1716

No. 11 of 1907.

LIFE INSURANCE COMPANIES.

$

(Date.) Brought forward,...

Renewal premiums received during the year on policies assuring $ after deduction of reassurance premiums

Consideration received for annuities granted during the year

All other premiums received during the year after deduction of reassurance premiums

Interest and dividends.

Other receipts (accounts to be specified)

(Date.) Brought forward,..

Commission on renewal premiums

Agents' travelling expenses & salaries

Medical fees and salaries

Salaries of other officers & employés

Advertising

Other expenses of management (accounts to be specified)

Dividends & bonuses to shareholders

Other payments (accounts to be specified)

Amount of Life Assurance Fund at the end of the year, as per 4th schedule....

****

C.

Note. Companies having separate accounts for annuities to return the particulars of their annuity business in a separate statement. Premiums received on new policies mean premiums of the first year actually received or falling due within the year of account.

(No. 2) PROFIT AND Loss Account.

(Date.) Balance of last year's account

Interests and dividends not carried to other accounts...

Profit realised (accounts to be specified)

Other receipts.

C.

(Date.) Dividends and bonuses to shareholders

Expenses not charged to other accounts...

Loss realised (accounts to be specified).

Other payments

Balance as per 4th schedule....

*A

$

Note. This account is not required if items have been incorporated in the other accounts of this schedule.

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