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Title Last updated Attachments
Form E-NAIC.PC: Annual Filing Checklist 11/05/2021 (Tue)
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PDF icon E-NAIC.PC 20210312.pdf262 KB
Form E-LSPF: Life Settlement Provider Anti-fraud Plan Checklist 10/05/2021 (Mon)
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PDF icon Life Settlement Provider E-LSPF Web.pdf4.48 MB
Form E-711: Purchasing Group List of Insurers and Agents 10/05/2021 (Mon)
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PDF icon Form E-711 Purchasing Group List of Insurers and Agents Web.pdf4.43 MB
Form E-710: Application for Purchasing Group Registration 10/05/2021 (Mon)
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PDF icon Form E-710 Purchasing Group Application Web.pdf938.73 KB
Form E-857: Bond of Service Company 08/05/2021 (Mon)
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PDF icon Form E-857 Bond of Service Company Web.pdf927.14 KB
Form E-811: Renewal of Service Company Permit 08/05/2021 (Mon)
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PDF icon Form E-811 Service Company Renewal Web.pdf833.71 KB
Form E-800-B: Service Company Biographical List 08/05/2021 (Mon)
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PDF icon Form E-800-B Service Company Application Biographical List Web.pdf971.4 KB
Form E-800: Application for Service Company Permit 08/05/2021 (Mon)
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PDF icon Form E-800 Service Company Application Web.pdf985.52 KB
Form L-CHG: License Information Change 01/04/2021 (Tue)
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PDF icon l-chg_20180618.pdf949.18 KB
Form E126XS: Application and Order for Release of Excess Deposit 12/03/2021 (Fri)
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PDF icon E126XS 20210326 web version.pdf837.54 KB
Form E-AHCCCS: AHCCCS Contractor Quarterly Premium Tax Report 04/03/2021 (Mon)
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File e-ahcccs_20210322.xlsx70.4 KB
Form E-UCLDR.AS: Annual Statement Filing Worksheet 04/03/2021 (Thu)
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PDF icon E-UCLDR.AS web version.pdf1.01 MB
Form E-UCLDR.I: Annual Statement Filing Instructions 04/03/2021 (Thu)
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PDF icon Unaffiliated L and D Rein Annual Instructions E-UCLDR.I 20210316.pdf147.88 KB
Form E-LR.I: Annual Statement Filing Instructions 04/03/2021 (Thu)
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PDF icon Life and Disability Reinsurer Annual Instructions E-LR.I 20210225.pdf146.73 KB
Form E-LR.AS: Annual Statement Filings Worksheet 04/03/2021 (Thu)
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PDF icon E-LR.AS web version.pdf1.03 MB
Form E-701: Certificate of Public Supervisory Official 11/02/2021 (Tue)
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PDF icon Form E-701 Web Versionpdf.pdf1.65 MB
Form E-700: Certificate of Surplus Lines Broker 11/02/2021 (Tue)
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PDF icon Form E-700 Web Version.pdf1.56 MB
Form E-CERTREQCAPTIVE: Certificate Request Form Captive 02/01/2021 (Tue)
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PDF icon Certificate Request Form Captive Web20210108.pdf1002.01 KB
For Risk Retention Groups: Captive Insurer Annual Report and Renewal Fee Transmittal 03/01/2021 (Wed)
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PDF icon CID-AnnRepTransRRG Web 01 2021.pdf1.09 MB
For Captives Other Than RRGs: Captive Insurer Annual Report and Renewal Fee Transmittal 03/01/2021 (Wed)
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PDF icon CID-AnnRepTrans Web 01 2021.pdf1.08 MB
FINANCIAL REPORTING - DOMESTIC: Captive Insurer 03/01/2021 (Wed)
Form E-TAX-I: Annual Tax and Fees Report Instructions 06/01/2021 (Tue)
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PDF icon E-Tax-Instructions_20210113.pdf454.9 KB
Form E-CR-INFO: Certified Reinsurer Information 04/01/2021 (Fri)
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PDF icon Cert Rein E-CR-INFO Info.pdf160.44 KB
Form E-CERTREQ: Certificate Request Form 09/01/2021 (Wed)
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PDF icon Certificate Request Form.pdf1.49 MB
Form E-TAX: Annual Tax and Fees Report 10/01/2021 (Tue)
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File E-Tax_20210107.xlsx112.08 KB
Form E-RE-A: Reinsurer Annual Instructions 09/01/2021 (Tue)
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PDF icon Reinsurer E-RE-A Instructions20210111.pdf115.56 KB
Form E-RE-I: Reinsurer Initial Instructions 09/01/2021 (Tue)
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PDF icon Reinsurer E-RE-I Instructions20210111.pdf114.71 KB
Form E-FBS: Annual Fees and Retaliation Report for a Fraternal Benefit Society 02/01/2021 (Tue)
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PDF icon E-FBS_20201231.pdf1.17 MB
Form E-II: Industrial Insured Premium Receipts Tax Report 02/01/2021 (Tue)
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PDF icon E-II_20201231-editable.pdf1.55 MB
Form E-SGHI: Accountable Health Plan Small-employer Group Health Insurance Plan Premium 01/01/2021 (Tue)
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File E-SGHI_20201231 (2).xlsx447.49 KB
Form E-TAX-AGENTS: 01/01/2021 (Tue)
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File e-tax-agents_20201231.xlsx4.01 MB
Form E-TC: Tax Credits 01/01/2021 (Tue)
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File E-TC_20201231.xlsx61.88 KB
Form E-LRTF: Local and Regional Taxes and Fees; Survey of Arizona Domestic Insurers 01/01/2021 (Tue)
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File E-LRTF_20201231 (1).xlsx1.01 MB
Form E-RT: Retaliation Report 01/01/2021 (Tue)
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File E-RT_20201231.xlsx108.09 KB
Form E-TITLE: Retaliation Report for a Foreign/Alien Title Insurer 01/01/2021 (Tue)
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File E-title_20201231.xlsx72.13 KB
Form E-UCLDR: Unaffiliated Credit Life & Disability Reinsurer Annual Fees Report 01/01/2021 (Tue)
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PDF icon e-ucldr_20201231.pdf686.33 KB