<PAGE> 1
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
RULE 24f-2 NOTICE
FOR
Provident Mutual Variable Annuity Separate Account
(Name of Registrant)
1050 Westlakes Drive
Berwyn, PA 19312
(Address of principal executive offices)
File Nos. 33-62588 and 33-70926
1. The following information is set forth pursuant to the requirements of
Rule 24f-2(b)(1):
(i). Fiscal year for which Notice is filed:
Fiscal year ended December 31, 1996
(ii). Number or amount of securities of the same class or series, if
any, which had been registered under the Securities Act of 1933
other than pursuant to Rule 24f-2 but which remained unsold at
the beginning of such fiscal year.
None
(iii). The number or amount of securities, if any, registered during
such fiscal year other than pursuant to Rule 24f-2:
None
(iv). The number or amount of securities sold during the fiscal year:
<TABLE>
<S> <C> <C>
Growth Money Market Bond
Subaccount Subaccount Subaccount
$1,220,538.49 $20,199,031.94 $251,221.85
worth of worth of worth of
policies(1) policies(2) policies(3)
Aggressive
Managed Growth International
Subaccount Subaccount Subaccount
$498,873.23 $142,092.00 $1,094,024.66
worth of worth of worth of
policies(4) policies(5) policies(6)
</TABLE>
<PAGE> 2
<TABLE>
<S> <C> <C> <C>
Fidelity High Fidelity Equity Fidelity Asset
Income Subaccount Income Subaccount Fidelity Growth Manager Subaccount
$1,035,641.07 $4,221,262.28 Subaccount $514,710.76
$3,011,521.58
worth of worth of worth of
policies (7) policies (8) worth of policies (10)
policies (9)
Fidelity Quest for Value Quest for Value
Fidelity Index 500 Contrafund Equity Small Cap
Subaccount Subaccount Subaccount Subaccount
$1,785,395.92 $673,925.35 $1,259,392.74 $1,601,291.31
worth of worth of worth of worth of
policies (11) policies (12) policies (13) policies (14)
Quest for Value Scudder Growth and Scudder
Managed Subaccount Scudder Bond Income International
$2,893,754.03 Subaccount Subaccount Subaccount
$398,233.30 $484,976.53 $177,193.11
worth of
policies (15) worth of worth of worth of
policies (16) policies (17) policies (18)
Federated U.S.
Dreyfus Zero Coupon Dreyfus Growth and Dreyfus Socially Government Bond
2000 Income Responsible Subaccount
Subaccount Subaccount Subaccount $52,735.74
$306,033.06 $684,340.08 $96,297.15
worth of
worth of worth of worth of policies (22)
policies (19) policies (20) policies (21)
Federated Utility
Subaccount
$79,304.13
worth of
policies (23)
</TABLE>
(v). The number or amount of securities sold during such fiscal year
in reliance upon registration pursuant to Rule 24f-2
<PAGE> 3
<TABLE>
<S> <C> <C> <C>
Growth Money Market Bond
Subaccount Subaccount Subaccount
$1,220,538.49 $20,199,031.94 $251,221.85
worth of worth of worth of
policies(1) policies(2) policies(3)
Aggressive
Managed Growth International
Subaccount Subaccount Subaccount
$498,873.23 $142,092.00 $1,094,024.66
worth of worth of worth of
policies(4) policies(5) policies(6)
Fidelity High Fidelity Equity Fidelity Asset
Income Subaccount Income Subaccount Fidelity Growth Manager Subaccount
$1,035,641.07 $4,221,262.28 Subaccount $514,710.76
$3,011,521.58
worth of worth of worth of
policies (7) policies (8) worth of policies (10)
policies (9)
Fidelity Quest for Value Quest for Value
Fidelity Index 500 Contrafund Equity Small Cap
Subaccount Subaccount Subaccount Subaccount
$1,785,395.92 $673,925.35 $1,259,392.74 $1,601,291.31
worth of worth of worth of worth of
policies (11) policies (12) policies (13) policies (14)
Quest for Value Scudder Growth and Scudder
Managed Subaccount Scudder Bond Income International
$2,893,754.03 Subaccount Subaccount Subaccount
$398,233.30 $484,976.53 $177,193.11
worth of
policies (15) worth of worth of worth of
policies (16) policies (17) policies (18)
</TABLE>
<PAGE> 4
<TABLE>
<S> <C> <C> <C>
Federated U.S.
Dreyfus Zero Coupon Dreyfus Growth and Dreyfus Socially Government Bond
2000 Income Responsible Subaccount
Subaccount Subaccount Subaccount $52,735.74
$306,033.06 $684,340.08 $96,297.15
worth of
worth of worth of worth of policies (22)
policies (19) policies (20) policies (21)
Federated Utility
Subaccount
$79,304.13
worth of
policies (23)
</TABLE>
2. An opinion of counsel with respect to the validity of the shares
accompanies this Notice.
3. Filing fee with respect to shares specified in 1(v) above:
<TABLE>
<S> <C> <C>
Growth Subaccount 289.30 (1)
Money Market Subaccount 284.60 (2)
Bond Subaccount 57.22 (3)
Managed Subaccount 143.84 (4)
Aggressive Growth Subaccount 24.96 (5)
International Subaccount 239.92 (6)
Fidelity High Income Subaccount 210.16 (7)
Fidelity Equity Income Subaccount 969.81 (8)
Fidelity Growth Subaccount 691.91 (9)
Fidelity Asset Manager Subaccount 127.26 (10)
Fidelity Index 500 Subaccount 440.93 (11)
Fidelity Contrafund Subaccount 197.98 (12)
Quest for Value Equity Subaccount 267.88 (13)
Quest for Value Small Cap Subaccount 247.53 (14)
Quest for Value Managed Subaccount 695.73 (15)
Scudder Bond Subaccount 92.27 (16)
Scudder Growth and Income Subaccount 138.24 (17)
Scudder International Subaccount 53.30 (18)
Dreyfus Zero Coupon 2000 Subaccount 56.40 (19)
Dreyfus Growth and Income Subaccount 199.31 (20)
Dreyfus Socially Responsible Subaccount 29.03 (21)
Federated U.S. Government Bond Subaccount 14.37 (22)
Federated Utility Subaccount 23.90 (23)
$5,495.84
</TABLE>
<PAGE> 5
Minimum Filing Fee (Certified Check Enclosed): $5,495.84
DATED: February 26, 1997
PROVIDENT MUTUAL VARIABLE ANNUITY SEPARATE ACCOUNT
BY: /s/ Adam Scaramella
--------------------------------
Adam Scaramella
- ------------------------
(1) The actual aggregate sales price was $1,220,538.49, which consists of 523
policies allocating premiums to the Growth Subaccount. During the fiscal year
ended December 31, 1996, the actual aggregate redemption price of Growth
Subaccount policies redeemed was $265,858.97. (No portion of such aggregate
redemption price has been applied by the Registrant pursuant to Rule 24f- 2(c)
in any filing made pursuant to Section 24(e)(1) of the Investment Company Act of
1940.) Pursuant to Rule 24f-2(c), the filing fee with respect to the policies in
calculated as follows:
$1,220,538.49 - 265,858.97 = $954,679.52 / 3300 = $289.30
(2) The actual aggregate sales price was $20,199,031.94, which consists of 726
policies allocating premiums to the Money Market Subaccount. During the fiscal
year ended December 31, 1996, the actual aggregate redemption price of Money
Market Subaccount policies redeemed was $19,259,858.10. (No portion of such
aggregate redemption price has been applied by the Registrant pursuant to Rule
24f-2(c) in any filing made pursuant to Section 24(e)(1) of the Investment
Company Act of 1940.) Pursuant to Rule 24f-2(c), the filing fee with respect to
the policies is calculated as follows:
$20,199,031.94 - 19,259,858.10 = $939,173.84 / 3300 = $284.60
(3) The actual aggregate sales price was $251,221.85, which consists of 118
policies allocating premiums to the Bond Subaccount. During the fiscal year
ended December 31, 1996, the actual aggregate redemption price of Bond
Subaccount policies redeemed was $62,395.33. (No portion of such aggregate
redemption price has been applied by the Registrant pursuant to Rule 24f- 2(c)
in any filing made pursuant to Section 24(e)(1) of the Investment Company Act of
1940.) Pursuant to Rule 24f-2(c), the filing fee with respect to the policies is
calculated as follows:
$251,221.85 - 62,395.33 = $188,826.52 / 3300 = $57.22
<PAGE> 6
(4) The actual aggregate sales price was $498,873.23, which consists of 108
policies allocating premiums to the Managed Subaccount. During the fiscal year
ended December 31, 1996, the actual aggregate redemption price of Managed
Subaccount policies redeemed was $24,216.83. (No portion of such aggregate
redemption price has been applied by the Registrant pursuant to Rule 24f- 2(c)
in any filing made pursuant to Section 24(e)(1) of the Investment Company Act of
1940.) Pursuant to Rule 24f-2(c), the filing fee with respect to the policies is
calculated as follows:
$498,873.23 - 24,216.83 = $474,656.40 / 3300 = $143.84
(5) The actual aggregate sales price was $142,092.00, which consists of 125
policies allocating premiums to the Aggressive Growth Subaccount. During the
fiscal year ended December 31, 1996, the actual aggregate redemption price of
Aggressive Growth Subaccount policies redeemed was $59,723.70. (No portion of
such aggregate redemption price has been applied by the Registrant pursuant to
Rule 24f-2(c) in any filing made pursuant to Section 24(e)(1) of the Investment
Company Act of 1940.) Pursuant to Rule 24f-2(c), the filing fee with respect to
the policies is calculated as follows:
$142,092.00 - 59,723.70 = $82,368.30 / 3300 = $24.96
(6) The actual aggregate sales price was $1,094,024.66, which consists of 421
policies allocating premiums to the International Subaccount. During the fiscal
year ended December 31, 1996, the actual aggregate redemption price of
International Subaccount policies redeemed was $302,283.50. (No portion of such
aggregate redemption price has been applied by the Registrant pursuant to Rule
24f-2(c) in any filing made pursuant to Section 24(e)(1) of the Investment
Company Act of 1940.) Pursuant to Rule 24f-2(c), the filing fee with respect to
the policies is calculated as follows:
$1,094,024.66 - 302,283.50 = $791,741.16 / 3300 = $239.92
(7) The actual aggregate sales price was $1,035,641.07, which consists of 317
policies allocating premiums to the Fidelity High Income Subaccount. During the
fiscal year ended December 31, 1996, the actual aggregate redemption price of
Fidelity High Income Subaccount policies redeemed was $342,115.04. (No portion
of such aggregate redemption price has been applied by the Registrant pursuant
to Rule 24f-2(c) in any filing made pursuant to Section 24(e)(1) of the
Investment Company Act of 1940.) Pursuant to Rule 24f-2(c), the filing fee with
respect to the policies is calculated as follows:
$1,035,641.07 - 342,115.04 = $693,526.03 / 3300 = $210.16
(8) The actual aggregate sales price was $4,221,262.28, which consists of 946
policies allocating premiums to the Fidelity Equity Income Subaccount. During
the fiscal year ended December 31, 1996, the actual aggregate redemption price
of Fidelity Equity Income Subaccount policies redeemed was $1,020,905.30. (No
portion of such aggregate redemption price has been applied by the Registrant
pursuant to Rule 24f-2(c) in any filing made pursuant to Section 24(e)(1) of the
Investment Company Act of 1940.) Pursuant to Rule 24f-2(c), the filing fee with
respect to the policies is calculated as follows:
$4,221,262.28 - 1,020,905.30 = $3,200,356.98 / 3300 = $969.81
<PAGE> 7
(9) The actual aggregate sales price was $3,011,521.58, which consists of 1,152
policies allocating premiums to the Fidelity Growth Subaccount. During the
fiscal year ended December 31, 1996, the actual aggregate redemption price of
Fidelity Growth Subaccount policies redeemed was $728,222.95. (No portion of
such aggregate redemption price has been applied by the Registrant pursuant to
Rule 24f-2(c) in any filing made pursuant to Section 24(e)(1) of the Investment
Company Act of 1940.) Pursuant to Rule 24f-2(c), the filing fee with respect to
the policies is calculated as follows:
$3,011,521.58 - 728,222.95 = $2,283,298.63 / 3300 = $691.91
(10) The actual aggregate sales price was $514,710.76, which consists of 294
policies allocating premiums to the Fidelity Asset Manager Subaccount. During
the fiscal year ended December 31, 1996, the actual aggregate redemption price
of Fidelity Asset Manager Subaccount policies redeemed was $94,750.73. (No
portion of such aggregate redemption price has been applied by the Registrant
pursuant to Rule 24f-2(c) in any filing made pursuant to Section 24(e)(1) of the
Investment Company Act of 1940.) Pursuant to Rule 24f-2(c), the filing fee with
respect to the policies is calculated as follows:
$514,710.76 - 94,750.73 = $419,960.03 / 3300 = $127.26
(11) The actual aggregate sales price was $1,785,395.92, which consists of 665
policies allocating premiums to the Fidelity Index 500 Subaccount. During the
fiscal year ended December 31, 1996, the actual aggregate redemption price of
Fidelity Index 500 Subaccount policies redeemed was $330,327.69. (No portion of
such aggregate redemption price has been applied by the Registrant pursuant to
Rule 24f-2(c) in any filing made pursuant to Section 24(e)(1) of the Investment
Company Act of 1940.) Pursuant to Rule 24f-2(c), the filing fee with respect to
the policies is calculated as follows:
$1,785,395.92 - 330,327.69 = $1,455,068.23 / 3300 = $440.93
(12) The actual aggregate sales price was $673,925.35, which consists of 141
policies allocating premiums to the Fidelity Contrafund Subaccount. During the
fiscal year ended December 31, 1996, the actual aggregate redemption price of
Fidelity Contrafund Subaccount policies redeemed was $20,581.13. (No portion of
such aggregate redemption price has been applied by the Registrant pursuant to
Rule 24f-2(c) in any filing made pursuant to Section 24(e)(1) of the Investment
Company Act of 1940.) Pursuant to Rule 24f-2(c), the filing fee with respect to
the policies is calculated as follows:
$673,925.35 - 20,581.13 = $653,344.22 / 3300 = $197.98
(13) The actual aggregate sales price was $1,259,392.74, which consists of 440
policies allocating premiums to the Quest for Value Equity Subaccount. During
the fiscal year ended December 31, 1996, the actual aggregate redemption price
of Quest for Value Equity Subaccount policies redeemed was $375,382.71. (No
portion of such aggregate redemption price has been applied by the Registrant
pursuant to Rule 24f-2(c) in any filing made pursuant to Section 24(e)(1) of the
Investment Company Act of 1940.) Pursuant to Rule 24f-2(c), the filing fee with
respect to the policies is calculated as follows:
$1,259,392.74 - 375,382.71 = $884,010.03 / 3300 = $267.88
<PAGE> 8
(14) The actual aggregate sales price was $1,601,291.31, which consists of 319
policies allocating premiums to the Quest for Value Small Cap Subaccount. During
the fiscal year ended December 31, 1996, the actual aggregate redemption price
of Quest for Value Small Cap Subaccount policies redeemed was $784,447.29. (No
portion of such aggregate redemption price has been applied by the Registrant
pursuant to Rule 24f-2(c) in any filing made pursuant to Section 24(e)(1) of the
Investment Company Act of 1940.) Pursuant to Rule 24f-2(c), the filing fee with
respect to the policies is calculated as follows:
$1,601,291.31 - 784,447.29 = $816,844.02 / 3300 = $247.53
(15) The actual aggregate sales price was $2,893,754.03, which consists of 661
policies allocating premiums to the Quest for Value Managed Subaccount. During
the fiscal year ended December 31, 1996, the actual aggregate redemption price
of Quest for Value Managed Subaccount policies redeemed was $597,836.29. (No
portion of such aggregate redemption price has been applied by the Registrant
pursuant to Rule 24f-2(c) in any filing made pursuant to Section 24(e)(1) of the
Investment Company Act of 1940.) Pursuant to Rule 24f-2(c), the filing fee with
respect to the policies is calculated as follows:
$2,893,754.03 - 597,836.29 = $2,295,917.74 / 3300 = $695.73
(16) The actual aggregate sales price was $398,233.30, which consists of 144
policies allocating premiums to the Scudder Bond Subaccount. During the fiscal
year ended December 31, 1996, the actual aggregate redemption price of Scudder
Bond Subaccount policies redeemed was $93,744.18. (No portion of such aggregate
redemption price has been applied by the Registrant pursuant to Rule 24f-2(c) in
any filing made pursuant to Section 24(e)(1) of the Investment Company Act of
1940.) Pursuant to Rule 24f-2(c), the filing fee with respect to the policies is
calculated as follows:
$398,233.30 - 93,744.18 = $304,489.12 / 3300 = $92.27
(17) The actual aggregate sales price was $484,976.53, which consists of 147
policies allocating premiums to the Scudder Growth and Income Subaccount. During
the fiscal year ended December 31, 1996, the actual aggregate redemption price
of Scudder Growth and Income Subaccount policies redeemed was $28,791.15. (No
portion of such aggregate redemption price has been applied by the Registrant
pursuant to Rule 24f-2(c) in any filing made pursuant to Section 24(e)(1) of the
Investment Company Act of 1940.) Pursuant to Rule 24f-2(c), the filing fee with
respect to the policies is calculated as follows:
$484,976.53 - 28,791.15 = $456,185.38 / 3300 = $138.24
(18) The actual aggregate sales price was $177,193.11, which consists of 68
policies allocating premiums to the Scudder International Subaccount. During the
fiscal year ended December 31, 1996, the actual aggregate redemption price of
Scudder International Subaccount policies redeemed was $1,303.18. (No portion of
such aggregate redemption price has been applied by the Registrant pursuant to
Rule 24f-2(c) in any filing made pursuant to Section 24(e)(1) of the Investment
Company Act of 1940.) Pursuant to Rule 24f-2(c), the filing fee with respect to
the policies is calculated as follows:
$177,193.11 - 1,303.18 = $175,889.93 / 3300 = $53.30
<PAGE> 9
(19) The actual aggregate sales price was $306,033.06, which consists of 166
policies allocating premiums to the Dreyfus Zero Coupon 2000 Subaccount. During
the fiscal year ended December 31, 1996, the actual aggregate redemption price
of Dreyfus Zero Coupon 2000 Subaccount policies redeemed was $119,900.11. (No
portion of such aggregate redemption price has been applied by the Registrant
pursuant to Rule 24f-2(c) in any filing made pursuant to Section 24(e)(1) of the
Investment Company Act of 1940.) Pursuant to Rule 24f-2(c), the filing fee with
respect to the policies is calculated as follows:
$306,033.06 - 119,900.11 = $186,132.95 / 3300 = $56.40
(20) The actual aggregate sales price was $684,340.08 which consists of 173
policies allocating premiums to the Dreyfus Growth and Income Subaccount. During
the fiscal year ended December 31, 1996, the actual aggregate redemption price
of Dreyfus Growth and Income Subaccount policies redeemed was $26,626.16. (No
portion of such aggregate redemption price has been applied by the Registrant
pursuant to Rule 24f-2(c) in any filing made pursuant to Section 24(e)(1) of the
Investment Company Act of 1940.) Pursuant to Rule 24f-2(c), the filing fee with
respect to the policies is calculated as follows:
$684,340.08 - 26,626.16 = $657,713.92 / 3300 = $199.31
(21) The actual aggregate sales price was $96,297.15, which consists of 13
policies allocating premiums to the Dreyfus Socially Responsible Subaccount.
During the fiscal year ended December 31, 1996, the actual aggregate redemption
price of Dreyfus Socially Responsible Subaccount policies redeemed was $491.89.
(No portion of such aggregate redemption price has been applied by the
Registrant pursuant to Rule 24f-2(c) in any filing made pursuant to Section
24(e)(1) of the Investment Company Act of 1940.) Pursuant to Rule 24f-2(c), the
filing fee with respect to the policies is calculated as follows:
$96,297.15 - 491.89 = $95,805.26 / 3300 = $29.03
(22) The actual aggregate sales price was $52,735.74, which consists of 12
policies allocating premiums to the Federated U.S. Government Bond Subaccount.
During the fiscal year ended December 31, 1996, the actual aggregate redemption
price of Federated U.S. Government Bond Subaccount policies redeemed was
$5,318.16. (No portion of such aggregate redemption price has been applied by
the Registrant pursuant to Rule 24f-2(c) in any filing made pursuant to Section
24(e)(1) of the Investment Company Act of 1940.) Pursuant to Rule 24f-2(c), the
filing fee with respect to the policies is calculated as follows:
$52,735.74 - 5,318.16 = $47,417.58 / 3300 = $14.37
(23) The actual aggregate sales price was $79,304.13, which consists of 21
policies allocating premiums to the Federated Utility Subaccount. During the
fiscal year ended December 31, 1996, the actual aggregate redemption price of
Federated Utility Subaccount policies redeemed was $436.41. (No portion of such
aggregate redemption price has been applied by the Registrant pursuant to Rule
24f-2(c) in any filing made pursuant to Section 24(e)(1) of the Investment
Company Act of 1940.) Pursuant to Rule 24f-2(c), the filing fee with respect to
the policies is calculated as follows:
$79,304.13 - 436.41 = $78,867.72 / 3300 = $23.90
<PAGE> 10
February 26, 1996
Provident Mutual Life Insurance Company
1050 Westlakes Drive
Berwyn, PA 19312
Re: Rule 24f-2 Notice
Provident Mutual Variable Annuity Separate Account
Registration Nos. 33-62588 and 33-70926
Dear Sirs/Madames:
I have served as counsel to Provident Mutual Life Insurance
Company in connection with the above-referenced Notice. In my opinion, the
securities being registered with respect to the Provident Mutual Variable
Annuity Separate Account are legally issued, fully paid and non-assessable.
Very truly yours,
Adam Scaramella
AS/ja
