| EIN |
01-0233346 |
| Industry Code |
65838 |
| Contract Number |
11490 |
| Contract Year |
01/01/2010 — 12/31/2010 |
| Value in General Account at Year End |
$542,267 |
| Value in Separate Accounts at Year End |
$39,642,498 |
| |
| |
| Agent/Broker |
Organization Code |
Commissions Paid |
Fees Paid |
Purpose of Fees Paid |
National Benefit Services
8523 South Redwood Road
West Jordan,
UT
84088
|
Third Party Administrator |
$17,366 |
$212,795 |
N/A |
David G Bartholomew
395 West 600 North
Lindon,
UT
84062
|
Agent or Broker other than Insurance |
$211,233 |
$0 |
N/A |
James B Mooring
395 West 600 North
Lindon,
UT
84062
|
Agent or Broker other than Insurance |
$19,941 |
$0 |
N/A |
|
| |
| 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 |
Guaranteed Investment
|
| Balance at the end of the previous year |
$430,838 |
|
Additions |
$166,605 |
| Contributions Deposited during the year |
$109,150 |
| Dividends and credits |
$0 |
| Interest credited during the year |
$8,855 |
| Transferred from separate account |
$36,618 |
| Other |
$11,982 |
|
| Total of Balance and Additions |
$597,443 |
|
Deductions |
$55,176 |
| Disbursed from fund to pay benefits or purchase annuities during the year |
$48,276 |
| Administration charge made by carrier |
$6,881 |
| Transferred to Separate Account |
$18 |
| Other |
$1 |
|
| Balance at the end of the current year |
$542,267 |
|
|
