0001686593-16-000001.txt : 20161006 0001686593-16-000001.hdr.sgml : 20161006 20161006104650 ACCESSION NUMBER: 0001686593-16-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b ITEM INFORMATION: Investment Company Act Section 3(c) ITEM INFORMATION: Section 3(c)(7) FILED AS OF DATE: 20161006 DATE AS OF CHANGE: 20161006 EFFECTIVENESS DATE: 20161006 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Lombard International Life Assurance Co Separate Account VL 165 CENTRAL INDEX KEY: 0001686593 IRS NUMBER: 520795747 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-271954 FILM NUMBER: 161924137 BUSINESS ADDRESS: STREET 1: ONE LIBERTY PLACE, 1650 MARKET STREET STREET 2: 54TH FLOOR CITY: PHILADELPHIA STATE: PA ZIP: 19103 BUSINESS PHONE: (484) 530-4800 MAIL ADDRESS: STREET 1: ONE LIBERTY PLACE, 1650 MARKET STREET STREET 2: 54TH FLOOR CITY: PHILADELPHIA STATE: PA ZIP: 19103 D 1 primary_doc.xml X0707 D LIVE 0001686593 Lombard International Life Assurance Co Separate Account VL 165 ONE LIBERTY PLACE, 1650 MARKET STREET 54TH FLOOR PHILADELPHIA PA PENNSYLVANIA 19103 (484) 530-4800 PENNSYLVANIA None None Other insurance company separate account true 2016 LILAC Lombard International Life Assurance Company One Liberty Place 1650 Market St., 54th Floor Philadelphia PA PENNSYLVANIA 19103 Promoter Issuer is an insurance company separate account formed under Pennsylvania insurance law. Pooled Investment Fund Other Investment Fund false Decline to Disclose 06b 3C 3C.7 false 2016-09-27 true true true variable life insurance contracts false 0 M Holdings Securities, Inc 43285 Chadwick L. Campbell 6459772 1125 NW Couch Street Suite 900 Portland OR OREGON 97209 SD SOUTH DAKOTA false Indefinite 1666667 Indefinite false 1 50000 0 Issuer pays commissions which are equal to a percentage of the premium received by the Issuer. LILAC also pays sales commissions from its corporate resources. 22420 Amount shown represents the total of all DAC tax, state premium tax, and underwriting charges. false Lombard International Life Assurance Co Separate Account VL 165 /s/ John F Reilly John F Reilly Senior Vice President and Deputy General Counsel 2016-10-06