FORM N-SAR
SEMI-ANNUAL REPORT
FOR REGISTERED INVESTMENT COMPANIES
Report for six month period ending: / / (a)
or fiscal year ending: 12/31/96 (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: Companion Life Separate Account C
B. File Number: 811-8814
C. Telephone Number: (402) 351-5087
2. A. Street: 401 Theodore Fremd Avenue
B. City: Rye C. State: NY D. Zip Code: 10580 Zip Ext: 1493
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.]
<PAGE>
If filing more than one
Page 47, "X" box: [ ]
For period ending 12/31/96
File number 811- 8814
UNIT INVESTMENT TRUSTS
111. A. [/] Depositor Name: Companion Life Insurance Company
B. [/] File Number (If any): N/A
C. [/] City: Rye State: NY Zip Code: 10580 Zip Ext.: 1493
[/] 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>
If filing more than one
Page 48, "X" box: [ ]
For period ending 12/31/96
File number 811- 8814
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: Mutual of Omaha Investor
Service, Inc.
B. [/] File Number 8- 137-82
C. [/] City: Omaha State: NE Zip Code:68175 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: DeLoitte & Touche,LLP
B. [/] City: Omaha State: NE Zip Code:68102 Zip Ext.:
[/] Foreign Country: Foreign Postal Code:
115. A. [/] Independent Public Accountant Name: Coopers & Lybrand
B. [/] City: Omaha State: NE Zip Code: 68102 Zip Ext.:
[/] Foreign Country: Foreign Postal Code:
<PAGE>
If filing more than one
Page 49, "X" box: [ ]
For period ending 12/31/96
File number 811- 8814
116. Family of investment companies information:
A. [/] Is Registrant part of a family of investment companies? (Y/N)
N
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)
Y
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)
Y
Y/N
C. [/] Scheduled premium variable life contracts? (Y/N)
N
Y/N
D. [/] Flexible premium variable life contracts? (Y/N)
N
Y/N
E. [/] Other types of insurance products registered under the
Securities Act of 1933? (Y/N)
N
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
2
119. [/] State the number of new series for which registration statements
under the Securities Act of 1933 became effective during the period
1
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 as the end of the period
2
122. [/] State the number of existing series for which additional units were
registered under the Securities Act of 1933 during the current
period
0
<PAGE>
If filing more than one
Page 50, "X" box: [ ]
For period ending 12/31/96
File number 811- 8814
123. [/] State the total value of the additional units considered in answering
item 122 ($000's omitted)
$ 0
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) $ 0
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)
$ 83
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 Assets Total Income
Series ($000's Distributions
Investing 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 ---- $--------- $-----------
J. All other equity securities 2 $ 2,111 $ 50
---- --------- -----------
K. Other securities ---- $--------- $-----------
L. Total assets of all series of
registrant ---- $--------- $-----------
<PAGE>
If filing more than one
Page 51, "X" box: [ ]
For period ending 12/31/96
File number 811- 8814
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)
N
[If answer is "N" (No), go to item 131.] Y/N
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.] Y/N
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)
----
Y/N
131. Total expenses incurred by all series of Registrant during the current
reporting period ($000's omitted)
$ 0
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 ----
This report is signed on behalf of the Registrant Companion Life Separate
Account C , State of Nebraska .
Date: February 21, 1997.
(Name of Registrant, Depositor, or Trustee)
By: /s/ Richard A. Witt, Vice President Witness: /s/ Kenneth W. Reitz
