FORM NL 28..
Statement as on: 30.09.2012..
Statement of Investment Assets (General Insurer, Re-insurers)
(Business within India)
Periodicity of Submission : Quarterly (As on 30.09.2012).
. . . Amount in Lakhs
No.  Particulars SCH  Amount 
1 Investments 8         4,038,393.80
2 Loans 9               46,953.42
3 Fixed Assets 10                  4,781.97
4 Current Assets    
. a.  Cash & Bank Balance 11             452,963.05
. b.  Advances & Other Assets 12             484,063.65
5 Current Liabilities . .
. a.  Current Liabilities 13       (1,641,758.43)
. b. Provisions 14           (630,841.31)
. c.  Misc. Exp. Not written off 15  
. d.  Debit Balance of P & L A/c    
. Application of Funds as per Balance Sheet (A) TOTAL (A)         2,754,556.15
. Less : Other Assets SCH  Amount 
1 Loans (if any) 9 251.18
2 Fixed Assets (if any) 10                  4,781.97
3 Cash & Bank Balance  (if any) 11             271,906.99
4 Advances & Other Assets  (if any) 12             478,632.28
5 Current Liabilities 13       (1,641,758.43)
6 Provisions 14           (630,841.31)
7 Misc. Exp. Not written off 15 .
8 Debit Balance of P & L A/c . .
. . TOTAL (B)       (1,517,027.32)
. Investment Assets' As per FORM 28 ( A - B )         4,271,583.47

 

Suraksha, 170, J. Tata Road, Churchgate, Mumbai - 400 020, INDIA
FORM 28 . . . . . . . . .
Statement as on: 30.09.2012 . . . . . . . . .
Periodicity of Submission : Quarterly (As on 30.09.2012) . . . . . . . Amount in Lakhs
No. Investment Represented as Reg. % . Share Holders Policy Holders Book Value (SH+PH) % Actual FVC Amount Total Market Value
. . . Balance  (a ) FRSM ( b ) ( c ) d = ( b + c ) . ( e ) ( d + e ) .
1 G. Sec. Not less than 20% . 119,326.11 379,946.33 499,272.44 21.06 -10,235.17 489,037.27 489,037.27
2 G. Sec and Other Apporved Sec. (incl. (1) above) Not less than 30% . 191,732.88 610,496.75 802,229.64 33.84 58,128.00 860,357.64 860,357.64
3 Investment subject to Exposure Norms . . . . . . . . 0
. 1. Housing & Loans to SG for Housing and FFE, Infrastructure Investments Not less than 15% . 106,624.15 339,502.00 446,126.15 18.82 100,644.12 546,770.27 546,770.27
. 2. Approved Investments Not exceeding 55% . 224,981.91 686,134.08 911,115.99 38.44 1,802,197.74 2,713,313.74 2,713,313.74
. 3.  Other Investments (not exceeding 25%) Not exceeding 55% . 55,734.87 155,176.73 210,911.61 8.9 -4,319.62 206,591.99 206,591.99
. Total Investment Assets 100% . 579,073.81 1,791,309.56 2,370,383.39 100 1,956,650.24 4,327,033.64 4,327,033.64
. - . . . . . . . . .
. 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 0.239:0.761 as per B/s as on 31.03.2012 . . . . .
. Certified that the information given herein are correct and complete to the best of my knowledge and belief and nothing has been canceled or suppressed. . .
. Date : . . . . . . . . .
. . . . . . . . Signature: . .
. . . . . . . . Full Name: . .
. . . . . . . . Designation: . .