The statement shall be on forms furnished by the director and shall show:

(1) Gross amount of each kind of insurance transacted;

(2) Aggregate gross premiums charged;

(3) Aggregate of returned premiums paid to insureds;

(4) Aggregate of net premiums; and

(5) Additional information as required by the director.

Source: SL 1966, ch 111, ch 11, § 17 (2).