[For insurance companies]
| Column A | Column B | Column C | Column D | Column E | Column F |
| Gross Amount | Ceded to other companies1 | Assumed from other companies | 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 |
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.