Schedule A
- Row 1
- Filing Id
- 86037210003473
- Form Id
- 35754788
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 1
- Row Num
- 0
- Image Form Id
- 99550373210003470004
- Ins Broker Comm Pd 01 Amount
- $0
- Ins Broker Fees Pd 01 Amount
- $0
- Row 2
- Filing Id
- 86037210003473
- Form Id
- 35754786
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 1
- Row Num
- 0
- Image Form Id
- 99550373210003470002
- Ins Broker Comm Pd 01 Amount
- $0
- Ins Broker Fees Pd 01 Amount
- $0
- Row 3
- Filing Id
- 86037210003473
- Form Id
- 35754781
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 1
- Row Num
- 0
- Image Form Id
- 99550373210003470001
- Ins Broker Comm Pd 01 Amount
- $0
- Ins Broker Fees Pd 01 Amount
- $0
- Row 4
- Filing Id
- 86037210003473
- Form Id
- 35754787
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 1
- Row Num
- 0
- Image Form Id
- 99550373210003470003
- Ins Broker Comm Pd 01 Amount
- $0
- Ins Broker Fees Pd 01 Amount
- $0
- Row 5
- Filing Id
- 86037210003473
- Form Id
- 35754789
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 1
- Row Num
- 0
- Image Form Id
- 99550373210003470005
- Ins Broker Comm Pd 01 Amount
- $0
- Ins Broker Fees Pd 01 Amount
- $0
- Row 6
- Ins Carrier Name: ALLSTATE LIFE INSURANCE
- Filing Id
- 86037210003473
- Form Id
- 35754781
- Schedule A EIN
- 56-2110719
- Schedule A Plan Num
- 001
- Schedule A Plan Year Begin Date
- 2002-01-01
- Schedule A Tax Period
- 20021231
- Ins Carrier Name
- ALLSTATE LIFE INSURANCE
- Ins Carrier EIN
- 36-2554642
- Ins Carrier Naic Code
- 60186
- Ins Contract Num
- 5646
- Ins Prsn Covered End of year Count
- 0
- Ins Policy From Date
- 2002-01-01
- Ins Policy To Date
- 2002-12-31
- Ins Broker Comm Total Amount
- $0
- Ins Broker Fees Total Amount
- $0
- Pension End of year Gen Account Amount
- $0
- Pension End of year Sep Account Amount
- $0
- Pension Prem Paid Total Amount
- $0
- Pension Unpaid Premium Amount
- $0
- Pension Contract Cost Amount
- $0
- Pnsn Type Unalloc Cntrct I
- 3
- Pension End Prev Bal Amount
- $111,326,464
- Pension Contribution Dep Amount
- $0
- Pension Divnd Cr Dep Amount
- $0
- Pension Interest Cr Dur Yr Amount
- $9,138,303
- Pension Transfer From Amount
- $0
- Pension Other Amount
- $0
- Pension Total Additions Amount
- $9,138,303
- Pension Total Bal Addn Amount
- $120,464,767
- 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
- $120,464,767
- 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
- Row 7
- Ins Carrier Name: JOHN HANCOCK LIFE INSURANCE
- Filing Id
- 86037210003473
- Form Id
- 35754786
- Schedule A EIN
- 56-2110719
- Schedule A Plan Num
- 001
- Schedule A Plan Year Begin Date
- 2002-01-01
- Schedule A Tax Period
- 20021231
- Ins Carrier Name
- JOHN HANCOCK LIFE INSURANCE
- Ins Carrier EIN
- 04-1414660
- Ins Carrier Naic Code
- 65099
- Ins Contract Num
- 7575
- Ins Prsn Covered End of year Count
- 0
- Ins Policy From Date
- 2002-01-01
- Ins Policy To Date
- 2002-12-31
- Ins Broker Comm Total Amount
- $0
- Ins Broker Fees Total Amount
- $0
- Pension End of year Gen Account Amount
- $0
- Pension End of year Sep Account Amount
- $0
- Pension Prem Paid Total Amount
- $0
- Pension Unpaid Premium Amount
- $0
- Pension Contract Cost Amount
- $0
- Pnsn Type Unalloc Cntrct I
- 3
- Pension End Prev Bal Amount
- $86,939,662
- Pension Contribution Dep Amount
- $0
- Pension Divnd Cr Dep Amount
- $0
- Pension Interest Cr Dur Yr Amount
- $6,632,552
- Pension Transfer From Amount
- $0
- Pension Other Amount
- $0
- Pension Total Additions Amount
- $6,632,552
- Pension Total Bal Addn Amount
- $93,572,214
- 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
- $93,572,214
- 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
- Row 8
- Ins Carrier Name: PRINCIPAL LIFE INSURANCE
- Filing Id
- 86037210003473
- Form Id
- 35754787
- Schedule A EIN
- 56-2110719
- Schedule A Plan Num
- 001
- Schedule A Plan Year Begin Date
- 2002-01-01
- Schedule A Tax Period
- 20021231
- Ins Carrier Name
- PRINCIPAL LIFE INSURANCE
- Ins Carrier EIN
- 42-0127290
- Ins Carrier Naic Code
- 61271
- Ins Contract Num
- 4-13866-1
- Ins Prsn Covered End of year Count
- 0
- Ins Policy From Date
- 2002-01-01
- Ins Policy To Date
- 2002-12-31
- Ins Broker Comm Total Amount
- $0
- Ins Broker Fees Total Amount
- $0
- Pension End of year Gen Account Amount
- $0
- Pension End of year Sep Account Amount
- $0
- Pension Prem Paid Total Amount
- $0
- Pension Unpaid Premium Amount
- $0
- Pension Contract Cost Amount
- $0
- Pnsn Type Unalloc Cntrct I
- 3
- Pension End Prev Bal Amount
- $191,717,552
- Pension Contribution Dep Amount
- $0
- Pension Divnd Cr Dep Amount
- $0
- Pension Interest Cr Dur Yr Amount
- $13,634,149
- Pension Transfer From Amount
- $0
- Pension Other Amount
- $0
- Pension Total Additions Amount
- $13,634,149
- Pension Total Bal Addn Amount
- $205,351,701
- Pension Bnfts Dsbrsd Amount
- $0
- Pension Admin Chrg Amount
- $0
- Pension Transfer To Amount
- $0
- Pension Oth Ded Amount
- $37,607,906
- Pension Oth Ded Text
- CONTRACT MATURITIES
- Pension Total Ded Amount
- $37,607,906
- Pension End of year Bal Amount
- $167,743,795
- 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
- Row 9
- Ins Carrier Name: PACIFIC MUTUAL LIFE INSURANCE
- Filing Id
- 86037210003473
- Form Id
- 35754788
- Schedule A EIN
- 56-2110719
- Schedule A Plan Num
- 001
- Schedule A Plan Year Begin Date
- 2002-01-01
- Schedule A Tax Period
- 20021231
- Ins Carrier Name
- PACIFIC MUTUAL LIFE INSURANCE
- Ins Carrier EIN
- 95-1079000
- Ins Carrier Naic Code
- 67466
- Ins Contract Num
- 25730-03
- Ins Prsn Covered End of year Count
- 0
- Ins Policy From Date
- 2002-01-01
- Ins Policy To Date
- 2002-12-31
- Ins Broker Comm Total Amount
- $0
- Ins Broker Fees Total Amount
- $0
- Pension End of year Gen Account Amount
- $0
- Pension End of year Sep Account Amount
- $0
- Pension Prem Paid Total Amount
- $0
- Pension Unpaid Premium Amount
- $0
- Pension Contract Cost Amount
- $0
- Pnsn Type Unalloc Cntrct I
- 3
- Pension End Prev Bal Amount
- $145,616,674
- Pension Contribution Dep Amount
- $0
- Pension Divnd Cr Dep Amount
- $0
- Pension Interest Cr Dur Yr Amount
- $7,284,318
- Pension Transfer From Amount
- $0
- Pension Other Amount
- $0
- Pension Total Additions Amount
- $7,284,318
- Pension Total Bal Addn Amount
- $152,900,992
- Pension Bnfts Dsbrsd Amount
- $0
- Pension Admin Chrg Amount
- $0
- Pension Transfer To Amount
- $0
- Pension Oth Ded Amount
- $55,130,249
- Pension Oth Ded Text
- CONTRACT MATURITIES
- Pension Total Ded Amount
- $55,130,249
- Pension End of year Bal Amount
- $97,770,743
- 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
- Row 10
- Ins Carrier Name: NEW YORK LIFE INSURANCE
- Filing Id
- 86037210003473
- Form Id
- 35754789
- Schedule A EIN
- 56-2110719
- Schedule A Plan Num
- 001
- Schedule A Plan Year Begin Date
- 2002-01-01
- Schedule A Tax Period
- 20021231
- Ins Carrier Name
- NEW YORK LIFE INSURANCE
- Ins Carrier EIN
- 13-5582869
- Ins Carrier Naic Code
- 66915
- Ins Contract Num
- 6572-002
- Ins Prsn Covered End of year Count
- 0
- Ins Policy From Date
- 2002-01-01
- Ins Policy To Date
- 2002-12-31
- Ins Broker Comm Total Amount
- $0
- Ins Broker Fees Total Amount
- $0
- Pension End of year Gen Account Amount
- $0
- Pension End of year Sep Account Amount
- $0
- Pension Prem Paid Total Amount
- $0
- Pension Unpaid Premium Amount
- $0
- Pension Contract Cost Amount
- $0
- Pnsn Type Unalloc Cntrct I
- 3
- Pension End Prev Bal Amount
- $136,912,142
- Pension Contribution Dep Amount
- $0
- Pension Divnd Cr Dep Amount
- $0
- Pension Interest Cr Dur Yr Amount
- $9,420,801
- Pension Transfer From Amount
- $0
- Pension Other Amount
- $0
- Pension Total Additions Amount
- $9,420,801
- Pension Total Bal Addn Amount
- $146,332,943
- Pension Bnfts Dsbrsd Amount
- $0
- Pension Admin Chrg Amount
- $0
- Pension Transfer To Amount
- $0
- Pension Oth Ded Amount
- $146,332,943
- Pension Oth Ded Text
- CONTRACT MATURITIES
- Pension Total Ded Amount
- $146,332,943
- 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
- 86037210003473
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 1
- Row Num
- 0
- Image Form Id
- 99550373210003470006
- DFE P1 Entity 01 Name
- EAFE FUND
- DFE P1 Spons 01 Name
- STATE STREET GLOBAL ADVISORS
- DFE P1 Plan 01 EIN Plan number
- 040025081130
- DFE P1 Entity 01 Code
- C
- DFE P1 Plan Interest End of year 01 Amount
- $5,985,982
- Row 2
- Filing Id
- 86037210003473
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 1
- Row Num
- 0
- Image Form Id
- 99550373210003470006
- Row 3
- Filing Id
- 86037210003473
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 2
- Row Num
- 1
- Image Form Id
- 99550373210003470006
- DFE P1 Entity 01 Name
- LIFE SOLUTIONS BALANCED FUND
- DFE P1 Spons 01 Name
- STATE STREET GLOBAL ADVISORS
- DFE P1 Plan 01 EIN Plan number
- 040025081055
- DFE P1 Entity 01 Code
- C
- DFE P1 Plan Interest End of year 01 Amount
- $154,583,328
- Row 4
- Filing Id
- 86037210003473
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 3
- Row Num
- 2
- Image Form Id
- 99550373210003470006
- DFE P1 Entity 01 Name
- LIFE SOLUTIONS GROWTH FUND
- DFE P1 Spons 01 Name
- STATE STREET GLOBAL ADVISORS
- DFE P1 Plan 01 EIN Plan number
- 040025081056
- DFE P1 Entity 01 Code
- C
- DFE P1 Plan Interest End of year 01 Amount
- $14,996,156
- Row 5
- Filing Id
- 86037210003473
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 4
- Row Num
- 3
- Image Form Id
- 99550373210003470006
- DFE P1 Entity 01 Name
- LIFE SOLUTIONS INCOME AND GROWTH
- DFE P1 Spons 01 Name
- STATE STREET GLOBAL ADVISORS
- DFE P1 Plan 01 EIN Plan number
- 040025081053
- DFE P1 Entity 01 Code
- C
- DFE P1 Plan Interest End of year 01 Amount
- $7,601,948
- Row 6
- Filing Id
- 86037210003473
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 1
- Row Num
- 4
- Image Form Id
- 99550373210003470006
- DFE P1 Entity 01 Name
- MIDCAP INDEX FUND
- DFE P1 Spons 01 Name
- STATE STREET GLOBAL ADVISORS
- DFE P1 Plan 01 EIN Plan number
- 040025081079
- DFE P1 Entity 01 Code
- C
- DFE P1 Plan Interest End of year 01 Amount
- $45,611,038
- Row 7
- Filing Id
- 86037210003473
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 2
- Row Num
- 5
- Image Form Id
- 99550373210003470006
- DFE P1 Entity 01 Name
- RUSSELL 2000 INDEX FUND
- DFE P1 Spons 01 Name
- STATE STREET GLOBAL ADVISORS
- DFE P1 Plan 01 EIN Plan number
- 040025081086
- DFE P1 Entity 01 Code
- C
- DFE P1 Plan Interest End of year 01 Amount
- $18,935,925
- Row 8
- Filing Id
- 86037210003473
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 3
- Row Num
- 6
- Image Form Id
- 99550373210003470006
- DFE P1 Entity 01 Name
- S AND P INDEX FUND
- DFE P1 Spons 01 Name
- STATE STREET GLOBAL ADVISORS
- DFE P1 Plan 01 EIN Plan number
- 040025081085
- DFE P1 Entity 01 Code
- C
- DFE P1 Plan Interest End of year 01 Amount
- $64,586,315
- Row 9
- Filing Id
- 86037210003473
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 4
- Row Num
- 7
- Image Form Id
- 99550373210003470006
- DFE P1 Entity 01 Name
- SEI STABLE ASSET FUND
- DFE P1 Spons 01 Name
- SEI INVESTMENTS
- DFE P1 Plan 01 EIN Plan number
- 237654996001
- DFE P1 Entity 01 Code
- C
- DFE P1 Plan Interest End of year 01 Amount
- $245,939,680
- Row 10
- Filing Id
- 86037210003473
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 5
- Row Num
- 8
- Image Form Id
- 99550373210003470006
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 11
- Filing Id
- 86037210003473
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 6
- Row Num
- 9
- Image Form Id
- 99550373210003470006
- DFE P1 Plan Interest End of year 01 Amount
- $0