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SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549
FORM N-8A
NOTIFICATION OF REGISTRATION
FILED PURSUANT TO SECTION 8(A) OF THE
INVESTMENT COMPANY ACT OF 1940
The undersigned investment company hereby notifies the Securities and Exchange
Commission that it registers under and pursuant to the provisions of Section
8(a) of the Investment Company Act of 1940 and in connection with such
notification of registration submits the following information:
Name: Farmers Annuity Separate Account A
Address of Principal Business Office:
3003 - 77th Avenue, S.E.
Mercer Island, Washington 98040
Telephone Number: 206-232-8400
Name and Address of Agents for Service of Process:
C. Paul Patsis, President
Paul G. Secord, Vice President
David A. Demmon, Treasurer
Farmers New World Life Insurance Company
3003 - 77th Avenue, S.E.
Mercer Island, Washington 98040
M. Douglas Close, Vice President and General Counsel
Farmers Insurance Group, Inc.
4680 Wilshire Boulevard
Los Angeles, California 90010
Check Appropriate Box:
Registrant is filing a Registration Statement pursuant to Section 8(b) of
the Investment Company Act of 1940 concurrently with the filing of Form N-8A:
Yes / X / No / /
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Item 1. Farmers Annuity Separate Account A
Item 2. Registrant was organized under the laws of the State of Washington
on April 6, 1999.
Item 3. Registrant is organized as a separate account of Farmers New World
Life Insurance Company.
Item 4. Registrant is a unit investment trust.
Item 5. Not applicable.
Item 6. Not applicable.
Item 7. Not applicable.
Item 8. (a) Farmers New World Life Insurance Company
3003 - 77th Avenue, S.E.
Mercer Island, WA 98040
(b)
<TABLE>
<CAPTION>
- --------------------------------------------------------------------------------------------------------------------
NAME POSITION WITH SPONSOR ADDRESS
- --------------------------------------------------------------------------------------------------------------------
<S> <C> <C>
3003 - 77th Avenue, S.E.
C. Paul Patsis President & Director Mercer Island, WA 98040
- --------------------------------------------------------------------------------------------------------------------
3003 - 77th Avenue, S.E.
Kathryn M. Callahan Vice President & Actuary Mercer Island, WA 98040
- --------------------------------------------------------------------------------------------------------------------
4680 Wilshire Blvd.
M. Douglas Close Vice President & General Counsel Los Angeles, CA 90010
- --------------------------------------------------------------------------------------------------------------------
3003 - 77th Avenue, S.E.
David A. Demmon Assistant Vice President & Treasurer Mercer Island, WA 98040
- --------------------------------------------------------------------------------------------------------------------
4680 Wilshire Blvd.
Gerald A. Dulek Assistant Vice President Los Angeles, CA 90010
- --------------------------------------------------------------------------------------------------------------------
4680 Wilshire Blvd.
Howard Falk Vice President & Assistant Treasurer Los Angeles, CA 90010
- --------------------------------------------------------------------------------------------------------------------
4680 Wilshire Blvd.
Gerald E. Faulwell Vice President Los Angeles, CA 90010
- --------------------------------------------------------------------------------------------------------------------
4680 Wilshire Blvd.
Doren E. Hohl Assistant Secretary Los Angeles, CA 90010
- --------------------------------------------------------------------------------------------------------------------
3003 - 77th Avenue, S.E.
Paul F. Hott Assistant Vice President Mercer Island, WA 98040
- ---------------------------------- ---------------------------------------------------------------------------------
4680 Wilshire Blvd.
Hubert L. Mountz Assistant Treasurer Los Angeles, CA 90010
- --------------------------------------------------------------------------------------------------------------------
2500 Farmers Way
Link R. Murphy, M.D. Assistant Medical Director Columbus, OH 43235
- --------------------------------------------------------------------------------------------------------------------
</TABLE>
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<TABLE>
- -----------------------------------------------------------------------------------------------------------------------
<S> <C> <C>
3003 - 77th Avenue, S.E.
John R. Patton Assistant Vice President Mercer Island, WA 98040
- -----------------------------------------------------------------------------------------------------------------------
3003 - 77th Avenue, S.E.
James I. Randolph Vice President & Assistant Secretary Mercer Island, WA 98040
- -----------------------------------------------------------------------------------------------------------------------
4680 Wilshire Blvd.
Paul G. Secord Vice President Los Angeles, CA 90010
- -----------------------------------------------------------------------------------------------------------------------
4680 Wilshire Blvd.
Maryann M. Seltzer Assistant Secretary Los Angeles, CA 90010
- -----------------------------------------------------------------------------------------------------------------------
2615 - 42nd Avenue West
Richard E. Bangert Director Seattle, WA 98199
- -----------------------------------------------------------------------------------------------------------------------
6300 Sand Point Way, N.E., #307
Donald J. Covey Director Seattle, WA 98115
- -----------------------------------------------------------------------------------------------------------------------
4680 Wilshire Blvd.
Martin D. Feinstein Director Los Angeles, CA 90010
- -----------------------------------------------------------------------------------------------------------------------
4680 Wilshire Blvd.
Paul N. Hopkins Director Los Angeles, CA 90010
- -----------------------------------------------------------------------------------------------------------------------
1600 Seventh Avenue, Room 1802
Dennis I. Okamoto Director Seattle, WA 98191
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4680 Wilshire Blvd.
Keitha T. Schofield Director Los Angeles, CA 90010
- -----------------------------------------------------------------------------------------------------------------------
6131 - 128th Avenue, N.E.
Gary R. Severson Director Kirkland, WA 98033
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1201 Third Avenue, Suite 3390
John F. Sullivan, Jr. Director Seattle, WA 98101
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</TABLE>
Item 9. (a) No.
(b) Not applicable.
(c) Yes.
(d) No.
(e) Not applicable.
Item 10. Zero.
Item 11. No.
Item 12. Not applicable.
3
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SIGNATURES
Pursuant to the requirements of the Investment Company Act of 1940, the Sponsor
of the registrant has caused this notification of registration to be duly signed
on behalf of the registrant in the City of Mercer Island, the State of
Washington on the 4th day of August, 1999.
FARMERS ANNUITY SEPARATE ACCOUNT A
ATTEST:
/s/John R. Patton By: /s/C. Paul Patsis
- ----------------- -----------------
Name: John R. Patton Name: C. Paul Patsis
Title: Assistant Vice President Title: President and Director
Farmers New World Life Farmers New World Life
Insurance Company Insurance Company
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