Schwab Advisor ChoiceTM Variable Annuity Investment Choice Fax Transfer Request Form
To: RROC From (Authorized Trader): ______Phone #: 888-667-2145, Opt 1 Master Account #: ______Fax #: 866-442-3887 Phone Number: ______Number of Pages: ______Date: ______
Authorized Signature (Authorized Trader): ______
Social Security # Contract Owner From Fund To Fund $ or %
• Faxes received by 4:00 PM EST (NYSE close) generally will be executed at that day’s valuation. • Transfer requests received after NYSE close will be executed at the next day’s valuation • If we do not confirm receipt of your fax within 30 minutes of its transmission, please call us to confirm. • Transfers will not affect the allocations of future contributions. Transfer requests for contracts within the right of cancellation period and where the assets are restricted to the Schwab Government Money Market sub-account, will not be executed. Please call us to make any changes to allocation of future contributions or to make any changes during the right of cancellation period. • All transactions are subject to the terms and conditions described in the contract and prospectus for the Schwab Advisor Choice Variable Annuity™ • To accomplish block trading, please indicate the allocations on page one and list your clients’ policy information on page 3.
Page 1 of 4 Revised 08/2018 Schwab Advisor ChoiceTM Variable Annuity Investment Choice Fax Transfer Request Form
Bond Mid-Cap Federated Fund for US Govt Sec II FUS AB VPS Small/Mid Cap Value A ABS Great-West Multi-Sector Bond Inv GLS American Century Investments VP Mid Cap Value II AMV Invesco VI High Yield I IHY ClearBridge Variable Mid Cap I CBM Janus Henderson Flexible Bond Inst JAF Delaware VIP® Smid Cap Core Series Std DGO PIMCO VIT Emerging Markets Bond Admin PEB DWS Small Mid Cap Growth VIP A SSC PIMCO VIT High Yield Admin PHY Dreyfus Investment Portfolio MidCap Stock Init DMS PIMCO VIT Low Duration Admin PLD Great-West Ariel Mid Cap Value Inv AMC PIMCO VIT Real Return Admin PRR Great-West Mid Cap Value Inv GGM PIMCO VIT Total Return Admin PVR Great-West T. Rowe Price Mid Cap Growth Inv TPM Pioneer Bond VCT I PBO LVIP Baron Growth Opportunities Svc BRC Putnam VT Income IA PIC MFS VIT III Mid Cap Value Init MMV Putnam VT Mortgage Securities IB PAG Neuberger Berman AMT Mid Cap Intrinsic Value S NBR Templeton Global Bond VIP 2 TPG Pioneer Select Mid Cap Growth VCT I SFG Wells Fargo VT Discovery 2 SMC Index Wells Fargo VT Opportunity 2 SOF DWS Small Cap Index VIP A BTS Great-West Bond Index Inv GWB NVIT Mid Cap Index II DMI Schwab® S&P 500 Index Portfolio SSP Large Cap Vanguard VIF Mid Cap Index VMI AB VPS Growth A AGP Vanguard VIF Real Estate Index VRI AB VPS Growth and Income A AGI Alger Capital Appreciation I-2 ACA Specialty American Century Investments® VP Income & Growth I ACG AB VPS Real Estate Investment A ARE American Century Investments® VP Value I ACV Columbia Variable Portfolio Seligman Global Tech 2 SGT American Funds IS® Growth-Income 4 AFG Goldman Sachs VIT Multi-Strat Alternatives Port Svc GMS ClearBridge Variable Large Cap Growth I CBL Janus Henderson Global Technology Inst JTI Columbia VP Large Cap Growth 2 CLC MFS VIT Utilities Svc MVU Delaware VIP Value Std DVS PIMCO VIT CommodityRealReturn® Strategy Admin PCD DWS Capital Growth VIP A SCC Putnam VT Global Health Care IB PHC DWS Core Equity VIP A SCS T. Rowe Price Health Sciences S TRH Dreyfus Variable Investment Fund Growth & Income Init DRG VanEck VIP Global Hard Assets S VIH Invesco VI Comstock I VKC Invesco VI Growth and Income I VKG Neuberger Berman AMT Sustainable Equity S NBA Small-Cap Pioneer Fund VCT I STE ClearBridge Variable Small Cap Growth I CBS Putnam VT Equity Income IB PTE Delaware VIP Small Cap Value Series Std DLS Putnam VT Multi-Cap Core Fund IA PUI Dimensional VA US Targeted Value Inst DTV Touchstone Focused TVM Franklin Small Cap Value VIP 2 FSV Vanguard VIF Capital Growth VCG Great-West Invesco Small Cap Value Inv GIS Vanguard VIF Diversified Value VDV Invesco VI Small Cap Equity I ASE JPMorgan Insurance Trust Small Cap Core 1 MSC Oppenheimer Main Street Small Cap VA Non-Svc OMS Money Market Touchstone Small Company SVS Schwab Government Money Market Portfolio™ SMM Vanguard VIF Small Company Growth VSG
Page 2 of 4 Revised 08/2018 Schwab Advisor ChoiceTM Variable Annuity Investment Choice Fax Transfer Request Form
International Asset Allocation/Other ALPS/Red Rocks Listed Private Equity I ARR American Century Investments® VP Balanced I ACB American Century VP International I ACI BlackRock Global Allocation V.I. I BGA American Funds IS® Global Growth 1 AGG Great-West Aggressive Profile Fund Inv GWA American Funds IS® International 2 AIT Great-West Conservative Profile Fund Inv GCP American Funds IS® New World Fund® 2 AFN Great-West Lifetime 2015 Inv G15 Delaware VIP® Emerging Markets Series Std DEG Great-West Lifetime 2020 Inv G20 Delaware VIP® International Value Equity Series Std DVI Great-West Lifetime 2025 Inv G25 DWS Global Small Cap VIP A DGC Great-West Lifetime 2030 Inv G30 Invesco VI International Growth I AIG Great-West Lifetime 2035 Inv G35 Ivy VIP International Core Equity II IIC Great-West Lifetime 2040 Inv G40 Janus Henderson Global Research Inst JGR Great-West Lifetime 2045 Inv G45 Lazard Retirement Emerging Markets Equity Svc LRE Great-West Lifetime 2050 Inv G50 MFS® VIT II International Value Svc MVI Great-West Lifetime 2055 Inv G55 Oppenheimer Global VA Non-Svc OGS Great-West Moderate Profile Fund Inv GMP Oppenheimer International Growth VA Non-Svc OIG Great-West Moderately Aggressive Profile Fund Inv GMA Putnam VT International Equity IA PIE Great-West Moderately Conservative Profile Fund Inv GMC Putnam VT International Value IA PIV Janus Henderson Balanced Inst JAB Putnam VT Global Asset Allocation IA PGL Schwab VIT Balanced PortfolioTM SBA Schwab VIT Balanced with Growth PortfolioTM SBG Schwab VIT Growth PortfolioTM SGR
The following sub-accounts are Closed to New Investments AB VPS International Growth A ABW Alger Large Cap Growth I-2 AAG Alger Mid Cap Growth I-2 AMG Columbia Variable Portfolio - Small Cap Value 2 CCV DWS CROCI U.S. VIP A SLC DWS Small Mid Cap Value VIP A DSV Dreyfus Variable Investment Fund Appreciation Init DRC Invesco VI Mid Cap Core Equity I AME Invesco VI Technology I ITF Pioneer Mid Cap Value VCT II PMC Prudential Series Natural Resources II PSN Royce Small Cap Svc RCS Templeton Foreign VIP 2 TFS Touchstone Bond SVB Touchstone Common Stock SVC VanEck VIP Unconstrained Emerging Markets Bond Init VIB
Page 3 of 4 Revised 08/2018 Schwab Advisor ChoiceTM Variable Annuity Investment Choice Fax Transfer Request Form
To: RROC From (Authorized Trader): ______Phone #: 888-667-2145, Opt 1 Master Account #: ______Fax #: 866-442-3887 Phone Number: ______Number of Pages: ______Date: ______
Authorized Signature (Authorized Trader): ______
BLOCK TRADING INFORMATION To accomplish block trading, please list the allocations on page 1 and list your client information below.
Policy Number Client SSN Client Name
Page 4 of 4 Revised 08/2018