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Title Last updated Attachments
Form E-CERTREQCAPTIVE: Certificate Request Form Captive 11/11/2020 (Wed)
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PDF icon Certificate Request Form Captive.pdf1000.36 KB
Form E-CERTREQ: Certificate Request Form 11/11/2020 (Wed)
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PDF icon Certificate Request Form.pdf1.49 MB
FINANCIAL REPORTING - FOREIGN/ALIEN: Mutual Aid Association 01/11/2020 (Tue)
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PDF icon Mutual Aid Association Filing Requirements E-MAA.pdf1015.68 KB
Form E-MG.CEDE: Supplementary Schedule F-3 12/11/2020 (Tue)
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PDF icon Mortgage Guaranty Cede E-MG.CEDE_.pdf163.5 KB
Form E-MRR.AS: Annual Statement Filings Worksheet 12/11/2020 (Tue)
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PDF icon Mechanical Reimbursement Reinsurer Annual Checklist E-MRRAS.pdf1.01 MB
Form E-LIFECARE.AMEND: Amendment to Annual Report 12/11/2020 (Tue)
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PDF icon Life Care Provider Annual Report Amendment E-LIFECARE.AMEND_.pdf971.53 KB
Form E-LIFECARE.AS: Annual Report Filing Checklist 12/11/2020 (Tue)
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PDF icon Life Care Provider Annual Report Filing Checklist E-LIFECARE.AS_.pdf1.17 MB
Form E-LIFECARE: Annual Report Form 12/11/2020 (Tue)
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PDF icon Life Care Provider Annual Report E-LIFECARE.pdf1.66 MB
Form E-UCLDR.I: Annual Statement Filing Instructions 05/11/2020 (Mon)
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PDF icon Unaffiliated L and D Rein Annual Instructions E-UCLDR.I.pdf145.03 KB
Form E-UCLDR.AS: Annual Statement Filing Worksheet 05/11/2020 (Mon)
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PDF icon E-UCLDR.AS web version.pdf1.01 MB
Form E-SR.INSTR: Sr. Residential Entrance Fee Contracts: Provider Compliance With A.R.S. Title 44, Chapter 25, Article 1 05/11/2020 (Mon)
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PDF icon Sr. Residential Entrance Fee Contract Provider E-SR.INSTR_.pdf116.43 KB
Form E-SR.AFR: Sr. Residential Entrance Fee Contracts: Provider Annual Audited Financial Report Transmittal Form 05/11/2020 (Mon)
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PDF icon Sr. Residential Entrance Fee Contract Provider Annual AFR Transmittal E-SR.AFR web version.pdf523.21 KB
Form E-MRR.I: Annual Statement Filing Instructions 05/11/2020 (Mon)
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PDF icon Mechanical Reimbursement Reinsurer Annual Instructions E-MRRI.pdf140.73 KB
Form E-MRR.05: Annual Report of Policy and Loss Reserves and Application for Certificate of Authority Renewal 05/11/2020 (Mon)
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PDF icon Mechanical Reimbursement Reinsurer Annual Reserves E-MRR.05 web version.pdf957.61 KB
Form E-UCLDR.CERT: Certification 05/11/2020 (Mon)
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PDF icon E-UCLDRCert web version.pdf1.01 MB
Form E-AFR.IC.RE: Audited Financial Report Internal Control Filings Transmittal Reinsurer 05/11/2020 (Mon)
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PDF icon Audited Financial Report Internal Control Filings E-AFR.IC_.RE web version.pdf4.31 MB
Form E-LR.I: Annual Statement Filing Instructions 05/11/2020 (Mon)
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PDF icon Life and Disability Reinsurer Annual Instructions E-LRI.pdf144.32 KB
Form E-LR.AS: Annual Statement Filings Worksheet 05/11/2020 (Mon)
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PDF icon Life and Disability Reinsurer Annual Checklist E-LR.AS web version.pdf1.55 MB
Form E-AFR.OHE: Audited Financial Report Organizational Hardship Exemption Guidelines and Sample Affidavit 05/11/2020 (Mon)
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PDF icon Audited Financial Report Organizational Hardship Exemption E-AFR-OHE web version.pdf4.48 MB
Form E-AFR.GFE: Audited Financial Report Exemption Guidelines 05/11/2020 (Mon)
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PDF icon Audited Financial Report Guidelines for Exemptions E-AFR-GFE web version.pdf4.46 MB
Form E-178: Certificate of Disclosure 05/11/2020 (Mon)
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PDF icon Certificate of Disclosure E-178 web version.pdf1018.01 KB
Form E185E: Instructions for the Completion of the Pre-acquisition Notification Form 05/11/2020 (Mon)
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PDF icon Holding Co Form E E-185E.pdf156.65 KB
Form E185F: Instructions for the Completion of the Enterprise Risk Report 05/11/2020 (Mon)
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PDF icon Holding Co Form F E-185F.pdf157.84 KB
FORM E-DIRCOMWAIVER: Arizona Domestic Insurers Board of Directors and/or Committees Waiver Application 05/11/2020 (Mon)
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PDF icon Holding Co Directors Committees Waiver E-DIRCOMWAIVER.pdf109.52 KB
Form E185F: Instructions for the completion of the Enterprise Risk Report 05/11/2020 (Mon)
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PDF icon Holding Co Form F E-185F.pdf157.84 KB
Form E185D: Instructions for the Completion of the Form D Prior Notice of a Transaction Pursuant to A.R.S. § 20-481.12 05/11/2020 (Mon)
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PDF icon Holding Co Form D E-185D.pdf168.35 KB
Form E185XD: Instructions for Approval of Extraordinary Dividends and Other Distributions 05/11/2020 (Mon)
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PDF icon Holding Co Extraordinary Dividends E-185XD.pdf157.05 KB
Form E185CHC: Instructions for a Change to Form C Summary of Registration Statement 05/11/2020 (Mon)
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PDF icon Holding Co Form C Change E-185CHC.pdf155.26 KB
Form E185CHB: Instructions for a Change to Form B Registration Statement 05/11/2020 (Mon)
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PDF icon Holding Co Form B Change E-185CHB.pdf155.17 KB
Form E185C: Instructions for the Completion of the Form C Summary of Registration Statement 05/11/2020 (Mon)
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PDF icon Holding Co Form C E-185C.pdf156.53 KB
Form E185B: Instructions for the Completion of the Form B Registration Statement 04/11/2020 (Mon)
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PDF icon Holding Co Form B E-185B.pdf172.03 KB
Form E185: Outline for Compliance with Insurance Holding Company Systems Reporting Requirements 04/11/2020 (Mon)
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PDF icon Holding Co Instructions E-185.pdf208.74 KB
Form E184: Instructions for the Completion of the Form A Statement Regarding the Acquisition of Control of, or Merger with, a Domestic Insurer 04/11/2020 (Mon)
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PDF icon Holding Co Form A E-184.pdf175.44 KB
Form E150 - Assignment of Certificate of Deposit or Time Deposit to Arizona State Treasurer 03/11/2020 (Thu)
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PDF icon E150.pdf125.07 KB
Form E126XS: Application and Order for Release of Excess Deposit 03/11/2020 (Thu)
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PDF icon E126XS.pdf135.37 KB
Form E126-CD: Request for Release of Certificate of Deposit 03/11/2020 (Thu)
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PDF icon E126CD.pdf139.99 KB