FORM NL 28..
Statement as on: 30.06.2012..
Statement of Investment Assets (General Insurer, Re-insurers)
(Business within India)
Periodicity of Submission : Quarterly (As on 30.06.2012).
.	.	.	Amount in Lakhs
No.	Particulars	SCH	Amount
1	Investments	8	3,853,612.93
2	Loans	9	47,049.78
3	Fixed Assets	10	4,866.07
4	Current Assets	.	.
.	a.  Cash & Bank Balance	11	458,424.31
.	b.  Advances & Other Assets	12	403,574.18
5	Current Liabilities	.	.
.	a.  Current Liabilities	13	-1,553,500.88
.	b. Provisions	14	-628,885.16
.	c.  Misc. Exp. Not written off	15	.
.	d.  Debit Balance of P & L A/c	.	.
.	Application of Funds as per Balance Sheet (A)	TOTAL (A)	2,585,141.23
.	Less : Other Assets	SCH	Amount
1	Loans (if any)	9	262.42
2	Fixed Assets (if any)	10	4,866.07
3	Cash & Bank Balance  (if any)	11	284,377.85
4	Advances & Other Assets  (if any)	12	398,272.43
5	Current Liabilities	13	-1,553,500.88
6	Provisions	14	-628,885.16
7	Misc. Exp. Not written off	15	.
8	Debit Balance of P & L A/c	.	.
.	.	TOTAL (B)	-1,494,607.27
.	Investment Assets' As per FORM 3B	( A - B )	4,079,748.50

 

Suraksha, 170, J. Tata Road, Churchgate, Mumbai - 400 020, INDIA
FORM 28		.	.	.	.	.	.	.	.	.
Statement as on: 30.06.2012		.	.	.	.	.	.	.	.	.
Periodicity of Submission : Quarterly (As on 30.06.2012)			.	.	.	.	.	.	.	Amount in Lakhs
No.	Investment Represented as	Reg. %	.	Share Holders	Policy Holders	Book Value (SH+PH)	% Actual	FVC Amount	Total	Market Value
.	.	.	Balance  (a )	FRSM ( b )	( c )	d = ( b + c )	.	( e )	( d + e )	.
1	G. Sec.	Not less than 20%	.	118,504.82	365,385.82	483,890.64	20.87	-13,050.72	470,839.92	470,839.92
2	G. Sec and Other Apporved Sec. (incl. (1) above)	Not less than 30%	.	191,809.86	591,407.20	783,217.06	33.78	-527.11	782,689.95	782,689.95
3	Investment subject to Exposure Norms	.	.	.	.	.	.	.	.	0
.	1. Housing & Loans to SG for Housing and FFE, Infrastructure Investments	Not less than 15%	.	103,280.33	318,444.18	421,724.52	18.19	124,366.99	546,091.50	546,091.50
.	2. Approved Investments	Not exceeding 55%	.	232,611.37	687,935.00	920,546.38	39.71	1,981,250.78	2,901,797.16	2,901,797.16
.	3.  Other Investments (not exceeding 25%)	Not exceeding 55%	.	52,522.59	140,359.77	192,882.36	8.32	35,326.87	228,209.23	228,209.23
.	Total Investment Assets	100%	.	580,224.15	1,738,146.16	2,318,370.32	100.00	2,140,417.53	4,458,787.85	4,458,787.85
.	Certification:	.	.	.	.	.	.	.	.	.
.	1.  Central Govt. Securities includes Treasury Bills,  Deposit Under Section 7 of Insurance Act, 1938 and Deposit with CCIL (securities)						.	.	.	.
.	2.  Shareholder and Policyholder Funds have been bifurcated in the ratio of 0.2449:0.7551 as per B/s as on 31.03.2012					.	.	.	.	.
.	Certified that the information given herein are  correct and complete to the best of my knowledge and belief and nothing has been canceled or suppressed.								.	.
.	Date :	.	.	.	.	.	.	.	.	.
.	.	.	.	.	.	.	.	Signature:	.	.
.	.	.	.	.	.	.	.	Full Name:	.	.
.	.	.	.	.	.	.	.	Designation:	.	.