| EIN |
04-1590850 |
| Industry Code |
65935 |
| Contract Number |
RM 82546-1 |
| Contract Year |
01/01/2010 — 12/31/2010 |
| Value in General Account at Year End |
$0 |
| Value in Separate Accounts at Year End |
$12,847,016 |
| |
| |
| Agent/Broker |
Organization Code |
Commissions Paid |
Fees Paid |
Purpose of Fees Paid |
Charles Epstein
330 Whitney Ave Ste 610
Holyoke,
MA
01040
|
Insurance Agent or Broker |
$45,297 |
$0 |
|
Peter Novak
330 Whitney Ave Ste 600
Holyoke,
MA
01040
|
Insurance Agent or Broker |
$7,021 |
$0 |
|
Charles Epstein
330 Whitney Ave Ste 610
Holyoke,
MA
01040
|
Insurance Agent or Broker |
$5,704 |
$0 |
|
|
| |
| 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 |
GROUP DEFERRED ANNUITY
|
| Balance at the end of the previous year |
$2,744,121 |
|
Additions |
$2,563,367 |
| Contributions Deposited during the year |
$2,089,363 |
| Dividends and credits |
$0 |
| Interest credited during the year |
$86,842 |
| Transferred from separate account |
$0 |
| Other |
$387,162 |
|
| Total of Balance and Additions |
$5,307,488 |
|
Deductions |
$2,272,380 |
| Disbursed from fund to pay benefits or purchase annuities during the year |
$187,718 |
| Administration charge made by carrier |
$1,327 |
| Transferred to Separate Account |
$2,022,797 |
| Other |
$60,538 |
|
| Balance at the end of the current year |
$3,035,108 |
|
|
