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					         ANNUAL STATEMENT
                               OF THE


     Segregated Gift Annuity Fund
                               OF THE




                                                         CHARITABLES
Of


In the State of


                               TO THE


     INSURANCE DEPARTMENT
                               OF THE


         STATE OF NEW YORK
                  For the Year Ended December 31, 2007




                         2007
                                                     ANNUAL STATEMENT
                                                     For The Year Ended December 31, 2007
                                                          OF THE CONDITION AND AFFAIRS OF THE
                                                              Segregated Gift Annuity Fund
                                                                             OF THE




NAIC Company Code:                                                                    Employer's ID Number:

Organized under the Laws of the State of                                                                                                 made to the

                                             Insurance Department of the State of New York
                                                          PURSUANT TO THE LAWS THEREOF

Incorporated/Organized                                                                 Commenced Business

Mailing Address:
                                                    (Street and Number)                                  (City or Town, State and Zip Code)
Administrative Office:
                                                    (Street and Number)                                  (City or Town, State and Zip Code)


                                                          (Area Code)                                           (Telephone Number)


Contact Person, Phone Number and E-mail address:

                                                                     OFFICERS 1




                                                                                      {
President 2
                                                                                                                          Title 3
Secretary 2
                                                                                                                          Title 3
               2
Treasurer
                                                                                                                          Title 3
                                                                     DIRECTORS OR TRUSTEES 1




STATE OF
COUNTY OF                                                        }      SS


                                  President 2,                                     Secretary 2,                                   Treasurer 2
of the ……………………………………………………, being duly sworn, each for himself deposes and says that they are the above
described officers of the said reporting entity, and that on the thirty-first day of December last, all of the above described assets were
segregated and held as a separate and distinct fund (subject to appropriation by the reporting entity of funds legally transferable to the
general funds thereof) free and clear from any liens or claims thereon, except as above stated, as required by the provisions of Section
1110 of the New York Insurance Law, and that the foregoing statement, with the schedules and explanations therein contained, annexed
or referred to is a full and correct exhibit of all of the assets, liabilities, income and disbursements, and of the condition and affairs of the
said reporting entity’s segregated gift annuity fund on the said thirty-first day of December last, and for the year ended on that date,
according to the best of their information, knowledge and belief, respectively.
       The UNDERSIGNED further certify, according to the best of their knowledge and belief, that the Annual Statement electronic
filing submitted for the reporting stated above is identical to the information contained in the 2007 Annual Statement blank filed with the
New York State Insurance Department.

Subscribed and sworn to before me this …………………..………..
day of ……………………………...………..…………, 20 ………                                            }
                                                                                                                                          President 2
                                                                                                                                          Secretary 2
                                                                                                                                                       2
                                                                                                                                          Treasurer

Agent for Service of Process
Address

1
    Show full name (initials are not acceptable).
2
    Or a corresponding officer of the reporting entity.
3
    Indicate title, if a corresponding officer.
              ANNUAL STATEMENT FOR THE YEAR 2007 OF THE                                                                        0




                                                                                                                       Current Year       Prior Year
                                                                ASSETS

1. Market Value of bonds (Schedule A, Part 1, Column 7) ………………………………………...……
2. Market Value of preferred stocks (Schedule A, Part 2, Column 7) ……………………...…………..
3. Market Value of common stocks (Schedule A, Part 3, Column 7) …………………………………..
4. Market Value of money market mutual funds (Schedule B, Column 9) …………………….……….
5. Market Value of other invested assets (Schedule D, Part 1, Column 4) …………………..…………
6. Cash (Schedule C, Column 6)
        6.1 Cash in office ………………………………………………………………….…...…………….
        6.2 Cash on deposit …………………………………………..………………..………………….…
7. Investment income due or accrued (Exhibit 1, Column 3, Line 3) …….………..……………….……
8. Miscellaneous assets:
        8.1
        8.2
        8.3
        8.4
9. Total Assets (sum of lines 1 to 8) …………………………………..……..…..……………..…………                                                               0                0




                                                                                                                       Current Year       Prior Year
                               LIABILITIES AND ANNUITY FUND BALANCE

10. Net present value of annuities 1 ………………………………………..….…....…..……....…………
11. Deduct net value of risks reinsured 2 ……………………….…..……..….…..….………..……….…
12. NET RESERVE (line 10 minus line 11) ………………………………………....…………….….…
13. Annuity payments due and unpaid …………………………………………………………….…….
14. Deposits received from donors pending issuance of annuity agreements …..………….…..……
15. General expenses due or accrued ……………………………..…….….….….….….…...……….…..
16. Taxes due or accrued …………………………………………..…..……………...…...….….….…….
17. Unearned investment income ………………………….….….….……………………….….…..……
18. Miscellaneous liabilities:
      18.1
      18.2
      18.3
      18.4
19. Total Liabilities (sum of lines 12 to 18) …………….………….….….….….….….....….……….….                                                     0                0
20. Annuity Fund Balance:
       20.1 Minimum required fund balance ……………………..………………...….….….………………
       20.2 Excess fund balance (surplus) ……………………………………...…...…...……....….….……
       20.3 Total Annuity Fund Balance (sum of lines 20.1 and 20.2) ………….…...……………...…….                                              0                0
21. Total Liabilities and Annuity Fund Balance (sum of lines 19 and 20.3; should equal Line 9) …                                      0                0
1
    Attach a listing that includes complete details relative to mortality tables, valuation interest rates, etc.
2
    See Annual Statement Instructions for "Page 2, Line 11, Reinsurance"




                                                                                                                   2
              ANNUAL STATEMENT FOR THE YEAR 2007 OF THE                                                                                                     0




                                                                                                                                                     Current Year                    Prior Year
                                                             INCOME

1. Amount of gifts received during the year conditioned upon annuity agreements ……..….....……..…………
2. Investment income (Exhibit 1, Column 3, Line 7) …………………………………………………..…….…………………
3. Realized capital gains/(losses) ………………………………………………………………….……………………
4. Unrealized capital gains/(losses) (Exhibit 2, Column 5, Line 16) ……………….…..……….…………………….
5. Other income:
       5.1
       5.2
       5.3
       5.4
6. Gross amount transferred from general funds of the corporation ……………..…..…………….…..….……….
7. Total Income (sum of lines 1 to 6) …………….………………………..…….…..………………..………………..                                                                                            0                          0


                                                      DISBURSEMENTS

8. Annuity payments to donors and others ……………………………..……...…....…..…….…….…………….
9. General expenses ……………………………………………...……….…..……..….…..….………………………
10. Other expenses and disbursements:
     10.1
     10.2
     10.3
     10.4
11. Gross amount transferred to general funds of the corporation …………..………..………..….…………….
12. Total Disbursements (sum of lines 8 to 11) ……………….………………………………...………………….                                                                                            0                          0
13. Net change in Annuity Fund (line 7 minus line 12) ………………………………………...……..….….…….                                                                                      0                          0
14. Prior year Annuity Fund Balance ……………………………………………...…..……………….……………
15. Annuity Fund Balance at end of year (sum of lines 13 and 14) …………………….…...….….….….………                                                                                0                          0




                                                                                           EXHIBIT OF ANNUITIES IN FORCE


                                                1                                         NUMBER AND ANNUALIZED AMOUNT OF ANNUITIES IN FORCE (OMIT CENTS)

             AT DEC 31,                                             At Beginning of Year                  Written During Year                 Terminated During Year               At End of Year
          YEAR ENDING                      RESERVE                 2                  3                  4                  5                  6                  7          8               9
                                                                  No.             Amount                No.             Amount               No.                Amount       No.          Amount
1.               2007
2.               2006
3.               2005
4.               2004
5.               2003
6.               2002
7.               2001
 Note: For the year 2007, exclude California business. For the years 2006 and prior, report same amounts as were reported in the filed 2006 Annual Statement.




                                                                  EXHIBIT OF ANNUITIES IN FORCE IN NEW YORK

Indicate the number, annualized amount of payments, and reserve thereon for annuities in force in New York State included in Line 1, Columns 1, 8 and 9 above:



                                    1. Reserve
                                    2. Number
                                    3. Annualized amount of payments




                                                                                                             3
3
                  ANNUAL STATEMENT FOR THE YEAR 2007 OF THE                                                                                            0


                                                                     GENERAL INTERROGATORIES

1.    Total amount loaned by the segregated gift annuity fund during the year to directors, members of the
       governing board or other officers. ..........................................................................................................

2.    Total amount of loans outstanding at end of year to directors, members of the governing board or other officers.

3.    Did any person while an officer, director, member of the governing board or trustee of the reporting entity
       receive directly or indirectly, during the period covered by this statement, any commission on the business
       transactions of the segregated gift annuity fund? If yes, explain.................................................................                  Yes   No

4.    Were any of the stocks, bonds or other assets of the segregated gift annuity fund loaned, placed under option
       agreement, or otherwise made available for use by another person during the year covered by this statement?
       If yes, give full and complete information relating thereto...........................................................................              Yes   No

5.    Are the assets of the segregated gift annuity fund maintained in a separate and distinct account, physically
       segregated from the other assets of the reporting entity, in the amount required by §1110(b) of the New York
       State Insurance Law? ………………......................................................................................................                   Yes   No
       5.1 Indicate name and address of Custodian: Name
          Address
          If no, explain:

6.    State as of what date the latest examination of this segregated gift annuity fund was made or is being made…
       6.1 By what insurance department or departments

7.    Has any change been made during the year of this statement in the charter, articles of incorporation, or deed
        of settlement of the reporting entity? ……………………..........................................................................                          Yes   No
      If not previously filed, furnish herewith a certified copy of the instrument as amended.

8.    Has there been any change in the name of the reporting entity since the date of the last statement filed with
       the Department? …………………….......................................................................................................                     Yes   No
      *8.1 If yes, indicate prior name
                           current name
      *See Instructions For Completing the New York State Segregated Gift Annuity Fund Annual Statement, General Interrogatories

9.    What officials and heads of departments of the reporting entity supervised the making of this report?
      Answer:

10. In what states, territories, or foreign countries is the segregated gift annuity fund authorized to issue
     charitable gift annuities?
    Answer:

11. Is the segregated gift annuity fund authorized to issue charitable gift annuities in states that require a separate
     trust account for the maintenance of assets for the sole benefit of its residents, e.g., California? ..................                               Yes   No
     11.1 If yes, has the segregated gift annuity fund followed the special directions given in the Instructions
          For Completing the New York State Segregated Gift Annuity Fund Annual Statement for reporting
          information on annuities issued in such states? .........................……………………………….……....                                                     Yes   No

12. Has the segregated gift annuity fund issued annuities conditioned upon receipt of gifts other than cash,
     cash equivalents, mutual funds, bonds or stocks? ..…......…......…......…......…......…......…......…........…                                        Yes   No
     12.1 If yes, has the segregated gift annuity fund completed Schedule D? ...…...…......…......….........….....                                         Yes   No

13. Has the segregated gift annuity fund followed the Instructions for reporting Reserves on Page 2 and submitted
     a listing that includes complete details relative to the mortality tables; valuation interest rates, etc. in compliance
     with the Instructions For Completing the New York State Segregated Gift Annuity Fund Annual Statement?                                                Yes   No

14. In accordance with Section 1110(a) of the New York Insurance Law, every “corporation or association shall,
    before making such agreement, file with the superintendent copies of its forms of agreements with annuitants..”
     14.1 Have all agreements and forms in use for the issue of annuities in New York State been filed with the
          Superintendent? .............................................................................................................................    Yes   No
          If no, refer to the Instructions For Completing the New York State Segregated Gift Annuity Fund
          Annual Statement.
                 Note: Each individual society must file its forms with the Superintendent. This includes any
                       revised or updated versions of the forms. There are no “pre-approved” forms currently
                       available in New York and the Superintendent does not pre-approve or endorse any
                       particular form-drafting software.

15. Is the purchase and sale of all investments of the segregated gift annuity fund approved within an approved
     investment policy and reviewed periodically either by its governing body or a subordinate committee thereof?                                          Yes   No
     If so, name the committee

16. Does the reporting entity keep a complete permanent record of the proceedings of its governing body and all
     subordinate committees thereof? ...…......…......…......…......…......…......…......…......….........…......…..                                       Yes   No
17. Has the segregated gift annuity fund reinsured any of its annuity contracts? If yes, complete Schedule E. …..                                          Yes   No




                                                                                                          4
     ANNUAL STATEMENT FOR THE YEAR 2007 OF THE                                                               0



                                     NOTES TO FINANCIAL STATEMENTS

                                Refer to the Instructions For Completing the New York State
                                      Segregated Gift Annuity Fund Annual Statement
                            for directions on the information that must be reported on this page.


     Each note must be included and numbered in accordance with the Instructions For Completing the New York State
     Segregated Gift Annuity Fund Annual Statement. If there is nothing to report at a Note, do not omit the Note, indicate
     "None" or "NA" at the appropriate Note number.


1.




2.




3.




                                                                    5
                                               ANNUAL STATEMENT FOR THE YEAR 2007 OF THE               0

                                                                                 EXHIBIT 1 --- VERIFICATION OF INVESTMENT INCOME


 1                                              2                                            3                    4                5           6               7                8
                                                                                                                Cash,                                                         Other
Line                                                                                                    Money Market and                                  Money Market       Invested
 #                                                                                         Total       Certificates of Deposit   Bonds       Stocks       Mutual Funds        Assets
 1.    Interest and dividends received during the year
 2.    Interest/dividends received on bonds, stocks, and other invested assets
       sold or otherwise disposed of during the year                                                           XXX                                           XXX
 3.    Interest due or accrued and dividends declared and unpaid, at end of
       current year                                                                                                                                          XXX              XXX
 4.    Gross investment income (sum of lines 1 to 3)                                               0                        0            0            0                  0              0
       Deduct:
 5.    Paid for accrued interest and dividends on bonds and stocks purchased
       during the year                                                                                         XXX                                           XXX              XXX
 6.    Interest due or accrued and dividends declared and unpaid, at end of
       prior year                                                                                                                                            XXX              XXX
 7.    Total investment income (line 4 minus lines 5 and 6)                                        0                        0            0            0                  0              0




                                                                                                           6
                                            ANNUAL STATEMENT FOR THE YEAR 2007 OF THE                                                                                     0

                                                                   EXHIBIT 2 --- UNREALIZED CAPITAL GAINS AND LOSSES
                                                        BONDS, STOCKS, MONEY MARKET MUTUAL FUNDS AND OTHER INVESTED ASSETS

  1                                                                      2                                                   3          4                   5
                                                                                                                                                   Unrealized Capital
                                                                                                                                   Market Value      Gains/(Losses)
Line #                                                                                                                      Cost   End of Year    (Col. 4 minus Col. 3)
  1.     From Schedule A - Part 1 --- Bonds, Total - Current Year
  2.     From Schedule A - Part 1 --- Bonds, Total - Prior Year
  3.     Sub-total - Unrealized Capital Gains/(Losses) - Bonds, Current Year (line 2 minus line 1)                         XXXXX     XXXXX                            0

  4.     From Schedule A - Part 2 --- Preferred Stocks, Total - Current Year
  5.     From Schedule A - Part 2 --- Preferred Stocks, Total - Prior Year
  6.     Sub-total - Unrealized Capital Gains/(Losses) - Preferred Stocks, Current Year (line 5 minus line 4)              XXXXX     XXXXX                            0

  7.     From Schedule A - Part 3 --- Common Stocks, Total - Current Year
  8.     From Schedule A - Part 3 --- Common Stocks, Total - Prior Year
  9.     Sub-total - Unrealized Capital Gains/(Losses) - Common Stocks, Current Year (line 8 minus line 7)                 XXXXX     XXXXX                            0

 10.     From Schedule B --- Money Market Mutual Funds, Total - Current Year
 11.     From Schedule B --- Money Market Mutual Funds, Total - Prior Year
 12.     Sub-total - Unrealized Capital Gains/(Losses) - Money Market Mutual Funds, Current Year (line 11 minus line 10)   XXXXX     XXXXX                            0

 13.     From Schedule D - Part 1 --- Other Invested Assets, Total - Current Year
 14.     From Schedule D - Part 1 --- Other Invested Assets, Total - Prior Year
 15.     Sub-total - Unrealized Capital Gains/(Losses) - Other Invested Assets, Current Year (line 14 minus line 13)       XXXXX     XXXXX                            0

 16.     Total - Unrealized Capital Gains/(Losses) - Bonds, Stocks, Money Market Mutual Funds, and Other Invested Assets
          (sum of lines 3, 6, 9, 12 and 15)                                                                                XXXXX     XXXXX                            0




                                                                                                           7
                                                             ANNUAL STATEMENT FOR THE YEAR 2007 OF THE                                                                                                                                                    0

                                                                                                                SCHEDULE A --- Part 1
                                                                                                  Showing all BONDS Owned December 31 of Current Year
       1                                           2                                               3                  4                        5                        6                       7                     8                         9
                                               Description                                      Interest                                                                                                                        Interest

     CUSIP                                                                                                                                                          Rate Used                               Amount Due or Accrued          Gross Amount
     Identi-                                                                                                      Maturity                  Cost                    to Obtain            Market Value       Dec. 31 of Current Year          Received
    fication1                Give complete description of all bonds owned                Rate       How Paid 2     Date          (excluding accrued interest)       Market Value         End of Year        on Bonds not in default         During Year




                                                                            TOTALS       XXX               XXX      XXX                                         0     XXX                               0                        0                        0
1
    From entry in the previous year's Annual Statement, if owned at that time; from the purchase confirmaton (or certificate), if purchased subsequently. Leave blank for private placements.
2
    Insert initial letters of months in which interest is payable.


                                                                                                                                    8
                                              ANNUAL STATEMENT FOR THE YEAR 2007 OF THE                                                                                                                                      0

                                                                                                        SCHEDULE A --- Part 2
                                                                                    Showing all PREFERRED STOCKS Owned December 31 of Current Year
           1                                        2                                         3             4                       5                           6         7                  8                   9
                                                Description
                                                                                                                                                          Rate Per
                                                                                                                                                        Share Used
         CUSIP                                                                                                                                           to Obtain                       Dividends
         Identi-                                                                            Year         No. of                                           Market     Market Value       Declared and       Income Received
        fication1         Give complete description of all preferred stocks owned         Acquired       Shares                   Cost                     Value     End of Year          Unpaid             During Year




                                                                             TOTALS         XXX           XXX                                      0       XXX                      0                  0                     0
    1
        From entry in the previous year's Annual Statement, if owned at that time; from the purchase confirmaton (or certificate), if purchased subsequently.




                                                                                                      SCHEDULE A --- Part 3
                                                                                     Showing all COMMON STOCKS Owned December 31 of Current Year

           1                                        2                                         3             4                       5                           6         7                  8                   9
                                                Description
                                                                                                                                                          Rate Per
                                                                                                                                                        Share Used
         CUSIP                                                                                                                                           to Obtain                       Dividends
         Identi-                                                                            Year         No. of                                           Market     Market Value       Declared and       Income Received
        fication1         Give complete description of all common stocks owned            Acquired       Shares                   Cost                     Value     End of Year          Unpaid             During Year




                                                                             TOTALS         XXX           XXX                                      0       XXX                      0                  0                     0
    1
        From entry in the previous year's Annual Statement, if owned at that time; from the purchase confirmaton (or certificate), if purchased subsequently.
9
                                                       ANNUAL STATEMENT FOR THE YEAR 2007 OF THE                                                                                                                                                0

                                                                                                             SCHEDULE A --- Part 4
                                                                                              Showing all Bonds and Stocks ACQUIRED During the Year

       1                                                            2                                                                3                  4                          5                          6                    7
                                                                Description
    CUSIP                                                                                                                                                                         Cost
    Identi-                                                                                                                                          No. of               (Excluding Accrued                                Accrued Interest
    fication                                 Give complete description of each bond and stock                                Date Acquired1          Shares             Interest and Dividends)       Par Value of Bonds   and Dividends Paid
                 BONDS
                                                                                                                                                      XXX
                                                                                                                                                      XXX
                                                                                                                                                      XXX
                                                                                                                                                      XXX
                                                                                                                                                      XXX
                                                                                                                                                      XXX
                                                                                                                                                      XXX
                                                                                                                                                      XXX
                                                                                                                                                      XXX
                                                                                                                                                      XXX
                                                                                                                                                      XXX
                                                                                                                                                      XXX
                                                                                                                                                      XXX
                                                                                                SUB-TOTALS -- BONDS               XXX                 XXX                                         0         XXX                                 0
                 STOCKS
                 Preferred Stocks:
                                                                                                                                                                                                            XXX
                                                                                                                                                                                                            XXX
                                                                                                                                                                                                            XXX
                                                                                                                                                                                                            XXX
                                                                                                                                                                                                            XXX
                                                                                                                                                                                                            XXX
                 Common Stocks:
                                                                                                                                                                                                            XXX
                                                                                                                                                                                                            XXX
                                                                                                                                                                                                            XXX
                                                                                                                                                                                                            XXX
                                                                                                                                                                                                            XXX
                                                                                                                                                                                                            XXX
                                                                                                                                                                                                            XXX
                                                                                                                                                                                                            XXX
                                                                                                                                                                                                            XXX
                                                                                                                                                                                                            XXX
                                                                                                                                                                                                            XXX
                                                                                                SUB-TOTALS -- STOCKS              XXX                 XXX                                         0         XXX                                 0
                                                                                SUB-TOTALS -- BONDS AND STOCKS                    XXX                 XXX                                         0         XXX                                 0
1
    The items with reference to each issue of bonds and stocks acquired at public offerings may be totaled in one line and the word "Various" inserted in Columns 3 and 4.


                                                                                                                                10
                                                                          ANNUAL STATEMENT FOR THE YEAR 2007 OF THE                                                                                                                                                                      0

                                                                                                                       SCHEDULE A --- Part 5
                                                                                       Showing all Bonds and Stocks SOLD, REDEEMED or otherwise DISPOSED OF During the Year

       1                                                   2                                                         3                4                        5                    6                   7                         8                     9                    10
                                                       Description
    CUSIP                                                                                                                                               Consideration                                  Cost                                         Interest on         Dividends on
    Identi-                                                                                                      Disposal          No. of            (Excluding Accrued          Par Value     (Excluding Accrued          Realized Capital       Bonds Received       Stocks Received
    fication                        Give complete description of each bond and stock                              Date1            Shares          Interest and Dividends)       of Bonds    Interest and Dividends)       Gains/(Losses)          During Year 2        During Year 2
               BONDS
                                                                                                                                    XXX
                                                                                                                                    XXX
                                                                                                                                    XXX
                                                                                                                                    XXX
                                                                                                                                    XXX
                                                                                                                                    XXX
                                                                                                                                    XXX
                                                                                                                                    XXX
                                                                                                                                    XXX
                                                                                                                                    XXX
                                                                                                                                    XXX
                                                                                                                                    XXX
                                                                                                                                    XXX
                                                                                 SUB-TOTALS -- BONDS               XXX              XXX                                      0     XXX                                 0                      0                    0        XXX

               STOCKS
               Preferred Stocks:
                                                                                                                                                                                   XXX
                                                                                                                                                                                   XXX
                                                                                                                                                                                   XXX
                                                                                                                                                                                   XXX
                                                                                                                                                                                   XXX
                                                                                                                                                                                   XXX
               Common Stocks:
                                                                                                                                                                                   XXX
                                                                                                                                                                                   XXX
                                                                                                                                                                                   XXX
                                                                                                                                                                                   XXX
                                                                                                                                                                                   XXX
                                                                                                                                                                                   XXX
                                                                                                                                                                                   XXX
                                                                                                                                                                                   XXX
                                                                                                                                                                                   XXX
                                                                                                                                                                                   XXX
                                                                                                                                                                                   XXX
                                                                                SUB-TOTALS -- STOCKS               XXX              XXX                                      0     XXX                                 0                      0       XXX                                0
                                                                      TOTALS -- BONDS AND STOCKS                   XXX              XXX                                      0     XXX                                 0                      0                    0                     0
1
  Segregated gift annuity funds may, at their option, summarize all bonds of the same issue called, matured or redeemed during the year and omit disposal dates.
2
  Include accrued interest and dividends on bonds and stocks disposed of.

                                                                                                                                                          11
                                                               ANNUAL STATEMENT FOR THE YEAR 2007 OF THE                                                                                                                               0

                                                                                         SCHEDULE B
                                                              Showing all MONEY MARKET MUTUAL FUNDS owned December 31 of Current Year

    1                                            2                                              3                      4                     5                     6                 7                 8                   9


                                                                                                                                                                 Total             Total
 ID # or                                                                                     No. of                                       Year                 Acquired          Disposed         Market Value       Income Received
 Symbol                                     Description                                      Shares                  Cost               Acquired*             During Year       During Year       End of Year          During Year




                                                                             TOTALS           XXX                                   0     XXX                               0                 0                  0                 0

* Year acquired is on a historical basis. Report the year that the mutual fund was first acquired. (See Annual Statement Instructions for further details.)




                                                                                                                               12
                                       ANNUAL STATEMENT FOR THE YEAR 2007 OF THE                                                                                                                                     0

                                                                                                SCHEDULE C
                                                                            CASH, MONEY MARKET AND CERTIFICATES OF DEPOSIT
                                                                                       As of December 31 of Current Year

                                                     1                                                                    2                       3                   4                    5                 6

                                                                                                                 Nature of account                                  Interest        Interest Accrued
                                                Depository                                                 (Checking, CD, Money Market)        Rate of             Received         December 31 of
                   Give complete description of each depository, including the full name.                         See note below               Interest           During Year         Current Year         Balance
 OPEN ACCOUNTS




                                                                          TOTALS -- OPEN ACCOUNTS                        XXX                    XXX                             0                      0             0
 CLOSED ACCOUNTS




                                                                       TOTALS -- CLOSED ACCOUNTS                         XXX                    XXX                             0        XXX                XXX
                                                                         TOTALS -- CASH ON DEPOSIT                       XXX                    XXX                             0                      0             0
                                             CASH IN SEGREGATED GIFT ANNUITY FUND'S OFFICE                               XXX                    XXX                  XXX                 XXX

Note: Money market bank accounts are to be reported in this Schedule; however, money market mutual funds (brokerage accounts) should be reported in Schedule B.
        Indicate the interest rate at December 31 of the current year in Column 3.



                                                                                                              12 cont.
                                                               ANNUAL STATEMENT FOR THE YEAR 2007 OF THE                                                                                                        0

Group each type of asset separately, i.e., real estate, etc.                                           SCHEDULE D --- PART 1
Arrange items in each group alphabetically.                                       Showing all OTHER INVESTED ASSETS Owned December 31 of Current Year

                              1                                   2               3                   4                    5                   6                    7                8                9
                          Description
                                                                                                                     Date of Most     Method of Valuation
                                                                Year                            Market Value           Recent       and Name of Person/Firm    Gross Income                       Amount of
            Give complete description of asset                 Acquired         Cost †          End of Year ††        Valuation     Performing the Valuation      Earned          Expenses       Encumbrances




                                                     TOTALS     XXX                       0                      0        XXX                XXX                              0              0                  0
  † If received as a gift, the cost is the market value on date of receipt.
 †† Should reflect the value of the asset that is reported on Page 2, Line 5.




                                                                                                                     13
                                                                        ANNUAL STATEMENT FOR THE YEAR 2007 OF THE                                                                                                       0

Group each type of asset separately, i.e., real estate, etc.                                             SCHEDULE D --- PART 2
Arrange items in each group alphabetically.                                           Showing all Other Invested Assets ACQUIRED During Current Year

                                      1                                       2                 3                4                     5                    6                    7                        8
                                  Description
                                                                                         Indicate if Asset                        Market Value         Date of Most     Method of Valuation
                                                                             Date        was Donated or                            on Date of            Recent       and Name of Person/Firm    ID No. of Annuity or
                 Give complete description of each asset                   Acquired         Purchased           Cost†              Acquisition          Valuation     Performing the Valuation   Name of Annuitant††




                                                               TOTALS       XXX               XXX                          0                     0        XXX                                           XXX
  † If received as a gift, the cost is the market value on date of receipt.
 †† Complete this column if the annuity issued was conditioned upon the donated asset.




                                                                                                                     13 cont.
                                                                                     ANNUAL STATEMENT FOR THE YEAR 2007 OF THE                                                                                                                                0

Group each type of asset separately, i.e., real estate, etc.                                                             SCHEDULE D --- PART 3
Arrange items in each group alphabetically.                                               Showing all Other Invested Assets SOLD or otherwise DISPOSED OF During Current Year

                                1                                 2          3                         4                        5               6                7                    8                   9                10                  11

                                                                                                                           Market Value      Date of                              Realized           Gross Income
                                                                 Date     Disposal                                          at Disposal     MostRecent      Consideration       Gains/(Losses)         Received                        ID No. of Annuity or
                     Description of asset                      Acquired    Date               Name of Purchaser                Date         Valuation         Received             on Sale           During Year        Expenses       Name of Annuitant†




                                                     TOTALS     XXX        XXX                       XXX                      XXX              XXX                          0                    0                  0              0          XXX
 † Complete this column if the asset sold or disposed of was a donated asset conditioned upon an annuity agreement.




                                                                                                                                    14
                                                      ANNUAL STATEMENT FOR THE YEAR 2007 OF THE 0


                                                                                 SCHEDULE E
                                                         Showing all REINSURANCE Agreements as of December 31 of Current Year

      1                 2                                3                                4                     5                6           7               8

   NAIC             Federal                                                                                  Effective       Type of     Amount Of       Reinsurance
  Company             ID                                                                                      Date of      Reinsurance    Reserves        Premium
   Code             Number                      Name of Reinsurer                      Location             Agreement      Agreement       Ceded            Paid




                                                                      TOTALS            XXX                   XXX               XXX                  0                 0
Note: Column 7 Total should reflect the amount reported on Page 2, line 11.




                                                                                              14 cont.

				
DOCUMENT INFO
Description: Minnesota Real Estate Purchase Agreement Form Free document sample