760

OTHER ACTS RELATING TO COMPANIES.

FIFTH SCHEDULE.

STATEMENT respecting the VALUATION of the LIABILITIES under
LIFE POLICIES and ANNUITIES of the

to be made by the ACTUARY.

(The answers should be numbered to accord with the numbers of the corresponding questions.)

1. The date up to which the valuation is made.

2. The principles upon which the valuation and distribution of profits among the policy holders are made, and whether these principles were determined by the instrument constituting the company, or by its regulations or bye-laws, or otherwise.

3. The table or tables of mortality used in the valuation. 4. The rate or rates of interest assumed in the calculations. 5. The proportion of the annual premium income, if any, reserved as a provision for future expenses and profits. (If none, state how this provision is made.)

6. The consolidated revenue account since the last valuation, or, in case of a company which has made no valuation, since the commencement of the business. (This return should be made in the form annexed.)

7. The liabilities of the company under life policies and annuities at the date of the valuation, showing the number of policies, the amount assured, and the amount of premiums payable annually under each class of policies, both with and without participation in profits; and also the net liabilities and assets of the company, with the amount of surplus or deficiency. (These returns should be made in the forms annexed.)

8. The time during which a policy must be in force in order to entitle it to share in the profits.

9. The results of the valuation, showing

(1.) The total amount of profit made by the company.
(2.) The amount of profit divided among the policy-holders,

Life Assurance Companies Act 1870.

and the number and amount of the policies which par-
ticipated.

(3.) Specimens of bonuses allotted to policies for 100l.

effected at the respective ages of 20, 30, 40, and 50,
and having been respectively in force for five years, ten
years, and upwards, at intervals of five years respec-
tively, together with the amounts apportioned under
the various modes in which the bonus might be re-
ceived.

761

for

years

(FORM referred to under heading No. 6. in the Fifth Schedule.

and ending

£

£

(FORM referred to under heading No. 7. in Fifth Schedule.)

SUMMARY and VALUATION of the POLICIES of the

as at

The term "extra premium" in this Act shall be taken to mean the charge for any risk not provided for in the minimum contract
premium. If policies are issued in or for any country at rates of premium deduced from tables other than the European mortality tables
adopted by the company, separate schedules similar in form to the above must be furnished.

763

(FORM referred to under heading No. 7. in Fifth Schedule.)

VALUATION BALANCE SHEET of

Dr.

To net liability under Assurance and Annuity
transactions (as per summary statement
provided in Schedule 5)

To surplus, if any

£

Cr.

as at

18.

By life assurance and annuity funds (as per balance sheet under schedule 2 or 4)

£

764

OTHER ACTS RELATING TO COMPANIES.