fenster
/s/ Donna Gaglione* Treasurer
Donna Gaglione
/s/ David R. Hubers* Director
David R. Hubers
/s/ Richard W. Kling* Director
Richard W. Kling
/s/ Edward Landes* Director
Edward Landes
Director
Michael P. Monaco
Director
Steven P. Norman
/s/ Gordon H. Ritz* Director
Gordon H. Ritz
Director
Michael R. Woodward
*Signed pursuant to Power of Attorney filed as Exhibit 14 to Post-
Effective Amendment No. 5 to Registration Statement No. 33-4174.
______________________________
Mary Ellyn Minenko
<PAGE>
PAGE 58
CONTENTS OF POST-EFFECTIVE AMENDMENT NO. 9
This Registration Statement is comprised of the following papers
and documents:
The Cover Page.
Cross-reference sheet.
Part A.
The prospectus.
Part B.
Statement of Additional Information.
Part C.
Other Information.
The signatures.
Exhibits.
<PAGE>
PAGE 1
IDS LIFE OF NEW YORK ACCOUNTS 4, 5, 6, 9, 10 & 11
Registration Number 33-4174/811-3500
EXHIBIT INDEX
Exhibit 1.1
Exhibit 1.2
Exhibit 3
Exhibit 4.1
Exhibit 4.2
Exhibit 4.3
Exhibit 5.2
<PAGE>
PAGE 1
MINUTES OF A MEETING OF THE EXECUTIVE COMMITTEE
OF THE BOARD OF DIRECTORS
OF IDS LIFE INSURANCE COMPANY OF NEW YORK
November 12, 1981
Pursuant to the call of the Chairman and written notice duly given,
a meeting of the Executive Committee of the Board of Directors of
IDS Life Insurance Company of New York was held at 10:30 A.M. on
November 12, 1981, at the IDS Tower, Minneapolis, Minnesota.
Members present were Messrs. Ceithaml, Franchot, Pickering, and
Taylor. Richard J. O'Brien was also present and recorded the
minutes of the meeting.
Following a discussion, upon motion duly made and seconded, the
following resolutions were unanimously adopted:
WHEREAS, This Executive Committee of the Board of Directors
has determined that it is desirable for the Corporation to
issue variable annuity contracts, the values and benefits of
which will vary with the investment performance of certain
mutual funds("the Funds") established by the parent company,
IDS Life Insurance Company, now, therefore, be it
RESOLVED, That the six separate accounts set forth below are
hereby established in accordance with Section 227, New York
Insurance Law and New York Insurance Law and New York
Insurance Regulation 47:
IDS Life of New York Account C, to invest in shares
of IDS Life Capital Resource Fund I, Inc.
IDS Life of New York Account D, to invest in shares
of IDS Life Special Income Fund I, Inc.
IDS Life of New York Account E, to invest in shares
of IDS Life Moneyshare Fund, Inc.
IDS Life of New York Account F, to invest in shares
of IDS Life Capital Resource Fund II, Inc.
IDS Life of New York Account G, to invest in shares
of IDS Life Special Income Fund II, Inc.
IDS Life of New York Account H, to invest in shares
of IDS Life Moneyshare Fund, Inc.
RESOLVED FURTHER, That the President of the Corporation is
hereby authorized, subject to any necessary approval by the
Superintendent of Insurance of the State of New York, to cause
the transfer of so much of the Corporation's funds from its
general account to the separate accounts as may be necessary
to comply with Section 14 of the Investment Company Act of
1940. Such funds shall be held therein until this Executive
Committee or the Board of Directors authorizes its retransfer
to the general account; and
<PAGE>
PAGE 2
RESOLVED FURTHER, That the proper officers of the Corporation
are hereby authorized and directed to accomplish all filings
and registrations necessary for the commencement of the sale
of variable annuity contracts based on the Accounts, and,
without limiting the generality of the foregoing, to execute
the following instruments on behalf of the Corporation:
a) Investment Company Act Notification and
Registration Statements of a unit investment
trust comprised of Accounts C, D, and E, and a
unit investment trust comprised of Accounts F,
G. and H.
b) Securities Act Registration Statements of both
unit investment trusts.
c) Such application for exemptive or other orders
under federal securities laws, and all other
instruments, as counsel deems necessary or
desirable.
There being no further business, the meeting was duly adjourned.
/s/ Richard J. O'Brien
Secretary
<PAGE>
PAGE 3
MINUTES OF THE MEETING OF
THE BOARD OF DIRECTORS
IDS LIFE INSURANCE COMPANY
OF NEW YORK
March 10, 1982
Pursuant to notice duly given, a regular meeting of the Board of
Directors of IDS Life Insurance Company of New York was held at
9:00 A.M. on March 10, 1982, in the IDS Tower, Minneapolis,
Minnesota. The following directors were present:
Joseph R. Pickering, Chairman
Amberson H. Birckhead
George F. Ceithaml
Douglas W. Franchot, III
Albert M. Frost
George A. Horton, III
Charles K. Morgan
Francis G. Perry
John P. Ryan
Walter D. Scott
Also present were: Richard N. Latzer, Investment Officer, Lee D.
McKenzie, Treasurer, and Arlyn Ruesink and Darryl Briley of Peat,
Marwick, Mitchell & Co. (PMM).
The Board then considered a proposal that the names of the Separate
Accounts established by the Executive Committee on November 12,
1981, be changed. Mr. Pickering stated that the accounts had been
designated alphabetically to correspond with the parent company's
separate accounts, but this was now perceived as a source of
potential confusion and that numeric names would be preferable.
Upon motion made and duly seconded, the following resolution was
adopted:
RESOLVED, that the name of each separate account of the
Corporation is changed to a numeric, rather than alphabetic,
designation, with Account C becoming Account 1 and seriately
thereafter.
<PAGE>
PAGE 1
MINUTES OF A SPECIAL MEETING
OF THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS
OF IDS LIFE INSURANCE COMPANY OF NEW YORK
A special meeting of the Executive Committee of the Board of
Directors of IDS Life Insurance Company of New York was held at
10:30 A.M., on February 12, 1986, at the office of James A.
Mitchell, 2900 IDS Tower, Minneapolis, Minnesota. All members of
the Executive Committee were present. Following discussion, the
following resolutions were duly adopted:
WHEREAS, This Committee has determined that it is desirable
for the Corporation to provide for the acquisition of shares
of IDS Life Managed Fund under its variable annuity contracts,
now, therefore, be it
RESOLVED, That the action taken by this Executive Committee on
April 17, 1985, with respect to establishing separate accounts
for IDS Life Managed Fund, Inc., is hereby rescinded.
RESOLVED FURTHER, That the separate account set forth below is
hereby established in accordance with Section 4240, New York
Insurance Law and New York Insurance Regulation 47:
IDS Life of New York Account 9, to invest in shares of
IDS Life Managed Fund Inc.
RESOLVED FURTHER, That the Unit Investment Trust comprised of
IDS Life of New York Accounts 4, 5, and 6 is hereby
reconstituted as IDS Life of New York Accounts 4, 5, 6, and 9.
RESOLVED FURTHER, That these resolutions be ratified by the
full Board of Directors of the Corporation at their next
regular meeting.
RESOLVED FURTHER, That the proper officers of the Corporation
are hereby authorized and directed to accomplish all filings
and registrations necessary to carry the foregoing into
effect.
There being no further business, the meeting was duly adjourned.
/s/ Paul D. Sabby
Assistant Secretary
<PAGE>
PAGE 1
VARIABLE ANNUITY AND LIFE INSURANCE DISTRIBUTION AGREEMENT
This Variable Annuity and Life Insurance Distribution Agreement
("Agreement") by and between IDS Life Insurance Company of New York
("IDSLNY"), a New York corporation, and IDS Financial Services,
Inc. ("IDS"), a Delaware corporation, with respect to the sale of
variable annuity and life insurance contracts in the State of New
York, all in consideration of the premises and the mutual
agreements herein contained,
WITNESSETH THAT:
1. IDSLNY is licensed in the State of New York by the New
York Insurance Department to conduct a life insurance, annuities,
and accident and health insurance business. IDS Life of New York
has established several separate accounts, ("the Accounts"), for
the purpose of providing variable annuity contracts and life
insurance policies. IDSLNY was organized under the laws of the
State of New York and will secure all necessary approvals from the
Superintendent of Insurance to sell its variable annuity contracts
in New York.
2. IDS is registered with the National Association of
Securities Dealers, Inc. ("NASD") as a broker-dealer under the
Securities Exchange Act of 1934 ("1934 Act") and is qualified to do
business as a foreign corporation in the State of New York. It
will seek approval from the New York Superintendent of Insurance to
sell variable annuity contracts and life insurance policies as
agent for IDSLNY.
3. IDSLNY hereby appoints IDS to solicit and procure,
within the State of New York, applications for variable annuity
contracts and life insurance policies to be issued by IDS Life of
New York through the Accounts. As used herein, the term "variable
annuity contract" or "variable life insurance policy" means any
annuity contract or life insurance policy under which all or any
part of the benefits may be paid on a variable basis.
4. No person affiliated with IDS shall offer or sell
IDSLNY variable annuity contracts or life insurance policies unless
duly licensed (a) as an "associated person" of IDS pursuant to the
1934 Act, and not subject to a bar or suspension order thereunder
and (b) as an insurance agent for IDSLNY under the New York
Insurance Law. Such qualification and licensing shall be the sole
responsibility of IDS.
5. Sales compensation of IDS managers and financial
planners with respect to each IDSLNY variable annuity contract or
life insurance policy sold shall be paid in accordance with
compensation schedules published from time to time by IDS. Any
compensation payable shall be subject to the terms and conditions
contained in the form of agreements between IDS and its managers
and financial planners, as amended.
<PAGE>
PAGE 2
6. It is agreed, with respect to those services which are
to be provided to IDSLNY upon an allocated cost basis by IDS, that
any such method of allocation or classification of expenses
incurred or services rendered shall be in conformance with
Regulation 33 of the New York Insurance Department. If at any time
either IDSLNY or IDS can reasonably demonstrate that any method of
allocation is more equitable in conformance with such Regulation
33, the current method of allocation shall then be subject to
renegotiation. In any event, review of all expenses for the year
will be made annually, to make all necessary adjustments in the
amounts billed hereunder in order to conform them with the amount
of such expenses actually incurred.
7. For the solicitation of applications by IDS through its
financial planners, and for the motivational and supervisory
services and field training services performed by IDS, IDSLNY will
reimburse IDS for the compensation it becomes obligated, by reason
of IDSLNY's variable annuity or life insurance business, to pay to
its financial planners, supervisors, managers and field trainers,
pursuant to written agreements with such persons; provided,
however, that such agreements have been approved in advance by
IDSLNY and comply in all respects with the insurance laws and
regulations of the State of New York; and provided, further, that
IDS hereby agrees that any such agreement will be terminated or
modified by it upon direction of IDSLNY. IDS agrees to hold IDSLNY
harmless from any claim for compensation by any such financial
planner or field trainer, or by any manager or supervisor with
respect to his services on behalf of IDS as contemplated in this
agreement.
8. IDSLNY agrees to pay IDS its allocated portion of IDS's
cost with respect to variable annuities and life insurance in
maintaining and providing so many division sales offices as may
reasonably be required, suitably located and appointed; staffing
each such office with personnel capable of providing secretarial,
filing, and telephone answering services to the sales force;
providing communication services, such as telephone, distribution
of mail, mailing, maintenance of supplies of forms and sales
literature, etc.,; conducting training schools and sales office
training,as needed; supplying the services of the IDS training and
development staff in providing technical assistance and training
with respect to employer-related marketing efforts; developing and
producing audiovisual training aids, and providing technical
assistance in the use thereof; providing technical assistance and
training with respect to special markets; and, generally, providing
complete training service and monitoring of field training
activities.
9. In recognition of the fact that IDS, as a trainer for
IDSLNY, incurs certain overhead or "cost of doing business"
expenses which are not directly allocable to specific variable
annuity or life insurance services provided by it to IDSLNY, IDSLNY
agrees to pay IDS a subsistence fee, determined on an equitable and
uniform allocation in conformance with Regulation 33 of the New
York Insurance Department, but without any provision for profit by
IDS. It is agreed that the amount of such fee should be included
<PAGE>
PAGE 3
in all amounts billed to IDSLNY under this agreement, and shall be
subject to annual or more frequent review and negotiation by
IDSLNY.
10. IDS assumes full responsibility for the supervision of
its associated persons in all their activities covered by this
agreement.
11. IDSLNY may conduct training programs for IDS sales
managers and financial planners at times and places to be agreed
upon, for the purpose of familiarizing IDS personnel with the
provisions of IDSLNY contracts, desirable sales techniques and
administrative procedures.
12. IDSLNY will supply IDS with reasonable quantities of
current prospectuses as filed with the Securities and Exchange
Commission, quarterly reports, and other sales material. In
selling IDSLNY contracts, IDS shall use only sales material which
has been approved by IDSLNY and filed with the NASD.
13. Purchase applications, IDSLNY prospectus receipts,
other IDSLNY forms and payments received by IDS financial planners
will be promptly forwarded to the appropriate IDS division office.
IDS will conduct a review to determine the suitability of the sale.
IDS financial planners shall follow established IDSLNY procedures
regarding forms, applications, prospectus receipts, and other such
matters of administration. After IDS has conducted its review, it
will forward all relevant material, including any of its own
completed forms, to IDSLNY's home office. IDSLNY will then make a
decision whether to accept or reject the variable annuity or life
insurance application.
14. Upon issuance, each variable annuity contract or life
insurance policy sold through IDS will be mailed directly from IDS
Life of New York to the appropriate IDS Division Office or to the
financial planner for personal delivery to the policyholder.
15. Except as otherwise provided in the Agreement, all
standard IDSLNY administrative procedures will be followed. IDSLNY
will, whenever appropriate, advise IDS of such procedures.
16. This agreement may be terminated at any time by mutual
agreement of the parties, or by thirty day notice given by either
to the other.
17. This agreement shall become effective July 1st, 1987,
subject to applicable regulatory approvals, and shall supersede all
prior agreements between the parties hereto regarding the
distribution of variable insurance policies or contracts.
18. This agreement shall be governed by New York Law.
<PAGE>
PAGE 4
IDS Life Insurance Company of New York
BY /s/ David P. Morency
Vice-President
IDS Financial Services, Inc.
BY /s/ Louis C. Fornetti
Vice-President
Dated________________________
<PAGE>
PAGE 1
IDS Life Insurance Company A stock Company
of New York
Box 5144
Albany, New York 12205
An American Express Company
DEFERRED ANNUITY CONTRACT
o Flexible purchase payments.
o Optional fixed dollar or variable accumulation values and annuity
payments.
o Annuity payments to begin on the retirement date.
o This contract is nonparticipating. Dividends are not payable.
Annuitant: John Doe
Contract Number: 9310-1234567
Contract Date: April 1, 1986
Retirement Date: April 1, 2006
This is a deferred annuity contract. It is a legal contract
between you, as the owner, and us, IDS Life Insurance Company of
New York. PLEASE READ YOUR CONTRACT CAREFULLY.
If the annuitant is living on the Retirement Date, we will begin to
pay you monthly annuity payments. Any payments made by us are
subject to the terms of this contract.
We issue this contract in consideration of your application and the
payment of the purchase payments.
Signed for and issued by IDS Life Insurance Company of New York in
Albany, New York, as of the contract date shown above.
ACCUMULATION VALUES AND ANNUITY PAYMENTS, WHEN BASED ON THE
INVESTMENT RESULTS OF THE SEPARATE ACCOUNTS, ARE VARIABLE AND NOT
GUARANTEED AS TO FIXED DOLLAR AMOUNT.
NOTICE OF YOUR RIGHT TO EXAMINE THIS CONTRACT FOR 10 DAYS
If for any reason you are not satisfied with this contract, return
it to us or our representative within 10 days after you receive it.
We will then cancel this contract. Upon such cancellation we will
then cancel this contract. Upon such cancellation we will refund
an amount equal to the sum of: (1) the contract value; and (2) any
premium tax charges paid. This contract will then be considered
void from its start.
President
James A. Mitchell
Secretary
Richard J. O'Brien
<PAGE>
PAGE 2
GUIDE TO CONTRACT PROVISIONS
Definitions Important words and meanings/Page 3
General Provisions Entire contract; Incontestability;
Misstatement of Age; State
Laws; Reports to owner; Evidence
of survival; Protection of proceeds;
Payments by us; Voting rights/Page 4
Ownership and Beneficiary Owner rights; Trust or custodial
ownership; Change of ownership;
Beneficiary; Change of Beneficiary
Page 5
Payments to Beneficiary Describes options and amounts
payable upon death/Page 6
Purchase Payments Purchase payments amount and
intervals; Payment limits;
Allocation of purchase payments
Page 7
Contract Value Describes the fixed and variable
account contract values; Interest to
be credited; Contract administrative
charge; Premium taxes; Transfers of
contract values/Page 8
Fixed and Variable Accounts Describes the variable accounts,
accumulation units and values; Net
investment factor; Mortality and
expense risk charge; Annuity unit
value/Page 9
Surrender Provisions Surrender of the contract for its
surrender value; Rules for
surrender/Page 10
Annuity Provisions When annuity payments begin;
Different ways to receive annuity
payments; Determination of payment
amounts/Page 12
Table of Settlement Rates Tables showing the amount of the
first variable annuity payment and
fixed annuity payments for the
various payment plans/Page 14
<PAGE>
PAGE 3
CONTRACT DATA
Annuitant: John Doe
Contract Number: Sample
Contract Date: April 1, 1986
Retirement Date: April 1, 2006
Contract Owner: John Doe
Upon issuance of this contract your purchase payments have been
scheduled to be paid and applied to the fixed and variable accounts
as shown below. You may change the amount, frequency and
allocations as provided in this contract. Refer to the purchase
payments provisions on Page 7.
Lump Sum Single Purchase Payment Only: None
Scheduled Purchase Payments: Annual Amount: $1,200
Payable: $100 monthly
Variable Purchase Payment
Accounts Mutual Fund Allocation Percentage
4 IDS Life Capital Resource Fund 20%
5 IDS Life Special Income Fund 20%
6 IDS Life Moneyshare Fund 20%
9 IDS Life Managed Fund 20%
Fixed
Account 20%
Surrender Charge: If you surrender all or a portion of this
contract surrender charges may apply. See Page __.
Contract Administrative Charge: See page __.
Maximum Purchase Payments Permitted
1st contract year: $250,000
each contract year
thereafter: 50,000
<PAGE>
PAGE 4
CONTRACT DATA (continued)
Annuitant: John Doe
Contract Number: Sample
Fixed Account
Table of Guaranteed Minimum Contract and Surrender Values
Guaranteed Interest Rate: 4% Per Year Compounded Annually
The following table shows the guaranteed minimum fixed account
contract and surrender values based on these assumptions: (1) $100
purchase payments are received and allocated 100% to the fixed
account at the beginning of each month; (2) There have been no
surrenders; (3) There are no premium tax charges. If purchase
payments are otherwise paid or allocated or if there are
surrenders, or premium tax charges, the values below will be
adjusted in accordance with the provisions of this contract.
<TABLE>
<CAPTION>
Guaranteed Guaranteed Guaranteed Guaranteed
End of Minimum Minimum End of Minimum Minimum
Contract Fixed Account Fixed Account Contract Fixed Account Fixed Account
Year Contract Value Surrender Value Year Contract Value Surrender Value
<C> <C> <C> <C> <C>
1 1201.86 1118.21 16 26232.83 25728.83
2 2451.93 2284.29 17 28484.15 27980.15
3 3752.01 3500.36 18 30825.51 30321.51
4 5104.09 4768.44 19 33260.53 32756.53
5 6510.26 6090.61 20 35792.95 35288.95
6 7972.67 7469.02 21 38426.67 37922.67
7 9493.57 8989.57 22 41165.74 40661.74
8 11075.31 10571.31 23 44014.37 43510.37
9 12720.33 12216.33 24 46976.94 46472.94
10 14431.14 13927.14 25 50058.02 49554.02
11 16210.39 15706.39 26 53262.34 52758.34
12 18060.80 17556.80 27 56594.84 56090.84
13 19985.23 19481.23 28 60060.63 59556.63
14 21986.64 21482.64 29 63665.05 63161.05
15 24068.11 23564.11 30 67413.66 66909.66
</TABLE>
Variable account contract and surrender values are not guaranteed.
Information concerning contract and surrender values will be
provided to you at any time upon written request.
<PAGE>
PAGE 5
DEFINITIONS
The following words are used often in this contract. When we use
these words, this is what we mean:
annuitant
The person on whose life monthly annuity payments depend.
you, your
The owner of this contract. The owner may be someone other than
the annuitant. The owner is shown in the application unless the
owner has been changed as provided in this contract.
we, our, us
IDS Life Insurance Company of New York.
accumulation unit
An accumulation unit is an accounting unit of measure. It is used
to calculate the contract value prior to settlement.
annuity unit
An annuity unit is an accounting unit of measure. It is used to
calculate the value of annuity payments from the variable accounts
on and after the retirement date.
contract date
It is the date from which contract anniversaries, contract years,
and contract months are determined. Your contract date is shown
under Contract Data.
contract anniversary
The same day and month as the contract date each year that the
contract remains in force.
contract value
The sum of the: (1) Fixed Account Contract Value; and (2) Variable
Account Contract Value.
retirement date
The date shown under Contract Data on which annuity payments are to
begin. This date may be changed as provided in this contract.
settlement
The application of the contract value of this contract to provide
annuity payments.
<PAGE>
PAGE 6
DEFINITIONS (contined)
valuation date
A valuation date is each day the New York Stock Exchange is open
for trading.
valuation period
A valuation period is the interval of time commencing at the close
of business on each valuation date and ending at the close of
business on the next valuation date.
fixed account
The fixed account is made up of all our assets other than those in
any separate account.
variable accounts
The variable accounts are named under Contract Data. Each is a
separate investment account of ours.
fixed annuity
A fixed annuity is an annuity with payments which are guaranteed by
us as to dollar amount during the annuity payment period.
variable annuity
A variable annuity is an annuity with payments which (1) are not
predetermined or guaranteed as to dollar amount; and (2) vary in
amount with the investment experience of one or more of the
variable accounts.
written request
A request in writing signed by you and delivered to us at our home
office.
<PAGE>
PAGE 7
GENERAL PROVISIONS
Entire Contract
This contract form is and the application form attached to it are
the entire contract between you and us.
No one except one of our corporate officers (President, Vice
President, Secretary or Assistant Secretary) can change or waive
any of our rights or requirements under this contract. That person
must do so in writing. None of our representatives or other
persons has the authority to change or waive any of our rights or
requirements under this contract.
In issuing this contract, we have relied upon the application. The
statements contained in the application are, considered
representations and not warranties. No statement made in
connection with the application will be used by us to void the
contract or to deny a claim unless that statement is part of the
application.
Incontestable
After this contract has been in force during the annuitant's life
for two years from its date of issue, we cannot contest the
contract.
Misstatement of Age or Sex
If the annuitant's birthdate or sex has been misstated, payments
under this contract will be adjusted. They will be based on what
would have been provided at the correct birthdate and sex. Any
underpayments made by us will be made up immediately. Any
overpayments made by us will be subtracted from the future
payments.
State Laws
This contract is governed by the law of the state in which it is
delivered. The values and benefits of this contract are at least
equal to those required by such state.
Reports to Owner
At least once a year we will send you a statement showing the
contract value of this contract. This statement will be based on
any laws or regulations that apply to contracts of this type.
Evidence of Survival
Where any payments under this contract depend on the recipient or
annuitant being alive on a given date, proof that such condition
has been met may be required by us. Such proof may be required
prior to making the payments.
<PAGE>
PAGE 8
GENERAL PROVISIONS (continued)
Protection of Proceeds
Payments under this contract are not assignable by any Beneficiary
prior to the time they are due. To the extent allowed by law,
payments are not subject to the claims of creditors or to legal
process.
Payments By Us
All sums payable by us are payable at our home office. Any payment
of a variable annuity or surrender based on the variable contract
value shall be payable only from the variable accounts.
Voting Rights
So long as federal law requires, you may have the right to vote at
the meetings of the Variable Contract Owners. If you have voting
rights we will send a notice to you telling you the time and place
of a meeting. The notice will also explain matters to be voted
upon and how many votes you get.
Trustee or custodian owners shall cast votes according to
instructions received from appropriate annuitants. All other votes
of such trustee or custodian under the same trust or custodial
agreement shall be cast in the same proportion. If no instructions
are received, the votes may be cast at the trustee's or custodian's
discretion.
<PAGE>
PAGE 9
OWNERSHIP AND BENEFICIARY
Owner's Rights
As long as the annuitant is living and unless otherwise provided in
this contract, you may exercise all rights and privileges provided
in this contract or allowed by us.
Trust or Custodial Ownership
If you are a tax qualified trust or tax qualified custodial
account, then your trustees or custodian (or their successors)
properly named by your trust or custodial agreement may exercise
all rights and privileges provided in this contract or allowed by
us.
Change of Ownership (Restricted)
Your right to change the ownership of this contract is restricted.
This contract may not be sold, assigned, transferred, discounted or
pledged as collateral for a loan or as security for the performance
of an obligation or for any other purpose to any person other than
to us. However, if you are a trust or a custodian or an employer
as a part of a qualified plan under Sections 401 or 403 or a
deferred compensation plan under Section 457 of the Internal
Revenue Code of 1954, you may transfer ownership of this contract
to the annuitant. Such transfer must be on a form approved by us.
The change must be made while the annuitant is living. Once the
change is received by us, it will take effect as of the date of
your request, subject to any action taken or payment made by us
before the receipt.
Beneficiary
Beneficiaries are those you name, in a form satisfactory to us, to
receive benefits of this contract if you or the annuitant die while
this contract is in force. The beneficiary is shown in the
application unless you have, since the issue date of this contract,
changed the beneficiary as provided below.
Change of Beneficiary
You may change the beneficiary anytime while the annuitant is
living by satisfactory written request to us. Once the change is
received by us, it will take effect as of the date of your request,
subject to any action taken or payment made by us before the
receipt.
Only those beneficiaries who are living when death benefits become
payable may share in the benefits, if any. If no beneficiary is
then living, we will pay the benefits to you, if living, otherwise
to your estate.
<PAGE>
PAGE 10
PAYMENTS TO BENEFICIARY
Death Benefit Before the Retirement Date
If the annuitant or owner dies before the retirement date while
this contract is in force we will pay to the beneficiary the
greater of:
1. the contract value; or
2. the purchase payments paid less any amounts surrendered.
The above amount will be payable in a lump sum upon the receipt of
due proof of death of the annuitant or owner whichever first
occurs.
In lieu of a lump sum, payment may be made under an Annuity Payment
Plan, provided:
1. the beneficiary elects the plan within 60 days after we
receive due proof of death; and
2. payments begin no later than one year after the date of death;
and
3. the plan provides payments over a period which does not exceed
the life of the beneficiary, or the life expectancy of the
beneficiary.
In this event, the reference to "annuitant" in the Annuity
Provisions shall apply to the beneficiary.
Any amounts payable or applied by us as described in this section
will be based on the contract value as of the valuation date on or
next following the date on which due proof of death is received at
our Home Office.
Spouse Option to Continue Contract
If death occurs prior to the retirement date, a spouse who is
designated as sole beneficiary may elect in writing to forego
receipt of the death benefit and instead continue this contract in
force as its owner. The election by the spouse must be made within
60 days after we receive due proof of death and is subject to the
following:
1. For contracts that are purchased under plans intended to
qualify under Sections 403(b) or 457 of the Internal Revenue
Code of 1954, as amended: The above option is available only
if the death benefit becomes payable by reason of the death of
the owner.
<PAGE>
PAGE 11
PAYMENTS TO BENEFICIARY (continued)
2. For contracts that are purchased under plans intended to
qualify under Sections 401(a) of the Internal Revenue Code of
1954, as amended: The above option is available only if the
death benefit becomes payable by reason of the death of the
annuitant prior to age 70-1/2. In this event this contract
may be continued in force only until the date on which the
annuitant would have attained age 70-1/2.
Annuitant's Death After the Retirement Date
If the annuitant dies after the retirement date, the amount
payable, if any, will be as provided in the Annuity Payment Plan
then in effect.
<PAGE>
PAGE 12
PURCHASE PAYMENTS
Purchase Payments
Purchase payments are the payments you make for this contract and
the benefits it provides. Purchase payments must be paid or mailed
to us at our home office or to an authorized agent. If requested,
we'll give you a receipt for your purchase payments. Upon payment
to us, purchase payments become our property.
Net purchase payments are that part of your purchase payments
applied to the contract value. A net purchase payment is equal to
the purchase payment less any applicable premium tax charge.
Amount and Intervals
Purchase payments may be paid in a single sum or in installments
until the earlier of: (1) the date this contract terminates by
surrender or otherwise; or (2) the date on which annuity payments
begin.
Based upon your application we have scheduled your purchase
payments for the amount and interval as shown under Contract Data.
Subject to the Payment Limits Provision you may: (1) stop and/or
restart purchase payments; or (2) increase or decrease the amount
of your purchase payments; or (3) change the interval of your
purchase payments.
Payment Limits Provision
Maximum Purchase Payments - The maximum purchase payments in the
first or later contract years may not exceed the amounts shown
under Contract Data. We reserve the right to increase the
maximums.
Minimum Purchase Payments - Upon issue of this contract, a purchase
payment intended as a Single Purchase Payment must be at least
$5,000. If you intend to make installment purchase payments such
payments, on an annualized basis, must be at least equal to $600.
We also reserve the right to cancel this contract if both of the
following conditions exist at the same time: (1) no purchase
payments have been paid for a continuous period of 24 months; and
(2) less than $600 in purchase payments have been paid under this
contract. In this event we will give you 30 days written notice of
our intent to cancel this contract. Upon such cancellation we will
pay you the contract value in one sum. This contract will then
terminate.
Allocation of Purchase Payments
You instruct us on how you want your purchase payments allocated
among the fixed account and variable accounts. Your choice for
each account may be made in any whole percent from 0% to 100% as
long as the total adds up to 100%. Your allocation instructions as
<PAGE>
PAGE 13
PURCHASE PAYMENTS (continued)
of the Contract Date are shown in the application. By written
request, or by another method agreed to by us, you may change your
choice of accounts or percentages. The first net purchase payment
will be allocated as of the end of the valuation period during
which we make an affirmative decision to issue this contract. Net
purchase payments after the first will be allocated as of the end
of the valuation period during which we receive the payment at our
home office.
<PAGE>
PAGE 14
CONTRACT VALUE
Contract Value
The contract value at any time is the sum of: (1) the Fixed Account
Contract Value; and (2) the Variable Account Contract Value.
If: (1) part or all of the contract value is surrendered; or (2)
charges described herein are made against the contract value; then
a number of accumulation units from the variable accounts and an
amount from the fixed account will be deducted to equal such
amount. For surrenders, deductions will be made from the fixed or
variable accounts that you specify. Otherwise, the number of units
from the variable accounts and the amount from the fixed account
will be deducted in the same proportion that your interest in each
bears to the total contract value.
Fixed Account Contract Value
The fixed account contract value at any time will be: (1) the sum
of all amounts credited to the fixed account under this contract;
less (2) any amounts deducted for charges or surrenders.
Interest to be Credited
We will credit interest to the fixed account contract value.
Interest will begin to accrue on the date the purchase payments
which are received in our home office become available to us for
use. Such interest will be credited at rates that we determine
from time to time. However, we guarantee that the rate will not be
less than the Guaranteed Interest Rate shown under Contract Data.
Variable Account Contract Value
The variable account contract value at any time will be: (1) the
sum of the value of all variable account accumulation units under
this contract resulting from purchase payments so allocated, or
transfers among the variable and fixed accounts; less (2) any units
deducted for charges or surrenders.
Contract Charge
We charge a fee for establishing and maintaining our records for
this contract. The charge is $6 per quarter and is deducted from
the contract value at the end of each three-month period measured
from the contract date or, if earlier, when the contract is
surrendered. The charge does not apply after settlement of this
contract.
Premium Tax Charges
A charge will be made by us against the contract value of this
contract at the time that any premium taxes not previously deducted
are payable.
<PAGE>
PAGE 15
CONTRACT VALUE (continued)
Transfers of Contract Values
While this contract is in force prior to the settlement date,
transfer of contract values may be made as outlined below:
1. You may transfer all or a part of the values held in one or
more of the variable accounts to another one or more of the
variable accounts. Subject to item 2, you may also transfer
values held in one or more of the variable accounts to the
fixed account.
2. On or within the 30 days after a contract anniversary you may
transfer values from the fixed account to one or more of the
variable accounts. Only one such transfer is allowed during
this period each year. If such a transfer is made, no
transfers from a variable account to the fixed account may be
made until the next contract anniversary.
You may make a transfer by written request. Transfer requests may
also be made by telephone if we have received a properly completed
authorization form. There is no fee or charge for these transfers.
However, the minimum transfer amount is $250, or if less, the
entire value in the account from which the transfer is being made.
This transfer privilege may be suspended or modified by us at any
time.
<PAGE>
PAGE 16
FIXED AND VARIABLE ACCOUNTS
The Fixed Account
The fixed account is our general account. It is made up of all of
our assets other than: (1) those in the variable accounts; and (2)
those in any other segregated asset account.
The Variable Accounts
The variable accounts are separate investment accounts of ours.
They are named under Contract Data. We have allocated a part of
our assets for this and certain other contracts to the variable
accounts. Such assets remain our property. However, they may not
be charged with the liabilities from any other business in which we
may take part.
Investments of the Variable Accounts
Purchase payments applied to the variable accounts will be
allocated as specified in your application for this contract or as
later changed. Each variable account will buy, at net asset value,
shares of the fund shown for that account under Contract Data or as
later added or changed.
Valuation of Assets
Mutual fund shares in the variable accounts will be valued at their
net asset value.
Variable Account Accumulation Units
The number of accumulation units for each of the variable accounts
is found by dividing: (1) the net amount allocated to the account;
by (2) the accumulation unit value for the account for the
valuation period during which we received the purchase payment.
Variable Account Accumulation Unit Value
The value of an accumulation unit for each of the variable accounts
was arbitrarily set at $1 when the first mutual fund shares were
bought. The value for any later valuation period is found as
follows:
The accumulation unit value for each variable account for the
last prior valuation period is multiplied by the net
investment factor for the same account for the next following
valuation period. The result is the accumulation unit value.
The value of an accumulation unit may increase or decrease
from one valuation period to the next.
<PAGE>
PAGE 17
FIXED AND VARIABLE ACCOUNTS (continued)
Net Investment Factor
The net investment factor is an index applied to measure the
investment performance of a variable account from one valuation
period to the next. The net investment factor may be greater or
less than one; therefore, the value of an accumulation unit may
increase or decrease.
The net investment factor for any such account for any valuation
period is determined by: dividing (1) by (2) and subtracting (3)
from the result. This is done where:
(1) is the sum of:
a. the net asset value per share of the mutual
fund held in the variable account determined at
the end of the current valuation period; plus
b. the per share amount of any dividend or capital
gain distributions made by the mutual fund held
in the variable account, if the "ex-dividend"
date occurs during the current valuation
period.
(2) is the net asset value per share of the mutual fund held in
the variable account, determined at the end of the last prior
valuation period.
(3) is a factor representing the mortality and expense risk
charge.
Mortality and Expense Risk Charge
In calculating accumulation unit values we will deduct a mortality
and expense risk charge from the variable accounts equal, on an
annual basis, to 1.00% of the daily net asset value. This
deduction is made to compensate us for assuming the mortality and
expense risks under contracts of this type. The deduction is: (1)
made from each variable account; and (2) computed on a daily basis.
Annuity Unit Value
The value of an annuity unit for each variable account was
arbitrarily set at $1 when the first mutual funds were bought. The
value of any later valuation period is found as follows:
1. The annuity unit value for each variable account for the last
prior valuation period is multiplied by the net investment
factor for the account for the valuation period for which the
annuity unit value is being calculated.
2. The result is multiplied by an interest factor. This is done
to neutralize the assumed investment rate which is built into
the annuity tables on page 14.
<PAGE>
PAGE 18
SURRENDER PROVISIONS
Surrender
By written request and subject to the rules below you may:
1. surrender this contract for the total surrender value; or
2. partially surrender this contract for a part of the surrender
value.
Surrender Value
The surrender value at any time will be:
1. the contract value;
2. minus the contract administrative charge;
3. minus any surrender charge.
Surrender Charge
In order to determine if a surrender charge applies to a partial or
total surrender we first divide the contract value into three
parts.
1. Contract Earnings - This is the contract value minus the sum
of all purchase payments we have received that have not been
previously surrendered.
2. Old Purchase Payments - These are purchase payments we
received in any contract year more than five years prior to
the contract year of surrrender.
3. New Purchase Payments - These are purchase payments we
received during the contract year in which the surrender is
made or in the five immediately preceding contract years.
We will then surrender your contract value in the following order
so that the amount surrendered, less any surrender charge that
applies, equals your requested surrender amount:
1. Contract Earnings, if any, are surrendered first. There is no
surrender charge on contract earnings.
2. Next, if necessary, we surrender Old Purchase Payments not
previously surrendered. There is no surrender charge on Old
Purchase payments.
3. Finally, if necessary, we surrender New Purchase Payments not
previously surrendered. There is a surrender charge of 7%
applied to New Purchase Payments surrendered.
<PAGE>
PAGE 19
SURRENDER PROVISIONS (continued)
Surrender Charge Calculation
The surrender charge for a total surrender is calculated by
multiplying the amount representing new purchase payments by .07.
The surrender charge for a partial surrender is calculated by
dividing the surrender amount requested representing "new purchase
payments" by .93 and multiplying the result by .07.
For example, the surrender charge on a $1,000 partial surrender
request (representing all "new purchase payments") would be $75.27,
resulting from the following calculation: ($1,000/.93) X .07 =
$75.27.
Rules For Surrender
All surrenders will have the following conditions:
1. You must apply by written request: (a) while this contract is
in force; and (b) prior to the earlier of the retirement date
or the death of the annuitant.
2. You must surrender an amount equal to at least $250. The
contract value after a partial surrender must be at least
$600.
3. The amount surrendered, less any charges, will normally be
paid to you within seven days of the receipt of your written
request and this contract, if required. For surrenders from
the fixed account, we have the right to defer payment to you
for up to 6 months from the date we receive your request.
4. For partial surrenders, if you do not specify from which
accounts the surrender is to be made, the surrender will be
made from the variable accounts and fixed account in the same
proportion as your interest in each bears to the contract
value.
5. Any amounts surrendered and charges which may apply can not be
repaid.
Upon surrender for the full surrender value this contract will
terminate. We may require that you return the contract to us
before we pay the full surrender value.
Suspension or Delay in Payment of Surrender
We have the right to suspend or delay the date of any surrender
payment from the variable accounts for any period:
1. When the New York Stock Exchange is closed; or
2. When trading on the New York Stock Exchange is restricted; or
<PAGE>
PAGE 20
SURRENDER PROVISIONS (continued)
3. When an emergency exists as a result of which: (a) disposal of
securities held in the variable accounts is not reasonably
practicable; or (b) it is not reasonably practicable to fairly
determine the value of the net assets of the variable account;
or
4. During any other period when the Securities and Exchange
Commission, by order, so permits for the protection of
security holders.
Rules and regulations of the Securities and Exchange Commission
will govern as to whether the conditions set forth in 2 and 3 exit.
<PAGE>
PAGE 21
ANNUITY PROVISIONS
Settlement
When settlement occurs, the contract value will be applied to make
annuity payments. The first payment will be made as of the
retirement date. This date is shown under Contract Data. Before
payments begin we will require satisfactory proof that the
annuitant is alive. We may also require that you exchange this
contract for a supplemental contract which provides the annuity
payments.
Change of Retirement Date
You may change the retirement date shown for this contract. Tell
us the new date by written request. However, the retirement date
must not be later than the annuitant's 75th birthday. Also, if you
select a new date, it must be at least 30 days after we receive
your written request at our home office.
Annuity Payment Plans
Subject to the terms of this contract, annuity payments may be made
on a fixed-dollar basis, a variable basis or a combination of both.
You can schedule receipt of annuity payment according to one of the
Plans A through E below or another plan agreed to by us provided:
1. the Plan selected provides for payments over the life of the
annuitant or over the life of the annuitant and a joint
annuitant; or
2. the Plan selected provides for payments over a period which
does not exceed the life expectancy of the annuitant, or over
the life expectancy of the annuitant and a joint annuitant.
Plan A - This provides monthly annuity payments during the
lifetime of the annuitant. No payments will be made after the
annuitant dies.
Plan B - This provides monthly annuity payments during the
lifetime of the annuitant with a guarantee by us that payments
will be made for a period of at least five, ten or fifteen
years. You must select the guaranteed period.
Plan C - This provides monthly annuity payments during the
lifetime of the annuitant with a guarantee by us that payments
will be made for a certain number of months. We determine the
number of months by dividing the amount applied under this
Plan by the amount of the first monthly annuity payment.
<PAGE>
PAGE 22
ANNUITY PROVISIONS (continued)
Plan D - Monthly payments will be paid during the lifetime of
the annuitant and a joint annuitant. When either the
annuitant or the joint annuitant dies we will continue to make
monthly payments during the lifetime of the survivor. No
payments will be paid after the death of both the annuitant
and joint annuitant.
Plan E - This provides monthly fixed dollar annuity payments
for a period of years. The period of years may be no less
than 5 nor more than 30.
By written request to us at least 30 days before the Retirement
Date, you may select the Plan. If at least 30 days before the
Retirement Date we have not received at our home office your
written request to select a Plan, we will make payments according
to Plan B with payments guaranteed for ten years.
If the amount to be applied to a Plan would not provide an initial
monthly payment of at least $20, we have the right to make a lump
sum payment of the contract value.
Fixed Annuity
A fixed annuity is an annuity with payments that are guaranteed by
us as to dollar amount. Fixed annuity payments after the first
payment will never be less than the amount of the first payment.
At settlement, the fixed account contract value will be applied to
the applicable Annuity Table. This will be done in accordance with
the Payment Plan chosen. The amount payable for each $1,000 so
applied is shown in Table B on page 15.
Variable Annuity
A variable annuity is an annuity with payments which: (1) are not
predetermined or guaranteed as to dollar amount; and (2) vary in
amount with the investment experience of the variable accounts.
Determination of First Variable Annuity Payment
At settlement, the variable account contract value will be applied
to the applicable Annuity Table. This will be done: (1) on the
valuation date on or next preceding the seventh calendar day before
the retirement date; and (2) in accordance with the Payment Plan
chosen. The amount payable for the first payment for each $1,000
so applied is shown in Table A on page 14.
Variable Annuity Payments After the First Payment
Variable annuity payments after the first payment vary in amount.
The amount changes with the investment performance of the variable
accounts. The dollar amount of variable annuity payments after the
first is not fixed. It may change from month to month. The dollar
amount of such payments is determined as follows:
<PAGE>
PAGE 23
ANNUITY PROVISIONS (continued)
1. The dollar amount of the first annuity payment is divided by
the value of an annuity unit as of the valuation date on or
next preceding the seventh calendar day before the retirement
date. This result establishes the fixed number of annuity
units for each monthly annuity payment after the first
payment. This number of annuity units remains fixed during
the annuity payment period.
2. The fixed number of annuity units is multiplied by the annuity
unit value as of the valuation date on or next preceding the
seventh calendar day before the date the payment is due. This
result establishes the dollar amount of the payment.
We guarantee that the dollar amount of each payment after the first
will not be affected by variations in expenses or mortality
experience.
Exchange of Annuity Units
Annuity units of any variable account may be exchanged for units of
any of the other variable accounts. This may be done no more than
once a year. Once annuity payments start no exchanges may be made
to or from any fixed annuity.
<PAGE>
PAGE 24
TABLE OF SETTLEMENT RATES
Annuity payments for each $1,000 of value applied under a Payment
Plan will be based on our table of settlement rates in effect on
the date of settlement. The amount of the first monthly variable
annuity payment, based on a 3-1/2% assumed investment return, is
guaranteed to be not less than the amount shown in Table A for the
adjusted age of the annuitant(s). The amount of the first and all
subsequent fixed dollar annuity payments is guaranteed to be not
less than the amount shown in Table B for the adjusted age of the
annuitant(s). Adjusted Age shall be equal to the age nearest
birthday minus an "adjustment" depending on the calendar year of
birth of the annuitant as follows:
Calendar
Year of
Annuitant's
Birth Adjustment
Prior to 1920 0
1920 through 1924 1
1925 through 1929 2
1930 through 1934 3
1935 through 1939 4
1940 through 1944 5
1945 through 1949 6
1950 through 1959 7
1960 through 1969 8
1970 through 1979 9
1980 through 1989 10
After 1989 11
<PAGE>
PAGE 25
TABLE OF SETTLEMENT RATES (continued)
<TABLE>
<CAPTION>
TABLE A Dollar Amount of First Monthly Variable Annuity Payment Per $1,000 Applied
PLAN A PLAN B PLAN C PLAN D - Joint and Survivor
Adjusted Age of Joint Annuitant
Adj. Life 5 years 10 years 15 years With Adj. 10 years 5 years Same 5 years 10 years
Age* Income Certain Certain Certain Refund Age* Younger Younger Age Older Older
<C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
40 3.73 3.73 3.72 3.71 3.69 40 3.34 3.41 3.48 3.54 3.59
41 3.76 3.76 3.76 3.75 3.72 41 3.36 3.44 3.51 3.57 3.62
42 3.80 3.80 3.80 3.78 3.76 42 3.39 3.46 3.53 3.60 3.65
43 3.84 3.84 3.84 3.82 3.80 43 3.41 3.48 3.56 3.63 3.69
44 3.89 3.88 3.88 3.86 3.83 44 3.43 3.51 3.59 3.66 3.73
45 3.93 3.93 3.92 3.91 3.87 45 3.45 3.54 3.62 3.70 3.76
46 3.98 3.98 3.97 3.95 3.92 46 3.48 3.57 3.66 3.74 3.80
47 4.03 4.03 4.02 4.00 3.96 47 3.50 3.60 3.69 3.78 3.85
48 4.08 4.08 4.07 4.05 4.01 48 3.53 3.63 3.73 3.82 3.89
49 4.14 4.13 4.12 4.10 4.06 49 3.56 3.66 3.77 3.86 3.94
50 4.20 4.19 4.18 4.15 4.11 50 3.59 3.70 3.81 3.91 3.99
51 4.26 4.25 4.24 4.21 4.16 51 3.62 3.74 3.85 3.96 4.04
52 4.32 4.32 4.30 4.26 4.22 52 3.65 3.78 3.90 4.01 4.10
53 4.39 4.38 4.36 4.33 4.27 53 3.69 3.82 3.95 4.06 4.16
54 4.46 4.46 4.43 4.39 4.34 54 3.73 3.86 4.00 4.12 4.22
55 4.54 4.53 4.51 4.46 4.40 55 3.76 3.91 4.05 4.18 4.29
56 4.62 4.61 4.58 4.53 4.47 56 3.80 3.96 4.11 4.25 4.36
57 4.71 4.70 4.66 4.60 4.54 57 3.85 4.01 4.17 4.31 4.44
58 4.80 4.79 4.75 4.68 4.62 58 3.89 4.06 4.23 4.39 4.52
59 4.90 4.88 4.84 4.76 4.70 59 3.94 4.12 4.30 4.47 4.60
60 5.00 4.99 4.93 4.84 4.78 60 3.99 4.18 4.37 4.55 4.70
61 5.11 5.09 5.03 4.93 4.87 61 4.04 4.25 4.45 4.64 4.79
62 5.23 5.21 5.14 5.02 4.96 62 4.10 4.31 4.53 4.73 4.90
63 5.36 5.33 5.25 5.12 5.06 63 4.16 4.39 4.62 4.83 5.01
64 5.49 5.46 5.37 5.21 5.17 64 4.22 4.47 4.71 4.94 5.13
65 5.64 5.60 5.50 5.31 5.28 65 4.29 4.55 4.81 5.05 5.26
66 5.79 5.75 5.63 5.42 5.39 66 4.36 4.64 4.92 5.18 5.40
67 5.95 5.91 5.77 5.53 5.52 67 4.44 4.73 5.03 5.31 5.54
68 6.13 6.08 5.91 5.63 5.65 68 4.52 4.83 5.15 5.45 5.70
69 6.32 6.26 6.07 5.74 5.79 69 4.60 4.94 5.28 5.61 5.87
70 6.53 6.46 6.23 5.86 5.94 70 4.70 5.05 5.43 5.77 6.06
71 6.75 6.67 6.40 5.97 6.09 71 4.79 5.18 5.58 5.95 6.25
72 6.99 6.89 6.58 6.08 6.26 72 4.90 5.31 5.74 6.14 6.47
73 7.26 7.13 6.76 6.18 6.44 73 5.01 5.45 5.92 6.35 6.70
74 7.54 7.39 6.95 6.29 6.63 74 5.13 5.61 6.11 6.58 6.95
75 7.85 7.67 7.14 6.39 6.83 75 5.26 5.77 6.32 6.82 7.22
*Adjusted age of annuitant.
Table A above is based on the "1983 Individual Annuitant Mortality Table a." Settlement rates for any age, or any combination of
age and sex not shown above, will be calculated on the same basis as those rates shown in the table above. Such rates will be
furnished by us upon request.
</TABLE>
<PAGE>
PAGE 26
TABLE OF SETTLEMENT RATES (continued)
<TABLE>
<CAPTION>
TABLE B Dollar Amount of Each Monthly Fixed Dollar Annuity Payment Per $1,000 Applied
PLAN A PLAN B PLAN C PLAN D - Joint and Survivor
Adjusted Age of Joint Annuitant
Adj. Life 5 Years 10 Years 15 Years With Adj. 10 Years 5 Years Same 5 Years 10 Years
Age* Income Certain Certain Certain Refund Age* Younger Younger Age Older Older
<C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
40 4.04 4.04 4.03 4.02 4.01 40 3.67 3.73 3.79 3.85 3.90
41 4.07 4.07 4.07 4.06 4.04 41 3.69 3.75 3.82 3.88 3.93
42 4.11 4.11 4.10 4.09 4.07 42 3.71 3.78 3.84 3.91 3.96
43 4.15 4.15 4.14 4.13 4.11 43 3.73 3.80 3.87 3.94 3.99
44 4.19 4.19 4.18 4.17 4.15 44 3.75 3.82 3.90 3.97 4.03
45 4.24 4.23 4.23 4.21 4.19 45 3.77 3.85 3.93 4.00 4.07
46 4.28 4.28 4.27 4.25 4.23 46 3.79 3.88 3.96 4.04 4.10
47 4.33 4.33 4.32 4.30 4.27 47 3.82 3.91 3.99 4.08 4.15
48 4.38 4.38 4.37 4.34 4.32 48 3.84 3.94 4.03 4.12 4.19
49 4.44 4.43 4.42 4.39 4.36 49 3.87 3.97 4.07 4.16 4.24
50 4.50 4.49 4.47 4.45 4.41 50 3.90 4.00 4.11 4.20 4.28
51 4.56 4.55 4.53 4.50 4.47 51 3.93 4.04 4.15 4.25 4.34
52 4.62 4.61 4.59 4.56 4.52 52 3.96 4.08 4.19 4.30 4.39
53 4.69 4.68 4.66 4.62 4.58 53 3.99 4.12 4.24 4.35 4.45
54 4.76 4.75 4.72 4.68 4.64 54 4.03 4.16 4.29 4.41 4.51
55 4.84 4.83 4.80 4.74 4.71 55 4.07 4.20 4.34 4.47 4.58
56 4.92 4.91 4.87 4.81 4.77 56 4.10 4.25 4.40 4.53 4.65
57 5.00 4.99 4.95 4.88 4.85 57 4.15 4.30 4.45 4.60 4.72
58 5.09 5.08 5.03 4.96 4.92 58 4.19 4.35 4.52 4.67 4.80
59 5.19 5.17 5.12 5.04 5.00 59 4.24 4.41 4.58 4.75 4.89
60 5.29 5.27 5.22 5.12 5.09 60 4.28 4.47 4.65 4.83 4.98
61 5.40 5.38 5.32 5.21 5.18 61 4.34 4.53 4.73 4.92 5.07
62 5.52 5.50 5.42 5.30 5.27 62 4.39 4.60 4.81 5.01 5.18
63 5.65 5.62 5.53 5.39 5.37 63 4.45 4.67 4.90 5.11 5.29
64 5.78 5.75 5.65 5.49 5.48 64 4.51 4.75 4.99 5.21 5.41
65 5.92 5.89 5.77 5.58 5.59 65 4.58 4.83 5.09 5.33 5.53
66 6.08 6.03 5.90 5.69 5.71 66 4.65 4.92 5.19 5.45 5.67
67 6.24 6.19 6.04 5.79 5.83 67 4.72 5.01 5.30 5.58 5.81
68 6.42 6.36 6.19 5.90 5.97 68 4.80 5.11 5.42 5.72 5.97
69 6.61 6.54 6.34 6.01 6.11 69 4.89 5.21 5.55 5.88 6.14
70 6.81 6.74 6.50 6.12 6.26 70 4.98 5.33 5.69 6.04 6.33
71 7.04 6.95 6.67 6.22 6.42 71 5.07 5.45 5.85 6.22 6.52
72 7.28 7.17 6.84 6.33 6.59 72 5.18 5.58 6.01 6.41 6.74
73 7.54 7.41 7.02 6.44 6.77 73 5.29 5.72 6.19 6.62 6.97
74 7.83 7.67 7.21 6.54 6.97 74 5.41 5.88 6.38 6.84 7.22
75 8.14 7.95 7.40 6.64 7.17 75 5.53 6.04 6.58 7.09 7.49
*Adjusted age of annuitant.
Table B above is based on the "1983 Individual Annuitant Mortality Table a" assuming an interest rate of 4% per year compounded
annually. Settlement rates for any age, or any combination of ages not shown above, will be calculated on the same basis as those
rates shown in the table above. Such rates will be furnished by us upon request. Amounts shown in the Table below are based on an
assumed interest rate of 4% per year compounded annually.
</TABLE>
<TABLE>
<CAPTION>
PLAN E Dollar Amount of Each Monthly Fixed Dollar Annuity Payment Per $1,000 Applied
Years Monthly Years Monthly Years Monthly
Payable Payment Payable Payment Payable Payment
<C> <C> <C> <C> <C> <C>
5 $18.32 15 $7.34 25 $5.22
6 15.56 16 7.00 26 5.10
7 13.59 17 6.71 27 5.00
8 12.12 18 6.44 28 4.90
9 10.97 19 6.21 29 4.80
10 10.06 20 6.00 30 4.72
11 9.31 21 5.81
12 8.69 22 5.64
13 8.17 23 5.49
14 7.72 24 5.35
</TABLE>
<PAGE>
PAGE 1
IDS Life Insurance Company A stock Company
of New York
Box 5144
Albany, New York 12205
An American Express Company
DEFERRED ANNUITY CONTRACT
o Flexible purchase payments.
o Optional fixed dollar or variable accumulation values and annuity
payments.
o Annuity payments to begin on the retirement date.
o This contract is nonparticipating. Dividends are not payable.
Annuitant: John Doe
Contract Number: 9310-1234567
Contract Date: April 1, 1986
Retirement Date: April 1, 2006
This is a deferred annuity contract. It is a legal contract
between you, as the owner, and us, IDS Life Insurance Company of
New York. PLEASE READ YOUR CONTRACT CAREFULLY.
If the annuitant is living on the Retirement Date, we will begin to
pay you monthly annuity payments. Any payments made by us are
subject to the terms of this contract.
We issue this contract in consideration of your application and the
payment of the purchase payments.
Signed for and issued by IDS Life Insurance Company of New York in
Albany, New York, as of the contract date shown above.
ACCUMULATION VALUES AND ANNUITY PAYMENTS, WHEN BASED ON THE
INVESTMENT RESULTS OF THE SEPARATE ACCOUNTS, ARE VARIABLE AND NOT
GUARANTEED AS TO FIXED DOLLAR AMOUNT.
NOTICE OF YOUR RIGHT TO EXAMINE THIS CONTRACT FOR 10 DAYS
If for any reason you are not satisfied with this contract, return
it to us or our representative within 10 days after you receive it.
We will then cancel this contract. Upon such cancellation we will
then cancel this contract. Upon such cancellation we will refund
an amount equal to the sum of: (1) the contract value; and (2) any
premium tax charges paid. This contract will then be considered
void from its start.
President
James A. Mitchell
Secretary
Richard J. O'Brien
<PAGE>
PAGE 2
CONTRACT DATA
Annuitant: John Doe
Contract Number: Sample
Contract Date: April 1, 1986
Retirement Date: April 1, 2006
Contract Owner: John Doe
Upon issuance of this contract your purchase payments have been
scheduled to be paid and applied to the fixed and variable accounts
as shown below. You may change the amount, frequency and
allocations as provided in this contract. Refer to the purchase
payments provisions on Page 7.
Lump Sum Single Purchase Payment Only: None
Scheduled Purchase Payments: Annual Amount: $1,200
Payable: $100 monthly
Variable Purchase Payment
Accounts Mutual Fund Allocation Percentage
4 IDS Life Capital Resource Fund 20%
5 IDS Life Special Income Fund 20%
6 IDS Life Moneyshare Fund 20%
9 IDS Life Managed Fund 20%
Fixed
Account 20%
Surrender Charge: If you surrender all or a portion of this
contract surrender charges may apply. See Page __.
Contract Administrative Charge: See page __.
Maximum Purchase Payments Permitted
1st contract year: $250,000
each contract year
thereafter: 50,000
<PAGE>
PAGE 3
CONTRACT DATA (continued)
Annuitant: John Doe
Contract Number: Sample
Fixed Account
Table of Guaranteed Minimum Contract and Surrender Values
Guaranteed Interest Rate: 4% Per Year Compounded Annually
The following table shows the guaranteed minimum fixed account
contract and surrender values based on these assumptions: (1) $100
purchase payments are received and allocated 100% to the fixed
account at the beginning of each month; (2) There have been no
surrenders; (3) There are no premium tax charges. If purchase
payments are otherwise paid or allocated or if there are
surrenders, or premium tax charges, the values below will be
adjusted in accordance with the provisions of this contract.
<TABLE>
<CAPTION>
Guaranteed Guaranteed Guaranteed Guaranteed
End of Minimum Minimum End of Minimum Minimum
Contract Fixed Account Fixed Account Contract Fixed Account Fixed Account
Year Contract Value Surrender Value Year Contract Value Surrender Value
<C> <C> <C> <C> <C>
1 1201.86 1118.21 16 26232.83 25728.83
2 2451.93 2284.29 17 28484.15 27980.15
3 3752.01 3500.36 18 30825.51 30321.51
4 5104.09 4768.44 19 33260.53 32756.53
5 6510.26 6090.61 20 35792.95 35288.95
6 7972.67 7469.02 21 38426.67 37922.67
7 9493.57 8989.57 22 41165.74 40661.74
8 11075.31 10571.31 23 44014.37 43510.37
9 12720.33 12216.33 24 46976.94 46472.94
10 14431.14 13927.14 25 50058.02 49554.02
11 16210.39 15706.39 26 53262.34 52758.34
12 18060.80 17556.80 27 56594.84 56090.84
13 19985.23 19481.23 28 60060.63 59556.63
14 21986.64 21482.64 29 63665.05 63161.05
15 24068.11 23564.11 30 67413.66 66909.66
</TABLE>
Variable account contract and surrender values are not guaranteed.
Information concerning contract and surrender values will be
provided to you at any time upon written request.
<PAGE>
PAGE 4
DEFINITIONS
The following words are used often in this contract. When we use
these words, this is what we mean:
annuitant
The person on whose life monthly annuity payments depend.
you, your
The owner of this contract. The owner may be someone other than
the annuitant. The owner is shown in the application unless the
owner has been changed as provided in this contract.
we, our, us
IDS Life Insurance Company of New York.
accumulation unit
An accumulation unit is an accounting unit of measure. It is used
to calculate the contract value prior to settlement.
annuity unit
An annuity unit is an accounting unit of measure. It is used to
calculate the value of annuity payments from the variable accounts
on and after the retirement date.
contract date
It is the date from which contract anniversaries, contract years,
and contract months are determined. Your contract date is shown
under Contract Data.
contract anniversary
The same day and month as the contract date each year that the
contract remains in force.
contract value
The sum of the: (1) Fixed Account Contract Value; and (2) Variable
Account Contract Value.
retirement date
The date shown under Contract Data on which annuity payments are to
begin. This date may be changed as provided in this contract.
settlement
The application of the contract value of this contract to provide
annuity payments.
<PAGE>
PAGE 5
DEFINITIONS (contined)
valuation date
A valuation date is each day the New York Stock Exchange is open
for trading.
valuation period
A valuation period is the interval of time commencing at the close
of business on each valuation date and ending at the close of
business on the next valuation date.
fixed account
The fixed account is made up of all our assets other than those in
any separate account.
variable accounts
The variable accounts are named under Contract Data. Each is a
separate investment account of ours.
fixed annuity
A fixed annuity is an annuity with payments which are guaranteed by
us as to dollar amount during the annuity payment period.
variable annuity
A variable annuity is an annuity with payments which (1) are not
predetermined or guaranteed as to dollar amount; and (2) vary in
amount with the investment experience of one or more of the
variable accounts.
written request
A request in writing signed by you and delivered to us at our home
office.
<PAGE>
PAGE 6
GENERAL PROVISIONS
Entire Contract
This contract form is and the application form attached to it are
the entire contract between you and us.
No one except one of our corporate officers (President, Vice
President, Secretary or Assistant Secretary) can change or waive
any of our rights or requirements under this contract. That person
must do so in writing. None of our representatives or other
persons has the authority to change or waive any of our rights or
requirements under this contract.
In issuing this contract, we have relied upon the application. The
statements contained in the application are, considered
representations and not warranties. No statement made in
connection with the application will be used by us to void the
contract or to deny a claim unless that statement is part of the
application.
Incontestable
After this contract has been in force during the annuitant's life
for two years from its date of issue, we cannot contest the
contract.
Misstatement of Age or Sex
If the annuitant's birthdate or sex has been misstated, payments
under this contract will be adjusted. They will be based on what
would have been provided at the correct birthdate and sex. Any
underpayments made by us will be made up immediately. Any
overpayments made by us will be subtracted from the future
payments.
State Laws
This contract is governed by the law of the state in which it is
delivered. The values and benefits of this contract are at least
equal to those required by such state.
Reports to Owner
At least once a year we will send you a statement showing the
contract value of this contract. This statement will be based on
any laws or regulations that apply to contracts of this type.
Evidence of Survival
Where any payments under this contract depend on the recipient or
annuitant being alive on a given date, proof that such condition
has been met may be required by us. Such proof may be required
prior to making the payments.
<PAGE>
PAGE 7
GENERAL PROVISIONS (continued)
Protection of Proceeds
Payments under this contract are not assignable by any Beneficiary
prior to the time they are due. To the extent allowed by law,
payments are not subject to the claims of creditors or to legal
process.
Payments By Us
All sums payable by us are payable at our home office. Any payment
of a variable annuity or surrender based on the variable contract
value shall be payable only from the variable accounts.
Voting Rights
So long as federal law requires, you may have the right to vote at
the meetings of the Variable Contract Owners. If you have voting
rights we will send a notice to you telling you the time and place
of a meeting. The notice will also explain matters to be voted
upon and how many votes you get.
<PAGE>
PAGE 8
OWNERSHIP AND BENEFICIARY
Owner's Rights
As long as the annuitant is living and unless otherwise provided in
this contract, you may exercise all rights and privileges provided
in this contract or allowed by us.
Change of Ownership
You can change the ownership of this contract by written request on
a form approved by us. The change must be made while the annuitant
is living. Once the change is received by us, it will take effect
as of the date of your request, subject to any action taken or
payment made by us before the receipt.
Beneficiary
Beneficiaries are those you name, in a form satisfactory to us, to
receive benefits of this contract if you or the annuitant die while
this contract is in force. The beneficiary is shown in the
application unless you have, since the issue date of this contract,
changed the beneficiary as provided below.
Change of Beneficiary
You may change the beneficiary anytime while the annuitant is
living by satisfactory written request to us. Once the change is
received by us, it will take effect as of the date of your request,
subject to any action taken or payment made by us before the
receipt.
Only those beneficiaries who are living when death benefits become
payable may share in the benefits, if any. If no beneficiary is
then living, we will pay the benefits to you, if living, otherwise
to your estate.
Assignment
While the annuitant is living, you can assign this contract or any
interest in it. Your interest and the interest of any beneficiary
is subject to the interest of the assignee. An assignment is not a
change of ownership and an assignee is not an owner as these terms
are used in this contract. Any amounts payable to the assignee
will be paid in a single sum.
A copy of any assignment must be submitted to us at our home
office. Any assignment is subject to any action taken or payment
made by us before the assignment was received at our home office.
We are not responsible for the validity of any assignment.
<PAGE>
PAGE 9
PAYMENTS TO BENEFICIARY
Death Benefit Before the Retirement Date
If the annuitant or owner dies before the retirement date while
this contract is in force we will pay to the beneficiary:
1. the greater of the contract value or the purchase payments
paid less any amounts surrendered (if death occurred prior to
Age 75); otherwise
2. the contract value (if death occurred on or after Age 75).
The above amount will be payable in a lump sum upon the receipt of
due proof of death of the annuitant or owner whichever first
occurs.
In lieu of a lump sum, payment may be made under an Annuity Payment
Plan, provided:
1. the beneficiary elects the plan within 60 days after we
receive due proof of death; and
2. payments begin no later than one year after the date of death;
and
3. the plan provides payments over a period which does not exceed
the life of the beneficiary, or the life expectancy of the
beneficiary.
In this event, the reference to "annuitant" in the Annuity
Provisions shall apply to the beneficiary.
Any amounts payable or applied by us as described in this section
will be based on the contract value as of the valuation date on or
next following the date on which due proof of death is received at
our Home Office.
Spouse Option to Continue Contract Upon Owner's Death
If the owner's death occurs prior to the retirement date, the
owner's spouse, if designated as sole beneficiary may elect in
writing to forego receipt of the death benefit and instead continue
this contract in force as its owner. The election by the spouse
must be made within 60 days after we receive due proof of death.
Annuitant's Death After the Retirement Date
If the annuitant dies after the retirement date, the amount
payable, if any, will be as provided in the Annuity Payment Plan
then in effect.
<PAGE>
PAGE 10
PURCHASE PAYMENTS
Purchase Payments
Purchase payments are the payments you make for this contract and
the benefits it provides. Purchase payments must be paid or mailed
to us at our home office or to an authorized agent. If requested,
we'll give you a receipt for your purchase payments. Upon payment
to us, purchase payments become our property.
Net purchase payments are that part of your purchase payments
applied to the contract value. A net purchase payment is equal to
the purchase payment less any applicable premium tax charge.
Amount and Intervals
Purchase payments may be paid in a single sum or in installments
until the earlier of: (1) the date this contract terminates by
surrender or otherwise; or (2) the date on which annuity payments
begin.
Based upon your application we have scheduled your purchase
payments for the amount and interval as shown under Contract Data.
Subject to the Payment Limits Provision you may: (1) stop and/or
restart purchase payments; or (2) increase or decrease the amount
of your purchase payments; or (3) change the interval of your
purchase payments.
Payment Limits Provision
Maximum Purchase Payments - The maximum purchase payments in the
first or later contract years may not exceed the amounts shown
under Contract Data. We reserve the right to increase the
maximums.
Minimum Purchase Payments - Upon issue of this contract, a purchase
payment intended as a Single Purchase Payment must be at least
$5,000. If you intend to make installment purchase payments such
payments, on an annualized basis, must be at least equal to $600.
We also reserve the right to cancel this contract if both of the
following conditions exist at the same time: (1) no purchase
payments have been paid for a continuous period of 24 months; and
(2) less than $600 in purchase payments have been paid under this
contract. In this event we will give you 30 days written notice of
our intent to cancel this contract. Upon such cancellation we will
pay you the contract value in one sum. This contract will then
terminate.
Allocation of Purchase Payments
You instruct us on how you want your purchase payments allocated
among the fixed account and variable accounts. Your choice for
each account may be made in any whole percent from 0% to 100% as
long as the total adds up to 100%. Your allocation instructions as
<PAGE>
PAGE 11
PURCHASE PAYMENTS (continued)
of the Contract Date are shown in the application. By written
request, or by another method agreed to by us, you may change your
choice of accounts or percentages. The first net purchase payment
will be allocated as of the end of the valuation period during
which we make an affirmative decision to issue this contract. Net
purchase payments after the first will be allocated as of the end
of the valuation period during which we receive the payment at our
home office.
<PAGE>
PAGE 12
CONTRACT VALUE
Contract Value
The contract value at any time is the sum of: (1) the Fixed Account
Contract Value; and (2) the Variable Account Contract Value.
If: (1) part or all of the contract value is surrendered; or (2)
charges described herein are made against the contract value; then
a number of accumulation units from the variable accounts and an
amount from the fixed account will be deducted to equal such
amount. For surrenders, deductions will be made from the fixed or
variable accounts that you specify. Otherwise, the number of units
from the variable accounts and the amount from the fixed account
will be deducted in the same proportion that your interest in each
bears to the total contract value.
Fixed Account Contract Value
The fixed account contract value at any time will be: (1) the sum
of all amounts credited to the fixed account under this contract;
less (2) any amounts deducted for charges or surrenders.
Interest to be Credited
We will credit interest to the fixed account contract value.
Interest will begin to accrue on the date the purchase payments
which are received in our home office become available to us for
use. Such interest will be credited at rates that we determine
from time to time. However, we guarantee that the rate will not be
less than the Guaranteed Interest Rate shown under Contract Data.
Variable Account Contract Value
The variable account contract value at any time will be: (1) the
sum of the value of all variable account accumulation units under
this contract resulting from purchase payments so allocated, or
transfers among the variable and fixed accounts; less (2) any units
deducted for charges or surrenders.
Contract Administrative Charge
We charge a fee for establishing and maintaining our records for
this contract. The charge is $6 per quarter and is deducted from
the contract value at the end of each three-month period measured
from the contract date or, if earlier, when the contract is
surrendered. The charge does not apply after settlement of this
contract.
Premium Tax Charges
A charge will be made by us against the contract value of this
contract at the time that any premium taxes not previously deducted
are payable.
<PAGE>
PAGE 13
CONTRACT VALUE (continued)
Transfers of Contract Values
While this contract is in force prior to the settlement date,
transfer of contract values may be made as outlined below:
1. You may transfer all or a part of the values held in one or
more of the variable accounts to another one or more of the
variable accounts. Subject to item 2, you may also transfer
values held in one or more of the variable accounts to the
fixed account.
2. On or within the 30 days after a contract anniversary you may
transfer values from the fixed account to one or more of the
variable accounts. Only one such transfer is allowed during
this period each year. If such a transfer is made, no
transfers from a variable account to the fixed account may be
made until the next contract anniversary.
You may make a transfer by written request. Transfer requests may
also be made by telephone if we have received a properly completed
authorization form. There is no fee or charge for these transfers.
However, the minimum transfer amount is $250, or if less, the
entire value in the account from which the transfer is being made.
This transfer privilege may be suspended or modified by us at any
time.
<PAGE>
PAGE 14
FIXED AND VARIABLE ACCOUNTS
The Fixed Account
The fixed account is our general account. It is made up of all of
our assets other than: (1) those in the variable accounts; and (2)
those in any other segregated asset account.
The Variable Accounts
The variable accounts are separate investment accounts of ours.
They are named under Contract Data. We have allocated a part of
our assets for this and certain other contracts to the variable
accounts. Such assets remain our property. However, they may not
be charged with the liabilities from any other business in which we
may take part.
Investments of the Variable Accounts
Purchase payments applied to the variable accounts will be
allocated as specified in your application for this contract or as
later changed. Each variable account will buy, at net asset value,
shares of the fund shown for that account under Contract Data or as
later added or changed.
Valuation of Assets
Mutual fund shares in the variable accounts will be valued at their
net asset value.
Variable Account Accumulation Units
The number of accumulation units for each of the variable accounts
is found by dividing: (1) the net amount allocated to the account;
by (2) the accumulation unit value for the account for the
valuation period during which we received the purchase payment.
Variable Account Accumulation Unit Value
The value of an accumulation unit for each of the variable accounts
was arbitrarily set at $1 when the first mutual fund shares were
bought. The value for any later valuation period is found as
follows:
The accumulation unit value for each variable account for the
last prior valuation period is multiplied by the net
investment factor for the same account for the next following
valuation period. The result is the accumulation unit value.
The value of an accumulation unit may increase or decrease
from one valuation period to the next.
<PAGE>
PAGE 15
FIXED AND VARIABLE ACCOUNTS (continued)
Net Investment Factor
The net investment factor is an index applied to measure the
investment performance of a variable account from one valuation
period to the next. The net investment factor may be greater or
less than one; therefore, the value of an accumulation unit may
increase or decrease.
The net investment factor for any such account for any valuation
period is determined by: dividing (1) by (2) and subtracting (3)
from the result. This is done where:
(1) is the sum of
a. the net asset value per share of the mutual
fund held in the variable account determined at
the end of the current valuation period; plus
b. the per share amount of any dividend or capital
gain distributions made by the mutual fund held
in the variable account, if the "ex-dividend"
date occurs during the current valuation
period.
(2) is the net asset value per share of the mutual fund held in
the variable account, determined at the end of the last prior
valuation period.
(3) is a factor representing the mortality and expense risk
charge.
Mortality and Expense Risk Charge
In calculating accumulation unit values we will deduct a mortality
and expense risk charge from the variable accounts equal, on an
annual basis, to 1.00% of the daily net asset value. This
deduction is made to compensate us for assuming the mortality and
expense risks under contracts of this type. The deduction will be:
(1) made from each variable account; and (2) computed on a daily
basis.
Annuity Unit Value
The value of an Annuity Unit for each variable account was
arbitrarily set at $1 when the first mutual funds were bought. The
value of any later valuation period is found as follows:
1. The annuity unit value for each variable account for the last
prior valuation period is multiplied by the net investment
factor for the account for the valuation period for which the
annuity unit value is being calculated.
2. The result is multiplied by an interest factor. This is done
to neutralize the assumed investment rate which is built into
the annuity tables on page 14.
<PAGE>
PAGE 16
SURRENDER PROVISIONS
Surrender
By written request and subject to the rules below you may:
1. surrender this contract for the total surrender value; or
2. partially surrender this contract for a part of the surrender
value.
Surrender Value
The surrender value at any time will be:
1. the contract value;
2. minus the contract administrative charge;
3. minus any surrender charge.
Surrender Charge
In order to determine if a surrender charge applies to a partial or
total surrender we first divide the contract value into three
parts.
1. Contract Earnings - This is the contract value minus the sum
of all purchase payments we have received that have not been
previously surrendered.
2. Old Purchase Payments - These are purchase payments we
received in any contract year more than five years prior to
the contract year of surrrender.
3. New Purchase Payments - These are purchase payments we
received during the contract year in which the surrender is
made or in the five immediately preceding contract years.
We will then surrender your contract value in the following order
so that the amount surrendered, less any surrender charge that
applies, equals your requested surrender amount:
1. Contract Earnings, if any, are surrendered first. There is no
surrender charge on contract earnings.
2. Next, if necessary, we surrender Old Purchase Payments not
previously surrendered. There is no surrender charge on Old
Purchase payments.
3. Finally, if necessary, we surrender New Purchase Payments not
previously surrendered. There is a surrender charge of 7%
applied to New Purchase Payments surrendered.
<PAGE>
PAGE 17
SURRENDER PROVISIONS (continued)
Surrender Charge Calculation
The surrender charge for a total surrender is calculated by
multiplying the amount representing new purchase payments by .07.
The surrender charge for a partial surrender is calculated by
dividing the surrender amount requested representing "new purchase
payments" by .93 and multiplying the result by .07.
For example, the surrender charge on a $1,000 partial surrender
request (representing all "new purchase payments") would be $75.27,
resulting from the following calculation: ($1,000/.93) X .07 =
$75.27.
Rules For Surrender
All surrenders will have the following conditions:
1. You must apply by written request: (a) while this contract is
in force; and (b) prior to the earlier of the retirement date
or the death of the annuitant.
2. You must surrender an amount equal to at least $250 or the
contract, if less. The contract value after a partial
surrender must be at least $600.
3. The amount surrendered, less any charges, will normally be
paid to you within seven days of the receipt of your written
request and this contract, if required. For surrenders from
the fixed account, we have the right to defer payment to you
for up to 6 months from the date we receive your request.
4. For partial surrenders, if you do not specify from which
accounts the surrender is to be made, the surrender will be
made from the variable accounts and fixed account in the same
proportion as your interest in each bears to the contract
value.
5. Any amounts surrendered and charges which may apply can not be
repaid.
Upon surrender for the full surrender value this contract will
terminate. We may require that you return the contract to us
before we pay the full surrender value.
Suspension or Delay in Payment of Surrender
We have the right to suspend or delay the date of any surrender
payment from the variable accounts for any period:
1. When the New York Stock Exchange is closed; or
2. When trading on the New York Stock Exchange is restricted; or
<PAGE>
PAGE 18
SURRENDER PROVISIONS (continued)
3. When an emergency exists as a result of which: (a) disposal of
securities held in the variable accounts is not reasonably
practicable; or (b) it is not reasonably practicable to fairly
determine the value of the net assets of the variable account;
or
4. During any other period when the Securities and Exchange
Commission, by order, so permits for the protection of
security holders.
Rules and regulations of the Securities and Exchange Commission
will govern as to whether the conditions set forth in 2 and 3 exit.
<PAGE>
PAGE 19
ANNUITY PROVISIONS
Settlement
When settlement occurs, the contract value will be applied to make
annuity payments. The first payment will be made as of the
retirement date. This date is shown under Contract Data. Before
payments begin we will require satisfactory proof that the
annuitant is alive. We may also require that you exchange this
contract for a supplemental contract which provides the annuity
payments.
Change of Retirement Date
You may change the retirement date shown for this contract. Tell
us the new date by written request. However the retirement date
may not be later than the later of: (1) the annuitant's 85th
Birthday; or (2) the tenth contract anniversary. Also, if you
select a new date, it must be at least 30 days after we receive
your written request at our home office.
Annuity Payment Plans
Subject to the terms of this contract annuity payments may be made
on a fixed-dollar basis, a variable basis, or a combination of
both. You can schedule receipt of annuity payments according to
one of the Plans A through E below or another plan agreed to by us.
Plan A - This provides monthly annuity payments during the
lifetime of the annuitant. No payments will be made after the
annuitant dies.
Plan B - This provides monthly annuity payments during the
lifetime of the annuitant with a guarantee by us that payments
will be made for a period of at least five, ten or fifteen
years. You must select the guaranteed period.
Plan C - This provides monthly annuity payments during the
lifetime of the annuitant with a guarantee by us that payments
will be made for a certain number of months. We determine the
number of months by dividing the amount applied under this
Plan by the amount of the first monthly annuity payment.
Plan D - Monthly payments will be paid during the lifetime of
the annuitant and a joint annuitant. When either the
annuitant or the joint annuitant dies we will continue to make
monthly payments during the lifetime of the survivor. No
payments will be paid after the death of both the annuitant
and joint annuitant.
Plan E - This provides monthly fixed dollar annuity payments
for a period of years. The period of years may be no less
than 5 nor more than 30.
<PAGE>
PAGE 20
ANNUITY PROVISIONS (continued)
By written request to us at least 30 days before the Retirement
Date, you may select the Plan. If at least 30 days before the
Retirement Date we have not received at our home office your
written request to select a Plan, we will make payments according
to Plan B with payments guaranteed for ten years.
If the amount to be applied to a Plan would not provide an initial
monthly payment of at least $20, we have the right to make a lump
sum payment of the contract value.
Fixed Annuity
A fixed annuity is an annuity with payments that are guaranteed by
us as to dollar amount. Fixed annuity payments after the first
will never be less than the amount of the first payment. At
settlement, the fixed account contract value will be applied to the
applicable Annuity Table. This will be done in accordance with the
Payment Plan chosen. The amount payable for each $1,000 so applied
is shown in Table B on page 15.
Variable Annuity
A variable annuity is an annuity with payments which: (1) are not
predetermined or guaranteed as to dollar amount; and (2) vary in
amount with the investment experience of the variable accounts.
Determination of First Variable Annuity Payment
At settlement, the variable account contract value will be applied
to the applicable Annuity Table. This will be done: (1) on the
valuation date on or next preceding the 7th calendar day before the
retirement date; and (2) in accordance with the Payment Plan
chosen. The amount payable for the first payment for each $1,000
so applied is shown in Table A on page 14.
Variable Annuity Payments After the First Payment
Variable annuity payments after the first vary in amount. The
amount changes with the investment performance of the variable
accounts. The dollar amount of variable annuity payments after the
first is not fixed. It may change from month to month. The dollar
amount of such payments is determined as follows:
1. The dollar amount of the first annuity payment is divided by
the value of an annuity unit as of the valuation date on or
next preceding the 7th calendar day before the retirement
date. This result establishes the fixed number of annuity
units for each monthly annuity payment after the first. This
number of annuity units remains fixed during the annuity
payment period.
<PAGE>
PAGE 21
ANNUITY PROVISIONS (continued)
2. The fixed number of annuity units is multiplied by the annuity
unit value as of the valuation date on or next preceding the
7th calendar day before the date the payment is due. This
result establishes the dollar amount of the payment.
We guarantee that the dollar amount of each payment after the first
will not be affected by variations in expenses or mortality
experience.
Exchange of Annuity Units
Annuity units of any variable account may be exchanged for units of
any of the other variable accounts. This may be done no more than
once a year. Once annuity payments start no exchanges may be made
to or from any fixed annuity.
<PAGE>
PAGE 22
TABLE OF SETTLEMENT RATES
Table A below shows the amount of the first monthly variable
annuity payment, based on a 3 1/2% assumed investment return, for
each $1,000 of value applied under any Payment Plan. The amount of
the first and all subsequent monthly fixed dollar annuity payments
for each $1,000 of value applied under any Payment Plan will be
based on our fixed dollar Table of Settlement Rates in effect on
the settlement date. Such Rates are guaranteed to be not less than
those shown in Table B. The amount of such annuity payments under
Plans A, B, and C will depend upon the sex and the adjusted age of
the annuitant on the date of settlement. The amount of such
annuity payments under Plan D will depend upon the sex and the
adjusted age of the annuitant and joint annuitant on the date of
settlement. Adjusted age shall be equal to the age nearest
birthday minus an "adjustment" depending on the calendar year of
birth of the annuitant as follows:
Calendar Year of
Annuitant's Birth Adjustment
Prior to 1920 0
1920 through 1924 1
1925 through 1929 2
1930 through 1934 3
1935 through 1939 4
1940 through 1944 5
1945 through 1949 6
1950 through 1959 7
1960 through 1969 8
1970 through 1979 9
1980 through 1989 10
After 1989 11
<PAGE>
PAGE 23
TABLE OF SETTLEMENT RATES (continued)
<TABLE>
<CAPTION>
TABLE A Dollar Amount of First Monthly Variable Annuity Payment Per $1,000 Applied
PLAN A PLAN B PLAN C PLAN D - Joint and Survivor
Adjusted Age of Female Joint Annuitant
Life 5 Years 10 Years 15 Years With Adj.
Adj. Income Certain Certain Certain Refund Male 10 Yrs. 5 Yrs. Same 5 Yrs. 10 Yrs.
Age* M F M F M F M F M F Age* Younger Younger Age Older Older
<C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
40 3.96 3.73 3.96 3.73 3.94 3.72 3.92 3.71 3.88 3.69 40 3.37 3.45 3.53 3.61 3.69
41 4.01 3.76 4.00 3.76 3.99 3.76 3.97 3.75 3.92 3.72 41 3.39 3.47 3.56 3.65 3.73
42 4.06 3.80 4.05 3.80 4.04 3.80 4.01 3.78 3.97 3.76 42 3.41 3.50 3.59 3.68 3.77
43 4.11 3.84 4.11 3.84 4.09 3.84 4.06 3.82 4.01 3.80 43 3.43 3.52 3.62 3.72 3.81
44 4.17 3.89 4.16 3.88 4.14 3.88 4.11 3.86 4.06 3.83 44 3.45 3.55 3.65 3.76 3.85
45 4.22 3.93 4.22 3.93 4.20 3.92 4.16 3.91 4.11 3.87 45 3.48 3.58 3.69 3.80 3.89
46 4.29 3.98 4.28 3.98 4.25 3.97 4.21 3.95 4.16 3.92 46 3.51 3.61 3.73 3.84 3.94
47 4.35 4.03 4.34 4.03 4.31 4.02 4.27 4.00 4.21 3.96 47 3.53 3.64 3.76 3.88 3.99
48 4.42 4.08 4.41 4.08 4.38 4.07 4.33 4.05 4.26 4.01 48 3.56 3.68 3.80 3.93 4.05
49 4.49 4.14 4.48 4.13 4.44 4.12 4.39 4.10 4.32 4.06 49 3.59 3.72 3.85 3.98 4.10
50 4.56 4.20 4.55 4.19 4.51 4.18 4.45 4.15 4.38 4.11 50 3.62 3.75 3.89 4.03 4.16
51 4.64 4.26 4.62 4.25 4.58 4.24 4.52 4.21 4.45 4.16 51 3.65 3.79 3.94 4.09 4.22
52 4.72 4.32 4.70 4.32 4.66 4.30 4.58 4.26 4.51 4.22 52 3.69 3.83 3.99 4.14 4.29
53 4.80 4.39 4.79 4.38 4.74 4.36 4.65 4.33 4.58 4.27 53 3.73 3.88 4.04 4.21 4.36
54 4.89 4.46 4.88 4.46 4.82 4.43 4.73 4.39 4.66 4.34 54 3.76 3.93 4.10 4.27 4.43
55 4.99 4.54 4.97 4.53 4.91 4.51 4.80 4.46 4.73 4.40 55 3.80 3.97 4.16 4.34 4.51
56 5.09 4.62 5.07 4.61 5.00 4.58 4.88 4.53 4.81 4.47 56 3.85 4.03 4.22 4.41 4.59
57 5.20 4.71 5.17 4.70 5.10 4.66 4.97 4.60 4.90 4.54 57 3.89 4.08 4.29 4.49 4.68
58 5.32 4.80 5.29 4.79 5.20 4.75 5.05 4.68 4.99 4.62 58 3.94 4.14 4.36 4.57 4.78
59 5.44 4.90 5.41 4.88 5.31 4.84 5.14 4.76 5.08 4.70 59 3.99 4.20 4.43 4.66 4.88
60 5.57 5.00 5.53 4.99 5.42 4.93 5.23 4.84 5.18 4.78 60 4.04 4.27 4.51 4.76 4.99
61 5.71 5.11 5.67 5.09 5.54 5.03 5.33 4.93 5.29 4.87 61 4.10 4.34 4.59 4.86 5.10
62 5.86 5.23 5.81 5.21 5.67 5.14 5.42 5.02 5.40 4.96 62 4.16 4.41 4.68 4.97 5.23
63 6.02 5.36 5.97 5.33 5.80 5.25 5.52 5.12 5.51 5.06 63 4.22 4.49 4.78 5.08 5.36
64 6.20 5.49 6.13 5.46 5.94 5.37 5.62 5.21 5.63 5.17 64 4.28 4.57 4.88 5.20 5.50
65 6.38 5.64 6.31 5.60 6.08 5.50 5.72 5.31 5.76 5.28 65 4.35 4.66 4.99 5.34 5.66
66 6.58 5.79 6.49 5.75 6.23 5.63 5.82 5.42 5.90 5.39 66 4.43 4.75 5.11 5.48 5.82
67 6.79 5.95 6.69 5.91 6.38 5.77 5.92 5.53 6.04 5.52 67 4.51 4.85 5.24 5.63 6.00
68 7.02 6.13 6.90 6.08 6.54 5.91 6.02 5.63 6.19 5.65 68 4.59 4.96 5.37 5.79 6.19
69 7.26 6.32 7.12 6.26 6.71 6.07 6.12 5.74 6.35 5.79 69 4.68 5.07 5.51 5.97 6.39
70 7.52 6.53 7.35 6.46 6.87 6.23 6.21 5.86 6.52 5.94 70 4.78 5.20 5.67 6.16 6.60
71 7.80 6.75 7.60 6.67 7.05 6.40 6.30 5.97 6.69 6.09 71 4.88 5.33 5.83 6.36 6.84
72 8.09 6.99 7.86 6.89 7.22 6.58 6.39 6.08 6.88 6.26 72 4.98 5.47 6.01 6.58 7.09
73 8.41 7.26 8.13 7.13 7.40 6.76 6.47 6.18 7.07 6.44 73 5.10 5.62 6.20 6.81 7.35
74 8.75 7.54 8.42 7.39 7.57 6.95 6.55 6.29 7.27 6.63 74 5.22 5.78 6.41 7.06 7.64
75 9.12 7.85 8.72 7.67 7.75 7.14 6.62 6.39 7.49 6.83 75 5.35 5.95 6.63 7.33 7.95
*Adjusted age of annuitant. M=Male F=Female
Table A above is based on the "1983 Individual Annuitant Mortality Table a." Settlement rates for any age, or any combination of
age and sex not shown above, will be calculated on the same basis as those rates shown in the table above. Such rates will be
furnished by us upon request.
</TABLE>
<PAGE>
PAGE 24
TABLE OF SETTLEMENT RATES (continued)
<TABLE>
<CAPTION>
TABLE B Dollar Amount of Each Monthly Fixed Dollar Annuity Payment Per $1,000 Applied
PLAN A PLAN B PLAN C PLAN D - Joint and Survivor
Adjusted Age of Female Joint Annuitant
Adj.
Adj. Life 5 Years 10 Years 15 Years With Male 10 Years 5 Years Same 5 Years 10 Years
Age* Income Certain Certain Certain Refund Age* Younger Younger Age Older Older
M F M F M F M F M F
<C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
40 4.27 4.04 4.26 4.04 4.25 4.03 4.23 4.02 4.20 4.01 40 3.69 3.76 3.84 3.92 4.00
41 4.31 4.07 4.31 4.07 4.30 4.07 4.27 4.06 4.24 4.04 41 3.71 3.79 3.87 3.95 4.03
42 4.36 4.11 4.36 4.11 4.34 4.10 4.32 4.09 4.28 4.07 42 3.73 3.81 3.90 3.99 4.07
43 4.42 4.15 4.41 4.15 4.39 4.14 4.36 4.13 4.32 4.11 43 3.75 3.84 3.93 4.02 4.11
44 4.47 4.19 4.46 4.19 4.44 4.18 4.41 4.17 4.37 4.15 44 3.77 3.86 3.96 4.06 4.15
45 4.53 4.24 4.52 4.23 4.50 4.23 4.46 4.21 4.42 4.19 45 3.80 3.89 3.99 4.10 4.19
46 4.59 4.28 4.58 4.28 4.55 4.27 4.51 4.25 4.47 4.23 46 3.82 3.92 4.03 4.14 4.24
47 4.65 4.33 4.64 4.33 4.61 4.32 4.56 4.30 4.52 4.27 47 3.85 3.95 4.07 4.18 4.29
48 4.72 4.38 4.71 4.38 4.67 4.37 4.62 4.34 4.58 4.32 48 3.87 3.98 4.10 4.22 4.34
49 4.79 4.44 4.77 4.43 4.74 4.42 4.68 4.39 4.63 4.36 49 3.90 4.02 4.15 4.27 4.39
50 4.86 4.50 4.85 4.49 4.81 4.47 4.74 4.45 4.69 4.41 50 3.93 4.06 4.19 4.32 4.45
51 4.94 4.56 4.92 4.55 4.88 4.53 4.80 4.50 4.76 4.47 51 3.96 4.09 4.23 4.38 4.51
52 5.02 4.62 5.00 4.61 4.95 4.59 4.87 4.56 4.82 4.52 52 4.00 4.13 4.28 4.43 4.57
53 5.10 4.69 5.08 4.68 5.03 4.66 4.94 4.62 4.90 4.58 53 4.03 4.18 4.33 4.49 4.64
54 5.19 4.76 5.17 4.75 5.11 4.72 5.01 4.68 4.97 4.64 54 4.07 4.22 4.39 4.56 4.72
55 5.29 4.84 5.26 4.83 5.20 4.80 5.09 4.74 5.05 4.71 55 4.11 4.27 4.45 4.62 4.79
56 5.39 4.92 5.36 4.91 5.29 4.87 5.17 4.81 5.13 4.77 56 4.15 4.32 4.51 4.70 4.88
57 5.49 5.00 5.47 4.99 5.38 4.95 5.25 4.88 5.21 4.85 57 4.19 4.37 4.57 4.77 4.96
58 5.61 5.09 5.58 5.08 5.48 5.03 5.33 4.96 5.30 4.92 58 4.24 4.43 4.64 4.85 5.06
59 5.73 5.19 5.70 5.17 5.59 5.12 5.42 5.04 5.40 5.00 59 4.28 4.49 4.71 4.94 5.16
60 5.86 5.29 5.82 5.27 5.70 5.22 5.51 5.12 5.50 5.09 60 4.34 4.55 4.79 5.03 5.27
61 6.00 5.40 5.96 5.38 5.82 5.32 5.60 5.21 5.60 5.18 61 4.39 4.62 4.87 5.13 5.38
62 6.16 5.52 6.10 5.50 5.95 5.42 5.69 5.30 5.72 5.27 62 4.45 4.69 4.96 5.24 5.50
63 6.32 5.65 6.26 5.62 6.08 5.53 5.79 5.39 5.83 5.37 63 4.51 4.77 5.06 5.35 5.64
64 6.49 5.78 6.42 5.75 6.21 5.65 5.89 5.49 5.96 5.48 64 4.57 4.85 5.16 5.48 5.78
65 6.68 5.92 6.60 5.89 6.35 5.77 5.98 5.58 6.09 5.59 65 4.64 4.94 5.27 5.61 5.93
66 6.88 6.08 6.78 6.03 6.50 5.90 6.08 5.69 6.23 5.71 66 4.71 5.03 5.38 5.75 6.09
67 7.09 6.24 6.98 6.19 6.65 6.04 6.18 5.79 6.38 5.83 67 4.79 5.13 5.51 5.90 6.27
68 7.31 6.42 7.18 6.36 6.81 6.19 6.28 5.90 6.53 5.97 68 4.87 5.24 5.64 6.06 6.46
69 7.56 6.61 7.40 6.54 6.97 6.34 6.37 6.01 6.69 6.11 69 4.96 5.35 5.78 6.24 6.66
70 7.82 6.81 7.64 6.74 7.14 6.50 6.47 6.12 6.86 6.26 70 5.06 5.47 5.94 6.43 6.87
71 8.09 7.04 7.88 6.95 7.31 6.67 6.55 6.22 7.04 6.42 71 5.16 5.60 6.10 6.63 7.11
72 8.39 7.28 8.14 7.17 7.48 6.84 6.64 6.33 7.23 6.59 72 5.26 5.74 6.28 6.84 7.36
73 8.71 7.54 8.41 7.41 7.65 7.02 6.72 6.44 7.43 6.77 73 5.38 5.89 6.47 7.08 7.62
74 9.05 7.83 8.70 7.67 7.83 7.21 6.80 6.54 7.64 6.97 74 5.50 6.05 6.68 7.33 7.91
75 9.41 8.14 9.00 7.95 8.00 7.40 6.87 6.64 7.86 7.17 75 5.63 6.22 6.90 7.60 8.22
*Adjusted age of annuitant. M=Male F=Female
Table B above is based on the "1983 Individual Annuitant Mortality Table a" assuming an interest rate of 4% per year compounded
annually. Settlement rates for any age, or any combination of age and sex not shown above, will be calculated on the same basis as
those rates shown in the table above. Such rates will be furnished by us upon request. Amounts shown in the Table below are based
on an assumed interest rate of 4% per year compounded annually.
</TABLE>
<TABLE>
<CAPTION>
PLAN E Dollar Amount of Each Monthly Fixed Dollar Annuity Payment Per $1,000 Applied
Years Monthly Years Monthly Years Monthly
Payable Payment Payable Payment Payable Payment
<C> <C> <C> <C> <C> <C>
5 $18.32 15 $7.34 25 $5.22
6 15.56 16 7.00 26 5.10
7 13.59 17 6.71 27 5.00
8 12.12 18 6.44 28 4.90
9 10.97 19 6.21 29 4.80
10 10.06 20 6.00 30 4.72
11 9.31 21 5.81
12 8.69 22 5.64
13 8.17 23 5.49
14 7.72 24 5.35
</TABLE>
<PAGE>
PAGE 25
DEFERRED ANNUITY CONTRACT
o Flexible purchase payments.
o Optional fixed dollar or variable accumulation values and
annuity payments.
o Annuity payments to begin on the retirement date.
o This contract is nonparticipating. Dividends are not payable.
IDS Life Insurance Company
of New York
Box 5144
Albany, New York 12205
An American Express Company
<PAGE>
PAGE 1
IDS Life Insurance Company A stock Company
of New York
Box 5144
Albany, New York 12205
An American Express Company
DEFERRED ANNUITY CONTRACT
o Flexible purchase payments.
o Optional fixed dollar or variable accumulation values and annuity
payments.
o Annuity payments to begin on the retirement date.
o This contract is nonparticipating. Dividends are not payable.
Annuitant: John Doe
Contract Number: 9310-1234567
Contract Date: April 1, 1986
Retirement Date: April 1, 2006
This is a deferred annuity contract. It is a legal contract
between you, as the owner, and us, IDS Life Insurance Company of
New York. PLEASE READ YOUR CONTRACT CAREFULLY.
If the annuitant is living on the Retirement Date, we will begin to
pay you monthly annuity payments. Any payments made by us are
subject to the terms of this contract.
We issue this contract in consideration of your application and the
payment of the purchase payments.
Signed for and issued by IDS Life Insurance Company of New York in
Albany, New York, as of the contract date shown above.
ACCUMULATION VALUES AND ANNUITY PAYMENTS, WHEN BASED ON THE
INVESTMENT RESULTS OF THE SEPARATE ACCOUNTS, ARE VARIABLE AND NOT
GUARANTEED AS TO FIXED DOLLAR AMOUNT.
NOTICE OF YOUR RIGHT TO EXAMINE THIS CONTRACT FOR 10 DAYS
If for any reason you are not satisfied with this contract, return
it to us or our representative within 10 days after you receive it.
We will then cancel this contract. Upon such cancellation we will
then cancel this contract. Upon such cancellation we will refund
an amount equal to the sum of: (1) the contract value; and (2) any
premium tax charges paid. This contract will then be considered
void from its start.
President
James A. Mitchell
Secretary
Richard J. O'Brien
<PAGE>
PAGE 2
GUIDE TO CONTRACT PROVISIONS
Definitions Important words and meanings/Page 3
General Provisions Entire contract; Incontestability;
Misstatement of Age or Sex; State
Laws; Reports to owner; Evidence
of survival; Protection of proceeds;
Payments by us; Voting rights/Page 4
Ownership and Beneficiary Owner rights; Trust or custodial
ownership; Change of ownership;
Beneficiary; Change of Beneficiary/
Page 5
Payments to Beneficiary Describes options and amounts
payable upon death/Page 6
Purchase Payments Purchase payments amounts and
intervals; Payment limits;
Allocation of purchase payments/
Page 7
Contract Value Describes the fixed and variable
account contract values; Interest to
be credited; Contract administrative
charge; Premium taxes; Transfers of
contract values/Page 8
Fixed and Variable Accounts Describes the variable accounts,
accumulation units and values; Net
investment factor; Mortality and
expense risk charge; Annuity unit
value/Page 9
Surrender Provisions Surrender of the contract for its
surrender value; Rules for
surrender/Page 10
Annuity Provisions When annuity payments begin;
Different ways to receive annuity
payments; Determination of payment
amounts/Page 12
Table of Settlement Rates Tables showing the amount of the
first variable annuity payment and
fixed annuity payments for the
various Payment plans/Page 14
<PAGE>
PAGE 3
CONTRACT DATA
Annuitant: John Doe
Contract Number: Sample
Contract Date: April 1, 1986
Retirement Date: April 1, 2006
Contract Owner: John Doe
Upon issuance of this contract your purchase payments have been
scheduled to be paid and applied to the fixed and variable accounts
as shown below. You may change the amount, frequency and
allocations as provided in this contract. Refer to the purchase
payments provisions on Page 7.
Lump Sum Single Purchase Payment Only: None
Scheduled Purchase Payments: Annual Amount: $1,200
Payable: $100 monthly
Variable Purchase Payment
Accounts Mutual Fund Allocation Percentage
4 IDS Life Capital Resource Fund 20%
5 IDS Life Special Income Fund 20%
6 IDS Life Moneyshare Fund 20%
9 IDS Life Managed Fund 20%
Fixed
Account 20%
Surrender Charge: If you surrender all or a portion of this
contract surrender charges may apply. See Page __.
Contract Administrative Charge: See page __.
Maximum Purchase Payments Permitted
1st contract year: $250,000
each contract year
thereafter: 50,000
<PAGE>
PAGE 4
CONTRACT DATA (continued)
Annuitant: John Doe
Contract Number: Sample
Fixed Account
Table of Guaranteed Minimum Contract and Surrender Values
Guaranteed Interest Rate: 4% Per Year Compounded Annually
The following table shows the guaranteed minimum fixed account
contract and surrender values based on these assumptions: (1) $100
purchase payments are received and allocated 100% to the fixed
account at the beginning of each month; (2) There have been no
surrenders; (3) There are no premium tax charges. If purchase
payments are otherwise paid or allocated or if there are
surrenders, or premium tax charges, the values below will be
adjusted in accordance with the provisions of this contract.
<TABLE>
<CAPTION>
Guaranteed Guaranteed Guaranteed Guaranteed
End of Minimum Minimum End of Minimum Minimum
Contract Fixed Account Fixed Account Contract Fixed Account Fixed Account
Year Contract Value Surrender Value Year Contract Value Surrender Value
<C> <C> <C> <C> <C>
1 1201.86 1118.21 16 26232.83 25728.83
2 2451.93 2284.29 17 28484.15 27980.15
3 3752.01 3500.36 18 30825.51 30321.51
4 5104.09 4768.44 19 33260.53 32756.53
5 6510.26 6090.61 20 35792.95 35288.95
6 7972.67 7469.02 21 38426.67 37922.67
7 9493.57 8989.57 22 41165.74 40661.74
8 11075.31 10571.31 23 44014.37 43510.37
9 12720.33 12216.33 24 46976.94 46472.94
10 14431.14 13927.14 25 50058.02 49554.02
11 16210.39 15706.39 26 53262.34 52758.34
12 18060.80 17556.80 27 56594.84 56090.84
13 19985.23 19481.23 28 60060.63 59556.63
14 21986.64 21482.64 29 63665.05 63161.05
15 24068.11 23564.11 30 67413.66 66909.66
</TABLE>
Variable account contract and surrender values are not guaranteed.
Information concerning contract and surrender values will be
provided to you at any time upon written request.
<PAGE>
PAGE 5
DEFINITIONS
The following words are used often in this contract. When we use
these words, this is what we mean:
annuitant
The person on whose life monthly annuity payments depend.
you, your
The owner of this contract. The owner is shown in the application.
we, our, us
IDS Life Insurance Company of New York.
accumulation unit
An accumulation unit is an accounting unit of measure. It is used
to calculate the contract value prior to settlement.
annuity unit
An annuity unit is an accounting unit of measure. It is used to
calculate the value of annuity payments from the variable accounts
on and after the retirement date.
contract date
It is the date from which contract anniversaries, contract years,
and contract months are determined. Your contract date is shown
under Contract Data.
contract anniversary
The same day and month as the contract date each year that the
contract remains in force.
contract value
The sum of the: (1) Fixed Account Contract Value; and (2) Variable
Account Contract Value.
retirement date
The date shown under Contract Data on which annuity payments are to
begin. This date may be changed as provided in this contract.
settlement
The application of the contract value of this contract to provide
annuity payments.
<PAGE>
PAGE 6
DEFINITIONS (contined)
valuation date
A valuation date is each day the New York Stock Exchange is open
for trading.
valuation period
A valuation period is the interval of time commencing at the close
of business on each valuation date and ending at the close of
business on the next valuation date.
fixed account
The fixed account is made up of all our assets other than those in
any separate account.
variable accounts
The variable accounts are named under Contract Data. Each is a
separate investment account of ours.
fixed annuity
A fixed annuity is an annuity with payments which are guaranteed by
us as to dollar amount during the annuity payment period.
variable annuity
A variable annuity is an annuity with payments which (1) are not
predetermined or guaranteed as to dollar amount; and (2) vary in
amount with the investment experience of one or more of the
variable accounts.
written request
A request in writing signed by you and delivered to us at our home
office.
<PAGE>
PAGE 7
GENERAL PROVISIONS
Entire Contract
This contract form is and the application form attached to it are
the entire contract between you and us.
No one except one of our corporate officers (President, Vice
President, Secretary or Assistant Secretary) can change or waive
any of our rights or requirements under this contract. That person
must do so in writing. None of our representatives or other
persons has the authority to change or waive any of our rights or
requirements under this contract.
In issuing this contract, we have relied upon the application. The
statements contained in the application are considered
representations and not warranties. No statement made in
connection with the application will be used by us to void the
contract or to deny a claim unless that statement is part of the
application.
This contract is intended to qualify as an Individual Retirement
Annuity (IRA) under Public Law 98-369. We agree to and reserve the
right to modify this contract to the extent necessary to qualify
this contract as an Individual Retirement Annuity as described in
Sections 408(b) or 219 or, if applicable, Section 220 of the
Internal Revenue Code of 1954, as amended and all related sections
and regulations which are in effect during the term of the
contract.
Incontestable
After this contract has been in force during the annuitant's life
for two years from its date of issue, we cannot contest the
contract.
Misstatement of Age or Sex
If the annuitant's birthdate or sex has been misstated, payments
under this contract will be adjusted. They will be based on what
would have been provided at the correct birthdate and sex. Any
underpayments made by us will be made up immediately. Any
overpayments made by us will be subtracted from the future
payments.
State Laws
This contract is governed by the law of the state in which it is
delivered. The values and benefits of this contract are at least
equal to those required by such state.
Reports to Owner
At least once a year we will send you a statement showing the
contract value of this contract. This statement will be based on
any laws or regulations that apply to contracts of this type.
<PAGE>
PAGE 8
GENERAL PROVISIONS (continued)
Evidence of Survival
Where any payments under this contract depend on the recipient or
annuitant being alive on a given date, proof that such condition
has been met may be required by us. Such proof may be required
prior to making the payments.
Protection of Proceeds
Payments under this contract are not assignable by any Beneficiary
prior to the time they are due. To the extent allowed by law,
payments are not subject to the claims of creditors or to legal
process.
Payments By Us
All sums payable by us are payable at our home office. Any payment
of a variable annuity or surrender based on the variable contract
value shall be payable only from the variable accounts.
Voting Rights
So long as federal law requires, you may have the right to vote at
the meetings of the Variable Contract Owners. If you have voting
rights we will send a notice to you telling you the time and place
of a meeting. The notice will also explain matters to be voted
upon and how many votes you get.
Trustee or custodian owners shall cast votes according to
instructions received from appropriate annuitants. All other votes
of such trustee or custodian under the same trust or custodial
agreement shall be cast in the same proportion. If no instructions
are received, the votes may be cast at the trustee's or custodian's
discretion.
<PAGE>
PAGE 9
OWNERSHIP AND BENEFICIARY
Owner's Rights
As long as the annuitant is living you may exercise all rights and
privileges provided in this contract or allowed by us. Your entire
interest is non-forfeitable.
Trust or Custodial Ownership
If you are a tax qualified trust or tax qualified custodial
account, then your trustees or custodian (or their successors)
properly named by your trust or custodial agreement may exercise
all rights and privileges provided in this contract or allowed by
us.
Change of Ownership (Restricted)
Your right to change the ownership of this contract is restricted.
This contract may not be sold, assigned, transferred, discounted or
pledged as collateral for a loan or as security for the performance
of an obligation or for any other purpose to any person other than
as may be required or permitted under Section 408 of the Internal
Revenue Code of 1954, as amended. Your interest in this contract
may be transferred to your former spouse, if any, under a divorce
decree or a written instrument incident to such divorce.
However, if this contract is owned by a trustee of a tax-qualified
trust or the custodian of a tax-qualified custodial account, such
trustee or custodian may transfer ownership of this contract to the
annuitant or to a qualified successor trustee or custodian. Such
transfer shall be effective only if received by us at our home
office. When so received, such transfer shall take effect as of
the date of the instrument, subject to any payment made or other
action taken by us before such receipt.
Beneficiary
Beneficiaries are those you name, in a form satisfactory to us, to
receive benefits of this contract if the annuitant dies while this
contract is in force. The beneficiary is shown in the application
unless you have, since the issue date of this contract, changed the
beneficiary as provided below.
Change of Beneficiary
You may change the beneficiary anytime while the annuitant is
living by satisfactory written request to us. Once the change is
received by us, it will take effect as of the date of your request,
subject to any action taken or payment made by us before the
receipt.
Only those beneficiaries who are living when death benefits become
payable may share in the benefits, if any. If no beneficiary is
then living, we will pay the benefits to you, if living, otherwise
to your estate.
<PAGE>
PAGE 10
PAYMENTS TO BENEFICIARY
Death Benefit Before the Retirement Date
If the annuitant dies before the retirement date while this
contract is in force we will pay to the beneficiary the greater of:
1. the contract value; or
2. the purchase payments paid less any amounts surrendered.
The above amount will be payable in a lump sum upon the receipt of
due proof of death of the annuitant. The beneficiary may elect to
receive payment anytime within 5 years after the date of death of
the annuitant.
In lieu of the above, payment may be made under an Annuity Payment
Plan, provided:
1. the beneficiary elects the plan within 60 days after we
receive due proof of death; and
2. payments begin no later than:
a. one year after the date of death, in the case
of a non-spouse beneficiary; or
b. the date on which the annuitant would have
attained age 70-1/2, in the case of a spouse
beneficiary; and
3. the plan provides payments over a period which does not exceed
the life of the beneficiary, or the life expectancy of the
beneficiary.
In this event, the reference to "annuitant" in the Annuity
Provisions shall apply to the beneficiary.
Any amounts payable or applied by us as described in this section
will be based on the contract value as of the valuation date on or
next following the date on which due proof of death is received at
our Home Office.
Spouse Option to Continue Contract
If death occurs prior to the retirement date, a spouse who is
designated as sole beneficiary may elect in writing to forego
receipt of the death benefit and instead continue this contract in
force as its owner and annuitant. The election by the spouse must
be made within 60 days after we receive due proof of death. In
this event, the retirement date may not be later than the April 1
following the calendar year in which the spouse attains age 70-1/2.
Annuitant's Death After the Retirement Date
If the annuitant dies after the retirement date, the amount
payable, if any, will be as provided in the Annuity Payment Plan
then in effect.<PAGE>
PAGE 11
PURCHASE PAYMENTS
Purchase Payments
Purchase payments are the payments you make for this contract and
the benefits it provides. Purchase payments must be paid or mailed
to us at our home office or to an authorized agent. If requested,
we'll give you a receipt for your purchase payments. Upon payment
to us, purchase payments become our property.
Net purchase payments are that part of your purchase payments
applied to the contract value. A net purchase payment is equal to
the purchase payment less any applicable premium tax charge.
Amount and Intervals
Purchase payments may be paid in a single sum or in installments
until the earlier of: (1) the date this contract terminates by
surrender or otherwise; or (2) the date on which annuity payments
begin.
Based upon your application we have scheduled your purchase
payments for the amount and interval as shown under Contract Data.
Subject to the Payment Limits Provision you may: (1) stop and/or
restart purchase payments; or (2) increase or decrease the amount
of your purchase payments; or (3) change the interval of your
purchase payments.
With the exception of employer purchase payments made in connection
with a Simplified Employee Pension Plan, no annual purchase
payments may be made with respect to the taxable year in which the
annuitant attains age 70-1/2 or any later year.
Payment Limits Provision
Maximum Purchase Payments - The maximum purchase payments in the
first or later contract years may not exceed the amounts shown
under Contract Data. We reserve the right to increase the
maximums.
Minimum Purchase Payments - Upon issue of this contract, a purchase
payment intended as a Single Purchase Payment must be at least
$5,000. If you intend to make installment purchase payments such
payments, on an annualized basis, must be at least equal to $600.
In addition, except as otherwise provided in this paragraph, the
total purchase payments for any taxable year may not exceed $2,000.
In the case of a rollover contribution described in Sections 402(a)
(5), 402(a) (7), 403(a) (4), 403(b) (8), 405(d) (3) or, 408(d) (3),
of the Internal Revenue Code of 1954, as amended, there is no limit
on the amount of your purchase payment. If this contract is
maintained in connection with a Simplified Employee Pension Plan,
employer purchase payments for any taxable year may not exceed 15%
of your compensation or $30,000, whichever is less. All purchase
payments must be made in cash. If you die before your entire
<PAGE>
PAGE 12
PURCHASE PAYMENTS (continued)
interest in this contract has been distributed to you, and your
beneficiary is other than your surviving spouse, no additional
purchase payments will be accepted from your beneficiary under this
contract.
We also reserve the right to cancel this contract if both of the
following conditions exist at the same time: (1) no purchase
payments have been paid for a continuous period of 24 months; and
(2) less than $600 in purchase payments have been paid under this
contract. In this event we will give you 30 days written notice of
our intent to cancel this contract. Upon such cancellation we will
pay you the contract value in one sum. This contract will then
terminate.
Allocation of Purchase Payments
You instruct us on how you want your purchase payments allocated
among the fixed account and variable accounts. Your choice for
each account may be made in any whole percent from 0% to 100% as
long as the total adds up to 100%. Your allocation instructions as
of the Contract Date are shown in the application. By written
request, or by another method agreed to by us, you may change your
choice of accounts or percentages. The first net purchase payment
will be allocated as of the end of the valuation period during
which we make an affirmative decision to issue this contract. Net
purchase payments after the first will be allocated as of the end
of the valuation period during which we receive the payment at our
home office.
<PAGE>
PAGE 13
CONTRACT VALUE
Contract Value
The contract value at any time is the sum of: (1) the Fixed Account
Contract Value; and (2) the Variable Account Contract Value.
If: (1) part or all of the contract value is surrendered; or (2)
charges described herein are made against the contract value; then
a number of accumulation units from the variable accounts and an
amount from the fixed account will be deducted to equal such
amount. For surrenders, deductions will be made from the fixed or
variable accounts that you specify. Otherwise, the number of units
from the variable accounts and the amount from the fixed account
will be deducted in the same proportion that your interest in each
bears to the total contract value.
Fixed Account Contract Value
The fixed account contract value at any time will be: (1) the sum
of all amounts credited to the fixed account under this contract;
less (2) any amounts deducted for charges or surrenders.
Interest to be Credited
We will credit interest to the fixed account contract value.
Interest will begin to accrue on the date the purchase payments
which are received in our home office become available to us for
use. Such interest will be credited at rates that we determine
from time to time. However, we guarantee that the rate will not be
less than the Guaranteed Interest Rate shown under Contract Data.
Variable Account Contract Value
The variable account contract value at any time will be: (1) the
sum of the value of all variable account accumulation units under
this contract resulting from purchase payments so allocated, or
transfers among the variable and fixed accounts; less (2) any units
deducted for charges or surrenders.
Contract Administrative Charge
We charge a fee for establishing and maintaining our records for
this contract. The charge is $6 per quarter and is deducted from
the contract value at the end of each three-month period measured
from the contract date, or, if earlier, when the contract is
surrendered. The charge does not apply after settlement of this
contract.
Premium Tax Charges
A charge will be made by us against the contract value of this
contract at the time that any premium taxes not previously deducted
are payable.
<PAGE>
PAGE 14
CONTRACT VALUE (continued)
Transfers of Contract Values
While this contract is in force prior to the settlement date,
transfer of contract values may be made as outlined below:
1. You may transfer all or a part of the values held in one or
more of the variable accounts to another one or more of the
variable accounts. Subject to item 2, you may also transfer
values held in one or more of the variable accounts to the
fixed account.
2. On or within the 30 days after a contract anniversary you may
transfer values from the fixed account to one or more of the
variable accounts. Only one such transfer is allowed during
this period each year. If such a transfer is made, no
transfers from a variable account to the fixed account may be
made until the next contract anniversary.
You may make a transfer by written request. Transfer requests may
also be made by telephone if we have received a properly completed
authorization form. There is no fee or charge for these transfers.
However, the minimum transfer amount is $250, or if less, the
entire value in the account from which the transfer is being made.
This transfer privilege may be suspended or modified by us at any
time.
<PAGE>
PAGE 15
FIXED AND VARIABLE ACCOUNTS
The Fixed Account
The fixed account is our general account. It is made up of all of
our assets other than: (1) those in the variable accounts; and (2)
those in any other segregated asset account.
The Variable Accounts
The variable accounts are separate investment accounts of ours.
They are named under Contract Data. We have allocated a part of
our assets for this and certain other contracts to the variable
accounts. Such assets remain our property. However, they may not
be charged with the liabilities from any other business in which we
may take part.
Investments of the Variable Accounts
Purchase payments applied to the variable accounts will be
allocated as specified in your application for this contract or as
later changed. Each variable account will buy, at net asset value,
shares of the fund shown for that account under Contract Data or as
later added or changed.
Valuation of Assets
Mutual fund shares in the variable accounts will be valued at their
net asset value.
Variable Account Accumulation Units
The number of accumulation units for each of the variable accounts
is found by dividing: (1) the net amount allocated to the account;
by (2) the accumulation unit value for the account for the
valuation period during which we received the purchase payment.
Variable Account Accumulation Unit Value
The value of an accumulation unit for each of the variable accounts
was arbitrarily set at $1 when the first mutual fund shares were
bought. The value for any later valuation period is found as
follows:
The accumulation unit value for each variable account for the
last prior valuation period is multiplied by the net
investment factor for the same account for the next following
valuation period. The result is the accumulation unit value.
The value of an accumulation unit may increase or decrease
from one valuation period to the next.
<PAGE>
PAGE 16
FIXED AND VARIABLE ACCOUNTS (continued)
Net Investment Factor
The net investment factor is an index applied to measure the
investment performance of a variable account from one valuation
period to the next. The net investment factor may be greater or
less than one; therefore, the value of an accumulation unit may
increase or decrease.
The net investment factor for any such account for any valuation
period is determined by: dividing (1) by (2) and subtracting (3)
from the result. This is done where:
(1) is the sum of:
a. the net asset value per share of the mutual
fund held in the variable account determined at
the end of the current valuation period; plus
b. the per share amount of any dividend or capital
gain distributions made by the mutual fund held
in the variable account, if the "ex-dividend"
date occurs during the current valuation
period.
(2) is the net asset value per share of the mutual fund held in
the variable account, determined at the end of the last prior
valuation period.
(3) is a factor representing the mortality and expense risk
charge.
Mortality and Expense Risk Charge
In calculating accumulation unit values we will deduct a mortality
and expense risk charge from the variable accounts equal, on an
annual basis, to 1.00% of the daily net asset value. This
deduction is made to compensate us for assuming the mortality and
expense risks under contracts of this type. The deduction is: (1)
made from each variable account; and (2) computed on a daily basis.
Annuity Unit Value
The value of an annuity unit for each variable account was
arbitrarily set at $1 when the first mutual funds were bought. The
value of any later valuation period is found as follows:
1. The annuity unit value for each variable account for the last
prior valuation period is multiplied by the net investment
factor for the account for the valuation period for which the
annuity unit value is being calculated.
2. The result is multiplied by an interest factor. This is done
to neutralize the assumed investment rate which is built into
the annuity tables on page 14.
<PAGE>
PAGE 17
SURRENDER PROVISIONS
Surrender
By written request and subject to the rules below you may:
1. surrender this contract for the total surrender value; or
2. partially surrender this contract for a part of the surrender
value.
Surrender Value
The surrender value at any time will be:
1. the contract value;
2. minus the contract administrative charge;
3. minus any surrender charge.
Surrender Charge
In order to determine if a surrender charge applies to a partial or
total surrender we first divide the contract value into three
parts.
1. Contract Earnings - This is the contract value minus the sum
of all purchase payments we have received that have not been
previously surrendered.
2. Old Purchase Payments - These are purchase payments we
received in any contract year more than five years prior to
the contract year of surrrender.
3. New Purchase Payments - These are purchase payments we
received during the contract year in which the surrender is
made or in the five immediately preceding contract years.
We will then surrender your contract value in the following order
so that the amount surrendered, less any surrender charge that
applies, equals your requested surrender amount:
1. Contract Earnings, if any, are surrendered first. There is no
surrender charge on contract earnings.
2. Next, if necessary, we surrender Old Purchase Payments not
previously surrendered. There is no surrender charge on Old
Purchase payments.
3. Finally, if necessary, we surrender New Purchase Payments not
previously surrendered. There is a surrender charge of 7%
applied to New Purchase Payments surrendered.
<PAGE>
PAGE 18
SURRENDER PROVISIONS (continued)
Surrender Charge Calculation
The surrender charge for a total surrender is calculated by
multiplying the amount representing new purchase payments by .07.
The surrender charge for a partial surrender is calculated by
dividing the surrender amount requested representing "new purchase
payments" by .93 and multiplying the result by .07.
For example, the surrender charge on a $1,000 partial surrender
request (representing all "new purchase payments") would be $75.27,
resulting from the following calculation: ($1,000/.93) X .07 =
$75.27.
Rules For Surrender
All surrenders will have the following conditions:
1. You must apply by written request: (a) while this contract is
in force; and (b) prior to the earlier of the retirement date
or the death of the annuitant.
2. You must surrender an amount equal to at least $250. The
contract value after a partial surrender must be at least
$600.
3. The amount surrendered, less any charges, will normally be
paid to you within seven days of the receipt of your written
request and this contract, if required. For surrenders from
the fixed account, we have the right to defer payment to you
for up to 6 months from the date we receive your request.
4. For partial surrenders, if you do not specify from which
accounts the surrender is to be made, the surrender will be
made from the variable accounts and fixed account in the same
proportion as your interest in each bears to the contract
value.
5. Any amounts surrendered and charges which may apply can not be
repaid.
Upon surrender for the full surrender value this contract will
terminate. We may require that you return the contract to us
before we pay the full surrender value.
Suspension or Delay in Payment of Surrender
We have the right to suspend or delay the date of any surrender
payment from the variable accounts for any period:
1. When the New York Stock Exchange is closed; or
2. When trading on the New York Stock Exchange is restricted; or
<PAGE>
PAGE 19
SURRENDER PROVISIONS (continued)
3. When an emergency exists as a result of which: (a) disposal of
securities held in the variable accounts is not reasonably
practicable; or (b) it is not reasonably practicable to fairly
determine the value of the net assets of the variable account;
or
4. During any other period when the Securities and Exchange
Commission, by order, so permits for the protection of
security holders.
Rules and regulations of the Securities and Exchange Commission
will govern as to whether the conditions set forth in 2 and 3
exist.
<PAGE>
PAGE 20
ANNUITY PROVISIONS
Settlement
When settlement occurs, the contract value will be applied to make
annuity payments. The first payment will be made as of the
retirement date. This date is shown under Contract Data. Before
payments begin we will require satisfactory proof that the
annuitant is alive. We may also require that you exchange this
contract for a supplemental contract which provides the annuity
payments.
Change of Retirement Date
The retirement date for this contract is as specified under
contract data. However, you may elect to change the retirement
date at any time upon at least 30 days written notice to us at our
home office. However, the retirement date may not be earlier than
the close of the annuitant's taxable year in which the annuitant
attains the age of 59-1/2 and not later than the April 1st
following the calendar year in which the annuitant attains age 70-
1/2.
Annuity Payment Plans
Subject to the terms of this contract, annuity payments may be made
on a fixed-dollar basis, a variable basis or a combination of both.
You can schedule receipt of annuity payment according to one of the
Plans A through E below or another plan agreed to by us provided:
1. the Plan selected provides for equal or substantially equal
payments over a period no longer than the life of the
annuitant or over the life of the annuitant and a joint
annuitant; or
2. the Plan selected provides for equal or substantially equal
payments over a period which does not exceed the life
expectancy of the annuitant, or the life expenctancy of the
annuitant and a joint annuitant.
Plan A - This provides monthly annuity payments during the
lifetime of the annuitant. No payments will be made after the
annuitant dies.
Plan B - This provides monthly annuity payments during the
lifetime of the annuitant with a guarantee by us that payments
will be made for a period of at least five, ten or fifteen
years. You must select the guaranteed period.
Plan C - This provides monthly annuity payments during the
lifetime of the annuitant with a guarantee by us that payments
will be made for a certain number of months. We determine the
number of months by dividing the amount applied under this
Plan by the amount of the first monthly annuity payment.
<PAGE>
PAGE 21
ANNUITY PROVISIONS (continued)
Plan D - Monthly payments will be paid during the lifetime of
the annuitant and a joint annuitant. When either the
annuitant or the joint annuitant dies we will continue to make
monthly payments during the lifetime of the survivor. No
payments will be paid after the death of both the annuitant
and joint annuitant.
Plan E - This provides monthly fixed dollar annuity payments
for a period of years. The period of years may be no less
than 5 nor more than 30.
By written request to us at least 30 days before the Retirement
Date, you may select the Plan or elect a lump sum payment of the
surrender value. If at least 30 days before the Retirement Date we
have not received at our home office your written request to select
a Plan, we will make payments according to Plan B with payments
guaranteed for ten years.
If the amount to be applied to a Plan would not provide an initial
monthly payment of at least $20, we have the right to make a lump
sum payment of the contract value.
Fixed Annuity
A fixed annuity is an annuity with payments that are guaranteed by
us as to dollar amount. Fixed annuity payments after the first
payment will never be less than the amount of the first payment.
At settlement, the fixed account contract value will be applied to
the applicable Annuity Table. This will be done in accordance with
the Payment Plan chosen. The amount payable for each $1,000 so
applied is shown in Table B on page 15.
Variable Annuity
A variable annuity is an annuity with payments which: (1) are not
predetermined or guaranteed as to dollar amount; and (2) vary in
amount with the investment experience of the variable accounts.
Determination of First Variable Annuity Payment
At settlement, the variable account contract value will be applied
to the applicable Annuity Table. This will be done: (1) on the
valuation date on or next preceding the seventh calendar day before
the retirement date; and (2) in accordance with the Payment Plan
chosen. The amount payable for the first payment for each $1,000
so applied is shown in Table A on page 14.
Variable Annuity Payments After the First Payment
Variable annuity payments after the first payment vary in amount.
The amount changes with the investment performance of the variable
accounts. The dollar amount of variable annuity payments after the
first is not fixed. It may change from month to month. The dollar
amount of such payments is determined as follows:
<PAGE>
PAGE 22
ANNUITY PROVISIONS (continued)
1. The dollar amount of the first annuity payment is divided by
the value of an annuity unit as of the valuation date on or
next preceding the seventh calendar day before the retirement
date. This result establishes the fixed number of annuity
units for each monthly annuity payment after the first
payment. This number of annuity units remains fixed during
the annuity payment period.
2. The fixed number of annuity units is multiplied by the annuity
unit value as of the valuation date on or next preceding the
seventh calendar day before the date the payment is due. This
result establishes the dollar amount of the payment.
We guarantee that the dollar amount of each payment after the first
will not be affected by variations in expenses or mortality
experience.
Exchange of Annuity Units
Annuity units of any variable account may be exchanged for units of
any of the other variable accounts. This may be done no more than
once a year. Once annuity payments start no exchanges may be made
to or from any fixed annuity.
<PAGE>
PAGE 23
TABLE OF SETTLEMENT RATES
Table A below shows the amount of the first monthly variable
annuity payment, based on a 3-1/2% assumed investment return, for
each $1,000 of value applied under any Payment Plan. The amount of
the first and all subsequent monthly fixed dollar annuity payments
for each $1,000 of value applied under any Payment Plan will be
based on our fixed dollar Table of Settlement Rates in effect on
the settlement date. Such Rates are guaranteed to be not less than
those shown in Table B. The amount of such annuity payments under
Plans A, B, and C will depend upon the sex and the adjusted age of
the annuitant on the date of settlement. The amount of such
annuity payments under Plan D will depend upon the sex and adjusted
age of the annuitant and joint annuitant on the date of settlement.
Adjusted age shall be equal to the age nearest birthday minus an
"adjustment" depending on the calendar year of birth of the
annuitant as follows:
Calendar
Year of
Annuitant's
Birth Adjustment
Prior to 1920 0
1920 through 1924 1
1925 through 1929 2
1930 through 1934 3
1935 through 1939 4
1940 through 1944 5
1945 through 1949 6
1950 through 1959 7
1960 through 1969 8
1970 through 1979 9
1980 through 1989 10
After 1989 11
<PAGE>
PAGE 24
TABLE OF SETTLEMENT RATES (continued)
<TABLE>
<CAPTION>
TABLE A Dollar Amount of First Monthly Variable Annuity Payment Per $1,000 Applied
PLAN A PLAN B PLAN C PLAN D - Joint and Survivor
Adjusted Age of Joint Annuitant
Life 5 Years 10 Years 15 Years With Adj.
Adj. Income Certain Certain Certain Refund Male 10 years 5 years Same 5 years 10 years
Age* M F M F M F M F M F Age* Younger Younger Age Older Older
<C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
40 3.96 3.73 3.96 3.73 3.94 3.72 3.92 3.71 3.88 3.69 40 3.37 3.45 3.53 3.61 3.69
41 4.01 3.76 4.00 3.76 3.99 3.76 3.97 3.75 3.92 3.72 41 3.39 3.47 3.56 3.65 3.73
42 4.06 3.80 4.05 3.80 4.04 3.80 4.01 3.78 3.97 3.76 42 3.41 3.50 3.59 3.68 3.77
43 4.11 3.84 4.11 3.84 4.09 3.84 4.06 3.82 4.01 3.80 43 3.43 3.52 3.62 3.72 3.81
44 4.17 3.89 4.16 3.88 4.14 3.88 4.11 3.86 4.06 3.83 44 3.45 3.55 3.65 3.76 3.85
45 4.22 3.93 4.22 3.93 4.20 3.92 4.16 3.91 4.11 3.87 45 3.48 3.58 3.69 3.80 3.89
46 4.29 3.98 4.28 3.98 4.25 3.97 4.21 3.95 4.16 3.92 46 3.51 3.61 3.73 3.84 3.94
47 4.35 4.03 4.34 4.03 4.31 4.02 4.27 4.00 4.21 3.96 47 3.53 3.64 3.76 3.88 3.99
48 4.42 4.08 4.41 4.08 4.38 4.07 4.33 4.05 4.26 4.01 48 3.56 3.68 3.80 3.93 4.05
49 4.49 4.14 4.48 4.13 4.44 4.12 4.39 4.10 4.32 4.06 49 3.59 3.72 3.85 3.98 4.10
50 4.56 4.20 4.55 4.19 4.51 4.18 4.45 4.15 4.38 4.11 50 3.62 3.75 3.89 4.03 4.16
51 4.64 4.26 4.62 4.25 4.58 4.24 4.52 4.21 4.45 4.16 51 3.65 3.79 3.94 4.09 4.22
52 4.72 4.32 4.70 4.32 4.66 4.30 4.58 4.26 4.51 4.22 52 3.69 3.83 3.99 4.14 4.29
53 4.80 4.39 4.79 4.38 4.74 4.36 4.65 4.33 4.58 4.27 53 3.73 3.88 4.04 4.21 4.36
54 4.89 4.46 4.88 4.46 4.82 4.43 4.73 4.39 4.66 4.34 54 3.76 3.93 4.10 4.27 4.43
55 4.99 4.54 4.97 4.53 4.91 4.51 4.80 4.46 4.73 4.40 55 3.80 3.97 4.16 4.34 4.51
56 5.09 4.62 5.07 4.61 5.00 4.58 4.88 4.53 4.81 4.47 56 3.85 4.03 4.22 4.41 4.59
57 5.20 4.71 5.17 4.70 5.10 4.66 4.97 4.60 4.90 4.54 57 3.89 4.08 4.29 4.49 4.68
58 5.32 4.80 5.29 4.79 5.20 4.75 5.05 4.68 4.99 4.62 58 3.94 4.14 4.36 4.57 4.78
59 5.44 4.90 5.41 4.88 5.31 4.84 5.14 4.76 5.06 4.70 59 3.99 4.20 4.43 4.66 4.88
60 5.57 5.00 5.53 4.99 5.42 4.93 5.23 4.84 5.18 4.78 60 4.04 4.27 4.51 4.76 4.99
61 5.71 5.11 5.67 5.09 5.54 5.03 5.33 4.93 5.29 4.87 61 4.10 4.34 4.59 4.86 5.10
62 5.86 5.23 5.81 5.21 5.67 5.14 5.42 5.02 5.40 4.96 62 4.16 4.41 4.68 4.97 5.23
63 6.02 5.36 5.97 5.33 5.80 5.25 5.52 5.12 5.51 5.06 63 4.22 4.49 4.78 5.08 5.36
64 6.20 5.49 6.13 5.46 5.94 5.37 5.62 5.21 5.63 5.17 64 4.29 4.57 4.88 5.20 5.50
65 6.38 5.64 6.31 5.60 6.08 5.50 5.72 5.31 5.75 5.28 65 4.35 4.66 4.99 5.34 5.66
66 6.58 5.79 6.49 5.75 6.23 5.63 5.82 5.42 5.90 5.39 66 4.43 4.75 5.11 5.48 5.82
67 6.79 5.95 6.69 5.91 6.38 5.77 5.92 5.53 6.04 5.52 67 4.51 4.85 5.24 5.63 6.00
68 7.02 6.13 6.90 6.08 6.54 5.91 6.02 5.63 6.19 5.65 68 4.59 4.96 5.37 5.79 6.19
69 7.26 6.32 7.12 6.26 6.71 6.07 6.12 5.74 6.35 5.79 69 4.68 5.07 5.51 5.97 6.39
70 7.52 6.53 7.35 6.46 6.87 6.23 6.21 5.86 6.52 5.94 70 4.78 5.20 5.67 6.16 6.60
71 7.80 6.75 7.60 6.67 7.05 6.40 6.30 5.97 6.69 6.09 71 4.88 5.33 5.83 6.36 6.84
72 8.09 6.99 7.86 6.89 7.22 6.58 6.39 6.08 6.88 6.26 72 4.98 5.47 6.01 6.58 7.09
73 8.41 7.26 8.13 7.13 7.40 6.76 6.47 6.18 7.07 6.44 73 5.10 5.62 6.20 6.81 7.35
74 8.75 7.54 8.42 7.39 7.57 6.95 6.55 6.29 7.27 6.63 74 5.22 5.78 6.41 7.06 7.64
75 9.12 7.85 8.72 7.67 7.75 7.14 6.62 6.39 7.49 6.83 75 5.35 5.95 6.63 7.33 7.95
*Adjusted age of annuitant. M=Male F=Female
Table A above is based on the "1983 Individual Annuitant Mortality Table a." Settlement rates for any age, or any combination of
age and sex not shown above, will be calculated on the same basis as those rates shown in the table above. Such rates will be
furnished by us upon request.
</TABLE>
<PAGE>
PAGE 25
TABLE OF SETTLEMENT RATES (continued)
<TABLE>
<CAPTION>
TABLE B Dollar Amount of Each Monthly Fixed Dollar Annuity Payment Per $1,000 Applied
PLAN A PLAN B PLAN C PLAN D - Joint and Survivor
Adjusted Age of Joint Annuitant
Life 5 Years 10 Years 15 Years With Adj.
Adj. Income Certain Certain Certain Refund Male 10 years 5 years Same 5 years 10 years
Age* M F M F M F M F M F Age* Younger Younger Age Older Older
<C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
40 4.27 4.04 4.26 4.04 4.25 4.03 4.23 4.02 4.20 4.01 40 3.69 3.76 3.84 3.92 4.00
41 4.31 4.07 4.31 4.07 4.30 4.07 4.27 4.06 4.24 4.04 41 3.71 3.79 3.87 3.95 4.03
42 4.36 4.11 4.36 4.11 4.34 4.10 4.32 4.09 4.28 4.07 42 3.73 3.81 3.90 3.99 4.07
43 4.42 4.15 4.41 4.15 4.39 4.14 4.36 4.13 4.32 4.11 43 3.75 3.84 3.93 4.02 4.11
44 4.47 4.19 4.46 4.19 4.44 4.18 4.41 4.17 4.37 4.15 44 3.77 3.86 3.96 4.06 4.15
45 4.53 4.24 4.52 4.23 4.50 4.23 4.46 4.21 4.42 4.19 45 3.80 3.89 3.99 4.10 4.19
46 4.59 4.28 4.58 4.28 4.55 4.27 4.51 4.25 4.47 4.23 46 3.82 3.92 4.03 4.14 4.24
47 4.65 4.33 4.64 4.33 4.61 4.32 4.56 4.30 4.52 4.27 47 3.85 3.95 4.07 4.18 4.29
48 4.72 4.38 4.71 4.38 4.67 4.37 4.62 4.34 4.58 4.32 48 3.87 3.98 4.10 4.22 4.34
49 4.79 4.44 4.77 4.43 4.74 4.42 4.68 4.39 4.63 4.36 49 3.90 4.02 4.15 4.27 4.39
50 4.86 4.50 4.85 4.49 4.81 4.47 4.74 4.45 4.69 4.41 50 3.93 4.06 4.19 4.32 4.45
51 4.94 4.56 4.92 4.55 4.88 4.53 4.80 4.50 4.76 4.47 51 3.96 4.09 4.23 4.38 4.51
52 5.02 4.62 5.00 4.61 4.95 4.59 4.87 4.56 4.82 4.52 52 4.00 4.13 4.28 4.43 4.57
53 5.10 4.69 5.08 4.68 5.03 4.66 4.94 4.62 4.90 4.58 53 4.03 4.18 4.33 4.49 4.64
54 5.19 4.76 5.17 4.75 5.11 4.72 5.01 4.68 4.07 4.64 54 4.07 4.22 4.39 4.56 4.72
55 5.29 4.84 5.26 4.83 5.20 4.80 5.09 4.74 5.05 4.71 55 4.11 4.27 4.45 4.62 4.79
56 5.39 4.92 5.36 4.91 5.29 4.87 5.17 4.81 5.13 4.77 56 4.15 4.32 4.51 4.70 4.88
57 5.49 5.00 5.47 4.99 5.38 4.95 5.25 4.88 5.21 4.85 57 4.19 4.37 4.57 4.77 4.96
58 5.61 5.09 5.58 5.08 5.48 5.03 5.33 4.96 5.30 4.92 58 4.24 4.43 4.64 4.85 5.06
59 5.73 5.19 5.70 5.17 5.59 5.12 5.42 5.04 5.40 5.00 59 4.28 4.49 4.71 4.94 5.16
60 5.86 5.29 5.82 5.27 5.70 5.22 5.51 5.12 5.50 5.09 60 4.34 4.55 4.79 5.03 5.27
61 6.00 5.40 5.96 5.38 5.82 5.32 5.60 5.21 5.60 5.18 61 4.39 4.62 4.87 5.13 5.38
62 6.16 5.52 6.10 5.50 5.95 5.42 5.69 5.30 5.72 5.27 62 4.45 4.69 4.96 5.24 5.50
63 6.32 5.65 6.26 5.62 6.08 5.53 5.79 5.39 5.83 5.37 63 4.51 4.77 5.06 5.35 5.64
64 6.49 5.78 6.42 5.75 6.21 5.65 5.89 5.49 5.96 5.48 64 4.57 4.85 5.16 5.48 5.78
65 6.68 5.92 6.60 5.89 6.35 5.77 5.98 5.58 6.09 5.59 65 4.64 4.94 5.27 5.61 5.93
66 6.88 6.08 6.78 6.03 6.50 5.90 6.08 5.69 6.23 5.71 66 4.71 5.03 5.38 5.75 6.09
67 7.09 6.24 6.98 6.19 6.65 6.04 6.18 5.79 6.38 5.83 67 4.79 5.13 5.51 5.90 6.27
68 7.31 6.42 7.18 6.36 6.81 6.19 6.28 5.90 6.53 5.97 68 4.87 5.24 5.64 6.06 6.46
69 7.56 6.61 7.40 6.54 6.97 6.34 6.37 6.01 6.69 6.11 69 4.96 5.35 5.78 6.24 6.66
70 7.82 6.81 7.64 6.74 7.14 6.50 6.47 6.12 6.86 6.26 70 5.06 5.47 5.94 6.43 6.87
71 8.09 7.04 7.88 6.95 7.31 6.67 6.55 6.22 7.04 6.42 71 5.16 5.60 6.10 6.63 7.11
72 8.39 7.28 8.14 7.17 7.48 6.84 6.64 6.33 7.23 6.59 72 5.26 5.74 6.28 6.84 7.36
73 8.71 7.54 8.41 7.41 7.65 7.02 6.72 6.44 7.43 6.77 73 5.38 5.89 6.47 7.08 7.62
74 9.05 7.83 8.70 7.67 7.83 7.21 6.80 6.54 7.64 6.97 74 5.50 6.05 6.68 7.33 7.91
75 9.41 8.14 9.00 7.95 8.00 7.40 6.87 6.64 7.86 7.17 75 5.63 6.22 6.90 7.60 8.22
*Adjusted age of annuitant. M=Male F=Female
Table B above is based on the "1983 Individual Annuitant Mortality Table a" assuming an interest rate of 4% per year compounded
annually. Settlement rates for any age, or any combination of age and sex not shown above, will be calculated on the same basis as
those rates shown in the table above. Such rates will be furnished by us upon request. Amounts shown in the Table below are based
on an assumed interest rate of 4% per year compounded annually.
</TABLE>
<TABLE>
<CAPTION>
PLAN E Dollar Amount of Each Monthly Fixed Dollar Annuity Payment Per $1,000 Applied
Years Monthly Years Monthly Years Monthly
Payable Payment Payable Payment Payable Payment
<C> <C> <C> <C> <C> <C>
5 18.32 15 7.34 25 5.22
6 15.56 16 7.00 26 5.10
7 13.59 17 6.71 27 5.00
8 12.12 18 6.44 28 4.90
9 10.97 19 6.21 29 4.80
10 10.06 20 6.00 30 4.72
11 9.31 21 5.81
12 8.69 22 5.64
13 8.17 23 5.49
14 7.72 24 5.35
</TABLE>
<PAGE>
PAGE 26
DEFERRED ANNNUITY CONTRACT
o Flexible purchase payments.
o Optional fixed dollar or variable accumulation values and
annuity payments.
o Annuity payments to begin on the retirement date.
o This contract is nonparticipating. Dividends are not
payable.
IDS Life Insurance Company
of New York
Box 5144
Albany, New York 12205
An American Express Company
<PAGE>
PAGE 1
IDS Life Insurance Company ANNUITY
of New York APPLICATION
Box 5144
Albany, New York 12205
<TABLE>
<CAPTION>
A Clients
__________________________________________________________________________________________
1 Annuitant
a Name (first) _______________________ (mi) _________ (last) _____________________________
b Home address (street, city, state, zip) ________________________________________________
___________________________________________ Phone no. ( ) ___________________________
c Social Security No. ______________________ ____ Male ____ Female
d Birth date _____/____/______ Age ________ (submit proof of age for immediate annuity)
e Citizenship ____ U.S. ____ Other __________________________________________________
f Relationship to the representative _____________________________________________________
g Is this annuity intended to replace existing annuities or life insurance? ___ Yes ___ No
If Yes, see State Requirements Section of the Reference Manual for required papers.
2 Joint Annuitant (for Immediate Joint Annuity only)
a Name (first) _______________________ (mi) _________ (last) _____________________________
b Social Security No. ______- ____-_________ ____ Male ____ Female
c Birth date _____/____/______ Age ________ (submit proof of age)
3 Owner
a Will the Annuitant own this Annuity? (must be Yes for IRA)
____ Yes
Mailing address if correspondence should not go to Annuitant's home
(street, city, state, zip) ________________________________________________________
______________________________________ and Phone no. ( ) ________________________
____ No (complete the following six (o) items)
Joint ownership and designation of a successor owner are not allowed
o Owner's name(s) ____ IDS Trust Co. ____ Other ______________________________
________________________________________________________________________________
o Type of ownership (check one)
____ Trustee ____ Sole Proprietorship
____ Custodian ____ Partnership
____ Individual ____ Corporation (State of incorporation) ____________
____ Other _____________________________________________________________________
o Trust or Custodial ownership basis (complete one if applicable)
____ Retirement Plan (name) ____________________________________________________
____ Trust (name) ______________________________ Trust Date ____________________
____ Purchased under Uniform Gifts to Minors Act of (state) ____________________
o Owner's address (street, city, state, zip) _____________________________________
____________________________________ Phone no. ( ) ___________________________
o Owner's Social Security or Taxpayer Identification No. _________________________
o If ownership is individual, give owner's birth date ____/___/_____ Age _________
Relationship to Annuitant ________________ and to Representative _______________
b Other ownership information and instructions ___________________________________________
________________________________________________________________________________________
<PAGE>
PAGE 2
B Purchase Basis (complete only one of the eight (o) responses on this page)
See New Business Section of Reference Manual for required papers
o ____ Non-qualified individual purchase
o ____ Non-qualified 1035 exchange
o ____ Non-qualified deferred compensation plan (non-governmental)
o ____ Non-qualified Gift under Uniform Gifts to Minor's Act. (If Donor is not custodian,
give Donor's name, Soc. Sec. No., residence state and relationship to Annuitant.)
_____________________________________________________________________________________
o ____ Other non-qualified:_________________________________________________________________
o ____ IRA (complete all that apply)
1 ____ Regular(active)IRA
a Type ____ Personal ____ Spousal ____ SEP Group no. of SEP_________________
(1) (2) (3) Name of employer_________________
Address__________________________
b Amount paid with this application for prior year $______________________
c Amount paid with this application for current year $______________________
2 ____ Rollover IRA (Rollover qualifications are specified in Your Guide to IRAs)
a Source ____ IRA/Sep distribution. ____ Deductible voluntary employee contribution.
____ Trusted or Custodial plan, Tax-Sheltered Annuity or Custodial Account.
b Amount paid, with this application, for rollover $______________________
c Does client want a rollover account which cannot take active, add-on contributions?
____ Yes Client maintains the right to roll back into another Trusted or
Custodial plan, TSA or TSCA if the distribution was from one of those
sources.
____ No Rollover amount cannot be rolled back to a plan of the same kind.
3 ____ Transfer IRA (submit"Request for Transfer" form. Send no money with application)
o ____ Tax-qualified Retirement Plan
1 Type ____ Profit Sharing (05) ____ Assumed/Target Benefit (04) ____ 401(k) (02)
____ Money Purchase (06) ____ Defined Benefit Pension (01) ____ Other (10) ____
2 Plan Fiscal Year-end Mo._____Day_______ Plan Starting Date Mo._____Yr._____
3 Is the Plan an IDS Financial Services prototype? ____ Yes ____ No
4 Plan administrative assistance by IDS Financial Services? ____ Yes ____ No
5 If Custodial Plan, identify participant (Annuitant) as ____ Employer/Sponsor
____ Other participant
6 Source of employee contribution to Participant Account
____ Deductible Voluntary ____ Salary Reduction ____ Non-deductible Voluntary
____ Transfer/Rollover
7 Plan Entry Date for Participant (Annuitant) Mo._____Yr._____
o ____ Other Tax-qualified Plan
1 Type of Plan ____ 403(b) TSA ____ 457/Government (07) ____ Other_________________
2 Type of group ____ Public Schools and Universities ____ State or subdivision
____ 501(c)(3) Non-profit ____ Other_______________________
3 ____ This is a 1035 TSA exchange.
4 403(b) Participant (Annuitant) information
a Current annual salary from employer $_________________
b Employment date ____/____/____ Has employment been continuous? ____ Yes ____ No
c Total contributions to other tax-sheltered plans while employed with present employer
were $____________ through end of last taxable year (usually Dec.31)
d Is Annuitant covered by employer's retirement plan? ____ Yes ____ No
If Yes, give name of plan______________________________________________
e Will the Annuitant be electing an alternative calculation under Section 415 of the
Internal Revenue Code? ____ Yes ____ No If Yes, state which _______________________
<PAGE>
PAGE 3
C Annuity Applied For
1 Type (complete one) Purchase payment Annuitant's Retirement* Other
____ Combination Deferred Annual $_________________ Date _____/_____/______ (Complete C2)
____ Variable Deferred Single $_________________ Date _____/_____/______ (Complete C2)
____ Fixed Deferred Single $_________________ Age __________________ Bailout? ____ Yes ____ No
Initial Guarantee Period __ 1-yr __ 3-yr __ 5-yr
____ Fixed Immediate Single $_________________ (Complete C3)
(not for IRA)
____ Other _______________________________________________________________________________________________________
*If omitted, later of 65th birthday or 10th contract anniversary, will be assumed.
2 Combination and Variable annuity information
a Payment allocation
Fixed Account (available with
combination annuity only) ___________% Special Income Fund _____________%
Moneyshare Fund _____________________% Capital Resource Fund ___________%
_____________________________________% _________________________________% Total = 100%
b ____ Owner requests Statement of Additional Information, per Annuity Prospectus.
c ____ The Owner requests to make transfers by telephone between the Account/Funds within
this one contract.
3 Immediate annuity information
a Payout option:____ Individual Annuitant
____ Joint and full to survivor ____ Joint and 2/3 to survivor
b Payout mode: ____Nonrefund____Installment refund (not available with Joint and 2/3 option)
____ 5 years certain ____ 10 years certain ____ 15 years certain
c Payout checks to be received on ____ day of each month
D Future Payments
1 Frequency of payment
____ Monthly ____ Quarterly ____ Semi-annual ____ Annual
____ Other - Specify months __ Jan __ Feb __ March __ April __ May __ June
__ July __ Aug __ Sept __ Oct __ Nov __ Dec
2 Payments to start (or first notice to be received) Mo.__________ Day__________
If omitted, the Home Office will establish a starting date.
3 Method of payment:
____ Add to existing bank authorization with IDS account no.____________________
____ New bank authorization (submit form 38905)
____ Individual direct billing
____ Other allowed method____________________________________
E Beneficiary
Either check a "standard designation" (A or B) and give the name of the Annuitant's
spouse, or check "other designation" and give the complete wording of the designation,
using the examples supplied with this form, as a guide.
____ Standard designation (see page 4) __ A __ B for (Spouse's name) _________________
____ Other designation (unless stated otherwise, proceeds will be paid equally to
surviving beneficiaries) ____________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
<PAGE>
PAGE 4
Definitions of standard beneficiary designations
A Beneficiary is: Annuitant's designated Spouse, if living,otherwise the beneficiaries are
the living lawful children of the Annuitant and they will receive equal shares of the
proceeds.
B Beneficiary is: Annuitant's designated Spouse, if living, otherwise the beneficiaries
are the lawful children of the Annuitant and they will receive equal shares of the
proceeds. If a child of the Annuitant has died before the Annuitant, that child's share
of the proceeds will be paid to his or her living lawful children in equal shares.
F Remarks and Instructions to the Home Office
Send contract to: ____ Representative ____ Owner
___________________________________________________________________________________________
___________________________________________________________________________________________
G Home Office Corrections and Additions
___________________________________________________________________________________________
___________________________________________________________________________________________
Agreement and Signatures
1 Agreement. By signing this application and checking each statement that pertains to your
annuity, you understand and acknowledge the following:
a All Annuities
____ Changes. Only the Company has authority to accept any representation or information
not contained in this application or to modify any annuity contract or waive any
requirement in the application.
Except where prohibited by law, acceptance of any annuity issued on this application
will constitute a ratification of any change in the Home Office Corrections and
Additions section of this application. However, the applicant must agree in
writing to any change in amount, issue age, plan or benefit.
____ Taxes. Earnings credited to the contract are usually not taxable until they are
actually received through surrender or monthly income payments. Under an IRA
annuity, all earnings are sheltered from taxes until distributed.
____ Earnings. The fixed and/or variable earnings basis for your particular contract has
been explained to you.
____ Release of information. Unless you indicate on your application or in writing to us
that you object, we may give information about you to another company so that it can
inform you about a product or service.
b IRA applications
____ Disclosure. You have received a copy of Your Guide to IRAs and understand the terms
contained in it.
____ Responsibility. You assume all responsibility for any tax consequences and
penalties that may result from making contributions to, transactions with, and
distributions from this IRA.
c Immediate Annuity
____ Access to contract value. The contract value of an immediate annuity may not be
surrendered or loaned. Also, there is no death benefit under the non-refund payout
mode.<PAGE>
PAGE 5
d Deferred Annuity (Please read all three headings, because several categories may apply
to your type of contract)
1 Combination, Variable and Fixed Deferred Annuity
____ Purpose. You understand that the basic purpose of an annuity is to provide
lifetime income at retirement and it should be purchased for this purpose.
Surrender of a contract may result in a loss to you because of the fees and
charges mentioned below.
____ Surrender. The contract value may be surrendered in full or in part before
annuity payments begin, but not after.
____ Fees and charges. The fees and charges (including possible surrender charges and
state or federal taxes) and the bail-out provision, if applicable, have been
explained to you. They are explained in detail in the contract.
2 Combination and Variable Annuity
____ Adequate information. You have received the current prospectuses for the annuity
applied for and any funds involved.
____ Variable values. Earnings, values and monthly income benefits based on the
performance of a Variable Fund are not guaranteed and may both increase and
decrease.
____ Transfers. A combination annuity may allow for transfers of value between the
fixed account and the Variable funds prior to retirement.
3 Variable and Fixed Deferred Annuity
____ Premium payments. You cannot make additional premium payments to a single premium
contract.
e Consolidated Statement
IDS Periodically sends out informational Statements, for each of its accounts, which are
consolidated into one Statement covering all accounts owned by members of the same
household. If you don't want this account reported that way, check here __.
f Declaration
You declare that each of the statements and answers given in this application is true and
complete to the best of your knowledge and belief and will be the basis of any annuity
issued from this application.
2 Signatures
Signatures of all Annuitants x_______________________________________________
x_______________________________________________
Owner's signature
(omit if owner already signed as an Annuitant)
x_______________________________________________
Other applicant's signature (if required) x_______________________________________________
Signed at (city) _________________________ (state)______________, on (date) ____/____/____
<PAGE>
PAGE 6
Representatives Report
1 Declaration and signature. You certify that you personally solicited this application and
witnessed its signing. The application and this report are complete and accurate tot he
best of your knowledge and belief.
This application ____ does ____ does not involve replacement of existing insurance or
annuities.
Representative's
Signature_____________________________No.________________DSO______________________________
Representative's
name (print)__________________________Phone ( )________________________
____ Junior ____ Trainer
name______________________________________________No._____________________
2 Immediate non-refund annuity report. Give any required explanation here or in a separate
letter attached to this application.
To the best of your knowledge:
a Are the Annuitants in good physical condition?
____ Yes ____ No If No,
explain______________________________________________________________
b Is any Annuitant now under a doctor's care?
____ Yes ____ No If Yes, explain. Be sure to give physician's name and address.
_________________________________________________________________
c Do the Annuitants fully understand this contract?
____ Yes ____ No If No, explain_____________________________________________________
d Are the finances of each Annuitant, not including proceeds from this annuity, adequate
to meet emergencies?
____ Yes ____ No If No, explain_____________________________________________________
e Does the Annuitant have an advisor, attorney, accountant, clergyman, etc. with whom he
or she consults concerning the management of financial affairs?
____ Yes ____ No If Yes, explain. Be sure to give their names and addresses and state
whether the purchase of this annuity was discussed with them.
______________________________________________________________________________
f Give names and addresses of close relative and identify those with whom the Annuitant
has discussed the purchase of this annuity.
________________________________________________________________________________________
________________________________________________________________________________________
g Attach a signed statement by the Annuitant, in the Annuitant's handwriting, indicating
his or her understanding that the contract does not provide for a death benefit, loan or
surrender.
For Home Office Use
<S> <C> <C>
Amount submitted IOM amount IOM date
$_______________________________________$_____________________________________/_____/________________________________________
Purchase date Accepted by
__________/_____/____________________________________________________________________________________________________________
</TABLE>
