<PAGE>
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 from the previous filing on this
form.
1. A. Registrant Name: Peoples Benefit Life Insurance Company
Separate Account IV
B. File Number: 811-6144
C. Telephone Number: (502) 560-3009
2. A. Street: 4333 Edgewood Road NE
B. City: Cedar Rapids C. State: Iowa D. Zip Code: 52499 Zip Ext:
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.]
7. A. Is Registrant a series or multiple portfolio company? (Y/N)
[If answer is "N" (No), go to item 8.]
B. How many separate series or portfolios did Registrant have at
the end of the period?
<PAGE>
For period ending 12/31/99 If filing more than one
File number 811-6144 Page 47, "X" box: [ ]
UNIT INVESTMENT TRUSTS
111. A. [/] Depositor Name: Peoples Benefit Life Insurance Company
B. [/] File Number (If any):
C. [/] City: Cedar Rapids State: Iowa Zip Code: 52499 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:
<PAGE>
For period ending 12/31/99 If filing more than one
File number 811-6144 Page 48, "X" box: [ ]
113. A. [/] Trustee Name:
B. [/] File Number (If any):
C. [/] City: State: Zip Code: Zip Ext.:
[/] Foreign Country: Foreign Postal Code:
113. A. [/] Trustee Name:
B. [/] File Number (If any):
C. [/] City: State: Zip Code: Zip Ext.:
[/] Foreign Country: Foreign Postal Code:
114. A. [/] Principal Underwriter Name: Vanguard Marketing Corporation
B. [/] File Number: 8-21570
C. [/] City: Malvern State: PA Zip Code: 19355 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: Ernst & Young, LLP
B. [/] City: Des Moines State: IA Zip Code: 50309 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:
<PAGE>
For period ending 12/31/99 If filing more than one
File number 811-6144 Page 49, "X"box: [ ]
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?
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 1
---
119. [/] State the number of new series for which registration
statements under the Securities Act of 1933 became effective
during the period 0
---
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) $ 0
---
121. [/] State the number of series for which a current prospectus
was in existence at the end of the period 1
---
122. [/] State the number of existing series for which additional
units were registered under the Securities Act of 1933
during the current period 1
---
<PAGE>
For period ending 12/31/99 If filing more than one
File number 811-6144 Page 50, "X" box: [ ]
123. [/] State the total value of the additional units considered
in answering item 122 ($000's omitted) $789,967
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):
<TABLE>
<CAPTION>
Number of Total Assets Total Income
Series ($000's Distributions
Investing omitted) ($000's omitted)
---------- ------------- ----------------
<S> <C> <C> <C>
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 $ $
broker's or dealer's 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$ $ $
J. All other equity securities 1 $5,389,341 $118,642
K. Other securities $ $
L. Total assets of all series of registrant 1 $5,389,341 $118,642
</TABLE>
<PAGE>
For period ending 12/31/99 If filing more than one
File number 811-6144 Page 51, "X" box: [ ]
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) $18,012
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-__________
<PAGE>
This report is signed on behalf of the registrant (or depositor or trustee).
City of: Louisville State of: Kentucky Date: February 22,2000
Name of Registrant, Depositor, or Trustee: Peoples Benefit Life Insurance
Company Separate Account IV
Witness: /s/ Michele A. Zabel By: /s/ Gregory E. Miller-Breetz
--------------------- -----------------------------
Assistant Secretary
