0001698393-17-000001.txt : 20170223 0001698393-17-000001.hdr.sgml : 20170223 20170223095613 ACCESSION NUMBER: 0001698393-17-000001 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: 20170223 DATE AS OF CHANGE: 20170223 EFFECTIVENESS DATE: 20170223 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Lombard International Life Assurance Co Separate Account VA 169 CENTRAL INDEX KEY: 0001698393 IRS NUMBER: 520795747 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-281168 FILM NUMBER: 17631044 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 0001698393 Lombard International Life Assurance Co Separate Account VA 169 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 2017-02-10 true true true variable annuity contracts false 0 M Holdings Securities, Inc 43285 Milton H. Cohn, Jr. 840000 1125 NW Couch Street Suite 900 Portland OR OREGON 97209 IL ILLINOIS false M Financial Securities Marketing, Inc. 139304 Milton H. Cohn, Jr. 840000 1125 NW Couch Street Suite 900 Portland OR OREGON 97209 IL ILLINOIS false Indefinite 4724423 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 169 /s/ John F Reilly John F Reilly Senior Vice President and Deputy General Counsel 2017-02-23