FORM - NL- 28
Company Name & Code:
Statement as on:  30.9.2010    
Statement of Investment Assets (General Insurer Re-insurers)
(Business within India)
Periodicity of Submission: Quarterly
  (Rs. in lacs)
No PARTICULARS SCH AMOUNT
1 Investments 8 3869585.08
2 Loans 9 64583.04
3 Fixed Assets 10 4364.95
4 Current Assets    
  a.  Cash & Bank Balance 11 348728.07
  b.  Advances & Other Assets 12 689954.50
5 Current Liabilities    
  a.  Current Liabilities 13 1324084.18
  b.  Provisions 14 559807.53
  c.  Misc. Exp not Written Off 15 0
  d.  Debit Balance of P&L A/c    
  Application of Funds as per Balance Sheet   (A)   3093323.93
       
  Less: Other Assets SCH Amount
1 Loans (if any) 9 282.48
2 Fixed Assets (if any) 10 4364.95
3 Cash & Bank Balance (if any) 11 307929.66
4 Advances & Other Assets (if any) 12 684609.63
5 Current Liabilities 13 1324084.18
6 Provisions 14 559807.53
7 Misc. Exp not Written Off 15  
8 Debit Balance of P&L A/c    
    TOTAL (B) -886704.99
  'Investment Assets' As per FORM 3B (A-B) 3980028.92
       


FORM 3B
Date :
Periodicity of Submission : Quarterly (As on 30th September 2010)
No 'Investment' represented as Reg. % SH PH Book Value (SH + PH) %Actual FVC Amount Total Market Value
Balance FRSM+
(a) (b) (c) d = (b+c) (e) (d + e)
1 G. Sec. Not less than 20% 0.00 167298.25 254745.77 422044.02 22.57 0.00 422044.02 422044.02
2 G. Sec and Other Apporved Sec. (incl. (1) above) Not less than 30% 0.00 262351.36 399483.56 661834.92 35.40 0.00 661834.92 661834.92
3 Investment subject to Exposure Norms                           
   1.'Housing & Loans to SG for Housing and FFE Infrastructure Investments Not less than 15% 0.00 144979.32 220760.65 365739.97 19.56 185209.62 550949.59 550949.59
   2. Approved Investments Not exceeding 55% 0.00 281358.65 413962.72 695321.37 37.19 1913844.82 2609166.19 2609166.19
   3. Other Investments (not exceeding 25%)    62462.21 84337.29 146799.50 7.85 11278.72 158078.22 158078.22
   Total Investment Assets 100%    751151.55 1118544.21 1869695.76 100.00 2110333.16 3980028.92 3980028.92
                                
   Certification:                           
   1. "Central Govt. Securities includes Treasury Bills Deposit Under Section 7 of Insurance Act 1938 and Deposit with CCIL (securities)         
   2. Shareholder and Policyholder Funds have been bifurcated in the ratio of 0.3964:0.6036 as per B/s as on 31.3.2010            
   3. Foreign Investments (Rs.9574.14 lacs) and Investment in Agricultural Insurance Corporation of India Ltd. (Rs.7000 lacs) are shown as          
   Shareholders' funds  under Approved and Unapproved investments respectively.                  
   5. Market value is given in respect of investment in equity and mutual fund.                  
  
   Certified that the information given herein are correct and complete to the best                  
   of my knowledge and belief and nothing has been concealed or suppressed                  
   Date:                   Signature: ____________________
                        Full name:   
                        Designation: