**FISCAL AND REGULATORY**

- **TAX PAYABLE BY (RE)INSURER(S):** None.
- **COUNTRY OF ORIGIN:** United States of America
- **OVERSEAS BROKER:** None – Independently Procured by the Insured
- **SURPLUS LINE BROKER:** Not Applicable
- **STATE OF FILING:** Not Applicable
- **US CLASSIFICATION:** Self Procured.
- **NAIC CODES:** Not applicable.
- **ALLOCATION OF PREMIUM TO CODING:** Not applicable.
  - In respect of electronic lines, please refer to the Settlement Information shown under Security Details herein.
- **ALLOCATION OF PREMIUM TO YEARS OF ACCOUNT:** Not applicable.
- **REGULATORY CLIENT CLASSIFICATION:** Large Risk

**Fiscal and Regulatory**
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