Reinsurance Company
Data Form
I LOCAL OPERATIONS
1a. Company Name:- 1b. Formerly known as(if applicable):- 2. Type of Operation(if applicable):- 3a. Address:- 3b. Telephone No.:- 3c. Facsimile No.:- 3d. Email:- 3e. Website:- 4a. Date Incorporated:- 4b. Country of Incorporation:
5. Substantial Shareholders (s): Please give name of ultimate owner or parent as well as that of any company or individual owning more than 10% of the share capital:
Show Email:
6c. Public Relations Manager (for local operations only please): Name: Job Title: Tel No.: Facsimile No.: Email:
7. Geographical Regions Served from this office: Country(ies)/Region(s) (eg. Worldwide,Indonesia,NE Asia,Europe, etc)
8. Please give names of Subsidiaries, Country located in, and Percentage of Ownership (if applicable): ( eg. Company Name - County Located - Percentage)
9a. Classes Written: (Please tick where appropriate) General Reinsurance Treaty Facultative Accident Aviation Casualty Engineering Healthcare Marine Cargo Motor Alternative Risk Transfer Bonds Energy Fire Liability Marine Hull Surety Others
Life Annuity Endowment Group Life Healthcare Individual Life Investment -Linked Personal Accident Others
9b. Please list below top 5 (by gross premium), Classes of Business Written. Currency: -- Select Currency -- USD United States Dollars EUR Euro GBP United Kingdom Pounds DEM Germany Deutsche Marks FRF France Francs JPY Japan Yen NLG Netherlands Guilders ITL Italy Lira CHF Switzerland Francs -------------- AUD Australia Dollars ATS Austria Schillings BEF Belgium Francs BDT Bangladesh Taka BND Brunei Dollar KHR Cambodia Riel CAD Canada Dollars CNY China Yuan Renmimbi CYP Cyprus Pounds DKK Denmark Kroner NLG Dutch Guilders EUR Euro FJD Fiji Dollars FRF France Francs DEM Germany Deutsche Marks HKD Hong Kong Dollars INR India Rupees IDR Indonesia Rupiah ITL Italy Lira JPY Japan Yen KRW Korea (South) Won LAK Laos Kip LUF Luxembourg Francs MYR Malaysia Ringgit MOP Macau Pataca MNT Mongolia Tughrik MMK Myanmar Kyat NLG Netherlands Guilders NPR Nepal Rupee NZD New Zealand Dollars PKR Pakistan Rupees PGK Papua New Guinea Kina PHP Philippines Pesos SAR Saudi Arabia Riyal SGD Singapore Dollars KRW South Korea Won LKR Sri Lanka Rupee CHF Switzerland Francs TWD Taiwan Dollars THB Thailand Baht TRL Turkey Lira GBP United Kingdom Pounds USD United States Dollars VND Vietnam Dong Amount: (specify if in '000 or '000'000, etc) Top 5 Classes Gross As % of own Share in local Name of manager Written(eg Motor) Premium Total Premium market(%) in charge of that class
10. Key Financial Indicators: (for local operations only) Currency: -- Select Currency -- USD United States Dollars EUR Euro GBP United Kingdom Pounds DEM Germany Deutsche Marks FRF France Francs JPY Japan Yen NLG Netherlands Guilders ITL Italy Lira CHF Switzerland Francs -------------- AUD Australia Dollars ATS Austria Schillings BEF Belgium Francs BDT Bangladesh Taka BND Brunei Dollar KHR Cambodia Riel CAD Canada Dollars CNY China Yuan Renmimbi CYP Cyprus Pounds DKK Denmark Kroner NLG Dutch Guilders EUR Euro FJD Fiji Dollars FRF France Francs DEM Germany Deutsche Marks HKD Hong Kong Dollars INR India Rupees IDR Indonesia Rupiah ITL Italy Lira JPY Japan Yen KRW Korea (South) Won LAK Laos Kip LUF Luxembourg Francs MYR Malaysia Ringgit MOP Macau Pataca MNT Mongolia Tughrik MMK Myanmar Kyat NLG Netherlands Guilders NPR Nepal Rupee NZD New Zealand Dollars PKR Pakistan Rupees PGK Papua New Guinea Kina PHP Philippines Pesos SAR Saudi Arabia Riyal SGD Singapore Dollars KRW South Korea Won LKR Sri Lanka Rupee CHF Switzerland Francs TWD Taiwan Dollars THB Thailand Baht TRL Turkey Lira GBP United Kingdom Pounds USD United States Dollars VND Vietnam Dong Amount: (specify if in '000 or '000'000, etc) Share Capital as at (date): (day/month/year) 10a . Authorised capital: 10b. Paid-up capital 10c. Shareholders Fund
Financial Year-End: (Month Only)
II REGIONAL OPERATIONS ( if different from local office or if applicable)
11. List the countries in Asia in which your parent has offices (excluding office listed in Section I) ( No need for other details as they will be contacted sepatately);
12. Regional Office Name :
13a. Address
13b. Tel No. 13c. Facsimile No. 13d. Email: 13e. Website
III GROUP / HEADQUARTERS OPERATIONS
15. Corporate Headquarters Name:
16a. Address
16b. Tel No. 16c. Facsimile. 16d. Email. 16e. Website.
17. Group / Headquarters Ownership Structure:
18. Key Financial Indicators: (for headquarters / group operations only): Currency: -- Select Currency -- USD United States Dollars EUR Euro GBP United Kingdom Pounds DEM Germany Deutsche Marks FRF France Francs JPY Japan Yen NLG Netherlands Guilders ITL Italy Lira CHF Switzerland Francs -------------- AUD Australia Dollars ATS Austria Schillings BEF Belgium Francs BDT Bangladesh Taka BND Brunei Dollar KHR Cambodia Riel CAD Canada Dollars CNY China Yuan Renmimbi CYP Cyprus Pounds DKK Denmark Kroner NLG Dutch Guilders EUR Euro FJD Fiji Dollars FRF France Francs DEM Germany Deutsche Marks HKD Hong Kong Dollars INR India Rupees IDR Indonesia Rupiah ITL Italy Lira JPY Japan Yen KRW Korea (South) Won LAK Laos Kip LUF Luxembourg Francs MYR Malaysia Ringgit MOP Macau Pataca MNT Mongolia Tughrik MMK Myanmar Kyat NLG Netherlands Guilders NPR Nepal Rupee NZD New Zealand Dollars PKR Pakistan Rupees PGK Papua New Guinea Kina PHP Philippines Pesos SAR Saudi Arabia Riyal SGD Singapore Dollars KRW South Korea Won LKR Sri Lanka Rupee CHF Switzerland Francs TWD Taiwan Dollars THB Thailand Baht TRL Turkey Lira GBP United Kingdom Pounds USD United States Dollars VND Vietnam Dong Amount: (specify if in '000 or '000'000, etc) Share Capital as at (date): (day/month/year) 18a. Authorised capital: 18b. Paid-up capital
19. This questionaire has been completed by (print name and title) :
20 . Name of person to contact (if different from 19):