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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 24F-2
ANNUAL NOTICE OF SECURITIES SOLD
PURSUANT TO RULE 24f-2
Read instructions at end of Form before preparing Form.
Please print or type.
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1. Name and address of issuer: Providian Life and Health Insurance Company
Separate Account IV
20 Moores Road
Frazer, PA 19355
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2. Name of each series or class of funds for which this notice is filed:
Vanguard Variable Annuity Plan Contract
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3. Investment Company Act File Number: 811-6144
Securities Act File Number: 33-36073
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4. Last day of fiscal year for which this notice is filed: December 31, 1996
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5. Check box if this notice is being filed more than 180 days after the close
of the issuer's fiscal year for purposes of reporting securities sold after
the close of the fiscal year but before termination of the issuer's 24f-2
declaration:
[ ]
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6. Date of termination of issuer's declaration under rule 24f-2(a)(1), if
applicable (see Instruction A.6):
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7. Number and amount of securities of the same class or series which had been
registered under the Securities Act of 1933 other than pursuant to rule
24f-2 in a prior fiscal year, but which remained unsold at the beginning
of the fiscal year: 0
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8. Number and amount of securities registered during the fiscal year other
than pursuant to rule 24f-2: 0
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9. Number and aggregate sale price of securities sold during the fiscal year:
6,342 polices sold for $445,286,545
$80,658,109 in dividends reinvested
Total: $525,944,654
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10. Number and aggregate sale price of securities sold during the fiscal year
in reliance upon registration pursuant to rule 24f-2:
6,342 policies sold for $445,286,545
$80,658,109 in dividends reinvested
Total: $525,944,654
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11. Number and aggregate sale price of securities issued during the fiscal
year in connection with dividend reinvestment plans, if applicable (see
Instruction B.7): 0
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12. Calculation of registration fee:
(i) Aggregate sale price of securities sold during
the fiscal year in reliance on rule 24f-2
(from Item 10): $525,944,654
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(ii) Aggregate price of shares issued in connection
with dividend reinvestment plans (from Item 11,
if applicable): + $0
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(iii) Aggregate price of shares redeemed or
repurchased during the fiscal year (if
applicable): -$58,488,717
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(iv) Aggregate price of shares redeemed or
repurchased and previously applied as a
reduction to filing fees pursuant to rule
24e-2 (if applicable): + $0
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(v) Net aggregate price of securities sold
and issued during the fiscal year in
reliance on rule 24f-2 [line (i), plus line
(ii), less line (iii), plus line (iv)] (if
applicable): $467,455,937
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(vi) Multiplier prescribed by Section 6(b) of
the Securities Act of 1933 or other applicable
law or regulation (see Instruction C.6): x 1/3300
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(vii) Fee due [line (i) or line (v) multiplied by
line (vi): $ 141,653.31
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Instruction: Issuers should complete lines (ii), (iii), (iv), and (v) only if
the form is being filed within 60 days after the close of the
issuer's fiscal year. See Instruction C.3.
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13. Check box if fees are being remitted to the Commission's lockbox
depository as described in section 3a of the Commission's Rules of
Informal and Other Procedures (17 CFR 202.3a).
[X]
Date of mailing or wire transfer of filing fees to the Commission's
lockbox depository: February 26, 1997
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SIGNATURES
This report has been signed below by the following persons on behalf of
the issuer and in the capacities and on the dates indicated.
By /s/ Kimberly A. Scouller
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Kimberly A. Scouller
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Assistant Secretary
Date: February 27, 1997
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*Please print the name and title of the signing officer below the signature.
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Providian Life and Health Insurance Company
400 West Market Street
PO Box 32830
Louisville, Kentucky 40232
502-560-3898
February 27, 1997
Securities and Exchange Commission
450 Fifth Street, NW
Judiciary Plaza
Washington, DC 20549
Re: Rule 24f-2 Notice for Providian Life and Health Insurance Company Separate
Account IV
Investment Company Act File Number:
811-6144
Securities Act File Number:
33-36073
Dear Sir or Madam:
It is my opinion that the securities issued in accordance with the captioned
filing and which this notice makes definite in number were legally issued and
fully paid and are nonassessable.
Very truly yours,
/s/ Kimberly A. Scouller
Kimberly A. Scouller
Assistant General Counsel
