Schedule A
- Row 1
- Filing Id
- 84037246086274
- Form Id
- 50509119
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 1
- Row Num
- 0
- Image Form Id
- 3020374246086020002
- Ins Broker 01 Name
- THOMAS OLEXA
- Ins Broker 01 Street Addr
- 1051 PERIMETER DRIVE-SUITE 1125
- Ins Broker 01 City
- SCHAUMBURG
- Ins Broker 01 State
- IL
- Ins Broker 01 ZIP Code
- 60173
- Ins Broker Comm Pd 01 Amount
- $515
- Ins Broker Fees Pd 01 Amount
- $0
- Ins Broker 01 Code
- 3
- Row 2
- Filing Id
- 84037246086274
- Form Id
- 50509119
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 2
- Row Num
- 1
- Image Form Id
- 3020374246086020002
- Ins Broker 01 Name
- THE BENEFITS CONSULTING GROUP
- Ins Broker 01 Street Addr
- 53 W. JACKSON BOULEVARD-SUITE 1651
- Ins Broker 01 City
- CHICAGO
- Ins Broker 01 State
- IL
- Ins Broker 01 ZIP Code
- 60604
- Ins Broker Comm Pd 01 Amount
- $370
- Ins Broker Fees Pd 01 Amount
- $0
- Ins Broker 01 Code
- 5
- Row 3
- Ins Carrier Name: MANULIFE FINANCIAL (USA)
- Filing Id
- 84037246086274
- Form Id
- 50509119
- Schedule A EIN
- 36-3090607
- Schedule A Plan Num
- 002
- Schedule A Plan Year Begin Date
- 2003-01-01
- Schedule A Tax Period
- 20031231
- Ins Carrier Name
- MANULIFE FINANCIAL (USA)
- Ins Carrier EIN
- 01-0233346
- Ins Carrier Naic Code
- 65838
- Ins Contract Num
- 74484
- Ins Prsn Covered End of year Count
- 14
- Ins Policy From Date
- 2003-01-01
- Ins Policy To Date
- 2003-12-31
- Ins Broker Comm Total Amount
- $885
- Ins Broker Fees Total Amount
- $0
- Pension End of year Gen Account Amount
- $0
- Pension End of year Sep Account Amount
- $798,779
- Pension Prem Paid Total Amount
- $0
- Pension Unpaid Premium Amount
- $0
- Pension Contract Cost Amount
- $0
- Pension Type Alloc Cntrct Indicator
- 3
- Pension Oth Alloc Type Text
- GUARANTEED INTERST
- Pension End Prev Bal Amount
- $0
- Pension Contribution Dep Amount
- $0
- Pension Divnd Cr Dep Amount
- $0
- Pension Interest Cr Dur Yr Amount
- $0
- Pension Transfer From Amount
- $0
- Pension Other Amount
- $0
- Pension Total Additions Amount
- $0
- Pension Total Bal Addn Amount
- $0
- Pension Bnfts Dsbrsd Amount
- $0
- Pension Admin Chrg Amount
- $0
- Pension Transfer To Amount
- $0
- Pension Oth Ded Amount
- $0
- Pension Total Ded Amount
- $0
- Pension End of year Bal Amount
- $0
- Wlfr Premium Rcvd Amount
- $0
- Wlfr Unpaid Due Amount
- $0
- Wlfr Reserve Amount
- $0
- Wlfr Total Earned Prem Amount
- $0
- Wlfr Claims Paid Amount
- $0
- Wlfr Incr Reserve Amount
- $0
- Wlfr Incurred Claim Amount
- $0
- Wlfr Claims Chrgd Amount
- $0
- Wlfr Ret Commissions Amount
- $0
- Wlfr Ret Admin Amount
- $0
- Wlfr Ret Oth Cost Amount
- $0
- Wlfr Ret Oth Expense Amount
- $0
- Wlfr Ret Taxes Amount
- $0
- Wlfr Ret Charges Amount
- $0
- Wlfr Ret Oth Chrgs Amount
- $0
- Wlfr Ret Total Amount
- $0
- Wlfr Refund Amount
- $0
- Wlfr Held Bnfts Amount
- $0
- Wlfr Claims Reserve Amount
- $0
- Wlfr Oth Reserve Amount
- $0
- Wlfr Divnds Due Amount
- $0
- Wlfr Total Charges Paid Amount
- $0
- Wlfr Acquis Cost Amount
- $0
Schedule D
- Row 1
- Filing Id
- 84037246086274
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 1
- Row Num
- 0
- Image Form Id
- 3020374246086020003
- Row 2
- Filing Id
- 84037246086274
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 1
- Row Num
- 0
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- LIFE STYLE BALANCED
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $81,387
- Row 3
- Filing Id
- 84037246086274
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 2
- Row Num
- 1
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- LIFE STYLE GROWTH
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $91,174
- Row 4
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 1
- Page Row Num
- 1
- Row Num
- 10
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- INCOME & VALUE
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $3,784
- Row 5
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 1
- Page Row Num
- 2
- Row Num
- 11
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- EQUITY INCOME
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $6,238
- Row 6
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 1
- Page Row Num
- 3
- Row Num
- 12
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- SMC
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $6,508
- Row 7
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 1
- Page Row Num
- 4
- Row Num
- 13
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- GROWTH & INCOME
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $1,640
- Row 8
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 1
- Page Row Num
- 5
- Row Num
- 14
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- USLCP
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $3,688
- Row 9
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 1
- Page Row Num
- 6
- Row Num
- 15
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- BLUE CHIP
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $53,831
- Row 10
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 2
- Page Row Num
- 1
- Row Num
- 16
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- QN EQUITY
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $1,204
- Row 11
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 2
- Page Row Num
- 2
- Row Num
- 17
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- LARGE CAP GROWTH
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $1,339
- Row 12
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 2
- Page Row Num
- 3
- Row Num
- 18
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- ALLCORE
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $1,184
- Row 13
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 2
- Page Row Num
- 4
- Row Num
- 19
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- IN QB
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $1,867
- Row 14
- Filing Id
- 84037246086274
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 3
- Row Num
- 2
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- LIFE STYLE AGGRESSIVE
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $59,684
- Row 15
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 2
- Page Row Num
- 5
- Row Num
- 20
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- INDEX MID CAP
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $4,740
- Row 16
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 2
- Page Row Num
- 6
- Row Num
- 21
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- STR OPPORTUNITY
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $1,152
- Row 17
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 3
- Page Row Num
- 1
- Row Num
- 22
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- INDEX 500
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $33,639
- Row 18
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 3
- Page Row Num
- 2
- Row Num
- 23
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- RESTS
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSUARNCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $3,610
- Row 19
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 3
- Page Row Num
- 3
- Row Num
- 24
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- INDEX TOTAL
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $20,790
- Row 20
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 3
- Page Row Num
- 4
- Row Num
- 25
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- MC ST
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $9,716
- Row 21
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 3
- Page Row Num
- 5
- Row Num
- 26
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- DYN GROWTH
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $2,876
- Row 22
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 3
- Page Row Num
- 6
- Row Num
- 27
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- INDEX SMALL
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $4,172
- Row 23
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 4
- Page Row Num
- 1
- Row Num
- 28
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- IT VL
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $1,527
- Row 24
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 4
- Page Row Num
- 2
- Row Num
- 29
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- EMGR
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $949
- Row 25
- Filing Id
- 84037246086274
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 4
- Row Num
- 3
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- MONEY MARKET FUND
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $345,816
- Row 26
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 4
- Page Row Num
- 3
- Row Num
- 30
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- PCRIM
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $499
- Row 27
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 1
- Row Num
- 4
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- U.S. GOVERNMENT
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $5,921
- Row 28
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 2
- Row Num
- 5
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- 3 YR COMP
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $409
- Row 29
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 3
- Row Num
- 6
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- TOTAL
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $2,190
- Row 30
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 4
- Row Num
- 7
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- GL BOND
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $7,268
- Row 31
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 5
- Row Num
- 8
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- VALUE
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $487
- Row 32
- Filing Id
- 84037246086274
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 6
- Row Num
- 9
- Image Form Id
- 3020374246086020003
- DFE P1 Entity 01 Name
- HIGH YIELD
- DFE P1 Spons 01 Name
- MANUFACTURERS LIFE INSURANCE CO.
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $2,506
- Row 33
- Filing Id
- 84037246086274
- Schedule D EIN
- 36-3090607
- Schedule D Plan number
- 002
- Schedule D Plan Year Begin Date
- 2003-01-01
- Schedule D Tax Period
- 20031231