oo <r ci oi *>. cc> to 
Valuation Balance Sheet—continued. 
(2.) If a Table or Tables have been used which are not 
published, fill in the particulars as on the other side. 
Note.—Where suras payable on the death of per 
sons under age 20 are assured, the rate of mortality 
per cent, used in the valuation must be stated helow 
for every age under 20. 
Valuation Age. 
Rate of 
Mortality 
per Cent. 
Valuation 
Age. 
Rate of 
Mortality 
per Cent. 
Under 3 months 
— 
9 years 
— 
Exceeding 3 months 
and not exceeding > 
— 
10 „ 
— 
6 months - - -j 
Ditto 6 ditto 9 ditto 
— 
11 „ 
— 
Ditto 9 ditto 12 ditto 
— 
12 „ 
— 
2 years - 
— 
13 „ 
— 
3 „ - - - - 
— 
14 „ 
-— 
4 „ - - - - 
— 
15 „ 
— 
5 „ - 
— 
16 „ 
— 
6 „ - - - 
— 
17 „ 
— 
7 „ - - - - 
— 
18 „ 
— 
8 „ 
— 
19 „ 
— 
(3.) Have the Tables used in the valuation, or the results 
of a valuation by such Tables, been in any way 
altered to suit special circumstances ? 
Valuation 
Age. 
Average Sickness 
per Annum in Weeks. 
Rate of Mortality 
per Cent. 
20 
— 
— 
25 
— 
— 
30 
— 
— 
35 
— 
— 
40 
— 
— 
45 
— 
— 
50 
— 
— 
55 
— 
60 
— 
— 
65 
— 
— 
70 
— 
— 
75 
— 
— 
80 
— 
— 
296 VALUATION.