REPORT OF THE COMMISSIONER OF INSURANCE.                  XXiX
RISKS
No.    Amount
1. In force on the 31st day of December of i he preced-
inu  year ........................... ........ ...... ............
2. Written and renewed during the year ...............................
8-.     Total ............. ....                               ...........
4.  Deduct those expired and cancelled .............     .... ...........
r.          In force at the end of the year ....... ........ ............
LOSSES AND CLAIMS
No.    Amount
6.  Losses and claims unpaid Dec. 31 of previous year .       .......
7.  Losses and claims incurred during the year ...................
8.      Total ..................... ............
Deduct:
9.  Losses and claims paid during year .         .      ...... ............
10.  Losses and claims scaled down and compromised
during year ......... ...                                ............
11.           Total deductions ........................ ...... ............
12.  Losses and claims remaining unpaid Dec. 31, end
of year .............                     ..... ......   ...........
1    A. Amount of losses paid since organization ..............................
14. Averalce insurance in force per policy ...........................;
TOWN MUTUALS.
BALANCE SHEIET
Amount of ledger assets (as per balance) December 31 of previous year
INCOME
1.  Gross premiums on all business written during the year ...............
2.  Assessments actually received on current year's assessments ..........
.'.  Assessments actually received on previous years' assessments.
4. *Po-licy fees: .... New. No .......  ; fee, *$ .......  amount $ .
5. Renewels: .......      No ........  ; fee, $ ......   amount, $.
a,. Additions : ........    No .        ; fee, $ ......;.amount $.
7.           Total policy fees .
8.          Total collections.
Deduct:
9.  Paid for reinsuranen ...............................................
10. Returned on cancellations ..........................................
11. Returned   in dividends ..............................................
1.2.          Total deductions ...........................................
1 2. Total premiums and assessments, less deductions ......................
14. Cash received as interest ............................................
1 5. Caslh received as borrowed money (date borrowed.  ..  .    )..........
1 1 . Cash received from all other sources, viz. : (Itemize)
17.   ................ .......................... ......................
IS  .   . .. ... .. . .. . ... ... . . ... .... ... . ...... . .. . .. .
... .... .. .. ... .. ..... .  . .. .. ... ... .. .  .. . ........
19.           Total incone during yer .
20.  Total assets of previous year and income .............................
DISBURSEMENTS
1. Paid for losses including $ ........ for losses occurring in previous
years.
2. Agents' balances charged off .......................................
2.  Paid for fire department taxes .....................................
4.  Paid for corporation tax  ..........................................
5. Borrowed money     (date repaid .....
6.  Tnterest on borrowed money ........................................
7.  Salaries, $ ......... and fees, $........... paid officials .
S. Agents' compensation:
9.    Commissions
10. Salaries ..........