7/4-2


P"ELICAN ASSURANCE CO.


Iiispectionsi and surveys ...........................................
-State taxes on premiums .        ......................
Inisuranice departuient licenses and fees............................
All other licenses, fees and taxes:
Federal corporation tax .......       .....................   $324 36
State licenses ..........                                      500 00
Local taxes ........     ...............................       644 67
Advertising required by law .......................            667 17


1, 685 20O
5,-)932> 72
2,116 35
2 ,136 (20


Other disbursements:
Bond premiums as re(luired by law       ................
Exchange ..........................................


$220 00
124 62


--                344 62
P'aid stockholders for interest or dividends ........................   
20,000 00
Agents' balances charged off .........................                  
    894 00
Gross decrease, by a.djustent, in book value of ledger assets:
Bonds .............................................................     
9,679 75,
Total  disbursements   ............! .............................  $294,397
 '5 6
Balance ................................................    $747,979 3)
LEDGER ASSETS.


Book value of bonds...............................
Deposits in trust companies and banks on interest...
Agents' balances representing business written sub-


$650,856 00
37,753 13


sequenlt to uctoner 1, 19.1                                 58,035 14
Agents' balances representing business written prior
to October 1, 1912 ............. .....I....l.t,'';''''      1,235 12
Other ledger assets: Phialdelphia UJnderwriters' de-
posit .                                                        100 00
Total ledger assets ...........        ..............................  $747,979
39
NON-LEDGER ASSETS.
Interest due. $1.546.93, and accrued, $5,095.84, on bonds ............. 
     .6,643 77
Other non-ledger assets: Reinsurance due on losses paid ..........      
      350 51
Gross assets ............$..........                     ........   $754,972
67
DEDUCT ASSETS NOT ADMITTED.
Ag-en's' balances representing business written prior to October 1,
1912.       ..............................................................
 1.235 12
Tot-al admitted assets .........         .........................  $753,737
55)
LIABILITIES.


Gross losses adjusted and unpaid, not yet due .......  $3,783 60
Gross claims for losses in process of adjustment or
In suispense, plus $1,307.00 reserve for losses in-
curred prior to December 31. of which no notice
had been received on that date ......................  :7,978 00
Gross claims for losses resisted .....................     200 00
Total ..                                          $41,961 00
Ieduct reinsurance due or ,accrued .....   ...............  17,361 00
Net amount of unpaid losses and elaims.....................
Gross p)reininms (less reinsiu mance) received and re-
ceivable 1upon a] ll un1expired fire risks* 1 1nnilln one
year or les-s from  date of policy. ineluding, interest
preumlimuiims on pierpetuitl lire risks, $18'2,551.20  un -
earned    ('ul pre(m1iu ns (fifty per (eat) ..................  $91 . 275
60
GoI-oS7s mu-emillnis (less reinsnraInce) received and ie-
ceivable upon all unexpired fire risks rinnin' miore
thlan one year from (daite of policy, $306,838.02; un-
earned(1 preilums (pro rata) ........................  169.496 82
Total unearned premiulums as computed above...............
Sal~aries. rets, expenses, bills, accounts, foes. etc., due or scernied
Estimatted apmount hereafter pavable for federal, state land other
tax-es based upon business of the year of this statement.........
1icinsurance premiums ............................................


$24,600 00


2960.772  2
3,500 00
7.000 0O
12,303 65


'1'O{3~ll ii~l~ifllt of' {mi1 liablities except ca pditil .......,........,.
 $308,176 07