Form N-8b-4 - Registration Statement Of Face-Amount Certificate Companies - Securities And Exchange Commission Page 12

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4.
Information need not be furnished as to any series of certificates for which the outstanding face-amount does not exceed five percent of
the aggregate outstanding face-amount of all certificates of the installment type or $1,000,000, whichever amount is the smaller.
Item 23. Table of Payments, Surrender Values, etc.
For each series of face-amount certificates of the installment type referred to in Item 22 furnish the following information for each
certificate year:
(a) Certificate year
(b) Gross payment
(c) Accumulated gross payments
(d) Call value
(e) Load
(f) Amount of payment credited to reserve
(g) Annual accretion
(h) Total reserve at end of certificate year
(i) Surrender charge
(j) Cash surrender value
Instructions.
1.
The information shall be furnished on the basis of the smallest face-amount for which full certificates of the particular series were issued.
The face-amount value for which the information is furnished shall be stated.
2.
Where the certificate provides for more than one payment method, the information shall be so presented as to show the resulting variations.
However, information need not be furnished with respect to any payment basis other than the annual, semi-annual, quarterly and monthly
payment basis.
DISTRIBUTION OF SECURITIES
Item 24. Geographical Distribution and State Deposits
(a) Furnish the names of the states in which sales of the registrant’s securities (1) are currently being made, (2) are presently proposed
to be made, and (3) have been discontinued, indicating by appropriate symbols the status with respect to each state. Designate
by a separate symbol those states in which the registrant is required to maintain assets on deposit in respect of its liabilities under
certificates issued to or held by residents of such states.
(b) For each state in which the registrant is required to maintain assets on deposit in respect of its liabilities under certificates issued
to or held by residents of such state, indicate the general requirements of the governing statute, order, regulation, requirement or
deposit agreement and identify the depositary. State briefly the basis of determining the amount of the required deposit and indicate
whether it is less than, equal to, or greater than the cash surrender value. If the assets on deposit, other than cash, do not consist of
“qualified investments” as defined in Section 28(b) of the Act, so state and indicate briefly the nature of such assets.
(c) If the registrant has more than one series of face-amount certificates outstanding, designate any state reported under (b) in which the
assets on deposit are segregated as to series. If none, so state.
Item 25. Restriction of Authority to Distribute Securities
Furnish the following information with respect to each instance where, during the past three years, any federal or state governmental officer,
agency or regulatory body denied, revoked, suspended or otherwise restricted authority to distribute securities of the registrant, excluding
denials which were merely a procedural step prior to any determination by such officer, etc., and which denial was subsequently rescinded.
(a) Name of officer, agency or body.
(b) Date of denial, revocation, suspension or other restriction.
(c) Brief statement of the reasons given for the action taken.
Item 26. Method of Distribution and Underwriting Agreements
(a) Furnish a general description of the method of distribution of securities of the registrant and state the name and address of each
principal underwriter currently offering securities of the registrant.
12

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