Broker-Dealer 

(Applicable only if registered securities products are to be distributed pursuant to

this Agreement and Retail Firm is not registered as a broker-
dealer):                                          (“Broker-Dealer”), an entity that is affiliated with Retail Firm, is
registered as a broker-dealer under the Securities Exchange Act of 1934, is a member of the
Financial Industry Regulatory Authority (“FINRA”) and has the authority from FINRA to sell and
service variable insurance products.