N.M. Admin. Code § 13.14.16.9
NEW MEXICO TITLE INSURANCE AGENCY STATISTICAL REPORT SCHEDULE A - STATEMENT OF INCOME AND EXPENSES For the Calendar Year Ending December 31, 20___. | |||||
AGENCY NAME | |||||
LICENSE NUMBER | |||||
ADDRESS | |||||
CONTACT NAME | |||||
Check one: | |||||
INDEPENDENT (NON-AFFILIATED) | Title insurance agencies that are independently owned and write title insurance business for one or more title insurers. | ||||
AFFILIATED | Title insurance agencies with 10% or greater ownership by a title insurer, including wholly-owned agencies. | ||||
DIRECT | Agency-type operations performed by the home or branch office of a title insurer. This does NOT include wholly-owned agencies. | ||||
Part A: Revenue | |||||
1. | Title insurance written premiums (from Schedule B) | ||||
2. | Less: Remitted title insurance premiums (from Schedule B) | ||||
3. | Retained title insurance premiums (from Schedule B) | ||||
4. | Other income (from Schedule C) | ||||
5. | Total Revenue | ||||
Part B: Expenses | |||||
1. | Employees' salaries and wages | ||||
2. | Owners' and partners' salaries and wages | ||||
3. | Employee benefits | ||||
4. | Rent | ||||
5. | Insurance | ||||
6. | Legal expense | ||||
7. | Licenses, taxes and fees | ||||
8. | Title plant expense and maintenance | ||||
9. | Office supplies | ||||
10. | Depreciation | ||||
11. | Automobile expense | ||||
12. | Communication expense | ||||
13. | Education expense | ||||
14. | Bad debts | ||||
15. | Interest expense | ||||
16. | Employee travel and lodging | ||||
17. | Loss and loss adjustment expense (from Schedule D) | ||||
18. | Accounting and auditing expense | ||||
19. | Public relations expense | ||||
20. | Other expenses (from Schedule E) | ||||
21. | Total Expenses | ||||
Part C: Net Income for Ratemaking Purposes | |||||
1. | Income (Loss) from Operations | ||||
Part D: Excluded Expenses | |||||
1. | NMLTA lobbying expense | ||||
2. | Direct lobbying expense | ||||
3. | Political contributions | ||||
4. | State and federal income tax expense | ||||
5. | 1/2 of meals and entertainment expense | ||||
6. | Penalties | ||||
7. | Country club dues | ||||
8. | Salaries in excess of salary cap | ||||
9. | Other excluded expenses (from Schedule E) | ||||
10. | Total Excluded Expenses | ||||
Part E: Net Income | |||||
1. | Net income as reported on the books of the agency | ||||
Part F: Equity | |||||
1. | Total equity as reported on balance sheet of the agency | ||||
Part G: Number of Employees | |||||
1. | Total number of employees | ||||
N.M. Admin. Code § 13.14.16.9