| EIN |
71-0294708 |
| Industry Code |
86509 |
| Contract Number |
888890 |
| Contract Year |
01/01/2010 — 12/31/2010 |
| Value in General Account at Year End |
$2,740,335 |
| Value in Separate Accounts at Year End |
$11,396,931 |
| |
| |
| Agent/Broker |
Organization Code |
Commissions Paid |
Fees Paid |
Purpose of Fees Paid |
Tower Square Securities Inc.
300 Davidson Ave Fl 3
Somerset,
NJ
08873
|
Insurance Agent or Broker |
$29,438 |
$0 |
|
Axa Network LLC
4251 Crums Mill Rd
Harrisburg,
PA
17112
|
Insurance Agent or Broker |
$23,481 |
$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 ANNUITY CONTRACT
|
| Balance at the end of the previous year |
$2,408,182 |
|
Additions |
$690,135 |
| Contributions Deposited during the year |
$325,213 |
| Dividends and credits |
$0 |
| Interest credited during the year |
$74,519 |
| Transferred from separate account |
$231,513 |
| Other |
$58,890 |
|
| Total of Balance and Additions |
$3,098,317 |
|
Deductions |
$357,982 |
| Disbursed from fund to pay benefits or purchase annuities during the year |
$303,722 |
| Administration charge made by carrier |
$6,408 |
| Transferred to Separate Account |
$0 |
| Other |
$47,852 |
|
| Balance at the end of the current year |
$2,740,335 |
|
|
