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{"sheet":"General Instructions","index":0,"n_rows":89,"n_cols":3,"rows_kept":89,"cut":false,"hidden":false,"merged":[[46,2,46,8],[42,1,42,8],[0,0,0,8],[1,0,1,8],[44,0,44,8],[37,1,37,8],[38,1,38,8],[5,0,5,8],[33,0,33,8],[35,0,35,8],[79,0,79,8],[51,1,51,8],[72,0,72,8],[52,0,52,8],[90,0,90,8],[56,0,56,8],[84,0,84,8],[88,0,88,8],[75,0,75,8],[58,2,58,8],[68,2,70,8],[47,0,47,8],[54,1,54,8],[62,1,62,8],[60,1,60,8],[57,2,57,8]]}
[" 2016 TEXAS DISALLOWED EXPENSE CALL"]
["CALENDAR YEAR 2016 EXPERIENCE"]
[]
["GENERAL INSTRUCTIONS"]
[]
["This data call requires companies to submit countrywide direct written premium and insurance expense exhibit data for all of the following property and casualty lines for which the company had writings in Texas in 2016:"]
[]
["·   Residential Fire"]
["·   Commercial Fire"]
["·   Combined Fire"]
["·   Residential Allied Lines "]
["·   Commercial Allied Lines "]
["·   Combined Allied Lines "]
["·  Private Crop"]
["·   Farmowners Mutiple Peril "]
["·   Homeowners Multiple Peril"]
["·   Commercial Multiple Peril (Non-Liability Portion)"]
["·   Commercial Multiple Peril (Liability Portion)"]
["·   Inland Marine"]
["·   Medical Malpractice"]
["·   Other General Liability"]
["·   Products Liability"]
["·   Private Passenger Auto Liability"]
["·   Commercial Auto Liability"]
["·   Private Passenger Auto Physical Damage "]
["·   Commercial Auto Physical Damage"]
["·   Fidelity (Other than Criminal Court Appearance Bonds)"]
["·   Surety (Other than Criminal Court Appearance Bonds)"]
[]
[]
[]
["Start Worksheet and Affidavit"]
[]
["In the “Start” worksheet, you must include the name of the company or group and the corresponding NAIC number or group number. Include only admitted companies in this submission; farm mutual and surplus lines insurers must be excluded. If submitting a group filing, go to the “Group Info” worksheet and list each company and corresponding NAIC number for all companies within the group for which you are submitting data. The Affidavit form must be signed by the highest ranking company official with management and control authority over the development of the reported information, and notarized."]
[]
["If you are submitting a group filing, you may do one of the following:"]
[]
["·   ","file insurance expense exhibit data by line in aggregate amounts for companies with Texas direct written premium, or"]
["·   ","make copies of the MS Excel files and submit a \"Report of Insurance Expense Exhibit Data\" file for each company in your group. "]
[]
["Report of Insurance Expense Exhibit Data"]
[]
["1.","Reported experience should be valued as of December 31, 2016. Report all amounts to the nearest thousand (000) as they are reported on the Insurance Expense Exhibit in your company’s annual statement.  "]
[]
["2.  If your company has no experience to report:  "]
[null,"·   ","Complete the appropriate information on the “Start” and “Group Info” worksheets."]
[null,"·   ","No entries or entries totaling zero in the Direct Premiums Written section of the “Start” worksheet will denote a “None” submission. Skip to Line 7."]
[]
[]
[]
[]
["3.","Direct premiums written must equal the amount reported on Part III - Allocation to Lines of Direct Business Written, column 1 of the Insurance Expense Exhibit."]
["If your company wrote Residential and Commercial Fire or Residential and Commercial Allied lines in Texas, and you are able to allocate the premium to Residential and Commercial, please do so. The total of the two should equal Part III - Allocation to Lines of Direct Business Written, column 1 of the Insurance Expense Exhibit for those lines. If you are unable to allocate the premium, please complete the \"Combined Fire\" and \"Combined Allied Lines\" sections of the report."]
[]
["4.","Other acquisition, field supervision, and collection expenses incurred (Line 2a) must equal the amount reported on Part III, column 27 of the Insurance Expense Exhibit."]
[]
["5.  Report all advertising expenses (Line 2b) incurred except the following: 1"]
[null,"·   ","advertising directly related to the services or products provided by the insurer, and"]
[null,"·   ","advertising designed and directed at loss prevention."]
[]
["6.","General expenses incurred (Line 3a) must equal the amount reported on Part III, column 29 of the Insurance Expense Exhibit."]
[]
["7.","Save your file according to the following standard: GRP NAIC DER2016.xls"]
[null,"·   ","If not making a group filing, enter a \"0\" after \"GRP.\""]
[null,"·   ","Example: GRP 0 12345 DER2016.xls"]
[null,"·   ","Email the report as an attachment to datacall@tdi.texas.gov using the file name as the subject, "]
[null,null,"and include the signed and notarized Affidavit as a separate attachment in the same email."]
[]
[null,1,"Reporting for the Advertising line item has changed from prior years. Do include advertising for promotion of organizations exempt from federal taxation under IRC 501(c)(3), or its subsequent amendments, in line 2b."]
[]
[]
[]
[]
["Retention of Records"]
[]
["The underlying data and other information utilized in the development of your call response must be maintained within your company’s records for a minimum of two years after the due date."]
[]
["Due Date"]
[]
["The Disallowed Expense data call is due on or before July XX, 2017."]
[]
[]
[]
[]
[]
[]
["Other"]
[]
["Questions concerning this data call should be directed to Brandon Easley in Property and Casualty Actuarial at 512-676-6690 or datacall@tdi.texas.gov."]

{"sheet":"Start","index":1,"n_rows":45,"n_cols":4,"rows_kept":45,"cut":false,"hidden":false,"merged":[[1,1,1,2],[2,1,2,2],[13,0,13,2],[12,0,12,2],[3,1,3,2],[4,1,4,2]]}
[]
[null,"Texas Department of Insurance "]
[null,"Disallowed Expense Report"]
[null,"Report of Insurance Expense Exhibit Data"]
[null,"Premiums in Thousands $000"]
[]
["Calendar Year:",2016]
["Group/Company Name:"]
["NAIC:"]
["Group No.:"]
["Group Filing:","Enter Yes or No",null,"Yes"]
[null,"(if \"Yes\", click here to enter detail on Group Info worksheet)",null,"No"]
["REPORT ONLY LINES WRITTEN IN TEXAS"]
["Enter Countrywide Direct Premiums Written from IEE Part III, Column 1 "]
[]
["Annual Statement   Line Numbers","Annual Statement Line Names","Direct Premiums Written"]
[1,"Residential Fire"]
[1,"Commercial Fire"]
[1,"Combined Fire",null,{"$f":"C17+C18","v":0}]
[2.1,"Residential Allied Lines"]
[2.1,"Commercial Allied Lines"]
[2.1,"Combined Allied Lines",null,{"$f":"C20+C21","v":0}]
[2.4,"Private Crop"]
[3,"Farmowners Multiple Peril"]
[4,"Homeowners Multiple Peril"]
[5.0999999999999996,"Commercial Multiple Peril (Non-liability Portion)"]
[5.2,"Commercial Multiple Peril (Liability Portion)"]
[9,"Inland Marine"]
[11,"Medical Malpractice"]
[17,"Other General Liability"]
[18,"Products Liability"]
["19.1 + 19.2","Private Passenger Auto Liability"]
["19.3 + 19.4","Commercial Auto Liability"]
[21.1,"Private Passenger Auto Physical Damage"]
[21.2,"Commercial Auto Physical Damage"]
[23,"Fidelity (Other than Criminal Court Appearance Bonds)"]
[24,"Surety (Other than Criminal Court Appearance Bonds)"]
[null,{"$f":"IF(SUM(C17:C37)=0,\"If ''NONE'' stop here and submit report\", \" \")","v":"If ''NONE'' stop here and submit report"}]
[null,{"$f":"IF(SUM(C17:C37)>0,\"Go to ''Enter Data'' worksheet - Click here\", \"\")","v":""}]
[null,"Save your file according to the following standard: GRP 0000 DER2016.xls."]
[null,"If not making a group filing, enter a \"0\" after \"GRP,\" then the NAIC company number."]
[null,"Example: GRP 0 12345 DER2016.xls"]
[null,"Email as attachment to datacall@tdi.texas.gov."]
[null,"Put the file name in the email subject line."]
[null,"For assistance, contact Brandon Easley at 512-676-6690."]

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[{"$f":"Year","v":2016}]
["GROUP NAME:",{"$f":"coname","v":0}]
["GROUP NUMBER:",{"$f":"group","v":0},null,"Click here to return to Start worksheet"]
[]
["COMPANY NAME",null,null,"NAIC NUMBER"]

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[null,null,"Enter all figures in 1,000's ($000)"]
[null,null,"Residential Fire",null,"Commercial Fire",null,"Combined Fire",null,"Residential Allied Lines",null,"Commercial Allied Lines",null,"Combined Allied Lines",null,"Private Crop",null,"Farmowners Multiple Peril",null,"Homeowners Multiple Peril",null,"Commercial Multiple Peril (Non-liability Portion)",null,"Commercial Multiple Peril (Liability Portion)",null,"Inland Marine",null,"Medical Malpractice",null,"Other General Liability",null,"Products Liability",null,"Private Passenger Auto Liability",null,"Commercial Auto Liability",null,"Private Passenger Auto Physical Damage",null,"Commercial Auto Physical Damage",null,"Fidelity",null,"Surety"]
[{"$f":"coname","v":0}]
[{"$f":"naic","v":0},"NAIC"]
[{"$f":"group","v":0},"GROUP","(IEE Part III-Line 1)",null,"(IEE Part III-Line 1)",null,"(IEE Part III-Line 1)",null,"(IEE Part III-Line 02.1)",null,"(IEE Part III-Line 02.1)",null,"(IEE Part III-Line 02.1)",null,"(IEE Part III-Line 2.4)",null,"(IEE Part III-Line 03)",null,"(IEE Part III-Line 04)",null,"(IEE Part III-Line 5.1)",null,"(IEE Part III-Line 5.2)",null,"(IEE Part III-Line 09)",null,"(IEE Part III-Line 11)",null,"(IEE Part III-Line 17)",null,"(IEE Part III-Line 18)",null,"(IEE Part III-Line 19.1 + 19.2)",null,"(IEE Part III-Line 19.3 + 19.4)",null,"(IEE Part III-Line 21.1)",null,"(IEE Part III-Line 21.2)",null,"(IEE Part III-Line 23)",null,"(IEE Part III-Line 24)"]
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[null,null,{"$f":"IF(C8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(E8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(G8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(I8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(K8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(M8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(O8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(Q8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(S8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(U8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(W8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(Y8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(AA8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(AC8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(AE8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(AG8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(AI8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(AK8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(AM8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(AO8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"},null,{"$f":"IF(AQ8>0,\"Enter this line\",\"DO NOT ENTER THIS LINE\")","v":"DO NOT ENTER THIS LINE"}]
[1,"Direct premiums written",{"$f":"Start!C17","v":0},{"$f":"IF(C8<>0,C8/C8,\"\")","v":""},{"$f":"Start!C18","v":0},{"$f":"IF(E8<>0,E8/E8,\"\")","v":""},{"$f":"Start!C19","v":0},{"$f":"IF(G8<>0,G8/G8,\"\")","v":""},{"$f":"Start!C20","v":0},{"$f":"IF(I8<>0,I8/I8,\"\")","v":""},{"$f":"Start!C21","v":0},{"$f":"IF(K8<>0,K8/K8,\"\")","v":""},{"$f":"Start!C22","v":0},{"$f":"IF(M8<>0,M8/M8,\"\")","v":""},{"$f":"Start!C23","v":0},{"$f":"IF(O8<>0,O8/O8,\"\")","v":""},{"$f":"Start!C24","v":0},{"$f":"IF(Q8<>0,Q8/Q8,\"\")","v":""},{"$f":"Start!C25","v":0},{"$f":"IF(S8<>0,S8/S8,\"\")","v":""},{"$f":"Start!C26","v":0},{"$f":"IF(U8<>0,U8/U8,\"\")","v":""},{"$f":"Start!C27","v":0},{"$f":"IF(W8<>0,W8/W8,\"\")","v":""},{"$f":"Start!C28","v":0},{"$f":"IF(Y8<>0,Y8/Y8,\"\")","v":""},{"$f":"Start!C29","v":0},{"$f":"IF(AA8<>0,AA8/AA8,\"\")","v":""},{"$f":"Start!C30","v":0},{"$f":"IF(AC8<>0,AC8/AC8,\"\")","v":""},{"$f":"Start!C31","v":0},{"$f":"IF(AE8<>0,AE8/AE8,\"\")","v":""},{"$f":"Start!C32","v":0},{"$f":"IF(AG8<>0,AG8/AG8,\"\")","v":""},{"$f":"Start!C33","v":0},{"$f":"IF(AI8<>0,AI8/AI8,\"\")","v":""},{"$f":"Start!C34","v":0},{"$f":"IF(AK8<>0,AK8/AK8,\"\")","v":""},{"$f":"Start!C35","v":0},{"$f":"IF(AM8<>0,AM8/AM8,\"\")","v":""},{"$f":"Start!C36","v":0},{"$f":"IF(AO8<>0,AO8/AO8,\"\")","v":""},{"$f":"Start!C37","v":0},{"$f":"IF(AQ8<>0,AQ8/AQ8,\"\")","v":""}]
["2a","Other acquisition",null,{"$f":"IF(C9<>0,C9/C8,\"\")","v":""},null,{"$f":"IF(E9<>0,E9/E8,\"\")","v":""},null,{"$f":"IF(G9<>0,G9/G8,\"\")","v":""},null,{"$f":"IF(I9<>0,I9/I8,\"\")","v":""},null,{"$f":"IF(K9<>0,K9/K8,\"\")","v":""},null,{"$f":"IF(M9<>0,M9/M8,\"\")","v":""},null,{"$f":"IF(O9<>0,O9/O8,\"\")","v":""},null,{"$f":"IF(Q9<>0,Q9/Q8,\"\")","v":""},null,{"$f":"IF(S9<>0,S9/S8,\"\")","v":""},null,{"$f":"IF(U9<>0,U9/U8,\"\")","v":""},null,{"$f":"IF(W9<>0,W9/W8,\"\")","v":""},null,{"$f":"IF(Y9<>0,Y9/Y8,\"\")","v":""},null,{"$f":"IF(AA9<>0,AA9/AA8,\"\")","v":""},null,{"$f":"IF(AC9<>0,AC9/AC8,\"\")","v":""},null,{"$f":"IF(AE9<>0,AE9/AE8,\"\")","v":""},null,{"$f":"IF(AG9<>0,AG9/AG8,\"\")","v":""},null,{"$f":"IF(AI9<>0,AI9/AI8,\"\")","v":""},null,{"$f":"IF(AK9<>0,AK9/AK8,\"\")","v":""},null,{"$f":"IF(AM9<>0,AM9/AM8,\"\")","v":""},null,{"$f":"IF(AO9<>0,AO9/AO8,\"\")","v":""},null,{"$f":"IF(AQ9<>0,AQ9/AQ8,\"\")","v":""}]
["2b","Advertising expenses",null,{"$f":"IF(C10<>0,C10/C8,\"\")","v":""},null,{"$f":"IF(E10<>0,E10/E8,\"\")","v":""},null,{"$f":"IF(G10<>0,G10/G8,\"\")","v":""},null,{"$f":"IF(I10<>0,I10/I8,\"\")","v":""},null,{"$f":"IF(K10<>0,K10/K8,\"\")","v":""},null,{"$f":"IF(M10<>0,M10/M8,\"\")","v":""},null,{"$f":"IF(O10<>0,O10/O8,\"\")","v":""},null,{"$f":"IF(Q10<>0,Q10/Q8,\"\")","v":""},null,{"$f":"IF(S10<>0,S10/S8,\"\")","v":""},null,{"$f":"IF(U10<>0,U10/U8,\"\")","v":""},null,{"$f":"IF(W10<>0,W10/W8,\"\")","v":""},null,{"$f":"IF(Y10<>0,Y10/Y8,\"\")","v":""},null,{"$f":"IF(AA10<>0,AA10/AA8,\"\")","v":""},null,{"$f":"IF(AC10<>0,AC10/AC8,\"\")","v":""},null,{"$f":"IF(AE10<>0,AE10/AE8,\"\")","v":""},null,{"$f":"IF(AG10<>0,AG10/AG8,\"\")","v":""},null,{"$f":"IF(AI10<>0,AI10/AI8,\"\")","v":""},null,{"$f":"IF(AK10<>0,AK10/AK8,\"\")","v":""},null,{"$f":"IF(AM10<>0,AM10/AM8,\"\")","v":""},null,{"$f":"IF(AO10<>0,AO10/AO8,\"\")","v":""},null,{"$f":"IF(AQ10<>0,AQ10/AQ8,\"\")","v":""}]
["2c","Adjusted other acquisition",{"$f":"C9-C10","v":0},{"$f":"IF(C11<>0,C11/C8,\"\")","v":""},{"$f":"E9-E10","v":0},{"$f":"IF(E11<>0,E11/E8,\"\")","v":""},{"$f":"G9-G10","v":0},{"$f":"IF(G11<>0,G11/G8,\"\")","v":""},{"$f":"I9-I10","v":0},{"$f":"IF(I11<>0,I11/I8,\"\")","v":""},{"$f":"K9-K10","v":0},{"$f":"IF(K11<>0,K11/K8,\"\")","v":""},{"$f":"M9-M10","v":0},{"$f":"IF(M11<>0,M11/M8,\"\")","v":""},{"$f":"O9-O10","v":0},{"$f":"IF(O11<>0,O11/O8,\"\")","v":""},{"$f":"Q9-Q10","v":0},{"$f":"IF(Q11<>0,Q11/Q8,\"\")","v":""},{"$f":"S9-S10","v":0},{"$f":"IF(S11<>0,S11/S8,\"\")","v":""},{"$f":"U9-U10","v":0},{"$f":"IF(U11<>0,U11/U8,\"\")","v":""},{"$f":"W9-W10","v":0},{"$f":"IF(W11<>0,W11/W8,\"\")","v":""},{"$f":"Y9-Y10","v":0},{"$f":"IF(Y11<>0,Y11/Y8,\"\")","v":""},{"$f":"AA9-AA10","v":0},{"$f":"IF(AA11<>0,AA11/AA8,\"\")","v":""},{"$f":"AC9-AC10","v":0},{"$f":"IF(AC11<>0,AC11/AC8,\"\")","v":""},{"$f":"AE9-AE10","v":0},{"$f":"IF(AE11<>0,AE11/AE8,\"\")","v":""},{"$f":"AG9-AG10","v":0},{"$f":"IF(AG11<>0,AG11/AG8,\"\")","v":""},{"$f":"AI9-AI10","v":0},{"$f":"IF(AI11<>0,AI11/AI8,\"\")","v":""},{"$f":"AK9-AK10","v":0},{"$f":"IF(AK11<>0,AK11/AK8,\"\")","v":""},{"$f":"AM9-AM10","v":0},{"$f":"IF(AM11<>0,AM11/AM8,\"\")","v":""},{"$f":"AO9-AO10","v":0},{"$f":"IF(AO11<>0,AO11/AO8,\"\")","v":""},{"$f":"AQ9-AQ10","v":0},{"$f":"IF(AQ11<>0,AQ11/AQ8,\"\")","v":""}]
["3a","General expenses incurred",null,{"$f":"IF(C12<>0,C12/C8,\"\")","v":""},null,{"$f":"IF(E12<>0,E12/E8,\"\")","v":""},null,{"$f":"IF(G12<>0,G12/G8,\"\")","v":""},null,{"$f":"IF(I12<>0,I12/I8,\"\")","v":""},null,{"$f":"IF(K12<>0,K12/K8,\"\")","v":""},null,{"$f":"IF(M12<>0,M12/M8,\"\")","v":""},null,{"$f":"IF(O12<>0,O12/O8,\"\")","v":""},null,{"$f":"IF(Q12<>0,Q12/Q8,\"\")","v":""},null,{"$f":"IF(S12<>0,S12/S8,\"\")","v":""},null,{"$f":"IF(U12<>0,U12/U8,\"\")","v":""},null,{"$f":"IF(W12<>0,W12/W8,\"\")","v":""},null,{"$f":"IF(Y12<>0,Y12/Y8,\"\")","v":""},null,{"$f":"IF(AA12<>0,AA12/AA8,\"\")","v":""},null,{"$f":"IF(AC12<>0,AC12/AC8,\"\")","v":""},null,{"$f":"IF(AE12<>0,AE12/AE8,\"\")","v":""},null,{"$f":"IF(AG12<>0,AG12/AG8,\"\")","v":""},null,{"$f":"IF(AI12<>0,AI12/AI8,\"\")","v":""},null,{"$f":"IF(AK12<>0,AK12/AK8,\"\")","v":""},null,{"$f":"IF(AM12<>0,AM12/AM8,\"\")","v":""},null,{"$f":"IF(AO12<>0,AO12/AO8,\"\")","v":""},null,{"$f":"IF(AQ12<>0,AQ12/AQ8,\"\")","v":""}]
["3b","Loss control and safety engineering expenses",null,{"$f":"IF(C13<>0,C13/C8,\"\")","v":""},null,{"$f":"IF(E13<>0,E13/E8,\"\")","v":""},null,{"$f":"IF(G13<>0,G13/G8,\"\")","v":""},null,{"$f":"IF(I13<>0,I13/I8,\"\")","v":""},null,{"$f":"IF(K13<>0,K13/K8,\"\")","v":""},null,{"$f":"IF(M13<>0,M13/M8,\"\")","v":""},null,{"$f":"IF(O13<>0,O13/O8,\"\")","v":""},null,{"$f":"IF(Q13<>0,Q13/Q8,\"\")","v":""},null,{"$f":"IF(S13<>0,S13/S8,\"\")","v":""},null,{"$f":"IF(U13<>0,U13/U8,\"\")","v":""},null,{"$f":"IF(W13<>0,W13/W8,\"\")","v":""},null,{"$f":"IF(Y13<>0,Y13/Y8,\"\")","v":""},null,{"$f":"IF(AA13<>0,AA13/AA8,\"\")","v":""},null,{"$f":"IF(AC13<>0,AC13/AC8,\"\")","v":""},null,{"$f":"IF(AE13<>0,AE13/AE8,\"\")","v":""},null,{"$f":"IF(AG13<>0,AG13/AG8,\"\")","v":""},null,{"$f":"IF(AI13<>0,AI13/AI8,\"\")","v":""},null,{"$f":"IF(AK13<>0,AK13/AK8,\"\")","v":""},null,{"$f":"IF(AM13<>0,AM13/AM8,\"\")","v":""},null,{"$f":"IF(AO13<>0,AO13/AO8,\"\")","v":""},null,{"$f":"IF(AQ13<>0,AQ13/AQ8,\"\")","v":""}]
["3c","Lobbying expenses",null,{"$f":"IF(C14<>0,C14/C8,\"\")","v":""},null,{"$f":"IF(E14<>0,E14/E8,\"\")","v":""},null,{"$f":"IF(G14<>0,G14/G8,\"\")","v":""},null,{"$f":"IF(I14<>0,I14/I8,\"\")","v":""},null,{"$f":"IF(K14<>0,K14/K8,\"\")","v":""},null,{"$f":"IF(M14<>0,M14/M8,\"\")","v":""},null,{"$f":"IF(O14<>0,O14/O8,\"\")","v":""},null,{"$f":"IF(Q14<>0,Q14/Q8,\"\")","v":""},null,{"$f":"IF(S14<>0,S14/S8,\"\")","v":""},null,{"$f":"IF(U14<>0,U14/U8,\"\")","v":""},null,{"$f":"IF(W14<>0,W14/W8,\"\")","v":""},null,{"$f":"IF(Y14<>0,Y14/Y8,\"\")","v":""},null,{"$f":"IF(AA14<>0,AA14/AA8,\"\")","v":""},null,{"$f":"IF(AC14<>0,AC14/AC8,\"\")","v":""},null,{"$f":"IF(AE14<>0,AE14/AE8,\"\")","v":""},null,{"$f":"IF(AG14<>0,AG14/AG8,\"\")","v":""},null,{"$f":"IF(AI14<>0,AI14/AI8,\"\")","v":""},null,{"$f":"IF(AK14<>0,AK14/AK8,\"\")","v":""},null,{"$f":"IF(AM14<>0,AM14/AM8,\"\")","v":""},null,{"$f":"IF(AO14<>0,AO14/AO8,\"\")","v":""},null,{"$f":"IF(AQ14<>0,AQ14/AQ8,\"\")","v":""}]
["3d","Bad faith",null,{"$f":"IF(C15<>0,C15/C8,\"\")","v":""},null,{"$f":"IF(E15<>0,E15/E8,\"\")","v":""},null,{"$f":"IF(G15<>0,G15/G8,\"\")","v":""},null,{"$f":"IF(I15<>0,I15/I8,\"\")","v":""},null,{"$f":"IF(K15<>0,K15/K8,\"\")","v":""},null,{"$f":"IF(M15<>0,M15/M8,\"\")","v":""},null,{"$f":"IF(O15<>0,O15/O8,\"\")","v":""},null,{"$f":"IF(Q15<>0,Q15/Q8,\"\")","v":""},null,{"$f":"IF(S15<>0,S15/S8,\"\")","v":""},null,{"$f":"IF(U15<>0,U15/U8,\"\")","v":""},null,{"$f":"IF(W15<>0,W15/W8,\"\")","v":""},null,{"$f":"IF(Y15<>0,Y15/Y8,\"\")","v":""},null,{"$f":"IF(AA15<>0,AA15/AA8,\"\")","v":""},null,{"$f":"IF(AC15<>0,AC15/AC8,\"\")","v":""},null,{"$f":"IF(AE15<>0,AE15/AE8,\"\")","v":""},null,{"$f":"IF(AG15<>0,AG15/AG8,\"\")","v":""},null,{"$f":"IF(AI15<>0,AI15/AI8,\"\")","v":""},null,{"$f":"IF(AK15<>0,AK15/AK8,\"\")","v":""},null,{"$f":"IF(AM15<>0,AM15/AM8,\"\")","v":""},null,{"$f":"IF(AO15<>0,AO15/AO8,\"\")","v":""},null,{"$f":"IF(AQ15<>0,AQ15/AQ8,\"\")","v":""}]
["3e","Legislative advocacy",null,{"$f":"IF(C16<>0,C16/C8,\"\")","v":""},null,{"$f":"IF(E16<>0,E16/E8,\"\")","v":""},null,{"$f":"IF(G16<>0,G16/G8,\"\")","v":""},null,{"$f":"IF(I16<>0,I16/I8,\"\")","v":""},null,{"$f":"IF(K16<>0,K16/K8,\"\")","v":""},null,{"$f":"IF(M16<>0,M16/M8,\"\")","v":""},null,{"$f":"IF(O16<>0,O16/O8,\"\")","v":""},null,{"$f":"IF(Q16<>0,Q16/Q8,\"\")","v":""},null,{"$f":"IF(S16<>0,S16/S8,\"\")","v":""},null,{"$f":"IF(U16<>0,U16/U8,\"\")","v":""},null,{"$f":"IF(W16<>0,W16/W8,\"\")","v":""},null,{"$f":"IF(Y16<>0,Y16/Y8,\"\")","v":""},null,{"$f":"IF(AA16<>0,AA16/AA8,\"\")","v":""},null,{"$f":"IF(AC16<>0,AC16/AC8,\"\")","v":""},null,{"$f":"IF(AE16<>0,AE16/AE8,\"\")","v":""},null,{"$f":"IF(AG16<>0,AG16/AG8,\"\")","v":""},null,{"$f":"IF(AI16<>0,AI16/AI8,\"\")","v":""},null,{"$f":"IF(AK16<>0,AK16/AK8,\"\")","v":""},null,{"$f":"IF(AM16<>0,AM16/AM8,\"\")","v":""},null,{"$f":"IF(AO16<>0,AO16/AO8,\"\")","v":""},null,{"$f":"IF(AQ16<>0,AQ16/AQ8,\"\")","v":""}]
["3f","Fees and penalties for violation of law",null,{"$f":"IF(C17<>0,C17/C8,\"\")","v":""},null,{"$f":"IF(E17<>0,E17/E8,\"\")","v":""},null,{"$f":"IF(G17<>0,G17/G8,\"\")","v":""},null,{"$f":"IF(I17<>0,I17/I8,\"\")","v":""},null,{"$f":"IF(K17<>0,K17/K8,\"\")","v":""},null,{"$f":"IF(M17<>0,M17/M8,\"\")","v":""},null,{"$f":"IF(O17<>0,O17/O8,\"\")","v":""},null,{"$f":"IF(Q17<>0,Q17/Q8,\"\")","v":""},null,{"$f":"IF(S17<>0,S17/S8,\"\")","v":""},null,{"$f":"IF(U17<>0,U17/U8,\"\")","v":""},null,{"$f":"IF(W17<>0,W17/W8,\"\")","v":""},null,{"$f":"IF(Y17<>0,Y17/Y8,\"\")","v":""},null,{"$f":"IF(AA17<>0,AA17/AA8,\"\")","v":""},null,{"$f":"IF(AC17<>0,AC17/AC8,\"\")","v":""},null,{"$f":"IF(AE17<>0,AE17/AE8,\"\")","v":""},null,{"$f":"IF(AG17<>0,AG17/AG8,\"\")","v":""},null,{"$f":"IF(AI17<>0,AI17/AI8,\"\")","v":""},null,{"$f":"IF(AK17<>0,AK17/AK8,\"\")","v":""},null,{"$f":"IF(AM17<>0,AM17/AM8,\"\")","v":""},null,{"$f":"IF(AO17<>0,AO17/AO8,\"\")","v":""},null,{"$f":"IF(AQ17<>0,AQ17/AQ8,\"\")","v":""}]
["3g","Charitable contributions",null,{"$f":"IF(C18<>0,C18/C8,\"\")","v":""},null,{"$f":"IF(E18<>0,E18/E8,\"\")","v":""},null,{"$f":"IF(G18<>0,G18/G8,\"\")","v":""},null,{"$f":"IF(I18<>0,I18/I8,\"\")","v":""},null,{"$f":"IF(K18<>0,K18/K8,\"\")","v":""},null,{"$f":"IF(M18<>0,M18/M8,\"\")","v":""},null,{"$f":"IF(O18<>0,O18/O8,\"\")","v":""},null,{"$f":"IF(Q18<>0,Q18/Q8,\"\")","v":""},null,{"$f":"IF(S18<>0,S18/S8,\"\")","v":""},null,{"$f":"IF(U18<>0,U18/U8,\"\")","v":""},null,{"$f":"IF(W18<>0,W18/W8,\"\")","v":""},null,{"$f":"IF(Y18<>0,Y18/Y8,\"\")","v":""},null,{"$f":"IF(AA18<>0,AA18/AA8,\"\")","v":""},null,{"$f":"IF(AC18<>0,AC18/AC8,\"\")","v":""},null,{"$f":"IF(AE18<>0,AE18/AE8,\"\")","v":""},null,{"$f":"IF(AG18<>0,AG18/AG8,\"\")","v":""},null,{"$f":"IF(AI18<>0,AI18/AI8,\"\")","v":""},null,{"$f":"IF(AK18<>0,AK18/AK8,\"\")","v":""},null,{"$f":"IF(AM18<>0,AM18/AM8,\"\")","v":""},null,{"$f":"IF(AO18<>0,AO18/AO8,\"\")","v":""},null,{"$f":"IF(AQ18<>0,AQ18/AQ8,\"\")","v":""}]
["3h","Advisory organization fees (please see updated Line Instruction)",null,{"$f":"IF(C19<>0,C19/C8,\"\")","v":""},null,{"$f":"IF(E19<>0,E19/E8,\"\")","v":""},null,{"$f":"IF(G19<>0,G19/G8,\"\")","v":""},null,{"$f":"IF(I19<>0,I19/I8,\"\")","v":""},null,{"$f":"IF(K19<>0,K19/K8,\"\")","v":""},null,{"$f":"IF(M19<>0,M19/M8,\"\")","v":""},null,{"$f":"IF(O19<>0,O19/O8,\"\")","v":""},null,{"$f":"IF(Q19<>0,Q19/Q8,\"\")","v":""},null,{"$f":"IF(S19<>0,S19/S8,\"\")","v":""},null,{"$f":"IF(U19<>0,U19/U8,\"\")","v":""},null,{"$f":"IF(W19<>0,W19/W8,\"\")","v":""},null,{"$f":"IF(Y19<>0,Y19/Y8,\"\")","v":""},null,{"$f":"IF(AA19<>0,AA19/AA8,\"\")","v":""},null,{"$f":"IF(AC19<>0,AC19/AC8,\"\")","v":""},null,{"$f":"IF(AE19<>0,AE19/AE8,\"\")","v":""},null,{"$f":"IF(AG19<>0,AG19/AG8,\"\")","v":""},null,{"$f":"IF(AI19<>0,AI19/AI8,\"\")","v":""},null,{"$f":"IF(AK19<>0,AK19/AK8,\"\")","v":""},null,{"$f":"IF(AM19<>0,AM19/AM8,\"\")","v":""},null,{"$f":"IF(AO19<>0,AO19/AO8,\"\")","v":""},null,{"$f":"IF(AQ19<>0,AQ19/AQ8,\"\")","v":""}]
["3i","Excess premium",null,{"$f":"IF(C20<>0,C20/C8,\"\")","v":""},null,{"$f":"IF(E20<>0,E20/E8,\"\")","v":""},null,{"$f":"IF(G20<>0,G20/G8,\"\")","v":""},null,{"$f":"IF(I20<>0,I20/I8,\"\")","v":""},null,{"$f":"IF(K20<>0,K20/K8,\"\")","v":""},null,{"$f":"IF(M20<>0,M20/M8,\"\")","v":""},null,{"$f":"IF(O20<>0,O20/O8,\"\")","v":""},null,{"$f":"IF(Q20<>0,Q20/Q8,\"\")","v":""},null,{"$f":"IF(S20<>0,S20/S8,\"\")","v":""},null,{"$f":"IF(U20<>0,U20/U8,\"\")","v":""},null,{"$f":"IF(W20<>0,W20/W8,\"\")","v":""},null,{"$f":"IF(Y20<>0,Y20/Y8,\"\")","v":""},null,{"$f":"IF(AA20<>0,AA20/AA8,\"\")","v":""},null,{"$f":"IF(AC20<>0,AC20/AC8,\"\")","v":""},null,{"$f":"IF(AE20<>0,AE20/AE8,\"\")","v":""},null,{"$f":"IF(AG20<>0,AG20/AG8,\"\")","v":""},null,{"$f":"IF(AI20<>0,AI20/AI8,\"\")","v":""},null,{"$f":"IF(AK20<>0,AK20/AK8,\"\")","v":""},null,{"$f":"IF(AM20<>0,AM20/AM8,\"\")","v":""},null,{"$f":"IF(AO20<>0,AO20/AO8,\"\")","v":""},null,{"$f":"IF(AQ20<>0,AQ20/AQ8,\"\")","v":""}]
["3j","Unreasonable expense",null,{"$f":"IF(C21<>0,C21/C8,\"\")","v":""},null,{"$f":"IF(E21<>0,E21/E8,\"\")","v":""},null,{"$f":"IF(G21<>0,G21/G8,\"\")","v":""},null,{"$f":"IF(I21<>0,I21/I8,\"\")","v":""},null,{"$f":"IF(K21<>0,K21/K8,\"\")","v":""},null,{"$f":"IF(M21<>0,M21/M8,\"\")","v":""},null,{"$f":"IF(O21<>0,O21/O8,\"\")","v":""},null,{"$f":"IF(Q21<>0,Q21/Q8,\"\")","v":""},null,{"$f":"IF(S21<>0,S21/S8,\"\")","v":""},null,{"$f":"IF(U21<>0,U21/U8,\"\")","v":""},null,{"$f":"IF(W21<>0,W21/W8,\"\")","v":""},null,{"$f":"IF(Y21<>0,Y21/Y8,\"\")","v":""},null,{"$f":"IF(AA21<>0,AA21/AA8,\"\")","v":""},null,{"$f":"IF(AC21<>0,AC21/AC8,\"\")","v":""},null,{"$f":"IF(AE21<>0,AE21/AE8,\"\")","v":""},null,{"$f":"IF(AG21<>0,AG21/AG8,\"\")","v":""},null,{"$f":"IF(AI21<>0,AI21/AI8,\"\")","v":""},null,{"$f":"IF(AK21<>0,AK21/AK8,\"\")","v":""},null,{"$f":"IF(AM21<>0,AM21/AM8,\"\")","v":""},null,{"$f":"IF(AO21<>0,AO21/AO8,\"\")","v":""},null,{"$f":"IF(AQ21<>0,AQ21/AQ8,\"\")","v":""}]
["3k","Disallowed general expenses",{"$f":"SUM(C14:C21)","v":0},{"$f":"IF(C22<>0,C22/C8,\"\")","v":""},{"$f":"SUM(E14:E21)","v":0},{"$f":"IF(E22<>0,E22/E8,\"\")","v":""},{"$f":"SUM(G14:G21)","v":0},{"$f":"IF(G22<>0,G22/G8,\"\")","v":""},{"$f":"SUM(I14:I21)","v":0},{"$f":"IF(I22<>0,I22/I8,\"\")","v":""},{"$f":"SUM(K14:K21)","v":0},{"$f":"IF(K22<>0,K22/K8,\"\")","v":""},{"$f":"SUM(M14:M21)","v":0},{"$f":"IF(M22<>0,M22/M8,\"\")","v":""},{"$f":"SUM(O14:O21)","v":0},{"$f":"IF(O22<>0,O22/O8,\"\")","v":""},{"$f":"SUM(Q14:Q21)","v":0},{"$f":"IF(Q22<>0,Q22/Q8,\"\")","v":""},{"$f":"SUM(S14:S21)","v":0},{"$f":"IF(S22<>0,S22/S8,\"\")","v":""},{"$f":"SUM(U14:U21)","v":0},{"$f":"IF(U22<>0,U22/U8,\"\")","v":""},{"$f":"SUM(W14:W21)","v":0},{"$f":"IF(W22<>0,W22/W8,\"\")","v":""},{"$f":"SUM(Y14:Y21)","v":0},{"$f":"IF(Y22<>0,Y22/Y8,\"\")","v":""},{"$f":"SUM(AA14:AA21)","v":0},{"$f":"IF(AA22<>0,AA22/AA8,\"\")","v":""},{"$f":"SUM(AC14:AC21)","v":0},{"$f":"IF(AC22<>0,AC22/AC8,\"\")","v":""},{"$f":"SUM(AE14:AE21)","v":0},{"$f":"IF(AE22<>0,AE22/AE8,\"\")","v":""},{"$f":"SUM(AG14:AG21)","v":0},{"$f":"IF(AG22<>0,AG22/AG8,\"\")","v":""},{"$f":"SUM(AI14:AI21)","v":0},{"$f":"IF(AI22<>0,AI22/AI8,\"\")","v":""},{"$f":"SUM(AK14:AK21)","v":0},{"$f":"IF(AK22<>0,AK22/AK8,\"\")","v":""},{"$f":"SUM(AM14:AM21)","v":0},{"$f":"IF(AM22<>0,AM22/AM8,\"\")","v":""},{"$f":"SUM(AO14:AO21)","v":0},{"$f":"IF(AO22<>0,AO22/AO8,\"\")","v":""},{"$f":"SUM(AQ14:AQ21)","v":0},{"$f":"IF(AQ22<>0,AQ22/AQ8,\"\")","v":""}]
["3l","Adjusted general expenses incurred",{"$f":"C12-C13-C22","v":0},{"$f":"IF(C23<>0,C23/C8,\"\")","v":""},{"$f":"E12-E13-E22","v":0},{"$f":"IF(E23<>0,E23/E8,\"\")","v":""},{"$f":"G12-G13-G22","v":0},{"$f":"IF(G23<>0,G23/G8,\"\")","v":""},{"$f":"I12-I13-I22","v":0},{"$f":"IF(I23<>0,I23/I8,\"\")","v":""},{"$f":"K12-K13-K22","v":0},{"$f":"IF(K23<>0,K23/K8,\"\")","v":""},{"$f":"M12-M13-M22","v":0},{"$f":"IF(M23<>0,M23/M8,\"\")","v":""},{"$f":"O12-O13-O22","v":0},{"$f":"IF(O23<>0,O23/O8,\"\")","v":""},{"$f":"Q12-Q13-Q22","v":0},{"$f":"IF(Q23<>0,Q23/Q8,\"\")","v":""},{"$f":"S12-S13-S22","v":0},{"$f":"IF(S23<>0,S23/S8,\"\")","v":""},{"$f":"U12-U13-U22","v":0},{"$f":"IF(U23<>0,U23/U8,\"\")","v":""},{"$f":"W12-W13-W22","v":0},{"$f":"IF(W23<>0,W23/W8,\"\")","v":""},{"$f":"Y12-Y13-Y22","v":0},{"$f":"IF(Y23<>0,Y23/Y8,\"\")","v":""},{"$f":"AA12-AA13-AA22","v":0},{"$f":"IF(AA23<>0,AA23/AA8,\"\")","v":""},{"$f":"AC12-AC13-AC22","v":0},{"$f":"IF(AC23<>0,AC23/AC8,\"\")","v":""},{"$f":"AE12-AE13-AE22","v":0},{"$f":"IF(AE23<>0,AE23/AE8,\"\")","v":""},{"$f":"AG12-AG13-AG22","v":0},{"$f":"IF(AG23<>0,AG23/AG8,\"\")","v":""},{"$f":"AI12-AI13-AI22","v":0},{"$f":"IF(AI23<>0,AI23/AI8,\"\")","v":""},{"$f":"AK12-AK13-AK22","v":0},{"$f":"IF(AK23<>0,AK23/AK8,\"\")","v":""},{"$f":"AM12-AM13-AM22","v":0},{"$f":"IF(AM23<>0,AM23/AM8,\"\")","v":""},{"$f":"AO12-AO13-AO22","v":0},{"$f":"IF(AO23<>0,AO23/AO8,\"\")","v":""},{"$f":"AQ12-AQ13-AQ22","v":0},{"$f":"IF(AQ23<>0,AQ23/AQ8,\"\")","v":""}]
[]
["E-mail completed reports to: "]
["Datacall@tdi.texas.gov"]

{"sheet":"Line Instructions","index":4,"n_rows":24,"n_cols":12,"rows_kept":24,"cut":false,"hidden":false,"merged":[[19,1,21,8],[7,1,7,8],[12,1,12,8],[10,1,10,8],[8,1,8,8],[7,11,8,11],[16,1,16,8],[17,1,17,8],[11,1,11,8],[13,1,13,8],[15,1,15,8],[0,0,0,9],[4,1,4,8],[5,1,5,8],[14,1,14,8],[6,1,6,8],[1,1,1,8],[2,1,2,8],[3,1,3,8],[9,1,9,8]]}
["Line by Line Instructions"]
[1,"Direct premiums written - must equal the amount reported on Part III, column 1 of the Insurance Expense Exhibit."]
["2a","Other acquisition, field supervision, and collection expenses incurred - must equal the amount reported on Part III, column 27 of the Insurance Expense Exhibit."]
["2b","All advertising expenses incurred except the following: 1                                                                                   •  advertising directly related to the services or products provided by the insurer; and      \n•  advertising designed and directed at loss prevention.       \n",null,null,null,null,null,null,null,null,null,"Click here to return to     \"Start\" worksheet"]
["2c","Adjusted other acquisition, field supervision, and collection expenses incurred - line 2a minus line 2b."]
["3a","General expenses incurred - must equal the amount reported on Part III, column 29 of the Insurance Expense Exhibit."]
["3b","Loss control and safety engineering expenses."]
["3c","All lobbying expenses. Lobbying expenses are considered to include all salaries, fees, and other expenses incurred to influence elected or appointed decision makers regarding legislation or rule-making, and all other activities required to be reported under the Texas Ethics Law.",null,null,null,null,null,null,null,null,null,"Click here to return to     \"Enter Data\" worksheet"]
["3d","All amounts paid or reserved by an insurer during the year, whether classified by the insurer as a loss or an expense, as damages in an action brought against the insurer for bad faith."]
["3e","All contributions to organizations engaged in legislative advocacy."]
["3f","All amounts paid or reserved by an insurer during the year, whether classified by the insurer as a loss or an expense, as fees, fines, or penalties for a civil or criminal violation of law."]
["3g","All contributions to social, religious, political, or fraternal organizations."]
["3h","All fees and assessments paid to advisory organizations, except as authorized by rule by the commissioner."]
[null,"Please note: Payments to advisory organizations licensed to do business in Texas for the development of statistical plans, data collection and reporting, the development and distribution of prospective loss costs, supplementary rating information, policy forms and endorsements, research,  performance of inspections, and other reasonably related activities are not disallowed expenses and should not be included."]
["3i","Any amount determined by the commissioner to be excess premiums charged by the insurer."]
["3j","Any unreasonably incurred expenses, as determined by the commissioner after notice and hearing."]
["3k","Disallowed general expenses - sum of lines 3c, 3d, 3e, 3f, 3g, 3h, 3i, and 3j."]
["3l","Adjusted general expenses incurred - line 3a minus line 3b minus line 3k."]
[]
[1,"Reporting for the Advertising line item has changed from prior years. Do include advertising for promotion of organizations exempt from federal taxation under IRC 501(c)(3), or its subsequent amendments, in line 2b."]
[]
[]
[]
["Email as attachment to:",null,null,"datacall@tdi.texas.gov"]

{"sheet":"Data Summary","index":5,"n_rows":22,"n_cols":24,"rows_kept":22,"cut":false,"hidden":true,"merged":[]}
["Name","NAIC","Group","Year","Group Filing","Line",1,"2a","2b","2c","3a","3b","3c","3d","3e","3f","3g","3h","3i","3j","3k","3l","None",{"$f":"SUM(Start!C17:C37)","v":0}]
[{"$f":"coname","v":0},{"$f":"naic","v":0},{"$f":"group","v":0},{"$f":"Year","v":2016},{"$f":"Grpfiling","v":"Enter Yes or No"},"Residential Fire",{"$f":"'Enter Data'!$C$8","v":0},{"$f":"'Enter Data'!$C$9","v":0},{"$f":"'Enter Data'!$C$10","v":0},{"$f":"'Enter Data'!$C$11","v":0},{"$f":"'Enter Data'!$C$12","v":0},{"$f":"'Enter Data'!$C$13","v":0},{"$f":"'Enter Data'!$C$14","v":0},{"$f":"'Enter Data'!$C$15","v":0},{"$f":"'Enter Data'!$C$16","v":0},{"$f":"'Enter Data'!$C$17","v":0},{"$f":"'Enter Data'!$C$18","v":0},{"$f":"'Enter Data'!$C$19","v":0},{"$f":"'Enter Data'!$C$20","v":0},{"$f":"'Enter Data'!$C$21","v":0},{"$f":"'Enter Data'!$C$22","v":0},{"$f":"'Enter Data'!$C$23","v":0},{"$f":"IF($X$1=0, -1, 0)","v":-1}]
[0,0,0,2016,"Enter Yes or No","Commercial Fire",{"$f":"'Enter Data'!$E$8","v":0},{"$f":"'Enter Data'!$E$9","v":0},{"$f":"'Enter Data'!$E$10","v":0},{"$f":"'Enter Data'!$E$11","v":0},{"$f":"'Enter Data'!$E$12","v":0},{"$f":"'Enter Data'!$E$13","v":0},{"$f":"'Enter Data'!$E$14","v":0},{"$f":"'Enter Data'!$E$15","v":0},{"$f":"'Enter Data'!$E$16","v":0},{"$f":"'Enter Data'!$E$17","v":0},{"$f":"'Enter Data'!$E$18","v":0},{"$f":"'Enter Data'!$E$19","v":0},{"$f":"'Enter Data'!$E$20","v":0},{"$f":"'Enter Data'!$E$21","v":0},{"$f":"'Enter Data'!$E$22","v":0},{"$f":"'Enter Data'!$E$23","v":0},{"$f":"IF($X$1=0, -1, 0)","v":-1}]
[0,0,0,2016,"Enter Yes or No","Combined Fire",{"$f":"'Enter Data'!$G$8","v":0},{"$f":"'Enter Data'!$G$9","v":0},{"$f":"'Enter Data'!$G$10","v":0},{"$f":"'Enter Data'!$G$11","v":0},{"$f":"'Enter Data'!$G$12","v":0},{"$f":"'Enter Data'!$G$13","v":0},{"$f":"'Enter Data'!$G$14","v":0},{"$f":"'Enter Data'!$G$15","v":0},{"$f":"'Enter Data'!$G$16","v":0},{"$f":"'Enter Data'!$G$17","v":0},{"$f":"'Enter Data'!$G$18","v":0},{"$f":"'Enter Data'!$G$19","v":0},{"$f":"'Enter Data'!$G$20","v":0},{"$f":"'Enter Data'!$G$21","v":0},{"$f":"'Enter Data'!$G$22","v":0},{"$f":"'Enter Data'!$G$23","v":0},{"$f":"IF($X$1=0, -1, 0)","v":-1}]
[0,0,0,2016,"Enter Yes or No","Residential Allied",{"$f":"'Enter Data'!$I$8","v":0},{"$f":"'Enter Data'!$I$9","v":0},{"$f":"'Enter Data'!$I$10","v":0},{"$f":"'Enter Data'!$I$11","v":0},{"$f":"'Enter Data'!$I$12","v":0},{"$f":"'Enter Data'!$I$13","v":0},{"$f":"'Enter Data'!$I$14","v":0},{"$f":"'Enter Data'!$I$15","v":0},{"$f":"'Enter Data'!$I$16","v":0},{"$f":"'Enter Data'!$I$17","v":0},{"$f":"'Enter Data'!$I$18","v":0},{"$f":"'Enter Data'!$I$19","v":0},{"$f":"'Enter Data'!$I$20","v":0},{"$f":"'Enter Data'!$I$21","v":0},{"$f":"'Enter Data'!$I$22","v":0},{"$f":"'Enter Data'!$I$23","v":0},{"$f":"IF($X$1=0, -1, 0)","v":-1}]
[0,0,0,2016,"Enter Yes or No","Commercial Allied",{"$f":"'Enter Data'!$K$8","v":0},{"$f":"'Enter Data'!$K$9","v":0},{"$f":"'Enter Data'!$K$10","v":0},{"$f":"'Enter Data'!$K$11","v":0},{"$f":"'Enter Data'!$K$12","v":0},{"$f":"'Enter Data'!$K$13","v":0},{"$f":"'Enter Data'!$K$14","v":0},{"$f":"'Enter Data'!$K$15","v":0},{"$f":"'Enter Data'!$K$16","v":0},{"$f":"'Enter Data'!$K$17","v":0},{"$f":"'Enter Data'!$K$18","v":0},{"$f":"'Enter Data'!$K$19","v":0},{"$f":"'Enter Data'!$K$20","v":0},{"$f":"'Enter Data'!$K$21","v":0},{"$f":"'Enter Data'!$K$22","v":0},{"$f":"'Enter Data'!$K$23","v":0},-1]
[0,0,0,2016,"Enter Yes or No","Combined Allied",{"$f":"'Enter Data'!$M$8","v":0},{"$f":"'Enter Data'!$M$9","v":0},{"$f":"'Enter Data'!$M$10","v":0},{"$f":"'Enter Data'!$M$11","v":0},{"$f":"'Enter Data'!$M$12","v":0},{"$f":"'Enter Data'!$M$13","v":0},{"$f":"'Enter Data'!$M$14","v":0},{"$f":"'Enter Data'!$M$15","v":0},{"$f":"'Enter Data'!$M$16","v":0},{"$f":"'Enter Data'!$M$17","v":0},{"$f":"'Enter Data'!$M$18","v":0},{"$f":"'Enter Data'!$M$19","v":0},{"$f":"'Enter Data'!$M$20","v":0},{"$f":"'Enter Data'!$M$21","v":0},{"$f":"'Enter Data'!$M$22","v":0},{"$f":"'Enter Data'!$M$23","v":0},-1]
[0,0,0,2016,"Enter Yes or No","Multiple Peril Crop",{"$f":"'Enter Data'!$O$8","v":0},{"$f":"'Enter Data'!$O$9","v":0},{"$f":"'Enter Data'!$O$10","v":0},{"$f":"'Enter Data'!$O$11","v":0},{"$f":"'Enter Data'!$O$12","v":0},{"$f":"'Enter Data'!$O$13","v":0},{"$f":"'Enter Data'!$O$14","v":0},{"$f":"'Enter Data'!$O$15","v":0},{"$f":"'Enter Data'!$O$16","v":0},{"$f":"'Enter Data'!$O$17","v":0},{"$f":"'Enter Data'!$O$18","v":0},{"$f":"'Enter Data'!$O$19","v":0},{"$f":"'Enter Data'!$O$20","v":0},{"$f":"'Enter Data'!$O$21","v":0},{"$f":"'Enter Data'!$O$22","v":0},{"$f":"'Enter Data'!$O$23","v":0},-1]
[0,0,0,2016,"Enter Yes or No","Farmowners",{"$f":"'Enter Data'!$Q$8","v":0},{"$f":"'Enter Data'!$Q$9","v":0},{"$f":"'Enter Data'!$Q$10","v":0},{"$f":"'Enter Data'!$Q$11","v":0},{"$f":"'Enter Data'!$Q$12","v":0},{"$f":"'Enter Data'!$Q$13","v":0},{"$f":"'Enter Data'!$Q$14","v":0},{"$f":"'Enter Data'!$Q$15","v":0},{"$f":"'Enter Data'!$Q$16","v":0},{"$f":"'Enter Data'!$Q$17","v":0},{"$f":"'Enter Data'!$Q$18","v":0},{"$f":"'Enter Data'!$Q$19","v":0},{"$f":"'Enter Data'!$Q$20","v":0},{"$f":"'Enter Data'!$Q$21","v":0},{"$f":"'Enter Data'!$Q$22","v":0},{"$f":"'Enter Data'!$Q$23","v":0},-1]
[0,0,0,2016,"Enter Yes or No","Homeowners",{"$f":"'Enter Data'!$S$8","v":0},{"$f":"'Enter Data'!$S$9","v":0},{"$f":"'Enter Data'!$S$10","v":0},{"$f":"'Enter Data'!$S$11","v":0},{"$f":"'Enter Data'!$S$12","v":0},{"$f":"'Enter Data'!$S$13","v":0},{"$f":"'Enter Data'!$S$14","v":0},{"$f":"'Enter Data'!$S$15","v":0},{"$f":"'Enter Data'!$S$16","v":0},{"$f":"'Enter Data'!$S$17","v":0},{"$f":"'Enter Data'!$S$18","v":0},{"$f":"'Enter Data'!$S$19","v":0},{"$f":"'Enter Data'!$S$20","v":0},{"$f":"'Enter Data'!$S$21","v":0},{"$f":"'Enter Data'!$S$22","v":0},{"$f":"'Enter Data'!$S$23","v":0},-1]
[0,0,0,2016,"Enter Yes or No","CMP Non Liab",{"$f":"'Enter Data'!$U$8","v":0},{"$f":"'Enter Data'!$U$9","v":0},{"$f":"'Enter Data'!$U$10","v":0},{"$f":"'Enter Data'!$U$11","v":0},{"$f":"'Enter Data'!$U$12","v":0},{"$f":"'Enter Data'!$U$13","v":0},{"$f":"'Enter Data'!$U$14","v":0},{"$f":"'Enter Data'!$U$15","v":0},{"$f":"'Enter Data'!$U$16","v":0},{"$f":"'Enter Data'!$U$17","v":0},{"$f":"'Enter Data'!$U$18","v":0},{"$f":"'Enter Data'!$U$19","v":0},{"$f":"'Enter Data'!$U$20","v":0},{"$f":"'Enter Data'!$U$21","v":0},{"$f":"'Enter Data'!$U$22","v":0},{"$f":"'Enter Data'!$U$23","v":0},-1]
[0,0,0,2016,"Enter Yes or No","CMP Liab",{"$f":"'Enter Data'!$W$8","v":0},{"$f":"'Enter Data'!$W$9","v":0},{"$f":"'Enter Data'!$W$10","v":0},{"$f":"'Enter Data'!$W$11","v":0},{"$f":"'Enter Data'!$W$12","v":0},{"$f":"'Enter Data'!$W$13","v":0},{"$f":"'Enter Data'!$W$14","v":0},{"$f":"'Enter Data'!$W$15","v":0},{"$f":"'Enter Data'!$W$16","v":0},{"$f":"'Enter Data'!$W$17","v":0},{"$f":"'Enter Data'!$W$18","v":0},{"$f":"'Enter Data'!$W$19","v":0},{"$f":"'Enter Data'!$W$20","v":0},{"$f":"'Enter Data'!$W$21","v":0},{"$f":"'Enter Data'!$W$22","v":0},{"$f":"'Enter Data'!$W$23","v":0},-1]
[0,0,0,2016,"Enter Yes or No","Inland Marine",{"$f":"'Enter Data'!$Y$8","v":0},{"$f":"'Enter Data'!$Y$9","v":0},{"$f":"'Enter Data'!$Y$10","v":0},{"$f":"'Enter Data'!$Y$11","v":0},{"$f":"'Enter Data'!$Y$12","v":0},{"$f":"'Enter Data'!$Y$13","v":0},{"$f":"'Enter Data'!$Y$14","v":0},{"$f":"'Enter Data'!$Y$15","v":0},{"$f":"'Enter Data'!$Y$16","v":0},{"$f":"'Enter Data'!$Y$17","v":0},{"$f":"'Enter Data'!$Y$18","v":0},{"$f":"'Enter Data'!$Y$19","v":0},{"$f":"'Enter Data'!$Y$20","v":0},{"$f":"'Enter Data'!$Y$21","v":0},{"$f":"'Enter Data'!$Y$22","v":0},{"$f":"'Enter Data'!$Y$23","v":0},-1]
[0,0,0,2016,"Enter Yes or No","Med Mal",{"$f":"'Enter Data'!$AA$8","v":0},{"$f":"'Enter Data'!$AA$9","v":0},{"$f":"'Enter Data'!$AA$10","v":0},{"$f":"'Enter Data'!$AA$11","v":0},{"$f":"'Enter Data'!$AA$12","v":0},{"$f":"'Enter Data'!$AA$13","v":0},{"$f":"'Enter Data'!$AA$14","v":0},{"$f":"'Enter Data'!$AA$15","v":0},{"$f":"'Enter Data'!$AA$16","v":0},{"$f":"'Enter Data'!$AA$17","v":0},{"$f":"'Enter Data'!$AA$18","v":0},{"$f":"'Enter Data'!$AA$19","v":0},{"$f":"'Enter Data'!$AA$20","v":0},{"$f":"'Enter Data'!$AA$21","v":0},{"$f":"'Enter Data'!$AA$22","v":0},{"$f":"'Enter Data'!$AA$23","v":0},-1]
[0,0,0,2016,"Enter Yes or No","Other GL",{"$f":"'Enter Data'!$AC$8","v":0},{"$f":"'Enter Data'!$AC$9","v":0},{"$f":"'Enter Data'!$AC$10","v":0},{"$f":"'Enter Data'!$AC$11","v":0},{"$f":"'Enter Data'!$AC$12","v":0},{"$f":"'Enter Data'!$AC$13","v":0},{"$f":"'Enter Data'!$AC$14","v":0},{"$f":"'Enter Data'!$AC$15","v":0},{"$f":"'Enter Data'!$AC$16","v":0},{"$f":"'Enter Data'!$AC$17","v":0},{"$f":"'Enter Data'!$AC$18","v":0},{"$f":"'Enter Data'!$AC$19","v":0},{"$f":"'Enter Data'!$AC$20","v":0},{"$f":"'Enter Data'!$AC$21","v":0},{"$f":"'Enter Data'!$AC$22","v":0},{"$f":"'Enter Data'!$AC$23","v":0},-1]
[0,0,0,2016,"Enter Yes or No","Products",{"$f":"'Enter Data'!$AE$8","v":0},{"$f":"'Enter Data'!$AE$9","v":0},{"$f":"'Enter Data'!$AE$10","v":0},{"$f":"'Enter Data'!$AE$11","v":0},{"$f":"'Enter Data'!$AE$12","v":0},{"$f":"'Enter Data'!$AE$13","v":0},{"$f":"'Enter Data'!$AE$14","v":0},{"$f":"'Enter Data'!$AE$15","v":0},{"$f":"'Enter Data'!$AE$16","v":0},{"$f":"'Enter Data'!$AE$17","v":0},{"$f":"'Enter Data'!$AE$18","v":0},{"$f":"'Enter Data'!$AE$19","v":0},{"$f":"'Enter Data'!$AE$20","v":0},{"$f":"'Enter Data'!$AE$21","v":0},{"$f":"'Enter Data'!$AE$22","v":0},{"$f":"'Enter Data'!$AE$23","v":0},-1]
[0,0,0,2016,"Enter Yes or No","PPA Liab",{"$f":"'Enter Data'!$AG$8","v":0},{"$f":"'Enter Data'!$AG$9","v":0},{"$f":"'Enter Data'!$AG$10","v":0},{"$f":"'Enter Data'!$AG$11","v":0},{"$f":"'Enter Data'!$AG$12","v":0},{"$f":"'Enter Data'!$AG$13","v":0},{"$f":"'Enter Data'!$AG$14","v":0},{"$f":"'Enter Data'!$AG$15","v":0},{"$f":"'Enter Data'!$AG$16","v":0},{"$f":"'Enter Data'!$AG$17","v":0},{"$f":"'Enter Data'!$AG$18","v":0},{"$f":"'Enter Data'!$AG$19","v":0},{"$f":"'Enter Data'!$AG$20","v":0},{"$f":"'Enter Data'!$AG$21","v":0},{"$f":"'Enter Data'!$AG$22","v":0},{"$f":"'Enter Data'!$AG$23","v":0},-1]
[0,0,0,2016,"Enter Yes or No","CA Liab",{"$f":"'Enter Data'!$AI$8","v":0},{"$f":"'Enter Data'!$AI$9","v":0},{"$f":"'Enter Data'!$AI$10","v":0},{"$f":"'Enter Data'!$AI$11","v":0},{"$f":"'Enter Data'!$AI$12","v":0},{"$f":"'Enter Data'!$AI$13","v":0},{"$f":"'Enter Data'!$AI$14","v":0},{"$f":"'Enter Data'!$AI$15","v":0},{"$f":"'Enter Data'!$AI$16","v":0},{"$f":"'Enter Data'!$AI$17","v":0},{"$f":"'Enter Data'!$AI$18","v":0},{"$f":"'Enter Data'!$AI$19","v":0},{"$f":"'Enter Data'!$AI$20","v":0},{"$f":"'Enter Data'!$AI$21","v":0},{"$f":"'Enter Data'!$AI$22","v":0},{"$f":"'Enter Data'!$AI$23","v":0},-1]
[0,0,0,2016,"Enter Yes or No","PPA PD",{"$f":"'Enter Data'!$AK$8","v":0},{"$f":"'Enter Data'!$AK$9","v":0},{"$f":"'Enter Data'!$AK$10","v":0},{"$f":"'Enter Data'!$AK$11","v":0},{"$f":"'Enter Data'!$AK$12","v":0},{"$f":"'Enter Data'!$AK$13","v":0},{"$f":"'Enter Data'!$AK$14","v":0},{"$f":"'Enter Data'!$AK$15","v":0},{"$f":"'Enter Data'!$AK$16","v":0},{"$f":"'Enter Data'!$AK$17","v":0},{"$f":"'Enter Data'!$AK$18","v":0},{"$f":"'Enter Data'!$AK$19","v":0},{"$f":"'Enter Data'!$AK$20","v":0},{"$f":"'Enter Data'!$AK$21","v":0},{"$f":"'Enter Data'!$AK$22","v":0},{"$f":"'Enter Data'!$AK$23","v":0},-1]
[0,0,0,2016,"Enter Yes or No","CA PD",{"$f":"'Enter Data'!$AM$8","v":0},{"$f":"'Enter Data'!$AM$9","v":0},{"$f":"'Enter Data'!$AM$10","v":0},{"$f":"'Enter Data'!$AM$11","v":0},{"$f":"'Enter Data'!$AM$12","v":0},{"$f":"'Enter Data'!$AM$13","v":0},{"$f":"'Enter Data'!$AM$14","v":0},{"$f":"'Enter Data'!$AM$15","v":0},{"$f":"'Enter Data'!$AM$16","v":0},{"$f":"'Enter Data'!$AM$17","v":0},{"$f":"'Enter Data'!$AM$18","v":0},{"$f":"'Enter Data'!$AM$19","v":0},{"$f":"'Enter Data'!$AM$20","v":0},{"$f":"'Enter Data'!$AM$21","v":0},{"$f":"'Enter Data'!$AM$22","v":0},{"$f":"'Enter Data'!$AM$23","v":0},-1]
[0,0,0,2016,"Enter Yes or No","Fidelity",{"$f":"'Enter Data'!$AO$8","v":0},{"$f":"'Enter Data'!$AO$9","v":0},{"$f":"'Enter Data'!$AO$10","v":0},{"$f":"'Enter Data'!$AO$11","v":0},{"$f":"'Enter Data'!$AO$12","v":0},{"$f":"'Enter Data'!$AO$13","v":0},{"$f":"'Enter Data'!$AO$14","v":0},{"$f":"'Enter Data'!$AO$15","v":0},{"$f":"'Enter Data'!$AO$16","v":0},{"$f":"'Enter Data'!$AO$17","v":0},{"$f":"'Enter Data'!$AO$18","v":0},{"$f":"'Enter Data'!$AO$19","v":0},{"$f":"'Enter Data'!$AO$20","v":0},{"$f":"'Enter Data'!$AO$21","v":0},{"$f":"'Enter Data'!$AO$22","v":0},{"$f":"'Enter Data'!$AO$23","v":0},-1]
[0,0,0,2016,"Enter Yes or No","Surety",{"$f":"'Enter Data'!$AQ$8","v":0},{"$f":"'Enter Data'!$AQ$9","v":0},{"$f":"'Enter Data'!$AQ$10","v":0},{"$f":"'Enter Data'!$AQ$11","v":0},{"$f":"'Enter Data'!$AQ$12","v":0},{"$f":"'Enter Data'!$AQ$13","v":0},{"$f":"'Enter Data'!$AQ$14","v":0},{"$f":"'Enter Data'!$AQ$15","v":0},{"$f":"'Enter Data'!$AQ$16","v":0},{"$f":"'Enter Data'!$AQ$17","v":0},{"$f":"'Enter Data'!$AQ$18","v":0},{"$f":"'Enter Data'!$AQ$19","v":0},{"$f":"'Enter Data'!$AQ$20","v":0},{"$f":"'Enter Data'!$AQ$21","v":0},{"$f":"'Enter Data'!$AQ$22","v":0},{"$f":"'Enter Data'!$AQ$23","v":0},-1]

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["2016 DISALLOWED EXPENSE REPORT AFFIDAVIT"]
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["(THIS FORM MUST BE COMPLETED AND RETURNED TO TDI)"]
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["THE STATE OF"]
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["COUNTY OF"]
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[]
["I, ",null,null,null,", the (position)"]
[]
["of the "]
["being duly sworn, deposes and says that all of the information of the named Company/Group contained herein, together with any necessary related exhibits, schedules, and explanations contained, annexed or referred to, are a full and true statement in accordance with the instructions provided, according to the best of my information, knowledge, and belief."]
[]
[]
[null,null,null,null,null,null,"Signature"]
[]
["SUBSCRIBED AND SWORN TO BEFORE ME this the ",null,null,null,null,null,null,null,"day of",null,null,20,null,"."]
[]
[]
[]
[null,null,null,null,null,null,"Notary Public"]
[]
[]
[null,null,null,null,null,null,"(Printed Name of Notary)"]
[]
[null,null,null,null,null,null,"My Commission Expires:"]
[]
[]
[]
[]
[null,null,null,"_________________"]
[null,null,null,"Contact Person",null,null,"Email address"]
[]
[null,null,null,"_________________"]
[null,null,null,"Phone Number",null,null,"Fax Number"]
[]
[]
[]
["Grp/Co:  ",null,0]
["NAIC:  ",null,{"$f":"naic","v":0},null,null,null,"Mailing Address"]
["Group#:  ",null,{"$f":"group","v":0}]
["Grp Filing:  ",null,{"$f":"Grpfiling","v":"Enter Yes or No"}]
[]
["2017 Texas Department of Insurance"]
[]
[]
[null,"EMAIL ADDRESSES "]
[null,"Under most circumstances, individual email addresses are protected by the Texas Public Information Act. Sharing this information for purposes of processing your information does not waive these confidentiality protections. However, you may affirmatively consent to release of your email address in response to a public information request or inquiry. If you would like more information about the public or confidential nature of information maintained by TDI, please consult our Open Records Policy and our Web Site Privacy Policy. This form is encrypted to meet privacy requirements. "]
[]
[]
[]
[]
[]
[]
[]
[null,"NOTICE ABOUT CERTAIN INFORMATION, LAWS, AND PRACTICES"]
[null,"With few exceptions, you are entitled to be informed about the information that the Texas Department of Insurance (TDI) collects about you. Under Texas Government Code §552.021 and §552.023, you have a right to review or receive copies of information about yourself, including private information. However, TDI may withhold information for reasons other than to protect your right to privacy. Under Texas Government Code §559.004, you are entitled to request that TDI correct information that TDI has about you that is incorrect. For more information about the procedure and costs for obtaining information from TDI or about the procedure for correcting information kept by TDI, please contact the Office of Agency Counsel in the Legal Section of the General Counsel Division at AgencyCounsel@tdi.texas.gov or visit the Corrections Procedure section of TDI's web page at www.tdi.texas.gov."]