THE HONGKONG GOVERNMENT GAZETTE, JULY 19, 1907.
THIRD SCHEDULE.
REVENUE ACCOUNTS of the
+
for the Year ending
19.
(No. 1) LIFE ASSURANCE ACCOUNT.
(Date.) Amount of Life As-
surance Fund at the beginning of the
on
year,
Promiums received new policies, assuring $ during the year, after deduction of reassurance pre- miums,
Renewal premiums received during the policies,
year on assuring $
re-
after deduction of reassurance pre- miums, Consideration
ceived for ammuities granted during the year, All other premiums received during the year, after deduct- tion of reassurance premiums,
Interest and divi-
dends,
Other receipts (accounts to be specified),
$ c. (Date.) | Claims under life!
policies, and addi- tions thereto, after deduction of sums reassured, Surrenders, Annuities,... Dividends to policy
holders,
Other payments to polley holders (i- tems to be given)........... Commission on first
premiums, Commission on 70- newal premiums, Agents' travelling expenses & salaries, Medical fees and
salaries,
Salaries of other officers & employés, Advertising,
Other expenses of
managemen (accounts to specified),
he
Dividends & bonuses to shareholders (if any).
Other payments (accounts to be specified).
Amount of Life As- surance Fund at the end of the year, as per Fourth Schedule,
$
$ c.
Note.--Companies having separate accounts for Annuities to return the parti-
culars of their annuity business in a separate statement.
(No. 2.) FIRE ACCOUNT.
(Date)
Amount of Fire Assur-
ance fund at the be- ginning of the year... Premium received, after deduction of reassur-
ances
Other receipts to be
specified
(Date.)
Losses by fire, after de- duction of reassur-
ances
Expenses of manage-
ment
Commission
Other payments to he
specified..
Amount of Fire AssuN' - ance Fund at the end of the year, as per Fourth Schedule
$
Note-When Marine or any other branch of business is carried on, the income and expenditure thereof to be in like manner stated in a separate account.
(No. 3.)
PROFIT AND Loss ACCOUNT.
(Date.)
$ c. (Date.)][
Balance of last year's
account
Interest and dividends
not carried to other accounts
Profit realised (accounts)
to be specified)
Other receipts......
Dividends and bonuses
to shareholders Expenses not charged to other accounts... Loss realised (accounts
to be specified) Other payments.. Balance as per Fourth
Schedule
Note. This account is not required if the items have been incorporated in the other acconuts of this Schedule.
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