SECOND SCHEDULE
Regulation 18(1)
INSURANCE ACT
(CHAPTER 142)
INSURANCE
(APPROVED MARINE, AVIATION AND
TRANSIT INSURANCE BROKERS AND
APPROVED REINSURANCE BROKERS)
REGULATIONS
FORM
NAME OF APPROVED INSURANCE BROKER _________________________
PLACEMENT OF BUSINESS HANDLED
FOR THE FINANCIAL YEAR ______ TO ______
I.Approved MAT Insurance Broking Business
Placement with
Premiums
(S$)
(a)Registered insurers
(b)Approved MAT insurers
(c)Other US Financial Institutions
 
 Total
 
II.Approved General Reinsurance Broking Business
Placement with
Premiums
(S$)
(a)Registered insurers
(b)Authorised General Reinsurers
(c)Others
 
 Total
 
III.Approved Life Reinsurance Broking Business
Placement with
Premiums
(S$)
(a)Registered insurers
(b)Authorised Life Reinsurers
(c)Others
 
 Total
 
Notes:
1.“Premiums” refers to premiums received or receivable during the financial year, including brokerage.
2.“Authorised General Reinsurers” refers to persons who are authorised under section 8A of the Insurance Act to carry on general business.
3.“Authorised Life Reinsurers” refers to persons who are authorised under section 8A of the Insurance Act to carry on life business.
Names and signatures of:
___________________
             Director
___________________
             Director
___________________
Chief Executive Officer
Date: ______________
 
 
 
___________________
 
[G.N. No. S 681/2003]