# Fiscal and Regulatory

## Tax Payable and Administered by (Re)Insurer(s)
- None

## Regulatory Risk Location
- **Risk Location 1**
  - Territory: United States of America
  - Premium Allocation: 100%

## Overseas Broker
- None - Independently Procured by the Insured

## US Classification
- Self-Procured

## Allocation of Premium to Coding
- Not Applicable.

In respect of electronic lines, please refer to the Settlement Information if shown under Security Details herein which is deemed to supersede the above.

## Allocation of Premium to Years of Account
- **Year 1**
  - Year of Account: 2024
  - Premium Allocation: 100%

In respect of electronic lines, please refer to the Settlement Information if shown under Security Details herein which is deemed to supersede the above.

## Premium Signing
- Signed for Period

## Regulatory Policyholder Classification
- Commercial - Large Risk

**Policy Number:** CSUSA2407557

**Page 26 of 31**

**CEBBS 18/5/2024 9:55 AM**

**XIS GREAT LAKES**

**2024-05-21**