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NEW AGENCY

Arizona Department of Insurance
100 North 15th Avenue, Suite 261
Phoenix, AZ  85007-2630

Starting July 1, 2020, we became the
Department of Insurance and Financial Institutions (DIFI).

(6) | " (1) | 0 (665) | 1 (1502) | 2 (91) | 3 (3) | 4 (7) | 5 (8) | 6 (20) | 7 (46) | 8 (107) | 9 (536) | > (1) | A (175) | B (22) | C (140) | D (44) | E (20) | F (278) | G (19) | H (57) | I (83) | J (2) | K (1) | L (58) | M (175) | N (84) | O (22) | P (229) | Q (1) | R (207) | S (53) | T (34) | U (13) | V (4) | W (66) | Y (3) | • (1)
Titlesort ascending Last updated Attachments
Form L-LTD: Limited License Authority Application 10/05/2019 (Tue)
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PDF icon l-ltd_20180618.pdf240.58 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-LOC: Branch Locations 01/08/2018 (Fri)
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PDF icon l-loc_20180618.pdf1.03 MB
Form L-HFAI-INST: Instructions for Using the Health Filing Access Interface (HFAI) 04/01/2015 (Thu)
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PDF icon L-HFAI-INST.pdf83.08 KB
Form L-FPV: Fingerprint Verification 10/08/2020 (Tue)
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PDF icon l-fpv_20180618.pdf62 KB
Form L-CRT: Letter of Certification Request 09/06/2019 (Fri)
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PDF icon form_l-crt_e_.pdf999.65 KB
Form L-CRT: Certification Letter Request 02/04/2019 (Tue)
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PDF icon form_l-crt_e_04022019.pdf999.65 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-CHG: License Information Change 01/08/2018 (Fri)
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PDF icon l-chg_20180618.pdf949.18 KB
Form L-BRA: Notice of Bail Recovery Agent Utilization 01/08/2018 (Fri)
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PDF icon l-bra_20180618.pdf942.56 KB
Form L-BFP: Bail Recovery Agent Fingerprint Submission 01/08/2018 (Fri)
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PDF icon l-bfp_20180618.pdf941.99 KB
Form L-BBAR: Bail Bond Agent Annual Report 11/03/2020 (Wed)
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PDF icon l-bbar_202000303.pdf111.06 KB
Form L-BBAA: Bail Bond Agent Affidavit of Residency 01/08/2018 (Fri)
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PDF icon l-bbaa_20180618.pdf923.26 KB
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-193: Certificate of Assumed Name 01/08/2018 (Fri)
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PDF icon l-193_20180618.pdf953.21 KB
Form L-192: License Renewal Application for a Business Entity 02/04/2019 (Tue)
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File l-192_20190402.docx81.02 KB
Form L-191: License Renewal Application for an Individual 12/07/2019 (Mon)
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PDF icon form_l-191_0.pdf314.72 KB
Form L-177: Report of a Change to Members, Officers or Directors 01/02/2019 (Wed)
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PDF icon Form L-177618.01 KB
Form L-176: Insurance License Application for a Business Entity 03/07/2019 (Fri)
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PDF icon L-176-Form-and-Instructions_20190712.pdf477.29 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 II-Certification: Industrial Insured Certification 03/03/2015 (Mon)
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PDF icon Industrial Insured Certification (01-2015) New Heading.pdf18.47 KB
Form HIPAADATA: HIPAA Report 09/05/2015 (Fri)
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PDF icon HIPAADATA FORM 2015 PDF.pdf50.91 KB
Form F101: Fraud Referral Form 05/04/2019 (Sat)
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PDF icon Form F-101: Fraud Referral Form219.47 KB
Form EXSAPP: Application for Workers' Compensation Deposit Reduction - Instructions 12/06/2015 (Tue)
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PDF icon EXSAPP.pdf204.59 KB
Form ER002: Registration Application 09/07/2018 (Fri)
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PDF icon Foreign Risk Retention Group Registration Application E-R002.pdf659.3 KB
Form ER002: Registration 10/02/2020 (Wed)
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PDF icon Foreign Risk Retention Group Registration Application E-R002.pdf691.81 KB
Form ER001: Filing Instructions 09/07/2018 (Fri)
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PDF icon Foreign Risk Retention Group Filing instructions E-R001.pdf58.69 KB
Form ER001: Filing Instructions 04/02/2015 (Wed)
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PDF icon Form ER001: Filing Instructions153.63 KB
Form ER001: Filing Instructions 03/02/2015 (Wed)
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PDF icon Form ER001: Filing Instructions654.89 KB
FORM ER001 FOREIGN RISK RETENTION GROUP FILING INSTRUCTIONS 10/02/2020 (Wed)
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PDF icon Foreign Risk Retention Group Filing instructions E-R001.pdf164.9 KB
Form E478I: Arizona Special Schedule P Report Instructions 04/12/2014 (Wed)
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PDF icon E478I.pdf25.47 KB
Form E230: Change to Domestic Insurer Statutory Agent 04/11/2016 (Thu)
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PDF icon E230_0.pdf520.69 KB
Form E185XD: Instructions for Approval of Extraordinary Dividends and Other Distributions 07/07/2018 (Thu)
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PDF icon Holding Company Extraordinary Dividends E-185XD.pdf54.25 KB
Form E185F: Instructions for the completion of the Enterprise Risk Report 09/07/2018 (Fri)
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PDF icon Holding Company Form F E-185F.pdf57.92 KB
Form E185F: Instructions for the Completion of the Enterprise Risk Report 08/07/2018 (Thu)
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PDF icon Holding Company Form F E-185F.pdf57.92 KB
Form E185E: Instructions for the Completion of the Pre-acquisition Notification Form 08/07/2018 (Thu)
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PDF icon Holding Company Form E E-185E.pdf56.32 KB

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