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Safe Income Plus Flexible Premium Fixed Deferred Indexed Annuity Options for your retirement planning ADV 1519 (08-2014) Fidelity & Guaranty Life Insurance Company Rev. 03-2018 18-0279

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Safe Income PlusFlexible Premium Fixed Deferred Indexed AnnuityOptions for your retirement planning

ADV 1519 (08-2014) Fidelity & Guaranty Life Insurance Company Rev. 03-2018 18-0279

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Safe Income Plusis a flexible premium fixed deferred indexed annuity

What is that?Flexible Premium: This means you can make multiple premium payments.

Deferred: This means the maturity date and annuitization does not begin immediately. Also, you pay no current income tax on interest earned. Taxes are deferred until you withdraw your earnings.*

Fixed: This means that Fidelity & Guaranty Life Insurance Company declares and guarantees for one year periods a fixed rate of interest on the fixed interest rate option.

Indexed: This means that it offers indexed interest crediting options. The indexed interest crediting options earn interest that depends in part on how amarket index performs. You could earn an indexed interest percentage change, limited to the declared cap or declared fixed rate, as applicable. You could never be credited less than 0%.The annuity does not participate in any stock, bond or equity investments. You aren’t buying shares of stock or an index. Dividends paid on the stocks on which the indices are based don’t increase your annuity earnings.

Annuity: An annuity is a vehicle to provide payments to the holder at specified intervals. It is designed to be a long-term retirement tool and not to be used to meet short-term financial goals.1 Tax defferal offers no additional value if the annuity is used to fund a

qualified plan, such as an IRA and may not be available if the owner of the annuity is not a natural person such as a corporations or certain types of trusts.

In this document are important points to think about before you buy the Safe Income Plus annuity from Fidelity & Guaranty Life Insurance Company. Fidelity & Guaranty Life has prepared this summary to help you understand Safe Income Plus’ many options, advantages, and limitations.Your agent will provide to you the Safe Income Plus - Statement of Understanding disclosure form. Please review the Statement of Understanding then confirm your understanding by completing and signing the Applicant Acknowledgement on the last page.

Product features include:

Minimum guarantees that protect your principal from market decline.

A Guaranteed Minimum Withdrawal Benefit Rider that guarantees a level lifetime income without the need to annuitize prior to maturity. (Rider charges apply)

Upside interest potential through four indexed interest crediting options or an annually declared fixed interest rate option.

Downside protection – any indexed interest credited is never taken away due to market decline.

Liquidity for life’s unexpected events. Surrender charges and market value adjustment charges are waived for home health care, diagnosis of a terminal illness or nursing home confinement. These riders (addendums to the contract) provide full access to your account value without penalty as long as certain conditions are met. (Riders may not be available in all states.)

GuaranteesThe guaranteed minimum surrender value is the minimum you would receive if you surrender your contract. It is meant to provide a known value, a floor, and is required of products of this type. The minimum guaranteed surrender value is 87.5% of your premiums compounding at the minimum guaranteed surrender value (MGSV) rate. That rate is between 1% and 3%, is set at issue and fixed for the life of the contract.

Safe Income PlusFlexible Premium Fixed Deferred Indexed Annuity

Options for Your Retirement Planning

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12.35%

5.55%

11.65% 2.16%

-35.61%

21.59% 12.26% 0.41%

14.51%

25.27%

3.00% 3.00% 0.00% 2.16%

3.00% 3.00% 0.41%

3.00% 3.00%

3.00%

1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00%

70,000

80,000

90,000

100,000

110,000

120,000

130,000

140,000

150,000

160,000

170,000

180,000

1/1/2005 1/1/2006 1/1/2007 1/1/2008 1/1/2009 1/1/2010 1/1/2011 1/1/2012 1/1/2013 1/1/2014 1/1/2015

How doesSafe Income Plus

work?

1. HOW WILL THE VALUE OF MY ANNUITY POTENTIALLY GROW?

Five Interest Crediting Options (Subject To Cap/Declared Rate)Four of the five interest crediting options in your annuity will potentially earn interest based on formulas in part linked to changes in an index. These are subject to a limit or cap rate. Please see the four Indexed Interest-Crediting Options listed in the side box. You choose which Interest-Crediting Options you wish to participate in. With respect to the indexed interest crediting options, interest, if any, is credited on each indexed crediting option’s anniversary. Because interest will never be less than 0%, your account value will never decrease due to a declining index.The fifth interest crediting option is the Fixed Interest Option. The initial interest rate is GUARANTEED for one year, and the rate thereafter is declared in advance and guaranteed in one year increments. The rate is guaranteed never to be less than 1%.

Indexed Interest Crediting Options S&P 500®

3 One-year monthly point-to-point with a cap3 One-year annual point-to-point with a cap3 One-year monthly average with a cap3 Point-to-point fixed declared rate on Index Gain

Fixed Interest Option1

The interest rate your annuity is issued with is guaranteed for one year. After the first contract anniversary, we will declare, on or before each contract anniversary, a new interest rate that is guaranteed for one year.

Indexed Interest Crediting Options:1 Minimum caps/fixed declared rateEach interest crediting option has a minimum cap/fixed declared rate. These are the lowest the rates could be set at each crediting option anniversary.3 One-year monthly point-to-point with a cap.

Minimum cap per month: 1%3 One-year annual point-to-point with a cap.

Minimum cap per year: 1%3 One-year monthly average with a cap.

Minimum cap per year: 1%3 Point-to-point fixed declared rate on Index Gain.

Minimum declared rate: 1%1 Refer to your agent for the current caps and rates.

S&P 500® index Account Value MGSV

S&P 500® IndexThis hypothetical example assumes a new Safe Income Plus contract was issued on January 1, 2005, utilizing $100,000 in premium allocated entirely to the one-year annual point-to-point with a cap Indexed Interest Crediting Option without any reallocation to other interest crediting options. This example further assumes the non-guaranteed cap rate was 3.00% and did not change throughout the entire period shown. In reality, cap rates are subject to change, subject to certain contractual minimum guarantees. The example further assumes that during the period shown, there were no additional premiums paid, no rider charges deducted, no premium bonus applied, no surrender, no withdrawals of any type and thus no surrender charges or market value adjustments applied. Safe Income Plus is not available for sale without the Enhanced Guaranteed Minimum Withdrawal Benefit Rider and rider charges will be deducted from the contract for this benefit. Although this product was not available for the time period referenced, actual historical prices of the S&P 500® Index have been used. The example is hypothetical, non-guaranteed and is not an indication of the annuity’s past or future performance. The use of alternate rates or assumptions would produce significantly different results.The S&P 500® Index does not include dividends paid on the underlying stocks, and therefore does not reflect the total return of the underlying stocks; neither a market index nor any market indexed annuity is comparable to a direct investment in the financial markets. Indexed annuities do not directly participate in any stock or equity investments. Minimum Guaranteed Surrender Value: 87.5% of premium accumulating at 1.00%

The following hypothetical examples demonstrates how this indexed interest crediting option works, assuming an allocation of $100,000 in premium without any additional premium payments. Keeping in mind that past performance is no guarantee of future results, let’s assume no vesting bonus, no rider charges, deductions, or withdrawals are made, and no surrender charges or market value adjustments apply.

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2. WHAT GUARANTEES ARE INCLUDED IN MY ANNUITY?

87.5% of Your Premium Compounding at a Rate Between 1% and 3% as a Minimum Guaranteed Surrender Value (MGSV)Your annuity contains a protective floor. The minimum guaranteed surrender value on a full surrender is 87.5% of premium, plus daily interest accruing at the MGSV accumulation interest rate. That rate is between 1% and 3%, is set at issue and fixed for the life of the contract. The MGSV is reduced by prior withdrawals.You will be paid the greater of:● the vested account value, less any applicable surrender charges, market value

adjustment (MVA) and rider charges● the MGSV

3. HOW DO I GET INCOME FROM MY ANNUITY?

There are several ways to access your account value, including transforming your account into annuity payments. If you take withdrawals and it is during the surrender charge period, you will be assessed a surrender charge and MVA if the amount withdrawn is in excess of the free amount.

Partial Free Withdrawals Each contract year (after the first contract year), you may withdraw, surrender charge free, 10% of your vested account value as of the prior anniversary, less any free withdrawals taken during the current contract year. If your annuity was issued in connection with a tax qualified plan, you may be required to take minimum distributions beginning at age 70½.

Partial Withdrawals and Option for Systematic WithdrawalsBefore annuity payments begin you may take up to four withdrawals per year ($500 minimum), or you may take regular systematic withdrawals on a monthly, quarterly, semi-annual or annual basis ($100 minimum). During the surrender charge period, withdrawals that exceed the annual 10% free partial withdrawal amount will be subject to surrender charges and MVA. Interest will not be credited to any amounts withdrawn if taken prior to the interest crediting date for your current options.

Annuity PayoutsYou must begin receiving annuity payments no later than the maturity date. The maturity date is fixed at contract issue and is no later than the contract anniversary following the annuitant’s (or the oldest annuitant’s if a second annuitant is named) 100th birthday. Annuity payments are based on the surrender value.1 An annuity option may be changed any time before annuity payments begin.

1 For TX, surrender charges are waived for annuitization. Surrender charges are assessed for full surrenders.

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See the Statement of Understanding for detailed descriptions of the indexedinterest crediting options. All of the indexed interest crediting options may not always be available for allocations. You may move your account value among the interest crediting options at the end of index crediting periods. Any premium paid between contract anniversaries is allocated to the fixed interest option until the nextapplicable index crediting period at which time your premium will be allocated to the chosen indexed interest option.

Annuities are issued with an effective date of the 1st, 8th, 15th or 22nd of the month. Premiums are held without interest untilthe next available effective date. Special rules apply if one of these dates falls on a weekend or holiday. If you withdrawmoney from an indexed interest crediting option on any day other than an interest crediting option anniversary you will not earn indexed interest on the amount you withdraw. The minimum initial premium to purchase this contract is $10,000 and the minimumallocation to any option is $2,000.

Safe Income Plus

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Payment In The Event Of DeathShould you die before annuity payments begin, we will pay the greater of the total account value and the MGSV to the beneficiary named in your annuity.We will also pay a partial interest credit, if applicable, up to the date of death.

Account ValueThe annuity’s account value equals 100% of premium, plus interest credited to each interest crediting option, less any previous withdrawals and associated surrender charges. For an explanation of the MGSV please see prior page.

Market Value AdjustmentWhat is a Market Value Adjustment?A Market Value Adjustment (MVA) is an adjustment made during the time the surrender charge schedule is in effect, to the part of the Account Value withdrawn that exceeds the free withdrawal amount. The MVA is based on a formula that takes into account changes in yields of the U.S. Treasury Constant Maturity Series between the date of issue and the date of the withdrawal. Generally, if treasury yields have risen since you purchased your annuity, the MVA will decrease your Surrender Value. If treasury yields have fallen, the MVA will increase your Surrender Value. See the Statement of Understanding for additional details.

SURRENDER CHARGESWhat happens if I take out some or all of the money from my annuity?A surrender charge and MVA applies for the first ten years on full or partial surrenders in excess of the 10% annual free amount allowed, and in calculating the annuity payments unless they do not apply under the conditions below. Notably, there is no free amount available in the first contract year.

Annuity Year:1 2 3 4 5 6 7 8 9 10 11+

Surrender Charge:12% 11% 10% 9% 8% 7% 6% 5% 4% 3% 0%

The surrender charge equals the surrender charge percentage for the applicable contract year multiplied by the amount of account value that exceeds the penalty free amount available. Please review your annuity for the appropriate surrender charge schedule.1

Is there any way to withdraw money during the surrender charge period without paying a surrender charge?Free partial withdrawals are available each contract year, after the first contract year, during the surrender charge period and you may withdraw up to 10% of your vested account value as of the prior contract anniversary. Waiver of surrender charge riders listed below.

• Home Health Care Rider2 If the annuitant requires Home Health Care Services by a licensed Home Health Care provider as a result of being impaired in performing two out of six activities of daily living as outlined in your contract, and such care begins at least one year after the annuity’s effective date, and the impairment has lasted at least 60 days and is expected to continue for at least 90 days following the request. Surrender charges and MVA will be waived on withdrawals made while the annuitant is impaired.

•NursingHomeBenefitRider3 If you are confined to a licensed nursing home for more than 60 days, and your confinement begins at least one year after the annuity’s effective date, surrender charges and MVA will be waived on withdrawals made during the period of your confinement.

• TerminalIllnessBenefitRiderIf a licensed physician certifies that you have been diagnosed with an illness or condition that causes your life expectancy to be less than one year, and the diagnosis takes place at least one year after the annuity’s effective date, surrender charges and MVA will be waived during this period of terminal illness.

Surrender charges and MVA are not imposed if you die. If your spouse, as beneficiary, elects to continue the contract and subsequently surrenders, your spouse will be subject to a surrender charge and MVA if within the surrender charge period.

1 The following states follow an alternate surrender charge schedule: CA, DE, MA, NJ, NV, OH, OK, SC, TX and UT. For these states, the surrender charge schedule is: 9%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, 0%

2 Home Health Care Rider is not available in MA, SD, and WI.3 Nursing Home Rider is not available in MA and SD.

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4. DO I PAY ANY FEESOR CHARGES?

Fees, Expenses & Other ChargesYour full premium is available to potentially earn interest from the effective date of your annuity (surrender charges and MVA apply for the first ten contract years on full or partial surrenders in excess of the free amount).

There is a charge for the Enhanced Guaranteed Minimum Withdrawal Benefit rider which is deducted from the contract’s account value annually after the completion of the first contract year. The annual charge for this rider is 1.05% multiplied by the income base.

Safe Income Plus

5. DOES THIS AFFECT MY TAXES?

How will annuity payments and withdrawals from my annuity be taxed?The annuity is tax-deferred, which means you don’t pay taxes on the interest it earns until the money is paid to you. When you take payouts or make a withdrawal, you pay ordinary income taxes on the earned interest. Withdrawals are treated as coming from earnings first and then as a return of your premium. Payments under an annuity payment plan are treated as coming partially from earnings and partially as return of premium. You may pay a federal income tax penalty on earnings you withdraw before age 59 ½.If your state imposes a premium tax, it may be deducted from the money you receive. You may exchange one tax-deferred annuity for another without paying taxes on the earnings when you make the exchange. Before you do, compare the benefits, features, and costs of the two annuities. You may pay a surrender charge on the annuity you are exchanging. Also, you may start a new surrender charge period in the new annuity.If your annuity was issued in connection with a tax qualified plan, you may be required to take minimum distributions beginning at age 70½.Internal Revenue Code provides that if an annuity is held by a non-natural person and such person is not holding as an agent for a natural person, the contract shall not be treated as an annuity contract for income tax purposes.Information provided regarding tax or estate planning should not be considered tax or legal advice. Consult your own tax professional or attorney regarding your unique situation.Does buying an annuity in a retirement plan provide extra tax benefit?Buying an annuity within an IRA doesn’t give you any extra tax benefit. The annuity is tax-deferred, which means you generally don’t pay taxes on the money until it is paid to you. Payments under an annuity payment plan are generally entirely taxable under most IRA plans.1 Choose the annuity based on its other features and benefits as well as its risks and costs, not its tax benefits. Please consult your tax advisor regarding your unique situation.

1 Taxation on IRA plans varies depending on the type of IRA, traditional IRA, Roth IRA, SEP IRA you own.

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6. WHAT ELSE DO INEED TO KNOW?

Other Information● This annuity is designed for people who do not anticipate needing access to their annuity beyond the free amount for at

least ten years.● We may change your annuity contract from time to time to follow federal or state laws and regulations. If we do, we’ll tell

you about the changes in writing.● You have a set number of days (at least 10) to look at the annuity after you buy it. If you decide during that time that you

don’t want it, you can return the annuity and get your premium back. Read the cover page of your annuity contract as soon as you receive it to understand how many days you have to decide if you want to keep it.

● At least once each year, we will send you a report of the current annuity values.● We pay the agent, broker, or firm for selling the annuity to you. Compensation is not deducted from your premium.

However, the compensation we pay impacts contract pricing including, surrender charges, interest rates, caps, participation rates and spread.

● Required Minimum Distributions – Certain tax qualified annuities are subject to required minimum distributions which generally require that distributions begin no later than April 1st of the year following your attainment of age 70½ and that amounts be paid to you over a period not longer than your life expectancy.

● Your annuity values are guaranteed by Fidelity & Guaranty Life Insurance Company. As a legal reserve company, Fidelity & Guaranty Life Insurance Company is required by state regulation to maintain reserves equal to or greater than guaranteed surrender values.

Safe Income Plus

7. WHAT SHOULD I KNOW ABOUT FIDELITY & GUARANTY LIFE?

Incorporated in 1959, Fidelity & Guaranty Life Insurance Company has a solid commitment to serving the individuals it knows best – middle market consumers seeking the safety, protection, accumulation potential and income features of secure life insurance and annuity products. Fidelity & Guaranty Life offers its series of focused life insurance and annuity products through its network of independent marketing organizations. Insurance products are offered through Fidelity & Guaranty Life Insurance Company in every state, other than New York, as well as the District of Columbia. In New York, products are offered through a wholly owned subsidiary, Fidelity & Guaranty Life Insurance Company of New York. That company is solely responsible for its contractual commitments.

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Flexible, guaranteed lifetime income withdrawals allow you to maintain control ofyourfinancialassetswhilehelpingyoutoavoidoutlivingyourmoney.Lifetime income withdrawals are available using the Enhanced Guaranteed Minimum Withdrawal Benefit (EGMWB) rider.2 This EGMWB rider is innovatively designed to provide you with level, guaranteed income payments for life.3 This rider allows you the opportunity to maintain control over your annuity and financial resources, giving you the freedom to withdraw more or less or all of your surrender value. Withdrawing more than the guaranteed withdrawal payment will reduce your guaranteed payment, perhaps even eliminate it, therefore you should carefully consider if you want to do this.

Protection against ImpairmentEGMWB includes a valuable feature that guarantees a higher guaranteed income stream while impaired and the account value is more than zero. If you are a single annuitant, the enhanced guaranteed withdrawal payment will be 2 times the guaranteed withdrawal payment. If there are joint annuitants, the enhanced guaranteed withdrawal payment will be 1.5 times the guaranteed withdrawal payment.In order to receive the enhanced guaranteed withdrawal payments you must be certified by a physician as impaired and expected to be permanently unable to perform at least two out of six activities of daily living (ADLs). ADLs include eating, bathing, dressing, transferring, toileting, and continence. Care for the related impairment must be received by a licensed professional.To qualify for this benefit all of the following conditions must apply:

● The contract must be in force for a minimum of three years with no premiums paid for at least three years. (This benefit will not be available until the completion of at least three contract years.)

● The annuitant is age 60 or older,● The annuitant must be a U.S. resident on the approval date and;● Must meet ADL guidelines listed above and the impairment under those guidelines must begin at least

1 year after the contract date of issue.If impairment conditions cease or if the account value has been reduced to $0 (assuming no excess withdrawals), the owner can continue GMWB payments at the original level prior to impairment, even if the account value has been reduced to zero. If the account value is depleted while receiving this benefit, the enhanced guaranteed withdrawal payment amount will revert to the original amount. You may not receive this benefit after the point at which the account value is depleted.

1 Not available in all states. See your Statement of Understanding for additional details.2 There is an explicit charge for the EGMWB rider. The charge is 1.05% of the income base and is deducted from the contract’s account value

annually after the completion of the first contract year.3 If you elect annuitization under your contract, you must elect a lifetime only payment option as defined in the contract in order to receive payments

for life. Annuitization amount may be different than guaranteed withdrawal amount.

Enhanced Guaranteed Minimum Withdrawal Benefit Rider1

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A time to build your savings

Accumulation PeriodDuring the accumulation period the income base is the value used to determine the guaranteed withdrawal payment. It is a value that is tracked separately from your account value and is not cash, but a means to determine the guaranteed withdrawal payment. The income base is the greater of:

● Initial premium plus any applicable Income Base Bonus; or● Premiums paid in the first policy year plus the applicable premium bonus, accruing for up to 10 years or

age 85 or when withdrawals begin at the current EGMWB annual roll-up rate.1

There is a 1.05% of income base annual charge for the EGMWB rider that is deducted from the account value. During the accumulation period, any withdrawals will cause the income base to be reduced in proportion to the reduction in the account value.During the accumulation period the income base can grow as defined above, adjusted proportionately for any withdrawals you may take prior to beginning the guaranteed withdrawal payments.2 If the income base grows, your guaranteed withdrawal payment will also grow.During the accumulation period, you may elect to “restart” a new 10-year roll-up period. Restarting a new 10-year period extends the accumulation period and continues the growth of the income base at the annual roll-up rate for up to 10 years or until guaranteed withdrawal payments or 85 if earlier.3

1 Please refer to your agent for the current EGMWB annual roll-up rate.2 If you begin taking withdrawals the accumulation period will end, starting the withdrawal period.3 Fidelity & Guaranty Life reserves the right to change the EGMWB roll-up rate upon restart.The roll-up rate is not to be less than the guaranteed rate

of 2%.

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A time to live off of your savingsWithdrawal Period1

You may begin taking payments through a series of withdrawals annually, semiannually, quarterly or monthly at ANY time after the first contract year, (subject to surrender charges and MVA, if any) and after having reached age 50. These withdrawal payments can be stopped and started at any time. You may take up to the guaranteed withdrawal payment amount, which is the maximum amount that can be withdrawn each contract year without negatively affecting your income base. This is the amount guaranteed to be paid for your lifetime, even if your annuity’s account value falls to zero (provided no excess withdrawals are taken). The amount of the guaranteed withdrawal payment is a percentage of the income base, an amount tracked separately from the account value.Your guaranteed withdrawal payment amount is calculated by multiplying your income base by your guaranteed withdrawal percentage and is based on your age at the time you elect to receive income payments. Joint Payout: Income under this rider can be based on the lives of two people as long as they are joint annuitants and legal spouses. In the case of joint annuitants, the guaranteed withdrawal percentage is determined by the age of the younger of the two annuitants at the time guaranteed withdrawal payments are elected. The guaranteed withdrawal payment is guaranteed to be paid until the death of the second annuitant.2

Spousal Continuation: If the rider is in the accumulation period on the date of the first owner’s death, this rider will continue if your spouse continues the contract. Should the policy later enter the Withdrawal Period, the Guaranteed Withdrawal Payments will be based on the life of the surviving spouse. If the rider is in the withdrawal period on the date of the first owner’s death, and the spouse was a joint annuitant under the contract, guaranteed withdrawal payments will continue based on the same annuitant’s age as it was at the time of the owner’s death.2

Contract Maturity: At contract maturity (age 100), should you elect a life only payment option of income, then the annuity payment amount is the greater of the annuity payment amount provided under the base contract for that payout option and the guaranteed withdrawal payment.3 Should you choose another payment option available under the contract, the annuity payment amount will be based on the annuity payment amount provided under the base contract.Excess Withdrawal: An excess withdrawal is a withdrawal that causes the total withdrawals for the contract year to exceed the guaranteed withdrawal payment amount. The income base will be reduced in proportion to the reduction in the account value.The guaranteed withdrawal payment amount will be recalculated following an excess withdrawal. Depending on the amount of the withdrawal, surrender charges, MVA and other penalties may apply.Guaranteed Withdrawal Percentages:Payout percentages vary for age. Please review the statement of understanding (or your contract) for details.

1 If you elect to begin taking withdrawals the Accumulation Period will end, starting the Withdrawal Period.2 In order for payments to continue until the death of the second annuitant, the second annuitant must select spousal continuation of the contract and,

at contract maturity, must annuitize as defined in the rider.3 If you annuitize under your contract, you must select a lifetime only payment option as defined in the contract in order to receive payments for life.

Annuitization amount may be different than guaranteed withdrawal amount.

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A time to live off of your savingsVesting Bonus1 of All Premium Received in the First Contract Year.2

How does it work?● Your annuity offers a premium bonus that is calculated as 8%3 of all premium received in the first

contract year.● The bonus is credited to your account value at issue, is split proportionally to each crediting option you

elect, and is eligible to earn interest based on the crediting options you elect.● The bonus amount, plus any interest earned on that amount, then vests over a period of ten years.The vesting schedule is as follows:

Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10+10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Fully Vested

Vested percentages shown in the vesting schedule are as of the end of the contract year for each crediting option you elect.The vested account value available to you at any given time for free withdrawals, surrenders, or annuitization includes only the vested portion of the bonus amount at that time.The account value available as a death benefit includes 100% of any bonus amounts regardless of the portion vested at that time.1 Annuities that offer bonus interest features may have higher fees and charges, longer surrender charge periods, lower credited interest rates and/or

lower cap rates than annuities that do not provide the bonus feature.2 The vesting bonus rates listed on this brochure are subject to change. 3 For the following states, the vesting bonus rate is 7%: California, Delaware, Massachusetts, Nevada, New Jersey, Ohio, Oklahoma, South Carolina,

Texas and Utah.

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Contracts issued by Fidelity & Guaranty Life Insurance Company, Des Moines, IA.Fidelity&GuarantyLifeInsuranceCompanyoffersadiverseportfoliooffixedandindexeddeferredannuitiesandoptionaladditionalfeatures.Beforepurchasing,consideryourfinancialsituationandalternativesavailabletoyou.YourFidelity&GuarantyLifeInsuranceCompanyfinancialprofessionalcanhelpyoudeterminethebestalternativesforyourgoalsandneeds,orvisitus at www.fglife.com for more information.Form numbers: API-1018 (11-13), ACI-1018 (11-13), ARI-1056 (06-13), ARI-1051 (11-12), ARI-1050 (11-12), ARI-1049 (11-12), ARI-1052(11-12), ARI 1054 (02-13), ARI-1045 (11-12), ARI-1065 (11-13); et al.

Provisions and riders have limitations, restrictions and additional charges. Subject to state availability. Certain restrictions may apply.This product is offered on a group or individual basis as determined by state approval.Forgroupcontracts,termsandconditionsaresetforthinthegroupcertificateandmastercontractandaresubjecttothelawsofthestate in which they were issued.This document is not a legal contract. For the exact terms and conditions, please refer to the annuity contract.“S&P 500®” is a trademark of The McGraw-Hill Companies, Inc. and has been licensed for use by Fidelity & Guaranty Life Insurance Company. Standard & Poor’s does not sponsor, endorse, promote, or make any representation regarding the advisability of purchasing the contract.Information provided regarding tax or estate planning should not be considered tax or legal advice. Consult your own tax professional or attorney regarding your unique situation.Annuities are long-term vehicles to help with retirement income needs.Indexedinterestcreditingoptionsaresubjecttoacap,fixeddeclaredrate,indexgaininterestrate,and/oraspread.Caps,fixeddeclaredrates, index gain interest rate, and spreads are subject to change at the discretion of Fidelity & Guaranty Life Insurance Company.Interest rates subject to change at insurer’s discretion and are effective annual rates.Youarepurchasingafixeddeferredindexedannuitycontractthatprovidesminimumguaranteedsurrendervalues.Youshouldunderstand how the minimum guaranteed surrender values are determined and the product features used to determine the values. Even though contract values may be affected by external indices, the contract annuity is not an investment in the stock market and does not participate in any stock, bond, or equity investments.

1.888.513.8797 www.fglife.com

No bank guarantee. • Not FDIC/NCUA/NCUSIF insured. • May lose value if surrendered early.

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Safe Income Plus – Statement of Understanding INSURER: FIDELITY & GUARANTY LIFE INSURANCE COMPANY

ADV1624 (11-2015) Fidelity & Guaranty Life Insurance Company Des Moines, IA Rev 06-2018v2 18-0575

1

Thank you for your interest in the Safe Income Plus annuity from Fidelity & Guaranty Life Insurance

Company (the “Company”). It is important that you understand the benefits, features, and limitations of this

annuity before making your purchasing decision. Please read the following information and sign the last

page of this disclosure document to acknowledge your understanding of the annuity policy (“Policy”) for

which you are applying. This document is intended to provide you with a summary of the Policy, including

benefits and limitations. To the extent the consumer product brochure conflicts with any information in this

document, this document controls. To the extent this document conflicts with any provision of the Policy, the

Policy controls. When you receive your Policy, read it carefully.

What is the Safe Income Plus annuity?

Safe Income Plus is a Flexible Premium Fixed Indexed Deferred Annuity. This policy includes an Enhanced

Guaranteed Minimum Withdrawal Benefit Rider (“EGMWB Rider”). The Policy is primarily intended for

customers seeking a long-term retirement savings vehicle. The included EGMWB Rider could benefit

customers who wish to trigger a lifetime withdrawal feature. You may deposit premium (the amount of

money you pay into the Policy) at any time prior to the Maturity Date (the date you must begin receiving

annuity payments) and before electing to begin the Withdrawal Period under the EGMWB Rider. Your initial

premium (the amount of money you initially pay) must be at least $10,000 and any additional premium (the

amount of money you may add prior to the Maturity Date) must be at least $2,000 and may not exceed

$1,000,000.

What if I decide I do not want my Policy after it is delivered?

After receipt of the Policy, it may be returned within the free look period for an unconditional refund of the

premium. The free look period is the amount of time you have to request a refund. The actual free look

period is stated on the cover page of your Policy.

How much interest will be credited to my Policy?

Account Value / Total Account Value

Your Policy has an account value which equals the sum of the fixed interest option and indexed interest

option account values, these options are discussed below. The account value is the sum of all the option

account values.

Each option account value equals all premiums allocated thereto, plus any interest credited thereon; plus

any vested premium bonus plus interest thereon; less any amounts previously withdrawn, less surrender

charges (explained below) thereon; less any rider charges, plus/minus Market Value Adjustment as

applicable.

The option account values grow based on the fixed interest option or potentially grow based on the indexed

interest options explained below plus any applicable vested premium bonus. You may choose any one or

combination of them subject to the Policy’s reallocation provisions. You may only reallocate values among

options once a Policy year effective for the next Policy year for the fixed interest option and effective the next

index crediting period for indexed crediting options. For the fixed interest option, you must notify us of any

reallocation at least 2 days prior to the beginning of the next Policy year (which starts on each policy

anniversary). For the indexed interest options, you must notify us of any reallocation at least 30 days prior to

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Safe Income Plus – Statement of Understanding INSURER: FIDELITY & GUARANTY LIFE INSURANCE COMPANY

ADV1624 (11-2015) Fidelity & Guaranty Life Insurance Company Des Moines, IA Rev 06-2018v2 18-0575

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the start of a new index crediting period. After the initial premium, any additional premium will be

automatically allocated to the fixed interest option account value.

The option account values are reduced by withdrawals of any type, any surrender charges thereon, rider

charges, and any positive Market Value Adjustment.

Fixed Interest Option

We will declare an initial fixed interest rate and renewal fixed interest rates that will determine the fixed rate

of interest credited to this option. These rates are guaranteed never to be less than the guaranteed

minimum effective annual interest rate of 1.00%. The initial fixed interest rate is guaranteed for the first

Policy year only. At the end of the first Policy year and any subsequent Policy year, we will declare a

renewal fixed interest rate that will be guaranteed for one Policy year only. Interest credits are credited daily.

One–Year Annual Point-to-Point With A Cap and Participation Rate Indexed Interest

Option (S&P 500® Index)

Any index interest credits for this option are calculated and credited only on an index crediting date by using

a formula that takes into account the beginning and ending values of the S&P 500® Index for a 1-year index

crediting period. The participation rate and cap rate limit how much of any increase will be used to calculate

any index interest credits. The participation rate and cap rate are declared prior to each 1-year index

crediting period.

We determine the index percentage change by subtracting the index value at the beginning of the 1-year

index crediting period from the index value at the end of the1-year index crediting period and then divide that

value by the index value at the beginning of the1-year index crediting period, multiplied by the participation

rate, and then the result is subject to the applicable cap rate. The participation rate will never be less than

100.00% for this option. The cap rate will never be less than 1.00% for this option.

If the index percentage change is zero or negative, no index interest is added. If the index percentage

change limited by the annual cap is positive, this capped percentage is multiplied by the option’s account

value to determine the index interest credits. The index interest credits pursuant to this option will never be

less than zero.

As with all the interest options, you decide how to allocate your premium. If you elect to allocate your

premium to this option or any other indexed interest option, keep in mind that your premium is never invested

directly in the external index. Linking your premiums to an external index only means that the underlying

index will be used to determine your credited interest, if any. The investment performance of the S&P 500®

Index does not directly pass through to you as an investment. You will not receive dividends off S&P 500®

Index.

One–Year Annual Point-to-Point Fixed Declared Rate On Index Gain Indexed Interest

Option (S&P 500® Index)

Any index interest credits for this option are calculated and credited only on an index crediting date, using a

formula that takes into account the beginning and ending values of the S&P 500® Index during a 1-year

index crediting period. The index gain interest rate is declared prior to each 1-year index crediting period.

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Safe Income Plus – Statement of Understanding INSURER: FIDELITY & GUARANTY LIFE INSURANCE COMPANY

ADV1624 (11-2015) Fidelity & Guaranty Life Insurance Company Des Moines, IA Rev 06-2018v2 18-0575

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We determine the index change by comparing the beginning value of the 1-year index crediting period and

the ending value of the 1-year index crediting period. The minimum index gain interest rate for this option is

1.00%.

If the change in the index value is zero or negative, no index interest is added. If the change in value of the

index during that 1-year period is positive, the declared index gain interest rate is multiplied by the option’s

account value to determine the index interest credits. The index interest credits pursuant to this option will

never be less than zero.

As with all the interest options, you decide how to allocate your premium. If you elect to allocate your

premium to this option or any other indexed interest option, keep in mind that your premium is never invested

directly in the external index. Linking your premiums to an external index only means that the underlying

index will be used to determine your credited interest, if any. The investment performance of the S&P 500®

Index does not directly pass through to you as an investment. You will not receive dividends off S&P 500®

Index.

One-Year Monthly Point-to-Point With A Cap and Participation Rate Indexed Interest

Option (S&P 500® Index)

Any index interest credits for this option are calculated and credited only on an index crediting date by using

a formula that takes into account the monthly beginning and ending values of the S&P 500® Index during a

1-year index crediting period. We add together 12 months of capped monthly index percentage changes and

that result is multiplied by the applicable participation rate. The participation rate and monthly cap rate are

declared prior to each 1-year index crediting period.

The monthly index percentage change equals the index value of the current monthly anniversary divided by

the index value on the prior monthly anniversary; minus one. A positive monthly index percentage change

will be limited to a monthly cap rate. A negative monthly index percentage change will not be subject to any

floor. The monthly cap rate for this option will never be less than 1.00%. The participation rate for any 1-year

index crediting period will never be less than 100.00% for this option.

If the sum of the 12 monthly percentage changes is zero or negative, no index interest credits will be added.

If the sum of the 12 monthly percentage changes is positive, this sum is then multiplied by the participation

rate, then this result will be multiplied by the option’s account value to determine the amount of index interest

credited. Index interest credits will never be less than zero.

As with all the interest options, you decide how to allocate your premium. If you elect to allocate your

premium to this option or any other indexed interest option, keep in mind that your premium is never invested

directly in the external index. Linking your premiums to an external index only means that the underlying

index will be used to determine your credited interest, if any. The investment performance of the S&P 500®

Index does not directly pass through to you as an investment. You will not receive dividends off S&P 500®

Index.

One-Year Monthly Average With A Cap and Participation Rate Indexed Interest Option

(S&P 500® Index)

Any index interest credits for this option are calculated and credited only on an index crediting date by using

a formula that takes into account the average of 12 months of monthly values of the S&P 500® Index during

a 1-year index crediting period. The index values are captured at one month intervals from the end of the

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Safe Income Plus – Statement of Understanding INSURER: FIDELITY & GUARANTY LIFE INSURANCE COMPANY

ADV1624 (11-2015) Fidelity & Guaranty Life Insurance Company Des Moines, IA Rev 06-2018v2 18-0575

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first month of the 1-year index crediting period to the end of the last month of the 1-year index crediting

period. The monthly average is the sum of these monthly index values divided by 12.

The index percentage change equals the monthly average minus the index value on the first day of the 1-

year index crediting period, divided by the index value on the first day of the 1-year crediting period,

multiplied by the participation rate, and then subject to the applicable cap rate. The participation rate will

never be less than 100.00% for this option. The cap rate will never be less than 1.00% for this option.

If the index percentage change is zero or negative, no index interest is added. If the index percentage

change limited by the annual cap is positive, this capped percentage is multiplied by the option’s account

value to determine the index interest credits. The index interest credits will never be less than zero.

As with all the interest options, you decide how to allocate your premium. If you elect to allocate your

premium to this option or any other indexed interest option, keep in mind that your premium is never invested

directly in the external index. Linking your premiums to an external index only means that the underlying

index will be used to determine your credited interest, if any. The investment performance of the S&P 500®

Index does not directly pass through to you as an investment. You will not receive dividends off S&P 500®

Index.

Does my Policy have a vesting premium bonus?

Yes, here is how the vesting bonus works. You will receive a premium bonus of 8% of your premiums paid

in the first Policy year only, which is subject to the premium bonus vesting schedule listed in this section.

For the following states, the vesting bonus works with an alternate rate: California, Delaware,

Massachusetts, Nevada, New Jersey, Ohio, Oklahoma, South Carolina, Texas and Utah. These states will

receive a premium bonus of 7% of your premiums paid in the first year only, which is subject to the premium

bonus vesting schedule listed below.

End of Policy year 1 2 3 4 5 6 7 8 9 10

Percentage 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

The premium bonus vesting schedule is the number of years over which the premium bonus and any interest

thereon vests and the percentage of the premium bonus and interest thereon that vests on policy

anniversaries each year during that period. Once any portion of the premium bonus and any interest thereon

vests, it becomes part of the vested account value available for surrender or withdrawal. Any unvested

premium bonus and any interest thereon are not available for surrender or withdrawal and is not part of the

surrender value (explained below).

Do I have access to my policy value before the Maturity Date (the date the Policy starts annuity

payments)?

Yes, Safe Income Plus provides access to the value of your Policy in several ways. However, any values

accessed during the first ten Policy years may also be subject to a surrender charge, a Market Value

Adjustment, and the premium bonus vesting schedule.

Penalty Free Withdrawal

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Safe Income Plus – Statement of Understanding INSURER: FIDELITY & GUARANTY LIFE INSURANCE COMPANY

ADV1624 (11-2015) Fidelity & Guaranty Life Insurance Company Des Moines, IA Rev 06-2018v2 18-0575

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Surrender charges and Market Value Adjustments will not apply to any penalty free withdrawal amounts,

required minimum distributions, or any payments received under the Terminal Illness Rider, Nursing Home

Rider and Home Health Care Rider (described below). Withdrawals from your annuity are taxable and may

result in a tax penalty for those under the age 59 ½. Please consult with a tax advisor prior to utilizing these

provisions.

In the first Policy year, all withdrawals will be subject to a surrender charge and Market Value Adjustment.

After the first Policy year, and prior to the end of the tenth Policy year, up to 10% of the vested account

value, as of the policy anniversary on the first day of that Policy year, is available without a surrender charge

and Market Value Adjustment. If you withdraw less than the penalty free withdrawal amount in any Policy

year, your penalty free withdrawal amount in future Policy years will not be increased. No surrender charge

or MVA will apply after the end of the 10th Policy year.

Any required minimum distribution under the Internal Revenue Code attributable to your Policy is part of and

is not in addition to the penalty free withdrawal amount. Please refer to the IRA Disclosure Statement for

additional information.

Penalty free withdrawal benefits under the Terminal Illness Rider

If you (as owner) meet all the conditions stated below and you become Terminally Ill (the owner has an illness or physical condition that results in having a life expectancy of 12 months or less), you may withdraw all or part of your vested account value without application of a surrender charge and Market Value Adjustment. If on full surrender, the minimum guaranteed surrender value is greater than the vested account value), the minimum guaranteed surrender value will be paid.

You qualify for this benefit if:

The Terminal Illness is diagnosed at least 1 year after the Policy's date of issue; and

Written proof of the Terminal Illness is received at our home office. This proof must include, but is not limited to, certification by a physician who provides medical care to you in connection with your Terminal Illness. We reserve the right to obtain a second medical certification, at our expense, from a physician selected by us.

There is no additional charge for this benefit.

Penalty free withdrawal benefits under the Nursing Home Rider

If you (as owner) meet all the conditions stated below and you become confined to a Nursing Home (a state-licensed, nursing long-term care facility that provides skilled, continuous nursing care or services under the supervision of a licensed nurse or physician), you may withdraw all or part of your vested account value if without application of a surrender charge and Market Value Adjustment. If on full surrender, the minimum guaranteed surrender value is greater than the vested account value, the minimum guaranteed surrender value will be paid.

You qualify for this benefit if:

Confinement to such Nursing Home first begins at least 1 year after the Policy's date of issue;

Confinement has continued for at least 60 consecutive days;

The surrender/withdrawal is made while you are confined; and

Written proof of confinement is received at our home office.

There is no additional charge for this benefit. The Nursing Home Rider is not available in Massachusetts.

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Safe Income Plus – Statement of Understanding INSURER: FIDELITY & GUARANTY LIFE INSURANCE COMPANY

ADV1624 (11-2015) Fidelity & Guaranty Life Insurance Company Des Moines, IA Rev 06-2018v2 18-0575

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Penalty free withdrawal benefits under the Home Health Care Rider

If any annuitant meets all the conditions stated below and a Physician certifies that he/she has an Impairment (cannot perform without the physical assistance of another person; or the presence of another person within arm’s reach to prevent, by physical intervention, injury to the annuitant while performing at least 2 out of 6 Activities of Daily Living as defined below) that requires need for Home Health Care Services (defined below), you may withdraw all or part of your vested account value without application of a surrender charge and Market Value Adjustment. If on full surrender, the minimum guaranteed surrender value is greater than the vested account value, the minimum guaranteed surrender value will be paid.

The 6 Activities of Daily Living are:

Bathing: washing oneself by sponge bath or in either a tub or shower, including the tasks of getting into or out of the shower;

Dressing: putting on and taking off all items of clothing and any required braces, fasteners, or artificial limbs;

Transferring: moving into and out of a bed, chair or wheelchair;

Toileting: getting to and from the toilet, getting on and off the toilet and performing related personal hygiene;

Continence: ability to maintain control of bowel or bladder function or, when not able to maintain control of bowel or bladder function, ability to perform related personal hygiene (including caring for catheter or colostomy bag);

Eating; feeding oneself by getting food into the body from a receptacle (such as a cup, plate, or table) or by feeding tube or intravenously.

Home Health Care Services means nursing care received in the annuitant’s residence from a licensed Home

Health Care Agency. Home Health Care Services includes, but is not limited to, part-time and intermittent

skilled nursing services, home health aide services, physical therapy, occupational therapy, or speech

therapy and audiology services, and medical social services by a social worker. Home Health Care Services

must be required due to Impairment in at least 2 of the 6 Activities of Daily Living.

The annuitant qualifies for the benefit if:

Home HealthCare Services begin at least 1 year after the Policy date of issue;

Impairment in at least 2 of the 6 Activities of Daily Living has continued for at least 60 consecutive days;

The surrender/withdrawal is made while the annuitant is receiving Home Health Care Services;

Satisfactory written proof is received, at our Home Office, that the annuitant is unable to perform, at least 2 of the 6 Activities of Daily Living and that the annuitant’s impairment requires the need for Home Health Care Services; and

Impairment is expected to last 90 days from the date of request.

There is no additional charge for this benefit.

What is the death benefit?

If the owner dies before the Maturity Date, the ownership of the Policy passes to the person(s) living in the

order as follows:

Surviving joint owner, if any;

Beneficiary

Contingent beneficiary

Estate of the last owner to die.

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Safe Income Plus – Statement of Understanding INSURER: FIDELITY & GUARANTY LIFE INSURANCE COMPANY

ADV1624 (11-2015) Fidelity & Guaranty Life Insurance Company Des Moines, IA Rev 06-2018v2 18-0575

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If a spousal continuation does not apply or is not invoked, the Policy must be fully surrendered and receive a

distribution of the entire proceeds within 5 years of the owner’s death except that a non-spouse may elect to

begin receiving payments with respect to his or her proportionate share within 1 year from the date of the

death provided such payments are distributed over the life or a period not to exceed the life expectancy of

such person. No surrender charge and Market Value Adjustment will be deducted and the vesting bonus will

fully vest. The surrender value will equal the total account value. If the minimum guaranteed surrender

value is greater than the total account value, the minimum guaranteed surrender value will be paid.

A partial index interest credit, if any, will be calculated and credited under applicable indexed interest

crediting options as if the date of death was on an index crediting date. After performing such calculation

and crediting any applicable index interest credits, all index interest crediting will stop, and the fixed interest

option rate will apply until the date of full surrender.

If the spouse of the first owner to die elects to continue the policy, surrender charges, Market Value

Adjustment, and premium bonus vesting schedule will continue to apply. Additionally, no partial index

interest credit calculation will occur.

What happens on the Policy’s Maturity Date?

On the Policy’s Maturity Date, you will receive the entire value of your Policy in the form of annuity

payments. There are a number of payout options from which to select. Regardless of the payout option

selected, once the amount of the payments is determined, your payments are guaranteed and can never be

changed. You should review the available payout options with your tax advisor to select the most appropriate

one based on your financial situation.

What if I decide to surrender (cancel) my Policy prior to the Maturity Date?

Prior to the Maturity Date, you may decide to surrender your Policy. If you elect to do this, the Company will

pay you the Policy’s surrender value. The surrender value is equal to the greater of the following values:

The vested account value, less any applicable surrender charges, plus/minus any applicable Market Value Adjustment; or

The total minimum guaranteed surrender value. A minimum guaranteed surrender value (MGSV) is the minimum amount you will receive if you surrender in full.

At any time before the Maturity Date, the minimum guaranteed surrender value equals the sum of the following:

87.5% of the premiums; plus

Interest credited daily at the MGSV Accumulation Interest Rate shown on the Policy information page; less

Any amounts previously surrendered from the minimum guaranteed surrender value accumulated at the MGSV Accumulation Interest Rate

What is a surrender charge? A surrender charge is the cost you incur if the Policy is surrendered or if any amount withdrawn exceeds the

penalty free withdrawal amount during the period the surrender charge schedule is in effect. The surrender

charge on these amounts is applied at the time of the surrender or withdrawal. Any amount withdrawn above

the penalty free withdrawal amount will be multiplied by the applicable percentages below, which determines

the amount of the surrender charge.

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Safe Income Plus – Statement of Understanding INSURER: FIDELITY & GUARANTY LIFE INSURANCE COMPANY

ADV1624 (11-2015) Fidelity & Guaranty Life Insurance Company Des Moines, IA Rev 06-2018v2 18-0575

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Surrender Charge Schedule

Policy year 1 2 3 4 5 6 7 8 9 10 11+

Percentage 12% 11% 10% 9% 8% 7% 6% 5% 4% 3% 0%

The following states follow an alternate surrender charge schedule: California, Delaware, Massachusetts,

Nevada, New Jersey, Ohio, Oklahoma, South Carolina, Texas and Utah. For these states, the surrender

charge schedule is: 9%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, 0%

For Texas, surrender charges are waived for annuitization. Surrender charges are assessed for full

surrenders.

If you surrender the Policy before the end of the 10th Policy year, you may receive less than your

premium.

The following chart shows hypothetical surrender charges to demonstrate sample surrender charges for the

Safe Income Plus product.

Policy Year

Hypothetical Vested Account Value

Penalty Free

Withdrawal

Surrender Charge

Percentage* Surrender

Charge

(1) Vested Account

Value less Surrender

Charge

(2) Minimum Guaranteed Surrender

Value

Surrender Value =

Greater of (1) and

(2)**

1 100,000 0 12% 12,000 88,000 87,500 88,000

5 104,000 10,000 8% 7,520 96,480 91,053 96,480

10 110,000 11,000 3% 2,970 107,030 95,697 107,030

20 150,000 150,000 0% 0 150,000 105,710 150,000 *Surrender Charge Percentages are based on a hypothetical Surrender Charge Schedule. Refer to your contract for the surrender charge percentage applicable each policy year. **The Surrender Value in this example does not account for any applicable Market Value Adjustment. Application of a Market Value Adjustment may increase or decrease the Surrender Value. Refer to your contract for Market Value Adjustment details.

What is a Market Value Adjustment?

A Market Value Adjustment (MVA) is an adjustment made during the time the surrender charge schedule is

in effect to the portion of the account value, withdrawn or applied to an annuity option that exceeds the

penalty free withdrawal amount. The MVA is in addition to the applicable surrender charge amount. The

MVA may increase or decrease the amount of the withdrawal or the surrender value depending on the

change in interest rates since you purchased your annuity. Generally, if interest rates have risen since you

purchased your annuity, the MVA will decrease your surrender value; and if interest rates have fallen, the

MVA will increase your surrender value. The net total of all MVA and surrender charges will not reduce the

surrender value to an amount which is less than the minimum guaranteed surrender value. If the MVA

results in an increase to the surrender value, the amount of the increase will not be greater than the amount

of the remaining surrender charge.

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ADV1624 (11-2015) Fidelity & Guaranty Life Insurance Company Des Moines, IA Rev 06-2018v2 18-0575

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The MVA is based on a formula that takes into account changes in yields of the U.S. Treasury Constant

Maturity Series between the date of Policy issue and the date of the withdrawal. We multiply the amount of

the account value withdrawn or applied to an annuity option that is subject to the MVA by the Market Value

Adjustment Factor. The Market Value Adjustment Factor is equal to:

, where:

* A and B are index rates based on the Treasury Constant Maturity Series (10 year maturity) published by the Federal Reserve;

* A is the index rate determined as of the Policy date of issue; * B is the index rate determined as of the date we process the surrender or

annuitization request; and * N is the number of months remaining to the end of the surrender charge

schedule, rounded up to the next higher number of months.

The net total of all MVA and surrender charges will not reduce the surrender value to an amount which is

less than the minimum guaranteed surrender value.

A positive MVA will decrease the surrender value, and a negative MVA will increase the surrender value.

For Policies issued in Delaware, Indiana and Ohio only, the MVA, positive or negative, will not exceed the

remaining surrender charge; the maximum increase or decrease to the otherwise payable surrender value

will be an amount equal to the remaining surrender charge.

In the states of Indiana and Ohio, the .0025 factor in the MVA Formula in the above example does not apply.

The following are examples of both a negative and a positive Market Value Adjustment:

TCM (Treasury Constant Maturity) Rate Decreases from 3.00% to 2.00%

TCM rate at Issue (A) 3.00% Premium 100,000.00 Surrender Charge Lengths (months) 120 TCM rate at surrender (B) 2.00% Number of months remaining (N) 96 Vested Account Value Surrendered 110,000.00 Free Withdrawal Allowed 11,000.00 Surrender Amount subject to charges 99,000.00 Surrender Charge Percentage 10.00% Surrender Charge 9,900.00 MVA Percentage 1-[(1+A)/(1+B+.0025)]N/12 -6.02% Amount Subject to Market Value Adjustment 99,000.00 Market Value Adjustment -5,960.64 ------------------------------------------------------------------------------------- Vested AV Surrendered 110,000.00 Surrender Charge 9,900.00 MVA -5,960.64 ------------------------------------------------------------------------------------- Surrender Value 106,060.64

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Safe Income Plus – Statement of Understanding INSURER: FIDELITY & GUARANTY LIFE INSURANCE COMPANY

ADV1624 (11-2015) Fidelity & Guaranty Life Insurance Company Des Moines, IA Rev 06-2018v2 18-0575

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TCM Rate Increases from 3.00% to 4.00%

TCM rate at Issue (A) 3.00% Premium 100,000.00 Surrender Charge Lengths (months) 120 TCM rate at surrender (B) 4.00% Number of months remaining (N) 96 Vested Account Value Surrendered 110,000.00 Free Withdrawal Allowed 11,000.00 Surrender Amount subject to charges 99,000.00 Surrender Charge Percentage 10.00% Surrender Charge 9,900.00 MVA Percentage 1-[(1+A)/(1+B+.0025)]N/12 9.20% Amount Subject to Market Value Adjustment 99,000.00 Market Value Adjustment 9,107.29 ------------------------------------------------------------------------------------- Vested AV Surrendered 110,000.00 Surrender Charge 9,900.00 MVA 9,107.29 ------------------------------------------------------------------------------------- Surrender Value 90,992.71

What information should I know about the Enhanced Guaranteed Minimum Withdrawal Benefit

(EGMWB) Rider?

For the EGMWB Rider, the owner and annuitant must be the same unless the owner is a non-natural person.

Additionally, joint annuitants must be spouses. No annuitant may be changed or added after the Withdrawal

Period (discussed below) begins. If the owner is a non-natural person, no annuitant may be changed except

as provided under the spousal continuation provisions.

Subject to certain limitations and conditions, the EGMWB Rider provides you with the ability to receive

guaranteed withdrawal benefits for your life (or the lives of you and your spouse) or where the owner is a

non-natural person, the life of the annuitant (or joint annuitant). This benefit is called the Guaranteed

Withdrawal Payment.

How much does the EGMWB Rider cost?

The initial charge for the EGMWB Rider is 1.05% of the Income Base (described below) deducted from the

account value on each policy anniversary. If you elect Restart (described below), the charge may change.

The rider charge rate is guaranteed to be no greater than 1.50%.

What are the two periods under the EGMWB Rider?

The two periods under the EGMWB Rider are:

Accumulation Period

The Accumulation Period is the period of time prior to the first Guaranteed Withdrawal Payment. The

Accumulation Period begins on the Policy’s issue date and ends the date Guaranteed Withdrawal

Payments commence.

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During the Accumulation Period, you may elect to start receiving Guaranteed Withdrawal Payments

at any time after first Policy year and the annuitant has attained age 50 (younger annuitant in the

case of joint annuitants).

If during the Accumulation Period, your vested account value is depleted to zero due to a withdrawal,

the Policy will terminate.

Withdrawal Period

The Withdrawal Period occurs when you are taking Guaranteed Withdrawal Payments (or Enhanced

Guaranteed Withdrawal Payments, if applicable) (described below). If during the Withdrawal Period

an Excess Withdrawal (explained below) reduces your vested account value to zero, the Policy will

terminate.

No additional premium will be accepted after the Withdrawal Period commences.

What is the Income Base?

The Income Base is used only to determine the Guaranteed Withdrawal Payment and the EGMWB Rider

Charge. The Income Base is not part of the Policy’s account value and is not used to determine the Policy’s

surrender value. The Income Base is not a value that can be surrendered or withdrawn.

How does the value of the Income Base grow?

The Income Base is equal to the greater than the following:

Initial premium plus any applicable Income Base Bonus; or

Premiums paid in Policy year one (1) plus the premium bonus, growing up to the earlier of

ten (10) years or age 85 or the Withdrawal Period begins, with compound interest at the

Roll-up-Rate shown on your Policy information page.

The Income Base Bonus is a percentage of the initial premium and is shown on the Policy information page.

The time during which the Income Base grows above is referred to as the “roll-up period,” and the rate at

which the Income Base grows is referred to as the “Roll-up Rate.” The Roll-up Rate for the initial roll-up

period is 7.50%. Upon Restart, the Roll-up Rate may change. The Roll-up Rate will never be less than

2.00%.

It is important to note that the Income Base will be reduced proportionally for withdrawals of any

type during the Accumulation Period. In the Withdrawal Period, the Income Base is only reduced by

Excess Withdrawals as explained below.

What is Restart?

After five (5) Policy years, provided the owner is not older than age 85 and during the initial ten (10) year roll-up period, the Owner may elect to start a new ten (10) year roll-up period. Upon Restart, if the vested account value is greater than the Income Base, the Income Base is increased to equal the vested account value. Restart must occur on a policy anniversary while the Policy is in the Accumulation Period.

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What is Step-up?

Step-up occurs when the Income Base is increased to the vested account value. The Step-up is automatic and is available on the day the Withdrawal Period begins and on each policy anniversary during the Withdrawal Period. At Step-up the Guaranteed Withdrawal Payment (or Enhanced Guaranteed Withdrawal Payment, if applicable) is recalculated and equals the stepped-up Income Base multiplied by the Guaranteed Withdrawal Percentage. At the time of Step-up, the Guaranteed Withdrawal Percentage will be based in the annuitant’s age (younger annuitant in the case of joint annuitants) at the time of the Step-up.

How is the Income Base reduced for withdrawals?

The Income Base during the Accumulation Period will be reduced proportionally for any withdrawals. The

Income Base after a withdrawal will equal the Income Base prior to the withdrawal multiplied by the partial

withdrawal adjustment. The partial withdrawal adjustment equals the ratio of the vested account value

immediately after the partial withdrawal to the vested account value immediately before the partial

withdrawal. If during the Accumulation Period the vested account value equals zero, the Income Base will

also equal zero, and the Policy will terminate.

The Income Base and Guaranteed Withdrawal Payments (or Enhanced Guaranteed Withdrawal Payments, if

applicable) will be reduced by Excess Withdrawals (explained below) in the Withdrawal Period. If during the

Withdrawal Period the vested account value is reduced to zero due to an Excess Withdrawal, the

Guaranteed Withdrawal Payment (or Enhanced Guaranteed Withdrawal Payments, if applicable) will also be

reduced to zero and the Policy will terminate.

How is the Guaranteed Withdrawal Payment calculated?

At the beginning of the Withdrawal Period, the Guaranteed Withdrawal Payment is equal to the applicable

(single withdrawal payments or joint withdrawal payments) Guaranteed Withdrawal Percentage multiplied by

the Income Base. The applicable Guaranteed Withdrawal Percentages are shown in the tables below.

Withdrawal Payments may be stopped and then restarted again at any time during the Withdrawal Period.

Stopping Withdrawal Payments, however, does not restart the Accumulation Period. Any unused portion of

the Guaranteed Withdrawal Payment amount in a Policy year cannot be carried over to any subsequent

Policy year.

The Guaranteed Withdrawal Payment is guaranteed to be paid for the applicable lifetime(s) provided no

Excess Withdrawal is taken and a life only annuity payout option is elected at maturity.

It is important to note that Excess Withdrawals in the Withdrawal Period will reduce the Guaranteed

Withdrawal Payment.

It is also important to note that the Guaranteed Withdrawal Payment may be subject to surrender

charges and any applicable Market Value Adjustment.

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What are the Guaranteed Withdrawal Percentages?

Attained Age

Payout Percentage SINGLE Annuitant

Payout Percentage JOINT Annuitant

Attained Age

Payout Percentage SINGLE Annuitant

Payout Percentage JOINT Annuitant

0-49 0.00% 0.00% 75 6.43% 5.73%

50 2.90% 2.20% 76 6.54% 5.84%

51 2.95% 2.25% 77 6.65% 5.95%

52 3.05% 2.35% 78 6.76% 6.06%

53 3.15% 2.45% 79 6.87% 6.17%

54 3.25% 2.55% 80 6.98% 6.28%

55 3.35% 2.65% 81 7.09% 6.39%

56 3.50% 2.80% 82 7.20% 6.50%

57 3.65% 2.95% 83 7.31% 6.61%

58 3.75% 3.05% 84 7.42% 6.72%

59 3.85% 3.15% 85 7.53% 6.83%

60 4.00% 3.30% 86 7.64% 6.94%

61 4.10% 3.40% 87 7.75% 7.05%

62 4.60% 3.90% 88 7.86% 7.16%

63 4.80% 4.10% 89 7.97% 7.27%

64 5.15% 4.45% 90 8.08% 7.38%

65 5.20% 4.50% 91 8.08% 7.38%

66 5.25% 4.55% 92 8.08% 7.38%

67 5.35% 4.65% 93 8.08% 7.38%

68 5.45% 4.75% 94 8.08% 7.38%

69 5.55% 4.85% 95 8.08% 7.38%

70 5.63% 4.93% 96 8.08% 7.38%

71 5.65% 4.95% 97 8.08% 7.38%

72 5.70% 5.00% 98 8.08% 7.38%

73 5.75% 5.05% 99 8.08% 7.38%

74 5.80% 5.10% 100 8.08% 7.38%

Payout percentages vary by age. Please review your policy for details.

Will my Guaranteed Withdrawal Payment ever increase after it is established?

The Guaranteed Withdrawal Payment will never increase after it is established, unless there is a Step-up. If

there is a Step-up, the Guaranteed Withdrawal Payment is recalculated and equals the stepped-up Income

Base multiplied by the Guaranteed Withdrawal Percentage based on the annuitant (younger annuitant in the

case of joint annuitants) at the time of the Step-up.

Will my Guaranteed Withdrawal Payment ever decrease after it is established?

Yes, if an Excess Withdrawal is taken.

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What is an Excess Withdrawal and what happens if I take an Excess Withdrawal?

During the Withdrawal Period, an Excess Withdrawal is any amount withdrawn over the Guaranteed

Withdrawal Payment (or Enhanced Guaranteed Withdrawal Payment, if applicable) available for that Policy

year.

The Income Base and the Guaranteed Withdrawal Payment (or Enhanced Guaranteed Withdrawal Payment,

if applicable) are reduced due to Excess Withdrawals. The reduced Guaranteed Withdrawal Payment (or

Enhanced Guaranteed Withdrawal Payment, if applicable) will equal the Guaranteed Withdrawal Payment

(or Enhanced Guaranteed Withdrawal Payment, if applicable) prior to the Excess Withdrawal multiplied by

the difference of one and the reduction percentage. The reduction percentage equals the ratio of the Excess

Withdrawal to the vested account value before the Excess Withdrawal.

If an Excess Withdrawal reduces the vested account value to zero, the Guaranteed Withdrawal

Payment (or Enhanced Guaranteed Withdrawal Payment, if applicable) and the Income Base will also

be reduced to zero and the Policy will terminate.

Examples of Excess Withdrawals:

Year

Vested Account Value

before Withdrawals

Annual Guaranteed Withdrawal Payment

before Excess Withdrawal

Excess Withdrawal*

Annual Guaranteed Withdrawal Payment

after Excess Withdrawal

5 120,000 7,500 10,000 6,833

10 89,000 7,500 10,000 6,580

20 20,000 7,500 10,000 1,500

*Excess Withdrawal is in addition to the annual Guaranteed Withdrawal Payment.

This table demonstrates the impact of an Excess Withdrawal on the Guaranteed Withdrawal Payment. When an Excess Withdrawal is taken, the Guaranteed Withdrawal Payment amount is reduced in the same proportion that the vested Account Value immediately prior to the Excess Withdrawal is reduced. See your policy for specific terms. This example is not intended to reflect the exact values of any one policy; rather, it is only intended to demonstrate how Excess Withdrawals can impact future income.

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What is the Enhanced Benefit (Enhanced Guaranteed Withdrawal Payment)?

You qualify for the Enhanced Benefit if:

Impairment (related to the Activities of Daily Living below) begins at least one (1) year after the

Policy date of issue;

The EGMWB Rider has been in force for three (3) years and the annuitant has attained age 60;

No premiums may have been paid into the Policy for at least three (3) years prior to the request for

the Enhanced Benefit;

The annuitant is a U.S. resident on the date we approve the benefit;

Satisfactory written proof is received, at our home office, that the annuitant is unable to perform, at

least two (2) of the six (6) Activities of Daily Living and that the annuitant’s impairment requires an

appropriately licensed professional to provide care related to the Impairment;

And the situation is expected to be permanent.

If you are receiving Guaranteed Withdrawal Payments, upon meeting the eligibility criteria of the Enhanced

Benefit, your payment amounts will change to the Enhanced Guaranteed Withdrawal Payment. The

Enhanced Guaranteed Withdrawal Payment is calculated by multiplying the Guaranteed Withdrawal

Payment by 2 for single annuitant policies and by 1.5 for joint annuitant policies.

We will require a written request for the Enhanced Benefit. A written request for the Enhanced Benefit must

be accompanied by documentation from the annuitant’s attending physician providing sufficient detail as to

the annuitant’s impairment.

We reserve the right to request documentation, as least annually, from the annuitant’s attending physician of

the annuitant’s continued inability to perform two (2) of six (6) Activities of Daily Living, which are defined

next.

Activities of Daily Living:

Bathing: washing oneself by sponge bath or in either a tub or shower, including the tasks of getting into or out of the shower;

Dressing: putting on and taking off all items of clothing and any required braces, fasteners, or artificial limbs;

Transferring: moving into and out of a bed, chair or wheelchair;

Toileting: getting to and from the toilet, getting on and off the toilet and performing related personal hygiene;

Continence: ability to maintain control of bowel or bladder function or, when not able to maintain control of bowel or bladder function, ability to perform related personal hygiene (including caring for catheter or colostomy bag);

Eating; feeding oneself by getting food into the body from a receptacle (such as a cup, plate, or table) or by feeding tube or intravenously.

Can my spouse continue this Policy?

If the surviving spouse of the deceased owner (or the deceased annuitant if the owner is a non-natural person) becomes the sole owner and the sole annuitant and elects to continue the Policy, the following will apply:

If the Policy is in the Accumulation Period at the time of the spousal continuation, the Policy will continue in the Accumulation Period. If the Policy then later enters the Withdrawal Period, the Guaranteed Withdrawal Payments will be based on the life of the surviving spouse.

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If the Policy is in the Withdrawal Period at or prior to the time of spousal continuation, the surviving spouse will continue to receive Guaranteed Withdrawal Payments if they were based, in part, on the life of the surviving spouse. If the Withdrawal Payments were based solely on the life of the deceased spouse then the EGMWB Rider will terminate and the base annuity Death Benefit provision will apply.

Spousal continuation can only apply once. It cannot apply a second time if the surviving spouse continues the Policy, remarries and then dies. Can I terminate the EGMWB Rider? For all states except Texas, you may only terminate the EGMWB Rider after it has been in effect for at least 10 years. Texas policies can terminate the EGMWB rider at any time. If you terminate it, the rider charges will cease.

The EGMWB Rider will terminate on the earliest of:

Policy termination;

Your request if made after the EGMWB rider has been in force at least 10 years (Texas polices can make this request at any point);

Annuitization;

Receipt of due proof of death of the first owner to die (or death of any annuitant if a non-natural; or person owner) except as provided under spousal continuation.

Are there any tax consequences if I take withdrawals from my Policy?

Income tax on interest credited to an annuity is deferred until withdrawals are taken. When you surrender, take a withdrawal from your Policy, or take a Guaranteed Withdrawal Payment or Enhanced Guaranteed Withdrawal Payment, if applicable, from your Policy, you may be subject to federal and state income tax on a portion or the entire amount withdrawn. In addition to income tax, you may be subject to a 10% federal penalty tax before age 59 ½. When annuity payments are elected, a portion of each payment will be taxable and a portion will be treated as a non-taxable return of the Policy’s cost basis. Distributions from a qualified annuity (e.g. IRA, 401(k), etc.) may also be taxable. You should consult with a tax advisor or attorney regarding the applicability of this information to your own situation. How is the insurance producer compensated?

The insurance producer earns a commission from the Company for each Policy sold. In addition to the commission paid to the insurance producer, override commissions or compensation will also be paid to agencies and/or independent marketing organizations (IMOs), which assist in the recruiting and training of selling producers. All commission or compensation will be paid by the Company, agency and/or IMO and will not be deducted from the premium paid for the Policy. In addition to such compensation and commissions, the Company, agency and/or IMO may provide education, training or other services including but not limited to meals and entertainment events, as non-cash compensation to the insurance producer. The Company

may also provide the same to the agency or IMO. Additionally, if your agent meets certain sales production goals, your agent may qualify to participate in a deferred compensation or retirement saving program as well

as receive errors and omission coverage through the Company. With respect to sales of annuity products

that are not tax-qualified only, in the event certain sales volumes levels are met, insurance producers will

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receive additional compensation, as well as non-cash compensation including but not limited to prizes, trips

and entertainment events from the Company, agency and/or IMO as a reward for achieving those sales

volumes. If an agency or IMO meets certain sales production goals, it may receive additional compensation

from the Company. With respect to sales of annuity products that are not tax-qualified only, in the event

certain sales volumes levels are met, agencies or IMOs will receive additional non-cash compensation

including but not limited to prizes, trips and entertainment events from the Company as a reward for

achieving those sales volumes. Commissions and other compensation items impact pricing, including

interest rates, cap rates and premium bonuses and may place limitations on access to your funds, such as

surrender charges (including the premium bonus vesting schedule, if applicable).

What other important information should I know about my Policy?

The guarantees provided by annuities are subject to the stability and claims paying ability of Fidelity

& Guaranty Life Insurance Company and are NOT FDIC insured, are subject to investment risks,

including interest-rate risk, and may experience loss of principal.

If this annuity is being purchased to replace an existing life insurance policy or annuity policy, you

should compare the two products carefully. You should consider any surrender charges and/or

market value adjustments and/or premium bonus vesting schedules or recapture charges that may

be incurred on the surrender of the existing policy.

Tax-deferral offers no additional value if the annuity is used to fund a qualified plan, such as an IRA

or 401k and may not be available if the owner of the annuity is not a natural person such as a

corporation or certain types of trusts.

It is within the Company’s sole discretion to set the interest rates, cap rates and participation rates

for this annuity, subject to any minimum or maximum guarantees contained in the Policy.

This product is offered on a group or individual basis as determined by state approval.

For group Policies, terms and conditions are set forth in the group certificate and master Policy and

are subject to the laws of the state in which they were issued.

Withdrawals in excess of the penalty free withdrawal amount may be subject to surrender charges

and Market Value Adjustments.

Past performance of a market index is not an indication of future performance.

The Company’s insurance producer may not make any statements that differ from what is stated in

this disclosure form or the applicable product brochure. No promises or assurances have been made

about the future values of any non-guaranteed elements of the annuity.

This Policy may be returned within the free look period (of no less than 20 days after you receive it)

for an unconditional refund if you are dissatisfied with the Policy for any reason.

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TERMS OF YOUR ANNUITY POLICY

Premium Bonus: Your annuity will receive a vesting premium bonus. The premium bonus is described in your annuity

Policy and summarized above under the heading “Does my Policy have a vesting premium bonus?”

Minimum Annual Interest Rate: For the fixed interest option, the interest rate can change each year and is guaranteed

never to be less than 1.00%.

Surrender Charge: Your annuity is subject to a surrender charge during the first 10 Policy years. A surrender charge is

the cost you incur on an amount surrendered or withdrawn that exceeds the penalty free withdrawal amount available

under your annuity. The surrender charge is described in your annuity and summarized above under the heading

“What if I decide to surrender (cancel) my Policy?” The surrender charge is applied at the time of the surrender or

withdrawal and is calculated by multiplying the applicable percentage shown in the table in the surrender charge

section by the amount withdrawn in excess of the penalty free withdrawal amount.

Market Value Adjustment: Your annuity is subject to a Market Value Adjustment during the first 10 Policy years. The

Market Value Adjustment is applied on an amount surrendered or withdrawn that exceeds the penalty free withdrawal

amount. The Market Value Adjustment is described in your annuity and summarized above under the heading “What

is a Market Value Adjustment?” The Market Value Adjustment may be positive or negative.

Disclosures:

“S&P 500®” is a trademark of The McGraw-Hill Companies, Inc. and has been licensed for use by Fidelity & Guaranty Life Insurance Company. Standard & Poor’s does not sponsor, endorse, promote, or make any representation regarding the advisability of purchasing the contract.

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Applicant Acknowledgement Form Instructions:

Please complete both Acknowledgements attached.

The entire Statement of Understanding and one copy of the

Acknowledgement are to be retained by the Applicant.

The second copy of the Acknowledgement is to be sent with

the application.

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Applicant Acknowledgement

By signing below, I acknowledge that I have read, or have been read this disclosure form and understand its contents. I have also

received and reviewed the information contained in the Safe Income Plus product brochure. I further understand that I have applied

for a Flexible Premium Fixed Indexed Deferred Annuity. In doing so, I have discussed my financial status, tax status, current

insurance products and investments (including my financial objectives) with my agent and believe this annuity will assist me in

meeting my current financial needs and objectives. I also confirm that I can complete without substantial assistance all six Activities

of Daily Living listed within this disclosure form. I also confirm that I have not been diagnosed with a Terminal Illness.

PLEASE CHECK TO INDICATE one of these 2 statements:

I currently reside in a nursing home facility or I currently DO NOT reside in a nursing home facility

Owner/Applicant Name (Please print) __________________________________________________

Owner/Applicant Signature___________________________________________________________

Phone #______________________________ Date_______________________________________

Joint Owner/Applicant Name (Please print)______________________________________________

Joint Owner/Applicant Signature_______________________________________________________

Phone #______________________________ Date________________________________________

Producer Confirmation

By signing below, I acknowledge that I have reviewed this disclosure form and the Safe Income Plus product brochure with the

applicant. I certify that a copy of this disclosure form, the Safe Income Plus product brochure, the Buyer’s Guide (and the

Supplement-to-Buyer’s Guide for VT only), as well as any advertisements, all of which were approved by the Company, used in

connection with the sale of this annuity, have been provided to the applicant. I have not made any statements that differ from

what is stated in this disclosure form or the brochure and no promises or assurances have been made about the future value of

any non-guaranteed elements of the annuity. I acknowledge that I have carefully read and have complied with the Safe Income

Plus Product Training and understand the indexed annuity features and limitations.

Producer Name (Please print)_________________________________ Producer Number______________________

Producer Signature__________________________________________

Business Address____________________________________________ City, State, Zip________________________

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Applicant Acknowledgement

By signing below, I acknowledge that I have read, or have been read this disclosure form and understand its contents. I have also

received and reviewed the information contained in the Safe Income Plus product brochure. I further understand that I have applied

for a Flexible Premium Fixed Indexed Deferred Annuity. In doing so, I have discussed my financial status, tax status, current

insurance products and investments (including my financial objectives) with my agent and believe this annuity will assist me in

meeting my current financial needs and objectives. I also confirm that I can complete without substantial assistance all six Activities

of Daily Living listed within this disclosure form. I also confirm that I have not been diagnosed with a Terminal Illness.

PLEASE CHECK TO INDICATE one of these 2 statements:

I currently reside in a nursing home facility or I currently DO NOT reside in a nursing home facility

Owner/Applicant Name (Please print) __________________________________________________

Owner/Applicant Signature___________________________________________________________

Phone #______________________________ Date_______________________________________

Joint Owner/Applicant Name (Please print)______________________________________________

Joint Owner/Applicant Signature_______________________________________________________

Phone #______________________________ Date________________________________________

Producer Confirmation

By signing below, I acknowledge that I have reviewed this disclosure form and the Safe Income Plus product brochure with the

applicant. I certify that a copy of this disclosure form, the Safe Income Plus product brochure, the Buyer’s Guide (and the

Supplement-to-Buyer’s Guide for VT only), as well as any advertisements, all of which were approved by the Company, used in

connection with the sale of this annuity, have been provided to the applicant. I have not made any statements that differ from

what is stated in this disclosure form or the brochure and no promises or assurances have been made about the future value of

any non-guaranteed elements of the annuity. I acknowledge that I have carefully read and have complied with the Safe Income

Plus Product Training and understand the indexed annuity features and limitations.

Producer Name (Please print)_________________________________ Producer Number______________________

Producer Signature__________________________________________

Business Address____________________________________________ City, State, Zip________________________