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Title Last updated Attachments
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-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-MG.MPP: Report of Policyholders Position 01/11/2019 (Tue)
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PDF icon Mortgage Guaranty MPP E-MG.MPP_.pdf1.56 MB
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-LSPS: Life Settlement Provider Annual Statement 03/11/2020 (Tue)
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PDF icon Life Settlement Provider Annual Statement E-LSPS.pdf1.31 MB
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-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-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 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-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-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-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-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.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-INSTALL: Tax Installment Report 11/01/2018 (Wed)
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File Form E-INSTALL3.62 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-HCSO.13: Certificate of Advertising Compliance 10/02/2020 (Mon)
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PDF icon Certificate of Advertising Compliance E-HCSO.13.pdf1023.7 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-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 E-CR-S Instructions 04/11/2020 (Mon)
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PDF icon Cert Rein E-CR-S Instructions.pdf136.33 KB
Form E-CR-INFO: Certified Reinsurer Information 10/09/2021 (Wed)
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PDF icon Reinsurer E-CR-INFO Info 20210825 - Cary Cook.pdf165.53 KB
Form E-CR-I: Certified Reinsurer Instructions 04/11/2020 (Mon)
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PDF icon Cert Rein E-CR-I Instructions.pdf139.8 KB
Form E-CR-F Instructions 04/11/2020 (Mon)
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PDF icon Cert Rein E-CR-F Instructions.pdf112.47 KB
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-CERTREQCAPTIVE: Certificate Request Form Captive 03/07/2021 (Thu)
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PDF icon Certificate Request Form Captive Web20210707.pdf1.08 MB
Form E-CERTREQ: Certificate Request Form 01/08/2021 (Thu)
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PDF icon Certificate Request Form Web20210802.pdf1.07 MB
Form E-AR-1: Certificate of Assuming Insurer 10/03/2020 (Fri)
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PDF icon Reinsurer E-AR-1 Certificate of Assuming Insurer.pdf811.39 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-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.IC: Audited Financial Report Internal Control Filings Transmittal 11/11/2019 (Thu)
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PDF icon Audited Financial Report Internal Control Filings E-AFR.IC_.pdf4.45 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-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