EFDID: 82407EFD: View Filing

Issuer: Lombard International Life Assurance Co Separate Account VA104 (0001568166) - D/A

Accession: 0001568166-16-000003 (XMLRaw Data) (EDGAREDGAR Files) (Form DForm D)

EDGAR: Issuer Information
  • CIK:
    0001568166
  • Entity Name:
    Lombard International Life Assurance Co Separate Account VA104
  • Entity Type:
    Other
  • Jurisdiction:
    PENNSYLVANIA
  • Year of Inc:
    Within 5 years (2013)
  • Address:
    ONE LIBERTY PLACE
    1650 MARKET STREET - 54TH FLOOR
    PHILADELPHIA, PA 19103
  • Persons:
    Related Persons 1
    LILAC Lombard International Life Assurance Company
    Promoter 
    Issuer is an insurance company separate account authorized by PA insurance statute.
EDGAR: Offering Information
  • Accession Date:
    03/22/2016
  • First Sale Date:
    10/09/2013
  • Offering Amount:
    Indefinite
  • Amount Sold:
    $2,126,406
  • Exemptions:
    Section 3(c)(7), Investment Company Act Section 3(c) , Rule 506
  • Security Type(s):
    Pooled Investment Fund, variable annuity contracts
EFD: Current State Notices

No State Notices found in EFD

EDGAR: Sales Compensation Recipient Information
RecipientCRDBroker DealerBD CRDStates
M Holdings Securities, Inc. 43285 Edward Houghton 735581 TX
Summit Equities, Inc. 11039 Donald Gross 1913749 FL, TX
Winklevoss Insurance Agency, LLC 39081 Brian F. Burke 1024635 FL
Summit Equities, Inc. 11039 Lawrence Bell 2227247 FL
EDGAR: Signatures
IssuerSignatureSigner NameTitleSignatureDate
Lombard International Life Assurance Co Separate Account VA104/s/ John F ReillyJohn F. ReillySenior Vice President and Deputy General Counsel2016-03-22
Related EDGAR Submissions
Type Edgar Date EFD: Accession
D/A Mar. 22, 2016 82407: 0001568166-16-000003 Lombard International Life Assurance Co Separate Account VA104
Amount Sold: $2,126,406
D/A Jan. 23, 2015 82407: 0001568166-15-000001 Philadelphia Financial Life Assurance Co Separate Account VA104
Amount Sold: $1,932,971
D Oct. 15, 2013 82407: 0001568166-13-000001 Philadelphia Financial Life Assurance Co Separate Account VA104
Amount Sold: $1,232,971