Reporting entity
1. Indicate which type of corporation this report covers.
- A single corporation
- Part of a corporation
- A consolidated family of corporations
- Other (specify)
2. Is the reporting entity part of a Canadian consolidation?
- Yes
- No
3. Does this reporting entity have investments in partnerships or joint ventures?
- Yes
- No
4. Indicate the accounting standard used to complete this questionnaire.
- International Financial Reporting Standards (IFRS)
- Accounting Standards for Private Enterprises (ASPE)
- United States Generally Accepted Accounting Principles (U.S. GAAP)
- Other (specify)
5. Indicate the currency used to complete this survey.
- Canadian dollars
- U.S. dollars
6. What are the start and end dates of this enterprise's reporting period for the quarter ending:
- From: YYYY-MM-DD to YYYY-MM-DD
Assets
7. Report your assets
- Cash and deposits – Canadian currency
- Cash and deposits – foreign currency
- Accounts receivable
- Allowance for credit losses on receivables
- Investments in and claims on parent, subsidiaries and affiliates ─ shares and equity
- In Canada
- Outside Canada
- Investments in and claims on parent, subsidiaries and affiliates ─ accumulated earnings
- In Canada
- Outside Canada
- Investments in and claims on parent, subsidiaries and affiliates ─ net assets of foreign offices
- Investments in and claims on parent, subsidiaries and affiliates ─ debt claims on affiliates
- In Canada
- Outside Canada
- Canadian investments in non-affiliates ─ debt securities issued by the Government of Canada
- Term-to-maturity of less than one year
- Term-to-maturity of one year or more
- Canadian investments in non-affiliates ─ debt securities issued by provincial and municipal governments
- Term-to-maturity of less than one year
- Term-to-maturity of one year or more
- Canadian investments in non-affiliates ─ debt securities issued by corporations, trusts or others
- Term-to-maturity of less than one year
- Term-to-maturity of one year or more
- Canadian investments in non-affiliates ─ corporate shares, fund or trust units and other equity
- Publicly traded
- Other equity
- Canadian investments in non-affiliates ─ other investments
- Foreign investments in non-affiliates ─ debt securities
- Term-to-maturity of less than one year
- Term-to-maturity of one year or more
- Foreign investments in non-affiliates ─ other investments
- Derivative assets
- Reverse repurchase agreements
- Mortgage loans to non-affiliates ─ secured by property in Canada
- Residential ─ to individuals and unincorporated businesses
- Residential ─ to others
- Non-residential ─ to individuals and unincorporated businesses
- Non-residential ─ to others
- Mortgage loans to non-affiliates ─ secured by property outside Canada
- Mortgage loans to non-affiliates ─ accumulated allowance for credit losses
- Home equity lines of credit
- Non-mortgage loans to non-affiliates
- To policyholders
- To others
- Non-mortgage loans to non-affiliates ─ accumulated allowance for credit losses
- Fixed assets
- Depreciable assets and land
- Investment properties ─ Canadian
- Investment properties ─ foreign
- Accumulated depreciation
- Deferred policy acquisition expense
- Reinsurance assets
- Intangible assets
- aa.1 Goodwill
- aa.2 Other intangible assets
- aa.3 Accumulated amortization
- ab. Accrued pension asset
- ac. Deferred income tax asset
- ad. Segregated funds net assets
- ae. All other assets
- Specify all major items within other assets
- af. Other allowances for credit losses
Total assets
Liabilities and equity
8. Report your liabilities.
- Amounts left on deposit by policyholders
- Unpaid claims and adjustment expenses
- Actuarial liabilities
- Insurance contracts
- Investment contracts
- Insurance premiums and annuity considerations received in advance
- Provisions for policyholder dividends and experience rating refunds
- Accounts payable
- Income taxes payable
- Amounts owing to affiliates
- In Canada
- Outside Canada
- Borrowing from non-affiliates ─ mortgage loans
- Residential
- Non-residential
- Borrowing from non-affiliates ─ non-mortgage loans and overdrafts
- From lenders in Canada ─ banks
- From lenders in Canada ─ credit unions
- From lenders in Canada ─ other lenders in Canada
- From lenders outside Canada
- Borrowing from non-affiliates ─ debt securities
- Term-to-maturity of less than one year
- Term-to-maturity of one year or more
- Borrowing from non-affiliates ─ other borrowings
- Equity securities classified as liabilities
- Derivative liabilities
- Obligations related to repurchase agreements
- Accrued pension liability
- Non-pension post retirement benefits
- Amounts due in respect of staff pension plan
- Segregated fund liabilities
- Deferred income taxes liability
- Unamortized balance of deferred gains (losses) on investments
- All other liabilities
- Specify all major items within other liabilities
Total liabilities
9. Report your equity.
- Share capital
- Preferred
- Common
- Contributed surplus
- Accumulated other comprehensive income
- Non-controlling interest
- Retained earnings/Head office account
- Appropriated
- Unappropriated
Closing balance
Total equity
Total liabilities and total equity
10. Report your unappropriated retained earnings.
- Unappropriated retained earnings
- Opening balance
- Net income (loss) for the current period
- Transfers from (to) share capital
- a.4 All other additions (deductions)
- Specify all major items within other additions (deductions)
- Dividends declared
- Cash ─ preferred shares
- Cash ─ common shares
- Other dividends
Closing balance
Revenues and expenses
11. What period does this income statement cover?
- From: YYYY-MM-DD to YYYY-MM-DD
12. Report your revenue.
- Net premiums
- Interest revenue from Canadian sources
- Debt securities
- Debt claims on affiliates
- Mortgages
- Other interest revenue
- Interest revenue from foreign sources
- Dividends
- From Canadian corporations
- From foreign corporations
- Rental revenue
- Gains and losses ─ fair value adjustments
- Realized
- Unrealized
- Gains and losses ─ foreign exchange
- Realized
- Unrealized
- All other revenues
- Specify all major items within other revenues
Total revenue
13. Report your expenses.
- Policyholder/Certificateholder benefits incurred and paid
- Commissions
- Benefits ceded
- Increase (decrease) in actuarial liabilities
- Fair value gains (losses) reflected in actuarial liabilities
- Other increases (decreases) in actuarial liabilities
- Dividends and experience rating refunds to policyholder/certificate holder
- Amounts paid during the period
- Estimated increase (decrease) in provision
- Wages and salaries
- Employer portion of employee benefits
- Pension expense
- Current service cost
- Other pension expense
- Stock option expense
- Indirect taxes
- Depreciation and amortization
- Depreciation
- Amortization ─ intangible assets
- Amortization ─ other
- Software and research development
- Impairments
- Credit losses on receivables
- Other impairments
- Interest expense
- Debt securities
- Amounts owing to affiliates
- Mortgages
- Other interest expenses
- Dividends paid on equity securities classified as liabilities
- Charitable donations
- All other expenses
- Specify all major items within other expenses
Total expenses
Income
14. Report your income.
- Income (loss) before income taxes
- Current income tax expense
- Deferred income tax expense
- Income (loss) after income taxes
- Equity in unconsolidated affiliates
- Net income (loss)
- Attributable to non-controlling interest
- Attributable to equity shareholders
- Other comprehensive income
- Items that will not be reclassified to net earnings
- Items that may be reclassified subsequently to net earnings
- Reclassification of realized (gains) losses to net earnings
- Income taxes
- Comprehensive income
- Attributable to non-controlling interest
- Attributable to equity shareholders
- Net income from foreign operations
Disclosure of selected accounts
15. Report premiums by line of business.
- Premiums ─ direct premiums
- Life
- Annuity
- Accident and sickness
- Property and casualty
- Other
- Premiums ─ premiums assumed
- Life
- Annuity
- Accident and sickness
- Property and casualty
- Other
- Premiums ─ premiums ceded
- Life
- Annuity
- Accident and sickness
- Property and casualty
- Other
- Policyholder/Certificateholder benefits paid and incurred ─ direct premiums
- Life
- Annuity
- Accident and sickness
- Property and casualty
- Other
- Policyholder/Certificateholder benefits paid and incurred ─ premiums assumed
- Life
- Annuity
- Accident and sickness
- Property and casualty
- Other
- Policyholder/Certificateholder benefits paid and incurred ─ premium ceded
- Life
- Annuity
- Accident and sickness
- Property and casualty
- Other
16. Report the number of policies in force by line of business
- Life
- Annuity
- Accident and sickness
- Property and casualty
- Other
17. Report other disclosures.
- Equity method dividends
- Canadian dividends
- Foreign dividends
- Securitized assets ─ recognized
- Credit cards
- Mortgages
- Other assets
- Securitized assets ─ unrecognized
- Credit cards
- Mortgages
- Other assets
- Capitalized expenses for software, research and development
18. Allocate the changes to selected assets and liabilities.
- Investments in and claims on parent, subsidiaries and affiliates
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange
- a.4 Other adjustments
- Closing balance
- Realized gains and losses
- Canadian and foreign investments in non-affiliates ─ debt securities
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange
- b.4 Other adjustments
- Closing balance
- Realized gains and losses
- Canadian and foreign investments in non-affiliates ─ corporate shares, funds or trust units and other equity
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange
- c.4 Other adjustments
- Closing balance
- Realized gains and losses
- Canadian and foreign investments in non-affiliates ─ other investments in non-affiliates
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange
- d.4 Other adjustments
- Closing balance
- Realized gains and losses
- Mortgage loans to non-affiliates
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange
- e.4 Other adjustments
- Closing balance
- Realized gains and losses
- Home Equity lines of credit
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange
- f.4 Other adjustments
- Closing balance
- Realized gains and losses
- Non-mortgage loans to non-affiliates
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange
- g.4 Other adjustments
- Closing balance
- Realized gains and losses
- Fixed assets ─ depreciable assets and land
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange
- h.4 Other adjustments
- Closing balance
- Realized gains and losses
- Fixed assets ─ investment properties
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange
- i.4 Other adjustments
- Closing balance
- Realized gains and losses
- Intangible assets
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange
- j.4 Other adjustments
- Closing balance
- Realized gains and losses
- Other assets
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange
- k.4 Other adjustments
- Closing balance
- Realized gains and losses
- Debt liability securities owing
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange
- l.4 Other adjustments
- Closing balance
- Realized gains and losses
- Other liabilities
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange
- m.4 Other adjustments
- Closing balance
- Realized gains and losses
- Derivatives (assets and liabilities)
- Initial balance
- Net (purchases-sales or issuances-repayments and other changes)
- Fair value adjustments and foreign exchange
- n.4 Other adjustments
- Closing balance
- Realized gains and losses