Valued Client. Financial Advisor PO Box 6250 Los Osos, CA An Annuity Illustration using. Designed for: Presented by:
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1 An Annuity Illustration using ING MVA ANNUITY (Standard Form # Nonqualified; may vary by state and not available in all states.) Designed for: Valued Client Presented by: Financial Advisor PO Box 6250 Los Osos, CA BA-208-NQ Page 1 of 6
2 ILLUSTRATION OF VALUES Nonqualified Annuity Prepared for: Valued Client, Owner Male, Birth Date: 01/01/1952 State of Issue: California Single Premium: $100, Initial Guarantee Period: 10 years Current Base Interest Rate: 3.00% Minimum Guaranteed Interest Rate: 3.00% The illustrated values are shown as of the end of each contract year, and assume the premium is applied at the beginning of the modal period. The interest in effect when the contract is issued is guaranteed for the length of the selected guarantee term, thus the guaranteed values illustrated below reflect the non-guaranteed rates for the first guarantee term, and 3.00% thereafter. Additionally, the illustrated values below assume that the contract renews each term for the same length of the term. GUARANTEED VALUES HYPOTHETICAL VALUES End Cash Cash of Yr Accum Surrender Accum Surrender Yr Age Premiums Value Value Value Value , ,000 96, ,000 96, ,090 99, ,090 99, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,980 Page 2 of 6
3 GUARANTEED VALUES HYPOTHETICAL VALUES End Cash Cash of Yr Accum Surrender Accum Surrender Yr Age Premiums Value Value Value Value , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,754 Total 100,000 - no surrender charge will be imposed for 30 days immediately following the end of each guaranteed period. After 30 days, the original surrender charge schedule will then resume with a percentage value corresponding to that point in time. Please refer to the sections titled GUARANTEED VALUES and HYPOTHETICAL VALUES on the Valuable Information Page of this illustration. Page 3 of 6
4 VALUABLE INFORMATION ABOUT YOUR ILLUSTRATION A fixed annuity guarantees regular fixed payments to the annuitant at some future time, typically retirement. The frequency of the payments depends on the payout method elected by the annuitant. Issued by insurance companies, fixed annuity contracts generally provide for an accumulation stage and a payout stage. In the accumulation stage the contract value has the potential to build and the interest earned is tax-deferred. In the payout stage, principal and any interest earned are distributed through regular fixed payments. These payments can provide income for the life of the annuitant. The earnings potential of fixed annuities can be realized through traditional fixed-interest crediting and/or index-linked interest crediting. For each premium deposit into the annuity, interest is credited based on either the new money rate or the index-linked interest crediting rate in effect at the time the premium is received. Regardless of the interest crediting method used, the interest is guaranteed for a specified period of time by the issuer. THIS IS AN ILLUSTRATION ONLY. AN ILLUSTRATION IS NOT INTENDED TO PREDICT ACTUAL PERFORMANCE. INTEREST RATES OR VALUES SET FORTH IN THE ILLUSTRATION ARE NOT GUARANTEED, EXCEPT FOR THOSE ITEMS CLEARLY LABELED AS GUARANTEED. This illustration does not recognize the effect of inflation. As a result of inflation, the illustrated values have more purchasing power today than in the future. ISSUER. ING MVA Annuity is a single premium deferred annuity available in most states. In those states where it is available, certain provisions may vary or may not be available. ING MVA Annuity is issued by (the Company), a member of the ING family of companies, located at 20 Washington Avenue South, Minneapolis, MN Form # (may vary by state). All guarantees are based upon the financial strength and claims-paying ability of the issuing Company, which is solely responsible for all obligations under its contracts. The annuity is not a deposit or other obligation of, or guaranteed by any bank or any affiliate of any bank. Annuities are not insured by the FDIC, national credit union administration, or any other agency of the United States, any financial institution or its affiliates. ILLUSTRATIONS. This illustration is not the actual annuity contract you will receive, nor is it part of the contract. The illustration is intended only to show you how the annuity might function based on the interest, tax rate, and premium payment assumptions contained in the illustration. Due to your individual circumstances, your contract, upon issue, may differ from what is illustrated. In that event, the terms of your contract control. GUARANTEED VALUES. During the first guarantee period, the guaranteed values are calculated using the current interest rate of 3.00% plus an additional first year interest rate of 0.00%. When the contract is renewed after the guarantee period, the guaranteed values are calculated using a level 3.00% interest rate, which is the minimum guaranteed rate shown in the contract. The actual guaranteed rate for each renewal period will be based on the effective interest rate then in effect at renewal. HYPOTHETICAL VALUES. The values illustrated are projections only and are not guaranteed beyond the end of the 10 year guarantee period. The hypothetical values are calculated using a 3.00% interest rate plus an additional first year interest rate of 0.00% credited during the first contract year of each guarantee term. You can find out the current rate by contacting your agent or ReliaStar Life Insurance Company. MARKET VALUE ADJUSTMENT. At any time prior to the maturity date the company will apply a market value adjustment to the accumulation value. The accumulation value is adjusted, either up or down, based on the difference between an external index when the premium was received and an external index at the time of each withdrawal. An MVA will not reduce the surrender value below the minimum guaranteed value. An MVA will not be applied to any withdrawal made within thirty (30) calendar days after the end of the guarantee period. PREMIUM TAXES. We may charge for state and local premium taxes depending on your state of residence. These taxes can range from 0% to 4% of the premium payment. We have the right to change this amount to conform with changes in the law or if you change your state of residence. Page 4 of 6
5 We may deduct the premium tax on the annuity start date. However, some jurisdictions impose a premium tax at the time initial and additional premiums are paid, regardless of when the annuity payments begin. In those states we may defer collection of the premium taxes from your accumulation value and deduct it when you surrender the contract or on the income phase start date. SURRENDER CHARGES. If the contract is surrendered within ten (10) years of its issue date, a surrender charge will be imposed, based on the following surrender charge schedule. At the end of each guarantee period, the entire accumulation value may be withdrawn, or the contract may be renewed. When the contract is renewed, the surrender charge schedule begins again at Year 1. Contract Year Following Issue or Renewal and later Percentage 6% 5% 4% 3% 2% 1% 0% Surrender charges as outlined above will be imposed on withdrawals which exceed the free withdrawal limit. Any withdrawal charges imposed on this illustration are reflected in the contract values. To illustrate this window, the values during the 30 day window at the end of the first 3 Guaranteed Periods are shown below. After 30 days, the surrender charge in subsequent guaranteed periods of the same length will be the same as shown above for the first period. Guaranteed Values Projected Values Annual Accum Cash Surr Accum Cash Surr Year Age Outlay Value Value Value Value , , , , , , , , , , , ,726 DEATH BENEFIT. The contract death benefit is equal to the total premium less any withdrawals or the accumulation value of the contract, if greater. TAX TREATMENT. When you make withdrawals from a non-qualified annuity, you will be subject to federal income tax on the amount withdrawn that represents interest credited. Federal law requires that withdrawals be taken first from interest credited. Withdrawals may be subject to Federal / State income tax and, if taken prior to age 59 1/2, an additional 10% Federal penalty tax. Individual Retirement Accounts (IRA's) and/or other qualified plans already receive tax-deferred treatment. The tax-deferred feature of an annuity should not be a factor in purchasing an annuity in a tax qualified plan. Tax deferral is provided by the plan and the tax-deferral of the annuity does not provide any additional benefit. Individuals should only purchase an annuity in a qualified plan when its other benefits, such as lifetime income payments, family protection through death benefits, and/or guaranteed fees meet their current needs. Other features of an annuity besides tax deferral should be considered. The tax treatment of annuity distributions may differ substantially from distributions from other investments. State premium taxes may reduce the value of your annuity. Tax laws change frequently. Neither the company nor its agents and representatives can provide tax, legal or accounting advice. Clients should consult their own attorney or tax advisor about your specific circumstances. FREE LOOK. The annuity contract contains a free-look period allowing you to review all of its provisions. The number of days in the free-look period is shown on the first page of your contract. If, within that free-look period, you do not wish to keep the contract, you may return it to the Company to receive a full refund of any premium paid. Page 5 of 6
6 I understand that: DISCLOSURE STATEMENT PURCHASE OF AN ANNUITY. I am buying a single premium deferred annuity issued by (the "Company"). ILLUSTRATIONS. This illustration is based on certain assumptions relating to interest rates, guaranteed periods, premium amount and withdrawals. Surrender charges, which may vary, depending on the type of annuity product I select, may apply to certain withdrawals and will reduce the value of my contract. Because my circumstances may vary from the assumptions used in the illustration, my results may differ from those illustrated. FREE LOOK. The actual contract contains a free look period allowing me to review all of its provisions. The number of days in the free look period, which is shown on the contract cover, is based on the state of issue. If within that free look period, I do not wish to keep the contract, I may return it to or my agent to receive a full refund of any premium paid. PARTIAL WITHDRAWALS. Partial withdrawals are available, subject to certain limits and charges as explained in the contract. SURRENDER CHARGES. As described in the contract, full or partial withdrawals taken from the contract that are in excess of the free withdrawals will be subject to a surrender charge. The illustration is not the actual contract I will receive nor is it a part of the contract. The illustration is intended only to show me how the contract might function based on the assumptions contained in the illustration. TAX MATTERS. I understand that the Company does not provide legal or tax advice in reference to this contract, and recommends that I consult with an independent tax advisor with respect to the purchase of this annuity contract. I, the undersigned, acknowledge I have read and understand the information provided. Furthermore, I understand this disclosure is intended to provide information only and does not take the place of the contract for which I am applying. I wish to have my contract issued as applied for. Applicant or Policyowner Date Financial Advisor PO Box 6250 Los Osos, CA Date Page 6 of 6
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