2018 ANNUAL STATEMENT

Charitable Annuity Society

General Filing Instructions

In accordance with Circular Letter No 4 (1993), the Department intends to strictly enforce the statutory filing requirements of Sections 307 and 308 of the New York Insurance Law and impose penalties for any violations thereof. Penalties of up to $250 per day shall be assessed, including possible suspension of the organization's special permit, for failure to file required forms on time and in the prescribed manner outline below.

The hard copy format of the Annual Statement is required to be submitted in the prescribed form and size (8 1/2" X 14"). Submissions in other than regulation size will not be accepted and the filing will be considered delinquent. The Annual Statement must be bound at the left side in sequential order and it must have a "Cover" page that indicates the Charitable Annuity Society's Name and the Year.

The Department no longer requires a hard copy of the reserve list. Please see annual statement instructions for new requirements.

A bar code is no longer required on the New York Charitable Annuity Society Annual Statement

Any correspondence and amendments to your Annual Statement must be filed in one hard copy format and one electronic format.

As a reminder to annual statement preparers, please maintain supporting documentation for the information reported in the statement, since this information is routinely requested for review during the Department's statutory 5-year examination.

Contact Person

On the jurat page, be sure to enter the name, telephone number and e-mail address of the Charitable Annuity Society's contact person whom the Department can reach with questions on your Annual Statement.

Signature and Notarization

The jurat in the hard copy format of the Annual Statement book must be signed with original signature by the appropriate officers and notarized. Photocopies of signatures and/or notarization will NOT be accepted.

This website also provides specific instructions for filing the New York Charitable Annuity Society Annual Statement with our Department. 

Specific Filing Information

The Charitable Annuity Society Filing Instructions and Forms Packet is a compressed zipped file:

after downloading, unzip to obtain the following files:

  • New York State Charitable Annuity Society 2018 Statement (Excel Spreadsheet)
  • Instructions for Completing Statement and Blank (PDF)

When printing blanks, use legal size paper (8 1/2" X 14"). Each Blank is bookmarked with a full table of contents for viewing online.

The Annual Statement blank is also available from the Supplement Blanks Page.

Due Date & Mailing

Blank Type Due Date Hard Copy Electronic Copy Where to File Hard Copies

Charitable Annuity Society
Annual Statement Blank

3/1/2019

1 1

Mail hard copy to:
Ellen Caesar, Life Bureau
New York State Department of Financial Services
1 State Street
New York, NY 10004

Email electronic copy to: [email protected]

NAIC Numbers and Charitable Annuity Society Names
To view the company listing for this blank type, select Charitable Societies List.

Questions?
If you need help or have questions about this filing, call David Hee, Life Bureau:  (212) 480-4762.