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[For insurance companies]
Column A
Column B
Gross amount
Column C
Ceded to other companies (1)
Column D
Assumed from other companies
Column E
Net amount (2)
Column F
Percentage of amount assumed to net (3)
Life insurance in force
_____________
______________
____________
____________
____________
_____________
______________
____________
____________
____________
Premiums
Life insurance 
Accident and health insurance
Property and liability insurance
Title insurance
_____________
______________
____________
____________
____________
Total premiums
_____________
______________
____________
____________
____________
_____________
______________
____________
____________
____________

1. Indicate in a note any amounts of reinsurance or coinsurance income netted against premiums ceded.
2. This Column represents the total of column B less column C plus column D. The total premiums in this column should represent the amount of premium revenue on the statement of comprehensive income (or statement of net income if comprehensive income is presented in two separate but consecutive financial statements).
3. Calculated as the amount in column D divided by amount in column E.
[46 FR 54338, Nov. 2, 1981, as amended at 83 FR 50208, Oct. 4, 2018]

This is a work of the U.S. Government

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