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Title Last updatedsort descending Attachments
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-700: Certificate of Surplus Lines Broker 01/09/2018 (Tue)
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PDF icon Certificate of Surplus Lines Broker Form E-700.pdf1.22 MB
Form E-701: Certificate of Public Supervisory Official 01/09/2018 (Tue)
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PDF icon Certificate of Public Supervisory Official Form E-701.pdf1.47 MB
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
FINANCIAL REPORTING - DOMESTIC: Captive Insurer 03/10/2018 (Mon)
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
Form E-AFR.OHE: Audited Financial Report Organizational Hardship Exemption Guidelines and Sample Affidavit 03/11/2018 (Tue)
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PDF icon Audited Financial Report Organizational Hardship Exemption E-AFR-OHE.pdf3.68 MB
Form E-AFR.GFE: Audited Financial Report Exemption Guidelines 03/11/2018 (Tue)
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PDF icon Audited Financial Report Guidelines for Exemptions E-AFR-GFE.pdf3.8 MB
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 E157: Bond of Life and Health Administrator 02/12/2018 (Tue)
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PDF icon Bond of Life and Health Administrator 645.6 KB
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-LR.AS: Annual Statement Filings Worksheet 03/12/2018 (Tue)
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PDF icon Form L-RA.AS Worksheet1.11 MB
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-AHCCCS: AHCCCS Contractor Quarterly Premium Tax Report 09/01/2019 (Fri)
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File Form E-AHCCCS56.59 KB
Form E-FBS: Annual Fees and Retaliation Report for a Fraternal Benefit Society 10/01/2019 (Fri)
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PDF icon Form E-FBS (v. 20190118)898.02 KB
Form E-II: Industrial Insured Premium Receipts Tax Report 10/01/2019 (Fri)
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PDF icon Form E-II (v. 20190118)1.26 MB
Form E-RT: Retaliation Report 10/01/2019 (Fri)
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File Form E-RT (v. 20181211)78.62 KB
Form E-SGHI: Accountable Health Plan Small-employer Group Health Insurance Plan Premium 11/01/2019 (Fri)
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File Form E-SGHI (v. 20190117)416.73 KB
Form E-TC: Tax Credits 11/01/2019 (Fri)
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File Form E-TC (v. 20190118)47.91 KB
Form E-TAX-I: Annual Tax and Fees Report Instructions 11/01/2019 (Fri)
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PDF icon E-TAX-I: Tax Instructions389.27 KB
Form E-TITLE: Retaliation Report for a Foreign/Alien Title Insurer 11/01/2019 (Fri)
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File Form E-TITLE (v. 20190118)52.21 KB
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
Form E-LRTF: Local and Regional Taxes and Fees; Survey of Arizona Domestic Insurers 12/01/2019 (Fri)
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File Form E-LRTF (v. 20190118)1.02 MB

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