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APPLICATION FOR THE APPROVAL OF AN INCREASE OF A PERCENTAGE OF THE INVESTMENT LIMITS IN TERMS OF SECTION
31(1)(c) OF THE LONG-TERM INSURANCE ACT
FOR THE SAKE OF CONSISTENCY AND COMPLETENESS OF STATISTICAL INFORMATION COMPILED FROM THE SPREADING
WORKBOOK, IT IS ESSENTIAL THAT LONG-TERM INSURERS COMPLETE ALL OF THE LIGHT TURQUOISE SHADED ITEMS ON BOTH
THE STATEMENTS.
NO ITEMS MAY BE DELETED AND OTHER ITEMS INSERTED IN THE PLACE THEREOF.


DISCLAIMER
This spreading workbook was designed by the Financial Services Board and it may be copied.
However, the Financial Services Board accepts no responsibility for any loss or damage arising from its use, nor for any decision
made by the insurer or any other person based on information or calculations made by, or obtained from the spreadsheet.


INFORMATION REGARDING THE SPREADING WORKBOOK
The spreading workbook consists of two worksheets:
i. Spread of Assets In or Deemed to Be in the RSA - Before Dispensation
i. Spread of Assets In or Deemed to Be in the RSA - After Dispensation


HOW TO COMPLETE THE SPREADING WORKBOOK
1. The spreading workbook needs to be completed in conjunction with the application form.
2. Please select insurer name from the drop-down box on the Spread of Assets In or Deemed to Be in the RSA - Before Dispensation
worksheet. The name will be linked to the Spread of Assets In or Deemed to Be in the RSA - After Dispensation worksheet.
3. Please complete the light turquoise shaded items on the Spread of Assets In or Deemed to Be in the RSA - Before Dispensation worksheet .
This information will be linked to the Spread of Assets In or Deemed to Be in the RSA - After Dispensation worksheet.
4. Please complete the relevant information in column 9 - Dispensation given, on the Spread of Assets In or Deemed to Be in the RSA
After Dispensation worksheet.
            LT2007 - Published version                                                                                                                                                                                                                                                                 Page 2 of 3



                                                                                              Name of long-term insurer     ABC Life Insurance Company
                                                                                              End of financial period
                                                                                              (yyyy/mm/dd)                  1/31/2007

                                                                                              SPREAD OF ASSETS IN OR DEEMED TO BE IN THE RSA
                                                                                                          BEFORE DISPENSATION
                                                                                                                                 ADD:            LESS:        SUBTOTALS         Maximum admissible for each item of this statement
                                                                                                                            Assets of asset-    Individual                                                                               Admitted for each
                                                                                                                                                                                                                   Total non-linked
                                                                                                 Linked       Non-linked          holding     excesses e.g. Assets held, less                                                            item (the lesser of
                                                                               Total assets                                                                                   per Regulation 2   Dispensation    liabilities x greater
                              DESCRIPTION                                                        assets        assets       intermediaries & banks, debtors,   individual                                                                   column (10) or
                                                                                                                                                                                 to the Act         given          of column (8) or
                                                                                                                              investments in investments &     excesses                                                                      column (7))
                                                                                                                                                                                                                      column (9)
                                                                                                                             linked products    properties
                                                                                  R'000          R'000          R'000            R'000           R'000            R'000              %                %                 R'000                  R'000             NOTE - ITEMS 13 + 14 :
                                     1                                              2              3              4                5               6                7                8                9                  10                      11            Admitted values are the lesser of
                                                                                                                                                                                                                                                               the individual, or the total amounts
 1 Mortgage bonds                                                                         0               0             0                0                0                0          -                -                   -                      -            in the previous column.
 2 Non-convertible debentures                                                             0               0             0                0                0                0          -                -                   -                      -
 3 Any other debtors                                                                      0               0             0                0                0                0          -                -                   -                      -            Items13+14:      Individual                                   0
   SUBTOTAL                                                                               0               0             0                0                0                0              25%               0%                       0                     0                    Total                                        0
                                                                                                                                                                                                                                                                                Admitted                                     0
                                                                                                                                                                                                                                                               CALCULATION OF FURTHER EXCESSES AND FINAL
 4 Shares - listed ordinary, convertible debentures & unit trusts - Domestic              0               0             0                0                0                0          -                -                   -                      -            ADMITTED VALUES
 5 Shares - unlisted - Domestic                                                           0               0             0                0                0                0               5%               0%                       0                     0
   SUBTOTAL                                                                               0               0             0                0                0                0              75%               0%                       0                     0                                                         R'000

 6   Listed securities & shares - Foreign, deemed to be domestic                          0               0             0                0                0                0              15%               0%                       0                     0   1. If Items 4+5+6+9+10+11+12 exceed 90%
 7   Policyholders' loans                                                                 0               0             0                0                0                0              95%               0%                       0                     0    of the non-linked liabilities, the
 8   Policies with other long-term insurers                                               0               0             0                0                0                0          -                -                             0                     0   excess is:                                                    0
 9   Property investments                                                                 0               0             0                0                0                0               25%              0%                       0                     0
10   Related party(ies) & associated companies                                            0               0             0                0                0                0                5%              0%                       0                     0   2. If Items 6+14+18+20 exceed 15%
11   Computer equipment                                                                   0               0             0                0                0                0                5%              0%                       0                     0    of the non-linked liabilities, the
12   Other equipment & motor vehicles                                                     0               0             0                0                0                0              2.5%              0%                       0                     0   excess is:                                                    0
     SUBTOTAL OF ITEMS 1 to 12                                                            0               0             0                0                0                0               95%              0%                       0                     0
                                                                                                                                                                                                                                                               3. If the admitted value of items 1
13 Margin deposits - Domestic                                                             0               0             0                0                0                0              2.5%              0%                       0                     0   to 12 exceeds:                              95%
14 Margin deposits - Foreign, deemed to be domestic                                       0               0             0                0                0                0              2.5%              0%                       0                     0   of the total non-linked liabilities, the excess
   SUBTOTAL                                                                               0               0             0                0                0                0              2.5%              0%                       0                     0   is:                                                           0

15   Cash                                                                                 0               0             0                0                0                0              100%         -                             0                     0   4. Overall admitted assets:
16   Krugerrands                                                                          0               0             0                0                0                0               10%              0%                       0                     0   Total of column (11) less 1, 2 & 3 above                      0
17   Bank balances & deposits - Domestic                                                  0               0             0                0                0                0              100%         -                             0                     0
18   Bank balances & deposits - Foreign, deemed to be domestic                            0               0             0                0                0                0               15%              0%                       0                     0        5. Surplus of overall admitted assets
19   Government & semi-government securities - Domestic                                   0               0             0                0                0                0              100%         -                             0                     0              over total non-linked liabilities
20   Government securities - Foreign, deemed to be domestic                               0               0             0                0                0                0               15%              0%                       0                     0                                                                 0
     SUBTOTAL OF ITEMS 13 to 20                                                           0               0             0                0                0                0                                                                               0

     TOTAL                                                                                0               0             0                0                0                0                                                                               0

DOMESTIC ASSETS MUST EXCEED THE FOLLOWING:
   Total Liabilities                                                                      0
   Less: Linked liabilities                                                               0
   Plus: CAR                                                                              0
   Plus: Asset-holding intermediaries' liabilities                                        0
   Total Non-linked Liabilities                                                           0
            LT2007 - Published version                                                                                                                                                                                                                                                                 Page 3 of 3



                                                                                              Name of long-term insurer     ABC Life Insurance Company
                                                                                              End of financial period
                                                                                              (yyyy/mm/dd)                  1/31/2007

                                                                                              SPREAD OF ASSETS IN OR DEEMED TO BE IN THE RSA
                                                                                                           AFTER DISPENSATION
                                                                                                                                 ADD:            LESS:        SUBTOTALS         Maximum admissible for each item of this statement
                                                                                                                            Assets of asset-    Individual                                                                               Admitted for each
                                                                                                                                                                                                                   Total non-linked
                                                                                                 Linked       Non-linked          holding     excesses e.g. Assets held, less                                                            item (the lesser of
                                                                               Total assets                                                                                   per Regulation 2   Dispensation    liabilities x greater
                              DESCRIPTION                                                        assets        assets       intermediaries & banks, debtors,   individual                                                                   column (10) or
                                                                                                                                                                                 to the Act         given          of column (8) or
                                                                                                                              investments in investments &     excesses                                                                      column (7))
                                                                                                                                                                                                                      column (9)
                                                                                                                             linked products    properties
                                                                                  R'000          R'000          R'000            R'000           R'000            R'000              %                %                 R'000                  R'000             NOTE - ITEMS 13 + 14 :
                                     1                                              2              3              4                5               6                7                8                9                  10                      11            Admitted values are the lesser of
                                                                                                                                                                                                                                                               the individual, or the total amounts
 1 Mortgage bonds                                                                         0               0             0                0                0                0          -                -                   -                      -            in the previous column.
 2 Non-convertible debentures                                                             0               0             0                0                0                0          -                -                   -                      -
 3 Any other debtors                                                                      0               0             0                0                0                0          -                -                   -                      -            Items13+14:      Individual                                   0
   SUBTOTAL                                                                               0               0             0                0                0                0              25%              33%                       0                     0                    Total                                        0
                                                                                                                                                                                                                                                                                Admitted                                     0
                                                                                                                                                                                                                                                               CALCULATION OF FURTHER EXCESSES AND FINAL
 4 Shares - listed ordinary, convertible debentures & unit trusts - Domestic              0               0             0                0                0                0          -                -                   -                      -            ADMITTED VALUES
 5 Shares - unlisted - Domestic                                                           0               0             0                0                0                0               5%               0%                       0                     0
   SUBTOTAL                                                                               0               0             0                0                0                0              75%               0%                       0                     0                                                         R'000

 6   Listed securities & shares - Foreign, deemed to be domestic                          0               0             0                0                0                0              15%               0%                       0                     0   1. If Items 4+5+6+9+10+11+12 exceed 90%
 7   Policyholders' loans                                                                 0               0             0                0                0                0              95%               0%                       0                     0    of the non-linked liabilities, the
 8   Policies with other long-term insurers                                               0               0             0                0                0                0          -                -                             0                     0   excess is:                                                    0
 9   Property investments                                                                 0               0             0                0                0                0               25%              0%                       0                     0
10   Related party(ies) & associated companies                                            0               0             0                0                0                0                5%              0%                       0                     0   2. If Items 6+14+18+20 exceed 15%
11   Computer equipment                                                                   0               0             0                0                0                0                5%              0%                       0                     0    of the non-linked liabilities, the
12   Other equipment & motor vehicles                                                     0               0             0                0                0                0              2.5%              0%                       0                     0   excess is:                                                    0
     SUBTOTAL OF ITEMS 1 to 12                                                            0               0             0                0                0                0               95%              0%                       0                     0
                                                                                                                                                                                                                                                               3. If the admitted value of items 1
13 Margin deposits - Domestic                                                             0               0             0                0                0                0              2.5%              0%                       0                     0   to 12 exceeds:                              95%
14 Margin deposits - Foreign, deemed to be domestic                                       0               0             0                0                0                0              2.5%              0%                       0                     0   of the total non-linked liabilities, the excess
   SUBTOTAL                                                                               0               0             0                0                0                0              2.5%              0%                       0                     0   is:                                                           0

15   Cash                                                                                 0               0             0                0                0                0              100%         -                             0                     0   4. Overall admitted assets:
16   Krugerrands                                                                          0               0             0                0                0                0               10%              0%                       0                     0   Total of column (11) less 1, 2 & 3 above                      0
17   Bank balances & deposits - Domestic                                                  0               0             0                0                0                0              100%         -                             0                     0
18   Bank balances & deposits - Foreign, deemed to be domestic                            0               0             0                0                0                0               15%              0%                       0                     0        5. Surplus of overall admitted assets
19   Government & semi-government securities - Domestic                                   0               0             0                0                0                0              100%         -                             0                     0              over total non-linked liabilities
20   Government securities - Foreign, deemed to be domestic                               0               0             0                0                0                0               15%              0%                       0                     0                                                                 0
     SUBTOTAL OF ITEMS 13 to 20                                                           0               0             0                0                0                0                                                                               0

     TOTAL                                                                                0               0             0                0                0                0                                                                               0

DOMESTIC ASSETS MUST EXCEED THE FOLLOWING:
   Total Liabilities                                                                      0
   Less: Linked liabilities                                                               0
   Plus: CAR                                                                              0
   Plus: Asset-holding intermediaries' liabilities                                        0
   Total Non-linked Liabilities                                                           0

				
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