Form Rct-124 - Marine Insurance Tax Report Domestic And Foreign Marine Insurance - 2011 Page 3
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2
3
4RCT-124
(I)
Page 3
1240011301
SCHEDULE E
MARINE LOSSES INCURRED ON BUSINESS WRITTEN WITHIN THE U.S.
FOR LAST THREE CALENDAR YEARS
1
2
3
4
5
6
NET
LAST THREE
GROSS
TOTAL
REINSURANCE
SALVAGE
(Column 2 minus
CALENDAR YEARS
LOSSES
(Columns 3 and 4)
Column 5)
a
Year 2009
b
Year 2010
c
Year 2011
d
Totals
SCHEDULE F
SPECIFIC MARINE EXPENSES INCURRED ON BUSINESS TRANSACTED WITHIN THE U.S.
1
2
3
4
5
6
7
8
AGENCY
TOTAL
ALL OTHER
LAST THREE
AGENCY
FEDERAL
STATE & CITY
LOSS
COMMISSIONS
COLUMNS 2-7
EXPENSES
CALENDAR
EXPENSES
TAXES
TAXES & FEES
ADJUSTMENT
INCLUDING
YEARS
EXPENSE
BROKERAGE
a
Year 2009
b
Year 2010
c
Year 2011
d
Totals
SCHEDULE G
GENERAL EXPENSES NOT CHARGEABLE SPECIFICALLY TO ANY PARTICULAR CLASS OF BUSINESS
1
2
3
4
5
6
7
8
ADVERTISING
ALL OTHER
LAST THREE
FEDERAL
PRINTING &
TOTAL
SALARIES OF
RENTS
&
EXPENSES
COLUMNS 2-7
CALENDAR
TAXES
STATIONERY
OFFICERS &
SUBSCRIP-
EMPLOYEES
YEARS
TIONS
a
Year 2009
b
Year 2010
c
Year 2011
d
Totals
Three-year ratio of U.S. marine premiums (Schedule A, Column 4, Item d) to total net premiums for all classes
e.
of business within the U.S. (Schedule C, Column 4, Item d) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
%
Three-year ratio of net marine premiums written within Pennsylvania (Schedule B, Column 4, Item d)
f.
to total net marine premiums written within the U.S. (Schedule A, Column 4, Item d) . . . . . . . . . . . . . . . . . . . . . . . .
%
Attach Copy of Pennsylvania Business Page of the Annual Report filed with the Pennsylvania Insurance Department.
NOTE: If the company is licensed to write ocean marine premiums in Pennsylvania, this report must be filed whether or not ocean
marine premiums were written.
1240011301
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