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NEW ADDRESS


Arizona Department of Insurance
100 North 15th Avenue, Suite 261

Phoenix, AZ  85007-2630

Starting July 1, 2020, we will be the
Department of Insurance and Financial Institutions (DIFI).


 

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Title Last updatedsort descending Attachments
Form 1024A: Insurer Rate Service Organization Reference Filing Adoption Form 08/11/2014 (Fri)
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PDF icon REFERENCE_FILING_ADOPTION_FORM_1024A_(Fillable).pdf30.92 KB
Form 1024B: Calculation of Company Loss Cost Multiplier 08/11/2014 (Fri)
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PDF icon CALCULATION_OF_COMPANY_LOSS_COST_MULTIPLIER_1024B_(Fillable).pdf70.68 KB
Form E110: Biographical Affidavit 08/11/2014 (Fri)
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PDF icon E110AZBiographicalAffidavit.pdf321.21 KB
Flooding after Wildfires: Department of Emergency and Military Affairs 06/11/2014 (Sat)
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PDF icon DEMA_PR_re_flooding_after_fires.pdf40.26 KB
Form P-LSA: Life Settlement Provider/Broker Disclosures to Owner; Affiliations 09/11/2014 (Thu)
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PDF icon p-lsa.pdf969.43 KB
Form P-LSC: Life Settlement Provider: Contract Checklist 09/11/2014 (Thu)
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PDF icon p-lsc.pdf144.34 KB
FINANCIAL REPORTING - DOMESTIC: Acquisition/Holding Company Registration 02/12/2014 (Fri)
FINANCIAL REPORTING - DOMESTIC: Life Care Provider 02/12/2014 (Fri)
FINANCIAL REPORTING - DOMESTIC: HMDO Service Corporation 02/12/2014 (Fri)
FINANCIAL REPORTING - DOMESTIC: Mortgage Guaranty Insurer 02/12/2014 (Fri)
FINANCIAL REPORTING - DOMESTIC: Prepaid Dental Plan Organization 02/12/2014 (Fri)
FINANCIAL REPORTING - DOMESTIC: Title Insurer 02/12/2014 (Fri)
FINANCIAL REPORTING - FOREIGN/ALIEN: Accredited Reinsurer 02/12/2014 (Fri)
FINANCIAL REPORTING - FOREIGN/ALIEN: Fraternal Benefit Society 02/12/2014 (Fri)
FINANCIAL REPORTING - FOREIGN/ALIEN: Health Care Services Organization 02/12/2014 (Fri)
FINANCIAL REPORTING - FOREIGN/ALIEN: Life Care Provider 02/12/2014 (Fri)
FINANCIAL REPORTING - FOREIGN/ALIEN: Mortgage Guaranty Insurer 02/12/2014 (Fri)
FINANCIAL REPORTING - FOREIGN/ALIEN: Prepaid Legal Insurer 02/12/2014 (Fri)
FINANCIAL REPORTING - FOREIGN/ALIEN: Title Insurer 02/12/2014 (Fri)
FINANCIAL REPORTING - DOMESTIC: Life & Disability Reinsurer 04/12/2014 (Fri)
FINANCIAL REPORTING: Senior Residential Entrance Fee Contract Provider 09/12/2014 (Fri)
FINANCIAL REPORTING - DOMESTIC: Life/Disability Insurer Filing on a Health Blank 08/12/2014 (Wed)
FINANCIAL REPORTING - DOMESTIC: Property/Casualty Insurer Filing on a Health Blank 08/12/2014 (Wed)
FINANCIAL REPORTING - DOMESTIC: Property/Casualty Insurer Not Filing on a Health Blank 08/12/2014 (Wed)
FINANCIAL REPORTING - DOMESTIC: Life/Disability Insurer Not Filing on a Health Blank 08/12/2014 (Wed)
FINANCIAL REPORTING - DOMESTIC: Unaffiliated Credit Life & Disability Reinsurer 08/12/2014 (Wed)
FINANCIAL REPORTING - FOREIGN/ALIEN: Life/Disability Insurer Not Filing on Health Blank 09/12/2014 (Wed)
FINANCIAL REPORTING - FOREIGN/ALIEN: Property/Casualty Insurer Not Filing on a Health Blank 09/12/2014 (Wed)
FINANCIAL REPORTING - FOREIGN/ALIEN: Property/Casualty Insurer Filing on a Health Blank 09/12/2014 (Wed)
FINANCIAL REPORTING - FOREIGN/ALIEN: Life/Disability Insurer Filing on a Health Form 09/12/2014 (Wed)
Form E110: Biographical Affidavit 07/12/2014 (Thu)
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PDF icon E110AZBiographicalAffidavit.pdf321.21 KB
Form LTCPP-AZ Attachment C: Post-purchase Notice 03/12/2014 (Mon)
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PDF icon LTCPP_POST-PURCHASE_NOTICE.pdf110.03 KB
Form LTCPP-AZ Attachment B: Pre-purchase Notice 03/12/2014 (Mon)
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PDF icon LTCPP_PRE-PURCHASE_NOTICE.pdf139.46 KB
Form LTCPP-AZ Attachment A: Insurer Certification Form 03/12/2014 (Mon)
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PDF icon LTCPP_INSURER_CERTIFICATION_FORM_2-4-10_rvsd.pdf267.45 KB
Form RT: Retaliation Report 01/12/2014 (Tue)
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File e-rt_20141215.xlsx76.06 KB
Financial Reporting for Foreign/Alien Entities 04/12/2014 (Fri)

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