0001725966-17-000001.txt : 20171221 0001725966-17-000001.hdr.sgml : 20171221 20171221100847 ACCESSION NUMBER: 0001725966-17-000001 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: 20171221 DATE AS OF CHANGE: 20171221 EFFECTIVENESS DATE: 20171221 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Lombard International Life Assurance Co Separate Account VA 191 CENTRAL INDEX KEY: 0001725966 IRS NUMBER: 520795747 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-301367 FILM NUMBER: 171268359 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 X0708 D LIVE 0001725966 Lombard International Life Assurance Co Separate Account VA 191 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 2017-12-15 true true true variable annuity contracts false 0 Niagara International Capital Limited 135327 Jason R. Zimmerman 2672423 16935 W. Bernardo Drive Suite 140 San Diego CA CALIFORNIA 92127 WI WISCONSIN false Indefinite 5025000 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 191 /s/ John F Reilly John F Reilly Senior Vice President and Deputy General Counsel 2017-12-21