Regulation S-X
Rule 12-17

Reinsurance

For insurance companies

Column A	Column B	Column C	Column D
	Gross amount	Ceded to other companies 1	Assumed from other companies
Life insurance in force
Premiums:
Life insurance	__________	__________	__________
Accident and health insurance	__________	__________	__________
Property and liability insurance	__________	__________	__________
Title insurance	__________	__________	__________
Total premiums	__________	__________	__________

Column A	Column E	Column F
	Net amount2	Percentage of amount assumed to net3
Life insurance in force
Premiums:
Life insurance	__________	__________
Accident and health insurance	__________	__________
Property and liability insurance	__________	__________
Title insurance	__________	__________
Total premiums	__________	__________

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 income statement.

³. Calculated as the amount in column D divided by amount in column E.