Profit and Loss Statement Mortgage Brokerage - Excel by jdf85161

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									   UCAA Proforma Financial Statements
                    Title Insurance Company




                                                                      AK   Alaska                 MT   Montana
                     Instructions                                     AL   Alabama                NC   North Carolina

 1. Enter the Company Name below                                      AR   Arkansas               ND   North Dakota
 2. Enter the first year of the proformas (start with 1st full year   AS   American Samoa         NE   Nebraska
 of operation).
 3. Select the states to be completed for proformas by clicking       AZ   Arizona                NH   New Hampshire
 the check boxes on the right and then click on the "Create
 Selected State Worksheets" button below.                             CA   California             NJ   New Jersey
 4. Complete all sections of the proforma statements                  CO   Colorado               NM   New Mexico
 contained on each tab below.
 5. Note that several tabs contain worksheets for 3 years of          CT   Connecticut            NV   Nevada
 data. Be sure to complete all years of data.
 6. Do not "Cut" and "Paste" cells in the worksheets. Use             DC   District Of Columbia   NY   New York
 "Copy" and "Paste" instead.                                          DE   Delaware               OH   Ohio
                                                                      FL   Florida                OK   Oklahoma
                                                                      GA   Georgia                OR   Oregon
                                                                      GU   Guam                   PA   Pennsylvania
                                                                      HI   Hawaii                 PR   Puerto Rico
                                                                      IA   Iowa                   RI   Rhode Island
            Enter the Company Name:                                   ID   Idaho                  SC   South Carolina
                                                                      IL   Illinois               SD   South Dakota
                               Company Name                           IN   Indiana                TN   Tennessee

                                                                      KS   Kansas                 TX   Texas
Year 1:                                                               KY   Kentucky               UT   Utah

                                                                      LA   Louisiana              VA   Virginia
Year 2:                                1                              MA   Massachusetts          VI   U.S. Virgin Islands

                                                                      MD   Maryland               VT   Vermont
Year 3:                                2                              ME   Maine                  WA   Washington

                                                                      MI   Michigan               WI   Wisconsin
                                                                      MN   Minnesota              WV   West Virginia
                                                                      MO   Missouri               WY   Wyoming
                                                                      MS   Mississippi



  If states were added to this spreadsheet in error:
  1. Select the states to be deleted by clicking the check
  boxes on the right.
  2. Click on the "Delete Selected State Worksheets" button
  above.




                                                                                                                             FORM 13 Title
                                                            Company Name:       Company Name
                                                            (Title Insurance Company)
                                                            Pro Forma Statutory Balance Sheet
                                                            (In Thousands)
Admitted Assets                                     0                                           1                 2
-------------------
1. Bonds
2. Stocks
3. Title Plants
4. Real Estate/Mortgage Loans
5. Affiliated Receivable
6. Affiliated Investments
7. Cash/Cash Equivalents
8. Total Admitted Assets                                -                                           -                   -




Liabilities
-------------------
9. Known Claims Reserve
10. Statutory Premium Reserve
11. Other Required Reserve
12. Ceded Reinsurance Payable
13. Payable to Parents, Subsidiaries & Affiliates
14. All Other Liabilities
15. Total Liabilities(6+7+8+9+10+11)                    -                                           -                   -

Capital and Surplus
-------------------
16. Capitol Stock
17. Gross Paid In and Contributed Surplus
18. Surplus Notes
19. Unassigned Surplus
20. Other Items(elaborate)
21. Total Capital and Surplus(16-20)                    -                                           -                   -




                                                                                                        FORM 13 Title
                                                                                                         Company Name:       Company Name
                                                                                                         (Title Insurance Company)
                                                                                                         Pro Forma Statutory Profit & Loss Statement
                                                                                                         (In Thousands)
                                                                                            0                                                          1                2


1. Title Premium Earned
2. Escrow Charges
3. Other Related Income
4. Net Losses Incurred
5. Net Loss Adjustment Expenses Incurred
6. Direct Commissions & Brokerage
7. Reinsurance Ceding Commissions
8. Net Commissions Incurred (6-7)
9. Other Contractual Agreements*
10. Other Underwriting Expenses Incurred**
11. Underwriting Gain (Loss) (1+2+3-(4+5+8+9+10))                                                -                                                          -                  -
12. Net Investment Income
13. Other Income
14. Income Taxes Incurred
15. Net Operating Income (Loss)
   (11+12+13-14)                                                                                 -                                                          -                  -


16. Prior YE Surplus
17. Net Income                                                                                   -                                                          -                  -
18. Capital Increases
19. Other Increases (decreases)
20. Dividends to Stockholders
21. YE Surplus                                                                       $               -                                         $                -   $              -
   Operating Percentages:
    Net Premiums Earned                                                                     100.00%                                                    100.00%              100.00%


22. Net Losses Incurred to Title Insurance
   Net Premiums Earned (4/(1+2+3))                                                              0.00%                                                      0.00%             0.00%
23. Net Loss Adjustment Expenses Incurred to Title Insurance
   Net Premium Earned (5/(1+2+3))                                                               0.00%                                                      0.00%             0.00%
24. Other Underwriting Expenses to Title Insurance
   Net Premium Earned ((8+9+10)/(1+2+3))                                                        0.00%                                                      0.00%             0.00%
25. Net Underwriting Gain Or (Loss) (11/(1+2+3))                                                0.00%                                                      0.00%             0.00%


   Other Percentages:


26. Other Underwriting Expenses to Net Premiums Written
   ((8+9+10)/Total Net Premiums Written))                                                       0.00%                                                      0.00%             0.00%

27. Net Loss and Loss Adjustment Expenses Incurred to
    Title Insurance and Related Income((4+5)/(1+2+3))                                           0.00%                                                      0.00%             0.00%




*ie... MGA(excluding amounts included above as agents commissions), service contracts, claims payment contracts
** Itemize in Assumptions




                                                                                                                                                                                       FORM 13 Title
                                                                  Company Name:       Company Name
                                                                  (Title Insurance Company)
                                                                  Pro Forma Statutory Cash Flow Statement
                                                                  (In Thousands)
                                                          0                                                 1       2
                  Cash From Operations
1. Premiums Collected Net of Reinsurance
2. Loss and Loss Adjustments Expenses Paid (Net of S&S)
3. Underwriting Expenses Paid
4. Other Underwriting Income(expenses)
5. Total Cash From Underwriting(1-2-3+4)                      -                                                 -         -


6. Net Investment Income
7. Other Income
8. Dividends to Policyholders
9. Federal and Foreign Income Taxes (Paid) Recovered
10. Net Cash From Operations(5+6+7-8+9)                       -                                                 -         -


                  Cash From Investments
11. Net Cash from Investments                                 -



        Cash From Financing and Misc Sources
12. Capital and Paid in Surplus
13. Surplus Notes
14. Borrowed Funds
15. Dividends
16. Other Cash Provided (Applied)
17. Net Cash from Financing and Misc. Sources                 -                                                 -         -

18. Net Change from Investments
   Investments(10+11+17)                                      -                                                 -         -




                                                                                                                        FORM 13 Title
                                         Company Name:       Company Name
       Nationwide                        (Title Insurance Company)
                                         Premiums Written to Surplus Ratios
                                         (Amounts in Whole Dollars)
Year       Direct          Assumed              Gross            Ceded            Net             Gross                Net
         Premiums          Premiums            Premiums        Premiums       Premiums      Written Premiums   Written Premiums
          Written           Written             Written         Written        Written          to Surplus         to Surplus
           ---------         ---------           ---------       ---------      ---------         ---------          ---------


 0                     -             -                   -               -              -        0.00%              0.00%


 1                     -             -                   -               -              -        0.00%              0.00%


 2                     -             -                   -               -              -        0.00%              0.00%




                                            No data entry is required on this page.




                                                                                                                      FORM 13 Title
Nationwide                                    Company Name:      Company Name
Year 1   0                                    (Title Insurance Company)
                                              Planned Premium Volume By Line of Business
                                              (Amounts in Whole Dollars)

                                                    Direct          Assumed             Ceded             Net          Direct         Assumed            Ceded               Net
                                                  Premiums          Premiums          Premiums        Premiums       Premiums         Premiums         Premiums          Premiums
         Description                               Written           Written           Written         Written        Earned           Earned           Earned            Earned
         ----------------------------------         ---------         ---------         ---------       ---------      ---------        ---------        ---------         ---------
         Title                                                                                                  -                                                                      -
                                                                                                                -                                                                      -
                                                 ___________       ___________       ___________      ___________    ___________      ___________      ___________    ___________
         Total                                             -                -                  -                -              -                -               -                -
                                               ==============    ==============    ==============   ============== ==============   ==============   ==============   ==============




                                                                                                                                                                          FORM 13 Title
Nationwide                                    Company Name:       Company Name
Year 2   1                                    (Title Insurance Company)
                                              Planned Premium Volume By Line of Business
                                              (Amounts in Whole Dollars)

                                               Direct             Assumed          Ceded                  Net       Direct          Assumed          Ceded            Net
                                               Premiums           Premiums         Premiums           Premiums      Premiums        Premiums         Premiums         Premiums
         Description                           Written            Written          Written             Written      Earned          Earned           Earned           Earned
         ----------------------------------    ---------          ---------        ---------            ---------   ---------       ---------        ---------        ---------
         Title                                                                                                  -                                                                    -
                                                                                                                -                                                                    -
                                                  ___________       ___________      ___________      ___________    ___________    ___________       ___________     ___________
         Total                                              -                -                 -                -              -               -                -                -
                                                ==============    ==============   ==============   ============== ==============   ==============   ==============   ==============




                                                                                                                                                                           FORM 13 Title
Nationwide                                    Company Name:      Company Name
Year 3   2                                    (Title Insurance Company)
                                              Planned Premium Volume By Line of Business
                                              (Amounts in Whole Dollars)

                                               Direct            Assumed           Ceded                  Net       Direct          Assumed          Ceded            Net
                                               Premiums          Premiums          Premiums           Premiums      Premiums        Premiums         Premiums         Premiums
         Description                           Written           Written           Written             Written      Earned          Earned           Earned           Earned
         ----------------------------------    ---------         ---------         ---------            ---------   ---------       ---------        ---------        ---------
         Title                                                                                                  -                                                                 -
                                                                                                                -                                                                 -
                                                 ___________       ___________       ___________      ___________    ___________      ___________      ___________      ___________
         Total                                             -                -                  -                -              -                -               -                 -
                                               ==============    ==============    ==============   ============== ==============   ==============   ==============   ==============




                                                                                                                                                                           FORM 13 Title
Nationwide                                       Company Name: Company Name
Year 1      0                                    (Title Insurance Company)
                                                 Incurred Loss Summary By Line of Business
                                                 (Amounts in Whole Dollars)

                                                                       Direct                  Assumed            Ceded                 Net
                                                                      Losses                     Losses           Losses              Losses
            Description                                              Incurred                   Incurred         Incurred            Incurred
---------   ----------------------------------                         ---------                 ---------        ---------           ---------
            Title                                                                                                                           -
                                                                  ______________             ______________   ______________     ______________

            Total                                                            -                         -                -                         -
            Verification from P & L                               ==============             ==============   ==============                      -




                                                                                                                               FORM 13 Title
Nationwide                                       Company Name: Company Name
Year 2      1                                    (Title Insurance Company)
                                                 Incurred Loss Summary By Line of Business
                                                 (Amounts in Whole Dollars)

                                                                       Direct                  Assumed            Ceded                 Net
                                                                      Losses                     Losses           Losses              Losses
            Description                                              Incurred                   Incurred         Incurred            Incurred
---------   ----------------------------------                         ---------                 ---------        ---------           ---------
            Title                                                                                                                           -
                                                                  ______________             ______________   ______________     ______________

            Total                                                            -                         -                -                         -
            Verification from P & L                               ==============             ==============   ==============                      -




                                                                                                                               FORM 13 Title
Nationwide                                       Company Name: Company Name
Year 3      2                                    (Title Insurance Company)
                                                 Incurred Loss Summary By Line of Business
                                                 (Amounts in Whole Dollars)

                                                                       Direct                  Assumed            Ceded                 Net
                                                                      Losses                     Losses           Losses              Losses
            Description                                              Incurred                   Incurred         Incurred            Incurred
---------   ----------------------------------                         ---------                 ---------        ---------           ---------
            Title                                                                                                                           -
                                                                  ______________             ______________   ______________     ______________

            Total                                                            -                         -                -                         -
            Verification from P & L                               ==============             ==============   ==============                      -




                                                                                                                               FORM 13 Title
Nationwide                                                   Company Name:          Company Name
                                                             (Title Insurance Company)
                                                             Net Premium and Loss Developments By Line of Business
                                                             (Amounts in Whole Dollars)

                                                                                              0                                                     1                                                    2
                                                                    Premiums             Losses              Loss         Premiums             Losses             Loss         Premiums             Losses                  Loss
             Description                                             Earned              Incurred            Ratio         Earned              Incurred           Ratio          Earned             Incurred                Ratio
             ----------------------------------                       ---------           ---------         ---------       ---------           ---------        ---------       ---------           ---------             ---------
             Title                                                                -                   -         0.0%                    -                   -        0.0%                    -                   -             0.0%
                                                                   ___________         ___________         _______       ___________         ___________         ______       ___________         ___________              _____

          Total                                                                   -                   -        0.0%                     -                   -       0.0%                     -                   -            0.0%
        Verification from P & L - should equal line above.
                                                                  ==============      ==============      =========     ==============      ==============      ========     ==============      ==============       =========




                                                                                                                                                                                                           FORM 13 Title
State                                                        Company Name:       Company Name
Year 1            0                                          (Title Insurance Company)
                                                             Planned Premium Volume By Line of Business
                                                             (Amounts in Whole Dollars)

                                                                 Direct          Assumed             Ceded           Net           Direct      Assumed         Ceded                    Net
                                                               Premiums          Premiums          Premiums      Premiums        Premiums      Premiums      Premiums               Premiums
                  Description                                   Written           Written           Written       Written         Earned        Earned        Earned                 Earned
                  ----------------------------------             ---------         ---------         ---------     ---------       ---------     ---------     ---------              ---------
                  Title                                                                                                      -                                                                  -
                                                               _________         _________         _________     _________       _________     _________     _________              _________

                    Total                                              -                 -                 -            -                -             -             -
Verification from Net Premiums and Loss Development by LOB     =========         =========         =========     =========       =========     =========     =========                         -




                                                                                                                                                                           FORM 13 Title
State                                                        Company Name:       Company Name
Year 2            1                                          (Title Insurance Company)
                                                             Planned Premium Volume By Line of Business
                                                             (Amounts in Whole Dollars)

                                                                 Direct          Assumed             Ceded           Net           Direct      Assumed         Ceded                    Net
                                                               Premiums          Premiums          Premiums      Premiums        Premiums      Premiums      Premiums               Premiums
                  Description                                   Written           Written           Written       Written         Earned        Earned        Earned                 Earned
                  ----------------------------------             ---------         ---------         ---------     ---------       ---------     ---------     ---------              ---------
                  Title                                                                                                      -                                                                  -
                                                               _________         _________         _________     _________       _________     _________     _________              _________

                    Total                                              -                 -                 -            -                -             -             -
Verification from Net Premiums and Loss Development by LOB     =========         =========         =========     =========       =========     =========     =========                         -




                                                                                                                                                                           FORM 13 Title
State                                                        Company Name:       Company Name
Year 3            2                                          (Title Insurance Company)
                                                             Planned Premium Volume By Line of Business
                                                             (Amounts in Whole Dollars)

                                                                 Direct          Assumed             Ceded           Net           Direct      Assumed         Ceded                    Net
                                                               Premiums          Premiums          Premiums      Premiums        Premiums      Premiums      Premiums               Premiums
                  Description                                   Written           Written           Written       Written         Earned        Earned        Earned                 Earned
                  ----------------------------------             ---------         ---------         ---------     ---------       ---------     ---------     ---------              ---------
                  Title                                                                                                      -                                                                  -
                                                               _________         _________         _________     _________       _________     _________     _________              _________

                    Total                                              -                 -                 -            -                -             -             -
Verification from Net Premiums and Loss Development by LOB     =========         =========         =========     =========       =========     =========     =========                         -




                                                                                                                                                                           FORM 13 Title
State                                                        Company Name:         Company Name
Year 1       0                                               (Title Insurance Company)
                                                             Incurred Loss Summary By Line of Business
                                                             (Amounts in Whole Dollars)

                                                                  Direct                                 Assumed          Ceded            Net
                                                                Losses                                     Losses         Losses         Losses
             Description                                        Incurred                                  Incurred       Incurred       Incurred
             ----------------------------------                  ---------                                 ---------      ---------      ---------
             Title                                                                                                                                 -
                                                              ___________                           ____________       ___________    ___________
                Total                                                  -                                       -                 -                 -
Verification from Net Premiums and Loss Development by LOB    ===========                           ============       ===========                 -




                                                                                                                                                FORM 13 Title
State                                                        Company Name:         Company Name
Year 2       1                                               (Title Insurance Company)
                                                             Incurred Loss Summary By Line of Business
                                                             (Amounts in Whole Dollars)

                                                                  Direct                                 Assumed          Ceded            Net
                                                                Losses                                     Losses         Losses         Losses
             Description                                        Incurred                                  Incurred       Incurred       Incurred
             ----------------------------------                  ---------                                 ---------      ---------      ---------
             Title                                                                                                                                 -
                                                              ___________                           ____________       ___________    ___________
                Total                                                  -                                       -                 -                 -
Verification from Net Premiums and Loss Development by LOB    ===========                           ============       ===========                 -




                                                                                                                                                FORM 13 Title
State                                                        Company Name:         Company Name
Year 3       2                                               (Title Insurance Company)
                                                             Incurred Loss Summary By Line of Business
                                                             (Amounts in Whole Dollars)

                                                                  Direct                                 Assumed          Ceded            Net
                                                                Losses                                     Losses         Losses         Losses
             Description                                        Incurred                                  Incurred       Incurred       Incurred
             ----------------------------------                  ---------                                 ---------      ---------      ---------
             Title                                                                                                                                 -
                                                              ___________                           ____________       ___________    ___________
                Total                                                  -                                       -                 -                 -
Verification from Net Premiums and Loss Development by LOB    ===========                           ============       ===========                 -




                                                                                                                                                FORM 13 Title
State                                        Company Name:          Company Name
                                             (Title Insurance Company)
                                             Net Premium and Loss Developments By Line of Business
                                             (Amounts in Whole Dollars)

                                                                            0                                              1                                           2
                                                     Premiums          Losses          Loss          Premiums         Losses          Loss       Premiums         Losses               Loss
        Description                                    Earned         Incurred*        Ratio           Earned         Incurred        Ratio       Earned          Incurred             Ratio
        ----------------------------------             ---------        ---------     ---------        ---------       ---------     ---------     ---------       ---------          ---------
        Title                                                    -            -         0%                       -           -         0%                    -               -          0%
                                                     _________       _________      _________        _________       _________     _________     _________       _________          _________

        Total                                                -               -         0%                    -               -        0%                -                -             0%
                                                     =========       =========      =========        =========       =========     =========     =========       =========          =========




                                                                                                                                                                            FORM 13 Title
FORM 13 Title
State                                                                                                              Company Name:       Company Name
Year 1       0                                                                                                     (Title Insurance Company)
                                                                                                                   Expense Allocation to Lines of Direct Business Written
                                                                                                                   (Amounts in Whole Dollars)

                                                                                                                                                          Loss               Commission               Taxes,                 Other
                                                                                       Direct        Direct                    Direct                 Adjustment             & Brokerage            Licenses,             Acquisition             All Other
             Premiums, Losses, Expenses and Percentages                              Premiums      Premiums                   Losses                   Expenses               Expenses                & Fees              Expenses                Expenses
             To Premiums Earned for Direct Business Written                           Written       Earned                   Incurred                   Incurred               Incurred              Incurred              Incurred                Incurred
             ---------------------------------------------------------------------     ---------     ---------                ---------                  ---------              ---------             ---------             ---------               ---------
                                                                                      Amount        Amount           %       Amount             %       Amount         %       Amount         %      Amount         %      Amount         %        Amount             %
             Title                                                                            -                -      0%                         0%                     0%                     0%                    0%                    0%                          0%
                                                                                     __________    _________       _____    _________         _____   _________      _____ _________        _____ _________       _____   _________     _____ _________             _____

                Total                                                                         -            -          0%                  -     0%               -     0%              -       0%             -     0%              -      0%                   -      0%
Verification from Planned Premium Volume by LOB Year 1.                                       -            -
                                                                                     ==========    =========       =====    =========         =====   =========      =====   =========      =====   =========     =====   =========     =====    =========          =====




                                                                                                                                                                                                                                                FORM 13 Title
State                                                                                                                  Company Name:       Company Name
Year 2       1                                                                                                         (Title Insurance Company)
                                                                                                                       Expense Allocation to Lines of Direct Business Written
                                                                                                                       (Amounts in Whole Dollars)

                                                                                                                                                          Loss               Commission               Taxes,                 Other
                                                                                       Direct            Direct                    Direct             Adjustment             & Brokerage            Licenses,             Acquisition             All Other
             Premiums, Losses, Expenses and Percentages                              Premiums          Premiums                   Losses               Expenses               Expenses                & Fees              Expenses                Expenses
             To Premiums Earned for Direct Business Written                           Written           Earned                   Incurred               Incurred               Incurred              Incurred              Incurred                Incurred
             ---------------------------------------------------------------------     ---------         ---------                ---------              ---------              ---------             ---------             ---------               ---------
                                                                                      Amount            Amount           %       Amount         %       Amount         %       Amount         %      Amount         %      Amount         %        Amount         %
             Title                                                                            -                    -      0%                     0%                     0%                     0%                    0%                    0%                      0%
                                                                                     __________        _________       _____    _________     _____   _________      _____ _________        _____ _________       _____   _________     _____ _________         _____

                Total                                                                              -               -      0%                    0%                     0%                      0%                   0%                     0%                      0%
Verification from Planned Premium Volume by LOB Year 1.                                            -               -
                                                                                     ==========        =========       =====    =========     =====   =========      =====   =========      =====   =========     =====   =========     =====    =========      =====




                                                                                                                                                                                                                                                FORM 13 Title
State                                                                                                              Company Name:       Company Name
Year 3       2                                                                                                     (Title Insurance Company)
                                                                                                                   Expense Allocation to Lines of Direct Business Written
                                                                                                                   (Amounts in Whole Dollars)

                                                                                                                                                      Loss               Commission               Taxes,                 Other
                                                                                       Direct        Direct                    Direct             Adjustment             & Brokerage            Licenses,             Acquisition             All Other
             Premiums, Losses, Expenses and Percentages                              Premiums      Premiums                   Losses               Expenses               Expenses                & Fees              Expenses                Expenses
             To Premiums Earned for Direct Business Written                           Written       Earned                   Incurred               Incurred               Incurred              Incurred              Incurred                Incurred
             ---------------------------------------------------------------------     ---------     ---------                ---------              ---------              ---------             ---------             ---------               ---------
                                                                                      Amount        Amount           %       Amount         %       Amount         %       Amount         %      Amount         %      Amount         %        Amount         %
             Title                                                                            -                -      0%                     0%                     0%                     0%                    0%                    0%                      0%
                                                                                     __________    _________       _____    _________     _____   _________      _____ _________        _____ _________       _____   _________     _____ _________         _____

                Total                                                                         -            -          0%                    0%                     0%                      0%                   0%                     0%                      0%
Verification from Planned Premium Volume by LOB Year 1.                                       -            -
                                                                                     ==========    =========       =====    =========     =====   =========      =====   =========      =====   =========     =====   =========     =====    =========      =====




                                                                                                                                                                                                                                            FORM 13 Title
State                                                                                      Company Name: Company Name
Year 1   0                                                                                 (Title Insurance Company)
                                                                                           Expense Allocation to Lines of Business Net of Reinsurance
                                                                                           (Amounts in Whole Dollars)

                                                                                                                                       Loss             Commission               Taxes,                 Other
                                                                                     Net        Net               Net              Adjustment           & Brokerage            Licenses,             Acquisition              All Other
         Premiums, Losses, Expenses and Percentages                              Premiums Premiums              Losses              Expenses             Expenses                & Fees              Expenses                 Expenses
         To Premiums Earned for Business Net of Reinsurance                       Written    Earned            Incurred              Incurred             Incurred              Incurred              Incurred                 Incurred
         ---------------------------------------------------------------------     ---------  ---------         ---------             ---------            ---------             ---------             ---------                ---------
                                                                                  Amount     Amount       %    Amount           %    Amount           %   Amount            %   Amount            %   Amount           %       Amount
         Title                                                                            -          -   0%                    0%                    0%                    0%                    0%                   0%
                                                                                 _________ _________ _______ ___________    _____ ____________    _____ __________     ______ ___________    ______ ___________    _____ ___________

         Total                                                                         -         -       0%          -      0%           -      0%          -      0%          -       0%         -       0%         -
                                                                                 ========= ========= ======= =========== ====== ============ ====== =========== ====== =========== ====== =========== ====== ===========




                                                                                                                                                                                                                   FORM 13 Title
State                                                                                      Company Name: Company Name
Year 2   1                                                                                 (Title Insurance Company)
                                                                                           Expense Allocation to Lines of Business Net of Reinsurance
                                                                                           (Amounts in Whole Dollars)

                                                                                                                                       Loss               Commission               Taxes,                 Other
                                                                                     Net        Net               Net              Adjustment             & Brokerage            Licenses,             Acquisition              All Other
         Premiums, Losses, Expenses and Percentages                              Premiums Premiums              Losses              Expenses               Expenses                & Fees              Expenses                 Expenses
         To Premiums Earned for Business Net of Reinsurance                       Written    Earned            Incurred              Incurred               Incurred              Incurred              Incurred                 Incurred
         ---------------------------------------------------------------------     ---------  ---------         ---------             ---------              ---------             ---------             ---------                ---------
                                                                                  Amount     Amount     %      Amount         %      Amount         %       Amount         %      Amount         %      Amount         %         Amount
         Title                                                                            -          -   0%                    0%                    0%                      0%                    0%                   0%
                                                                                 _________ _________ _______ ___________    _____ ____________    _____   __________     ______ ___________    ______ ___________    _____ ___________

         Total                                                                         -         -       0%          -      0%           -      0%          -      0%          -       0%         -       0%         -
                                                                                 ========= ========= ======= =========== ====== ============ ====== =========== ====== =========== ====== =========== ====== ===========




                                                                                                                                                                                                                     FORM 13 Title
State                                                                                      Company Name: Company Name
Year 3   2                                                                                 (Title Insurance Company)
                                                                                           Expense Allocation to Lines of Business Net of Reinsurance
                                                                                           (Amounts in Whole Dollars)

                                                                                                                                       Loss               Commission               Taxes,                 Other
                                                                                     Net        Net               Net              Adjustment             & Brokerage            Licenses,             Acquisition              All Other
         Premiums, Losses, Expenses and Percentages                              Premiums Premiums              Losses              Expenses               Expenses                & Fees              Expenses                 Expenses
         To Premiums Earned for Business Net of Reinsurance                       Written    Earned            Incurred              Incurred               Incurred              Incurred              Incurred                 Incurred
         ---------------------------------------------------------------------     ---------  ---------         ---------             ---------              ---------             ---------             ---------                ---------
                                                                                  Amount     Amount     %      Amount         %      Amount         %       Amount         %      Amount         %      Amount         %         Amount
         Title                                                                            -          -   0%                    0%                    0%                      0%                    0%                   0%
                                                                                 _________ _________ _______ ___________    _____ ____________    _____   __________     ______ ___________    ______ ___________    _____ ___________

         Total                                                                         -         -       0%          -      0%           -      0%          -      0%          -       0%         -       0%         -
                                                                                 ========= ========= ======= =========== ====== ============ ====== =========== ====== =========== ====== =========== ====== ===========




                                                                                                                                                                                                                     FORM 13 Title
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   0%
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   0%
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         FORM 13 Title
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   0%
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         FORM 13 Title
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         FORM 13 Title
                                 UCAA Proforma Financial Statements


List all of the relevant assumptions used to create the proformas.
Note, assumptions enclosed within the Plan of Operation need not be disclosed again here.




                                                                                            FORM 13 Title

								
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