Funeral Or Burial Funds Act Annual Forms (Page 2 of 11) in pdf

GENERAL INSTRUCTIONS

Each licensee’s annual report is due 75 days after the end of the licensee’s fiscal year. If needed, upon written request to the Comptroller,

an additional extension of 60 days will be granted for good cause. To be considered, requests for extension must be postmarked no later

than the due date of your annual report. Please be aware that Section 3 of the Illinois Funeral or Burial Funds Act requires the Comptroller

to impose upon a licensee a penalty of $5 for each and every day the licensee remains delinquent in submitting an annual report within the

time required. 225 ILCS 45/3. Incomplete or illegible reports may result in the imposition of the penalty.

Licensees must submit an original report, one copy of the report, and a check or money order in the amount of $10 payable to the

“Comptroller, State of Illinois.”

Please send the report to:

Office of the Comptroller • Cemetery Care and Burial Trust Department • 100 W. Randolph, Suite 15-500 • Chicago, Illinois 60601

If you have any questions please contact our office at 1-877-203-3401.

The Illinois Office of the Comptroller reserves the right to reject incomplete or illegible reports. To that end, please adhere to the follow-

ing guidelines when preparing your report:

• Return this form with all pages completed and all inquiries answered. All inapplicable spaces should be marked “N/A”.

• Information provided by the licensee must be legible and completed in ink.

• Use of computer generated printouts to present the financial data required on supporting schedules is acceptable so long as the appro-

priate totals are reflected on the forms provided by this office. However, please complete in full the page entitled “Annual Statement

of Funeral or Burial Trust Funds” provided by this office.

• Provide all year-end investment reports from banks or trust companies, as applicable.

• Please attach as part of this annual report a copy of the annual report prepared by each insurance company issuing insurance policies

and/or tax-deferred annuities used to fund pre-need contracts sold by licensee. The report must list all active policies and annuities writ-

ten after January 1, 1994 and contain the following information for each policy or annuity: (1) the contract date, (2) the name of insured

(3) the policy or annuity number, (4) the beginning of the reporting year face amount, (5) increases to the face amount, (6) surren-

der/death benefits paid, (7) the end of year face amount, (8) the fiscal year premium paid, and (9) the status of the policy (e.g., can-

celled, cash surrender, death, extended term, in force, limited death benefit, reduced paid up).

• Forms may be duplicated unless otherwise indicated.

Explanation of Terms

Terms used throughout the Funeral or Burial Funds Act Annual Forms have the meanings indicated below.

Beneficiary

The person specified in the pre-need contract upon whose death funeral services or merchandise shall be pro-

vided or delivered.

Corporation

A statutory entity having authority under law to act as a single person distinct from the shareholders that make

it up and having rights to issue stock and exist indefinitely. 805 ILCS 5/1.01, et seq.

Custodian

A depository institution (e.g., a bank) holding funds entrusted to a licensee or independent trustee pursuant to the

Illinois Funeral or Burial Funds Act.

Independent Trustee

A trustee, other than the licensee, that has a written agreement with the licensee to hold and administer funer-

al or burial funds and who must manage this property for the benefit of the consumer pursuant to the Illinois

Funeral or Burial Funds Act. 225 ILCS 45/1, et seq. Section 1b of the Illinois Funeral and Burial Funds Act

mandates licensee to entrust all funds over $500,000 with an (multiple) Independent Trustee (s). 225 ILCS

45/1b.

Insurance Agent

Individual licensed from the Department of Insurance to sell life insurance in the State of Illinois.

Corporate Fiduciary

A trust company; the trust department of a bank, savings bank, savings and loan association, a foreign banking

corporation issued a certificate of authority pursuant to the Foreign Banking Office Act; or any person that is

required to and has received a certificate of authority under this act authorizing the exercise of trust powers. A

national bank or federally chartered savings and loan association or savings bank which is authorized by the

appropriate federal agency to accept and execute trust and which has its principal place of business in this state,

whenever in this act such construction is necessary so that the national bank or federally chartered savings and

loan association or savings bank may enjoy and exercise in this state all of the powers, rights and privileges author-

ized or permitted to a corporate fiduciary holding a certificate of authority under the Corporate Fiduciary Act. 205

ILCS 620/1-5.05.

Licensee

A person issued a license by the Office of the Comptroller pursuant to the Illinois Funeral or Burial Funds Act.

225 ILCS 45/1, et seq.

License Number

A unique number assigned by the Office of the Comptroller to a licensee under the Illinois Funeral or Burial

Funds Act.

N.A.I.C. Number

Number assigned to an insurance company by the National Association of Insurance Commissioners.

Name of Business

The name under which a business entity is commonly known.

Person

Any person, partnership, association, corporation, or other entity.

Premium

The amount paid in the reporting year to purchase a pre-need insurance policy or annuity.

Pre-Need Contract

Any agreement or contract, or any series or combinations of agreements or contracts, whether funded by trust

deposits or life insurance policies or annuities, which has for a purpose the furnishing or performance of funer-

al services or the furnishing or delivery of any personal property, merchandise, or services of any nature in con-

nection with the final disposition of a dead human body.

Trustee

A person authorized to hold funds in trust under the Illinois Funeral or Burial Funds Act.

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Funeral Or Burial Funds Act Annual Forms Page 2

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