QUARTERLY REPORT OF FEDERAL BUSINESS
ASSUMED AND OUTSTANDING
CERTIFIED REINSURERS – PLEASE FILE WITH THE U.S. DEPARTMENT OF TREASURY,
BUREAU OF THE FISCAL SERVICE, SURETY BOND SECTION, ON A QUARTERLY BASIS,
THE FOLLOWING INFORMATION:
For the Quarter ended________________:
1) $____________________ PENAL SUM OF ALL SURETY BONDS WRITTEN DURING
THE QUARTER WHERE THE U.S. GOVERNMENT WAS THE OBLIGEE OR CO-
OBLIGEE.
2) $___________________PENAL SUM OF ALL SURETY BONDS OUTSTANDING AS
OF THE END OF THE QUARTER WHERE THE U.S. GOVERNMENT WAS THE
OBLIGEE OR CO-OBLIGEE.
3) $___________________TOTAL AMOUNT OF FEDERAL BONDS WRITTEN.
4) CURRENTLY WRITING THE FOLLOWING TYPES OF FEDERAL SURETY
BONDS(i.e., Construction Contract, Customs, Land Reclamation, etc.):
5) CURRENTLY DOING BUSINESS WITH THE FOLLOWING FEDERAL AGENCIES (List
agency name and amount of business written below):
Name of Reporting Surety Company:
Contact Person’s Printed Name and Title:
Phone Number
Date:_______________________________
SURETY BOND BRANCH ~ 3700 EAST-WEST HIGHWAY, Rm. 6D22 ~ FAX (202) 874-9978
INTERNET WEB SITE: https://www.fiscal.treasury.gov/fsreports/ref/suretyBnd/surety_home.htm
Rev. 12/2019
RETURN THIS FORM TO:
surety.bonds@fiscal.treasury.gov
(and/or the financial analyst assigned to
examine the company)
