Securities Lawyer's Deskbook                          published by The University of Cincinnati College of Law

Rule 12-15 -- Summary of Investments--Other than Investments in Related Parties

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     Column A                       Column B     Column C      Column D
     --------                       --------     --------      --------
                                                             Amount at which
    Type of Investment                Cost 1      Value       shown on the
                                                             balance sheet 2
Fixed maturities:
  Bonds:
    United States Government and
     government agencies and author-
     ities
    States, municipalities and
     political subdivisions
    Foreign governments
    Public utilities
    Convertibles and bonds with
     warrants attached 3
    All other corporate bonds

   Certificates of deposit
   Redeemable preferred stock      __________     __________     ___________
         Total fixed maturities    __________     __________     ___________

Equity securities:
    Common stocks
      Public utilities
      Banks, trust and insur-
       ance companies
      Industrial, miscellaneous
       and all other
    Nonredeemable preferred 
       stocks                      __________     __________     ___________
         Total equity securities   __________     __________     ___________

Mortgage loans on real estate                       xxxxxx

Real estate 4                                       xxxxxx

Policy loans                                        xxxxxx

Other long-term investments                         xxxxxx

Short-term investments             __________       xxxxxx       ___________
         Total investments         __________       xxxxxx       ___________

1. Original cost of equity securities and, as to fixed maturities, original cost reduced by repayments and adjusted for amortization of premiums or accrual of discounts.


2. If the amount at which shown in the balance sheet is different from the amount. shown in either column B or C, state the reason for such difference. The total of this column should agree with the balance sheet.


3. All convertibles and bonds with warrants shall be included in this caption, regardless of issuer.


4. State separately any real estate acquired in satisfaction of debt.

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