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EXHIBIT 4(h)
----GOLDEN MINIMUM GUARANTEED
-------AMERICAN WITHDRAWAL 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. The Rider's provisions shall control
when there is a conflict between this Rider and the Contract.
Where used in this Rider, the term Contract shall mean Certificate
when the Rider is attached to a Certificate. This Rider becomes
effective as of the Contract Date unless a different Rider Date is
stated below. If not defined in the Contract to which this Rider is
attached, the Credit shall be zero.
Benefits provided and charges made under the terms and conditions of
this Rider are described below. Under specified circumstances, this
Rider may provide periodic payments, a commuted value, or a death
benefit. A periodic charge to the Contract's Accumulation Value
will be made prior to the date that any Rider benefits become
payable. This Rider will remain in effect until terminated under
conditions described below.
GUARANTEED WITHDRAWAL
---------------------
On the Rider Date, this Rider is placed in Guaranteed Withdrawal
Status. Thereafter, while this status is maintained, this Rider
does not modify rights of the Owner under the Contract and no Rider
Benefits are provided. This status will be maintained while all of
the following conditions exist:
1) The MGWB Base and the Accumulation Value are both greater than
zero;
2) The latest Annuity Commencement Date under the Contract has not
been reached;
3) The Contract has not been surrendered or otherwise terminated;
and
4) The Rider has not been cancelled or otherwise terminated.
If the MGWB Base is reduced to zero while the Rider is in Guaranteed
Withdrawal Status, this Rider will terminate and no Rider benefits
will be payable.
AUTOMATIC WITHDRAWAL STATUS
---------------------------
If the Accumulation Value is reduced to zero while the Rider is in
Guaranteed Withdrawal Status, the status changes to Automatic
Withdrawal Status ("AWS") and the Minimum Guaranteed Withdrawal
Benefit ("MGWB") will be payable, subject to conditions described
below. MGWB consists of:
1) MGWB Periodic Payments; and
2) MGWB Death Benefit.
If this Rider enters AWS, the Contract is modified as follows:
1) No further premiums will be accepted;
2) The Contract will provide no further benefits other than as
provided in this Rider; and
3) Any other Riders attached to the Contract shall terminate
unless specified otherwise in the Rider.
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After this Rider enters AWS, the Contract and this Rider will
terminate at the earliest of the following:
1) Payment of the final MGWB Periodic Payment;
2) Payment of the Commuted Value; and
3) Payment of the MGWB Death Benefit.
MGWB PERIODIC PAYMENTS
----------------------
MGWB Periodic Payments will be made annually, and will begin on the
Contract Anniversary following the date the Rider enters AWS. The
amount of each MGWB Periodic Payment equals the Maximum Annual
Withdrawal ("MAW"), until the MGWB Base is reduced to zero. If the
MGWB Base is less than or equal to the Maximum Annual Withdrawal at
the time an MGWB Periodic Payment is due, that payment will equal
the remaining MGWB Base, and it will be the final MGWB Periodic
Payment.
COMMUTED VALUE
--------------
At the Annuity Commencement Date, the Commuted Value will be paid to
the Owner. Commuted Value will be the present value of any
remaining MGWB Periodic Payments. The interest rates used to
determine the commuted value of the payments are listed or described
on the Schedule Page.
MGWB DEATH BENEFIT
------------------
If the Owner dies while the Rider is in AWS, MGWB Periodic Payments
will cease and the MGWB Death Benefit will be payable.
If the Rider Death Benefit Option is One (1) and the MAW was never
exceeded in any year, the MGWB Death Benefit will be the death
benefit provided under the terms of the Contract, determined by
treating the Alternate Death Benefit, if applicable, and the
Accumulation Value as zero and MGWB Periodic Payments as Special
Partial Withdrawals.
If the Rider Death Benefit Option is Two (2) or the MAW was ever
exceeded, the MGWB Death Benefit shall be the remaining MGWB Base.
MGWB BASE
---------
On the Rider Date, the MGWB Base equals 100% of Eligible Premiums
plus [100%] of any applicable credits. Thereafter, the MGWB Base is
increased by payment of additional Eligible Premiums, adjusted for
any Partial Withdrawals and any Rider benefits paid.
Eligible Premiums are premiums paid within 2 years after the Rider
Date. If the Rider Date is other than the Contract Date, Eligible
Premiums also includes the Accumulation Value on the Rider Date.
The MGWB Base is calculated separately for Special Funds and non-
Special Funds. The MGWB Base equals the sum of (1) the lesser of
the MGWB Base allocated to Special Funds and the Accumulation Value
in Special Funds and (2) the MGWB Base for non-Special Funds.
PARTIAL WITHDRAWAL ADJUSTMENTS
------------------------------
The MGWB Base will be reduced for any withdrawals taken. For
withdrawals up to the Maximum Annual Withdrawal in a Contract year,
the MGWB Base for non-Special Funds will be reduced by the amount of
the withdrawal. Any withdrawals in excess of the Maximum Annual
Withdrawal will reduce the MGWB Base for non-Special Funds by the
proportion that the withdrawal bears to the Accumulation Value.
Withdrawals from Special Funds will reduce MGWB Base for Special
Funds prorata. Any MGWB Periodic Payments will reduce the MGWB Base
by the amount of the payment.
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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.
TRANSFERS
---------
Net transfers from Special to non-Special Funds will reduce the MGWB
Base allocated to Special Funds on a pro-rata basis. There will be a
corresponding increase in the MGWB Base for non-Special Funds. The
amount of such increase will equal the lesser of the reduction in
MGWB Base allocated to Special Funds and the net Accumulation Value
transferred.
Net transfers from non-Special Funds will reduce the MGWB Base
allocated to the non-Special Funds on a prorata basis. There will be
a corresponding increase in the MGWB Base for Special Funds. If
applicable, the resulting increase in the MGWB Base allocated to
Special Funds will equal the reduction in the MGWB Base allocated to
non-Special Funds.
MAXIMUM ANNUAL WITHDRAWAL ("MAW")
---------------------------------
The initial Maximum Annual Withdrawal is on the Schedule Page. If
withdrawals in any Contract Year exceed the Maximum Annual
Withdrawal, the Maximum Annual Withdrawal available in subsequent
years will be reduced by the proportion that the withdrawal bears to
the Accumulation Value.
MGWB CHARGE
The rate of the MGWB Charge is stated in the Schedule. The MGWB
charge is the rate multiplied by [100%] of the Eligible Premiums
plus 100% of any Credits and is deducted quarterly, in arrears, from
the Accumulation Value. Deduction Dates are measured from the
Contract Date. The MGWB Charge will be deducted from the
Accumulation Value in the Variable Separate Account divisions, in
the same proportion that the accumulation value in each division
bears to the total Accumulation Value in the Variable Separate
Account. If there is insufficient accumulation value in the
Variable 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 a charge less than the maximum charge. The maximum
charge on the Rider Date is stated on the Schedule.
If the Contract to which this 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 Eligible Premiums
immediately prior to termination.
DEATH OF OWNER
--------------
At the death of any Owner while this Rider is in Guaranteed
Withdrawal Status, this Rider terminates and no further Rider
benefits are provided. However, if the surviving spouse of the
deceased Owner continues the Contract as their own, this Rider will
continue in effect.
CHANGE OF OWNER
---------------
Except as provided above under Death of Owner, upon change of Owner
while this Rider is in force, this Rider shall terminate and no
Rider benefits will thereafter be payable.
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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
--------------------
Barnett Chernow
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