| EIN |
95-1079000 |
| Industry Code |
67466 |
| Contract Number |
G-27351-1 |
| Contract Year |
01/01/2010 — 12/31/2010 |
| Value in General Account at Year End |
$0 |
| Value in Separate Accounts at Year End |
$0 |
| |
| |
| There are no brokers listed for this plan. |
|
| |
| 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 |
$11,762,700 |
|
Additions |
$5,055 |
| Contributions Deposited during the year |
$0 |
| Dividends and credits |
$0 |
| Interest credited during the year |
$5,055 |
| Transferred from separate account |
$0 |
| Other |
$0 |
|
| Total of Balance and Additions |
$11,767,755 |
|
Deductions |
$500,146 |
| Disbursed from fund to pay benefits or purchase annuities during the year |
$0 |
| Administration charge made by carrier |
$0 |
| Transferred to Separate Account |
$0 |
| Other |
$500,146 |
|
| Balance at the end of the current year |
$11,267,609 |
|
|
| EIN |
22-1211670 |
| Industry Code |
68241 |
| Contract Number |
062063211 |
| Contract Year |
01/01/2010 — 12/31/2010 |
| Value in General Account at Year End |
$0 |
| Value in Separate Accounts at Year End |
$0 |
| |
| |
| There are no brokers listed for this plan. |
|
| |
| 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 |
$5,986,965 |
|
Additions |
$61,407 |
| Contributions Deposited during the year |
$0 |
| Dividends and credits |
$0 |
| Interest credited during the year |
$61,407 |
| Transferred from separate account |
$0 |
| Other |
$0 |
|
| Total of Balance and Additions |
$6,048,372 |
|
Deductions |
$6,048,372 |
| Disbursed from fund to pay benefits or purchase annuities during the year |
$0 |
| Administration charge made by carrier |
$0 |
| Transferred to Separate Account |
$0 |
| Other |
$6,048,372 |
|
| Balance at the end of the current year |
$0 |
|
|
