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  4. Assurance Companies Act, 1909

Assurance Companies Act, 1909
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THIRD SCHEDULE.

Section 4 .

Balance Sheet of the_____on the_____19.

Liabilities.

£ s. d.

Shareholders’ capital paid up (if any) - - - - £

Life assurance funds*:—

Ordinary branch - - - - - - -

Industrial do. - - - - - - -

Annuity fund* - - - - - - - -

Fire insurance fund - - - - - - -

Accident insurance fund - - - - - -

Employers’ liability insurance fund - - - - -

Bond investment and endowment certificate fund - - -

Marine insurance fund - - - - - - -

Sinking fund and capital redemption fund - - - -

Profit and loss account - - - - - -

Other funds (if any) to be specified - - - - -

£

Claims admitted or intimated but not paid†

Life assurance - - - - - - -

Fire insurance - - - - - - -

Bond investment - - - - - - -

Annuities due and unpaid† - - - - - - - -

Other sums owing by the Company† (to be stated separately under each class of business).

£

Assets.

£ s. d.

Mortgages on property within the United Kingdom - - - - -

Do. do. out of the United Kingdom - - - - -

Loans on parochial and other public rates - - - - - -

Do. Life interests - - - - - - - - -

Do. Reversions - - - - - - - - -

Do. Stocks and shares - - - - - - - -

Do. Company’s policies within their surrender values - - - -

Do. Personal security - - - - - - - - -

Investments:

Deposit with the High Court (securities to be specified) - - - -

British Government securities - - - - - - - -

Municipal and county securities, United Kingdom - - - - -

Indian and Colonial Government securities - - - - - -

Do. provincial securities - - - - - -

Do. municipal do. - - - - - -

Foreign Government securities - - - - - - -

Do. provincial securities - - - - - - - -

Do. municipal do. - - - - - - - -

Railway and other debentures and debenture stocks—Home and Foreign - -

Do. do. preference and guaranteed stocks - - - -

Do. ordinary stocks - - - - - - - -

Rent charges - - - - - - - - - -

Freehold ground rents - - - - - - - - -

Leasehold do. - - - - - - - - -

House property - - - - - - - - - -

Life interests - - - - - - - - - -

Reversions - - - - - - - - - -

Agents’ balances - - - - - - - - - -

Outstanding premiums† - - - - - - - - -

Do. interest, dividends, and rents† - - - - - -

Interest accrued but not payable† - - - - - - -

Bills receivable - - - - - - - - - -

Cash:

On deposit - - - - - - - - - -

In hand and on current account - - - - - - -

Other assets (to be specified) - - - - - - - -

£

* Life companies having separate annuity fund to show amount thereof separately.

† These items are or have been included in the corresponding items in the First Schedule.

Note 1.—When part of the assets of the company are specifically deposited, under local laws, in various places out of the United Kingdom, as security to holders of policies there issued, each such place and the amount compulsorily lodged therein must be specified in respect of each class of business, except that, in the case of fire, accident, or employers’ liability insurance business, it shall be sufficient to state the fact that a part of the assets has been so deposited.

Note 2.—A Balance Sheet in the above form must be rendered in respect of each separate fund for which separate investments are made.

Note 3.—The Balance Sheet must state how the values of the Stock Exchange securities are arrived at, and a certificate must be appended, signed by the same persons as sign the Balance Sheet, to the effect that in their belief the assets set forth in the Balance Sheet are in the aggregate fully of the value stated therein, less any investment reserve fund taken into account. In the case of a company transacting life assurance business or bond investment business, this certificate is to be given on the occasions only when a statement respecting valuation under the Fourth Schedule is made.

Note 4.—In the case of a company required to keep separate funds under section 3 of this Act, a certificate must be appended, signed by the same persons as signed the Balance Sheet and by the auditor, to the effect that no part of any such fund has been applied, directly or indirectly, for any purpose other than the class of business to which it is applicable.