0001696760-17-000001.txt : 20170202 0001696760-17-000001.hdr.sgml : 20170202 20170202170934 ACCESSION NUMBER: 0001696760-17-000001 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: 20170202 DATE AS OF CHANGE: 20170202 EFFECTIVENESS DATE: 20170202 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Lombard International Life Assurance Co Separate Account VA 165 CENTRAL INDEX KEY: 0001696760 IRS NUMBER: 520795747 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-279945 FILM NUMBER: 17569232 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 0001696760 Lombard International Life Assurance Co Separate Account VA 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 2017 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 2017-01-26 true true true variable annuity contracts false 0 Lion Street Financial, LLC 165828 David C. Friezo 1705729 515 Congress Ave. Suite 2500 Austin TX TEXAS 78701 NJ NEW JERSEY false Indefinite 500000 Indefinite false 1 0 0 Issuer pays no sales commissions or finders' fees. LILAC will pay sales commissions from its corporate resources. 0 false Lombard International Life Assurance Co Separate Account VA 165 /s/ John F Reilly John F Reilly Senior Vice President and Deputy General Counsel 2017-02-02