0001104659-18-035471.txt : 20180523 0001104659-18-035471.hdr.sgml : 20180523 20180523163440 ACCESSION NUMBER: 0001104659-18-035471 CONFORMED SUBMISSION TYPE: D/A 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: 20180523 DATE AS OF CHANGE: 20180523 EFFECTIVENESS DATE: 20180523 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/A SEC ACT: 1933 Act SEC FILE NUMBER: 021-301311 FILM NUMBER: 18855481 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/A 1 primary_doc.xml X0708 D/A 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 & Annuity Company 700 Newport Center Drive Newport Beach CA CALIFORNIA 92660 Executive Officer Director Darryl D Button Pacific Life & Annuity Company 700 Newport Center Drive Newport Beach CA CALIFORNIA 92660 Executive Officer Director Adrian S Griggs Pacific Life & Annuity Company 700 Newport Center Drive Newport Beach CA CALIFORNIA 92660 Executive Officer Director Sharon A Cheever Pacific Life & Annuity Company 700 Newport Center Drive Newport Beach CA CALIFORNIA 92660 Director Dawn M Trautman Pacific Life & Annuity Company 700 Newport Center Drive Newport Beach CA CALIFORNIA 92660 Executive Officer Dewey P Bushaw Pacific Life & Annuity Company 700 Newport Center Drive Newport Beach CA CALIFORNIA 92660 Executive Officer Insurance Decline to Disclose 3C 3C.1 06b 3C.7 true 0001104659-17-074334 true true true Interests in Separate Account 21 of Pacific Life & Annuity Company under Private Placement Variable Life Insurance Products false 500000 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 2018-05-23