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EXHIBIT 4(g)
----GOLDEN MINIMUM GUARANTEED
-------AMERICAN INCOME BENEFIT RIDER
---------LIFE INSURANCE
-------COMPANY
Golden American is a stock company domiciled in Delaware.
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GOLDEN AMERICAN LIFE INSURANCE COMPANY
(HEREINAFTER CALLED WE, US AND OUR)
The Contract to which this Rider is attached is hereby modified by the
provisions of this Rider. This Rider's provisions control when there
is a conflict between this Rider and the Contract.
Where used in this Rider the term Contract shall mean Certificate when
this Rider is attached to a Certificate. This Rider becomes effective
as of the Contract Date unless a different date, the Rider Date, is
stated below. The term Credit is as defined in the Contract. If not
defined in the Contract to which this Rider is attached, the Credit
shall be zero.
MINIMUM GUARANTEED INCOME BENEFIT
This Rider provides an option to take the Minimum Guaranteed Income
Benefit ("MGIB") instead of the annuity benefits payable under the
Contract. This option may only be exercised at specified times,
Exercise Dates, as described below and on the Schedule Page. This
Rider has no cash surrender value.
MGIB provides a minimum periodic income. MGIB will be paid monthly,
unless you elect to receive it less frequently. You can elect to
receive MGIB on a monthly, quarterly, semi-annual, or annual basis.
Payments may be subject to company minimums.
To elect to receive the MGIB, you must provide us a written election.
Such election must be received by us within the 30 days prior to an
Exercise Date. Your election will become effective as of the Exercise
Date following receipt of your request. Exercise Dates are shown on
the Schedule Page. On the Exercise Date that you elect to begin
receiving the MGIB, the Contract terminates, and no other benefits
under the Contract are payable. If the Contract terminates for any
other reason, this Rider terminates and provides no benefits.
MGIB is determined as follows:
1) The MGIB Benefit Base on the Exercise Date less any surrender
charges and premium tax and after any market value adjustments, is
multiplied by;
2) The applicable MGIB Income Factor on the Exercise Date.
The MGIB Benefit Base for determining the MGIB on the Exercise Date
equals the sum of (1) the Accumulation Value in Special Funds and (2)
the MGIB Base for non-Special Funds.
MGIB BASE
If this Rider is effective as of the Contract Date, the initial MGIB
Base is equal to the initial premium paid for the Contract plus any
credits. If this Rider is added to a Contract after the Contract
Date, the initial MGIB Base shall be equal to the Accumulation Value
on the Rider Date. Thereafter, the MGIB Base is increased by Eligible
Premiums, and Credits thereon reduced by any Prorata Partial
Withdrawal Adjustments and accumulated for the calculation period at
the MGIB Rate. Eligible Premiums are defined in the Schedule Page.
The MGIB Base is calculated separately for Special Funds and non-
Special Funds.
GA-RA-1047(REV).DOC
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MGIB RATE
The MGIB Rate is equal to the rate stated on the Schedule Page for
this Rider.
On the earlier of: (1) the Contract Anniversary on which the Owner's
attained age equals the MGIB maximum age stated in the Schedule, or
(2) the date the MGIB Base is equal to or would exceed the Maximum
MGIB Base, the MGIB Rate will be set to [zero.]
SPECIAL FUNDS
Where used in this Rider the Special Funds, if any, are listed on the
Schedule Page. We reserve the right to classify newly available
divisions as Special Funds from the date of availability to the Owner.
We may also reclassify an existing division as Special Funds or remove
such designation. Such reclassification shall be made with 30 days
notice to Contract Owners, and will apply to amounts transferred or
otherwise added to such division after the date of change.
PRORATA PARTIAL WITHDRAWAL ADJUSTMENT
The MGIB Base will be reduced by a Prorata Partial Withdrawal
Adjustment each time a partial withdrawal is made. The Prorata
Partial Withdrawal Adjustment is equal to (1) divided by (2),
multiplied by (3), where: (1) is the Accumulation Value withdrawn; (2)
is the Accumulation Value immediately prior to withdrawal; and (3) is
the amount of MGIB Base immediately prior to the withdrawal. Separate
adjustments will apply to Special and non-Special Funds.
TRANSFERS
Net transfers from Special to non-Special Funds will reduce the MGIB
Base allocated to Special Funds on a pro-rata basis. There will be a
corresponding increase in the MGIB Base for non-Special Funds. The
amount of such increase will equal the lesser of the reduction in MGIB
Base allocated to Special Funds and the net Accumulation Value
transferred.
Net transfers from non-Special Funds will reduce the MGIB Base
allocated to the non-Special Funds on a prorata basis. There will be
a corresponding increase in the MGIB Base for Special Funds. The
resulting increase in the MGIB Base allocated to Special Funds will
equal the reduction in the MGIB Base allocated to non-Special Funds.
MAXIMUM MGIB BASE
The Maximum MGIB Base is shown or defined on the Schedule Page. Any
addition to the Accumulation Value due to spousal continuation will
have no effect on the MGIB Base or the Maximum MGIB Base.
MGIB CHARGES
Charges for this Rider will be deducted from the Contract's
Accumulation Value. The rate and frequency of deduction of charges
are stated on the Schedule Page. Deduction dates are measured from
the Contract Date. The charge is a percentage of the total MGIB Base
as of the deduction date. It is deducted in arrears from the portion
of Accumulation Value allocated to the Variable Separate Account in
proportion to the Accumulation Value in each division. If there is
insufficient Accumulation Value in the separate account, charges will
be deducted from the Fixed Division nearest maturity. An MVA
adjustment may be applied to charges deducted from the Fixed Division.
We may charge less than the maximum. The maximum charge is stated on
the Schedule Page.
If the Contract to which the Rider is attached is terminated by
surrender, cancellation or application of the Contract's value to an
Income Benefit, the Rider charge for the current period will be
deducted from the Accumulation Value prior to termination of the
Contract. Charges will be calculated using the MGIB Charge Base
immediately prior to termination.
GA-RA-1047(REV).DOC
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RIDER TERMINATION
This Rider will terminate immediately under any of the following
circumstances:
1. If the Contract to which this Rider is attached terminates;
2. If you die, unless the Contract is continued on the life of your
spouse, in which case the Rider will continue with your surviving
spouse as Owner; or,
3. If the Owner is not a natural person and the Annuitant dies.
4. If the Ownership of this Contract changes and the new Owner is
other than the spouse of the previous Owner.
5. If the Accumulation Value is insufficient to pay the MGIB Charge
deduction.
PREMIUM TAX
Any premium taxes paid by us relating to premiums for the Contract
will be deducted from the MGIB Benefit Base prior to determining the
amount of MGIB payable.
NOTIFICATION
The Company will notify the Owner 30 days prior to an Exercise Date of
the Owner's options on that Exercise Date.
MGIB INCOME FACTORS
MGIB Income Factors are calculated using interest at a rate of [2.5%]
per annum and, where applicable, the [Annuity 2000] Mortality Table
[with improvements based on Projection Scale G]. The following are
the MGIB Income Options available:
1) Income for Life (Single Life or Joint with 100% Survivor) and 10-
30 Years Certain;
2) Any other Income Plan offered by the Company in connection with
the Rider on the Exercise Date.
Monthly Income Factors for certain ages are shown below. Factors
shown are per $1000 of Rider proceeds applied to the Income Option.
Income Factors for other ages and/or payment frequencies are available
upon request.
Income Payments made under Option 1 will be paid for a minimum period
(Certain period) and for the life of the payee after the Certain
period. If the payee dies during the Certain period, payments will
continue until the end of the Certain period, but will be paid to the
Beneficiary.
Income Factors for Option 1 vary by sex and attained Age of the payee
on the Exercise Date that MGIB begins.
GA-RA-1047(REV).DOC
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TABLE OF INCOME FOR LIFE
YEARS
MALE/FEMALE MALE/FEMALE CERTAIN
10 YEAR CERTAIN 20 YEAR CERTAIN INCOME
--------------- --------------- ------
AGE YEARS
--- -----
[50 3.56/3.33 3.49/3.29 20
55 3.91/3.63 3.78/3.56 21
60 4.37/4.02 4.12/3.89 22
65 4.96/4.54 4.47/4.27 23
70 5.71/5.24 4.81/4.66 24
75 6.59/6.13 5.06/4.98 25
80 7.52/7.18 5.21/5.18 26
85 8.35/8.17 5.26/5.26 27
90 8.94/8.87 5.27/5.27] 28
29
30
This Rider has no surrender value or other non-forfeiture benefits
upon termination. This Rider may not be cancelled unless the Contract
is terminated.
Rider Date: _________________________
(if other than Contract Date)
Signed: /s/ Barnett Chernow
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Barnett Chernow
GA-RA-1047(REV).DOC
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