First Acceptance Insurance Company of Georgia, Inc.

QUARTERLY STATEMENT OF THE First Acceptance Insurance Company of Georgia, Inc. 0 4 OF Kennesaw IN THE STATE OF Georgia TO THE INSURANCE DEPARTMENT OF THE STATE OF AS OF SEPTEMBER 0, 04 PROPERTY AND CASUALTY 04

*508040000* PROPERTY AND CASUALTY COMPANIES ASSOCIATION EDITION QUARTERLY STATEMENT AS OF SEPTEMBER 0, 04 OF THE CONDITION AND AFFAIRS OF THE First Acceptance Insurance Company of Georgia, Inc. NAIC Group Code 6, 6 NAIC Company Code 508 Employer s ID Number 75-06057 (Current Period) (Prior Period) Organized under the Laws of Georgia, State of Domicile or Port of Entry Georgia Country of Domicile United States Incorporated/Organized 09/9/00 Commenced Business 0/0/00 Statutory Home Office 490 Bells Ferry Road, Suite 4, Kennesaw, GA, US 044 (Street and Number) (City or Town, State, Country and Zip Code) Main Administrative Office 8 Green Hills Village Drive Nashville, TN, US 75 65-7-4888 (Street and Number) (City or Town, State, Country and Zip Code) (Area Code) (Telephone Number) Mail Address 8 Green Hills Village Drive, Nashville, TN, US 75 (Street and Number or P.O. Box) (City or Town, State, Country and Zip Code) Primary Location of Books and Records 8 Green Hills Village Drive Nashville, TN, US 75 65-7-4888 (Street and Number) (City or Town, State, Country and Zip Code) (Area Code) (Telephone Number) Internet Web Site Address N/A Statutory Statement Contact Michael John Bodayle 65-844-907 (Name) (Area Code) (Telephone Number) (Extension) mbodayle@facins.com 65-844-806 (E-Mail Address) (Fax Number) OFFICERS Name Title Name Title Joseph Sandor Borbely, President Michael John Bodayle, Secretary-Treasurer Brent James Gay, Chief Financial Officer, OTHER OFFICERS Daniel Lawrence Walker, Sr Vice President-Oprations, DIRECTORS OR TRUSTEES Joseph Sandor Borbely Michael John Bodayle Christopher Patrick Wills State of County of Tennessee Davidson ss The officers of this reporting entity being duly sworn, each depose and say that they are the described officers of said reporting entity, and that on the reporting period stated above, all of the herein described assets were the absolute property of the said reporting entity, free and clear from any liens or claims thereon, except as herein stated, and that this statement, together with related exhibits, schedules and explanations therein contained, annexed or referred to, is a full and true statement of all the assets and liabilities and of the condition and affairs of the said reporting entity as of the reporting period stated above, and of its income and deductions therefrom for the period ended, and have been completed in accordance with the NAIC Annual Statement Instructions and Accounting Practices and Procedures manual except to the extent that: () state law may differ; or, () that state rules or regulations require differences in reporting not related to accounting practices and procedures, according to the best of their information, knowledge and belief, respectively. Furthermore, the scope of this attestation by the described officers also includes the related corresponding electronic filing with the NAIC, when required, that is an exact copy (except for formatting differences due to electronic filing) of the enclosed statement. The electronic filing may be requested by various regulators in lieu of or in addition to the enclosed statement. Joseph Sandor Borbely Michael John Bodayle Brent James Gay President Secretary-Treasurer Chief Financial Officer a. Is this an original filing? Yes [X] No [ ] Subscribed and sworn to before me this b. If no: day of November, 04. State the amendment number. Date filed. Number of pages attached Tracy Janeczko, Assistant Controller July 6, 05

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. ASSETS Assets Current Statement Date 4 Nonadmitted Assets Net Admitted Assets (Cols. - ) December Prior Year Net Admitted Assets. Bonds,0,588,0,588 5,9,96. Stocks:. Preferred stocks,70,800,70,800,578,000. Common stocks 0 0. Mortgage loans on real estate:. First liens 0 0. Other than first liens 0 0 4. Real estate: 4. Properties occupied by the company (less $ encumbrances) 0 0 4. Properties held for the production of income (less $ encumbrances) 0 0 4. Properties held for sale (less $ encumbrances) 0 0 5. Cash ($,58,78 ), cash equivalents ($ 0 ) and short-term investments ($,89,77 ) 5,978,498 5,978,498,765,77 6. Contract loans (including $ premium notes) 0 0 7. Derivatives 0 0 8. Other invested assets 0 0 0 9. Receivables for securities 0 0 0. Securities lending reinvested collateral assets 0 0. Aggregate write-ins for invested assets 0 0 0 0. Subtotals, cash and invested assets (Lines to ) 5,00,886 0 5,00,886 49,57,64. Title plants less $ charged off (for Title insurers only) 0 0 4. Investment income due and accrued 06,064 06,064,765 5. Premiums and considerations: 5. Uncollected premiums and agents balances in the course of collection,90,47,90,47,07,504 5. Deferred premiums, agents balances and installments booked but deferred and not yet due (including $ earned but unbilled premiums) 0,76,68 0,76,68 8,54,679 5. Accrued retrospective premiums 0 0 6. Reinsurance: 6. Amounts recoverable from reinsurers 0 0 6. Funds held by or deposited with reinsured companies 0 0 6. Other amounts receivable under reinsurance contracts 0 0 7. Amounts receivable relating to uninsured plans 0 0 8. Current federal and foreign income tax recoverable and interest thereon 0 0 8. Net deferred tax asset 0 0 9. Guaranty funds receivable or on deposit 0 0 0. Electronic data processing equipment and software 0 0. Furniture and equipment, including health care delivery assets ($ ) 0 0. Net adjustment in assets and liabilities due to foreign exchange rates 0 0. Receivables from parent, subsidiaries and affiliates,,54,,54,7,6 4. Health care ($ ) and other amounts receivable 0 0 5. Aggregate write-ins for other-than-invested assets 78,5 78,5 0 0 6. Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines to 5) 67,74,7 78,5 67,96, 60,655,75 7. From Separate Accounts, Segregated Accounts and Protected Cell Accounts 0 0 8. Total (Lines 6 and 7) 67,74,7 78,5 67,96, 60,655,75 DETAILS OF WRITE-INS 0. 0 0 0. 0 0 0. 0 0 98. Summary of remaining write-ins for Line from overflow page 0 0 0 0 99. Totals (Lines 0 through 0 plus 98) (Line above) 0 0 0 0 50. Prepaid Expenses 77,87 77,87 0 0 50. Due From Vendors 674 674 0 0 50. Rounding 0 0 598. Summary of remaining write-ins for Line 5 from overflow page 0 0 0 0 599. Totals (Lines 50 through 50 plus 598) (Line 5 above) 78,5 78,5 0 0

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. LIABILITIES, SURPLUS AND OTHER FUNDS Current Statement Date December, Prior Year. Losses (current accident year $,7,000 ) 9,706,657 7,99,758. Reinsurance payable on paid losses and loss adjustment expenses,89,80,048,69. Loss adjustment expenses,95,656,84,48 4. Commissions payable, contingent commissions and other similar charges 0 5. Other expenses (excluding taxes, licenses and fees) 6,064 5,797 6. Taxes, licenses and fees (excluding federal and foreign income taxes) 908,8,00,7 7.Current federal and foreign income taxes (including $ on realized capital gains (losses)) 0 7. Net deferred tax liability 0 8. Borrowed money $ and interest thereon $ 0 9. Unearned premiums (after deducting unearned premiums for ceded reinsurance of $,00,66 and including warranty reserves of $ and accrued accident and health experience rating refunds including $ for medical loss ratio rebate per the Public Health Service Act) 7,79,70 4,7,70 0. Advance premium 54,9 50,857. Dividends declared and unpaid:. Stockholders 0. Policyholders 0. Ceded reinsurance premiums payable (net of ceding commissions) 8,068 6,87. Funds held by company under reinsurance treaties 0 4. Amounts withheld or retained by company for account of others 0 5. Remittances and items not allocated 0 6. Provision for reinsurance (including $ certified) 0 7. Net adjustments in assets and liabilities due to foreign exchange rates 0 8. Drafts outstanding 0 9. Payable to parent, subsidiaries and affiliates 9,9 0,9 0. Derivatives 0. Payable for securities 0. Payable for securities lending 0. Liability for amounts held under uninsured plans 0 4. Capital notes $ and interest thereon $ 0 5. Aggregate write-ins for liabilities 0 76 6. Total liabilities excluding protected cell liabilities (Lines through 5) 45,85,95 9,97,69 7. Protected cell liabilities 0 8. Total liabilities (Lines 6 and 7) 45,85,95 9,97,69 9. Aggregate write-ins for special surplus funds 0 0 0. Common capital stock,500,000,500,000. Preferred capital stock 0. Aggregate write-ins for other than special surplus funds 0 0. Surplus notes 0 4. Gross paid in and contributed surplus 0,866,57 0,866,57 5. Unassigned funds (surplus) 6. Less treasury stock, at cost: (0,896,96) (,008,5) 6. shares common (value included in Line 0 $ ) 0 6. shares preferred (value included in Line $ ) 0 7. Surplus as regards policyholders (Lines 9 to 5, less 6),470,77,58,060 8. Totals (Page, Line 8, Col. ) 67,96, 60,655,75 DETAILS OF WRITE-INS 50. Unclaimed Checks 0 76 50. 0 50. 0 598. Summary of remaining write-ins for Line 5 from overflow page 0 0 599. Totals (Lines 50 through 50 plus 598) (Line 5 above) 0 76 90. 0 90. 0 90. 0 998. Summary of remaining write-ins for Line 9 from overflow page 0 0 999. Totals (Lines 90 through 90 plus 998) (Line 9 above) 0 0 0. 0 0. 0 0. 0 98. Summary of remaining write-ins for Line from overflow page 0 0 99. Totals (Lines 0 through 0 plus 98) (Line above) 0 0

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. STATEMENT OF INCOME Current Year to Date Prior Year to Date Prior Year Ended December UNDERWRITING INCOME. Premiums earned:. Direct (written $,688,44 ) 0,, 8,759,454 7,8,60. Assumed (written $ 45,70,064 ) 4,6,084 9,8,50 5,994,96. Ceded (written $,688,44 ) 0,, 8,759,454 7,8,60.4 Net (written $ 45,70,064 ) 4,6,084 9,8,50 5,994,96 DEDUCTIONS:. Losses incurred (current accident year $ 7,59,000 ):. Direct 8,97,95 8,06,75 4,095,45. Assumed 6,57,599,5,098,,64. Ceded 8,97,95 8,06,75 4,095,45.4 Net 6,57,599,5,098,,64. Loss adjustment expenses incurred 4,664,957 4,755,655 5,95,75 4. Other underwriting expenses incurred 5,805,5 4,978,087 9,7,8 5. Aggregate write-ins for underwriting deductions 0 0 () 6. Total underwriting deductions (Lines through 5) 46,87,809 4,45,840 56,870,80 7. Net income of protected cells 0 0 8. Net underwriting gain (loss) (Line minus Line 6 + Line 7) (4,664,75) (,97,590) (4,876,64) INVESTMENT INCOME 9. Net investment income earned 974,95,09,78,44,689 0. Net realized capital gains (losses) less capital gains tax of $ (6,54) (6,54). Net investment gain (loss) (Lines 9 + 0) 974,95,08,77,80,48 OTHER INCOME. Net gain or (loss) from agents' or premium balances charged off (amount recovered $ amount charged off $ ) 0 0. Finance and service charges not included in premiums,680,59,484,96 4,60,604 4. Aggregate write-ins for miscellaneous income 0 5. Total other income (Lines through 4),680,60,484,96 4,60,605 6. Net income before dividends to policyholders, after capital gains tax and before all other federal and foreign income taxes (Lines 8 + + 5) (0,70) 595,44,07,9 7. Dividends to policyholders 0 0 8. Net income, after dividends to policyholders, after capital gains tax and before all other federal and foreign income taxes (Line 6 minus Line 7) (0,70) 595,44,07,9 9. Federal and foreign income taxes incurred 0 0 0. Net income (Line 8 minus Line 9)(to Line ) (0,70) 595,44,07,9 CAPITAL AND SURPLUS ACCOUNT. Surplus as regards policyholders, December prior year,58,060 9,940,56 9,940,56. Net income (from Line 0) (0,70) 595,44,07,9. Net transfers (to) from Protected Cell accounts 0 0 4. Change in net unrealized capital gains or (losses) less capital gains tax of $ 44,9 (60,80) (4,794) 5. Change in net unrealized foreign exchange capital gain (loss) 0 0 6. Change in net deferred income tax 0 0 7. Change in nonadmitted assets (,005) (5,80) () 8. Change in provision for reinsurance 0 0 9. Change in surplus notes 0 0 0. Surplus (contributed to) withdrawn from protected cells 0 0. Cumulative effect of changes in accounting principles 0 0. Capital changes:. Paid in 0 0. Transferred from surplus (Stock Dividend) 0 0. Transferred to surplus 0 0. Surplus adjustments:. Paid in 0 0. Transferred to capital (Stock Dividend) 0 0. Transferred from capital 0 0 4. Net remittances from or (to) Home Office 0 0 5. Dividends to stockholders 0 0 6. Change in treasury stock 0 0 7. Aggregate write-ins for gains and losses in surplus () 54,50 54,50 8. Change in surplus as regards policyholders (Lines through 7),7 87,59,47,54 9. Surplus as regards policyholders, as of statement date (Lines plus 8),470,77 0,777,885,58,060 DETAILS OF WRITE-INS 050. Rounding 0 () 050. Litigation Settlement 0 0 050. 0598. Summary of remaining write-ins for Line 5 from overflow page 0 0 0 0599. TOTALS (Lines 050 through 050 plus 0598) (Line 5 above) 0 0 () 40. Rounding 0 40. 0 0 40. 0 0 498. Summary of remaining write-ins for Line 4 from overflow page 0 0 0 499. TOTALS (Lines 40 through 40 plus 498) (Line 4 above) 0 70. Rounding () 70. Prior Period Adjustment 54,59 54,59 70. 0 0 798. Summary of remaining write-ins for Line 7 from overflow page 0 0 0 799. TOTALS (Lines 70 through 70 plus 798) (Line 7 above) () 54,50 54,50 4

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. CASH FLOW Current Year To Date Prior Year To Date Prior Year Ended December Cash from Operations. Premiums collected net of reinsurance 4,647,75 9,60,50 5,078,797. Net investment income,0,094,,860,56,665. Miscellaneous income,680,60,484,96 4,60,605 4. Total (Lines to ) 46,9,06 44,6,686 59,09,067 5. Benefit and loss related payments 4,0,589,78,967 0,06,40 6. Net transfers to Separate Accounts, Segregated Accounts and Protected Cell Accounts 0 0 0 7. Commissions, expenses paid and aggregate write-ins for deductions 0,489,605 9,96,76 5,98,088 8. Dividends paid to policyholders 0 0 0 9. Federal and foreign income taxes paid (recovered) net of $ tax on capital gains (losses) 0 0 0 0. Total (Lines 5 through 9) 44,79,94 4,80,4 55,504,58. Net cash from operations (Line 4 minus Line 0),546,9,056,54,704,549 Cash from Investments. Proceeds from investments sold, matured or repaid:. Bonds,860,85,0,5,49,850. Stocks 0 0 0. Mortgage loans 0 0 0.4 Real estate 0 0 0.5 Other invested assets 0 0 0.6 Net gains or (losses) on cash, cash equivalents and short-term investments 0 0 0.7 Miscellaneous proceeds 0 60,58 60,59.8 Total investment proceeds (Lines. to.7),860,85,6,670,500,69. Cost of investments acquired (long-term only):. Bonds 0. Stocks 0 0 0. Mortgage loans 0 0 0.4 Real estate 0 0 0.5 Other invested assets 0 0 0.6 Miscellaneous applications 0 60,590 60,590.7 Total investments acquired (Lines. to.6) 60,590 60,59 4. Net increase (or decrease) in contract loans and premium notes 0 0 0 5. Net cash from investments (Line.8 minus Line.7 and Line 4),860,84,0,080,49,777 Cash from Financing and Miscellaneous Sources 6. Cash provided (applied): 6. Surplus notes, capital notes 0 0 0 6. Capital and paid in surplus, less treasury stock 0 0 0 6. Borrowed funds 0 0 0 6.4 Net deposits on deposit-type contracts and other insurance liabilities 0 0 6.5 Dividends to stockholders 0 0 0 6.6 Other cash provided (applied) (94,964),74,096,,484 7. Net cash from financing and miscellaneous sources (Line 6. through Line 6.4 minus Line 6.5 plus Line 6.6) (94,964),74,096,,484 RECONCILIATION OF CASH, CASH EQUIVALENTS AND SHORT-TERM INVESTMENTS 8. Net change in cash, cash equivalents and short-term investments (Line, plus Lines 5 and 7),,77 6,99,79 8,57,80 9. Cash, cash equivalents and short-term investments: 9. Beginning of year,765,77 4,507,96 4,507,96 9. End of period (Line 8 plus Line 9.) 5,978,498,499,65,765,77 5

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. NOTES TO FINANCIAL STATEMENTS. Summary of Significant Accounting Policies A. Accounting Practices State of Domicile 04 0 NET INCOME () Company state basis (Page 4, Line 0, Columns & ) Georgia... $...(0,70) $...,07,9 (4) NAIC SAP (--=4) Georgia... $...(0,70) $...,07,9 SURPLUS (5) Company state basis (Page, Line 7, Columns & ) Georgia... $...,470,77 $...,58,060 (8) NAIC SAP (5-6-7=8) Georgia... $,470,77 $...,58,060. Accounting Changes and Corrections of Errors. Business Combinations and Goodwill 4. Discontinued Operations 5. Investments 6. Joint Ventures, Partnerships and Limited Liability Companies 7. Investment Income 8. Derivative Instruments 9. Income Taxes No significant change. 0. Information Concerning Parent, Subsidiaries, Affiliates and Other Related Parties D.. At September 0, 04 the Company was owed $,,54 on account from affiliates and such amount was fully repaid prior to October, 04.. Debt. Retirement Plans, Deferred Compensation, Postemployment Benefits and Compensated Absences and Other Postretirement Benefit Plans.. Capital and Surplus, Dividend Restrictions and Quasi-Reorganizations 4. Contingencies No significant changes. 5. Leases No significant changes. 6. Information About Financial Instruments With Off-Balance-Sheet Risk And Financial Instruments With Concentrations of Credit Risk 7. Sale, Transfer and Servicing of Financial Assets and Extinguishments of Liabilities 8. Gain or Loss to the Reporting Entity from Uninsured Plans and the Uninsured Portion of Partially Insured Plans 9. Direct Premium Written/Produced by Managing General Agents/Third Party Administrators The Company wrote $,688,44 in direct premiums written for the nine months ended September 0, 04 through the following affiliated MGA: Acceptance Insurance Agency of Tennessee, Inc. ( Acceptance ) Nashville, TN FEIN Number: 6-55707 Acceptance operates under an exclusive contract with the Company. It writes only private-passenger non-standard automobile insurance in the state of Georgia, has binding authority, and also handles premium collection. 0. Fair Value Measurements A. () Fair Value Measurements at Reporting Date Description for each class of asset or liability (Level ) (Level ) (Level ) Total a. Assets at fair value Perpetual Preferred Stock $,70,800 $ $ $,70,800 Bonds $ - $ 5,498,65 $ $ 5,498,65 Total assets at fair value $,70,800 $ 5,498,65 $ $ 7,9,45. Other Items. Events Subsequent No significant subsequent events. 6

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc.. Reinsurance No significant changes. 4. Retrospectively Rated Contracts & Contracts Subject to Redetermination 5. Changes in Incurred Losses and Loss Adjustment Expenses Reserves for incurred losses and loss adjustment expenses attributable to insured events of prior years have decreased by approximately $. million from December, 0 to September 0, 04 as a result of the re-estimation of unpaid losses and loss adjustment expenses. This change is generally the result of the ongoing analysis of recent loss development trends. Original estimates are increased or decreased as additional information becomes known regarding actual losses. 6. Intercompany Pooling Arrangements The Company participates in a quota share reinsurance pooling arrangement with the following affiliated companies (the Pooling Arrangement ) NAIC Pooling Pool Participant Code % First Acceptance Insurance Company, Inc. (Lead Reinsurer) 06 66% First Acceptance Insurance Company of Georgia, Inc. 508 6% First Acceptance Insurance Company of Tennessee, Inc. 85 8% Under the terms of the Pooling Arrangement, the Pool Participants cede to the Lead Reinsurer all of their insurance business and assume from the Lead Reinsurer an amount equal to their respective pooling percentages as outlined in the Pooling Arrangement. All premiums, losses, loss adjustment expenses, underwriting expenses and the related finance and service charge income are allocated among the Pool Participants on the basis of each company s respective pooling percentages as outlined in the Pooling Arrangement. The Pooling Arrangement provides indemnification against loss or liability relating to insurance risk and has been accounted for as reinsurance. Per SSAP No. 6 Property and Casualty Reinsurance, ceded reinsurance premiums payable may be deducted from amount due from the reinsurer when a legal right of offset exists. As the Pooling Agreement provides for the right of offset, the Company has netted within the Statement of Assets and Liabilities the amount due to the Lead Reinsurer under ceded reinsurance premiums payable with the amount due from the Lead Reinsurer on assumed reinsurance premiums receivable for transactions under the Pooling Arrangement. The following tabular presentation reflects the ceded reinsurance premiums payable and assumed premiums receivable at September 0, 04, between each Pool Participant and the Lead Reinsurer resulting in the net amount due to or due from the Lead Reinsurer. Balances at 9/0/4 Assumed Reinsurance Receivable Ceded Reinsurance Payable Net Assumed Reinsurance Receivable / (Net Ceded Reinsurance Payable) First Acceptance Insurance Company, Inc. $ (,58,7) $ (7,677,089) $ (,906,64) First Acceptance Insurance Company of Georgia, Inc. $ (6,09,894) $ (9,084,05) $,874,40 First Acceptance Insurance Company of Tennessee, Inc. $ (,467,94) $ (,499,697) $,0,50 7. Structured Settlements 8. Health Care Receivables 9. Participating Policies 0. Premium Deficiency Reserves. High Deductibles. Discounting of Liabilities for Unpaid Losses or Unpaid Loss Adjustment Expenses. Asbestos/Environmental Reserves 4. Subscriber Savings Accounts 5. Multiple Peril Crop Insurance 6. Financial Guaranty Insurance 6.

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. GENERAL INTERROGATORIES PART - COMMON INTERROGATORIES GENERAL. Did the reporting entity experience any material transactions requiring the filing of Disclosure of Material Transactions with the State of Domicile, as required by the Model Act? Yes [ ] No [X]. If yes, has the report been filed with the domiciliary state? Yes [ ] No [ ]. Has any change been made during the year of this statement in the charter, by-laws, articles of incorporation, or deed of settlement of the reporting entity? Yes [ ] No [X]. If yes, date of change:. Is the reporting entity a member of an Insurance Holding Company System consisting of two or more affiliated persons, one or more of which is an insurer? Yes [X] No [ ] If yes, complete Schedule Y, Parts and A.. Have there been any substantial changes in the organizational chart since the prior quarter end? Yes [ ] No [X]. If the response to. is yes, provide a brief description of those changes. 4. Has the reporting entity been a party to a merger or consolidation during the period covered by this statement? Yes [ ] No [X] 4. If yes, provide the name of entity, NAIC Company Code, and state of domicile (use two letter state abbreviation) for any entity that has ceased to exist as a result of the merger or consolidation. Name of Entity NAIC Company Code State of Domicile 5. If the reporting entity is subject to a management agreement, including third-party administrator(s), managing general agent(s), attorney-infact, or similar agreement, have there been any significant changes regarding the terms of the agreement or principals involved? Yes [ ] No [X] NA [ ] 6. If yes, attach an explanation. State as of what date the latest financial examination of the reporting entity was made or is being made. //00 6. State the as of date that the latest financial examination report became available from either the state of domicile or the reporting entity. This date should be the date of the examined balance sheet and not the date the report was completed or released. //00 6. State as of what date the latest financial examination report became available to other states or the public from either the state of domicile or the reporting entity. This is the release date or completion date of the examination report and not the date of the examination (balance sheet date). 0//0 6.4 By what department or departments? Georgia Department of Insurance 6.5 Have all financial statement adjustments within the latest financial examination report been accounted for in a subsequent financial statement filed with Departments? Yes [ ] No [ ] NA [X] 6.6 Have all of the recommendations within the latest financial examination report been complied with? Yes [X] No [ ] NA [ ] 7. Has this reporting entity had any Certificates of Authority, licenses or registrations (including corporate registration, if applicable) suspended or revoked by any governmental entity during the reporting period? Yes [ ] No [X] 7. If yes, give full information: 8. Is the company a subsidiary of a bank holding company regulated by the Federal Reserve Board? Yes [ ] No [X] 8. If response to 8. is yes, please identify the name of the bank holding company. 8. Is the company affiliated with one or more banks, thrifts or securities firms? Yes [ ] No [X] 8.4 If response to 8. is yes, please provide below the names and location (city and state of the main office) of any affiliates regulated by a federal regulatory services agency [i.e. the Federal Reserve Board (FRB), the Office of the Comptroller of the Currency (OCC), the Federal Deposit Insurance Corporation (FDIC) and the Securities Exchange Commission (SEC)] and identify the affiliate s primary federal regulator.] Affiliate Name Location (City, State) FRB 4 OCC 5 FDIC 6 SEC 7

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. GENERAL INTERROGATORIES 9. Are the senior officers (principal executive officer, principal financial officer, principal accounting officer or controller, or persons performing similar functions) of the reporting entity subject to a code of ethics, which includes the following standards? Yes [X] No [ ] (a) Honest and ethical conduct, including the ethical handling of actual or apparent conflicts of interest between personal and professional relationships; (b) Full, fair, accurate, timely and understandable disclosure in the periodic reports required to be filed by the reporting entity; (c) Compliance with applicable governmental laws, rules and regulations; (d) The prompt internal reporting of violations to an appropriate person or persons identified in the code; and (e) Accountability for adherence to the code. 9. If the response to 9. is No, please explain: 9. Has the code of ethics for senior managers been amended? Yes [ ] No [X] 9. If the response to 9. is Yes, provide information related to amendment(s). 9. Have any provisions of the code of ethics been waived for any of the specified officers? Yes [ ] No [X] 9. If the response to 9. is Yes, provide the nature of any waiver(s). FINANCIAL 0. Does the reporting entity report any amounts due from parent, subsidiaries or affiliates on Page of this statement? Yes [X] No [ ] 0. If yes, indicate any amounts receivable from parent included in the Page amount: $,09,76 INVESTMENT. Were any of the stocks, bonds, or other assets of the reporting entity loaned, placed under option agreement, or otherwise made available for use by another person? (Exclude securities under securities lending agreements.). If yes, give full and complete information relating thereto: Yes [ ] No [X]. Amount of real estate and mortgages held in other invested assets in Schedule BA: $. Amount of real estate and mortgages held in short-term investments: $ 4. Does the reporting entity have any investments in parent, subsidiaries and affiliates? Yes [ ] No [X] 4. If yes, please complete the following: Prior Year-End Book/Adjusted Carrying Value Current Quarter Book/Adjusted Carrying Value 4. Bonds $ $ 4. Preferred Stock $ $ 4. Common Stock $ $ 4.4 Short-Term Investments $ $ 4.5 Mortgage Loans on Real Estate $ $ 4.6 All Other $ $ 4.7 Total Investment in Parent, Subsidiaries and Affiliates (Subtotal Lines 4. to 4.6) $ 0 $ 0 4.8 Total Investment in Parent included in Lines 4. to 4.6 above $ $ 5. Has the reporting entity entered into any hedging transactions reported on Schedule DB? Yes [ ] No [X] 5. If yes, has a comprehensive description of the hedging program been made available to the domiciliary state? Yes [ ] No [ ] If no, attach a description with this statement. 7.

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. GENERAL INTERROGATORIES 6 For the reporting entity s security lending program, state the amount of the following as of the current statement date: 6. Total fair value of reinvested collateral assets reported on Schedule DL, Parts and $ 6. Total book adjusted/carrying value of reinvested collateral assets reported on Schedule DL, Parts and $ 6. Total payable for securities lending reported on the liability page $ 7. Excluding items in Schedule E Part Special Deposits, real estate, mortgage loans and investments held physically in the reporting entity s offices, vaults or safety deposit boxes, were all stocks, bonds and other securities, owned throughout the current year held pursuant to a custodial agreement with a qualified bank or trust company in accordance with Section, III General Examination Considerations, F. Outsourcing of Critical Functions, Custodial or Safekeeping Agreements of the NAIC Financial Condition Examiners Handbook? Yes [X] No [ ] 7. For all agreements that comply with the requirements of the NAIC Financial Condition Examiners Handbook, complete the following: Name of Custodian(s) Bank of America-Merrill Lynch Chicago, IL Custodian Address 7. For all agreements that do not comply with the requirements of the NAIC Financial Condition Examiners Handbook, provide the name, location and a complete explanation: Name(s) Location(s) Complete Explanation(s) 7. Have there been any changes, including name changes, in the custodian(s) identified in 7. during the current quarter? Yes [ ] No [X] 7.4 If yes, give full and complete information relating thereto: Old Custodian New Custodian Date of Change 4 Reason 7.5 Identify all investment advisors, broker/dealers or individuals acting on behalf of broker/dealers that have access to the investment accounts, handle securities and have authority to make investments on behalf of the reporting entity: Central Registration Depository Name(s) Not applicable DTF Holdings, LLC New York, NY Address 8. Have all the filing requirements of the Purposes and Procedures Manual of the NAIC Securities Valuation Office been followed? Yes [X] No [ ] 8. If no, list exceptions: 7.

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. GENERAL INTERROGATORIES PART - PROPERTY & CASUALTY INTERROGATORIES. If the reporting entity is a member of a pooling arrangement, did the agreement or the reporting entity's participation change? Yes [ ] No [X] NA [ ] If yes, attach an explanation.. Has the reporting entity reinsured any risk with any other reporting entity and agreed to release such entity from liability, in whole or in part, from any loss that may occur on the risk, or portion thereof, reinsured? Yes [ ] No [X] If yes, attach an explanation.. Have any of the reporting entity's primary reinsurance contracts been canceled? Yes [ ] No [X]. If yes, give full and complete information thereto. 4. Are any of the liabilities for unpaid losses and loss adjustment expenses other than certain workers' compensation tabular reserves (see Annual Statement Instructions pertaining to disclosure of discounting for definition of tabular reserves, ) discounted at a rate of interest greater than zero? Yes [ ] No [X] 4. If yes, complete the following schedule: Line of Business Maximum Interest Discount Rate 4 Unpaid Losses TOTAL DISCOUNT 5 6 Unpaid LAE IBNR 7 TOTAL DISCOUNT TAKEN DURING PERIOD 8 9 0 Unpaid Unpaid Losses LAE IBNR TOTAL TOTAL 0 0 0 0 0 0 0 0 5. Operating Percentages: 5. A&H loss percent % 5. A&H cost containment percent % 5. A&H expense percent excluding cost containment expenses % 6. Do you act as a custodian for health savings accounts? Yes [ ] No [X] 6. If yes, please provide the amount of custodial funds held as of the reporting date. $ 6. Do you act as an administrator for health savings accounts? Yes [ ] No [X] 6.4 If yes, please provide the balance of the funds administered as of the reporting date. $ 8

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. NAIC Company Code ID Number Name of Reinsurer SCHEDULE F - CEDED REINSURANCE Showing All New Reinsurance Treaties - Current Year to Date 4 Domiciliary Jurisdiction Type of Reinsurer 5 6 Certified Reinsurer Rating ( through 6) 7 Effective Date of Certified Reinsurer Rating 9

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. States, etc. SCHEDULE T - EXHIBIT OF PREMIUMS WRITTEN Current Year to Date - Allocated by States and Territories Direct Premiums Written Direct Losses Paid (Deducting Salvage) Direct Losses Unpaid 4 5 6 7 Active Status Current Year To Date Prior Year To Date Current Year To Date Prior Year To Date Current Year To Date Prior Year To Date. Alabama AL N 0 0 0. Alaska AK N 0 0 0. Arizona AZ N 0 0 0 4. Arkansas AR N 0 0 0 5. California CA N 0 0 0 6. Colorado CO N 0 0 0 7. Connecticut CT N 0 0 0 8. Delaware DE N 0 0 0 9. Dist. Columbia DC N 0 0 0 0. Florida FL N 0 0 0. Georgia GA L,688,44 9,6,80 7,889,09 8,44,75,87,5,004,70. Hawaii HI N 0 0 0. Idaho ID N 0 0 0 4. Illinois IL N 0 0 0 5. Indiana IN N 0 0 0 6. Iowa IA N 0 0 0 7. Kansas KS N 0 0 0 8. Kentucky KY N 0 0 0 9. Louisiana LA N 0 0 0 0. Maine ME N 0 0 0. Maryland MD N 0 0 0. Massachusetts MA N 0 0 0. Michigan MI N 0 0 0 4. Minnesota MN N 0 0 0 5. Mississippi MS N 0 0 0 6. Missouri MO N 0 0 0 7. Montana MT N 0 0 0 8. Nebraska NE N 0 0 0 9. Nevada NV N 0 0 0 0. New Hampshire NH N 0 0 0. New Jersey NJ N 0 0 0. New Mexico NM N 0 0 0. New York NY N 0 0 0 4. No. Carolina NC N 0 0 0 5. No. Dakota ND N 0 0 0 6. Ohio OH N 0 0 0 7. Oklahoma OK N 0 0 0 8. Oregon OR N 0 0 0 9. Pennsylvania PA N 0 0 0 40. Rhode Island RI N 0 0 0 4. So. Carolina SC N 0 0 0 4. So. Dakota SD N 0 0 0 4. Tennessee TN N 0 0 0 44. Texas TX N 0 0 0 45. Utah UT N 0 0 0 46. Vermont VT N 0 0 0 47. Virginia VA N 0 0 0 48. Washington WA N 0 0 0 49. West Virginia WV N 0 0 0 50. Wisconsin WI N 0 0 0 5. Wyoming WY N 0 0 0 5. American Samoa AS N 0 0 0 5. Guam GU N 0 0 0 54. Puerto Rico PR N 0 0 0 55. U.S. Virgin Islands VI N 0 0 0 56. Northern Mariana Islands MP N 0 0 0 57. Canada CAN N 0 0 0 58. Aggregate Other Alien OT XXX 0 0 0 0 0 0 59. Totals (a),688,44 9,6,80 7,889,09 8,44,75,87,5,004,70 DETAILS OF WRITE-INS 5800. XXX 5800. XXX 5800. XXX 58998. Summary of remaining writeins for Line 58 from overflow page XXX 0 0 0 0 0 0 58999. TOTALS (Lines 5800 through 5800 plus 58998) (Line 58 above) XXX 0 0 0 0 0 0 (L) Licensed or Chartered - Licensed Insurance Carrier or Domiciled RRG; (R) Registered - Non-domiciled RRGs; (Q) Qualified - Qualified or Accredited Reinsurer; (E) Eligible - Reporting Entities eligible or approved to write Surplus Lines in the state; (N) None of the above - Not allowed to write business in the state. (a) Insert the number of L responses except for Canada and Other Alien. 0

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. SCHEDULE Y - INFORMATION CONCERNING ACTIVITIES OF INSURER MEMBERS OF A HOLDING COMPANY GROUP PART - ORGANIZATIONAL CHART

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. SCHEDULE Y PART A DETAIL OF INSURANCE HOLDING COMPANY SYSTEM Group Code 06 Group Name NAIC Company Code 4 Federal ID Number First Acceptance Insurance Group 06 6-6506 00000 00000 First Acceptance Insurance 06 Group 508 75-06057 First Acceptance Insurance 06 Group 85 0-55088 5 Federal RSSD 6 CIK 00007907 7 Name of Securities Exchange if Publicly Traded (U.S. or International) 8 Name of Parent Subsidiaries or Affiliates 9 Domiciliary Location 0 Relationship to Reporting Entity Directly Controlled by (Name of Entity/Person) Type of Control (Ownership, Board, Management, Attorney-in-Fact, Influence, Other) If Control is Ownership Provide Percentage 4 Ultimate Controlling Entity(ies)/ Person(s) * New York Stock Exchange First Acceptance Corporation DE UIP Gerald J. Ford Ownership 59.0 Gerald J. Ford 0 USAuto Holdings, Inc. DE UIP First Acceptance Corporation Ownership 00.0 Gerald J. Ford 0 First Acceptance Insurance Company, Inc. TX UDP USAuto Holdings, Inc. Ownership 00.0 Gerald J. Ford 0 Acceptance Insurance Agency of Tennessee, Inc. TN NIA USAuto Holdings, Inc. Ownership 00.0 Gerald J. Ford 0 Transit Automobile Club, Inc. TN NIA USAuto Holdings, Inc. Ownership 00.0 Gerald J. Ford 0 Acceptance Life Insurance Reinsurance Company, Ltd. ZZZ NIA USAuto Holdings, Inc. Ownership 00.0 Gerald J. Ford 0 First Acceptance Insurance First Acceptance Insurance Company of Georgia, Inc. GA Company, Inc. Ownership 00.0 Gerald J. Ford 0 First Acceptance Insurance Company of Tennessee, Inc. TN IA First Acceptance Insurance Company, Inc. Ownership 00.0 Gerald J. Ford 0 0.0 0 0.0 0 0.0 0 0.0 0 5 Asterisk Explanation

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. PART - LOSS EXPERIENCE Direct Premiums Earned Current Year to Date 4 Direct Losses Direct Loss Incurred Percentage Prior Year to Date Direct Loss Percentage Line of Business. Fire 0.0 0.0. Allied lines 0.0 0.0. Farmowners multiple peril 0.0 0.0 4. Homeowners multiple peril 86,950,674 66.. 5. Commercial multiple peril 0.0 0.0 6. Mortgage guaranty 0.0 0.0 8. Ocean marine 0.0 0.0 9. Inland marine 0.0 0.0 0. Financial guaranty 0.0 0.0. Medical professional liability -occurrence 0.0 0.0. Medical professional liability -claims made 0.0 0.0. Earthquake 0.0 0.0. Group accident and health 0.0 0.0 4. Credit accident and health 0.0 0.0 5. Other accident and health 0.0 0.0 6. Workers compensation 0.0 0.0 7. Other liability occurrence 0.0 0.0 7. Other liability-claims made 0.0 0.0 7. Excess Workers Compensation 0.0 0.0 8. Products liability-occurrence 0.0 0.0 8. Products liability-claims made 0.0 0.0 9.,9. Private passenger auto liability 9,875,5,65,04 6.7 6.9 9.,9.4 Commercial auto liability 0.0 0.0. Auto physical damage 0,059,85 5,809,7 57.7 64.7. Aircraft (all perils) 0.0 0.0. Fidelity 0.0 0.0 4. Surety 0.0 0.0 6. Burglary and theft 0.0 0.0 7. Boiler and machinery 0.0 0.0 8. Credit 0.0 0.0 9. International 0.0 0.0 0. Warranty 0.0 0.0. Reinsurance - Nonproportional Assumed Property XXX XXX XXX XXX. Reinsurance - Nonproportional Assumed Liability XXX XXX XXX XXX. Reinsurance - Nonproportional Assumed Financial Lines XXX XXX XXX XXX 4. Aggregate write-ins for other lines of business 0 0 0.0 0.0 5. TOTALS 0,, 8,97,95 60.4 6. DETAILS OF WRITE-INS 40. 0.0 0.0 40. 0.0 0.0 40. 0.0 0.0 498. Sum. of remaining write-ins for Line 4 from overflow page 0 0 0.0 0.0 499. Totals (Lines 40 through 40 plus 498) (Line 4) 0 0 0.0 0.0 PART - DIRECT PREMIUMS WRITTEN Current Quarter Current Year to Date Prior Year Year to Date Line of Business. Fire 0 0. Allied lines 0 0. Farmowners multiple peril 0 0 4. Homeowners multiple peril 79,45 57,46 8,984 5. Commercial multiple peril 0 0 6. Mortgage guaranty 0 0 8. Ocean marine 0 0 9. Inland marine 0 0 0. Financial guaranty 0 0. Medical professional liability-occurrence 0 0. Medical professional liability-claims made 0 0. Earthquake 0 0. Group accident and health 0 0 4. Credit accident and health 0 0 5. Other accident and health 0 0 6. Workers compensation 0 0 7. Other liability occurrence 0 0 7. Other liability-claims made 0 0 7. Excess Workers Compensation 0 0 8. Products liability-occurrence 0 0 8. Products liability-claims made 0 0 9.,9. Private passenger auto liability 7,66,57,99,0 9,6,9 9.,9.4 Commercial auto liability 0 0. Auto physical damage,849,04,,795 9,98,894. Aircraft (all perils) 0 0. Fidelity 0 0 4. Surety 0 0 6. Burglary and theft 0 0 7. Boiler and machinery 0 0 8. Credit 0 0 9. International 0 0 0. Warranty 0 0. Reinsurance - Nonproportional Assumed Property XXX XXX XXX. Reinsurance - Nonproportional Assumed Liability XXX XXX XXX. Reinsurance - Nonproportional Assumed Financial Lines XXX XXX XXX 4. Aggregate write-ins for other lines of business 0 0 0 5. TOTALS,95,09,688,44 9,6,80 DETAILS OF WRITE-INS 40. 0 0 40. 0 0 40. 0 0 498. Sum. of remaining write-ins for Line 4 from overflow page 0 0 0 499. Totals (Lines 40 through 40 plus 498) (Line 4) 0 0 0

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. PART (000 omitted) LOSS AND LOSS ADJUSTMENT EXPENSE RESERVES SCHEDULE 4 5 6 7 8 9 0 Years in Which Losses Occurred Prior Year-End Known Case Loss and LAE Reserves Prior Year-End IBNR Loss and LAE Reserves Total Prior Year-End Loss and LAE Reserves (Cols. + ) 04 Loss and LAE Payments on Claims Reported as of Prior Year-End 04 Loss and LAE Payments on Claims Unreported as of Prior Year-End Total 04 Loss and LAE Payments (Cols. 4 + 5) Q.S. Date Known Case Loss and LAE Reserves on Claims Reported and Open as of Prior Year End Q.S. Date Known Case Loss and LAE Reserves on Claims Reported or Reopened Subsequent to Prior Year End Q.S. Date IBNR Loss and LAE Reserves Total Q.S. Loss and LAE Reserves (Cols.7 + 8 + 9) Prior Year-End Known Case Loss and LAE Reserves Developed (Savings)/ Deficiency (Cols. 4 + 7 minus Col. ) Prior Year-End IBNR Loss and LAE Reserves Developed (Savings)/ Deficiency (Cols. 5 + 8 + 9 minus Col. ) Prior Year-End Total Loss and LAE Reserve Developed (Savings)/ Deficiency (Cols. + ). 0 + Prior,040,79,759,05 5,0 94,,548 559 (550) 9. 0,644,577 4,,08 5,069 74 56,5,49,6 (,9) (). Subtotals 0 + prior,684 4,96 6,980, 66,89,6 78,48,697,675 (,669) 6 4. 0 6,896 7,959 4,855 7,87 887 8,074,80 6,49 5,604,09 (,70) (,77) 5. Subtotals 0 + prior 9,580,55,85 0,40 95,6,98 44 5,9 9,0,768 (4,99) (,7) 4 6. 04 XXX XXX XXX XXX 7,859 7,859 XXX 7,76 7,55 4, XXX XXX XXX 7. Totals 9,580,55,85 0,40 8,8 9,,98 7,67,077,6,768 (4,99) (,7) Prior Year-End 8. Surplus As Col., Line 7 Col., Line 7 Col., Line 7 Regards Policyholders,58 Line 7 Line 7 Line As % of Col., As % of Col., As % of Col., 7. 9.. (40.). (5.4) Col., Line 7 Line 8 4. (5.5)

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. SUPPLEMENTAL EXHIBITS AND SCHEDULES INTERROGATORIES The following supplemental reports are required to be filed as part of your statement filing. However, in the event that your company does not transact the type of business for which the special report must be filed, your response of NO to the specific interrogatory will be accepted in lieu of filing a report and a bar code will be printed below. If the supplement is required of your company but is not being filed for whatever reason enter SEE EXPLANATION and provide an explanation following the interrogatory questions. Response. Will the Trusteed Surplus Statement be filed with the state of domicile and the NAIC with this statement? NO. Will Supplement A to Schedule T (Medical Professional Liability Supplement) be filed with this statement? NO. Will the Medicare Part D Coverage Supplement be filed with the state of domicile and the NAIC with this statement? NO 4. Will the Director and Officer Insurance Coverage Supplement be filed with the state of domicile and the NAIC with this statement? NO Explanation:... 4. Bar Code:. *508044900000*. *508044550000*. *50804650000* 4. *508045050000* 5

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. OVERFLOW PAGE FOR WRITE-INS 6

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. SCHEDULE A VERIFICATION Real Estate Prior Year Ended Year To Date December. Book/adjusted carrying value, December of prior year 0 0. Cost of acquired:. Actual cost at time of acquisition 0. Additional investment made after acquisition 0. Current year change in encumbrances 0 4. Total gain (loss) on disposals 0 5. Deduct amounts received on disposals 0 6. Total foreign exchange change in book/adjusted carrying value 0 7. Deduct current year s other-than-temporary impairment recognized 0 8. Deduct current year s depreciation 0 9. Book/adjusted carrying value at the end of current period (Lines +++4-5+6-7-8) 0 0 0. Deduct total nonadmitted amounts 0 0. Statement value at end of current period (Line 9 minus Line 0) 0 0 SCHEDULE B VERIFICATION Mortgage Loans Prior Year Ended Year To Date December. Book value/recorded investment excluding accrued interest, December of prior year 0 0. Cost of acquired:. Actual cost at time of acquisition 0. Additional investment made after acquisition 0. Capitalized deferred interest and other 0 4. Accrual of discount 0 5. Unrealized valuation increase (decrease) 0 6. Total gain (loss) on disposals 0 7. Deduct amounts received on disposals 0 8. Deduct amortization of premium and mortgage interest points and commitment fees 0 9. Total foreign exchange change in book value/recorded investment excluding accrued interest 0 0. Deduct current year s other-than-temporary impairment recognized 0. Book value/recorded investment excluding accrued interest at end of current period (Lines +++4+5+6-7- 8+9-0) 0 0. Total valuation allowance 0. Subtotal (Line plus Line ) 0 0 4. Deduct total nonadmitted amounts 0 0 5. Statement value at end of current period (Line minus Line 4) 0 0 SCHEDULE BA VERIFICATION Other Long-Term Invested Assets Prior Year Ended Year To Date December. Book/adjusted carrying value, December of prior year 0 0. Cost of acquired:. Actual cost at time of acquisition 0 0. Additional investment made after acquisition 0 0. Capitalized deferred interest and other 0 0 4. Accrual of discount 0 0 5. Unrealized valuation increase (decrease) 0 0 6. Total gain (loss) on disposals 0 0 7. Deduct amounts received on disposals 0 0 8. Deduct amortization of premium and depreciation 0 0 9. Total foreign exchange change in book/adjusted carrying value 0 0 0. Deduct current year s other-than-temporary impairment recognized 0 0. Book/adjusted carrying value at end of current period (Lines +++4+5+6-7-8+9-0) 0 0. Deduct total nonadmitted amounts 0 0. Statement value at end of current period (Line minus Line ) 0 0 SCHEDULE D VERIFICATION Bonds and Stocks Prior Year Ended Year To Date December. Book/adjusted carrying value of bonds and stocks, December of prior year 6,77,97 0,76,86. Cost of bonds and stocks acquired 0 0. Accrual of discount 0,46 4,79 4. Unrealized valuation increase (decrease) 44,9 (4,7) 5. Total gain (loss) on disposals 0 (,95) 6. Deduct consideration for bonds and stocks disposed of,860,85,49,850 7. Deduct amortization of premium 5,44 8,55 8. Total foreign exchange change in book/adjusted carrying value 0 0 9. Deduct current year s other-than-temporary impairment recognized 0 60,590 0. Book/adjusted carrying value at end of current period (Lines +++4+5-6-7+8-9) 5,04,87 6,77,97. Deduct total nonadmitted amounts 0 0. Statement value at end of current period (Line 0 minus Line ) 5,04,87 6,77,97 SI0

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. SCHEDULE D - PART B Showing the Acquisitions, Dispositions and Non-Trading Activity During the Current Quarter for all Bonds and Preferred Stock by NAIC Designation NAIC Designation Book/Adjusted Carrying Value Beginning of Current Quarter Acquisitions During Current Quarter Dispositions During Current Quarter 4 Non-Trading Activity During Current Quarter 5 Book/Adjusted Carrying Value End of First Quarter 6 Book/Adjusted Carrying Value End of Second Quarter 7 Book/Adjusted Carrying Value End of Third Quarter 8 Book/Adjusted Carrying Value December Prior Year BONDS. NAIC (a) 6,08,49 94,404,60,909 (,607),64,400 6,08,49 5,8,79 4,09,57. NAIC (a),76,45 0 0 896,75,458,76,45,77,4,74,58. NAIC (a) 0 0 0 0 0 0 0 0 4. NAIC 4 (a) 0 0 0 0 0 0 0 0 5. NAIC 5 (a) 0 0 0 0 0 0 0 0 6. NAIC 6 (a) 49,05 0,76,48 44,8 49,05 47,68 444,470 7. Total Bonds 7,84,86 94,404,64,670 (0,9) 5,45,669 7,84,86 7,,0 5,90,587 SI0 PREFERRED STOCK 8. NAIC 0 0 0 0 0 0 0 0 9. NAIC,695,600 0 0 5,00,704,000,695,600,70,800,578,000 0. NAIC 0 0 0 0 0 0 0 0. NAIC 4 0 0 0 0 0 0 0 0. NAIC 5 0 0 0 0 0 0 0 0. NAIC 6 0 0 0 0 0 0 0 0 4. Total Preferred Stock,695,600 0 0 5,00,704,000,695,600,70,800,578,000 5. Total Bonds & Preferred Stock 9,59,46 94,404,64,670 4,908 7,56,669 9,59,46 8,844,0 7,488,587 (a) Book/Adjusted Carrying Value column for the end of the current reporting period includes the following amount of non-rated short-term and cash equivalent bonds by NAIC designation: NAIC $ 0 ; NAIC $ 0 ; NAIC $ 0 ; NAIC 4 $ 0 ; NAIC 5 $ 0 ; NAIC 6 $ 0

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. SCHEDULE DA - PART Short-Term Investments Book/Adjusted Carrying Value Par Value Actual Cost 4 Interest Collected Year To Date 5 Paid for Accrued Interest Year To Date 999999,89,77 XXX,89,77,544 0 SCHEDULE DA - VERIFICATION Short-Term Investments Year To Date Prior Year Ended December. Book/adjusted carrying value, December of prior year 0,76,67 5,496,69. Cost of short-term investments acquired 5,456,40,555,84. Accrual of discount 0 0 4. Unrealized valuation increase (decrease) 0 0 5. Total gain (loss) on disposals 0 0 6. Deduct consideration received on disposals,5,64 6,5, 7. Deduct amortization of premium 0 0 8. Total foreign exchange change in book/adjusted carrying value 0 0 9. Deduct current year s other-than-temporary impairment recognized 0 0 0. Book/adjusted carrying value at end of current period (Lines +++4+5-6-7+8-9),89,77 0,76,67. Deduct total nonadmitted amounts 0 0. Statement value at end of current period (Line 0 minus Line ),89,77 0,76,67 SI0

STATEMENT AS OF SEPTEMBER 0, 04 OF THE First Acceptance Insurance Company of Georgia, Inc. Schedule DB - Part A - Verification Schedule DB - Part B - Verification Schedule DB - Part C - Section Schedule DB - Part C - Section Schedule DB - Verification Schedule E - Verification Schedule A - Part Schedule A - Part Schedule B - Part Schedule B - Part Schedule BA - Part SI04, SI05, SI06, SI07, SI08, E0, E0, E0