The Securities and Exchange Commission has not necessarily reviewed the information in this filing and has not determined if it is accurate and complete. | |||||||||||||||||
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM D Notice of Exempt Offering of Securities |
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1. Issuer's Identity
CIK (Filer ID Number) | Previous Names |
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Entity Type | ||||||||||||||
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0001432334 |
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Insurance Company Separate Account |
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Name of Issuer | |||||||||||||||||
Keyport Life Ins Co Separate Account Q | |||||||||||||||||
Jurisdiction of Incorporation/Organization | |||||||||||||||||
RHODE ISLAND | |||||||||||||||||
Year of Incorporation/Organization | |||||||||||||||||
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2. Principal Place of Business and Contact Information
Name of Issuer | |||
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Keyport Life Ins Co Separate Account Q | |||
Street Address 1 | Street Address 2 | ||
230 THIRD AVENUE, 6TH FLOOR | |||
City | State/Province/Country | ZIP/PostalCode | Phone Number of Issuer |
WALTHAM | MASSACHUSETTS | 02451 | 7817908774 |
3. Related Persons
Last Name | First Name | Middle Name |
---|---|---|
Life Insurance Company | Delaware | |
Street Address 1 | Street Address 2 | |
230 Third Avenue | 6th Floor | |
City | State/Province/Country | ZIP/PostalCode |
Waltham | MASSACHUSETTS | 02451 |
Relationship: | Executive Officer | Director | X | Promoter |
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Clarification of Response (if Necessary):
Delaware Life Insurance Company4. Industry Group
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5. Issuer Size
Revenue Range | OR | Aggregate Net Asset Value Range | ||
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No Revenues | No Aggregate Net Asset Value | |||
$1 - $1,000,000 | $1 - $5,000,000 | |||
$1,000,001 - $5,000,000 | $5,000,001 - $25,000,000 | |||
$5,000,001 - $25,000,000 | $25,000,001 - $50,000,000 | |||
$25,000,001 - $100,000,000 | $50,000,001 - $100,000,000 | |||
X | Over $100,000,000 | Over $100,000,000 | ||
Decline to Disclose | Decline to Disclose | |||
Not Applicable | Not Applicable |
6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)
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7. Type of Filing
New Notice | Date of First Sale | 2008-07-22 | First Sale Yet to Occur | ||||||
X | Amendment |
8. Duration of Offering
Does the Issuer intend this offering to last more than one year? |
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9. Type(s) of Securities Offered (select all that apply)
Equity | Pooled Investment Fund Interests | ||
Debt | Tenant-in-Common Securities | ||
Option, Warrant or Other Right to Acquire Another Security | Mineral Property Securities | ||
Security to be Acquired Upon Exercise of Option, Warrant or Other Right to Acquire Security | X | Other (describe) | |
Flexible Premium Variable Life and Annuity Contracts |
10. Business Combination Transaction
Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer? |
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Clarification of Response (if Necessary):
11. Minimum Investment
Minimum investment accepted from any outside investor | $250,000 | USD |
12. Sales Compensation
Recipient |
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Raymond James & Associates | 705 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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880 Carillon Parkway | |||||||
City | State/Province/Country | ZIP/Postal Code | |||||
St. Petersburg | FLORIDA | 33716 | |||||
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Recipient |
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M Holding Securities | 43285 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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1125 Northwest Couch Street | Suite 900 | ||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Portland | OREGON | 97209 | |||||
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Recipient |
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Clark Securities, Inc. | 43083 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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2121 San Jacinto St. | Suite 2200 | ||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Dallas | TEXAS | 75201 | |||||
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Recipient |
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Crown Capital Securities LP | 6312 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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725 Town & Country Road | Suite 530 | ||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Orange | CALIFORNIA | 92868 | |||||
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Recipient |
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Legacy Financial Services, Inc. | 38697 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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2090 Marina Ave. | |||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Petaluma | CALIFORNIA | 94954 | |||||
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Recipient |
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Investors Capital Corp. | 30613 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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230 Broadway | |||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Lynnfield | MASSACHUSETTS | 01940 | |||||
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Recipient |
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Grant Williams LP | 45961 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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1560 Market Street | 53rd Floor, Suite 220 | ||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Philadelphia | PENNSYLVANIA | 19103 | |||||
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Recipient |
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VFIC Securities, Inc. | 103160 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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1030 Old valley Forge Road | |||||||
City | State/Province/Country | ZIP/Postal Code | |||||
King of Prussia | PENNSYLVANIA | 19406 | |||||
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Recipient |
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Brookstreet Securities Corporation | 14667 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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2361 Campuss Drive | |||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Irvine | CALIFORNIA | 92612 | |||||
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Recipient |
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FSC Securities Corp. | 7461 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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3585 Atlanta Avenue | |||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Hapeville | GEORGIA | 30365 | |||||
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Recipient |
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SIG Securities LLC | 45915 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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14785 Preston Road | Suite 1000 | ||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Dallas | TEXAS | 75254-7876 | |||||
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Recipient |
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Lincoln Financial Advisors Corp. | 3978 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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1300 South Clinton Street | Suite 150 | ||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Fort Wayne | INDIANA | 46802 | |||||
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Recipient |
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Geneos Wealth Management, Inc. | 120894 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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4700 S. Syracuse Parkway | Suite 1000 | ||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Denver | COLORADO | 80237 | |||||
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Recipient |
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Mutual Trust Company of America Securities | 8494 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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2963 Gulf to Bay Boulevard | Suite 120 | ||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Clearwater | FLORIDA | 33759 | |||||
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Recipient |
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AIG Financial Advisors, Inc. | 133763 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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2800 North Central Ave. | |||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Phoenix | ARIZONA | 85004 | |||||
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Recipient |
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InterSecurities, Inc. | 16164 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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570 Carillon Parkway | |||||||
City | State/Province/Country | ZIP/Postal Code | |||||
St. Petersburg | FLORIDA | 33716 | |||||
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Recipient |
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Metlife Securities, Inc. | 14251 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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300 Davidson Ave. | 1st Floor East Wing | ||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Summerset | NEW JERSEY | 08873 | |||||
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Recipient |
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Royal Alliance Associates | 23131 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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2300 Windy Riadge Parkway | Suite 1100 | ||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Atlanta | GEORGIA | 30339 | |||||
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Recipient |
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ProEquities, Inc. | 15708 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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2801 Highway 2805 | |||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Birmingham | ALABAMA | 35223 | |||||
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Recipient |
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Regal Seucrities, Inc. | 7297 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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1400 Colonial Blvd #14 | Suite 2020 | ||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Fort Meyers | FLORIDA | 33907 | |||||
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Recipient |
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GA Financial, Inc. | 42293 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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41 South High Street | Suite 3400 | ||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Columbus | OHIO | 43215 | |||||
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Recipient |
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JP Turner & Co. LLC | 43177 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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3060 Peach Tree Road | |||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Atlanta | GEORGIA | 30305 | |||||
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Recipient |
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ManorHouse Capital LLC | 140863 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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2005 Market Street | 8th Floor, Suite 820 | ||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Philadelphia | PENNSYLVANIA | 19103 | |||||
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Recipient |
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National Planning Corp. | 29604 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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410 Wilshire Boulevard | Suite 110 | ||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Santa Monica | CALIFORNIA | 90401 | |||||
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Recipient |
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NFP Securities, Inc. | 42046 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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1250 Capital of Texas Highway | Suite 125 | ||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Austin | TEXAS | 78746 | |||||
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Recipient |
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Oakbrook Financial Group | 44225 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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2100 Clearwater Dr. | |||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Oakbrook | ILLINOIS | 60523-1927 | |||||
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Recipient |
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Stanford Group Company | 39285 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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5050 Westheimer | |||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Houston | TEXAS | 77056 | |||||
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Recipient |
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United Global Securities, Inc. | 35331 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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12950 Dairy Ashford Road | |||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Sugar Land | TEXAS | 77478 | |||||
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Recipient |
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USF Securities LP | 37942 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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11 E. Greenway Plaza | Suite 2900 | ||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Houston | TEXAS | 77046 | |||||
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Recipient |
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Brookstone Securities, Inc. | 13366 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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2920 Drane Field Road | |||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Lakeland | FLORIDA | 33813 | |||||
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Recipient |
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SagePoint Financial, Inc. | 133763 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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2800 N. Central Ave. | Suite 2100 | ||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Phoenix | ARIZONA | 85004-1072 | |||||
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Recipient |
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Sunbelt Securities, Inc. | 42180 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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5065 Westheimer | Suite 600 | ||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Houston | TEXAS | 77056 | |||||
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Recipient |
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Triad Advisors, Inc. | 25803 | ||||||
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None | None | ||||||
Street Address 1 | Street Address 2 | ||||||
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5185 Peachtree Parkway | Suite 280 | ||||||
City | State/Province/Country | ZIP/Postal Code | |||||
Norcross | GEORGIA | 30092 | |||||
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13. Offering and Sales Amounts
Total Offering Amount | USD |
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Total Amount Sold | $27,731,313 | USD | ||||
Total Remaining to be Sold | USD |
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Clarification of Response (if Necessary):
14. Investors
Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors, and enter the number of such non-accredited investors who already have invested in the offering. | |||
Regardless of whether securities in the offering have been or may be sold to persons who do not qualify as accredited investors, enter the total number of investors who already have invested in the offering: |
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15. Sales Commissions & Finder's Fees Expenses
Provide separately the amounts of sales commissions and finders fees expenses, if any. If the amount of an expenditure is not known, provide an estimate and check the box next to the amount.
Sales Commissions | $0 | USD |
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Finders' Fees | $0 | USD |
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Clarification of Response (if Necessary):
16. Use of Proceeds
Provide the amount of the gross proceeds of the offering that has been or is proposed to be used for payments to any of the persons required to be named as executive officers, directors or promoters in response to Item 3 above. If the amount is unknown, provide an estimate and check the box next to the amount.
$0 | USD |
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Clarification of Response (if Necessary):
Signature and Submission
Please verify the information you have entered and review the Terms of Submission below before signing and clicking SUBMIT below to file this notice.
Terms of Submission
In submitting this notice, each issuer named above is: |
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Each Issuer identified above has read this notice, knows the contents to be true, and has duly caused this notice to be signed on its behalf by the undersigned duly authorized person.
For signature, type in the signer's name or other letters or characters adopted or authorized as the signer's signature.
Issuer | Signature | Name of Signer | Title | Date |
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Keyport Life Ins Co Separate Account Q | /s/ Daniel T. Smyth | Daniel T. Smyth | Director | 2024-11-12 |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.
* This undertaking does not affect any limits Section 102(a) of the National Securities Markets Improvement Act of 1996 ("NSMIA") [Pub. L. No. 104-290, 110 Stat. 3416 (Oct. 11, 1996)] imposes on the ability of States to require information. As a result, if the securities that are the subject of this Form D are "covered securities" for purposes of NSMIA, whether in all instances or due to the nature of the offering that is the subject of this Form D, States cannot routinely require offering materials under this undertaking or otherwise and can require offering materials only to the extent NSMIA permits them to do so under NSMIA's preservation of their anti-fraud authority.