| EIN |
31-4156830 |
| Industry Code |
66869 |
| Contract Number |
GAP-B2-HW19 |
| Contract Year |
07/01/2010 — 06/30/2011 |
| Value in General Account at Year End |
$717,786 |
| Value in Separate Accounts at Year End |
$0 |
| |
| |
| Agent/Broker |
Organization Code |
Commissions Paid |
Fees Paid |
Purpose of Fees Paid |
Joseph Bonasera
Summit Financial Corporation
Burlington,
MA
01803
|
|
$2,783 |
$696 |
ADMINISTRATION |
|
| |
| Type of Contract |
Unspecified |
| Basis of premium rates |
|
| Premiums paid to carrier |
$0 |
| Premiums due but unpaid at the end of the year |
$0 |
| If the carrier, service, or other organization incurred any specific costs in connection with the acquisition or retention of the contract or policy, enter amount |
$0 |
| Specify the nature of the costs |
|
|
| |
| Type of Contract |
Unspecified
|
| Balance at the end of the previous year |
$679,017 |
|
Additions |
$73,618 |
| Contributions Deposited during the year |
$36,676 |
| Dividends and credits |
$0 |
| Interest credited during the year |
$23,592 |
| Transferred from separate account |
$11,968 |
| Other |
$1,382 |
|
| Total of Balance and Additions |
$752,635 |
|
Deductions |
$34,849 |
| Disbursed from fund to pay benefits or purchase annuities during the year |
$29,490 |
| Administration charge made by carrier |
$0 |
| Transferred to Separate Account |
$5,359 |
| Other |
$0 |
|
| Balance at the end of the current year |
$717,786 |
|
|
