Attachment 3 - Audit Confirmation Sample.pdf
PDF 1 MB Posted
- Attached to
- Banking Safekeeping Depository Account Services
- Solicitation number
- 300000271989357
- Issued by
- Missouri
About this file
This is an Audit Confirmation Sample document issued by the Missouri Department of Commerce and Insurance, Division of Insurance Company Regulation, addressed to insurance companies maintaining securities on joint deposit with the Department. The document serves as a confirmation request for securities held in safekeeping at designated financial institutions as of December 31, 2025. Companies are required to verify the accuracy of listed securities, account values, and deposit information and return the signed confirmation within 30 days of the notice date. The sample indicates total capital and reserve accounts of $300,000.00 each, with detailed security descriptions including par values, coupon rates, maturity dates, and CUSIP identifiers for tracking purposes.
The confirmation process requires company representatives to sign and return the documentation to the Securities Section at the Department of Commerce and Insurance in Jefferson City, Missouri, or via email to DCIDeposit@insurance.mo.gov. Companies must notify the Department immediately if any discrepancies exist between the stated amounts and their internal records. This audit confirmation is part of the Department's Banking Safekeeping Depository Account Services contract opportunity, which establishes the framework for secure deposit of insurance company securities with qualified financial institutions under state oversight and regulatory compliance.
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Text version
SAMPLE
The above amounts are correct and in agreement with the company records
Company
Signature Title
Print Name Phone Number and/or Email Address 301 West High Street, Room 530, P.O. Box 690 · Jefferson City, Missouri 65102-0690 ·
Telephone 573/751-4126 · RelayMo TTY Dial 711 or 1-800-735-2966 http://www.dci.mo.gov 01/01/2022 08:38:01 9999-99997 BAP094084 094 BAP0685
Governor Mike Kehoe State of Missouri
Department of Commerce & Insurance Angela L. Nelson, Director
DIVISION OF INSURANCE COMPANY REGULATION
John F. Rehagen, Division Director
DEC 31, 20259999-99999
INSURANCE COMPANY
1111 STREET
CITY, STATE, ZIP
ATTN: SECURITIES INVESTMENTS/TREASURER
The records of the Missouri Department of Commerce and Insurance (the Department) indicate your Company has securities on joint deposit with the Department at [FINANCIAL INSTITUTION] in [LOCATION] as of December 31, 2025, in the amounts listed below.
If these figures are correct, please print, sign, and return this letter to the Securities Section, Department of Commerce and Insurance, P.O. Box 690, Jefferson City, Missouri 65102-0690 or email the completed letter to: DCIDeposit@insurance.mo.gov. Should this amount differ in any way, please advise.
** Responses are due within 30 days of the date of this notice. **
REQUIRED PAR VALUE
CAPITAL ACCOUNTS XXXXXXXXX xxxxxxxxx
RESERVE ACCOUNTS XXX XXX
SPECIAL ACCOUNTS XXXXXXXXX XXXXXXXXX
TOTALS 300,000.00 300,000.00
SECURITY DESCRIPTION COUPON
RATE
MATURITY
DATE
SECURITY
TYPE
CUSIP LOC TYPE
(C,R,S)
PAR MARKET
00000000 UNITED STATES TREAS NTS 2.500 05/15/2024 010 XXXXXXXXXX F S XXXXXXXXXX XXXXXXXXXX
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