THE HONGKONG GOVERNMENT GAZETTE, JULY 19, 1907.
(Form referred to under heading No. 6 in the Fifth Schedule.)
Consolidated Berenue Arcount of the
for
and ending
years, commenring
Amounts of funds on
19
the beginning of.. Premiums received on
policies, assuring $
Dow
ance premiums.
after deduction of reassur-
Renewal premiums reccival policies, assuring
On
$
after deduction of reassurance premiums. Consideration received for au-
unities granted
All other premiums received, after deduction of reassur- ance premium- Interest and dividends. Other receipts (accounts to be
specified).
Claims under policies, and ad- ditions thereto, after dedne- tion of sumus reassure........... Surrenders Annuities
Dividends to policy holders Other payments to policy
holders (items to be given) Commission on first premiums Commission on renewal pre-
miams
Agents travelling expenses
and salaries...
Medical fees and salaries
Salaries of other officers and
employés. Advertising.
Other expenss of manage- ment (accounts to be speci- tied)
Dividends and bonuses to
shareholders (if any)
Other payments (Lecounts to
be specified).
Amount of funds on
19 the end of the perio
:
As per First (or Third) Schedule
(Form referred to under heading No. 7 in Fifth Schedule)
Summary and Valuation of the Polices of the
DESCRIPTION OF TRAX-
SACTIONS.
ASSURANCES.
I. With participation in profits.
For whole term of life..
Other classes (to be specified) Extra premiums payable,
Total Assurances with profits.
II. Without participation in profits.
For whole term of life.
Other classes (to be specified),. Extra premiums payable....................
Total
Assurances
profits,
Total Assurances,
Deduct Reassurances,
without
Net amount of Assurances,
Adjustment (if any),
ANNUITIES.
as at
19
VALUATION.
PARTICULARS OF THE POLICIES, TOR
VALUATION.
Value by the
Policies.
Number of
Sumis Assured. and Bonuses.
Office Yearly
Premiums.
Not Yearly
Premiums if
ascertained.
Interest,
Table.
per cent.
and Bonuses,
Office Yearly
Premiums
computed.
Net Yearly
Premiums if
Net Liability.
pounssy sung
Immediate,
Other classes (to be specified)..
Total of the results,
The term
HE
"extra premium" in this Ordinance shall be taken to mean the charge for any risk not provided for in the minimum contract premium. policies are issued in or for any country at rates of premium deduccil from tables other than the European mortality tables adopted by the Company, separate Schedules similar in form to the above must be furnished.
903