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NEW ADDRESS

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

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

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Titlesort descending Last updated Attachments
FINANCIAL REPORTING - FOREIGN/ALIEN: Reinsurer 04/02/2016 (Tue)
FINANCIAL REPORTING - FOREIGN/ALIEN: Risk Retention Group 11/02/2015 (Tue)
FINANCIAL REPORTING - FOREIGN/ALIEN: Title Insurer 02/12/2014 (Fri)
Financial Reporting for Foreign/Alien Entities 04/12/2014 (Fri)
FINANCIAL REPORTING: Senior Residential Entrance Fee Contract Provider 09/12/2014 (Fri)
FIND US AT OUR NEW ADDRESS!! 09/12/2018 (Tue)
Finding a License Record 07/04/2018 (Sun)
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PDF icon FindingALicenseRecord.pdf178.19 KB
Fingerprinting Services 12/06/2019 (Mon)
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PDF icon FingerprintServices_201906.pdf172.34 KB
Flood Insurance Information 10/09/2015 (Thu)
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PDF icon Flood Insurance Information Sept 2015 Update.pdf26.29 KB
Flooding after Wildfires: Department of Emergency and Military Affairs 05/04/2018 (Tue)
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PDF icon DEMA_PR_re_flooding_after_fires_0.pdf149.78 KB
Flooding after Wildfires: Department of Emergency and Military Affairs 06/11/2014 (Sat)
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PDF icon DEMA_PR_re_flooding_after_fires.pdf40.26 KB
For Captives Other Than RRGs: Captive Insurer Annual Report and Renewal Fee Transmittal 03/10/2018 (Mon)
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PDF icon Captive AR-Transmittal 10 2018.SAVEABLE.pdf840.41 KB
For Risk Retention Groups: Captive Insurer Annual Report and Renewal Fee Transmittal 03/10/2018 (Mon)
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PDF icon Captive RRG - Annual Transmittal 844.78 KB
FOREIGN INSURER: Accredited Reinsurer 05/01/2020 (Fri)
FOREIGN INSURER: Exempt Insurer; Employee Benefit Trust/Association 06/01/2020 (Fri)
FOREIGN INSURER: Fraternal Benefit Society 03/01/2019 (Fri)
FOREIGN INSURER: Health Care Services Organization 03/01/2019 (Fri)
FOREIGN INSURER: HMDO Service Corporation 03/01/2019 (Fri)
FOREIGN INSURER: Life/Disability/Health Insurer 03/01/2019 (Fri)
FOREIGN INSURER: Mortgage Guaranty Insurer 03/01/2019 (Fri)
FOREIGN INSURER: Prepaid Legal Insurer 03/01/2019 (Fri)
FOREIGN INSURER: Property/Casualty Insurer 07/10/2019 (Wed)
FOREIGN INSURER: Risk Retention Group 03/01/2019 (Fri)
FOREIGN INSURER: Service Corporation (HMDO) 03/01/2019 (Fri)
FOREIGN INSURER: Title Insurer 03/01/2019 (Fri)
FOREIGN INSURER: Unaffiliated Credit Life & Disability Reinsurer 06/01/2020 (Fri)
Foreign Insurers 04/01/2020 (Thu)
Form 1024A: Insurer Rate Service Organization Reference Filing Adoption Form 08/11/2014 (Fri)
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PDF icon REFERENCE_FILING_ADOPTION_FORM_1024A_(Fillable).pdf30.92 KB
Form 1024B: Calculation of Company Loss Cost Multiplier 08/11/2014 (Fri)
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PDF icon CALCULATION_OF_COMPANY_LOSS_COST_MULTIPLIER_1024B_(Fillable).pdf70.68 KB
Form C-RFI 03/07/2018 (Mon)
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PDF icon form_c-rfi.pdf850.66 KB
Form C-TPC: Third-party Consent 08/04/2018 (Sun)
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PDF icon Form C-TPC137.9 KB
Form CU 1621: Credit Property/Credit Unemployment Certification of Rates 02/04/2019 (Mon)
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PDF icon CU 1621 Certification Form.pdf694.38 KB
Form E-100-A: Life and Health Administrator Registration Addendum 02/12/2018 (Tue)
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PDF icon Form E-100-A TPA New Application Addendum.pdf762.14 KB
Form E-100-B: Life and Health Administrator Biographical List 02/12/2018 (Tue)
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PDF icon Form E-100-B TPA Biographical List.pdf767.11 KB
Form E-100: Application for Life and Health Administrator Registration 08/08/2019 (Mon)
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PDF icon Form E-100 TPA New Application 20190809.pdf1.72 MB
Form E-111: Renewal Application for Life and Health Administrator Registration 02/12/2018 (Tue)
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PDF icon Form E-111 TPA Renewal Application.pdf1.41 MB

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