XXX11       REPORT OF THE COMMISSIONER OF INSURANCE.
10.    Policy fees ......................................................
11.           Total paid agents.
12. Paid for collection of assessments ....................................
18.  Postage, printing and stationery .....................................
14. Express, telegraph, telephone and exchange ...........................
15.  All other disbursements, viz.. (Itemize)
1 ... ................................................
17. ................... ....                    . ......................
.1.. . . ............ ..............................   .......   ...  .......................
  ..................
209.    Total expenses....................
21.    'Petal disburseien'tis  ............................................
'"Balance. .                .     .
LEDGER ASSETS
1. (Cash in company's office, or in hands of secretary ....................
2.  Cash deposited in banks (name banks) ..............................
at.   . . . . .   . . . . . . .   . . . . . . . . . . . . . .   . . . . .
. . .. . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . .
. .
4 .   . ..... . ... .   . . . . . . . . . . . . .   . . . . ...   . . . .
. . .   .... . . . . . . . . . . . .   . . . . . . . . I. . . . . . . . .
.
5.  Cash belonging to company, in hands of treasurer .....................
6. Book value of real estate ...........................................
7.   Mlortag,,e loans on real estate, first liens ............................
8.  Bills receivable secured .   usiness written subs..uen.................
9.  Agents' balances representing business written subsequent to Oct. 1,
1912.
10. Ag'ents' balances representing business written prior to Oct. 1, 1912......
11. Other ledger assets, viz. : (Itemize) ...      ...............
2  .   . .. . ... . ..... ..... . .. .. .. .   .... ... ...... . ...   .
.. ....   . .. ..   ....  .- . .. . .. .. . .. .. .. . ..
1.11 ... .. .. .. .. .. . ..........................   .......   .................
  ....... .................
14-.  . . .. ................. ....................  .......   .................
 ....... .................
15 .         Total ledger assets ( as per balance on page 3 ) .......
NON-LEDGER ASSETS
1 . .In tr(rst clue or accruer ..................................
1.7. I~npalid assessments levied on -or after Nov. 1, of curre  year ..........
18. U~npaid assessments levied during current year prior to Nov. I ..........
19Sa. Unpaid assessme~nts levied prior to current year ...........
20.            Total unpaid assessments ..................W..............
"21 . X Loan s   on   bills   receivable, not   secured  ..........................................
...
22.  Fulrnitulre, fixtures  and   safes,  S ........ ;s p le ,$.....................
upis
2'2. Other ite'ns, viz. : (Itemize) ........................................
2 4 . . . . . . . . . . . . . . .   . . . . . . .   . . . . . . . . . . .
. . .   . . . . . . . . . . . . . . . . . .
r>r  otal1   non fledger   assets  .. .. .. .. .. .. .. .. .. .. .. ..
.. .. .. .. .. .. .. .. .. ...
'26.          Gross eisigets .......................
DEDTUCT AKSSECTS NOT A&DMITT'ED
1.  U~npaid assessments levied during current year prior to Nov. I ..........
2. Unpaid assessments levied prior tov current year ...........
.1      Total    unpaid   assessments .   .......................... .. ..
..
4. Agents' balanceq, representing business written prior to Oct. 1, 19122..
LsToan s on bills receiva bly not secured ..................
6. IFurnitllre, fixtures and safes, $; ..................... ; supies, ',s.'.......
i. Other items, vhiz. : (Itemize) .......................................
S.    . . . . . . . . . . . . . . . . . . . . . .... . .... . . . . . ...
. .. . . . . . .. . .   . . . . . . . . . . . . . . . .   . . . . . . . .
. . . . . .   . . . ........
9.      D~edilet  total, assets  not  admitted  . . ... . ..  .. . . . ..
.
1 ( .        Tota l admitted  assets  .. . . . . . . . . . . . . . . . .
. .
LIABILITIES
1 1. zt inounlt; of  losses  due  and  unpaid   (No ......... ) .............................)
12.  Amount  of  losses  adjusted, not  due   (No ......... ) .............................)
1'  A-mount of losses reported not adjusted (No ......... )....................
.   ) ....
1-4.  Amrollnt  of  losses   resisted   (No ......... ) ..............................)
l=).     Toital ,amount of unpaid losses .................
1 G;. A mount 'canried for unearned premiums, if any .......................
17. Amolint dule for sallaries and comnmissions ............................
I ,<  ltor owr( d  money^ In~pald, $ ..................; interest  on
 same, _$ .............. ......
19. All other acecounts, bills' ate., remaining unpaid, viz. : (Itemize)
20).   ................. .................................  ... . . ..........
 ........  ..................
2 1  .   ..... . . . . . . . . . . . . . . . . . . . . . . .  . . . .  .
. . . . . . . .   . . . . . . . . . . . . . . . . . . .. . . . . ..... ,
,22.     Tot-a, liabilities ..........................................;.
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