Form B-RARevenue Account
for the year ended 31st March, 2000Policyholders account(Technical Account)
No. Particulars Schedule Current Year
Previous Year
1.2.
3.4.
1.2.3.
Premium earned (Net)Profit/loss on sale /redemption of investmentOthers (to be specified)Interest, Dividend & Rent- gross Total (A)Claims Incurred (Net)CommissionOperating expenses related to insurance business Total (B)Operating profit/(Loss) from fire/marine/miscellaneous Business (A-B)
1
234
Form B-BSBalance Sheet
as at 31st March,2000 No. Particulars Schedule Current
YearPrevious Year
Sources of funds:Share CapitalReserves and SurplusFair Value Change AccountBorrowings TotalApplication of funds:Investments-Loans-Fixed Assets-Current Assets:Cash and Bank BalancesAdvances and other assets Sub-total (A)
56
7
8910
1112
No. Particulars Schedule Current year
Previous year
Current LiabilitiesProvisions Sub-total (B)Net Current Assets (C) =(A-B)Miscellaneous Expenditure (to extent not written off or adjusted)Debit Balance in Profit/loss Account
Total
1314
Contingent LiabilitiesNo. Current
yearPrevious year
1.2.
3.
4.5.6.
7.
Partly paid up investmentsClaims other than against policies, not acknowledged as debts by the companyUnderwriting commitments outstanding(in respect of shares and securities)Guarantees given by or on behalf of the companyStatutory demands/liabilities in dispute, not provided forReinsurance obligations to the extent not provided for in accountsOthers (to be specific)
Total
Schedules forming part of financial statements
Schedule 1- Premium Earned
No. Particulars Current year
Previous year
Premium from direct business writtenAdd: Premium on reinsurance acceptedLess: Premium on reinsurance cededNet PremiumAdjustment for change in reserve for unexpired risksTotal Premium earned (Net)
Schedule 2-Claims Incurred (Net)No. Particulars Current
yearPrevious year
Claims paidAdd: Reinsurance acceptedLess: Reinsurance cededNet Claims paidAdd: Claims outstanding at the end of the yearLess: Claims outstanding at the beginning of the yearAdd: Expenses regarding claimTotal claims incurred
Schedule 3- CommissionNo. Particulars Current
yearPrevious year
Commission paidDirectAdd: Reinsurance acceptedLess: Commission on reinsurance cededNet commission:
Schedule 4- Operating expenses related to insurance business
No. Particulars Current year
Previous year
1.2.3.4.5.6.7.8.9.
Employees remuneration & welfare benefitsTravel, conveyance and vehicle running expensesTraining expensesRents, rates & taxesRepairsPrinting & stationaryCommunicationLegal & professional chargesAuditors fees, expenses etc. (a) as auditor
No. Particulars Current year
Previous year
10.11.12.13.
(b) as advisor or in any other capacity in respect of: i. Taxation matters ii. Insurance matters iii. Management services and (c) in any other capacityAdvertisement and publicityInterest & Bank chargesOthers (to be specified)Depreciation
Total
Schedule 5- Share CapitalNo. Particulars Current
yearPrevious year
1.
2.
3.
4.
Authorised CapitalEquity Shares of Rs…eachIssued CapitalEquity Shares of Rs...eachSubscribed CapitalEquity Shares of Rs…eachCalled up CapitalEquity shares of Rs…eachLess: Calls unpaidAdd: Equity shares forfeited (amount originally paid up)Less: Preliminary ExpensesExpenses including commission or brokerage on underwriting or subscription of shares
Total
Schedule 5A- Share capital pattern of shareholding(As certified by the Management)
No. Current year Previous yearNo. of shares % of holding No. of shares % of holding
Promoters•Indian•Foreign
Schedule 6-Reserves and surplusNo. Particulars Current
yearPrevious year
1.2.3.4.
5.6.7.
Capital ReserveCapital Redemption ReserveSecurities PremiumGeneral ReservesLess: Debit Balance in Profit & Loss AccountLess: Amount utilised for Buy BackCatastrophe reserveOther Reserve (to be specified)Balance of Profit in P&L A/cTotal
Schedule 7- BorrowingsNo. Particulars Current
yearPrevious year
1.2.3.4.
Debentures/BondsBanksFinancial InstitutionsOthers (to be specified)
Total
Schedule 8-InvestmentNo. Particulars Current
yearPrevious year
1.
2.3.
4.5.
Long Term InvestmentsGovernment Securities & Govt. guaranteed bonds including Treasury BillsOther Approved SecuritiesOther Investments(a) Shares (1) Equity (2) Preference(b) Mutual Funds(c) Derivative Instruments(d) Debentures/ Bonds(e) Other Securities (to be specified)(f) Subsidiaries(g) Investment Properties- Real EstateInvestments in Infrastructure & Social SectorOther than Approved Investments
No. Particulars Current year
Previous year
1.
2.3.
4.5.
Short Term Investments:Govt. Securities & Govt. guaranteed bonds including Treasury BillsOther Approved SecuritiesOther Investments(a) Shares (1) Equity (2) Preference(b) Mutual Funds(c) Derivative Instruments(d) Debentures/ Bonds(e) Other Securities (to be specified)(f) Subsidiaries(g) Investment Properties- Real EstateInvestments in Infrastructure & Social SectorOther than Approved Investments
Schedule 9- LoansNo. Particulars Current
yearPrevious year
1.
2.
Security –wise classification:Secured(a) On mortgage of property (i) In India (ii) Outside India(b) On shares, bonds, govt. securities etc.(c) Others (to be specified)UnsecuredTotalBarrower-wise Classification:(b) Central & State govt.(c) Banks & Financial Institutions(d) Subsidiaries(e) Industrial Undertakings(f) Others (to be specified)
No. Particulars Current year
Previous year
3.
4.
Performance-wise classification:(a) Loans classified as Standard (i) In India (ii) Outside IndiaTotalMaturity- wise Classification:(b) Short term(c) Long term
Total
Schedule 10- Fixed AssetsCost/Gross Block
Depreciation Net Block
Particulars Opening
Additions
Deductions
Closing
Upto last year
For the yea
On Sales/Adjusmnts
To Date
As at year end
Previous year
GoodwillIntangibles(specify)Land-FreeholdLeasehold PropertyBuildingsFurniture & FittingsInformation TechnologyEquipmentVehiclesOther equipmentOthers (specify nature)TotalWork-in-progressGrand TotalPrevious year
Schedule 11-Cash & Bank BalancesNo. Particulars Current
yearPrevious year
1.2.
3.
4.
Cash (including cheques, drafts & stamps)Bank Balance(a) Deposit accounts (i) Short terms (due within 12 months) (ii) Others(b) Current account(c) Others (to be specified)Money at call and short notice(b) With banks(c) With other institutionsOthers (to be specified)
Total
Schedule 12- Advances and other assets
No. Particulars Current year
Previous year
1.2.3.4.5.
6.
Advances:Reserve deposits with ceding companiesApplication money for investmentsPrepaymentsAdvances to directors/ officersAdvance tax paid and taxes deducted at source (Net of provision for taxation)Others (to be specified) Total (A)
No. Particulars Current year
Previous year
1.2.3.4.5.
6.7.
8.
Others Assets:Income accrued on investmentsOutstanding premiumsAgents BalancesForeign Agencies BalancesDue from other entities carrying on insurance business (including reinsurance)Due from subsidiaries/ holdingDeposit with RBI (Pursuant to Section 7 of Insurance Act 1938)Others (to be specified) Total (B)
Total (A+B)
Schedule 13- Current LiabilitiesNo. Particulars Current
yearPrevious year
1.2.3.4.5.6.7.8.9.10.
Agents BalancesBalance due to other insurance companiesDeposits held on reinsurance cededPremiums received in advanceUnallocated PremiumSundry CreditorsDue to subsidiaries/ holding companyClaims outstandingDue to officers/ directorsOthers (to be specified)
Total
Schedule 14- ProvisionsNo. Particulars Current
yearPrevious year
1.2.
3.4.5.
Reserve for Unexpired RiskFor taxation (less advance tax paid & taxes deducted at source)For proposed dividendsFor dividend distribution taxOthers (to be specified)
Total
Schedule 15- Miscellaneous Expenditure(to the extent not written off or adjusted)
No. Particulars Current year
Previous year
1.2.
Discount allowed on issue of shares/ debenturesOthers (to be specified)Total
Form B-PLProfit & Loss Account
for the year ended 31st 2000
Shareholders account (non –technical Account)No. Particulars Schedule Current
yearPrevious year
1.
2.
3.
4.
Operating profit/(loss)(a) Fire insurance(b) Marine insurance(c) Miscellaneous insuranceIncome from investments(d) Interest , dividend & rent- gross(e) Profit on sale of investmentLess: Loss on sale of investmentsOther income (to be specified) Total (A)Provisions (other than taxation):(f) For diminution in the value of investments(g) For doubtful debts(h) Others (to be specified)
No. Particulars Schedule Current year
Previous year
5. Other expenses:(a) Expenses other than those related to
insurance business(b) Bad debts written off(c) Others (to be specified) Total (B)Profit before tax (A-B)Provision for taxationProfit after taxLess: Transfer to catastrophe ReserveProfit available for appropriationAppropriations:(d) Interim dividends paid during the year(e) Proposed final dividend(f) Dividend distribution tax(g) Transfer to Reserves or other accounts (to
be specified)Balance in P&L brought forward from last yearBalance carried forward to B/S
Revenue Account in respect of Life Insurance Act,1938:Form A-RA
Revenue Accountfor the year ended 31st March, 2000
Policy holders Account (Technical Account)No. Particulars Schedule Current
yearPrevious year
Premiums earned: (net)(a) Premium(b) Re-insurance ceded(c) Re-insurance acceptedIncome from investments(d) Interest ,dividend & Rent –Gross(e) Profit on sale/ redemption of investments(f) (Loss on sale/ redemption of investments)(g) Transfer/ Gain on revaluation/ change in fair
value)Other income (to be specified)Total (A)
1
No. Particulars Schedule Current year
Previous year
CommissionOperating Expenses related to insurance businessProvision for doubtful debtsBad debts written offProvision for taxProvisions (other than taxation):(a) For diminution in the value of investments
(Net)(b) Others (to be specified) Total (B)Benefits paid (Net)Interim bonuses paidChange in valuation of liability in respect of life
policies(c) Gross(d) re-insurance(e) Amount accepted in re- insurance Total (C)Surplus (deficit) (D)=(A)-(B)-(C)
23
4
No. Particulars Schedule Current year
Previous year
AppropriationsTransfer to Shareholders AccountTransfer to other Reserves (to be specified)Balance being Funds for future Appropriations Total (D)
Calculation of surplus or deficiency by Valuation B/S
as on…To Net Liability as per Actuary’s valuationTo surplus
By Life Assurance Fund as per B/SBy Deficiency
Statement showing net profit for the valuation period
Surplus as per valuation of B/S xxxAdd: Interim Bonus (if any) as it is really advance payment
of bonus xxxLess: Any expenses still to be charged(eg amount of dividend to shareholders set aside) xxx
Total Surplus xxxLess: Surplus at the beginning of the period xxxNet profit for the valuation period xxx