0000729522-19-000033.txt : 20190319
0000729522-19-000033.hdr.sgml : 20190319
20190319124746
ACCESSION NUMBER: 0000729522-19-000033
CONFORMED SUBMISSION TYPE: NTFNCEN
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181231
FILED AS OF DATE: 20190319
DATE AS OF CHANGE: 20190319
EFFECTIVENESS DATE: 20190319
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: FS VARIABLE SEPARATE ACCOUNT
CENTRAL INDEX KEY: 0000931344
IRS NUMBER: 000000000
STATE OF INCORPORATION: NY
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: NTFNCEN
SEC ACT: 1940 Act
SEC FILE NUMBER: 811-08810
FILM NUMBER: 19690874
BUSINESS ADDRESS:
STREET 1: ONE WORLD FINANCIAL CENTER
STREET 2: 200 LIBERTY STREET
CITY: NEW YORK
STATE: NY
ZIP: 10281
BUSINESS PHONE: 2125515440
MAIL ADDRESS:
STREET 1: ONE WORLD FINANCIAL CENTER
STREET 2: 200 LIBERTY STREET
CITY: NEW YORK
STATE: NY
ZIP: 10281
0000931344
S000010609
FS VARIABLE SEPARATE ACCOUNT
C000111545
Polaris Platinum III (EA) (NY) 333-178841
C000111547
Polaris Choice IV (NY) 333-178842
C000111549
Polaris Platinum O-Series (NY) 333-178843
C000111551
Polaris Advantage (NY) 333-178844
C000111553
Polaris Preferred Solution (NY) 333-178845
C000111558
Polaris II (NY) VA 333-178846
C000111559
Polaris II (Jones NY) 333-178846
C000111561
Polaris Choice III (NY) 333-178847
C000111564
Polaris Advantage II (W) NY 333-178848
C000111565
Polaris Advantage II (I) NY 333-178848
C000111567
Polaris Retirement Protector (NY) 333-178849
C000111569
Polaris Advantage (NY) (G) 333-178850
C000111571
Polaris II A-Class Platinum Series (NY) 333-178852
C000111574
Polaris Choice (NY) (G) 333-178853
C000111575
Polaris Choice III (NY) (G) 333-178853
C000111580
Polaris (NY) VA (G) 333-178854
C000111581
Polaris II (NY) (G) 333-178854
C000111582
Polaris II (Jones NY) (G) 333-178854
C000111583
Polaris II A-Class Platinum Series (NY) VA (G) 333-178855
C000111587
FSA Advisor (NY) VA (G) 333-178857
C000111591
WM Diversified Strategies III (NY) (G) 333-178859
C000134223
Polaris Preferred Solution Non Rew (NY) 333-178845
C000147989
Polaris Select Investor 333-198224
C000171412
Polaris Platinum III (NY) 333-178841
NT-NCEN
1
18FSVSA-931344-form12b-25.txt
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
-----------
FORM 12b-25
-----------
NOTIFICATION OF LATE FILING
(Check one): [ ] Form 10-K [ ] Form 20-F [ ] Form 11-K [ ] Form 10-Q
[ ] Form 10-D [X] Form N-CEN [ ] Form N-CSR
For Period Ended: December 31, 2018
[ ] Transition Report on Form 10-K
[ ] Transition Report on Form 20-F
[ ] Transition Report on Form 11-K
[ ] Transition Report on Form 10-Q
[ ] Transition Report on Form N-CEN
For the Transition Period Ended:________________
-------------------------------------------------------------------------------
Nothing in this form shall be construed to imply that the Commission has
verified any information contained herein.
-------------------------------------------------------------------------------
If the notification relates to a portion of the filing checked above, identify
the Item(s) to which the notification relates:
PART I - REGISTRANT INFORMATION
FS Variable Separate Account
------------------------------
Full Name of Registrant
-------------------------
Former Name if Applicable
200 LIBERTY STREET
---------------------------------------------------------
Address of Principal Executive Office (Street and Number)
New York, NY 10281
------------------------
City, State and Zip Code
PART II - RULES 12b-25(b) AND (c)
If the subject report could not be filed without unreasonable effort or expense
and the registrant seeks relief pursuant to Rule 12b-25(b), the following
should be completed. (Check box if appropriate)
[X] (a) The reason described in reasonable detail in Part III of this form
could not be eliminated without unreasonable effort or expense;
[X] (b) The subject annual report, semi-annual report, transition report on
Form 10-K, Form 20-F, Form 11-K, Form N-CEN or Form N-CSR, or portion
thereof, will be filed on or before the fifteenth calendar day
following the prescribed due date; or the subject quarterly report or
transition report on Form 10-Q or subject distribution report on Form
10-D, or portion thereof, will be filed on or before the fifth calendar
day following the prescribed due date; and
[ ] (c) The accountant's statement or other exhibit required by Rule 12b-25(c)
has been attached if applicable.
PART III - NARRATIVE
State below in reasonable detail why Forms 10-K, 20-F, 11-K, 10-Q, 10-D, N-CEN,
N-CSR, or the transition report or portion thereof, could not be filed within
the prescribed time period.
Registrant is unable to timely file Form N-CEN by the date required due to
extensive efforts involved in extracting the data.
(Attach extra Sheets if Needed)
PART IV - OTHER INFORMATION
(1) Name and telephone number of person to contact in regard to this
notification
Craig Anderson 713 552-1111
----------------------------- ----------- -------------------
(Name) (Area Code) (Telephone Number)
(2) Have all other periodic reports required under Section 13 or 15(d) of the
Securities Exchange Act of 1934 or Section 30 of the Investment Company
Act of 1940 during the preceding 12 months or for such shorter period that
the registrant was required to file such report(s) been filed? If answer
is no, identify report(s). Yes[X] No[ ]
(3) Is it anticipated that any significant change in results of operations
from the corresponding period for the last fiscal year will be refrected
by the earnings statements to be included in the subject report or portion
thereof? Yes[ ] No[X]
If so, attach an explanation of the anticipated change, both narratively
and quantitatively, and, if appropriate, state the reasons why a
reasonable estimate of the results cannot be made.
FS Variable Separate Account
--------------------------------------------
(Name of Registrant as Specified in Charter)
has caused this notification to be signed on its behalf by the undersigned
hereunto duly authorized.
Date: March 18, 2019 By: /s/ Craig A. Anderson
--------------------------
Craig A. Anderson
Senior Vice President and Life Controller