Total  Amount  Paid  on  Account  of—

Year  Ending

Sums  at  Death.

Annuities  Commencing

Endowments.

Other  Payments
(to  be  specified).

At  Age

At  Age

At  Age

31  December  18
„  18  -
„  18  -
„  18  -
„  18  -
Total  -  -  -

£.

£.

£.

£.

£.

£.

(3.)  State  according  to  the  rules  of  the  Society—
(a.)  When  full  pay  ceases  and  reduced  pay  begins,
and  what  the  reduction  is;
(b.)  When  such  reduced  pay  is  still  further  reduced,
and  by  how  much;

292  VALUATION.