FORM NL 28..
Statement as on: 31.12.2012..
Statement of Investment Assets (General Insurer, Re-insurers)
(Business within India)
Periodicity of Submission : Quarterly (As on 31.12.2012).
. . . Amount in Lakhs
No.  Particulars SCH  Amount 
1 Investments 8   4,197,656.31
2 Loans 9         46,653.88
3 Fixed Assets 10            5,581.02
4 Current Assets    
. a.  Cash & Bank Balance 11       447,712.19
. b.  Advances & Other Assets 12       384,981.82
5 Current Liabilities    
. a.  Current Liabilities 13  -1,653,479.93
. b. Provisions 14     -630,954.96
. 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)   2,798,150.33
. Less : Other Assets SCH  Amount 
1 Loans (if any) 9               238.89
2 Fixed Assets (if any) 10            5,581.02
3 Cash & Bank Balance  (if any) 11       209,978.64
4 Advances & Other Assets  (if any) 12       379,555.84
5 Current Liabilities 13  -1,653,479.93
6 Provisions 14     -630,954.96
7 Misc. Exp. Not written off 15  
8 Debit Balance of P & L A/c    
. . TOTAL (B)  -1,689,080.50
. Investment Assets' As per FORM 28 ( A - B )   4,487,230.83

 

Suraksha, 170, J. Tata Road, Churchgate, Mumbai - 400 020, INDIA
FORM 28 . . . . . . . . .
Statement as on: 31.12.2012 . . . . . . . . .
Periodicity of Submission : Quarterly (As on 31.12.2012) . . . . . . . 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% . 123,422.33 395,376.87 518,799.20 21 -1,921.85 516,877.35 516,877.35
2 G. Sec and Other Apporved Sec. (incl. (1) above) Not less than 30% . 197,890.81 633,932.68 831,823.49 33.68 6,434.04 838,257.53 838,257.53
3 Investment subject to Exposure Norms . . 0 0 0 0 0 0 0
. 1. Housing & Loans to SG for Housing and FFE, Infrastructure Investments Not less than 15% . 110,778.95 354,874.46 465,653.40 18.85 102,589.28 568,242.68 568,242.68
. 2. Approved Investments Not exceeding 55% . 240,774.68 740,895.94 981,670.62 39.75 1,916,592.74 2,898,263.36 2,898,263.36
. 3.  Other Investments (not exceeding 25%) Not exceeding 55% . 50,719.89 140,054.34 190,774.23 7.72 -2,030.96 188,743.28 188,743.28
. Total Investment Assets 100% . 600,164.33 1,869,757.42 2,469,921.74 100 2,023,585.10 4,493,506.85 4,493,506.85
. - . . . . . . . . .
. 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 0.2397:0.7621 as per B/s as on 31.12.2012 . . . . .
. 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: . .