| EIN |
13-1624203 |
| Industry Code |
69345 |
| Contract Number |
104653,104654 |
| Contract Year |
01/01/2010 — 12/31/2010 |
| Value in General Account at Year End |
$21,098,474 |
| Value in Separate Accounts at Year End |
$32,438,877 |
| |
| |
| 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 |
$21,173,420 |
|
Additions |
$3,929,803 |
| Contributions Deposited during the year |
$741,587 |
| Dividends and credits |
$0 |
| Interest credited during the year |
$799,338 |
| Transferred from separate account |
$94,607 |
| Other |
$2,294,271 |
|
| Total of Balance and Additions |
$25,103,223 |
|
Deductions |
$4,004,749 |
| Disbursed from fund to pay benefits or purchase annuities during the year |
$1,761,120 |
| Administration charge made by carrier |
$0 |
| Transferred to Separate Account |
$0 |
| Other |
$2,243,629 |
|
| Balance at the end of the current year |
$21,098,474 |
|
|
| EIN |
41-1437943 |
| Industry Code |
97721 |
| Contract Number |
00000 |
| Contract Year |
01/01/2010 — 12/31/2010 |
| Value in General Account at Year End |
$102,992 |
| 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 |
$880,667 |
|
Additions |
$10,299 |
| Contributions Deposited during the year |
$0 |
| Dividends and credits |
$0 |
| Interest credited during the year |
$10,299 |
| Transferred from separate account |
$0 |
| Other |
$0 |
|
| Total of Balance and Additions |
$890,966 |
|
Deductions |
$787,974 |
| Disbursed from fund to pay benefits or purchase annuities during the year |
$0 |
| Administration charge made by carrier |
$6,116 |
| Transferred to Separate Account |
$781,858 |
| Other |
$0 |
|
| Balance at the end of the current year |
$102,992 |
|
|
