KEYSTONE INDEX KEYSTONE INDEX - 10 SINGLE PREMIUM DEFERRED EQUITY INDEX ANNUITY RSL

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1 KEYSTONE INDEX KEYSTONE INDEX - 10 SINGLE PREMIUM DEFERRED EQUITY INDEX ANNUITY RSL Proposal Date: 4/4/2017 Prepared For: d Client Prepared By: Joseph Salvemini RELIANCE STANDARD LIFE INSURANCE COMPANY ADMINISTRATIVE OFFICE: 2001 Market Street, Suite 1500 Philadelphia, Pennsylvania (800) HOME OFFICE: Schaumburg, Illinois Page 1 of 5

2 Annuitant: d Client Issue Age: 55 Gender: M Owner: d Client Prepared By: Joseph Salvemini State: FL Annuitization Age: 85 Type of Fund: Non-Qualified Single Premium: $1,000,000 Proposal Date: 4/4/2017 Premium Strategy Allocation Premium Initial s s Point to Point - Participation $1,000, % Participation 10.00% Participation Charge Schedule Percentage: 9% 9% 8% 7% 6% 5% 4% 3% 2% 1% Contract Year: The following information consists of hypothetical illustrations of s, s, s and at for the Reliance Standard Life Keystone Single Premium Deferred Equity ed Contract. While the contract values may be affected by an external index, the contract does not directly participate in any stock, bond or equity investments. The illustrated values and index interest credited are based on the actual historical performance of the Standard & Poor s 500 Composite Stock Price for the periods indicated. The index does not include or reflect any dividends that may be paid by the companies included in the index. Standard & Poor s 500 is a trademark of The McGraw-Hill Companies, Inc. and has been licensed for use by Reliance Standard Life Insurance Company. This Product is not sponsored, endorsed, sold or promoted by Standard & Poor s and Standard & Poor s makes no representation regarding the advisability of purchasing this Product. These illustrations are intended only to demonstrate how the contract values would have been affected based on the performance of the Standard & Poor s 500 in the historical periods reflected below, and must not be assumed to be reflective of future performance. Past performance is no guarantee of future results. These illustrations are calculated as follows: The s, s, Credited, s, and s at shown are each determined as of the end of each contract year shown. The single premium is paid at the beginning of the first contract year and withdrawals, if any, are made at the end of each contract year after interest is credited. No will be earned on any withdrawals or surrenders that occur during the contract year. The values shown for the End of Charge Period are, in each case, measured as of the beginning of the first contract year during which surrender charges no longer apply. The contract continues through the maturity date specified on your contract, with certain exceptions, including a surrender of the contract. Page 2 of 5

3 Point to Point - Participation Recent Period The following Recent Period values shown are for the 10 year period ending 3/31/2017. This period was selected to show the values for the most recent period. ed at 3/31/ ,000, %.00% 1,000, ,000 1,010, ,190 3/31/ %.00% 1,000, ,000 1,020, ,472 3/31/ % 23.28% 1,232, ,849 1,144,083 1,030, ,119 3/31/ % 6.69% 1,315,287 82,439 1,232,424 1,040, ,046 3/30/ % 3.12% 1,356,279 40,992 1,283,040 1,051, ,256 3/28/ % 5.71% 1,433,663 77,383 1,369,148 1,061,520 1,013,752 3/31/ % 9.66% 1,572, ,484 1,515,549 1,072,135 1,033,538 3/31/ % 5.22% 1,654,246 82,099 1,609,581 1,082,857 1,053,620 3/31/ %.00% 1,654, ,624,469 1,093,685 1,073,999 3/31/ % 7.35% 1,775, ,666 1,759,929 1,104,622 1,094,681 End of Charge Period 1,775,912 1,775,912 1,104,622 1,104,622 Below Average Period The following Below Average Period values shown are for the 10 year period ending 12/31/1974. This period was selected to show the values for a period of below average returns. ed at 12/31/ ,000, % 4.53% 1,045,310 45, ,639 1,010, ,190 12/30/ %.00% 1,045, ,639 1,020, ,472 12/29/ % 10.05% 1,150, ,012 1,067,499 1,030, ,119 12/31/ % 3.83% 1,194,381 44,060 1,119,135 1,040, ,046 12/31/ %.00% 1,194, ,129,885 1,051, ,256 12/31/ %.05% 1,194, ,141,192 1,061,520 1,013,752 12/31/ % 5.39% 1,259,415 64,449 1,214,076 1,072,135 1,033,538 12/29/ % 7.82% 1,357,859 98,444 1,321,197 1,082,857 1,053,620 12/31/ %.00% 1,357, ,333,417 1,093,685 1,073,999 12/31/ %.00% 1,357, ,345,638 1,104,622 1,094,681 End of Charge Period 1,357,859 1,357,859 1,104,622 1,104,622 Above Average Period The following Above Average Period values shown are for the 10 year period ending 12/31/1999. This period was selected to show the values for a period of above average returns. ed at 12/31/ ,000, %.00% 1,000, ,000 1,010, ,190 12/31/ % 13.15% 1,131, ,534 1,039,879 1,020, ,472 12/31/ % 2.23% 1,156,791 25,258 1,073,502 1,030, ,119 12/31/ % 3.53% 1,197,598 40,807 1,122,149 1,040, ,046 12/30/ %.00% 1,197, ,132,928 1,051, ,256 12/29/ % 17.06% 1,401, ,255 1,338,769 1,061,520 1,013,752 12/31/ % 10.13% 1,543, ,034 1,488,306 1,072,135 1,033,538 12/31/ % 15.50% 1,783, ,366 1,735,104 1,082,857 1,053,620 12/31/ % 13.33% 2,021, ,784 1,984,657 1,093,685 1,073,999 12/31/ % 9.76% 2,218, ,314 2,198,384 1,104,622 1,094,681 End of Charge Period 2,218,350 2,218,350 1,104,622 1,104,622 Page 3 of 5

4 Important Information Relating to These Illustrations The Standard & Poor s 500 Composite Stock Price s are, in each case, for the 12 month periods ending on the dates shown. The is accumulated using the Credited in each contract year illustrated less withdrawals. credited is illustrated based on the Initial Cap or the Initial Participation, as applicable, shown on Page Two of this illustration. The Initial Cap or Initial Participation, as applicable, is guaranteed for the first contract year. After the first contract year, Reliance Standard has the right to change the Cap or Participation on an annual basis. Any such change will be effective at the beginning of a contract year. The Cap or the Participation will never be lower than the Cap or Participation shown on Page Two of this illustration. Point to Point Participation Strategy: credited under this Strategy for a Contract Year will be equal to a percentage (the Participation ) of the change in the for that year, but will not be less than zero. Page 4 of 5

5 How Can I Withdraw Money from My? : You may completely surrender your annuity in any Contract Year. A Charge will apply to the annuity value in excess of the penalty-free amount described below under partial withdrawals. The amount of the Charge will vary according to the Contract Year in which the surrender occurs, according to the Charge Schedule contained in the contract. See Charges, below. Amounts withdrawn from an Strategy during a Contract Year will not receive any index interest for that year. Partial Withdrawals: You may make partial withdrawals from your annuity at any time. During the first Contract Year, you can withdraw without penalty up to 10% of the single premium paid, and, in any Contract Year thereafter, up to 10% of the annuity value without penalty. If you withdraw more than the penalty-free amount in any Contract Year during the Charge Period, a Charge will apply to any amount withdrawn in excess of the penalty-free amount. The amount of the Charge will vary according to the Contract Year in which the withdrawal occurs according to the Charge Schedule contained in the contract. See Charges, below. Amounts withdrawn from an Strategy during a Contract Year will not receive any index interest for that year. Annuitization: At any time after the first Contract Year, you may select one of the Settlement Options specified in the contract and begin receiving an income from your annuity; however, this normally occurs on the contract s maturity date. The contract s maturity date is established so that it occurs on the later of the date on which the annuitant, if living, would attain age 85 (70 in some states) or the date that is 10 years after the contract s date of issue. Charges will be deducted from the annuity value applied to a Settlement Option, unless payments under the Settlement Option begin after the fifth Contract Year, and have a duration of at least five years. RSL will deduct any applicable premium tax from the annuity value applied to a Settlement Option. Payments of income under the Settlement Options listed below will be based on the life of the designated annuitant. The Settlement Options specified in the contract are as follows: Life Designated Period Life with Payments Certain Joint and Last Survivor Withdrawals of funds from your annuity prior to age 59 ½ may have adverse tax consequences. See Tax Treatment, below. Sales Charges and Fees 100% of your premium earns interest from the Date the contract is issued by Reliance Standard. No deductions are made for sales charges or fees. Reliance Standard pays the Agent a commission. Traditional Individual Retirement Account Roth Individual Retirement Account If you purchase an annuity in an Individual Retirement Account (IRA), you should be aware the annuity contract offers no additional tax deferral since IRAs already provide tax-deferred status. Accordingly, you should purchase an annuity in such an account only if one or more of the terms of the annuity, such as minimum guarantees, death benefits and life income options, are of value to you. Reliance Standard Life and its representatives do not provide tax, legal or accounting advice. You should seek competent professional advice concerning any tax, legal or accounting questions you may have. The Keystone contract is a long-term retirement planning vehicle. It is not a substitute for an index-linked mutual fund or other equity investment. Page 5 of 5

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