FORWARD MUTUAL INSURANCE COMPANY

PROFORMA STATEMENT OF ADMITTED ASSETS, LIABILITIES, AND POLICYHOLDERS
SURPLUS–STATUTORY BASIS
December 31, 2021

ADMITTED ASSETS

Cash and Invested Cash	$148,290
Bonds	4,946,160
Stocks and Mutual Funds	3,516,246
Real Estate	257,083
Total Cash and Investments	8,867,779
Uncollected Premiums	156,489
Investment Income Due or Accrued	39,355
Fire Dues Recoverable	556
Federal Income Taxes Recoverable	37,500
Electronic Data Processing Equipment	5,812
Furniture and Fixtures	4,934
Total Assets	$9,112,425
Less Nonadmitted Assets: Furniture and Fixtures	(4,934)
TOTAL ADMITTED ASSETS	$9,107,491

LIABILITIES
Net Unpaid Losses	$57,467
Unpaid Loss Adjustment Expenses	2,125
Commissions and Accounts Payable	55,077
Other Liabilities	3,200
Unearned Premiums	675,110
Premiums Received in Advance	32,549
Reinsurance Premiums Payable	26,397
Deferred Income Taxes	142,000
Total Liabilities	$993,925
POLICYHOLDERS SURPLUS	$ 8,113,566
TOTAL LIABILITIES AND POLICYHOLDERS SURPLUS	$9,107,491