0000931788-17-000001.txt : 20170120 0000931788-17-000001.hdr.sgml : 20170120 20170120102940 ACCESSION NUMBER: 0000931788-17-000001 CONFORMED SUBMISSION TYPE: D/A PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170120 DATE AS OF CHANGE: 20170120 EFFECTIVENESS DATE: 20170120 FILER: COMPANY DATA: COMPANY CONFORMED NAME: JACKSON NATIONAL LIFE INSURANCE CO CENTRAL INDEX KEY: 0000931788 IRS NUMBER: 000000000 STATE OF INCORPORATION: MI FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D/A SEC ACT: 1933 Act SEC FILE NUMBER: 021-255557 FILM NUMBER: 17537778 BUSINESS ADDRESS: STREET 1: 1 CORPORATE WAY CITY: LANSING STATE: MI ZIP: 48951 BUSINESS PHONE: 517-381-5500 MAIL ADDRESS: STREET 1: 1 CORPORATE WAY CITY: LANSING STATE: MI ZIP: 48951 FORMER COMPANY: FORMER CONFORMED NAME: JACKSON NATIONAL LIFE INSURANCE CO /MI DATE OF NAME CHANGE: 19941021 D/A 1 primary_doc.xml X0707 D/A LIVE 0000931788 JACKSON NATIONAL LIFE INSURANCE CO 1 CORPORATE WAY LANSING MI MICHIGAN 48951 517-381-5500 MICHIGAN JACKSON NATIONAL LIFE INSURANCE CO /MI Corporation true Barry L. Stowe 1 CORPORATE WAY LANSING MI MICHIGAN 48951 Director Gregory P. Cicotte 1 CORPORATE WAY LANSING MI MICHIGAN 48951 Executive Officer Bradley O. Harris 1 CORPORATE WAY LANSING MI MICHIGAN 48951 Executive Officer Director Paul C. Myers 1 CORPORATE WAY LANSING MI MICHIGAN 48951 Executive Officer Director James R. Sopha 1 CORPORATE WAY LANSING MI MICHIGAN 48951 Executive Officer Director Andrew J. Bowden 1 CORPORATE WAY LANSING MI MICHIGAN 48951 Executive Officer Michael A. Costello 1 CORPORATE WAY LANSING MI MICHIGAN 48951 Executive Officer Dennis J. Manning 1 CORPORATE WAY LANSING MI MICHIGAN 48951 Director Morten N. Friis 1 CORPORATE WAY LANSING MI MICHIGAN 48951 Director James J. Scanlan 1 CORPORATE WAY LANSING MI MICHIGAN 48951 Director Insurance Decline to Disclose 06b true 0000931788-16-000004 2016-01-31 false true Deferred Commission Plan false 0 728843 728843 0 false 38 0 0 0 false JACKSON NATIONAL LIFE INSURANCE CO Scott Forbush Scott Forbush Assistant Vice President 2017-01-20