| Return Reference | Explanation |
|---|---|
| Part I Line 8 | ADJUSTMENT TO BALANCE $1.00 |
| Part I Line 16 | Insurance $1933.00 |
| Part I Line 16 | GENERAL ACCOUNT EXPENSES $9790.00 |
| Part I Line 16 | RESTRICTED ACCOUNT EXPENS $1591.00 |
| Part I Line 16 | SPECIALITY EXPENSES $33364.00 |
| Part I Line 20 | Prior period adjustments $63.00 |
| Software ID: | |
| Software Version: |