Retain This Worksheet in Your Records. Do Not Submit It with Your Experience Report

ALLOCATION RECONCILIATION WORKSHEET FOR THE CALENDAR YEAR ENDED DECEMBER 31, 2013 [Retain this worksheet in your records. Do not submit it with your experience report.]

Agency Name:______

A Income Title Insurance Escrow Non-Policy Total for Other Combined Abstract Business Operations Totals Not Reported on Form A (whole dollars only) (whole dollars only) (whole dollars only) (whole dollars only) (whole dollars only) 1. Title Insurance Premiums

2. Remitted Title Premiums < > 3. Retained Title Premiums

4. Fees Received for Title Examination and Furnishing Title Evidence 5. Fees Received for Closing

6. Tax Certificates

7. Recording Fees

8. Restrictions

9. Inspection Fees

10. Courier and Overnight Delivery

11. Telephone and Facsimile

12. Interest Income

13. Other Income

14. Total for Each Column

15. Total Income (sum of lines 1-13, all columns)

of 3 ALLOCATION RECONCILIATION WORKSHEET FOR THE CALENDAR YEAR ENDED DECEMBER 31, 2013 [Retain this worksheet in your records. Do not submit it with your experience report.] Agency Name:______

B Expenses Title Insurance Escrow Non-Policy Abstract Total for Other Combined Business Totals Operations (whole dollars only) Not Reported (whole dollars only) (whole dollars only) on Form A (whole dollars only) (whole dollars only) Salaries/Wages: a. Employees, Including Temp and Contract b. Owners and Partners

Employee Benefits and Welfare: a. Employees b. Owners and Partners

Fees Paid for Title Examination and Furnishing Title Evidence: a. Other Agents and Underwriters b. Attorneys/Others

Fees Paid for Closing: a. Other Agents and Underwriters b. Attorneys/Others

Utilities

Accounting and Auditing

Advertising and Promotions

Employee Travel, Lodging, and Education

Insurance

Interest Expense

Legal Expense

Licenses, Taxes, and Fees

Postage and Freight

of 3 ALLOCATION RECONCILIATION WORKSHEET FOR THE CALENDAR YEAR ENDED DECEMBER 31, 2013 [Retain this worksheet in your records. Do not submit it with your experience report.] Courier and Overnight Delivery

Telephone and Fax

of 3 ALLOCATION RECONCILIATION WORKSHEET FOR THE CALENDAR YEAR ENDED DECEMBER 31, 2013 [Retain this worksheet in your records. Do not submit it with your experience report.] Agency Name:______

B Expenses Title Insurance Escrow Non-Policy Abstract Total for Other Combined Business Totals Operations (whole dollars only) Not Reported (whole dollars only) (whole dollars only) on Form A (whole dollars only) (whole dollars only) Printing and Photocopying

Office Supplies

Equipment and Vehicle Leases

Depreciation

Directors' Fees

Dues, Boards, and Associations

Bad Debts

Loss and Loss Adjustment Expenses

Tax Certificates Paid Tax Authorities

Recording Fees Paid County Clerk

Plant Lease/Maintenance Costs

Damages Paid for Bad Faith Suits

Fines or Penalties

Donations/Lobbying

Trade Association Fees

Other Expenses

Total for Each Column

Total Expenses (sum of lines 1-32, all columns)

of 3 ALLOCATION RECONCILIATION WORKSHEET FOR THE CALENDAR YEAR ENDED DECEMBER 31, 2013 [Retain this worksheet in your records. Do not submit it with your experience report.] Net Income for Each Column (A14 minus B33) Net Income from All Operations (A15 minus B34)