SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
THE LIFE INSURANCE COMPANY GUARANTY CORP of NY
 
Employer identification number

13-3528849
Return Reference Explanation
Form 990, Part VI, Section A, Line 2 James Donellan and Susan Donellan have a family relationship
Form 990, Part VI, Section B, Line 11b Copies of the complete Form 990 are emailed to each member of the Audit Committee for their review prior to filing.
Form 990, Part VI, Section B, Line 12c Each director and vendor is required to confirm on an annual basis in writing their understanding and compliance with the Corporation's conflict of interest policy.
Form 990, Part VI, Section C, Line 19 The Corporation does not make its financial statements available to the public. The financial statements are provided to the New York State Department of Financial Services. The Corporation's conflict of interest policy is available upon request.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


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