Form E-800-B: Service Company Biographical List
Complete this form to report:
- All members of the board of directors/trustees, members of the executive committee or any other governing board of the committee; and,
- If applicant is a corporation, all officers and all shareholders that directly or indirectly own 25% or more of the voting securities of the applicant if a corporation; and,
- If applicant is a partnership or association, all partners.
IMPORTANT! The Department will investigate information provided and may deny or refuse to renew a permit if the applicant fails to provide complete and truthful information about itself and the individuals responsible for the service company’s affairs.
We are aware of a phishing scam targeting insurance professionals claiming that the National Association of Insurance Commissioners received a complaint that the professional submitted a falsified claim. This fraudulent email displays the NAIC and CIPR logos, can originate from what appears to be an naic.org or gmail.com email account, and instructs the recipient to click on a link to download the complaint notification.
Certain antivirus products will detect this as a malicious email. If you receive a similar email and have any concerns, contact the NAIC Service Desk at (816) 783-8500 or [email protected].