RECONCILIATION REPORT
Name of Insurer: ___________________________________________ Calendar Year ________________
NEW MEXICO CREDITOR-PLACED INSURANCE
Type of Data | (1) New Mexico Form A Column (5) Total | (2) New Mexico Form C Column(3) Total | (3) Total (1)+(2) | (4) New Mexico Supplement of the Annual Statement Total Property | 56) Difference (3)-(4) |
A. Written Premium Net of | |||||
Terminations | |||||
B. Direct Earned Premium | |||||
C. Direct Incurred Losses | |||||
D. Commissions and | |||||
Service Fees Incurred | |||||
E. Other Incurred | |||||
Compensation |
Instructions:
Explain any non-zero differences.
COUNTRYWIDE CREDITOR-PLACED INSURANCE
Type of Data | (1) Countrywide Form A Total | (2) Countrywide All Other Credit Property Insurance | (3) Total (1) + (2) | (4) Countrywide Credit Property Supplement of the Annual Statement Total | (5) Difference (3) - (4) |
A. Written Premium Net of Terminations | |||||
B. Direct Earned Premium | |||||
C. Direct Incurred Losses | |||||
D. Commissions and Service Fees Incurred | |||||
E. Other Incurred Compensation |
Instructions:
N.M. Admin. Code § 13.18.3.24