FORM B

CUSTODIAN AFFIDAVIT

(For use in instances where a custodian corporation maintains securities on deposit with The Depository Trust Company or like entity.)

STATE OF                            )

)    SS.:

COUNTY OF                           )

, being duly sworn deposes and says that he or she is                 of                                                     , a corporation organized under and pursuant to the laws of the                               with the principal place of business at                                               (hereinafter called the "corporation"):

That his or her duties involve supervision of activities of the corporation as custodian and records relating thereto;

That the corporation is custodian for certain securities of

having a place of business at

(hereinafter called the "insurance company") pursuant to an agreement between the corporation and the insurance company;

That the corporation has caused certain of such securities to be deposited with                               and that the schedule attached hereto is a true and complete statement of the securities of the insurance company of which the corporation was custodian as of the close of business on                     , and which were so deposited on such date;

That any securities which are held as a statutory deposit and are not available for withdrawal without approval by the Commissioner of Insurance are noted by appropriate clear legend;

That the corporation as custodian has the responsibility for the safekeeping of the securities both in the possession of the corporation or deposited with                 as is specifically set forth in the agreement between the corporation as custodian and the insurance company; and

That, to the best of his knowledge and belief, unless otherwise shown on the schedule, the securities were the property of the insurance company and were free of all liens, claims, or encumbrances whatsoever.

Subscribed and sworn to before me this             day of                        , 20     .

Vice President [or other authorized officer]