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FORM NL-39Rural & Social Obligations (Quarterly Returns)
Insurer:	-	Date:	-	-	-
	-	(Rs in Lakhs)	-	-	-
Rural & Social Obligations (Quarterly Returns)
Sl.No.	Line of Business	Particular	No. of Policies Issued	Premium Collected	Sum Assured
1	Fire	Rural	-	-	-
1	Fire	Social	-	-	-
2	Cargo & Hull	Rural	NOT APPLICABLE
2	Cargo & Hull	Social	-	-	-
3	Motor TP	Rural	-	-	-
3	Motor TP	Social	-	-	-
4	Motor OD	Rural	-	-	-
4	Motor OD	Social	-	-	-
5	Engineering	Rural	-	-	-
5	Engineering	Social	-	-	-
6	Workmen's Compensation	Rural	-	-	-
6	Workmen's Compensation	Social	-	-	-
7	Employer's Liability	Rural	-	-	-
7	Employer's Liability	Social	-	-	-
8	Aviation	Rural	-	-	-
8	Aviation	Social	-	-	-
9	Personal Accident	Rural	-	-	-
9	Personal Accident	Social	-	-	-
10	Health	Rural	-	-	-
10	Health	Social	-	-	-
11	Others*	Rural	-	-	-
11	Others*	Social	-	-	-

	*any other segment contributing more than 5% needs to be shown separately