TRIP 05 Data Call

Terrorism Risk Insurance Program (TRIP)

TRIP Form 05 Data Call.xls

OMB: 1505-0200

Document [xlsx]
Download: xlsx | pdf
Control Number:









(Treasury Use)
TERRORISM RISK INSURANCE PROGRAM
DATA CALL






























Insurer Name:






NAIC Insurer Number:






TIN:






Calendar Year:






Data as of:






Deductible Estimate:
















Field #: 1 2 3 4 5 6 7 8 9

CAT CODE LINE OF BUSINESS CODE TOTAL CUMULATIVE LOSS PAYMENTS ALAE PAID LOSS CASE RESERVES ALAE CASE RESERVES LOSS IBNR ALAE IBNR TOTAL ESTIMATED LOSS AND ALLOCATED LOSS ADJUSTMENT






































































Totals: NA NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00










Instruction to add more lines






As this spreadsheet has been constructed with formulae for data fields that need to be totaled, please insert any additional data records (rows) before (above) the “Totals” row.











Notice under the Paperwork Reduction Act

We estimate it will take you about 5 hours to complete this form. However, you are not required to provide the information requested unless a valid OMB control number is displayed on the form. Any comments or suggestions regarding this form should be sent to the Terrorism Risk Insurance Program Office, Department of the Treasury, 1500 Pennsylvania Avenue NW, Room 1410 MT, Washington, DC 20220. Do not send completed forms to this address. Submit forms according to instructions provided at https://tripclaims.treas.gov/TRIP/



File Typeapplication/vnd.ms-excel
AuthorFurstN
Last Modified ByBaldwin, Lindsey
File Modified2017-04-19
File Created2008-08-15

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