This is the Primary Document downloaded from EDGAR on 12/15/2021 10:11:56 AM EST for EFDID 421948 and Accession Number 0001836983-21-000002.

Please note that this is not the current Accession Number for this EFDId.

SEC FORM D

The Securities and Exchange Commission has not necessarily reviewed the information in this filing and has not determined if it is accurate and complete.
The reader should not assume that the information is accurate and complete.

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

Notice of Exempt Offering of Securities
OMB APPROVAL
OMB Number: 3235-0076
Estimated average burden
hours per response: 4.00

1. Issuer's Identity

CIK (Filer ID Number) Previous Names
X None
Entity Type
0001836983
   Corporation
   Limited Partnership
   Limited Liability Company
   General Partnership
   Business Trust
X Other (Specify)

Insurance Company Separate Account
Name of Issuer
Protective COLI PPVUL
Jurisdiction of Incorporation/Organization
TENNESSEE
Year of Incorporation/Organization
   Over Five Years Ago
X Within Last Five Years (Specify Year) 2020
   Yet to Be Formed

2. Principal Place of Business and Contact Information

Name of Issuer
Protective COLI PPVUL
Street Address 1 Street Address 2
2801 HIGHWAY 280 SOUTH
City State/Province/Country ZIP/PostalCode Phone Number of Issuer
BIRMINGHAM ALABAMA 35223 205-268-1000

3. Related Persons

Last Name First Name Middle Name
Protective Life Insurance Company
Street Address 1 Street Address 2
2801 Highway 280 South
City State/Province/Country ZIP/PostalCode
Birmingham ALABAMA 35223
Relationship:    Executive Officer    Director X Promoter

Clarification of Response (if Necessary):

The issuer is an insurance company separate account established and maintained by Protective Life Insurance Company.

4. Industry Group

   Agriculture
Banking & Financial Services
   Commercial Banking
   Insurance
   Investing
   Investment Banking
X Pooled Investment Fund
   Hedge Fund
   Private Equity Fund
   Venture Capital Fund
X Other Investment Fund
Is the issuer registered as
an investment company under
the Investment Company
Act of 1940?
   Yes X No
   Other Banking & Financial Services
   Business Services
Energy
   Coal Mining
   Electric Utilities
   Energy Conservation
   Environmental Services
   Oil & Gas
   Other Energy
Health Care
   Biotechnology
   Health Insurance
   Hospitals & Physicians
   Pharmaceuticals
   Other Health Care
   Manufacturing
Real Estate
   Commercial
   Construction
   REITS & Finance
   Residential
   Other Real Estate
  
 Retailing
  
 Restaurants
Technology
   Computers
   Telecommunications
   Other Technology
Travel
   Airlines & Airports
   Lodging & Conventions
   Tourism & Travel Services
   Other Travel
  
 Other

5. Issuer Size

Revenue Range OR Aggregate Net Asset Value Range
   No Revenues    No Aggregate Net Asset Value
   $1 - $1,000,000    $1 - $5,000,000
   $1,000,001 - $5,000,000    $5,000,001 - $25,000,000
   $5,000,001 - $25,000,000    $25,000,001 - $50,000,000
   $25,000,001 - $100,000,000    $50,000,001 - $100,000,000
   Over $100,000,000    Over $100,000,000
   Decline to Disclose X Decline to Disclose
   Not Applicable    Not Applicable

6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)

   Rule 504(b)(1) (not (i), (ii) or (iii))
   Rule 504 (b)(1)(i)
   Rule 504 (b)(1)(ii)
   Rule 504 (b)(1)(iii)
X Rule 506(b)
   Rule 506(c)
   Securities Act Section 4(a)(5)
X Investment Company Act Section 3(c)
   Section 3(c)(1)    Section 3(c)(9)  
   Section 3(c)(2)    Section 3(c)(10)
   Section 3(c)(3)    Section 3(c)(11)
   Section 3(c)(4)    Section 3(c)(12)
   Section 3(c)(5)    Section 3(c)(13)
   Section 3(c)(6)    Section 3(c)(14)
X Section 3(c)(7)

7. Type of Filing

X New Notice Date of First Sale 2021-02-01    First Sale Yet to Occur
   Amendment

8. Duration of Offering

Does the Issuer intend this offering to last more than one year?
X Yes    No

9. Type(s) of Securities Offered (select all that apply)

   Equity X Pooled Investment Fund Interests
   Debt    Tenant-in-Common Securities
   Option, Warrant or Other Right to Acquire Another Security    Mineral Property Securities
   Security to be Acquired Upon Exercise of Option, Warrant or Other Right to Acquire Security X Other (describe)
Variable life insurance contract

10. Business Combination Transaction

Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer?
   Yes X No

Clarification of Response (if Necessary):

The issuer is an insurance company separate account established and maintained by Protective Life Insurance Company

11. Minimum Investment

Minimum investment accepted from any outside investor $0 USD

12. Sales Compensation

Recipient
Recipient CRD Number    None
Scott Cohen 2400506
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
Kestra Financial 42046
Street Address 1 Street Address 2
5707 SW PKWY Bldg 2, Ste 400
City State/Province/Country ZIP/Postal Code
Austin TEXAS 78735
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
TEXAS
Recipient
Recipient CRD Number    None
James Wheeler 6541425
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
NMIS LLC 2881
Street Address 1 Street Address 2
720 W Wisconsin Ave
City State/Province/Country ZIP/Postal Code
Milwaukee WISCONSIN 53202
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
NORTH CAROLINA
WISCONSIN
Recipient
Recipient CRD Number    None
Sean Devlin 2782108
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
Newport Securities Inc 29722
Street Address 1 Street Address 2
300 Primera Blvd #200
City State/Province/Country ZIP/Postal Code
Lake Mary FLORIDA 32746
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
TEXAS
Recipient
Recipient CRD Number    None
Mike Nolan 1157483
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
Lincoln Financial 3978
Street Address 1 Street Address 2
8219 Leesburg Pike
City State/Province/Country ZIP/Postal Code
Vienna VIRGINIA 22182
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
COLORADO
Recipient
Recipient CRD Number    None
Thomas Cook 557751
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
Valmark 15384
Street Address 1 Street Address 2
130 Springside Drive Suite 300
City State/Province/Country ZIP/Postal Code
Akron OHIO 44333
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
COLORADO
Recipient
Recipient CRD Number    None
Phi Currie 1942867
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
Valmark 31243
Street Address 1 Street Address 2
5515 Peachtree Pkwy #3220
City State/Province/Country ZIP/Postal Code
Norcross GEORGIA 30092
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
COLORADO
Recipient
Recipient CRD Number    None
Corby Dell 2060321
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
Triad Advisors 25803
Street Address 1 Street Address 2
300 International Pkwy #350
City State/Province/Country ZIP/Postal Code
Lake Mary FLORIDA 32746
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
COLORADO
Recipient
Recipient CRD Number    None
Brian Donofry 2820997
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
Kestra 42046
Street Address 1 Street Address 2
1250 Capital of Texas Hwy S
City State/Province/Country ZIP/Postal Code
Austin TEXAS 78746
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
IOWA
Recipient
Recipient CRD Number    None
Jimmy Edwards 4342552
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
M Holdings 43285
Street Address 1 Street Address 2
1125 Couch Street Suite 900
City State/Province/Country ZIP/Postal Code
Porland OREGON 97209
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
DELAWARE
Recipient
Recipient CRD Number    None
William Schantz 1923047
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
M Holdings 43285
Street Address 1 Street Address 2
1125 Couch Street Suite 900
City State/Province/Country ZIP/Postal Code
Porland OREGON 97209
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
DELAWARE
Recipient
Recipient CRD Number    None
Rhonda Miller 281773
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
M Holdings 43285
Street Address 1 Street Address 2
100 N Pacific Coast HWY
City State/Province/Country ZIP/Postal Code
El Segundo CALIFORNIA 90245
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
ARIZONA
Recipient
Recipient CRD Number    None
Rick Callister 3185802
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
FAS Corp 66224
Street Address 1 Street Address 2
4747 W 135th St
City State/Province/Country ZIP/Postal Code
Leawood KANSAS 66224
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
ARIZONA
Recipient
Recipient CRD Number    None
Sam Sheth 2511571
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
FAS Corp 43536
Street Address 1 Street Address 2
4747 W 135th St
City State/Province/Country ZIP/Postal Code
Leawood KANSAS 66224
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
ARIZONA
Recipient
Recipient CRD Number    None
Jonathan Resin 2308703
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
RBC Wealth Mgmt 31194
Street Address 1 Street Address 2
1801 California St
City State/Province/Country ZIP/Postal Code
Denver COLORADO 80202
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
ARIZONA
Recipient
Recipient CRD Number    None
Phillip Hammit 2409244
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
RBC Wealth Mgmt 31194
Street Address 1 Street Address 2
1801 California St
City State/Province/Country ZIP/Postal Code
Denver COLORADO 80202
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
ARIZONA
Recipient
Recipient CRD Number    None
Todd Mezrah 2313891
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
Lion Street 165828
Street Address 1 Street Address 2
515 Congress Ave Ste 2500
City State/Province/Country ZIP/Postal Code
Austin TEXAS 78701
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
COLORADO
Recipient
Recipient CRD Number    None
Thomas Cook 557755
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
Capacuity 118
Street Address 1 Street Address 2
300 International Pkwy #200
City State/Province/Country ZIP/Postal Code
Lake Mary FLORIDA 32746
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
ARIZONA
Recipient
Recipient CRD Number    None
Bryant Kirk 1049653
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
Capacuity 15384
Street Address 1 Street Address 2
300 International Pkwy #350
City State/Province/Country ZIP/Postal Code
Lake Mary FLORIDA 32746
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
ARIZONA
Recipient
Recipient CRD Number    None
Bryan Murphy 716265
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
Triad 25803
Street Address 1 Street Address 2
15615 Alton Pkwy
City State/Province/Country ZIP/Postal Code
Irvine CALIFORNIA 92618
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
ARIZONA
Recipient
Recipient CRD Number    None
Curt Burris 2751954
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
Newport Securities 29722
Street Address 1 Street Address 2
300 Primera Blvd #200
City State/Province/Country ZIP/Postal Code
Lake Mary FLORIDA 32746
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
MINNESOTA
Recipient
Recipient CRD Number    None
Larry Deatherage 2205503
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
Triad 25803
Street Address 1 Street Address 2
15615 Alton Pkwy
City State/Province/Country ZIP/Postal Code
Irvine CALIFORNIA 92618
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
MINNESOTA
Recipient
Recipient CRD Number    None
Gordon Chislm 2938261
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
Valmark 31243
Street Address 1 Street Address 2
300 Primera Blvd #200
City State/Province/Country ZIP/Postal Code
Lake Mary FLORIDA 32746
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
COLORADO
Recipient
Recipient CRD Number    None
David Fisher 1438120
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
Valmark 31243
Street Address 1 Street Address 2
600 36th St
City State/Province/Country ZIP/Postal Code
Newport Beach CALIFORNIA 92663
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
COLORADO
Recipient
Recipient CRD Number    None
Kevin Segal 3092034
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
M Holding 43285
Street Address 1 Street Address 2
1125 NW Couch Street #900
City State/Province/Country ZIP/Postal Code
Port OREGON 97209
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
ARIZONA
Recipient
Recipient CRD Number    None
David Hauptman 2749100
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
M Holdings 43285
Street Address 1 Street Address 2
1125 NW Couch Street #900
City State/Province/Country ZIP/Postal Code
Port OREGON 97209
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
ARIZONA
Recipient
Recipient CRD Number    None
Scott McGee 4768668
(Associated) Broker or Dealer    None
(Associated) Broker or Dealer CRD Number    None
Newport Group Securities 29722
Street Address 1 Street Address 2
300 Primera Blvd #200
City State/Province/Country ZIP/Postal Code
Lake Mary FLORIDA 32746
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States		    All States
   Foreign/non-US
MINNESOTA

13. Offering and Sales Amounts

Total Offering Amount USD
or X Indefinite
Total Amount Sold $463,317,533 USD
Total Remaining to be Sold USD
or X Indefinite

Clarification of Response (if Necessary):

14. Investors

  
 Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors, and enter the number of such non-accredited investors who already have invested in the offering.
Regardless of whether securities in the offering have been or may be sold to persons who do not qualify as accredited investors, enter the total number of investors who already have invested in the offering:
17

15. Sales Commissions & Finder's Fees Expenses

Provide separately the amounts of sales commissions and finders fees expenses, if any. If the amount of an expenditure is not known, provide an estimate and check the box next to the amount.

Sales Commissions $0 USD
   Estimate
Finders' Fees $0 USD
   Estimate

Clarification of Response (if Necessary):

Sales comp paid by Ins. Co. out of its own resources. The Company periodically deducts ins. & other contract charges from amounts allocated to the separate account issuer in accordance with the terms of the applicable variable life ins contract.

16. Use of Proceeds

Provide the amount of the gross proceeds of the offering that has been or is proposed to be used for payments to any of the persons required to be named as executive officers, directors or promoters in response to Item 3 above. If the amount is unknown, provide an estimate and check the box next to the amount.

$0 USD
   Estimate

Clarification of Response (if Necessary):

No gross premiums received under VUL contracts have been or are proposed to be used for pymnts to promoter. Ins Co periodically deducts ins & other contract charges from amnts allocated to separate account issuer under terms of applicable VUL contracts.

Signature and Submission

Please verify the information you have entered and review the Terms of Submission below before signing and clicking SUBMIT below to file this notice.

Terms of Submission

In submitting this notice, each issuer named above is:
  • Notifying the SEC and/or each State in which this notice is filed of the offering of securities described and undertaking to furnish them, upon written request, in the accordance with applicable law, the information furnished to offerees.*
  • Irrevocably appointing each of the Secretary of the SEC and, the Securities Administrator or other legally designated officer of the State in which the issuer maintains its principal place of business and any State in which this notice is filed, as its agents for service of process, and agreeing that these persons may accept service on its behalf, of any notice, process or pleading, and further agreeing that such service may be made by registered or certified mail, in any Federal or state action, administrative proceeding, or arbitration brought against the issuer in any place subject to the jurisdiction of the United States, if the action, proceeding or arbitration (a) arises out of any activity in connection with the offering of securities that is the subject of this notice, and (b) is founded, directly or indirectly, upon the provisions of:  (i) the Securities Act of 1933, the Securities Exchange Act of 1934, the Trust Indenture Act of 1939, the Investment Company Act of 1940, or the Investment Advisers Act of 1940, or any rule or regulation under any of these statutes, or (ii) the laws of the State in which the issuer maintains its principal place of business or any State in which this notice is filed.
  • Certifying that, if the issuer is claiming a Regulation D exemption for the offering, the issuer is not disqualified from relying on Rule 504 or Rule 506 for one of the reasons stated in Rule 504(b)(3) or Rule 506(d).

Each Issuer identified above has read this notice, knows the contents to be true, and has duly caused this notice to be signed on its behalf by the undersigned duly authorized person.

For signature, type in the signer's name or other letters or characters adopted or authorized as the signer's signature.

Issuer Signature Name of Signer Title Date
Protective COLI PPVUL Ron Laeyendecker Ron Laeyendecker SVP, Executive Benefits Markets 2021-12-15

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 number.

* This undertaking does not affect any limits Section 102(a) of the National Securities Markets Improvement Act of 1996 ("NSMIA") [Pub. L. No. 104-290, 110 Stat. 3416 (Oct. 11, 1996)] imposes on the ability of States to require information. As a result, if the securities that are the subject of this Form D are "covered securities" for purposes of NSMIA, whether in all instances or due to the nature of the offering that is the subject of this Form D, States cannot routinely require offering materials under this undertaking or otherwise and can require offering materials only to the extent NSMIA permits them to do so under NSMIA's preservation of their anti-fraud authority.