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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).

(6) | " (1) | 0 (666) | 1 (1504) | 2 (88) | 3 (3) | 4 (7) | 5 (8) | 6 (20) | 7 (45) | 8 (107) | 9 (536) | > (1) | A (175) | B (22) | C (140) | D (44) | E (20) | F (275) | G (18) | H (57) | I (83) | J (2) | K (1) | L (58) | M (175) | N (83) | O (22) | P (229) | Q (1) | R (207) | S (53) | T (34) | U (13) | V (4) | W (66) | Y (3) | (1)
Title Last updatedsort descending Attachments
Form L-195: Bond of Bail Bond Agent 01/08/2018 (Fri)
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PDF icon l-195_20180618.pdf893.64 KB
Form L-152: Licensing Eligibility (Lawful Presence in the US) Requirement 01/08/2018 (Fri)
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PDF icon Form L-152501.26 KB
Form L-CLR: Clearance Letter Request 01/08/2018 (Fri)
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PDF icon l-clr_20180618.pdf1.04 MB
Form L-193: Certificate of Assumed Name 01/08/2018 (Fri)
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PDF icon l-193_20180618.pdf953.21 KB
Form L-CHG: License Information Change 01/08/2018 (Fri)
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PDF icon l-chg_20180618.pdf949.18 KB
Form L-FPV: Fingerprint Verification 01/08/2018 (Fri)
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PDF icon l-fpv_20180618.pdf62 KB
Form L-LSB: Life Settlement Broker Application 01/08/2018 (Fri)
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PDF icon l-lsb_20180618.pdf87.3 KB
Form L-NAV: Application for Navigator or Certified Application Counselor License 01/08/2018 (Fri)
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PDF icon form_l-nav.pdf600.85 KB
Form L-LOC: Branch Locations 01/08/2018 (Fri)
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PDF icon l-loc_20180618.pdf1.03 MB
Form RO31010: License Application for a Rating Organization 01/08/2018 (Fri)
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Microsoft Office document icon RatingOrgApp31010.doc35.5 KB
Form L-PFD: Petition for Determination 01/08/2018 (Fri)
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PDF icon Form L-PFD216.64 KB
Form E125-CD: Certificate of Deposit Transmittal 09/09/2018 (Tue)
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PDF icon E125CD.pdf699.49 KB
Form E126LOC: Request for Release of Letter of Credit 09/09/2018 (Tue)
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PDF icon E126LOC.pdf635.16 KB
Form E126XS: Application and Order for Release of Excess Deposit 09/09/2018 (Tue)
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PDF icon E126XS.pdf1.2 MB
Form E126-CD: Request for Release of Certificate of Deposit 09/09/2018 (Tue)
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PDF icon E126CD.pdf696.61 KB
Form E150 - Assignment of Certificate of Deposit or Time Deposit to Arizona State Treasurer 09/09/2018 (Tue)
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PDF icon E150.pdf752.53 KB
Form E-SR.REG: Sr. Residential Entrance Fee Contracts: Provider Registration 01/09/2018 (Tue)
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PDF icon Sr. Residential Entrance Fee Contract Provider E-SR.REG_.pdf603.68 KB
Form E-RE-A: Reinsurer Annual Instructions 10/09/2018 (Thu)
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PDF icon Reinsurer E-RE-A Instructions.pdf51.71 KB
FY 2019 INSURER ANNUAL ASSESSMENT INVOICES ARE AVAILABLE 02/09/2018 (Wed)
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PDF icon AssessmentNoticesFY2019_20180710.pdf10.22 MB
Filing a Complaint 02/10/2018 (Wed)
For Captives Other Than RRGs: Captive Insurer Annual Report and Renewal Fee Transmittal 03/10/2018 (Mon)
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PDF icon Captive AR-Transmittal 10 2018.SAVEABLE.pdf840.41 KB
For Risk Retention Groups: Captive Insurer Annual Report and Renewal Fee Transmittal 03/10/2018 (Mon)
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PDF icon Captive RRG - Annual Transmittal 844.78 KB
Form E-PC.INDINS: Report of Policies Issued to Industrial Insureds 03/11/2018 (Tue)
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PDF icon Indistrial Insured E-PC.INDINS.pdf724.32 KB
Form E-MRR.05: Annual Report of Policy and Loss Reserves and Application for Certificate of Authority Renewal 03/11/2018 (Tue)
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PDF icon Form E-MRR.05787.98 KB
FIND US AT OUR NEW ADDRESS!! 09/12/2018 (Tue)
Form L-WAV: Fee Waiver Request 02/12/2018 (Tue)
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PDF icon Form L-WAV164.4 KB
Form E-100-B: Life and Health Administrator Biographical List 02/12/2018 (Tue)
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PDF icon Form E-100-B TPA Biographical List.pdf767.11 KB
Form E-111: Renewal Application for Life and Health Administrator Registration 02/12/2018 (Tue)
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PDF icon Form E-111 TPA Renewal Application.pdf1.41 MB
Form E-115: Life and Health (Third-party) Administrator Information Update 02/12/2018 (Tue)
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PDF icon TPA Form E-1151.46 MB
Form E-100-A: Life and Health Administrator Registration Addendum 02/12/2018 (Tue)
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PDF icon Form E-100-A TPA New Application Addendum.pdf762.14 KB
Form E-200: TPA Registration Application Checklist 02/12/2018 (Tue)
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PDF icon TPA Form E-200_20160721.pdf927.57 KB
Form E-503-TPA: Affidavit of Lost Certificate of Registration 03/12/2018 (Tue)
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PDF icon Form E-503-TPA Affidavit of Lost Certificate of Registration.pdf983.69 KB
Form E-MRR.AS: Annual Statement Filings Worksheet 09/12/2018 (Thu)
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PDF icon Form E-MRR.AS 1.11 MB
Form E-UCLDR: Unaffiliated Credit Life & Disability Reinsurer Annual Fees Report 11/01/2019 (Fri)
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PDF icon Form E-UCLDR (v. 20181217)366.26 KB
FOREIGN INSURER: Fraternal Benefit Society 03/01/2019 (Fri)
FOREIGN INSURER: Health Care Services Organization 03/01/2019 (Fri)

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