Form S-1 Surety Company Annual Report

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FORM S-1
SURETY COMPANY ANNUAL REPORT
READ THE INSTRUCTIONS CAREFULLY BEFORE PREPARING THIS REPORT.

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This form is for use by surety companies in filing reports on bond experience with respect to bonds required by the
Labor-Management Reporting and Disclosure Act of 1959, as amended (LMRDA), and under the Employee Retirement Income
Security Act if 1974 (ERISA). This report is mandatory under P.L. 86-257, as amended. Failure to comply may result in criminal
prosecution, fines, or civil penalties as provided by 29 U.S.C. 439 or 440.

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Part I - Identification
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Part III - Loss Data
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Part IV - Itemization of Losses Reported During Year
15. Report Information for Each Loss for Which a Notice Was Received During the Report Year
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