0001104659-21-038483.txt : 20210319 0001104659-21-038483.hdr.sgml : 20210319 20210318183543 ACCESSION NUMBER: 0001104659-21-038483 CONFORMED SUBMISSION TYPE: 15-12B PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20210319 DATE AS OF CHANGE: 20210318 EFFECTIVENESS DATE: 20210319 FILER: COMPANY DATA: COMPANY CONFORMED NAME: PROTECTIVE LIFE INSURANCE CO CENTRAL INDEX KEY: 0000310826 STANDARD INDUSTRIAL CLASSIFICATION: LIFE INSURANCE [6311] IRS NUMBER: 630169720 STATE OF INCORPORATION: TN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 15-12B SEC ACT: 1934 Act SEC FILE NUMBER: 001-31901 FILM NUMBER: 21755845 BUSINESS ADDRESS: STREET 1: 2801 HIGHWAY 280 SOUTH CITY: BIRMINGHAM STATE: AL ZIP: 35223 BUSINESS PHONE: 2058799230 MAIL ADDRESS: STREET 1: PO BOX 2606 CITY: BIRMINGHAM STATE: AL ZIP: 35202 15-12B 1 a21-9390_11512b.htm 15-12B

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

FORM 15

 

CERTIFICATION AND NOTICE OF TERMINATION OF REGISTRATION UNDER SECTION 12(g) OF THE SECURITIES EXCHANGE ACT OF 1934 OR SUSPENSION OF DUTY TO FILE REPORTS UNDER SECTIONS 13 AND 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934.

 

 

Commission File Number  

333-229837

 

Protective Life Insurance Company

(Exact name of registrant as specified in its charter)

 

2801 Highway 280 South

Birmingham, Alabama 35223

(205) 879-9230

(Address, including zip code, and telephone number, including area code, of registrant’s principal executive offices)

 

Interests in ProSaver Platinum Annuity Contract

(Title of each class of securities covered by this Form)

 

N/A

(Titles of all other classes of securities for which a duty to file reports under section 13(a) or 15(d) remains)

 

 

Please place an X in the box(es) to designate the appropriate rule provision(s) relied upon to terminate or suspend the duty to file reports:

 

 

Rule 12g-4(a)(1)

o

 

 

 

 

 

Rule 12g-4(a)(2)

x

 

 

 

 

 

Rule 12h-3(b)(1)(i)

o

 

 

 

 

 

Rule 12h-3(b)(1)(ii)

o

 

 

 

 

 

Rule 15d-6

o

 

 

 

 

 

Rule 15d-22(b)

o

 

 

 

 

 

Approximate number of holders of record of as of the certification or notice date: Fewer than 300 holders of record as of the certification or notice date.

 

Instruction: This form is required by Rules 12g-4, 12h-3 and 15d-6 of the General Rules and Regulations under the Securities Exchange Act of 1934. The registrant shall file with the Commission three copies of Form 15, one of which shall be manually signed. It may be signed by an officer of the registrant, by counsel or by any other duly authorized person. The name and title of the person signing the form shall be typed or printed under the signature.

 

 

EXPLANATORY NOTE

 

Protective Life Insurance Company has terminated the offering, under the Securities Act of 1933, as amended (the “1933 Act”), of the market value adjusted interests in the ProSaver Platinum Annuity Contract (“Interests”), removed from registration any Interests that remained unsold under the Form S-3 registration statement as of the close of business on March 16, 2021, and amended the terms of the Interests so that they qualify for the Section 3(a)(8) exemption from registration under the 1933 Act. This certification on Form 15 is being filed to suspend the Company’s duty to file reports, subject only to the Company’s obligation to file an Annual Report on Form 10-K for its 2020 fiscal year. 

 

 

Pursuant to the requirements of the Securities Exchange Act of 1934, each of the undersigned registrants has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person.

 

Date: March 19, 2021

 

PROTECTIVE LIFE INSURANCE COMPANY

 

 

 

 

 

 

 

 

 

By:

/s/ Bradford Rodgers

 

 

Name:

Bradford Rodgers

 

 

Title:

Vice President and Senior Counsel