Form SEC 2125 SEC 2125 Form N-4

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

FORM N-4

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REGISTRATION STATEMENT UNDER THE SECURITIES ACT OF 1933
Pre-Effective Amendment No. _______
Post-Effective Amendment No. _______
and/or
REGISTRATION STATEMENT UNDER THE INVESTMENT COMPANY ACT OF 1940
Amendment No. ____
(Check appropriate box or boxes.)
____________________________________________________________________________________________________________________________________________________________
(Exact Name of Registrant)
____________________________________________________________________________________________________________________________________________________________
(Name of Depositor)
____________________________________________________________________________________________________________________________________________________________
(Address of Depositor’s Principal Executive Offices)
(Zip Code)
Depositor’s Telephone Number, including Area Code ________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________
(Name and Address of Agent for Service)
Approximate Date of Proposed Public Offering ________________________________________________________________________________
It is proposed that this filing will become effective (check appropriate box)
immediately upon filing pursuant to paragraph (b)
on (date) pursuant to paragraph (b)
60 days after filing pursuant to paragraph (a)(1)
on (date) pursuant to paragraph (a)(1).
If appropriate, check the following box:
this post-effective amendment designates a new effective date for a previously filed post-effective amendment.
Title of Securities Being Registered
Omit from the facing sheet reference to the other Act if the Registration Statement or amendment is filed under only one of the Acts.
Include the “Approximate Date of the Proposed Public Offering” and “Title of Securities Being Registered” only where securities are
being registered under the Securities Act of 1933.

Persons who respond to the collection of information contained in this form are not
required to respond unless the form displays a currently valid OMB control number.
SEC 2125 (8-06)

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GENERAL INSTRUCTIONS
A. Rule as to Use of Form N-4
Form N-4 shall be used by all separate accounts offering variable annuity contracts which are registered under the Investment
Company Act of 1940 (“1940 Act”) as unit investment trusts for: (1) an initial registration statement required by Section 8(b) of the 1940
Act [15 U.S.C. 80a-8(b)] and any amendments thereto; (2) a registration statement required under the Securities Act of 1933 (“1933
Act”) and any amendments thereto; or (3) any combination of these 1940 Act and 1933 Act filings.
Form N-4 shall also be used to file a registration statement under the 1933 Act and any amendments thereto for variable annuity
contracts funded by separate accounts which would be required to be registered under the 1940 Act as unit investment trusts except for
the exclusion provided by Section 3(c)(11) of the 1940 Act [15 U.S.C. 80a-3(c)(11)].
B. Registration Fees
Registration fees should not be paid when filing this form. See section 24(f) of the Investment Company Act and rule 24f-2
thereunder.
C. Number of Copies
Filings of registration statements on Form N-4 shall contain the number of copies specified in Securities Act Rule 402 [17 CFR
230.402], except that seven additional copies of the registration statement shall be furnished to the Commission, instead of the ten
additional copies required by Rule 402(b).
Filings of amendments on Form N-4 shall contain the number of copies specified in Securities Act Rule 472 [17 CFR 230.472],
except that there shall be filed with the Commission three additional copies of such amendment, two of which shall be marked to indicate
clearly and precisely, by underlining or in some other appropriate manner, the changes made in the registration statement by the
amendment, instead of the eight additional copies with at least five marked as required by Rule 472(a) [17 CFR 230.472(a)].
D. Special Terms
The following terms, when used in Form N-4, shall mean:
Registrant. The term “Registrant” means the separate account (as defined in Section 2(a)(37) of the 1940 Act [15 U.S.C. 80a2(a)(37)] which offers the variable annuity contracts.
Depositor. The term “depositor” means the person primarily responsible for the organization of the Registrant and the person who
has continuing functions or responsibilities with respect to the administration of the affairs of the Registrant other than the trustee or
custodian. The term includes the sponsoring insurance company that establishes and maintains the separate account. If there is more than
one such person the information called for in this Form about the depositor shall be provided for each such person.
Variable Annuity Contract. The term “variable annuity contract” means any accumulation contract or annuity contract, any portion
thereof, or any unit of interest or participation therein pursuant to which the value of the contract, either during an accumulation period
or after annuitization, or both, varies according to the investment experience of the separate account in which the contract participates.
Unless the context otherwise requires, the term refers to the variable annuity contracts being offered pursuant to the Registration
Statement prepared on this Form.
Contractowner Account. The term “contractowner account” means any account of a contractowner, participant, annuitant, or
beneficiary to which (net) purchase payments under a variable annuity contract are added and from which administrative or transaction
charges may be subtracted.
Portfolio Company. The term “portfolio company” means any company in which the Registrant invests.
E. Applications of General Rules and Regulations
If the registration statement is being filed under both the 1933 and 1940 Acts or under only the 1933 Act, the General Rules and
Regulations under the 1933 Act, particularly Regulation C [17 CFR 230.400-497], shall apply, and compliance with them will be deemed
to meet the rules for 1940 Act Registration Statements. However, if the registration statement is being filed only under the 1940 Act,
the General Rules and Regulations under that Act, particularly Regulation 8(b) [17 CFR 270.8b-l to 8b-32], shall apply, except as noted
in General Instruction F below.
F. Amendments
Where Form N-4 has been used to file a registration statement under both the 1933 and 1940 Acts, any amendment of that registration
statement shall be deemed to be filed under both Acts unless otherwise indicated on the facing sheet.

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G. Incorporation by Reference
A Registrant may, at its discretion, incorporate all or part of the Statement of Additional Information into the prospectus, without
physically delivering the Statement of Additional Information to investors with the prospectus. But the Statement of Additional
Information must be available to the investor upon request at no charge and any information or documents incorporated by reference
into the Statement of Additional Information must be provided along with the Statement of Additional Information.
Rule 411 under the 1933 Act [17 CFR 230.411], and rules 0-4, 8b-23, 8b-24, and 8b-32 under the 1940 Act [17 CFR 270.0-4, 270.8b23, 270.8b-24, and 270.8b-32] contain guidance on incorporating information or documents by reference into a registration statement
filed on Form N-4. In general, a Registrant may incorporate by reference, in the answer to any item of Form N-4 not required to be in
the prospectus, any information elsewhere in the registration statement or in other statements, applications, or reports filed with the
Commission.
The rules on incorporation by reference under both the 1933 Act and the 1940 Act are subject to the limitations of Rule 24 of the
Commission’s Rules of Practice [17 CFR 201.24]. Since Rule 24 may be amended from time to time, Registrants are advised to review
the rule prior to incorporating by reference any document as an exhibit to a registration statement.
H. Documents Comprising the Registration Statement or Amendment

I.

1.

A registration statement or an amendment to it filed under both the 1933 and 1940 Acts, except for an amendment described
in paragraph 5 below, shall consist of the facing sheet of the Form, the cross-reference sheet required by Rule 495(a) under the
1933 Act [17 CFR 230.495(a)], Part A, Part B, Part C, required signatures, all other documents filed as a part of the registration
statement, and documents or information permitted to be incorporated by reference, whether or not required to be filed.

2.

A registration statement or an amendment to it which is filed under only the 1933 Act shall contain all the information and
documents specified in paragraph 1 of this Instruction H.

3.

A registration statement or an amendment to it which is filed under only the 1940 Act shall consist of the facing sheet of the
Form, a cross-reference sheet, responses to all items of Part A and B except Items 1, 2, 8, and 9, responses to all items of Part
C except Items 21(b)(3), (9), (10), and (11), required signatures, and all other documents filed as part of the registration
statement.

4.

An amendment permitted by paragraph (d)(2) of Rule 485 under the 1933 Act [17 CFR 230.485], which is filed under paragraph
(b) of that rule to change the disclosure in an amendment filed under paragraph (a), shall consist of the facing sheet of the Form,
a cross-reference sheet, responses to any items of Part A, Part B, or Part C that are amended or supplemented by the amendment,
required signatures, and all other documents filed as part of the registration statement.

SEC’s Collection of Information

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a
currently valid control number. Filing of this Form is mandatory. The principal purpose of this collection of information is to enable
issuers to register Variable Annuity Contracts with the Commission. Any member of the public may direct to the Commission any
comments concerning the accuracy of the burden estimate of this Form, and any suggestions for reducing this burden. This collection
of information has been reviewed by the Office of Management and Budget in accordance with the clearance requirements of 44 U.S.C.
§ 3507. The responses to the collection of information will not be kept confidential.
J.

Preparation of the Registration Statement or Amendment

The instructions for Form N-4 are in three parts. Part A relates to the prospectus required by Section 10(a) of the 1933 Act; Part
B relates to the Statement of Additional Information that must be provided upon request to recipients of the prospectus; Part C relates
to other information that is required to be in the registration statement.
Part A: The Prospectus
The purpose of the prospectus is to provide essential information about the Registrant in a way that will help investors decide
whether to purchase the securities being offered. The prospectus should be clear, concise, and understandable. Avoid the use of technical
or legal terms, complex language, or excessive detail.
Responses to the items of Part A should be as simple and direct as possible and include only information needed to understand the
fundamental characteristics of the Registrant. Descriptions of practices that are required by law generally should not include detailed
discussions of the law itself.

Part B: Statements of Additional Information
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The items in Part B call for additional information about Registrant which is not required in the prospectus, but which may be of
interest to some investors. In addition, Part B gives Registrants an opportunity to provide information about matters that they believe
may interest investors.
Registrants should not repeat in Part B information that is in the prospectus, except where necessary to make Part B understandable.
General Instructions for Parts A and B
1. The information in the prospectus and Statement of Additional Information should be organized to make it easy to understand the
organization and operation of the Registrant and the variable annuity contracts. The information need not be in any particular order, with
the exception that Items 1, 2, 3, and 4(a) must be in numerical order in the prospectus and may not be preceded or separated by any other
item.
2. The prospectus or the Statement of Additional Information may contain more information than called for by this Form, provided
that the information is not incomplete, inaccurate, or misleading and does not, because of its nature, quantity, or manner of presentation,
obscure or impede understanding of required information. Specifically, Registrants are free to include in the prospectus financial
statements required to be in the Statement of Additional Information, and may include in the Statement of Additional Information
financial statements that may be placed in Part C.
3. The statutory provisions relating to the dating of the prospectus apply equally to the dating of the Statement of Additional
Information for purposes of Rule 423 under the 1933 Act [17 CFR 230.423]. Furthermore, the Statement of Additional Information
should be made available at the same time that the prospectus becomes available for purposes of Rules 430 and 460 under the 1933 Act
[17 CFR 230.430, 230.460].
4.

Instructions for charts, graphs, tables, and sales literature:
(a) A Registration Statement on this Form may include any chart, graph, or table that is not misleading; however, with the exception
of the fee table and the table of contents (required by Rule 481(c) [17 CFR 230.481(c)] under the 1933 Act), no chart, graph,
or table should precede the condensed financial information specified in Item 4(a).
(b) If “sales literature” is included in the prospectus, (1) the literature should not significantly lengthen the prospectus, and it should
not obscure essential disclosure and (2) members of the National Association of Securities Dealers, Inc. (NASD) are not
relieved of the filing and other requirements of the NASD for investment company sales literature (See Securities Act Release
No. 5359, January 26, 1973 [38 FR 7220 (March 19, 1973)]).
PART A
INFORMATION REQUIRED IN PROSPECTUS

Item 1. Cover Page
(a) The outside cover page must contain the following information:
(i)

the Registrant’s name;

(ii) the depositor’s name;
(iii) the types of variable annuity contracts offered by the prospectus (e.g., group, individual, single premium immediate,
flexible premium deferred);
(iv) any limitations on the class or classes of purchasers to whom the contract is being offered, in general terms;
(v)

a statement or statements that: (A) the prospectus sets forth the information about the Registrant that a prospective investor
ought to know before investing; (B) the prospectus should be kept for future reference; (C) additional information about
the Registrant has been filed with the Commission and is available upon written or oral request without charge (This
statement should explain how to obtain the Statement of Additional Information, whether any of it has been incorporated
by reference into the prospectus, and where the table of contents of the Statement of Additional Information appears in
the prospectus. If the Registrant intends to disseminate its prospectus electronically and is an electronic filer, also include
the information that the Commission maintains a web site (http://www.sec.gov) that contains the Statement of Additional
Information, material incorporated by reference, and other information regarding registrants that file electronically with
the Commission.);

(vi) the date of the prospectus, and the date of the Statement of Additional Information;
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(vii) the statement required by Rule 481(b)(1) under the 1933 Act [17 CFR 230.481(b)(1)];
(viii) the names of the portfolio companies;
(ix) such other information as is required by rules of the Commission or of any other governmental authority having
jurisdiction over the Registrant for the issuance of its securities.
(b) The cover page may include other information, if it does not, by its nature, quantity, or manner of presentation, impede
understanding of required information.
Item 2. Definitions
Define the special terms used in the prospectus (e.g., accumulation unit, contractowner, participant, sub-account, etc.) in a glossary.
In lieu of a glossary, Registrants may use an index of special terms that refers to the page on which each special term is defined.
Instruction:
Only special terms used throughout the prospectus must be defined or listed. If a special term, e.g., “net investment factor,” is used in
only one section of the prospectus, it may be defined there. However, all special terms used in the prospectus must be defined.
Item 3. Synopsis
(a) Include the following information, in plain English under rule 421(d) under the Securities Act [17 CFR 430.421(d)]:
The following tables describe the fees and expenses that you will pay when buying, owning, and surrendering the contract. The
first table describes the fees and expenses that you will pay at the time that you buy the contract, surrender the contract, or
transfer cash value between investment options. State premium taxes may also be deducted.
Contractowner Transaction Expenses
Sales Load Imposed on Purchases (as a percentage of purchase payments)
Deferred Sales Load (as a percentage of purchase payments or amount surrendered, as applicable)
Surrender Fees (as a percentage of amount surrendered, if applicable)
Exchange Fee

______%
______%
______%
______%

The next table describes the fees and expenses that you will pay periodically during the time that you own the contract, not
including [portfolio company] fees and expenses.
[Annual] Contract Fee
Separate Account Annual Expenses
(as a percentage of average account value)
Mortality and Expense Risk Fees
Account Fees and Expenses
Total Separate Account Annual Expenses

______
______%
______%
______%

The next item shows the minimum and maximum total operating expenses charged by the portfolio companies that you may pay
periodically during the time that you own the contract. More detail concerning each [portfolio company’s] fees and expenses
is contained in the prospectus for each [portfolio company].
Total Annual [Portfolio Company] Operating Expenses
(expenses that are deducted from [portfolio company]
assets, including management fees, distribution
[and/or service] (12b-1) fees, and other expenses)

Minimum
_______%

Maximum
—

________%

Example
This Example is intended to help you compare the cost of investing in the contract with the cost of investing in other variable
annuity contracts. These costs include contract owner transaction expenses, contract fees, separate account annual expenses,
and [portfolio company] fees and expenses.
The Example assumes that you invest $10,000 in the contract for the time periods indicated. The Example also assumes that your

5

investment has a 5% return each year and assumes the maximum fees and expenses of any of the [portfolio companies]. Although
your actual costs may be higher or lower, based on these assumptions, your costs would be:
(1) If you surrender your contract at the end of the applicable time period:
1 year
$_______

3 years
$_______

5 years
$_______

10 years
$_______

(2) If you annuitize at the end of the applicable time period:
1 year
$_______

3 years
$_______

5 years
$_______

10 years
$_______

5 years
$_______

10 years
$_______

(3) If you do not surrender your contract:
1 year
$_______
Instructions:

3 years
$_______

General Instructions

1. Include the narrative explanations in the order indicated. A Registrant may modify a narrative explanation if the explanation
contains comparable information to that shown.
2. Assume that the annuity contract is owned during the accumulation period for purposes of the table (including the Example). If an
annuitant would pay different fees or be subject to different expenses, disclose this in the brief narrative and provide a cross-reference
to those portions of the prospectus describing these fees.
3. A Registrant may omit captions if the Registrant does not charge the fees or expenses covered by the captions. A Registrant may
modify or add captions if the captions shown do not provide an accurate description of the Registrant’s fees and expenses.
4.

Round all dollar figures to the nearest dollar and all percentages to the nearest hundredth of one percent.

5. In the Contractowner Transaction Expenses, [Annual] Contract Fee, and Separate Account Annual Expenses tables, the Registrant
must disclose the maximum guaranteed charge, unless a specific instruction directs otherwise. The Registrant may disclose the current
charge, in addition to the maximum charge, if the disclosure of the current charge is no more prominent than, and does not obscure or
impede understanding of, the disclosure of the maximum charge. In addition, the Registrant may include in a footnote to the table a
tabular, narrative, or other presentation providing further detail regarding variations in the charge. For example, if deferred sales charges
decline over time, the Registrant may include in a footnote a presentation regarding the scheduled reductions in the deferred sales
charges.
6. Provide a separate fee table (or separate column within the table) for each contract form offered by the prospectus that has different
fees. If a Registrant uses one prospectus to offer a contract in both the group and individual variable annuity contract markets, the
Registrant may a) add narrative disclosure following the fee table identifying markets where certain fees are either inapplicable or
waived or lower fees charged to contractowners in group markets, or b) provide a separate fee table for group and individual contracts.
[Annual] Contract Fee
7.

“[Annual] Contract Fee” includes any contract, account, or similar fee imposed on all contractowner accounts on any recurring basis.
Contractowner Transaction Expenses

8. “Sales Load Imposed on Purchase Payments” includes the maximum sales load imposed upon purchase payments and may include
a tabular presentation, within the larger table, of the range of such sales loads.
9. “Deferred Sales Load” includes the maximum contingent deferred sales load, expressed as a percentage of the original purchase
price or amount surrendered, and may include a tabular presentation, within the larger table, of the range of contingent deferred sales
loads over time.
10. “Surrender Fee” includes any fee charged for any surrender or partial surrender, but does not include any sales load charged upon
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surrender or partial surrender.
11. “Exchange Fee” includes the maximum fee charged for any exchange or transfer of account value from the Registrant to another
investment company or from one sub-account of the Registrant to another sub-account or the insurance company’s general account. The
Registrant may include a tabular presentation of the range of exchange fees unless such a presentation would be so lengthy as to encumber
the larger table, in which case the Registrant should only provide a cross-reference to the narrative portion of the prospectus discussing
the exchange fee.
12. If the Registrant (or any other party pursuant to an agreement with the Registrant) charges any other transaction fee, add another
caption describing it and list the (maximum) amount or basis on which the fee is deducted.
Separate Account Annual Expenses
13. “Mortality and Expense Risk Fees” may be listed separately on two lines in the table.
14. “Account Fees and Expenses” include all fees and expenses (except sales loads and mortality and expense risk fees) that are
deducted from separate account assets or charged to all contractowner accounts. The Registrant may subdivide the caption into no more
than three subcategories of the Registrant’s choosing, but must also include a total of all “Other Account Fees.”
Portfolio Company Annual Expenses
15. If the Registrant (or any other party pursuant to an agreement with the Registrant) imposes any other recurring charge other than
annual portfolio company total operating expenses, add another caption describing it and list the (maximum) amount or basis on which
the charge is deducted.
Total Annual [Portfolio Company] Operating Expenses
16. “Management Fees” include investment advisory fees (including any component thereof based on the performance of the portfolio
company), any other management fees payable by the portfolio company to the investment advisor or its affiliates, and administrative
fees payable to the investment adviser or its affiliates not included as “Other Expenses.”
17. (a) If a Registrant has multiple sub-accounts, it should disclose the minimum and maximum “Total Annual [Portfolio Company]
Operating Expenses” for any portfolio company. “Total Annual [Portfolio Company] Operating Expenses” include all expenses that
are deducted from a portfolio company’s assets. The amount of expenses deducted from a portfolio company’s assets are the amounts
shown as expenses in the portfolio company’s statement of operations (including increases resulting from complying with paragraph
2(g) of rule 6-07 of Regulation S-X [17 CFR 210.6-07]). If any Portfolio Company invests in shares of one or more Acquired Funds,
“Total Annual [Portfolio Company] Operating Expenses” for the Portfolio Company must also include fees and expenses incurred
indirectly by the Portfolio Company as a result of investment in shares of one or more Acquired Funds, calculated in accordance with
Instruction 3(f) to Item 3 of Form N-1A (17 CFR 239.15A; 17 CFR 274.11A). For purposes of this paragraph, an Acquired Fund means
any company in which the Portfolio Company invests that (i) is an investment company or (ii) would be an investment company under
section 3(a) of the 1940 Act (15 U.S.C. 80a-3(a)) but for the exceptions to that definition provided for in sections 3(c)(1) and 3(c)(7)
of the 1940 Act (15 U.S.C. 80a3(c)(1) and 80a3(c)(7)).
(b) “Total Annual [Portfolio Company] Operating Expenses” do not include extraordinary expenses as determined under generally
accepted accounting principles (see Accounting Principles Board Opinion No. 30). If extraordinary expenses were incurred by any
portfolio company that would, if included, materially affect the minimum or maximum amounts shown in the table, disclose in a footnote
to the table what the minimum and maximum “Total Annual [Portfolio Company] Operating Expenses” would have been had the
extraordinary expenses been included.
18. (a) Base the percentages of “Total Annual [Portfolio Company] Operating Expenses” on amounts incurred during the most recent
fiscal year, but include in expenses amounts that would have been incurred absent expense reimbursement or fee waiver arrangements.
If a portfolio company has a fiscal year different from that of the Registrant, base the expenses on those incurred during either the period
that corresponds to the fiscal year of the Registrant, or the most recently completed fiscal year of the portfolio company. If the Registrant
or a portfolio company has changed its fiscal year and, as a result, the most recent fiscal year is less than three months, use the fiscal
year prior to the most recent fiscal year as the basis for determining “Total Annual [Portfolio Company] Operating Expenses.”
(b) If there have been any changes in “Total Annual [Portfolio Company] Operating Expenses” that would materially affect the
information disclosed in the table:

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(i)

Restate the expense information using the current fees as if they had been in effect during the previous fiscal year; and

(ii) In a footnote to the table, disclose that the expense information in the table has been restated to reflect current fees.
(c) A change in “Total Annual [Portfolio Company] Operating Expenses” means either an increase or a decrease in expenses that
occurred during the most recent fiscal year or that is expected to occur during the current fiscal year. A change in “Total Annual
[Portfolio Company] Operating Expenses” does not include a decrease in operating expenses as a percentage of assets due to economies
of scale or breakpoints in a fee arrangement resulting from an increase in a portfolio company’s assets.
19. A Registrant may reflect minimum and maximum actual total [portfolio company] operating expenses that include expense
reimbursement or fee waiver arrangements in a footnote to the table. If the Registrant provides this disclosure, also disclose the period
for which the expense reimbursement or fee waiver arrangement is expected to continue, or whether it can be terminated at any time at
the option of a portfolio company.
20. A Registrant may include additional tables showing annual operating expenses separately for each portfolio company immediately
following the required table of “Total Annual [Portfolio Company] Operating Expenses.” The additional tables should be prepared in
the format, and in accordance with the Instructions, prescribed in Item 3 of Form N-1A [17 CFR 239.15A; 17 CFR 274.11A] for
disclosing “Annual Fund Operating Expenses.”
Example
21. For purposes of the Example in the table:
(a) Assume that the percentage amounts listed under “Separate Account Annual Expenses” remain the same in each year of the 1, 3-, 5-, and 10-year periods, except that an adjustment may be made to reflect reduced annual expenses resulting from completion of
the amortization of initial organization expenses;
(b) Assume deduction of the maximum percentage amount of expenses shown under “Total Annual [Portfolio Company] Operating
Expenses,” and that this amount remains the same in each year of the 1-, 3-, 5-, and 10-year periods, except that an adjustment may be
made to reflect reduced annual expenses resulting from completion of the amortization of initial organization expenses. An additional
example that assumes deduction of the minimum percentage amount of expenses shown under “Total Annual [Portfolio Company]
Operating Expenses” may also be provided, immediately following the required expense example based on maximum portfolio company
expenses. In lieu of providing the required example based on maximum portfolio company expenses, a Registrant may include separate
expense examples based on the expenses of each portfolio company;
(c) Assume the maximum sales load that may be deducted from purchase payments is deducted;
(d) For any breakpoint in any fee, assume that the amount of the Registrant’s (and the portfolio company’s) assets remains constant
as of the level at the end of the most recently completed fiscal year;
(e) Assume no exchanges or other transactions;
(f) Reflect any [annual] contract fee by dividing the total amount of [annual] contract fees collected during the year that are
attributable to the contract offered by the prospectus by the total average net assets that are attributable to the contract offered by the
prospectus. Add the resulting percentage to “Separate Account Annual Expenses,” and assume that it remains the same in each year
of the 1-, 3-, 5-, and 10-year periods;
(g) Reflect any contingent deferred sales load by assuming a complete surrender on the last day of the year;
(h) Provide the information required in the third section of the Example only if a sales load or other fee is charged upon a complete
surrender; and
(i) Include in the Example the information provided by the caption “If you annuitize at the end of the applicable time period” only
if the Registrant charges fees upon annuitization that are different from those charged upon surrender.
22. New Registrants. For purposes of this Item, a “New Registrant” is a Registrant that does not include in Form N-4 financial statements
reporting operating results or that includes financial statements for the Registrant’s initial fiscal year reporting operating results for a
period of 6 months or less. The following Instructions apply to New Registrants:
(a) Base the percentages in “Total Annual [Portfolio Company] Operating Expenses” on payments that will be made, but include
in expenses amounts that will be incurred without reduction for expense reimbursement or fee waiver arrangements, estimating amounts
8

of expenses that are not established pursuant to contract. Disclose in a footnote to the table that “Total Annual [Portfolio Company]
Operating Expenses” are based, in part, on estimated amounts for the current fiscal year.
(b) A New Registrant may reflect in a footnote to the table expense reimbursement or fee waiver arrangements that are expected
to reduce the minimum and/or maximum total [portfolio company] operating expenses shown in the table. If the New Registrant provides
this disclosure, also disclose the period for which the expense reimbursement or fee waiver arrangement is expected to continue, or
whether it can be terminated at any time at the option of a portfolio company.
(c) Complete only the 1- and 3-year period portions of the Example, and estimate any [annual] contract fees collected.
Item 4. Condensed Financial Information
(a) Furnish the following information for each class of accumulation units of the Registrant.
ACCUMULATION UNIT VALUES
(for an accumulation unit outstanding throughout the period)
1. accumulation unit value at beginning of period;
2. accumulation unit value at end of period;
3. number of accumulation units outstanding at the end of period.
Instructions:
1. The above information must be provided for each class of accumulation units of the Registrant derived from contracts
offered by means of this prospectus and each class derived from contracts no longer offered for sale, but for which
registrant may continue to accept payments. Information need not be provided for any class of accumulation units of the
Registrant derived from contracts that are currently offered for sale by means of a different prospectus. Also, information
need not be provided for any class of accumulation units that is no longer offered for sale but for which Registrant may
continue to accept payments, if the information is provided in a different, but current prospectus of the Registrant.
2.

The information shall be presented in comparative columns for each of the last ten fiscal years of the Registrant (or for
life of the Registrant and its immediate predecessors, if less) but only from the later of the effective date of Registrant’s
or the relevant portfolio company’s first 1933 Act Registration Statement. In addition, the information shall be presented
for the period between the end of the latest fiscal year and the date of the latest balance sheet or statement of assets and
liabilities furnished.

3.

Accumulation unit amounts shall be given at least to the nearest cent. If the computation of the offering price is extended
to tenths of a cent or more, then the amounts on the table should be given in tenths of a cent.

4.

Accumulation unit values should only be given for sub-accounts that fund obligations of the Registrant under variable
annuity contracts offered by means of this prospectus.

(b) If all the required financial statements of the Registrant and the depositor (see Item 23) are not in the prospectus, state, under
a separate caption, where the financial statements may be found. Briefly explain how any financial statements not in the
Statement of Additional Information may be obtained.
Item 5. General Description of Registrant, Depositor, and Portfolio Companies
Concisely discuss the organization and operation or proposed operation of the Registrant. Include the information specified below.
(a) Briefly describe each depositor, including:
(i)

its name, address, and a description of the general nature of its business;
Instruction:
The description of the depositor’s business should be short and need not list all of the businesses in which the depositor
engages or identify the jurisdictions where it does business, if a general description (e.g., “life insurance” or “reinsurance”)
is provided.

(ii) the date and form of organization of the depositor and the name of the state or other jurisdiction under whose laws it is
organized; and
(iii) if the depositor is controlled by another person, the name of that person and the general nature of its business. (If the
depositor is subject to more than one level of control, simply give the name of the ultimate control person).
9

(b) Briefly describe the Registrant, including:
(i)

the date and form of organization of the Registrant and the Registrant’s classification pursuant to Section 4 of the 1940
Act [15 U.S.C. 80a-4] (i.e., a separate account and a unit investment trust);

(ii) a statement indicating
(A) that income, gains, and losses, whether or not realized, for assets allocated to the Registrant, are, in accordance with
the applicable annuity contracts, credited to or charged against the Registrant without regard to other income, gains,
or losses of the depositor; and
(B) that the assets of the Registrant may not be charged with liabilities arising out of any other business of the depositor;
and
(C) whether the obligations under the variable annuity contracts are obligations of the depositor.
(iii) whether there are sub-accounts of the Registrant (i.e., for qualified and non-qualified contracts or for different portfolio
companies).
Instruction:
Sub-accounts that fund obligations of the Registrant under contracts that are not offered by means of this prospectus need
not be described.
(c) Briefly describe each portfolio company, including:
(i)

its name;

(ii) its type (e.g., money market fund, bond fund, balanced fund, etc.) or a brief statement concerning its investment objectives;
and
(iii) its investment adviser.
(d) State conspicuously from whom a prospectus containing more complete information on each portfolio company may be
obtained, and that an investor should read the prospectus carefully before investing.
(e) Concisely discuss the rights of contractowners, annuitants, participants, or beneficiaries to instruct the Registrant on the voting
of portfolio company securities underlying their interest in the Registrant, including the manner in which votes will be allocated.
(f) Identify and state the principal business address of any person who provides significant administrative or business affairs
management services (e.g., an “Administrator,” “Sub-Administrator,” “Servicing Agent”), and briefly describe the services
provided.
Instruction:
Information need not be given in response to this Item about any services described in response to Item 6(a).
Item 6. Deductions
(a) Briefly describe all deductions from purchase payments, contractowner accounts, or assets of the Registrant (e.g., sales loads,
administrative and transaction charges, risk charges, and premium taxes). Specify the amount of any such deduction as a
percentage or dollar figure (e.g., .95% of the average daily net assets or $5 per exchange). Except for the deduction for premium
taxes, identify the person who receives the amount deducted, briefly describe what is provided in consideration for the
deduction, and explain the extent to which the deduction can be modified.
Instruction:
1. Identification of the range of current premium taxes is sufficient.
2.

If proceeds from explicit sales loads will not cover the expected costs of distributing the contracts, identify from what
source the shortfall, if any, will be paid. If any shortfall is to be made from assets from the depositor’s general account,
disclose, if applicable, that any amounts paid by the depositor may consist, among other things, of proceeds derived from
mortality and expense risk charges deducted from the account.

10

(b) State the sales load as a percentage of each purchase payment, if it is so calculated, and as a percentage of the net amount invested
for each breakpoint. For contracts with a deferred sales load, state the sales load as a percentage of the amount withdrawn or
surrendered. The percentages should be shown in a table.
(c) Unless set forth in response to paragraph (b), list any special purchase plans or methods established pursuant to a rule or an
exemptive order that reflect scheduled variations in, or elimination of, the sales load (e.g., group discounts, waiver of sales load
upon annuitization or attainment of a certain age, waiver of deferred sales load for a certain percentage of contract value (“free
corridor”), investment of proceeds from another policy, exchange privileges, employee benefit plans, or the terms of a merger,
acquisition or exchange offer made pursuant to a plan of reorganization); identify each class of individuals or transactions to
which such plans apply; state each different sales charge available as a percentage of the public offering price and as a
percentage of the net amount invested; and state from whom additional information may be obtained. Describe any other special
purchase plans or methods established pursuant to a rule that reflect other variations in, or elimination of, the sales load or in
any administrative charge or other deductions from purchase payments, and generally describe the basis for the variation or
elimination in the sales load or other deduction (i.e., the size of the purchaser, a prior or existing relationship with the purchaser,
the purchaser’s assumption of certain administrative functions, or other characteristics that result in differences in costs or
services).
(d) State the commissions paid to dealers as a percentage of purchase payments.
(e) State that there are deductions from and expenses paid out of the assets of the portfolio companies that are described in the
prospectuses for those companies.
(f) Describe the type of operating expenses for which the Registrant is responsible. If organizational expenses of the Registrant
are to be paid out of its assets, explain how the expenses will be amortized and the period over which the amortization will occur.
Item 7. General Description of Variable Annuity Contracts
(a) Identify the person or persons (e.g., the contractowner, participant, annuitant, or beneficiary) who have material rights under
the variable annuity contracts, and the nature of those rights, (1) during the accumulation period, (2) during the annuity period,
or (3) after the death of the annuitant or contractowner.
Instruction:
The Registrant need not repeat rights that are described elsewhere in the prospectus.
(b) Briefly describe any provisions and limitations for:
(i)

allocation of purchase payments among sub-accounts of the Registrant;

(ii) transfer of contract values between sub-accounts of the Registrant; and
(iii) exchanges of variable annuity contracts, including interests or participations therein.
(c) Briefly describe the changes that can be made in the variable annuity contracts or the operations of the Registrant by the
Registrant or the depositor, including:
(i)

why a change may be made (e.g., changes in applicable law or interpretations of law);

(ii) who, if anyone, must approve any change (e.g., the contractowner or the Securities and Exchange Commission); and
(iii) who, if anyone, must be notified of any change.
Instruction:
Describe only those changes that would be material to a purchaser of the variable annuity contracts, such as a reservation of
the right to deregister the separate account under the 1940 Act. Do not describe possible non-material changes, such as changing
the time of day at which accumulation unit values are determined.
(d) Describe how contractowner inquiries should be made.
(e) (i) Describe the risks, if any, that frequent transfers of contract value among sub-accounts of the Registrant may present for
other contractowners and other persons (e.g., participants, annuitants, or beneficiaries) who have material rights under the
variable annuity contracts.

11

(ii) State whether or not the Registrant or depositor has policies and procedures with respect to frequent transfers of contract
value among sub-accounts of the Registrant.
(iii) If neither the Registrant nor the depositor has any such policies and procedures, provide a statement of the specific basis
for the view of the depositor that it is appropriate for the Registrant and depositor not to have such policies and procedures.
(iv) If the Registrant or depositor has any such policies and procedures, describe those policies and procedures, including:
(A) whether or not the Registrant or depositor discourages frequent transfers of contract value among sub-accounts of the
Registrant;
(B) whether or not the Registrant or depositor accommodates frequent transfers of contract value among sub-accounts of
the Registrant; and
(C) any policies and procedures of the Registrant or depositor for deterring frequent transfers of contract value among
sub-accounts of the Registrant, including any restrictions imposed by the Registrant or depositor to prevent or
minimize frequent transfers. Describe each of these policies, procedures, and restrictions with specificity. Indicate
whether each of these restrictions applies uniformly in all cases or whether the restriction will not be imposed under
certain circumstances, including whether each of these restrictions applies to trades that occur through omnibus
accounts at intermediaries, such as investment advisers, broker-dealers, transfer agents, and third party administrators.
Describe with specificity the circumstances under which any restriction will not be imposed. Include a description
of the following restrictions, if applicable:
(1) any restrictions on the volume or number of transfers that may be made within a given time period;
(2) any transfer fee;
(3) any costs or administrative or other fees or charges that are imposed on persons deemed to be engaged in frequent
transfers of contract value among sub-accounts of the Registrant, together with a description of the circumstances
under which such costs, fees, or charges will be imposed;
(4) any minimum holding period that is imposed before a transfer may be made from a sub-account into another subaccount of the Registrant;
(5) any restrictions imposed on transfer requests submitted by overnight delivery, electronically, or via facsimile or
telephone; and
(6) any right of the Registrant or depositor to reject, limit, delay, or impose other conditions on transfers or to terminate
or otherwise limit contracts based on a history of frequent transfers among sub-accounts, including the circumstances
under which such right will be exercised.
(v)

If applicable, include a statement, adjacent to the disclosure required by paragraphs (e)(i) through (e)(iv) of this Item, that
the Statement of Additional Information includes a description of all arrangements with any person to permit frequent
transfers of contract value among sub-accounts of the Registrant.

Item 8. Annuity Period
Briefly describe the annuity options available. The discussion should include:
(a) Material factors that determine the level of annuity benefits;
(b) The annuity commencement date (give the earliest and latest possible dates);
(c) Frequency and duration of annuity payments, and the effect of these on the level of payment;
(d) The effect of assumed investment return;
(e) Any minimum amount necessary for an annuity option and the consequences of an insufficient amount; and
(f) Rights, if any, to change annuity options or to effect a transfer of investment base after the annuity commencement date.
Instructions:
1. Describe the choices, if any, available to a prospective annuitant, and the effect of not specifying a choice. Where an
annuitant is given a choice in assumed investment return, explain the effect of choosing a higher, as opposed to a lower,
assumed investment return.
12

2.

Detailed disclosure on the method of calculating annuity payments should be placed in the Statement of Additional
Information, Item 22.

Item 9. Death Benefit
Briefly describe the death benefit available under a variable annuity contract during the accumulation and the annuity periods.
Include:
(a) when the death benefit is calculated and payable and the effect of choosing a specific method of payment on calculation of the
death benefit, and
(b) the forms the benefit may take, including the effect of not choosing a payment option and the period, if any, during which
payments must begin under any annuity option.
Item 10. Purchases and Contract Value
(a) Briefly describe the procedures for purchasing a variable annuity contract. Include a concise explanation of:
(i)

the minimum initial and subsequent purchase payments required and any limitations on the amount of purchase payments
that will be accepted (if there are separate limits for each sub-account, state these limits);

(ii) a statement of when initial and subsequent purchase payments are credited;
(iii) the way in which purchase payments are credited, including: (A) an explanation that purchase payments are credited on
the basis of accumulation unit value; (B) how accumulation unit value is determined; and (C) how the number of
accumulation units credited to a contract is determined.
(b) Explain that investment performance of the portfolio company, expenses, and deduction of certain charges affect accumulation
unit value.
(c) Describe when calculations of accumulation unit value are made and that purchase payments are credited to a contract on the
basis of accumulation unit value next determined after receipt of a purchase payment.
(d) Identify each principal underwriter (other than the depositor) of the variable annuity contracts and state its principal business
address. If the principal underwriter is affiliated with the Registrant, the depositor, or any affiliated person of the Registrant
or the depositor, identify how they are affiliated (e.g., the principal underwriter is controlled by the depositor).
Item 11. Redemptions
(a) Briefly describe how a contractowner or annuitant (if the annuity option chosen by the annuitant is not based on a life
contingency) can redeem a variable annuity contract, including how the proceeds are calculated and when they are payable.
(b) If the Registrant offers the variable annuity contracts in connection with the Texas Optional Retirement Program, describe the
restrictions on redemption that apply.
Instruction:
Registrants can satisfy this Item by describing the applicable restrictions on redemption on a supplement attached to
prospectuses delivered to participants in the Texas Optional Retirement Program.
(c) If a request for redemption may not be honored for a period of time after a contractowner’s investment, describe briefly.
(d) Briefly describe any provision for lapse or involuntary redemptions under the contract and the reasons for it, such as the size
of the account or infrequency of purchase payments.
(e) Briefly describe any revocation rights (e.g., “ten-day free look” provisions).
Item 12. Taxes
(a) Briefly describe the tax consequences to investors of an investment in the variable annuity contracts being offered.
Instruction:
This disclosure need not include detailed description of applicable law. The discussion should include the taxation of annuity
payments, death proceeds, periodic and nonperiodic withdrawals, pledges and assignments of the contract (if permitted), and
any other method by which taxable income may be received by the investor under the variable annuity contract, as well as the
tax benefits accorded annuities during the accumulation period. If the tax consequences vary depending on the use of the
variable annuity contract (i.e., to fund an individual retirement annuity or corporate plan), the variations should be briefly
described.
13

(b) Identify the types of qualified plans for which the variable annuity contracts are intended to be used.
Instructions:
1. Identify the types of persons who may use the plans (e.g., corporations, self-employed individuals) and disclose, if
applicable, that the terms of the plan may limit the rights otherwise available under the contracts.
2.

Do not describe the Internal Revenue Code requirements for qualifications of plans or the non-annuity tax consequences
of qualification (e.g., the effect on employer taxation).

(c) Briefly describe the impact, if any, of taxation on the determination of account or sub-account values.
Item 13. Legal Proceedings
Briefly describe any material pending legal proceedings, other than ordinary routine litigation incidental to the business, to which
the Registrant, any subsidiary of the Registrant, or the Registrant’s principal underwriter or depositor is a party. Include the name of
the court where the case is pending, the date filed, and the principal parties. Include similar information for any proceedings instituted
by governmental authorities.
Instruction:
Legal proceedings are material only to the extent that they are likely to have a material adverse effect upon: (1) the ability of the principal
underwriter to perform its contract with the Registrant or of the depositor to meet its obligations under the variable annuity contracts;
or (2) the Registrant.
Item 14. Table of Contents of the Statement of Additional Information
List the contents of the Statement of Additional Information.

14

PART B
INFORMATION REQUIRED IN A STATEMENT OF ADDITIONAL INFORMATION
Item 15. Cover Page
(a) The outside cover page must contain the following information:
(i) the Registrant’s name;
(ii) the depositor’s name;
(iii) a statement or statements (A) that the Statement of Additional Information is not a prospectus; (B) that the Statement of
Additional Information should be read with the prospectus; and (C) how a copy of the prospectus may be obtained;
(iv) the date of the Statement of Additional Information; and
(v) the date of the related prospectus and any other identifying information that the Registrant deems appropriate.
(b) The cover page may include other information, provided that it does not by its nature, quantity, or manner of presentation,
impede understanding of required information.
Item 16. Table of Contents
List the contents of the Statement of Additional Information and, where useful, provide cross-references to the prospectus.
Item 17. General Information and History
(a) If the depositor’s name was changed during the past five years, state its former name and the approximate date on which it was
changed. If, at the request of any state, sales of contracts offered by the Registrant have been suspended at any time, or if sales
of contracts offered by the depositor have been suspended during the past five years, briefly describe the reasons for and results
of the suspension.
(b) If 10 percent or more of the assets of any sub-account are not attributable to variable annuity contracts or to accumulated
deductions or reserves (e.g., initial capital contributed by the depositor), state what percentage those assets are of the total assets
of the separate account. If the depositor, or any other person controlling the assets, has any present intention of removing the
assets from the sub-account, so state.
(c) If the depositor is controlled by another person that, in turn, is controlled by another person, give the name of each control person
and the nature of its business.
Item 18. Services
(a) Describe all fees, expenses, and costs of the Registrant which are to be paid by persons other than the depositor or the Registrant,
and identify such persons.
(b) Give a summary of any contract for the provision of management-related services to the Registrant that may be of interest to
a purchaser of Registrant’s securities, unless the contract is described in response to some other item of this form. Identify the
parties to the contract, and show, for the past three years, the total dollars paid and by whom.
Instructions:
1. A contract for “management-related services” includes any agreement whereby another person agrees to keep, prepare,
or file such accounts, books, records, or other documents as the Registrant may be required to keep under federal or state
law, or to provide any similar services with respect to the daily operations of the Registrant, but does not include the
following: (i) any agreement to act as custodian or agent to administer purchases and redemptions under the contracts, or
(ii) bona fide contracts for outside legal or auditing services, or bona fide contracts for personal employment entered into
in the ordinary course of business.
2. In summarizing a management-related service contract, include: the name of the person providing the service; any direct
or indirect relationships between such person and the Registrant, its depositor, or its principal underwriter; the nature of
the services provided; and the basis of the compensation paid for the last three fiscal years.
(c) Give the name and principal business address of the Registrant’s custodian and independent public accountant and provide a
general description of the services they perform.
(d) If the assets of the Registrant are held by a person other than the depositor, a commercial bank, trust company, or depository
registered with the Commission as custodian, state the nature of the business of each such person.
(e) If an affiliated person of the Registrant or the depositor, or an affiliated person of such an affiliated person, acts as administrative
or servicing agent for the Registrant, furnish a description of the services performed by that person and the basis for
remuneration. State, for the past three years, the total dollars paid for the services, and by whom.
15

Instruction:
No disclosure need be given in response to paragraph (e) of this Item for an administrative or servicing agent who is also the
depositor.
(f) If the depositor is the principal underwriter of the variable annuity contracts, so state.
Item 19. Purchase of Securities Being Offered
(a) Describe the manner in which Registrant’s securities are offered to the public. Include a description of any special purchase
plans and any exchange privileges not described in the prospectus.
Instruction:
Address exchange privileges between sub-accounts, between the Registrant and other separate accounts, and between the
Registrant and contracts offered through the depositor’s general account.
(b) Describe the method that will be used to determine the sales load on the variable annuity contracts offered by the Registrant.
Instruction:
Explain fully any difference in the price at which variable annuity contracts are offered to members of the public, as individuals
or as groups, and the prices at which the contracts are offered for any class of transactions or to any class of individuals,
including officers, directors, members of the board of managers, or employees of the Registrant’s depositor, underwriter,
portfolio company, or investment adviser to the portfolio company.
(c) Describe any arrangements with any person to permit frequent transfers of contract value among sub-accounts of the Registrant,
including the identity of the persons permitted to engage in frequent transfers pursuant to such arrangements, and any
compensation or other consideration received by the Registrant, the depositor, or any other party pursuant to such arrangements.
Instructions:
1. The consideration required to be disclosed by Item 19(c) includes any agreement to maintain assets in the Registrant or
in other investment companies or accounts managed or sponsored by the depositor, any investment adviser of a portfolio
company, or any affiliated person of the depositor or of any such investment adviser.
2.

If the Registrant has an arrangement to permit frequent transfers of contract value among sub-accounts of the Registrant
by a group of individuals, such as the participants in a defined contribution plan that meets the requirements for
qualification under Section 401(k) of the Internal Revenue Code (26 U.S.C. 401(k)), the Registrant may identify the group
rather than identifying each individual group member.

Item 20. Underwriters
(a) If the depositor or an affiliate of the depositor is the principal underwriter of the variable annuity contracts, so state.
(b) State whether the offering is continuous.
(c) State the aggregate dollar amount of underwriting commissions paid to, and the amount retained by, the principal underwriter
for each of the last three fiscal years.
(d) If during the Registrant’s last fiscal year any payments were made by the Registrant to an underwriter of or dealer in the variable
annuity contracts that is unaffiliated with the Registrant or the depositor, other than payments made through deduction from
the purchase payments at the time of sale of the variable annuity contracts or from contract values upon redemption, give the
following information:
(i)

the name and address of the underwriter or dealer;

(ii) the circumstances surrounding the payments;
(iii) the amount paid; and
(iv) how the amount of the payment was determined and the consideration received for it.
Instructions:
1. Information need not be given about the service of mailing proxies or periodic reports of the Registrant.
2.

Information need not be given about any service for which total payments of less than $5,000 were made during each of
the last three fiscal years.

3.

Information need not be given about payments made under any contract to act as administrative or servicing agent.
16

4.

If the payments were made under an arrangement or policy applicable to dealers generally, simply describe the
arrangement or policy.

Item 21. Calculation of Performance Data
(a) Money Market Funded Sub-Accounts. Yield quotation(s) included in the prospectus for an account or sub-account that holds
itself out as a “money market” account or sub-account should be calculated according to paragraphs (a)(i) - (ii).
(i)

Yield Quotation. Based on the 7 days ended on the date of the most recent balance sheet of the Registrant included in the
registration statement, calculate the yield by determining the net change, exclusive of capital changes and income other
than investment income, in the value of a hypothetical pre-existing account having a balance of one accumulation unit of
the account or sub-account at the beginning of the period, subtracting a hypothetical charge reflecting deductions from
contractowner accounts, and dividing the difference by the value of the account at the beginning of the base period to
obtain the base period return, and then multiplying the base period return by (365/7) with the resulting yield figure carried
to at least the nearest hundredth of one percent.

(ii) Effective Yield Quotation. Based on the 7 days ended on the date of the most recent balance sheet of the Registrant
included in the registration statement, calculate the effective yield, carried to at least the nearest hundredth of one percent,
by determining the net change, exclusive of capital changes and income other than investment income, in the value of a
hypothetical pre-existing account having a balance of one accumulation unit of the account or sub-account at the beginning
of the period, subtracting a hypothetical charge reflecting deductions from contractowner accounts, and dividing the
difference by the value of the account at the beginning of the base period to obtain the base period return, and then
compounding the base period return by adding 1, raising the sum to a power equal to 365 divided by 7, and subtracting
1 from the result, according to the following formula:
EFFECTIVE YIELD = [(BASE PERIOD RETURN +1)365/7]-1.
Instructions:
1. When calculating the yield or effective yield quotations, the calculation of net change in account value must include all
deductions that are charged to all contractowner accounts in proportion to the length of the base period. For any account
fees that vary with the size of the account, assume an account size equal to the sub-account’s mean (or median) account
size.
2.

Deductions from purchase payments and sales loads assessed at the time of redemption or annuitization should not be
reflected in the computation of yield and effective yield. However, the amount or specific rate of such deductions must
be disclosed.

3.

Exclude realized gains and losses from the sale of securities and unrealized appreciation and depreciation from the
calculation of yield and effective yield. Exclude income other than investment income.

4.

The Registrant may furnish separate yield quotations for individual and group contracts.

(b) Other Sub-Accounts. Performance information included in the prospectus should be calculated according to paragraphs (b)(i)
– (iii).
(i)

Average Annual Total Return Quotation. For the 1-, 5-, and 10-year periods ended on the date of the most recent balance
sheet of the Registrant included in the registration statement, calculate the average annual total return by finding the
average annual compounded rates of return over the 1-, 5-, and 10-year periods that would equate the initial amount
invested to the ending redeemable value, according to the following formula:
P(1+T) n = ERV
Where:
P= a hypothetical initial payment of $1,000
T= average annual total return
n= number of years
ERV= ending redeemable value of a hypothetical $1,000 payment made at the beginning of the 1-, 5-, or 10-year
periods at the end of the 1-, 5-, or 10- year periods (or fractional portion).
Instructions:
1. Assume the maximum sales load (or other charges deducted from payments) is deducted from the initial $1,000
payment.

17

2.

Include all recurring fees that are charged to all contractowner accounts. For any account fees that vary with the size
of the account, assume an account size equal to the sub-account’s mean (or median) account size. If recurring fees
charged to contractowner accounts are paid other than by redemption of accumulation units, they should be
appropriately reflected.

3.

Determine the ending redeemable value by assuming a complete redemption at the end of the 1, 5, or 10 year periods
and the deduction of all nonrecurring charges deducted at the end of each period.

4.

If the Registrant’s registration statement has been in effect less than one, five, or ten years, the time period during
which the registration statement has been in effect should be substituted for the period stated.

5.

Carry the total return quotation to the nearest hundredth of one percent.

6.

Total return information in the prospectus need only be current to the end of the Registrant’s most recent fiscal year.

(ii) Yield Quotation. Based on a 30-day (or one month) period ended on the date of the most recent balance sheet of the
Registrant included in the registration statement, calculate yield by dividing the net investment income per accumulation
unit earned during the period by the maximum offering price per unit on the last day of the period, according to the
following formula:
YIELD = 2[( a − b +1)6-1]

cd

Where:
a= net investment income earned during the period by the portfolio company attributable to shares owned by the subaccount.
b= expenses accrued for the period (net of reimbursements).
c= the average daily number of accumulation units outstanding during the period.
d= the maximum offering price per accumulation unit on the last day of the period.
Instructions:
1. Include among the expenses accrued for the period all recurring fees that are charged to all contractowner accounts.
For any account fees that vary with the size of the account, assume an account size equal to the sub-account’s mean
(or median) account size.
2.

If a broker-dealer or an affiliate (as defined in paragraph (b) of Rule 1-02 [17 CFR 210.1-02(b) of Regulation S-X)
of the broker-dealer has, in connection with directing the portfolio company’s brokerage transactions to the brokerdealer, provided, agreed to provide, paid for, or agreed to pay for, in whole or in part, services provided to the portfolio
company (other than brokerage and research services as these terms are defined in Section 28(e) of the Securities
Exchange Act of 1934 [15 U.S.C. 78bb(e)]), add to expenses accrued for the period an estimate of additional amounts
that would have been accrued for the period if the portfolio company had paid for the services directly in an armslength transaction.

3.

Net investment income must be calculated by the portfolio company as prescribed by Item 22(b)(ii) of Form N-1A.
Note: (a-b) = net investment income in the Item 22(b)(ii) equation.

4.

Disclose the amount or specific rate of any nonrecurring account or sales charges.

(iii) Non-Standardized Performance Quotation. A Registrant may calculate performance using any other historical measure
of performance (not subject to any prescribed method of computation) if the measurement reflects all elements of return.
Item 22. Annuity Payments
Describe the method for determining the amount of annuity payments if not described in the prospectus. In addition, describe how
any change in the amount of a payment after the first payment is determined.
Item 23. Financial Statements
(a) Provide financial statements of the Registrant.
Instruction:
The financial statements and schedules required by Regulation S-X [17 CFR 210] shall be provided in a separate section.
Financial statements of the Registrant may be limited to:
(i)

An audited balance sheet or statement of assets and liabilities as of the end of the most recent fiscal year;
18

(ii) An audited statement of operations of the most recent fiscal year conforming to the requirements of Rule 6-07 of
Regulation S-X [17 CFR 210.6-07];
(iii) An audited statement of cash flows for the most recent fiscal year if necessary to comply with generally accepted
accounting principles; and
(iv) Audited statements of changes in net assets conforming to the requirements of Rule 6-09 of Regulation S-X [17 CFR
210.6-09] for the two most recent fiscal years.
(b) Provide financial statements of the depositor.
Instructions:
1. The financial statements and schedules of the depositor required by Regulation S-X shall be provided in a separate section
following the response to paragraph (a) of this Item. If the Insurance Company would not have to prepare financial
statements in accordance with generally accepted accounting principles except for use in this registration statement or other
registration statements filed on Forms N-3 or N-4, its financial statements may be prepared in accordance with statutory
requirements.
2.

Notwithstanding Instruction 1 above, all statements and schedules required by Regulation S-X, except for the consolidated
balance sheets described in Rule 3-01 of Regulation S-X [17 CFR 210.3-01], and any notes thereto, may be omitted from
Part B and instead included in Part C of the Registration Statement.

3.

Notwithstanding Rule 3-12 of Regulation S-X [17 CFR 210.3-12], the financial statements of the depositor need not be
more current than as of the end of the most recent fiscal year of the depositor unless:
(i)

the depositor’s financial statements have never been included in an effective registration statement under the
Securities Act of 1933 of a separate account which offers variable annuity contracts or funds variable life insurance
contracts; or

(ii) the balance sheet of the depositor at the end of either of the two most recent fiscal years included in response to this
Item shows a combined capital and surplus, if a stock company, or an unassigned surplus, if a mutual company, of
less than $1,000,000; or
(iii) the balance sheet of the depositor at the end of a fiscal quarter within 135 days of the expected date of effectiveness
under the 1933 Act (or a fiscal quarter within 90 days of filing if the registration statement is filed solely under the
1940 Act) would show a combined capital surplus, if a stock company, or an unassigned surplus, if a mutual company,
of less than $1,000,000. If two fiscal quarters end within the 135 day period, the depositor may choose either for
purposes of this test.
Any interim financial statements required by this Item need not be comparative with financial statements for the same interim period
of an earlier year.

19

PART C
OTHER INFORMATION
Item 24. Financial Statements and Exhibits
List all financial statements and exhibits filed as part of the Registration Statement.
(a) Financial statements.
Instruction:
Designate those financial statements which are included in Part A and Part B of the Registration Statement.
(b) Exhibits:
(1)

copies of the resolution of the board of directors of the depositor authorizing the establishment of the Registrant;

(2)

copies of all agreements for custody of securities and similar investments of the Registrant, including the schedule of
remuneration;

(3)

copies of each underwriting or distribution contract between the Registrant and the principal underwriter or the depositor
and the principal underwriter, and specimens or copies of all agreements between principal underwriters and dealers;

(4)

the form of each variable annuity contract;

(5)

the form of application used with any variable annuity contract provided in response to (4) above;

(6)

copies of the certificate of incorporation or other instrument of organization and the by-laws of the depositor;

(7)

a copy of any contract of reinsurance in connection with the variable annuity contracts being offered;

(8)

copies of all other material contracts not made in the ordinary course of business which are to be performed in whole or
in part on or after the date of filing the Registration Statement;

(9)

an opinion of counsel and consent to its use as to the legality of the securities being registered, indicating whether they
will be legally issued and will represent binding obligations of the depositor;

(10) copies of any other opinions, appraisals, or rulings, and consents of their use relied on in preparing this Registration
Statement and required by Section 7 of the 1933 Act;
(11) all financial statements omitted from Item 23; and
(12) copies of any agreements or understandings made in consideration for providing the initial capital between or among the
Registrant, the depositor, underwriter, or initial contractowners and written assurances from the depositor or initial
contractowners that the purchases were made for investment purposes without any present intention of redeeming.
Instructions:
1. Subject to the Rules regarding incorporation by reference and Instruction 2 below, the foregoing exhibits shall be filed
as part of the Registration Statement. Exhibits numbered 3, 9, 10, and 11 above need to be filed only as part of a 1933
Act Registration Statement. Exhibits shall be lettered or numbered for convenient reference. Exhibits incorporated by
reference may bear the designation given in a previous filing. Where exhibits are incorporated by reference, the reference
shall be made in the list of exhibits.
2.

A Registrant need not file an exhibit as part of a post-effective amendment if the exhibit has been filed in the Registrant’s
initial registration statement or in a previous post-effective amendment, unless there has been a change in the exhibit or
unless the exhibit is a copy of a consent required by Section 7 of the 1933 Act or is a financial statement omitted from
Item 23.

Item 25. Directors and Officers of the Depositor
Give the following information about each director or officer of the depositor:
Name and Principal
Business Address

Positions and Offices
with Depositor

20

Instruction:
Registrants need only provide the above information for officers or directors who are engaged directly or indirectly in activities relating
to the Registrant or the variable annuity contracts offered by the Registrant, and for executive officers including the depositor’s
president, secretary, treasurer, and vice presidents who have authority to act as president in his or her absence.
Item 26. Persons Controlled by or Under Common Control with the Depositor or Registrant
Provide a list or diagram of all persons directly or indirectly controlled by or under common control with the depositor or Registrant
and for each such person indicate (1) if a company, the state or other sovereign power under whose laws it is organized, (2) the percentage
of voting securities owned or other basis of control by the person, if any, immediately controlling it, and (3) its principal business unless
such principal business is implicit in its name.
Instructions:
1. The list or diagram shall include the Registrant and the depositor and shall show clearly the relationships between each company
named. If a company is controlled by direct ownership of its securities by two or more persons, so indicate by appropriate crossreference.
2. Designate: (i) subsidiaries for which separate financial statements are filed; (ii) subsidiaries included in the respective consolidated
financial statements; (iii) subsidiaries included in the respective group financial statements filed for unconsolidated subsidiaries; and
(iv) other subsidiaries, indicating briefly why statements of such subsidiaries are not filed.
Item 27. Number of Contractowners
State as of a specified date within 90 days prior to the date of filing the number of contract owners of qualified and non-qualified
contracts offered by Registrant.
Item 28. Indemnification
State the general effect of any contract, arrangements, or statute under which any underwriter or affiliated person of the Registrant
is insured or indemnified in any manner against any liability which may be incurred in such capacity, other than insurance provided by
any underwriter or affiliated person for his own protection.
Instruction:
In responding to this Item the Registrant should note the requirements of Rules 461 and 484 under the 1933 Act [17 CFR 230.461,
230.484] and Section 17 of the 1940 Act [15 U.S.C. 80a-17].
Item 29. Principal Underwriters
(a) Give the name of each investment company (other than the Registrant) for which each principal underwriter currently
distributing securities of the Registrant also acts as a principal underwriter, depositor, sponsor, or investment adviser.
(b) Give the information required by the following table with respect to each director, officer, or partner of each principal
underwriter named in the answer to Item 10(d):
(1)
Name and Principal
Business Address

(2)
Positions and Offices
with Underwriter

Instruction:
If a principal underwriter is the depositor or an affiliate thereof, and is also an insurance company, the above information for officers
or directors need only be provided for officers or directors who are engaged directly or indirectly in activities relating to the Registrant
or the variable annuity contracts offered by the Registrant, and for executive officers, including the depositor’s or its affiliate’s president,
secretary, treasurer, and vice presidents who have authority to act as president in his or her absence.
(c) Give the following information about all commissions and other compensation received by each principal underwriter, directly
or indirectly, from the Registrant during the Registrant’s last fiscal year:
(1)
Name of Principal
Underwriter

(2)
Net Underwriting
Discounts and
Commissions

(3)
Compensation on
Redemption

21

(4)
Brokerage
Commissions

(5)
Compensation

Instructions:
1. Show in a note, or otherwise, the nature of the services provided in return for the compensation shown in column (5).
2. Information need not be given about bona fide contracts with the Registrant or its depositor for outside legal or auditing services,
or bona fide contracts for personal employment entered into with the Registrant or its depositor in the ordinary course of business.
3. Information need not be given about any service for which total payments of less than $5,000 were made during each of the last three
fiscal years.
4. Information need not be given about payments made under any agreement whereby another person contracts with the Registrant or
its depositor to perform as custodian or administrative or servicing agent.
Item 30. Location of Accounts and Records
Give the name and address of each person who maintains physical possession of each account, book, or other document, required
to be maintained by Section 31(a) of the 1940 Act [15 U.S.C. 80a-30(a)] and the Rules under it [17 CFR 270.31a-1 to 31a-3].
Item 31. Management Services
Give a summary of any contract not discussed in Part A or Part B of this Form under which management-related services are provided
to the Registrant, showing the parties to the contract and the total dollars paid and by whom, for the last three fiscal years.
Instructions:
1. The instructions to Item 18(b) of this Form shall also apply to this Item.
2. Information need not be given about any service for which total payments of less than $5,000 were made during each of the last three
fiscal years.
Item 32. Undertakings
Give the following undertakings in substantially this form in all initial registration statements filed under the 1933 Act:
(a) An undertaking to file a post-effective amendment to this registration statement as frequently as is necessary to ensure that the
audited financial statements in the registration statement are never more than 16 months old for so long as payments under the
variable annuity contracts may be accepted;
(b) An undertaking to include either (1) as part of any application to purchase a contract offered by the prospectus, a space that
an applicant can check to request a Statement of Additional Information, or (2) a post card or similar written communication
affixed to or included in the prospectus that the applicant can remove to send for a Statement of Additional Information;
(c) An undertaking to deliver any Statement of Additional Information and any financial statements required to be made available
under this Form promptly upon written or oral request.

22

SIGNATURES
As required by (the Securities Act of 1933 and) the Investment Company Act of 1940, the Registrant (certifies that it meets the
requirements of Securities Act Rule 485(b) for effectiveness of this Registration Statement and) has caused this Registration Statement
to be signed on its behalf, in the City of __________________________, and State of __________________________ on this ________________
day of __________________________ , ________.
___________________________________________________
(Registrant)
By
____________________________________________________
(Signature)
___________________________________________________
(Title)
By
____________________________________________________
(Depositor)
By
____________________________________________________
(Name of officer of depositor)
____________________________________________________
(Title)
Instruction:
If the registration statement is being filed only under the Securities Act or under both the Securities Act and the Investment Company
Act, it should be signed by both the Registrant and its depositor. If the registration statement is being filed only under the Investment
Company Act, it should be signed only by the Registrant.
As required by the Securities Act of 1933, this Registration Statement has been signed by the following persons in the capacities
and on the duties indicated.
____________________________________________________________________________________________________________________________________________________________
(Signature)
(Title)
(Date)

23

GUIDELINES FOR FORM N-4
This release contains Guidelines prepared by the Division of Investment Management for registration statements on Form N-4 for
separate accounts organized as unit investment trusts. The Guidelines are based on Commission releases and staff interpretations.
Adherence to these Guidelines should speed the examination by the Division’s staff of registration statements on Form N-4.
The Guidelines are not rules of the Commission and, except as noted, represent only the views of the staff of the Division, not the
Commission. The Guidelines should be read with the Investment Company Act Releases cited in them. The policies stated in the
Guidelines may be changed if necessary.
TABLE OF CONTENTS
Guide 1
Guide 2
Guide 3
Guide 4
Guide 5
Guide 6
Guide 7
Guide 8
Guide 9
Guide 10
Guide 11
Guide 12

—
—
—
—
—
—
—
—
—
—
—
—

Name of Registrant
Business History
Redemption
Distribution Expenses
Financial Statements
Performance Data
The Synopsis
Administrative Charges
Deferred Sales Loads
Annuity Payments
Crediting of Contract Values
Automatic Annuity Options

Guide 1. Name of Registrant
The registrant’s name must be consistent with section 35 of the Investment Company Act of 1940 (“1940 Act”), which prohibits,
among other things, use of a name or title that may be deceptive or misleading.
In the Division’s view, the discussion in Investment Company Act Release No. 5510 (October 8, 1968) about the proprietary rights
of an investment company in its name is not applicable to separate accounts.
Guide 2. Business History
The registrant should list in the Statement of Additional Information all prior names of its depositor for the past five years. For a
newly organized insurance company, registrant should state that the company has no prior history.
Guide 3. Redemption
Section 22(e) of the 1940 Act prohibits suspension of the right of redemption or the postponement of payment upon redemption of
a redeemable security of a separate account organized as a unit investment trust, for more than seven days after the proper tender of the
security for redemption, with certain limited exceptions. The staff has taken the position, however, that redemption payments can be
withheld for more than seven days if necessary to prevent the loss or dilution of net asset value that can occur when purchase checks
are dishonored. 1 The procedures for obtaining payment upon redemption shortly after purchase must be disclosed in the prospectus, as
should any procedures an investor can follow to avoid delays in redemption payments, such as use of a certified check to purchase the
variable annuity contracts.
To accommodate contracts that provide for variable annuity options based on life contingencies, rules 22e-1 and 27c-1 under the
1940 Act [17 CFR 270.22e-1 and 27c-1] grant exemptions from the redemption requirements of sections 22(e) and 27(c)(1). Rule 27c1 exempts registered separate accounts, their depositors and underwriters from the requirement in section 27(c)(1) of the 1940 Act that
a periodic payment plan certificate be a redeemable security (and from the surrender provisions of section 27(d) of the 1940 Act) with
respect to the annuity payment period of variable annuity contracts under which payments are based on life contingencies.
If there is a synopsis in the prospectus, it should show where in the prospectus investors can find a description of redemption
procedures.2
Redemption procedures are frequently confusing to investors. Therefore, special care should be given to explaining when signature
guarantees are necessary, and who can make such guarantees.3
Guide 4. Distribution Expenses
Many registrants are exempted from sections 26(a)(2)(C) and 27(c)(2) of the 1940 Act to permit them to deduct a charge for the
assumption of mortality and/or expense risks from the separate account. In furtherance of requests for this exemptive relief, where
proceeds from explicit sales loads will not be sufficient to cover expected distribution costs, many registrants represent that there is a
24

reasonable likelihood that the separate account’s distribution financing arrangement will benefit the separate account and contractowners,
among other requirements. 4 These representations should be disclosed in the Statement of Additional Information.
When special arrangements will be made to sell variable annuity contracts to customers of depository institutions, possible
applicability of the Glass-Steagall Act should be discussed in the prospectus. The legal issues raised by payments to depository
institutions for their services in this connection should be identified, and the consequences for the separate account, if these issues are
resolved adversely, should also be discussed.
Guide 5. Financial Statements
The form, content, and presentation of financial statements are prescribed by Regulation S-X [17 CFR 210]. If financial statements
of the registrant are not provided because the registrant does not have any assets, a statement to that effect should be placed before the
financial statements of the depositor.
Guide 6. Performance Data
Item 4(b) requires a brief explanation of how the registrant calculates its historical performance for purposes of advertising this data.
Algebraic equations and detailed, intricate explanations should be avoided in favor of a more general, concise description of the essential
features of the data and how it is computed. For example, a registrant advertising its money market sub-account’s yield and effective
yield might describe these two yields in the following manner:

For a discussion of the conditions under which an investment company can delay redemption for more than seven days pending clearance of purchase checks,
see Investment Company Institute (Pub. avail. May 3, 1975).
2
See Guide 7: The Synopsis.
3
Investment Company Act Release No. 7220 (June 9, 1972) [37 FR 12790 (June 24, 1972)].
4
For a discussion of representations by applicants seeking this exemptive relief, see Investment Company Act Release No. 14190 (October 11, 1984) [49 FR
40879 (October 8, 1984)].
1

25

From time to time the Account advertises its money market sub-account’s “yield” and “effective yield.” Both yield
figures are based on historical earnings and are not intended to indicate future performance. The “yield” of the subaccount refers to the income generated by an investment in the sub-account over a seven-day period (which period will
be stated in the advertisement). This income is then “annualized.” That is, the amount of income generated by the
investment during that week is assumed to be generated each week over a 52-week period and is shown as a percentage
of the investment. The “effective yield” is calculated similarly but, when annualized, the income earned by an investment
in the sub-account is assumed to be reinvested. The “effective yield” will be slightly higher than the “yield” because of
the compounding effect of this assumed reinvestment.
For guidance in responding to Item 21, the registrant should refer to Investment Company Act Release No. 13049 (February 28,
1983) [48 FR 10297 (March 11, 1983)]; Investment Company Act Release No. 11028 (January 28, 1980) [45 FR 7578 (February 4,
1980)]; and Investment Company Act Release No. 11379 (September 30, 1980) [45 FR 67079 (October 9, 1980)].
Deductions should be prorated among the sub-accounts of the separate account. If the deduction is a flat fee charged to all
contractowner accounts (e.g., $25.00 per contractowner account per year), the deduction should be prorated by multiplying the flat fee
by a fraction the numerator of which is the average number of contractowner accounts that have money allocated to the sub-account and
the denominator of which is the sum of the average number of contractowner accounts that have money allocated to each of the subaccounts for the same kind of contract.
Where the registrant issues more than one contract form and the performance for each is materially different (due, for example, to
different sales loads, fees, or other charges), the registrant should quote the performance relating to the contract form containing the
highest level of charges or calculate and quote separate performance figures for each contract form advertised. Where the charge
structure among or between different contract forms is so different that none can be determined to possess the “highest level” of charges,
performance figures for all forms should be quoted. Where separate performance figures are quoted for different contract forms, the
omitting prospectus advertisement should clearly disclose the trade name or other appropriate identification of each form and, if
relevant, the particular category of investor who may purchase each form (e.g., groups or individuals), or type of retirement plan.
Guide 7. The Synopsis
A synopsis provided pursuant to Item 3 of Form N-4 should clearly and concisely describe the key features of the offering and the
registrant. The information in the synopsis need not be in the order or the manner described in this Guide, and it may be presented in
a question-and-answer format.
The synopsis should include: (i) a cross-reference to the description in the prospectus of how to purchase the variable annuity
contracts being offered; (ii) cross-references to the descriptions in the prospectus of how a contractowner (or annuitant) may effect a
redemption and any penalty taxes that may be assessed upon redemption; (iii) the maximum percentage load that may be assessed against
any given amount redeemed or annuitized and a cross-reference to the description in the prospectus of the deductions and expenses; and
(iv) either a full description of or a cross-reference to the description in the prospectus of any “ten-day free look” or similar provisions.
The synopsis may include additional information, provided that it does not, by its nature, quantity, or manner of presentation, impede
understanding of required information.
Guide 8. Administrative Charges
The discussion of any administrative charge deducted from the value of the contractowner’s account should (1) concisely describe
how the charge is deducted in both the accumulation and annuity periods, (2) explain whether the charge is deducted at the beginning
of the contract year for the coming year or deducted at the end of the contract year for the prior year, (3) describe whether the charge
is prorated for any period (e.g., between the contract anniversary date and the date of redemption or the date of annuitization), and (4)
if the administrative charge is a percentage of assets, disclose that there is no necessary relationship between the amount of
administrative charge imposed on a given contract and the amount of expenses that may be attributable to that contract.
Any administrative charge that is deducted from contractowner accounts and is not a charge or expense of the registrant should not
be accounted for as an expense or otherwise included in the determination of net investment income of the registrant. Rather, the amount
of the administrative charges should be accounted for, and presented in financial statements of the registrant, as a reduction of ownership
units. Whether the amount of such administrative charges is separated in the registrant’s financial statements from other withdrawal or
redemption amounts that result in a reduction of ownership units depends upon individual facts.
Guide 9. Deferred Sales Loads
Item 6 of Form N-4 requires the registrant to describe any sales loads. A sales load not subject to any contingency should be
described as a deferred sales load, not a “contingent” deferred sales load. A deferred sales load does not become contingent solely
because the sales load is waived in the event of an annuitant’s death or if the registrant provides that a given percentage of contract value
may be withdrawn without imposition of sales load (a “free corridor”).
The description of any deferred sales load (contingent or not) should include how the deduction will be allocated among subaccounts of the Registrant; when, if ever, the sales load will be waived (for example, as part of the death benefit or upon redemptions
by contractowners who are also employees of the depositor); and the maximum amount of the sales load as a percentage of purchase
payments received. See rule 6c-8 under the 1940 Act [17 CFR 270.6c-8] which limits the amount of a deferred sales load to no more
26

than nine percent of the purchase payments received. If the deferred sales load varies according to the length of time a particular purchase
payment has been invested, the description should indicate whether withdrawals will be attributed to purchase payments in the order
in which they were invested in the separate account (FIFO) or in the reverse order of investment (LIFO).
The description of a deferred sales load should also explain whether, in the case of a partial redemption, the amount deducted will
be a percentage of the amount requested by the contractowner or the total amount withdrawn, and whether the sales load will be deducted
from the amount requested or the amount remaining after the contractowner has received the amount requested. For example, if the sales
load is 7% and the contractowner has requested $100, the description should make plain whether:
(a) the contractowner receives $93 and the sales load is $7 for a total withdrawal of $100 (i.e., the sales load is 7% of both the
amount requested and the total withdrawal and is deducted from the amount requested);
(b) the contractowner receives $100 and the sales load is $7 for a total withdrawal of $107 (i.e., the sales load is 7% of the amount
requested and is deducted from the contract value remaining after the contractowner is paid the amount requested); or
(c) the contractowner receives $100 and the sales load is $7.53 for a total withdrawal of $107.53 (i.e., the sales load is 7% of the
total withdrawal and is deducted from the contract value remaining after the contractowner is paid the amount requested).
Additionally, if the registrant allows withdrawal of a given percentage of contract value without imposing a deferred sales load (e.g.,
a 10% free withdrawal each year), the description of this privilege should indicate when the contract value will be computed to determine
the amount of the permitted free withdrawal (e.g., at the beginning of the contract year or the date of the requested withdrawal).
Guide 10. Annuity Payments
Item 8 of Form N-4 requires registrants to describe in the prospectus the annuity options available under a contract and the material
factors that determine the level of annuity benefits. Registrants should discuss variables that impact the level of payments such as the
age at which payments begin, the form of annuity, the frequency of payments, annuity purchase rates, and assumed investment return.
The discussion should include any options on the form of annuity such as life annuities, term certain annuities, joint and survivor life
annuities, and any other variations. In general, responses to this item should include practical narrative disclosure. Mathematical
illustrations and the mechanics of determining annuity payments should be placed in the Statement of Additional Information, Item 22.
Item 8 also calls for disclosure of the effect of assumed investment return. Registrants should explain that annuity payments will
vary to reflect the investment experience of the portfolio company and that the assumed investment return is a fulcrum rate around which
variable annuity payments will fluctuate to reflect whether investment experience of the portfolio company is better or worse than the
assumed investment return. Where annuitants are given a choice in assumed investment return, registrants should explain that a higher
assumed investment return will result in a higher initial payment, a more slowly rising series of subsequent payments when actual
investment performance (minus any deductions and expenses) exceeds the assumed investment return, and a more rapid drop in
subsequent payments when actual investment performance (minus any deductions and expenses) is less than the assumed investment
return.
Item 22 requires registrants to disclose in the Statement of Additional Information the method for determining the amount of annuity
payments. Registrants should disclose how the initial annuity payment is determined, and if subsequent payments differ from the first,
an explanation of how the subsequent payments are determined. Generally, registrants should explain that the amount of the initial
payment is determined by applying the value of the annuitant’s contract as of the date of annuitization (adjusted for any deductions) to
the annuity purchase rate for the annuitant’s annuity option, sex, and adjusted age. The specific time when the calculation will be made
and the particular deductions that will be made at that time also should be disclosed. Registrants should disclose that the amount of
subsequent annuity payments is determined by multiplying the number of annuity units credited to an annuitant’s account by the value
of an annuity at the time of each payment where (1) the number of annuity units credited to an annuitant’s account is determined by
dividing the amount of the first annuity payment by the value of an annuity unit at the time of that payment, and (2) the value of an annuity
unit changes to reflect investment performance of the underlying portfolio company, adjusted by a factor to neutralize the assumed
investment return. Registrants should disclose any deductions affecting the amount of annuity payments, and, where applicable, that
changes in the value of an annuity unit reflect deductions of mortality and expense risk charges.
Guide 11. Crediting of Contract Values
Item 10 of Form N-4 requires disclosure about when initial and subsequent purchase payments are credited. Section 22(c) of the
1940 Act [15 U.S.C. 80a-22(c)] and rule 22c-1 [17 CFR 270.22c-1] establish standards for crediting purchase payments for securities
of registered investment companies. However, the staff has not objected to disclosure that an initial purchase payment under a variable
annuity contract would be credited within two business days of receipt if the contract application and other necessary information were
complete as received by the office issuing the contract, and within five business days of receipt if the application and other information
were incomplete when received. Registrants following this practice must disclose it and also disclose that, if the initial purchase payment
is not credited within five business days, the purchase payment will be immediately returned unless the prospective purchaser has been
informed of the delay and specifically requests that the purchase payment not be returned.5
5

The Commission proposed codifying these standards in an amendment to rule 22c-1 under the Act. See Investment Company Act Release No. 13913 (May
1, 1984) [49 FR 19320 (May 7, 1984)].

27

Additionally, registrants should disclose any special procedures for crediting initial purchase payments in the case of incomplete
applications (e.g., allocation of an initial purchase payment to the sub-account which invests in the money market fund if no sub-account
has been specified).
Guide 12. Automatic Annuity Options
Item 8 of Form N-4 calls for disclosure about annuity option choices available to a prospective annuitant and the effect of not
specifying a choice. Registrants should disclose any automatic purchase of a fixed annuity (i.e., the annuity selection that will be made
by the company if the prospective annuitant has not chosen an option.) The staff has taken the position that an automatic annuity involving
a fixed pay out of amounts that have accumulated on a variable basis is not consistent with Section 27(c)(1) of the 1940 Act [15 U.S.C.
80a-27(c)(1)]. However, the staff does not object to an automatic fixed annuity purchase if the only options available under the variable
annuity contract are fixed annuities.
Guide 13. Fee Table
Item 3 requires inclusion of a fee table in the front of the prospectus. The amounts listed in the Example should represent cumulative
expenses. Therefore, the Registrant should aggregate any sales load or other fee deducted from payments, together with cumulative
annual expenses, and any sales load or other fee deducted upon surrender. The Registrant may compute annual expenses by multiplying
average annual assets of the hypothetical $1,000 account for each year by total annual expenses (a percentage taken from the second
part of the table). Compute the account’s average annual assets by adding the beginning account value to the ending account value and
dividing by two. Determine the ending account value by multiplying the beginning account value by the assumed growth rate less total
annual expenses (5% x X%) and adding the result to the beginning account value. Determine the beginning account value in the first
year by subtracting the maximum amount of any sales load deducted from payments from the hypothetical $1000 payment; in each
subsequent year, the beginning account value is the previous year’s ending account value.

28