QUARTERLY BLANKS |
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Fraternal Quarterly Blank |
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2-3-10 |
Changed Line 2 from “Paid/(Consideration Received)” to “(Paid)/Consideration Received” |
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Health Quarterly Blank |
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2-3-10 |
Changed Line 2 from “Paid/(Consideration Received)” to “(Paid)/Consideration Received” |
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Life Quarterly Blank |
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2-3-10 |
Changed Line 2 from “Paid/(Consideration Received)” to “(Paid)/Consideration Received” |
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Property Quarterly Blank |
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2-3-10 |
Changed Line 2 from “Paid/(Consideration Received)” to “(Paid)/Consideration Received” |
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Title Quarterly Blank |
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2-3-10 |
Changed Line 2 from “Paid/(Consideration Received)” to “(Paid)/Consideration Received” |
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ANNUAL BLANKS |
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Fraternal Annual Blank |
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| Supplemental Health Care Exhibit – Part 3 |
11/9/10 | Removed "xxx" from Cols. 1, 6, 7, 8 and 9. |
| Supplemental Health Care Exhibit – Part 2 | 2/3/11 | Added “xxx” to Lines 1.5,1.6 and 1.7, Cols. 1 through 7. Removed “+ 1.7” in the parenthetical reference in Line 1.8. Revised the formula on Line 1.13 in parenthetical reference to read "1.8 + 1.9 + 1.10 - 1.11 + 1.12." Revised the formula on Line 2.15 in parenthetical reference to read "2.10 + 2.11 + 2.12 - 2.13 + 2.14. |
| 10/26/10 | Added "xxx" to Line 12, Cols. 1 through 7. Removed "xxx" from Lines 13 and 15, Col. 7. | |
| Analysis of Increase in Annuity Reserves During the Year | 9/27/10 | Added "xxx" to Line 3, Cols. 4 and 5 |
Health Annual Blank |
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| Supplemental Health Care Exhibit – Part 3 |
11/9/10 | Removed "xxx" from Cols. 1, 6, 7, 8 and 9. |
| Supplemental Health Care Exhibit – Part 2 | 2/3/11 | Added “xxx” to Lines 1.5,1.6 and 1.7, Cols. 1 through 7. Removed “+ 1.7” in the parenthetical reference in Line 1.8. Revised the formula on Line 1.13 in parenthetical reference to read "1.8 + 1.9 + 1.10 - 1.11 + 1.12." Revised the formula on Line 2.15 in parenthetical reference to read "2.10 + 2.11 + 2.12 - 2.13 + 2.14." |
| Supplemental Health Care Exhibit – Part 1 | 10/26/10 | Added "xxx" to Line 12, Cols. 1 through 7. Removed "xxx" from Lines 13 and 15, Col. 7. |
Life Annual Blank |
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| Supplemental Health Care Exhibit – Part 3 |
11/9/10 | Removed "xxx" from Cols. 1, 6, 7, 8 and 9. |
| Supplemental Health Care Exhibit – Part 2 | 2/3/11 | Added “xxx” to Lines 1.5,1.6 and 1.7, Cols. 1 through 7. Removed “+ 1.7” in the parenthetical reference in Line 1.8. Revised the formula on Line 1.13 in parenthetical reference to read "1.8 + 1.9 + 1.10 - 1.11 + 1.12." Revised the formula on Line 2.15 in parenthetical reference to read "2.10 + 2.11 + 2.12 - 2.13 + 2.14." |
| Supplemental Health Care Exhibit – Part 1 | 10/26/10 | Added "xxx" to Line 12, Cols. 1 through 7. Removed "xxx" from Lines 13 and 15, Col. 7. |
Property Annual Blank |
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| Supplemental Health Care Exhibit – Part 3 |
11/9/10 | Removed "xxx" from Cols. 1, 6, 7, 8 and 9. |
| Supplemental Health Care Exhibit – Part 2 | 2/3/11 | Added “xxx” to Lines 1.5,1.6 and 1.7, Cols. 1 through 7. Removed “+ 1.7” in the parenthetical reference in Line 1.8. Revised the formula on Line 1.13 in parenthetical reference to read "1.8 + 1.9 + 1.10 - 1.11 + 1.12." Revised the formula on Line 2.15 in parenthetical reference to read "2.10 + 2.11 + 2.12 - 2.13 + 2.14." |
| Supplemental Health Care Exhibit – Part 1 | 10/26/10 | Added "xxx" to Line 12, Cols. 1 through 7. Removed "xxx" from Lines 13 and 15, Col. 7. |
Protected Cell Annual Blank |
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Separate Accounts Annual Blank |
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Title Annual Blank |
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