Conn. Agencies Regs. § ScheduleA
1. Revocability of proxy. State whether or not the person giving the proxy has the power to revoke it. If the right of revocation before the proxy is exercised is limited or is subject to compliance with any formal procedure, briefly describe such limitation or procedure.
2. Dissenters’ rights of appraisal. Outline briefly the rights of appraisal or similar rights of dissenting security holders with respect to any matter to be acted upon and indicate any statutory procedure required to be followed by such security holders in order to perfect their rights. Where such rights may be exercised only within a limited time after the date of the adoption of a proposal, the filing of a charter amendment, or other similar act, state whether the person solicited will be notified of such date.
3. Persons making solicitations not subject to section 38a-147-10.
(c) If the solicitation is to be made by specially engaged employees or paid solicitors, state (1) the material features of any contract or arrangement for such solicitation and identify the parties, and (2) the cost or anticipated cost thereof.
(c) If action is to be taken with respect to the election of directors and if the persons solicited have cumulative voting rights, make a statement that they have such rights and state briefly the conditions precedent to the exercise thereof.
(d) State, as of the most recent practicable date, the approximate amount of each class of equity securities of the insurer or any of its parents, subsidiaries or affiliates other than directors’ qualifying shares, benefically owned directly or indirectly by him. If he is not the beneficial owner of any such securities, make a statement to that effect.
(c) If the plan to be acted upon may be amended, other than by a vote of security holders, in a manner which would materially increase the cost thereof to the insurer or materially alter the allocation of the benefits as between the groups specified in paragraph (b) of this item, the nature of such amendments should be specified.
(b) State (1) the approximate total amount necessary to fund the plan with respect to past services, the period over which such amount is to be paid and the estimated annual payments necessary to pay the total amount over such period;
(2) the estimated annual payment to be made with respect to current services; and (3) the amount of such annual payments to be made for the benefit of (a) each person named in item 7 of this schedule, (b) directors and officers as a group and (c) employees as a group.
(c) If the plan to be acted upon may be amended, other than by a vote of security holders, in a manner which would materially increase the cost thereof to the insurer or materially alter the allocation of the benefits as between the groups specified in subparagraph (b) (3) of this item, the nature of such amendments should be specified.
(b) If known, state separately the amount of securities called for or to be called for by warrants received or to be received by the following persons, naming each such person:
10. Options, warrants or rights. If action is to be taken with respect to the granting or extension of any options, warrants or rights, all referred to herein as "warrants," to purchase securities of the insurer or any subsidiary or affiliate, other than warrants issued to all security holders on a pro rata basis, furnish the following information:
(c) If known, state also the total amount of securities called for or to be called for by such warrants, received or to be received by all directors and officers of the company as a group and all employees, without naming them.
(c) If the shares of securities to be authorized or issued are other than additional shares of common stock of a class outstanding, the commissioner may require financial statements comparable to those contained in the annual report.
(a) If action is to be taken with respect to a merger, consolidation, acquisition or similar matter, furnish in brief outline the following information:
(b) For each company involved in a merger, consolidation or acquisition, the following financial statements should be furnished:
(3) a pro forma combined balance sheet and income and expenses statement for the last fiscal year giving effect to the necessary adjustments with respect to the resulting company.
(c) state the name and amount of each account affected by the restatement and the effect of the restatement thereon.
14. Matters not required to be submitted. If action is to be taken with respect to any matter which is not required to be submitted to a vote of security holders, state the nature of such matter, the reason for submitting it to a vote of security holders and what action is intended to be taken by the management in the event of a negative vote on the matter by the security holders.
15. Amendment of charter, bylaws or other documents. If action is to be taken with respect to any amendment of the insurer’s charter, bylaws or other documents as to which information is not required above, state briefly the reasons for and general effect of such amendment and the vote needed for its approval.
13. Restatement of accounts. If action is to be taken with respect to the restatement of any asset, capital or surplus of the insurer, furnish the following information:
12. Mergers, consolidations, acquisitions and similar matters.
11. Authorization or issuance of securities.
9. Pension and retirement plan. If action is to be taken with respect to any pension or retirement plan of the insurer, furnish the following information:
7. Remuneration and other transactions with management and others. Furnish the information reported or required in item One of Schedule SIS under the heading "Information Regarding Management and Directors" if action is to be taken with respect to (1) the election of directors, (2) any remuneration plan, contract or arrangement in which any director, nominee for election as a director, or officer of the insurer will participate, (3) any pension or retirement plan in which any such person will participate, or (4) the granting or extension to any such person of any options, warrants or rights to purchase any securities, other than warrants or rights issued to security holders, as such, on a pro rata basis. If the solicitation is made on behalf of persons other than the management, information shall be furnished only as to Item One-A of the aforesaid heading of Schedule SIS.
8. Bonus, profit sharing and other remuneration plans. If action is to be taken with respect to any bonus, profit sharing or other remuneration plan of the insurer, furnish the following information:
6. Nominees and directors. If action is to be taken with respect to the election of directors, furnish the following information, in tabular form to the extent practicable, with respect to each person nominated for election as a director and each other person whose term of office as a director will continue after the meeting:
4. Interest of certain persons in matters to be acted upon. Describe briefly any substantial interest, direct or indirect, by security holdings or otherwise, of any director, nominee for election for director, officer and, if the solicitation is made otherwise than on behalf of management, each person on whose behalf the solicitation is made, in any matter to be acted upon other than elections to office.
5. Voting securities and principal holders thereof.
(Effective September 25, 1992)