NEW MEXICO TITLE INSURANCE AGENCY STATISTICAL REPORT SCHEDULE B - PREMIUMS BY INSURER For the Calendar Year Ending December 31, 20___. Name of each insurer for which this agency charged premiums Title premiums written by this agency Title premiums remitted or owed by this agency to insurers Title premiums retained by this agency Total (Carry total forward to Schedule A, line A-1) (Carry total forward to Schedule A, line A-2) (Carry total forward to Schedule A, line A-3) Percentage of premiums remitted: 0.0%

NEW MEXICO TITLE INSURANCE AGENCY STATISTICAL REPORT

SCHEDULE B - PREMIUMS BY INSURER

For the Calendar Year Ending December 31, 20___.

Name of each insurer for which this agency charged premiums

Title premiums written by this agency

Title premiums remitted or owed by this agency to insurers

Title premiums retained by this agency

Total

(Carry total forward to Schedule A, line A-1)

(Carry total forward to Schedule A, line A-2)

(Carry total forward to Schedule A, line A-3)

Percentage of premiums remitted: 0.0%

[13.14.16.10 NMAC – Rp, 13.14.16.10 NMAC, 1/1/2021]