United States
Securities and Exchange Commission
Washington, D.C. 20549
FORM N-SAR
SEMI-ANNUAL REPORT
FOR REGISTERED INVESTMENT COMPANIES
Report for six month period ending: / / (a)
or fiscal year ending: 12 /31/ 99 (b)
Is this a transition report? (Y/N): N
Is this an amendment to a previous filing? ( Y / N ): N
Those items or sub-items with a box "[/]" after the item number should be
completed only if the answer has changed form the previous filing on this form.
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1. A. Registrant Name: Cova Variable Annuity Account One
B. File Number: 811 - 5200
C. Telephone Number: (800) 523-1661
2. A. Street: One Tower Lane, Suite 3000
B. City: Oakbrook Terrace C. State: IL D. Zip Code: 60181 Zip Ext: 4644
E. Foreign Country Foreign Postal Code:
3. Is this the first filing on this form by Registrant? (Y/N): N
4. Is this the last filing on this form by Registrant? (Y/N): N
5. Is Registrant a small business investment company (SBIC)? (Y/N): N
[If answer is "Y" (Yes), complete only items 89 through 110.]
6. Is Registrant a unit investment trust (UIT)? (Y/N): Y
[If answer is "Y" (Yes), complete only items 111 through 132.]
FOR PERIOD ENDING 12/31/99
FILE NUMBER 811 - 5200
UNIT INVESTMENT TRUSTS
111. A. [/] Depositor Name:
B. [/] File Number (If any):
C. [/] City: State: Zip Code: Zip Ext.:
[/] Foreign Country: Foreign Postal Code:
111. A. [/] Depositor Name:
B. [/] File Number (if any):
C. [/] City: State: Zip Code: Zip Ext.:
[/] Foreign Country: Foreign Postal Code:
112. A. [/] Sponsor Name:
B. [/] File Number (if any):
C. [/] City: State: Zip Code: Zip Ext.:
[/] Foreign Country: Foreign Postal Code:
112. A. [/] Sponsor Name:
B. [/] File Number (if any):
C. [/] City: State: Zip Code: Zip Ext.:
[/] Foreign Country: Foreign Postal Code:
For period ending 12/31/99
FILE NUMBER 811 - 5200
113. A. [/] Trustee Name:
B. [/] City: State: Zip Code: Zip Ext.:
[/] Foreign Country: Foreign Postal Code:
113. A. [/] Trustee Name:
B. [/] City: State: Zip Code: Zip Ext.:
[/] Foreign Country: Foreign Postal Code:
114. A. [/] Principal Underwriter Name:
B. [/] File Number: 8 -
C. [/] City: State: Zip Code: Zip Ext.:
[/] Foreign Country: Foreign Postal Code:
114. A. [/] Principal Underwriter Name:
B. [/] File Number: 8 -
C. [/] City: State: Zip Code: Zip Ext.:
[/] Foreign Country: Foreign Postal Code:
115. A. [/] Independent Public Accountant Name:
B. [/] City: State: Zip Code: Zip Ext.:
[/] Foreign Country: Foreign Postal Code:
115. A. [/] Independent Public Accountant Name:
B. [/] City: State: Zip Code: Zip Ext.:
[/] Foreign Country: Foreign Postal Code:
For period ending 12/31/99
FILE NUMBER 811 - 5200
116. Family of investment companies information:
A. [/] Is Registrant part of a family of investment companies? (Y/N):_____
B. [/] Identify the family in 10 letters:_________________________________
(NOTE: In filing this form, use this identification consistently for all
investment companies in family. This designation is for purposes of this form
only.)
117. A. [/] Is Registrant a separate account of an insurance company? (Y/N)___
If answer is "Y" (Yes), are any of the following types of contracts funded
by the Registrant:
B. [/] Variable annuity contracts? (Y/N)__________________________________
C. [/] Scheduled premium variable life contracts? (Y/N)___________________
D. [/] Flexible premium variable life contracts? (Y/N)____________________
E. [/] Other types of insurance products registered under the Securities
Act of 1933? (Y/N)_________________________________________________
118. [/] State the number of series existing at the end of the period that
had securities registered under the Securities Act of 1933_____________
119. [/] State the number of new series for which registration statements
under the Securities Act of 1933 became effective during the
period_________________________________________________________________
120. [/] State the total value of the portfolio securities on the date of
deposit for the new series included in item 119
($000's omitted)_______________________________________________________$
121. [/] State the number of series for which a current prospectus was in
existence at the end of the period_____________________________________
122. [/] State the number of existing series for which additional units
were registered under the Securities Act of 1933 during the current
period_________________________________________________________________
For period ending 12/31/99
FILE NUMBER 811 - 5200
123. [/] State the total value of the additional units considered in
answering item 122 ($000's omitted)___________________________________$
124. [/] State the total value of units of prior series that were placed
in the portfolios of subsequent series during the current period
(the value of these units is to be measured on the date they were
placed in the subsequent series) ($000's omitted)_____________________$
125. [/] State the total dollar amount of sales loads collected (before
reallowances to other brokers or dealers) by Registrant's
principal underwriter and any underwriter which is an affiliated
person of the principal underwriter during the current period
solely from the sale of units of all series of Registrant
($000's omitted)______________________________________________________$
126. Of the amount shown in item 125, state the total dollar amount of
sales loads collected from secondary market operations in
Registrant's units (include the sales loads, if any, collected on
units of a prior series placed in the portfolio of a subsequent
series.) ($000's omitted)____________________________________________$0
127. List opposite the appropriate description below the number of series
whose portfolios are invested primarily (based upon a percentage
of NAV) in each type of security shown, the aggregate total assets
at market value as of a date at or near the end of the current
period of each such group of series and the total income
distributions made by each such group of series during the current
period (excluding distributions of realized gains, if any):
Number of Total Income
Series Total Assets Distributions
Investing ($000's omitted) ($000's omitted)
--------- ---------------- ----------------
A. U.S. Treasury direct issue------ _____ $_________ $_________
B. U.S. Government agency---------- _____ $_________ $_________
C. State and municipal tax-free---- _____ $_________ $_________
D. Public utility debt------------- _____ $_________ $_________
E. Brokers or dealers debt or debt
of brokers' or dealers' parent-- _____ $_________ $_________
F. All other corporate intermed.
& long-term debt--------------- _____ $_________ $_________
G. All other corporate short-term
debt---------------------------- _____ $_________ $_________
H. Equity securities of brokers or
dealers or parents of brokers or
dealers------------------------- _____ $_________ $_________
I. Investment company equity
securities---------------------- 1 $2,343,957 $0
J. All other equity securities----- _____ $_________ $_________
K. Other securities---------------- _____ $_________ $_________
L. Total assets of all series of
registrant---------------------- 1 $2,343,957 $0
For period ending 12/31/99
FILE NUMBER 811 - 5200
128. [/] Is the timely payment of principal and interest on any of the
portfolio securities held by any of Registrant's series at the
end of the current period insured or guaranteed by an entity
other than the issuer? (Y/N)_________________________________
[If answer is "N" (No), go to item 131.]
129. [/] Is the issuer of any instrument covered in item 128 delinquent or
in default as to payment of principal or interest at the end of
the current period? (Y/N)____________________________________
[If answer is "N" (No), go to item 131.]
130. [/] In computations of NAV or offering price per unit, is any part of
the value attributed to instruments identified in item 129
derived from insurance or guarantees? (Y/N)__________________
131. Total expenses incurred by all series of Registrant during the
current reporting period ($000's omitted)____________________$27,959
132. [/] List the "811" (Investment Company Act of 1940) registration
number for all Series of Registrant that are being included in
this filing:
811-_____ 811-_____ 811-_____ 811-_____ 811-_____
811-_____ 811-_____ 811-_____ 811-_____ 811-_____
811-_____ 811-_____ 811-_____ 811-_____ 811-_____
811-_____ 811-_____ 811-_____ 811-_____ 811-_____
811-_____ 811-_____ 811-_____ 811-_____ 811-_____
811-_____ 811-_____ 811-_____ 811-_____ 811-_____
811-_____ 811-_____ 811-_____ 811-_____ 811-_____
811-_____ 811-_____ 811-_____ 811-_____ 811-_____
811-_____ 811-_____ 811-_____ 811-_____ 811-_____
SIGNATURE PAGE
The following form of signature shall follow items 79, 85, 88, 104, 110 or 132
as appropriate.
This report is signed on behalf of the registrant (or depositor or trustee).
CITY OF: STATE OF: DATE:
Oakbrook Terrace Illinois 2/23/2000
NAME OF REGISTRANT, DEPOSITOR, OR TRUSTEE:
Cova Variable Annuity Account One (registrant) by Cova Financial Services
Life Insurance Company (depositor)
BY (NAME AND TITLE): WITNESS (NAME AND TITLE):
/s/ Peter L. Witkewiz /s/ William P. Flory Jr.
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First Vice President and Assistant Vice President
Controller
