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Title Last updated Attachments
Form E-AHCCCS: AHCCCS Contractor Quarterly Premium Tax Report 09/02/2021 (Wed)
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File e-ahcccs_20210219.xlsx70.36 KB
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-LR.AS: Annual Statement Filings Worksheet 04/02/2021 (Wed)
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PDF icon Life and Disability Reinsurer Annual Checklist E-LR.AS_.pdf205.86 KB
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
Form E-LSP1: Life Settlement Provider Application for Certificate of Authority 01/12/2020 (Fri)
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PDF icon Life Settlement Provider E-LSP1.pdf960.47 KB
Form E-LSPI: Life Settlement Provider Application for Certificate of Authority - Instructions 01/12/2020 (Fri)
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PDF icon Life Settlement Provider E-LSPI.pdf202.96 KB
Form E-LSP4: Life Settlement Provider Statutory Agent Appointment and Acceptance 01/12/2020 (Fri)
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PDF icon Life Settlement Provider E-LSP4.pdf891.93 KB
Form E-LSP3: Life Settlement Provider Report of Officers, Directors, Members, Partners and Designated Employees 01/12/2020 (Fri)
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PDF icon Life Settlement Provider E-LSP3.pdf891.78 KB
Form E-LSP2: Life Settlement Provider Report of Stockholders/Owners 01/12/2020 (Fri)
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PDF icon Life Settlement Provider E-LSP2.pdf946.77 KB
Form SL-112: Application for Domestic Surplus Lines Insurer Designation 01/12/2020 (Fri)
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PDF icon Domestic Surplus Lines Insurer Application Form SL-112.pdf1.06 MB
Form E-CR-C: Uniform Application Checklist for Certified Reinsurers 01/12/2020 (Fri)
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PDF icon Cert Rein E-CR-C Application Checklist.pdf1.69 MB
Form E-CR-1: Certificate of Certified Reinsurer 01/12/2020 (Fri)
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PDF icon Cert Rein E-CR-1 Certificate .pdf4.09 MB
Form E-NAIC.LD: Annual Filing Checklist 04/12/2020 (Tue)
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PDF icon E-NAIC.LD_.pdf269.11 KB
Form E-NAIC.LD: Annual Filing Checklist 04/12/2020 (Tue)
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PDF icon E-NAIC.LD_.pdf269.11 KB
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