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Jnlny Separate Account I, et al. – ‘N-4’ on 1/6/05 – EX-99

On: Thursday, 1/6/05, at 5:16pm ET · Accession #: 927730-5-1 · File #s: 811-08401, 333-121884

  As Of                Filer                Filing    For·On·As Docs:Size              Issuer               Agent

 1/06/05  Jnlny Separate Account I          N-4                    4:361K                                   Jackson Nat’l Sep A… - I
          Jnlny Separate Account I

Registration Statement for a Separate Account (Unit Investment Trust) — Form N-4
Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: N-4         Registration Statement for a Separate Account        123±   493K 
                          (Unit Investment Trust)                                
 2: EX-99       Miscellaneous Exhibit                                  6     24K 
 3: EX-99       Miscellaneous Exhibit                                  6     26K 
 4: EX-99       Miscellaneous Exhibit                                  1      7K

EX-99 — Miscellaneous Exhibit

EX-99 1st Page of 6 TOC ↑Top Previous Next ↓Bottom Just 1st
 
                                                                          EX-4.p

                   JACKSON NATIONAL LIFE
                                          INSURANCE COMPANY  [Graphic Omitted]
[2900 Westchester Avenue                         OF NEW YORK                    
Purchase, New York 10577]                    A STOCK COMPANY                    

--------------------------------------------------------------------------------

 5% FOR LIFE GUARANTEED MINIMUM WITHDRAWAL
 BENEFIT ENDORSEMENT

THIS  ENDORSEMENT  IS MADE A PART OF THE CONTRACT TO WHICH IT IS ATTACHED AND IS
EFFECTIVE ON THE ISSUE DATE OF THE CONTRACT,  UNLESS ANOTHER  EFFECTIVE DATE FOR
THIS ENDORSEMENT IS SHOWN BELOW. TO THE EXTENT ANY PROVISIONS  CONTAINED IN THIS
ENDORSEMENT ARE CONTRARY TO OR INCONSISTENT  WITH THOSE OF THE CONTRACT TO WHICH
IT IS ATTACHED, THE PROVISIONS OF THIS ENDORSEMENT WILL CONTROL.                

PLEASE  NOTE:  THIS  ENDORSEMENT  CANNOT BE  TERMINATED  INDEPENDENTLY  FROM THE
CONTRACT TO WHICH IT IS ATTACHED.                                               

THE  GUARANTEED  MINIMUM  WITHDRAWAL  BENEFIT  (GMWB)  CAN  ONLY BE  TAKEN  AS A
WITHDRAWAL BENEFIT AND DOES NOT INCREASE THE CONTRACT VALUE. THIS IS AN OPTIONAL
BENEFIT AND THERE IS AN  ADDITIONAL  COST TO THE CONTRACT  VALUE FOR THE BENEFIT
PROVIDED.                                                                       

A  PARTIAL  WITHDRAWAL  IN  EXCESS  OF  THE  GREATER  OF THE  GUARANTEED  ANNUAL
WITHDRAWAL AMOUNT (GAWA) OR THE MINIMUM REQUIRED  DISTRIBUTION (MRD) MAY HAVE AN
ADVERSE  EFFECT  ON THE  GUARANTEED  WITHDRAWAL  BALANCE  (GWB) AND THE FOR LIFE
GUARANTEE.   IF  THE  CONTRACT  VALUE  HAS  DECREASED  BECAUSE  OF  POOR  MARKET
PERFORMANCE,  THE CONTRACT VALUE AFTER THE WITHDRAWAL WOULD BE THE NEW GWB WHICH
COULD CAUSE A  CONSIDERABLE  REDUCTION IN THE GWB. A WITHDRAWAL IN EXCESS OF THE
GREATER  OF THE  GAWA OR THE MRD IN ANY  CONTRACT  YEAR  WILL  VOID THE FOR LIFE
GUARANTEE.                                                                      

WITHDRAWALS UNDER THE GMWB ARE NOT CUMULATIVE.  GUARANTEED WITHDRAWALS AVAILABLE
BUT NOT TAKEN  DURING ANY GIVEN  CONTRACT  YEAR CANNOT BE TAKEN AS A  GUARANTEED
WITHDRAWAL IN A SUBSEQUENT CONTRACT YEAR.                                       

UPON FULL  SURRENDER OF THE  CONTRACT,  THE GMWB IS  TERMINATED  WITHOUT  VALUE.
SURRENDER  OF YOUR  CONTRACT  DUE TO REDUCED OR ZERO  CONTRACT  VALUE MAY NOT BE
APPROPRIATE IF THE GWB IS POSITIVE.                                             

FOR INFORMATION ON HOW THIS GMWB IS CALCULATED,  PLEASE SEE THE  ILLUSTRATION ON
PAGE 6.                                                                         

CERTAIN  DEFINITIONS  AS  FOUND  IN THE  CONTRACT  WHICH  ARE  RELATIVE  TO THIS
ENDORSEMENT HAVE BEEN LISTED BELOW FOR INFORMATIONAL PURPOSES.                  

CONTRACT  VALUE.  The  Contract  Value  equals the sum of the  Separate  Account
Contract Value and the Fixed Account Contract Value.                            

INCOME DATE. The date on which annuity payments are scheduled to begin.         

WITHDRAWAL VALUE. The Contract Value, less any tax payable, minus, any          
applicable Withdrawal Charges, Annual Contract Maintenance Charges, and charges 
due under any optional endorsement to the Contract, adjusted for any applicable 
Interest Rate Adjustment.                                                       

7489NY                                                                          

EX-99 2nd Page of 6 TOC 1st Previous Next ↓Bottom Just 2nd
THE CONTRACT IS AMENDED AS FOLLOWS:                                             

1) The following language is added to the CONTRACT DATA PAGE of the Contract:   

"5% FOR LIFE GUARANTEED MINIMUM      On an annual basis, the charge equals      
WITHDRAWAL BENEFIT (GMWB) CHARGE:    [0.40% - 1.30%] of the daily net asset     
                                     value of the Investment Divisions. The GMWB
                              Charge will be discontinued upon the
                                    earlier of the termination of this benefit
                                 or the date on which the Contract Value
      equals zero.

                                   On each Contract Anniversary, the Company
                          may reduce the GMWB Charge if no
                                 withdrawals have been taken before that
time."

2) The following language is added to the DEFINITIONS section of the Contract:  

"GUARANTEED  ANNUAL  WITHDRAWAL  AMOUNT (GAWA).  The maximum amount the Owner is
allowed to withdraw each Contract Year,  subject to the exception stated in this
endorsement,  for the GMWB to remain  fully  effective  and to keep the For Life
Guarantee effective.                                                            

GUARANTEED  WITHDRAWAL BALANCE (GWB). The guaranteed amount available for future
periodic partial withdrawals.                                                   

MINIMUM  REQUIRED  DISTRIBUTION  (MRD).  For certain  qualified  contracts,  the
Minimum Required Distribution is the amount defined by the Internal Revenue Code
as the minimum distribution requirement that applies to this Contract only.     

RECAPTURE  CHARGE.  The charge  assessed  against certain  withdrawals  from the
Contract  Value  whenever a withdrawal of the Premium  allocated to the Contract
Value that has received a Contract  Enhancement is made, or upon the exercise of
the Right to Examine if any Premium allocated to the Contract Value has received
a Contract Enhancement."                                                        

3) The following language is added to the WITHDRAWAL PROVISIONS of the Contract:

"5% FOR LIFE GUARANTEED MINIMUM WITHDRAWAL BENEFIT. The GMWB allows the Owner to
make periodic partial withdrawals,  prior to the Income Date, for the longer of:
1) the duration of the Owner's life,  or with Joint Owners,  the duration of the
Joint Owner's life who dies first (the For Life  Guarantee,  which is subject to
the terms of this endorsement); or 2) until the total periodic withdrawals equal
a) the total Premium payments net of any applicable  premium taxes if elected at
issue or b) the Contract  Value net of any  applicable  Recapture  Charge on the
effective  date of this  endorsement  if elected after issue,  regardless of the
performance of the Investment  Divisions or level of the Contract  Value. If the
GMWB is elected after issue, the request must be received within the 30 calendar
days prior to the  Contract  Anniversary  and will be  effective on the Contract
Anniversary  following  receipt of the request in Good Order.  The  guarantee is
fully effective if periodic  partial  withdrawals  taken within any one Contract
Year do not exceed the greater of the GAWA or the Minimum Required  Distribution
(MRD). The Owner may "step-up" the Guaranteed  Withdrawal Balance to the current
Contract Value subject to the Guaranteed  Withdrawal Balance Step-Up provisions.
The  withdrawals  under  the  GMWB  are  non-cumulative;  therefore,  guaranteed
withdrawals  available  but not taken during any given  Contract  Year cannot be
taken as a guaranteed withdrawal in a subsequent Contract Year.                 

If withdrawals exceed the greater of the GAWA in a Contract Year or the MRD, the
For Life Guarantee will be null and void.                                       

7489NY                                  2                                       

EX-99 3rd Page of 6 TOC 1st Previous Next ↓Bottom Just 3rd
The withdrawals made under this endorsement are considered to be the same as any
other partial withdrawals for the purposes of calculating any other values under
the Contract or any other endorsements attached to the Contract.                

For purposes of this endorsement,  partial  withdrawals are considered to be the
entire amount withdrawn from the Contract,  including any applicable charges and
adjustments.  The total amount received under the guarantee may be less than the
GWB at  election  or  step-up  due to  the  application  of  these  charges  and
adjustments.                                                                    

Any  withdrawal  less  than or  equal to the  greater  of the GAWA or the MRD is
considered a partial  withdrawal,  not a full withdrawal,  even if it is greater
than or equal to the Contract Value.                                            

A partial withdrawal in excess of the Withdrawal Value will be permitted as long
as the total  partial  withdrawal  for the  Contract  Year does not  exceed  the
greater of the GAWA or the MRD. A partial  withdrawal  in excess of the Contract
Value will be permitted as long as the total partial withdrawal for the Contract
Year does not exceed  the  greater  of the GAWA or the MRD.  In this  case,  the
Contract  Value  will be set to zero  and the  Contract  Value  Reduces  to Zero
provision will apply.                                                           

If the age of any Owner is incorrectly stated at the time of the election of the
GMWB,  on the date the  misstatement  is discovered  the Contract  Value will be
adjusted by the difference  between the GMWB Charges  actually paid and the GMWB
Charges that would have been paid assuming the correct age.  Future GMWB Charges
will be based on the correct age.                                               

GUARANTEED WITHDRAWAL BALANCE.                                                  

On the effective date of this endorsement,  the GWB is determined as follows and
is subject to a maximum of $5,000,000.00:                                       

1.   If elected as of the Issue Date of the Contract, the GWB equals the initial
Premium (net of any applicable premium taxes).                        

2.   If  elected  after the  Issue  Date of the  Contract,  the GWB  equals  the
     Contract  Value  on the  effective  date  of  this  endorsement,  less  any
applicable Recapture Charges.                                         

With each subsequent  Premium received after this endorsement is effective,  the
GWB will be  recalculated to equal the GWB prior to the Premium payment plus the
amount of the Premium payment (net of any applicable premium taxes),  subject to
the maximum shown above.                                                        

With each partial withdrawal, the GWB is reduced. If You choose to withdraw an  
amount that exceeds the greater of the GAWA during any Contract Year or the MRD,
the guarantee provided by this endorsement may be reduced to an amount less than
the GWB at election or step-up.                                                 

Partial withdrawals will affect the GWB as follows:                             

1.   If the partial  withdrawal plus all prior partial  withdrawals  made in the
     current  Contract  Year is less than or equal to the greater of the GAWA or
the MRD, the GWB is equal to the greater of:                          

     a.   the GWB prior to the partial  withdrawal less the partial  withdrawal;
or                                                          

b.   zero.                                                            

2.   If the partial  withdrawal plus all prior partial  withdrawals  made in the
     current  Contract  Year exceeds the greater of the GAWA or the MRD, the GWB
is equal to the lesser of:                                            

     a.   the Contract  Value after the partial  withdrawal  less any applicable
Recapture Charges; or                                       

     b.   the  greater  of the GWB  prior  to the  partial  withdrawal  less the
partial withdrawal, or zero.                                

7489NY                                  3                                       

EX-99 4th Page of 6 TOC 1st Previous Next ↓Bottom Just 4th
GUARANTEED ANNUAL WITHDRAWAL AMOUNT.                                            

On the effective  date of this  endorsement,  the Guaranteed  Annual  Withdrawal
Amount is equal to 5% of the GWB.                                               

With  each  subsequent  Premium  received  after  the  effective  date  of  this
endorsement,  the  GAWA  will be  recalculated  to equal  the GAWA  prior to the
Premium payment plus 5% of the subsequent Premium payment (net of any applicable
premium taxes), or 5% of the increase on the GWB, if less.                      

Partial withdrawals will affect the GAWA as follows:                            

1.   If the partial withdrawal plus all prior partial withdrawals made in the   
   current Contract Year is less than or equal to the greater of the GAWA or
 the MRD and the For Life Guarantee is still effective, the GAWA will be
unchanged.                                                            

2.   If the partial withdrawal plus all prior partial withdrawals made in the   
   current Contract Year is less than or equal to the greater of the GAWA or
    the MRD and the For Life Guarantee is not still effective, the GAWA is the
lesser of:                                                            

a.   the GAWA prior to the partial withdrawal; or                     

b.   the GWB after the partial withdrawal.                            

3.   If the partial  withdrawal plus all prior partial  withdrawals  made in the
     current  Contract  Year exceeds the greater of the GAWA or the MRD, the For
Life Guarantee is null and void and the GAWA is the lesser of:        

a.   the GAWA prior to the partial withdrawal; or                     

b.   the GWB after the partial withdrawal; or                         

     c.   5% of the  Contract  Value  after  the  partial  withdrawal  less  any
applicable Recapture Charges.                               

CONTRACT  VALUE REDUCES TO ZERO. If the Contract  Value is reduced to zero,  all
other  rights  under the  Contract  cease  (except  for the right to change  the
Beneficiary),  no subsequent  Premium  payments will be accepted,  and all other
endorsements are terminated without value.                                      

If the For Life  Guarantee is still  effective,  the Owner will  receive  annual
payments  of the GAWA  until  the  death of the  Owner or the death of any Joint
Owner.                                                                          

If the For Life  Guarantee  is not  effective,  the Owner  will  receive  annual
payments of the GAWA until the GWB, if any, is  depleted.  The last payment will
not exceed the remaining GWB at the time of payment.                            

Subject to the Company's approval,  the Owner may elect to receive payments more
frequently than annually.  However, the sum of the payments made during the year
may not exceed the annual payment amount described above.                       

With each payment, the GWB is reduced by the amount of the payment until the GWB
is depleted.                                                                    

Upon the death of the Owner or the death of any  Joint  Owner,  the  Beneficiary
will  receive  the  scheduled  payments  until the  remaining  GWB,  if any,  is
depleted. No other death benefit will apply.                                    

GUARANTEED  WITHDRAWAL  BALANCE STEP-UP.  On or after the 5th anniversary of the
effective date of this  endorsement,  the Owner may choose to step-up the GWB to
equal the Contract Value, subject to a maximum of $5,000,000.00.  The step-up is
subject to the following restrictions:                                          

7489NY                                  4                                       

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1.   The first step-up must be at least 5 years after the effective date of this
endorsement.                                                          

2.   A subsequent  step-up may not be elected until the 5th (or later)  Contract
Anniversary after the latest step-up.                                 

3.   The  step-up  can only be elected on or during the  30-calendar  day period
     following a Contract  Anniversary.  The request  will be  processed  and be
effective on the day We receive the request in Good Order.            

At the time of step-up:                                                         

1.   The GWB equals the Contract Value.                                         

2.   The GAWA is the greater of:                                                

a.   5% of the new GWB; or                                            

b.   the GAWA prior to the step-up."                                  

4)   The  following  language is added to the DEATH  BENEFIT  PROVISIONS  of the
Contract:                                                             

"Upon the death of the Owner or the death of any Joint Owner, while the Contract
is still in force and before the Income Date, the GMWB terminates without value.

Upon continuation of the Contract by a spousal Beneficiary, the spouse may elect
to terminate  the GMWB on the  Continuation  Date and  thereafter no GMWB Charge
will be assessed.  If the spouse does not make such election on the Continuation
Date,  the GMWB  will  remain in force  and may not be  subsequently  terminated
independently from the Contract to which it is attached.                        

If the  GMWB is  continued,  the  spouse  will not be  entitled  to the For Life
Guarantee.  With the exception of the election of a step-up, no adjustments will
be made to the GWB or the GAWA at the time of such continuation.                

The spouse may elect to step-up to the Contract Value  (including any applicable
adjustments) on the Continuation Date. Subsequent step-ups are subject to all of
the restrictions in the Guaranteed Withdrawal Balance Step-Up provision."       

TERMINATION  OF THE GMWB.  The GMWB will  terminate and all benefits  under this
endorsement will cease on the earlier of:                                       

1.   the date You elect to receive income payments under the Contract;          

2.   the date You make a full withdrawal from the Contract;                     

3.   the date upon which the Contract  terminates because the Owner or any Joint
Owner dies;                                                           

4.   the Continuation  Date if the spousal  Beneficiary  elects to terminate the
GMWB; and                                                             

5.   the date upon which all obligations for payment under this endorsement have
been satisfied after the Contract has been terminated.                

Endorsement effective date (if different from Issue Date of the Contract):      

7489NY                                  5                                       

EX-99 Last Page of 6 TOC 1st Previous Next ↓Bottom Just 6th
ILLUSTRATION OF THE CALCULATION OF THE 5% FOR LIFE GUARANTEED MINIMUM WITHDRAWAL
BENEFIT                                                                         

THESE EXAMPLES ARE PROVIDED TO ASSIST YOU IN UNDERSTANDING  HOW THE GWB AND GAWA
VALUES ARE  COMPUTED FOR THIS  ENDORSEMENT.  THE  EXAMPLES  ONLY DEPICT  LIMITED
CIRCUMSTANCES AND SPECIFIC FACTUAL  ASSUMPTIONS.  THE RESULTS MAY VARY DEPENDING
UPON THE TIMING OR SEQUENCE OF ACTIONS AS WELL AS CHANGES IN MARKET  CONDITIONS.
THE ENDORSEMENT  PERMITS PERIODIC  PARTIAL  WITHDRAWALS FOR THE LONGER OF 1) THE
OWNER'S  LIFE OR THE LIFE OF THE FIRST OF THE JOINT  OWNERS TO DIE (THE FOR LIFE
GUARANTEE  WHICH IS SUBJECT TO TERMS OF THE  ENDORSEMENT)  OR 2) UNTIL THE TOTAL
PERIODIC  WITHDRAWALS  EQUAL A) THE TOTAL PREMIUM PAYMENTS NET OF ANY APPLICABLE
PREMIUM TAXES IF ELECTED AT ISSUE OR B) THE CONTRACT VALUE NET OF ANY APPLICABLE
RECAPTURE  CHARGE ON THE  EFFECTIVE  DATE OF THE  ENDORSEMENT  IF ELECTED  AFTER
ISSUE.                                                                          

THE FOLLOWING  EXAMPLES  ASSUME YOU ELECT THE 5% FOR LIFE GMWB WHEN YOU PURCHASE
YOUR CONTRACT AND YOUR INITIAL  PREMIUM  PAYMENT IS $100,000.  NO OTHER OPTIONAL
BENEFITS ARE ELECTED.  UNDER THESE  CIRCUMSTANCES,  YOUR INITIAL GWB IS $100,000
AND YOUR INITIAL GAWA IS $5,000.                                                

EXAMPLE 1:  WITHDRAWAL  EQUAL TO THE GAWA WHEN THE CONTRACT  VALUE HAS DECREASED
DUE TO NEGATIVE MARKET PERFORMANCE.                                             

If you withdraw the GAWA ($5,000) and your Contract Value is $80,000 at the time
of withdrawal, then                                                             

     o    YOUR GWB BECOMES $95,000, which is your prior GWB ($100,000) minus the
GAWA ($5,000).                                              

     o    Your GAWA for the next year remains  $5,000,  because you did not take
          more  than  the  GAWA  ($5,000)  and the For  Life  Guarantee  remains
effective.                                                  

EXAMPLE  2:  WITHDRAWAL  EXCEEDS  THE  GREATER  OF THE  GAWA OR THE MRD WHEN THE
CONTRACT VALUE HAS DECREASED DUE TO NEGATIVE MARKET PERFORMANCE.                

If your  MRD is  $7,500  and  your  Contract  Value  is  $80,000  at the time of
withdrawal, then if you withdraw $10,000                                        

     o    We recalculate  your GWB by comparing the results of two  calculations
and choosing the lesser amount:                             

          o    First, we deduct the amount of the withdrawal ($10,000) from your
               Contract  Value  ($80,000).  This equals  $70,000 and is your new
Contract Value.                                   

          o    Second,  we deduct the amount of the  withdrawal  ($10,000)  from
               your  GWB  ($100,000).  This is  $90,000.  YOUR  NEW GWB  BECOMES
   $70,000, since this is the lesser of the two amounts.

     o    Since the Contract Value prior to the partial withdrawal  ($80,000) is
          less  than  or  equal  to the  GWB  prior  to the  partial  withdrawal
          ($100,000),  the GAWA is  reduced.  The new GAWA is 5% of the new GWB,
          which is $3,500.  Since the withdrawal exceeds the greater of the GAWA
or the MRD, the For Life Guarantee is null and void.        

AS YOU CAN SEE FROM THE EXAMPLES  ABOVE,  TAKING A  WITHDRAWAL  THAT EXCEEDS THE
GREATER OF THE GAWA OR THE MRD WHEN YOUR  CONTRACT  VALUE HAS  DECREASED  DUE TO
NEGATIVE MARKET PERFORMANCE  REDUCES THE GUARANTEED MINIMUM WITHDRAWAL  BENEFIT.
IN THE CASE  ILLUSTRATED  HERE,  THE GWB WAS REDUCED BY $20,000 AND THE FOR LIFE
GUARANTEE WAS MADE NULL AND VOID ELIMINATING POTENTIAL ADDITIONAL BENEFIT.      

                                    SIGNED FOR THE JACKSON NATIONAL LIFE
                             INSURANCE COMPANY OF NEW YORK

                    /s/ Clark P. Manning

                                     PRESIDENT AND CHIEF EXECUTIVE OFFICER

7489NY                                  6

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8 Subsequent Filings that Reference this Filing

  As Of               Filer                 Filing    For·On·As Docs:Size             Issuer                      Filing Agent

 4/25/24  Jnlny Separate Account I          485BPOS     4/29/24    3:6.1M
 4/25/24  Jnlny Separate Account I          485BPOS     4/29/24    3:5.7M
 4/27/23  Jnlny Separate Account I          485BPOS     5/01/23    3:5.9M
 4/27/23  Jnlny Separate Account I          485BPOS     5/01/23    3:5.7M
 4/21/22  Jnlny Separate Account I          485BPOS     4/25/22    3:6M
 4/21/22  Jnlny Separate Account I          485BPOS     4/25/22    3:5.8M
 4/22/21  Jnlny Separate Account I          485BPOS     4/26/21    3:27M
 4/21/21  Jnlny Separate Account I          485BPOS     4/26/21    3:68M

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Filing Submission 0000927730-05-000001 – Alternative Formats (Word / Rich Text, HTML, Plain Text, et al.)

Jnlny Separate Account I, et al. – ‘N-4’ on 1/6/05 – EX-99

On: Thursday, 1/6/05, at 5:16pm ET · Accession #: 927730-5-1 · File #s: 811-08401, 333-121884

Registration Statement for a Separate Account (Unit Investment Trust) — Form N-4Filing Table of Contents

EX-99 — Miscellaneous Exhibit

8 Subsequent Filings that Reference this Filing

Registration Statement for a Separate Account (Unit Investment Trust) — Form N-4
Filing Table of Contents