Deferred Premium Sample

Effective

Policy effective date.

Policyholder

Policy holder name.

Report Period

Period being reported.

Line of Insurance

Line of insurance for the policy.

Gross Premium

Total premium due.

Net of Comm

Amount of gross premium that is commission.

Net of MGU Fee

Amount of gross premium that is MGU fees.

Net Due

Premium amount less net commission and net MGU fee.

Amount Received

Premium amount received.

Variance

Variance amount.

Received Date

When the premium was received.