<p> 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.]</p><p>Agency Name:______</p><p>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</p><p>2. <less> Remitted Title Premiums < > 3. Retained Title Premiums</p><p>4. Fees Received for Title Examination and Furnishing Title Evidence 5. Fees Received for Closing</p><p>6. Tax Certificates</p><p>7. Recording Fees</p><p>8. Restrictions </p><p>9. Inspection Fees </p><p>10. Courier and Overnight Delivery</p><p>11. Telephone and Facsimile</p><p>12. Interest Income</p><p>13. Other Income</p><p>14. Total for Each Column</p><p>15. Total Income (sum of lines 1-13, all columns)</p><p>Page 1 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:______</p><p>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</p><p>Employee Benefits and Welfare: a. Employees b. Owners and Partners</p><p>Fees Paid for Title Examination and Furnishing Title Evidence: a. Other Agents and Underwriters b. Attorneys/Others </p><p>Fees Paid for Closing: a. Other Agents and Underwriters b. Attorneys/Others</p><p>Rent</p><p>Utilities</p><p>Accounting and Auditing</p><p>Advertising and Promotions</p><p>Employee Travel, Lodging, and Education</p><p>Insurance</p><p>Interest Expense</p><p>Legal Expense</p><p>Licenses, Taxes, and Fees</p><p>Postage and Freight</p><p>Page 2 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</p><p>Telephone and Fax</p><p>Page 3 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:______</p><p>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</p><p>Office Supplies</p><p>Equipment and Vehicle Leases</p><p>Depreciation</p><p>Directors' Fees</p><p>Dues, Boards, and Associations</p><p>Bad Debts</p><p>Loss and Loss Adjustment Expenses</p><p>Tax Certificates Paid Tax Authorities</p><p>Recording Fees Paid County Clerk</p><p>Plant Lease/Maintenance Costs</p><p>Damages Paid for Bad Faith Suits</p><p>Fines or Penalties</p><p>Donations/Lobbying</p><p>Trade Association Fees</p><p>Other Expenses</p><p>Total for Each Column</p><p>Total Expenses (sum of lines 1-32, all columns)</p><p>Page 4 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)</p><p>Page 5 of 3</p>