| EIN |
84-0467907 |
| Industry Code |
68322 |
| Contract Number |
934556-01 |
| Contract Year |
01/01/2010 — 12/31/2010 |
| Value in General Account at Year End |
$142,677 |
| Value in Separate Accounts at Year End |
$827,405 |
| |
| |
| Agent/Broker |
Organization Code |
Commissions Paid |
Fees Paid |
Purpose of Fees Paid |
Neill,Allen,Simon
1218 Muirfield Pl
Houston,
TX
77055
|
Insurance Agent or Broker |
$1,156 |
$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 |
|
| Balance at the end of the previous year |
$197,954 |
|
Additions |
$38,797 |
| Contributions Deposited during the year |
$19,529 |
| Dividends and credits |
$0 |
| Interest credited during the year |
$4,840 |
| Transferred from separate account |
$14,266 |
| Other |
$162 |
|
| Total of Balance and Additions |
$236,751 |
|
Deductions |
$94,074 |
| Disbursed from fund to pay benefits or purchase annuities during the year |
$90,329 |
| Administration charge made by carrier |
$66 |
| Transferred to Separate Account |
$3,679 |
| Other |
$0 |
|
| Balance at the end of the current year |
$142,677 |
|
|
