Form N-6ei-1 Notification Of Claim Of Exemption Pursuant

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UNITED STATES
OMB APPROVAL
SECURITIES AND EXCHANGE COMMISSION
OMB Number:
235-0177
Washington, D.C. 20549
Expires:
April 30, 2018
Estimated average burden
hours per response
1
Form N-6EI-1
[As last amended in Release No. IC-14234, November 14, 1984, 49 F.R. 47208]
FORM N-6EI-1
Notification of Claim of Exemption Pursuant to Rule 6e-2 or 6e-3(T) Under
The Investment Company Act of 1940
__________________________________________________________________________________________________
Exact Name of Separate Account
__________________________________________________________________________________________________
Exact Name of Life Insurance Company which Established and Main
the Separate Account (“Life Insurer”)
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.
SEC1130 (3-03)

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