5a. NON-QUALIFIED CONTRACT 5b. QUALIFIED CONTRACT Indicate type and amount of initial Payment below. Indicate type of plan for new contract, source of funds, and amount OR below.Deferred Variable Annuity Application • April 27th, 2011 • Variable Separate Account
Contract Type FiledApril 27th, 2011 Company
5a. NON-QUALIFIED CONTRACT 5b. QUALIFIED CONTRACT Indicate type and amount of initial Payment below. Indicate type of plan for new contract, source of funds, and amount OR below.Deferred Variable Annuity Application • April 27th, 2011 • Fs Variable Separate Account
Contract Type FiledApril 27th, 2011 Company