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Annual Notice of Securities Sold Pursuant to Rule 24F-2
U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
FORM 24F-2
Annual Notice of Securities Sold
Pursuant to Rule 24f-2
1. Name and address of issuer:
Peoples Benefit Life Insurance Company Separate Account V
4333 Edgewood Road NE
Cedar Rapids, Iowa 52499
2. Name of each series or class of funds for which this notice is filed (If the
Form is being filed for all series and classes of securities of the issuer,
check the box but do not list series or classes): [ ]
PRISM Variable Annuity
3. Investment Company Act File Number:
811-6564
Securities Act File Number:
33-45862
4(a). Last date of fiscal year for which this Form is filed:
December 31, 1999
4(b).[ ] Check box if this Form is being filed late (i.e., more than 90
calendar days after the end of the issuer's fiscal year). (See
Instruction A.2)
Note: If the Form is being filed late, interest must be paid on the
registration fee due.
4(c).[ ] Check box if this is the last time the issuer will be filing this
Form.
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5. Calculation of registration fee:
(i) Aggregate sale price of securities sold during the fiscal year
pursuant to section 24(f): $29,188,617
(ii) Aggregate price of securities redeemed or repurchased during the
fiscal year: $31,721,842
(iii) Aggregate price of securities redeemed or repurchased during any
prior fiscal year ending no earlier than October 11, 1995 that were
not previously used to reduce registration fees payable to the
Commission: $437,659
(iv) Total available redemption credit [add Items 5(ii) and 5(iii)]:
-$32,159,501
(v) Net sales - if Item 5(i) is greater than Item 5(iv) [subtract Item
5(iv) from Item 5(i)] $0
(vi) Redemption credits available for use in future years - if Item 5(i)
is less than Item 5(iv) [subtract Item 5(iv) from Item 5(i)]:
$(2,970,883)
(vii) Multiplier for determining registration fee (See Instruction C.9):
x .000264
(viii) Registration fee due [multiply Item 5(v) by Item 5(vii)] (enter
"0" if no fee is due): = $0.00
6. Prepaid Shares
If the response to Item 5(i) was determined by deducting an amount of
securities that were registered under the Securities Act of 1993 pursuant to
rule 24e-2 as in effect before October 11, 1997, then report the amount of
securities (number of shares or other units) deducted here: _____. If there
is a number of shares or other units that were registered pursuant to rule
24e-2 remaining unsold at the end of the fiscal year for which this form is
filed that are available for use by the issuer in future fiscal years, then
state the number here: ______.
7. Interest due - if this Form is being filed more than 90 days after the end
of the issuer's fiscal year (See Instruction D): + $__________
8. Total of the amount of the registration fee due plus any interest due [line
5(iii) plus Line 7]: = $0.00
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9. Date the registration fee and any interest payment were sent to the
Commission's lockbox depository:
Method of delivery:
[ ] Wire Transfer
[ ] Mail or other means
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 (Signature and Title) /s/ Gregory E. Miller-Breetz
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Gregory E. Miller-Breetz
Assistant Secretary
Date: March 27,2000
