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H.—l2

SCHEDULE IX

1. What published table or tables^" and what rate or rates of interest have been used in the valuation of — (a) the sickness benefits, (b) the sums payable at death, (c) the widow and orphau fund, (d) the other benefits, if any (specifying them) ? State clearly whether the mortality risk is spread over all the lodges in the district; and, if so, how this circumstance has been taken into account in valuing the sums payable at death. 2. If a table or tables have been used which are not published, state clearly and fully, in the subjoined form, the rates of sickness and mortality assumed at quinquennial periods of age, from 20 to 80,' both inclusive; in other words, give the assumed rates at ages 20, 25, 30, 35, 40, 45, 50, 55, 00, 65, 70, 75, and 80.

* That is, the number of members or persons with whom contracts for the respective benefits are in force at the date of valuation ; in other words, the number of policies, so to speak, assuring lhe said benelits. t The total full sick-pay per week is to be made the basis ofthe first entry in this column. X Here state fully the rates of further reduced pay (if any), and the periods of continuous sickness to which these rates are applicable. § The third column of this table, giving the " Amount Assured," is not to be totalled. || Amongst these should be included the amount of those funds which from their nature do not admit of valuation, such as the management fund, benevolent fund, &c. m In describing the tables the name of the publication should be stated, together with the edition used, and the number of the page where the table may be found.

" Friendly Societies Act Ameni iment Act, 1878." independent order op odd fellows (manciie: STER UNITY) FRIENDLY SOCIETr. Lodge, No. , held at , ;he Valuation to be made by the Valuer 'aluation of the Assets and Liabilities of the as at tho of , 18 . —[Abstract of t appointed by the Lodge.] Summary of Results of Valuation, at s at , 18 . Present Value of i Total Yearl Contribu-i Nature of Benefits Assured. No. of Benefits.* Total Amount Assured.f tions applicable to Benefits. Benefits. Contributions applicable to Benefits. Sickness allowance of shillings per week during the first months of continuous sickness, shillings per week during and J Sums payable at the death of members... Sums payable at the death of members' wives Other benefits capable of valuation (to be specified) £ s. d. £ s. d. cC . Total§ Dr. Valui ttion Bala. <ce Sheet as at , 18 Cr. £ £ To Present value of benefits assured by the lodne, as per summary ... Other li abilities jj—viz., (Full particulars to be given) Surplus (if any) By Total funds as per Secretary's return Present value of future contributions applicable to benefits, as por summary Other assets —viz., (Fullparticulars to be given) ... Deficiency (if any) ... Total Total

Valuation Age. Rate of Sickness. Rate of Mortality.