New York Codes, Rules and Regulations › Title 11 - INSURANCE › Appendices › Appendix 22

Current through Register Vol. 46, No. 28, July 10, 2024
(cf. Subpart 81-2)
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(cf. Subpart 81-2)
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13. What is the admitted asset value of the subsidiary as a
				percentage of the parent corporation's total admitted assets as of the
				thirty-first day of December next preceding this report? ____________.
14. What investments that must comply with article 17 of the
				New York Insurance Law have been made in this subsidiary during the calendar
				year ending the thirty-first day of December next preceding this report?
				____________.
15. Attach as Exhibit B a description of any changes, other
				than changes already provided for questions 8, 9, 10, 12, and 13 of the
				Information Report, with respect to information or material supplied in
				connection with the Preliminary Information Report required by section
				81-2.3 
				of Regulation 115 or the previously filed Information Report. If a Preliminary
				Information Report has never been filed for this subsidiary, furnish the answer
				that would have been provided for question 12 of that report. A description of
				any change should reference the question number affected.
16. Attach as Exhibit C a chart showing as of the day of the
				last day of the fiscal year covered by this report the parent corporation and
				all of its subsidiaries indicating the percentage of voting securities owned
				directly or indirectly by the parent corporation and by each subsidiary listed.
				If ownership is through other than voting securities provide details.
17. Attach as Exhibit D as of the last day of the fiscal year
				covered by this report, the identities of any officer or director of the
				subsidiary, and the identity of any person, to the parent corporation's
				knowledge, who owns or owned, directly or indirectly, more than five percent of
				the voting securities of the securities, who owns or owned, directly or
				indirectly, more than a five-percent ownership interest in the
				subsidiary.
18. Attach as Exhibit E financial projections, for three full
				years and provide the identities of the persons making such projections.
19. Attach as Exhibit F financial statements of the subsidiary
				for the most recent fiscal year accompanied by the certificate of an
				independent certified public accountant to the effect that such financials
				present fairly the subsidiary's financial position and the results of its
				operations for the year then ended, in conformity with generally accepted
				accounting principles or with requirements of insurance or other accounting
				principles prescribed or permitted under the laws of the jurisdiction in which
				such subsidiary is organized. The first Information Report filed for the
				subsidiary shall contain financial statements for the three most recent years
				if they are available.
20. Attach as Exhibit G a copy of the most recent Annual
				Statement filed with the state of domicile if filling is for an insurance
				subsidiary not authorized to do an insurance business in this State.
21. Attach as Exhibit H a brief description of all transactions
				entered into during the subsidiary's next preceding fiscal year by the
				subsidiary with the parent corporation, or its parent, subsidiaries or
				affilliates (other than any transactions otherwise reported to or approved by
				the Superintendent under any provision of the Insurance Law) inclusive of
				arrangements for common management or cooperative or joint use of personnel,
				property or services. Transactions not deemed material, transactions in series,
				or numerous similar transactions, may be reported in the aggregate provided
				that they are reasonably described. The issuance of contracts of insurance
				issued in the normal course of business other than contracts of reinsurance
				shall not be deemed transactions hereunder. Descriptions of transactions, other
				than those reported in the aggregate shall include at least the following: the
				nature and purpose of the transaction the nature and amounts of any payments or
				transactions the nature and amounts of any payments or transfers of assets
				between the parties the identities of all parties to such transactions and
				whether any officers or directors of a party are pecuniarily interested
				therein, and copies of any contracts, agreements or memoranda of understanding
				(not previously filed) between the parties relating to the transaction.
22. Attach as Exhibit I a copy of the latest annual report, if
				any, to shareholders of the subsidiary.
23. Attach as Exhibit J a statement as to whether the
				investment in or acquisition of the subsidiary complies with the individual and
				aggregate investment limitations set forth in Article 17. Supply statistics in
				support thereof.
24. Are there any plans to materially change the principal
				business activity of the subsidiary? ____________ Yes ________ No
				________.
25. Are there any plans to dispose of any significant assets of
				the subsidiary? ____________ Yes ________ No ________.
26. Attach as Exhibit K any additional information necessary to
				prevent this report from being misleading or incomplete, including events
				subsequent to the subsidiary's fiscal year.
27. Do you wish to except any part or parts of this filing from
				disclosure pursuant to paragraph (d) of section 87.2 of the Public Officers Law
				or Section 1709  of the Insurance Law all as permitted
				by section
				81-2.9 
				of Regulation 115? ____________ Yes ________ No ________.
If answer is yes, indicate which part or parts as Exhibit
				L.
28. Name, title, signature and telephone number of officer
				responsible for preparing this report.
Name
Title
Signature
Telephone Number
FORM IR-85
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