Form 1 - Statement Of Income And Expenses

NEW MEXICO TITLE INSURER STATISTICAL REPORT FORM 1 - STATEMENT OF INCOME AND EXPENSES For the Calendar Year Ending December 31, 20___ NEW MEXICO EXPERIENCE ONLY Insurer NAIC Code Direct Operations Non-Affiliated Agency Operations Affiliated Agency Operations Total NAIC Annual Statement Schedule T Difference Part A - Revenue 13.14.17 NMAC 2 1 Direct written premiums 0 0 2 Direct written premiums retained by agency 0 3 Direct written premiums remitted to insurer 0 0 0 0 4 Escrow and settlement service charges 0 5 Other title fees and service charges 0 6 Total other income 0 0 0 0 0 7 Total revenue 0 0 0 0 For an insurer that charges rates below the promulgated rates: From Form 3 Difference 8 Direct premiums as if they had been written at promulgated rates 0 0 0 Part B - Expenses Line 1 as defined per NAIC annual statement, STATEMENT OF INCOME exhibit. Lines 2 through 22 as defined per NAIC annual statement, EXPENSES exhibit. All entries should show NEW MEXICO expenses only and should NOT include direct charges from direct operations. 1 Losses and loss adjustment expenses incurred 0 2 Total personnel costs 0 3 Total production services purchased outside 0 4 Advertising 0 5 Boards, bureaus, and associations 0 6 Title plant rent and maintenance 0 7 Claim adjustment services 0 8 Amounts charged off, net of recoveries 0 13.14.17 NMAC 3 9 Marketing and promotional expenses 0 10 Insurance 0 11 Directors’ fees 0 12 Travel and travel items 0 13 Rent and rent items 0 14 Equipment 0 15 Cost or depreciation of EDP equipment and software 0 16 Printing, stationery, books, and periodicals 0 17 Postage, telephone, messenger, and express delivery 0 18 Legal and auditing 0 19 Total taxes, licenses, and fees 0 20 Real estate expenses 0 21 Real estate taxes 0 22 Aggregate write-ins for miscellaneous expenses 0 23 Total Expenses 0 0 0 0 Part C - Net Income 1 Income (Loss) 0 0 0 0