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Form D/A GREAT-WEST LIFECO INC.

April 11, 2022 4:22 PM EDT

The Securities and Exchange Commission has not necessarily reviewed the information in this filing and has not determined if it is accurate and complete.
The reader should not assume that the information is accurate and complete.

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM D

Notice of Exempt Offering of Securities

OMB APPROVAL
OMB Number:3235-0076
Expires:August 31, 2015
Estimated average burden
hours per response:4.00

1. Issuer's Identity

CIK (Filer ID Number)Previous Names
None
Entity Type
0000850918
GREAT-WEST LIFECO INC
GREAT WEST LIFECO INC
XCorporation
Limited Partnership
Limited Liability Company
General Partnership
Business Trust
Other (Specify)

Name of Issuer
GREAT-WEST LIFECO INC.
Jurisdiction of Incorporation/Organization
CANADA (FEDERAL LEVEL)
Year of Incorporation/Organization
XOver Five Years Ago
Within Last Five Years (Specify Year) 
Yet to Be Formed

2. Principal Place of Business and Contact Information

Name of Issuer
GREAT-WEST LIFECO INC.
Street Address 1Street Address 2
100 OSBORNE ST. N.
CityState/Province/CountryZIP/PostalCodePhone Number of Issuer
WINNIPEGMANITOBA, CANADAR3C 3A5204-946-1190

3. Related Persons

Last NameFirst NameMiddle Name
MahonPaulA.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:XExecutive OfficerXDirectorPromoter

Clarification of Response (if Necessary):

President & Chief Executive Officer and Director of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
SrivastavaRaman
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:XExecutive OfficerDirectorPromoter

Clarification of Response (if Necessary):

Executive Vice-President and Global Chief Investment Officer of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
SonnenAnneC.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:XExecutive OfficerDirectorPromoter

Clarification of Response (if Necessary):

Senior Vice-President and Chief Compliance Officer of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
JamalArshil
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:XExecutive OfficerDirectorPromoter

Clarification of Response (if Necessary):

President and Group Head, Strategy, Investments, Reinsurance and Corporate Development of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
MacounJeffreyF.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:XExecutive OfficerDirectorPromoter

Clarification of Response (if Necessary):

President and Chief Operating Officer, Canada of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
MacNicholasGarry
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:XExecutive OfficerDirectorPromoter

Clarification of Response (if Necessary):

Executive Vice-President and Chief Financial Officer of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
RussellNancyD.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:XExecutive OfficerDirectorPromoter

Clarification of Response (if Necessary):

Senior Vice-President and Chief Internal Auditor of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
TrickettJeremyW.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:XExecutive OfficerDirectorPromoter

Clarification of Response (if Necessary):

Senior Vice President and Chief Governance Officer of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
OrrR.Jeffrey
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:Executive OfficerXDirectorPromoter

Clarification of Response (if Necessary):

Director of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
CoutuMarcelR.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:Executive OfficerXDirectorPromoter

Clarification of Response (if Necessary):

Director of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
DesmaraisAndreA.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:Executive OfficerXDirectorPromoter

Clarification of Response (if Necessary):

Director of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
Desmarais, Jr.Paul
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:Executive OfficerXDirectorPromoter

Clarification of Response (if Necessary):

Director of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
ConwayHeatherE.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:Executive OfficerXDirectorPromoter

Clarification of Response (if Necessary):

Director of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
DoerGaryA.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:Executive OfficerXDirectorPromoter

Clarification of Response (if Necessary):

Director of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
GeraghtySharonC.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnepegMANITOBA, CANADAR3C 3A5
Relationship:XExecutive OfficerDirectorPromoter

Clarification of Response (if Necessary):

Executive Vice-President and General Counsel of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
BarrettDeborahJ.
Street Address 1Street Address 2
100 Osborne Street North100
CityState/Province/CountryZIP/PostalCode
WinnepegMANITOBA, CANADAR3C 3A5
Relationship:Executive OfficerXDirectorPromoter

Clarification of Response (if Necessary):

Director of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
FullerDavidG.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:Executive OfficerXDirectorPromoter

Clarification of Response (if Necessary):

Director of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
TretiakGregoryD.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:Executive OfficerXDirectorPromoter

Clarification of Response (if Necessary):

Director of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
WalshBrianE.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:Executive OfficerXDirectorPromoter

Clarification of Response (if Necessary):

Director of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
BirdGrahamR.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:XExecutive OfficerDirectorPromoter

Clarification of Response (if Necessary):

Executive Vice-President and Chief Risk Officer of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
PalomboGraceM.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:XExecutive OfficerDirectorPromoter

Clarification of Response (if Necessary):

Executive Vice-President and Chief Human Resources Officer of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
RyanT.Timothy
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:Executive OfficerXDirectorPromoter

Clarification of Response (if Necessary):

Director of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
VanaseljaSiimA.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:Executive OfficerXDirectorPromoter

Clarification of Response (if Necessary):

Director of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
GenereuxClaude
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:Executive OfficerXDirectorPromoter

Clarification of Response (if Necessary):

Director of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
TomlinDervlaM.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnepegMANITOBA, CANADAR3C 3A5
Relationship:XExecutive OfficerDirectorPromoter

Clarification of Response (if Necessary):

Executive Vice-President and Chief Actuary of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
RulloSteve
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:XExecutive OfficerDirectorPromoter

Clarification of Response (if Necessary):

Executive Vice-President and Global Chief Information Officer of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
ReynoldsRobertL.
Street Address 1Street Address 2
100 Federal Street
CityState/Province/CountryZIP/PostalCode
BostonMASSACHUSETTS02110
Relationship:XExecutive OfficerDirectorPromoter

Clarification of Response (if Necessary):

Chair of Great-West Lifeco U.S. Holdings, LLC, the General Partner of Great-West Lifeco U.S. Holdings, L.P.
Last NameFirst NameMiddle Name
BolotinAndraS.
Street Address 1Street Address 2
100 Federal Street
CityState/Province/CountryZIP/PostalCode
BostonMASSACHUSETTS02110
Relationship:XExecutive OfficerDirectorPromoter

Clarification of Response (if Necessary):

Vice-President of Great-West Lifeco U.S. Holdings, LLC, the General Partner of Great-West Lifeco U.S. Holdings, L.P.
Last NameFirst NameMiddle Name
McArthurSusanJ.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:Executive OfficerXDirectorPromoter

Clarification of Response (if Necessary):

Director of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
AmendMichaelR.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:Executive OfficerXDirectorPromoter

Clarification of Response (if Necessary):

Director of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
LempresElizabethC.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:Executive OfficerXDirectorPromoter

Clarification of Response (if Necessary):

Director of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
MadoffPaulaB.
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:Executive OfficerXDirectorPromoter

Clarification of Response (if Necessary):

Director of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
HarneyDavid
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnepegMANITOBA, CANADAR3C 3A5
Relationship:XExecutive OfficerDirectorPromoter

Clarification of Response (if Necessary):

President and Chief Operating Officer, Europe of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
BienfaitRoberta
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:Executive OfficerXDirectorPromoter

Clarification of Response (if Necessary):

Director of Great-West Lifeco Inc.
Last NameFirst NameMiddle Name
SimmondsDavid
Street Address 1Street Address 2
100 Osborne Street North
CityState/Province/CountryZIP/PostalCode
WinnipegMANITOBA, CANADAR3C 3A5
Relationship:XExecutive OfficerDirectorPromoter

Clarification of Response (if Necessary):

Senior Vice-President and Chief Communications and Sustainability Officer of Great West Lifeco Inc.
Last NameFirst NameMiddle Name
Murphy, IIIEdmundF.
Street Address 1Street Address 2
8515 E. Orchard Road
CityState/Province/CountryZIP/PostalCode
Greenwood VillageCOLORADO80111
Relationship:XExecutive OfficerDirectorPromoter

Clarification of Response (if Necessary):

President and Chief Executive Officer, Empower Retirement

4. Industry Group

 Agriculture
Banking & Financial Services
 Commercial Banking
XInsurance
 Investing
 Investment Banking
 Pooled Investment Fund
 Hedge Fund
 Private Equity Fund
 Venture Capital Fund
 Other Investment Fund
Is the issuer registered as
an investment company under
the Investment Company
Act of 1940?
 Yes No
 Other Banking & Financial Services
 Business Services
Energy
 Coal Mining
 Electric Utilities
 Energy Conservation
 Environmental Services
 Oil & Gas
 Other Energy
Health Care
 Biotechnology
 Health Insurance
 Hospitals & Physicians
 Pharmaceuticals
 Other Health Care
 Manufacturing
Real Estate
 Commercial
 Construction
 REITS & Finance
 Residential
 Other Real Estate
 
Retailing
 
Restaurants
Technology
 Computers
 Telecommunications
 Other Technology
Travel
 Airlines & Airports
 Lodging & Conventions
 Tourism & Travel Services
 Other Travel
 
Other

5. Issuer Size

Revenue RangeORAggregate Net Asset Value Range
  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
  Over $100,000,000  Over $100,000,000
XDecline to Disclose  Decline to Disclose
  Not Applicable   Not Applicable

6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)

  Rule 504(b)(1) (not (i), (ii) or (iii))
   Investment Company Act Section 3(c)
   Section 3(c)(1)   Section 3(c)(9)
   Section 3(c)(2)   Section 3(c)(10)
   Section 3(c)(3)   Section 3(c)(11)
   Section 3(c)(4)   Section 3(c)(12)
   Section 3(c)(5)   Section 3(c)(13)
   Section 3(c)(6)   Section 3(c)(14)
   Section 3(c)(7)
   Rule 504 (b)(1)(i)
   Rule 504 (b)(1)(ii)
   Rule 504 (b)(1)(iii)
   Rule 505
XRule 506(b)
   Rule 506(c)
   Securities Act Section 4(a)(5)
  

7. Type of Filing

   New NoticeDate of First Sale2014-04-02   First Sale Yet to Occur
XAmendment

8. Duration of Offering

Does the Issuer intend this offering to last more than one year?
XYes   No

9. Type(s) of Securities Offered (select all that apply)

XEquity   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 SecurityXOther (describe)

10. Business Combination Transaction

Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer?
   YesXNo

Clarification of Response (if Necessary):

 

11. Minimum Investment

Minimum investment accepted from any outside investor$0USD

12. Sales Compensation

Recipient
Recipient CRD NumberXNone
(Associated) Broker or DealerXNone
(Associated) Broker or Dealer CRD NumberXNone
Street Address 1Street Address 2
CityState/Province/CountryZIP/Postal Code
State(s) of Solicitation (select all that apply)
Check “All States” or check individual States
   All States
   Foreign/non-US

13. Offering and Sales Amounts

Total Offering Amount$  USD
orXIndefinite
Total Amount Sold$112,007,344USD
Total Remaining to be Sold$  USD
orXIndefinite

Clarification of Response (if Necessary):

This Form D/A relates to the offering described in the Form D initially filed on April 15, 2014 (Accession No. 0001140361-14-016712) and the Form D/A most recently filed on April 9, 2021 (Accession No. 0000850918-21-000001).

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:
36

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$0USD
   Estimate
Finders' Fees$0USD
   Estimate

Clarification of Response (if Necessary):

There will be no sales commissions or finders' fees in connection with this offering.

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.

$0USD
   Estimate

Clarification of Response (if Necessary):

Gross proceeds of this offering will not be used for payment to any of the persons required to be named as executive officers, directors or promoters in response to item 3 above.

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:
  • Notifying the SEC and/or each State in which this notice is filed of the offering of securities described and undertaking to furnish them, upon written request, in the accordance with applicable law, the information furnished to offerees.*
  • Irrevocably appointing each of the Secretary of the SEC and, the Securities Administrator or other legally designated officer of the State in which the issuer maintains its principal place of business and any State in which this notice is filed, as its agents for service of process, and agreeing that these persons may accept service on its behalf, of any notice, process or pleading, and further agreeing that such service may be made by registered or certified mail, in any Federal or state action, administrative proceeding, or arbitration brought against it in any place subject to the jurisdiction of the United States, if the action, proceeding or arbitration (a) arises out of any activity in connection with the offering of securities that is the subject of this notice, and (b) is founded, directly or indirectly, upon the provisions of: (i) the Securities Act of 1933, the Securities Exchange Act of 1934, the Trust Indenture Act of 1939, the Investment Company Act of 1940, or the Investment Advisers Act of 1940, or any rule or regulation under any of these statutes, or (ii) the laws of the State in which the issuer maintains its principal place of business or any State in which this notice is filed.
  • Certifying that, if the issuer is claiming a Rule 505 exemption, the issuer is not disqualified from relying on Rule 505 for one of the reasons stated in Rule 505(b)(2)(iii) or Rule 506(d).

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.

  I also am a duly authorized representative of the other identified issuer(s) in Item 1 above and authorized to sign on their behalf.
IssuerSignatureName of SignerTitleDate
GREAT-WEST LIFECO INC./s/ Garry MacNicholasGarry MacNicholasExecutive Vice President and Chief Financial Officer2022-04-11
Great-West Lifeco U.S. Holdings, LP/s/ Stephen J. TateStephen J. TateVice President2022-04-11

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.




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