0001144204-12-011878.txt : 20120229
0001144204-12-011878.hdr.sgml : 20120229
20120229124801
ACCESSION NUMBER: 0001144204-12-011878
CONFORMED SUBMISSION TYPE: NSAR-U
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20111231
FILED AS OF DATE: 20120229
DATE AS OF CHANGE: 20120229
EFFECTIVENESS DATE: 20120229
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: ZALICO VARIABLE SEPARATE ACCOUNT
CENTRAL INDEX KEY: 0000810369
IRS NUMBER: 363050975
STATE OF INCORPORATION: IL
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: NSAR-U
SEC ACT: 1940 Act
SEC FILE NUMBER: 811-05025
FILM NUMBER: 12651150
BUSINESS ADDRESS:
STREET 1: C/O CHASE LIFE
STREET 2: 2500 WESTFIELD DRIVE
CITY: ELGIN
STATE: IL
ZIP: 60123
BUSINESS PHONE: 847-930-7272
MAIL ADDRESS:
STREET 1: C/O CHASE LIFE
STREET 2: 2500 WESTFIELD DRIVE
CITY: ELGIN
STATE: IL
ZIP: 60123
FORMER COMPANY:
FORMER CONFORMED NAME: KILICO VARIABLE SEPARATE ACCOUNT/IL
DATE OF NAME CHANGE: 19920703
NSAR-U
1
v304142_nsar-u.txt
NSAR-U
FORM N-SAR-U
SEMI-ANNUAL REPORT
FOR REGISTERED INVESTMENT COMPANIES
Report for six month period ending: __/__/__(a)
or fiscal year ending: 12/31/11(b)
Is this a transition report? (Y/N) N
Is this an amendment to a previous filing? (Y/N) N
Those items or sub-items with a box "[/]" after the item number should be
completed only if the answer has changed from the previous filing on this form.
1. A. Registrant Name: ZALICO Variable Separate Account
B. File Number: 811-05025
C. Telephone Number: 425-577-5100
2. A. Street: 1400 American Lane
B. City: Schaumburg
C. State: IL
D. Zip Code: 60196 Zip Ext: 1091
E. Foreign Country: ____________ Foreign Postal Code: ___________
3. Is this the first filing on this form by Registrant? (Y/N) N
4. Is this the last filing on this form by Registrant? (Y/N) N
5. Is Registrant a small business investment company (SBIC)? (Y/N) N
[If answer is "Y" (Yes), complete only items 89 through 110.]
6. Is Registrant a unit investment trust (UIT)? (Y/N) Y
[If answer is "Y" (Yes) complete only items 111 through 132.]
7. A. Is Registrant a series or multiple portfolio company? (Y/N) N
[If answer is "N" (No), go to item 8.]
B. How many separate series or portfolios did Registrant have at the end
of the period? _____
1
If filing more than one
Page 47, "X" box: [ ]
For period ending 12/31/11
File number 811-05025
UNIT INVESTMENT TRUSTS
111. A. [/] Depositor Name: __________________________________________________
B. [/] File Number (If any): ____________________________________________
C. [/] City: ________ State: ________ Zip Code: ______ Zip Ext.: _____
[/] Foreign Country: ______________ Foreign Postal Code: ___________
111. A. [/] Depositor Name: __________________________________________________
B. [/] File Number (If any): ____________________________________________
C. [/] City: ________ State: ________ Zip Code: ______ Zip Ext.: _____
[/] Foreign Country: ______________ Foreign Postal Code: ___________
112. A. [/] Sponsor Name: ____________________________________________________
B. [/] File Number (If any): ____________________________________________
C. [/] City: ________ State: ________ Zip Code: ______ Zip Ext.: _____
[/] Foreign Country: ______________ Foreign Postal Code: ___________
112. A. [/] Sponsor Name: ____________________________________________________
B. [/] File Number (If any): ____________________________________________
C. [/] City: ________ State: ________ Zip Code: ______ Zip Ext.: _____
[/] Foreign Country: ______________ Foreign Postal Code: ___________
2
If filing more than one
Page 48, "X" box: [ ]
For period ending 12/31/11
File number 811-05025
113. A. [/] Trustee Name: ____________________________________________________
B. [/] City: ________ State: ________ Zip Code: ______ Zip Ext.: _____
[/] Foreign Country: ______________ Foreign Postal Code: ___________
113. A. [/] Trustee Name: ____________________________________________________
B. [/] City: ________ State: ________ Zip Code: ______ Zip Ext.: _____
[/] Foreign Country: ______________ Foreign Postal Code: ___________
114. A. [/] Principal Underwriter Name: ______________________________________
B. [/] File Number 8-____________
C. [/] City: ________ State: ________ Zip Code: ______ Zip Ext.: _____
[/] Foreign Country: ______________ Foreign Postal Code: ___________
114. A. [/] Principal Underwriter Name: ______________________________________
B. [/] File Number 8-_____________
C. [/] City: ________ State: ________ Zip Code: ______ Zip Ext.: _____
[/] Foreign Country: ______________ Foreign Postal Code: ___________
115. A. [/] Independent Public Accountant Name: ______________________________
B. [/] City: ________ State: ________ Zip Code: ______ Zip Ext.: _____
[/] Foreign Country: ______________ Foreign Postal Code: ___________
115. A. [/] Independent Public Accountant Name: ______________________________
B. [/] City: ________ State: ________ Zip Code: ______ Zip Ext.: _____
[/] Foreign Country: ______________ Foreign Postal Code: ___________
3
If filing more than one
Page 49, "X" box: [ ]
For period ending 12/31/11
File number 811-05025
116. Family of investment companies information:
A. [/] Is Registrant part of a family of investment companies?
(Y/N) _______ ____
Y/N
B. [/] Identify the family in 10 letters: _________________________
(Note: In filing this form, use this identification
consistently for all investment companies in family. This
designation is for purposes of this form only.)
117. A. [/] Is Registrant a separate account of an insurance company?
(Y/N) _______ ____
Y/N
If answer is "Y" (Yes), are any of the following types of contracts
funded by the Registrant?
B. [/] Variable annuity contracts? (Y/N) _______ ____
Y/N
C. [/] Scheduled premium variable life contracts? (Y/N) _______ ____
Y/N
D. [/] Flexible premium variable life contracts? (Y/N) _______ ____
Y/N
E. [/] Other types of insurance products registered under the
Securities Act of 1933? (Y/N) _______ ____
Y/N
118. [/] State the number of series existing at the end of the period
that had securities registered under the Securities Act of 1933
______________________________ ____
119. [/] State the number of new series for which registration statements
under the Securities Act of 1933 became effective during the
period _________________________ ____
120. [/] State the total value of the portfolio securities on the date of
deposit for the new series included in item 119 ($000's omitted)
___________________________ $___
121. [/] State the number of series for which a current prospectus was in
existence at the end of the period _____________________________ ____
122. [/] State the number of existing series for which additional units
were registered under the Securities Act of 1933 during the
current period _____________________ ____
4
If filing more than one
Page 50, "X" box: [ ]
For period ending 12/31/11
File number 811-05025
123. [/] State the total value of the additional units considered in
answering item 122 ($000's omitted) ____________________________ $___
124. [/] State the total value of units of prior series that were placed
in the portfolios of subsequent series during the current period
(the value of these units is to be measured on the date they
were placed in the subsequent series) ($000's omitted) _________ $___
125. [ ] State the total dollar amount of sales loads collected (before
reallowances to other brokers or dealers) by Registrant's
principal underwriter and any underwriter which is an affiliated
person of the principal underwriter during the current period
solely from the sale of units of all series of Registrant
($000's omitted) _______________________________________________ $ 16
126. Of the amount shown in item 125, state the total dollar amount
of sales loads collected from secondary market operations in
Registrant's units (include the sales loads, if any, collected
on units of a prior series placed in the portfolio of a
subsequent series.) ($000's omitted) ___________________________ $ 0
127. List opposite the appropriate description below the number of
series whose portfolios are invested primarily (based upon a
percentage of NAV) in each type of security shown, the aggregate
total assets at market value as of a date at or near the end of
the current period of each such group of series and the total
income distributions made by each such group of series during
the current period (excluding distributions of realized gains,
if any):
Number of Total Assets Total Income
Series ($000's Distributions
Investing omitted) ($000's omitted)
--------- ------------ ----------------
A. U.S. Treasury direct issue _________ $___________ $________
B. U.S. Government agency _________ $___________ $________
C. State and municipal tax-free _________ $___________ $________
D. Public utility debt _________ $___________ $________
E. Brokers or dealers debt or debt of brokers' or dealers' parent _________ $___________ $________
F. All other corporate intermed. & long-term debt _________ $___________ $________
G. All other corporate short-term debt _________ $___________ $________
H. Equity securities of brokers or dealers or parents of brokers
or dealers _________ $___________ $________
I. Investment company equity securities 1 $ 45,893 $ 604
J. All other equity securities _________ $___________ $________
K. Other securities _________ $___________ $________
L. Total assets of all series of registrant 1 $ 45,893 $ 604
5
If filing more than one
Page 51, "X" box: [ ]
For period ending 12/31/11
File number 811-05025
128. [/] Is the timely payment of principal and interest on any of the
portfolio securities held by any of Registrant's series at the
end of the current period insured or guaranteed by an entity
other than the issuer? (Y/N) _______ ____
[If answer is "N" (No), go to item 131.] Y/N
129. [/] Is the issuer of any instrument covered in item 128 delinquent
or in default as to payment of principal or interest at the end
of the current period? (Y/N) _______ ____
[If answer is "N" (No), go to item 131.] Y/N
130. [/] In computations of NAV or offering price per unit, is any part
of the value attributed to instruments identified in item 129
derived from insurance or guarantees? (Y/N) _______ ____
Y/N
131. Total expenses incurred by all series of Registrant during the
current reporting period ($000's omitted) ______________________ $389
132. [/] List the "811" (Investment Company Act of 1940) registration
number for all Series of Registrant that are being included in
this filing:
811-______ 811-______ 811-______ 811-______ 811-______
811-______ 811-______ 811-______ 811-______ 811-______
811-______ 811-______ 811-______ 811-______ 811-______
811-______ 811-______ 811-______ 811-______ 811-______
811-______ 811-______ 811-______ 811-______ 811-______
811-______ 811-______ 811-______ 811-______ 811-______
811-______ 811-______ 811-______ 811-______ 811-______
811-______ 811-______ 811-______ 811-______ 811-______
811-______ 811-______ 811-______ 811-______ 811-______
This report is signed on behalf of the Registrant in the City of New York and
State of New York .
Date: February 27, 2012
(Name of Registrant, Depositor, or Trustee)
ZALICO Variable Separate Account (formerly KILICO Variable Separate Account)
By: /s/ Richard W. Grilli Witness: /s/ Patrick J. Carty
--------------------------------- -------------------------------
Richard W. Grilli, Patrick J. Carty,
Chief Operating Officer and General Counsel, Corporate
Senior Vice President Secretary, and Vice President
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