0001958257-23-000001.txt : 20230202 0001958257-23-000001.hdr.sgml : 20230202 20230202095242 ACCESSION NUMBER: 0001958257-23-000001 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: 20230202 DATE AS OF CHANGE: 20230202 EFFECTIVENESS DATE: 20230202 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Lombard International Life Assurance Co Separate Account VL 412 CENTRAL INDEX KEY: 0001958257 IRS NUMBER: 520795747 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-472419 FILM NUMBER: 23579095 BUSINESS ADDRESS: STREET 1: ONE LIBERTY PLACE STREET 2: 1650 MARKET ST., 54TH FLOOR CITY: PHILADELPHIA STATE: PA ZIP: 19103 BUSINESS PHONE: (484) 530-4800 MAIL ADDRESS: STREET 1: ONE LIBERTY PLACE STREET 2: 1650 MARKET ST., 54TH FLOOR CITY: PHILADELPHIA STATE: PA ZIP: 19103 D 1 primary_doc.xml X0708 D LIVE 0001958257 Lombard International Life Assurance Co Separate Account VL 412 ONE LIBERTY PLACE 1650 MARKET ST., 54TH FLOOR PHILADELPHIA PA PENNSYLVANIA 19103 (484) 530-4800 PENNSYLVANIA None None Other insurance company separate account true 2022 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 law. Pooled Investment Fund Other Investment Fund false Decline to Disclose 06b 3C 3C.7 false 2023-01-31 true true true variable life insurance contracts false 0 M Holdings Securities, Inc. 43285 Michael A. Mingolelli 4744404 1125 N.W. Couch Street Suite 900 Portland OR OREGON 97209 SD SOUTH DAKOTA false Indefinite 7476369 Indefinite false 1 0 0 Issuer pays no sales commissions or finders' fees. LILAC will pay sales commissions from its corporate resources. 83165 Amount shown represents the total of all DAC tax, state premium tax, and underwriting charges. false Lombard International Life Assurance Co Separate Account VL 412 /s/ Paul Ryan Henry Paul Ryan Henry VP & Associate General Counsel 2023-02-02