0001104659-17-074334.txt : 20171220 0001104659-17-074334.hdr.sgml : 20171220 20171220164139 ACCESSION NUMBER: 0001104659-17-074334 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b ITEM INFORMATION: Investment Company Act Section 3(c) ITEM INFORMATION: Section 3(c)(1) ITEM INFORMATION: Section 3(c)(7) FILED AS OF DATE: 20171220 DATE AS OF CHANGE: 20171220 EFFECTIVENESS DATE: 20171220 FILER: COMPANY DATA: COMPANY CONFORMED NAME: PACIFIC LIFE & ANNUITY CO CENTRAL INDEX KEY: 0001094010 IRS NUMBER: 000000000 STATE OF INCORPORATION: AZ FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-301311 FILM NUMBER: 171267178 BUSINESS ADDRESS: STREET 1: 1775 EYE STREET N.W. CITY: WASHINGTON STATE: DC ZIP: 20006 BUSINESS PHONE: 949-219-7286 MAIL ADDRESS: STREET 1: 700 NEWPORT CENTER DRIVE CITY: NEWPORT BEACH STATE: CA ZIP: 92660 D 1 primary_doc.xml X0708 D LIVE 0001094010 PACIFIC LIFE & ANNUITY CO 700 Newport Center Drive Newport Beach CA CALIFORNIA 92660 949-219-3943 ARIZONA None None Other Stock Life Insurance Company true James T Morris Pacific Life Insurance Company 700 Newport Center Drive Newport Beach CA CALIFORNIA 92660 Executive Officer Director Darryl D Button Pacific Life Insurance Company 700 Newport Center Drive Newport Beach CA CALIFORNIA 92660 Executive Officer Director Adrian S Griggs Pacific Life Insurance Company 700 Newport Center Drive Newport Beach CA CALIFORNIA 92660 Executive Officer Director Mary Ann Brown Pacific Life Insurance Company 700 Newport Center Drive Newport Beach CA CALIFORNIA 92660 Executive Officer Dawn M Trautman Pacific Life Insurance Company 700 Newport Center Drive Newport Beach CA CALIFORNIA 92660 Executive Officer Dewey P Bushaw Pacific Life Insurance Company 700 Newport Center Drive Newport Beach CA CALIFORNIA 92660 Executive Officer Sharon A Cheever Pacific Life Insurance Company 700 Newport Center Drive Newport Beach CA CALIFORNIA 92660 Director Insurance Decline to Disclose 3C 3C.1 06b 3C.7 false true true true Interests in Separate Account 21 of Pacific Life & Annuity Company under Private Placement Variable Life Insurance Products false 50 Indefinite 0 Indefinite false 0 0 0 0 true Pacific Life & Annuity Co /s/ Brandon J. Cage Brandon J. Cage Assistant Vice President and Counsel 2017-12-20