NEW ADDRESS Starting January 27, 2020

Arizona Department of Insurance

100 North 15th Avenue, Suite 261

Phoenix, AZ  85007-2630

VISITORS

Citizens, license applicants, process servers:

  • We will continue to provide assistance from Suite 102 through Friday, January 24, 2020. 
  • We will be up and running in Suite 261 starting Monday, January 27, 2020.

 

    MAIL

    Send mail to our new suite number effective immediately (before January 27, 2020). 

    Please make sure to update our address in your contact lists and information systems.

    Sitemap

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    Titlesort descending Last updated Attachments
    Form E-FBS: Annual Fees and Retaliation Report for a Fraternal Benefit Society 10/01/2019 (Fri)
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    PDF icon Form E-FBS (v. 20190118)898.02 KB
    Form E-HCSO.13: Certificate of Advertising Compliance 12/01/2019 (Tue)
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    PDF icon Certificate of Advertising Compliance E-HCSO.13.WebVersion.pdf639.16 KB
    Form E-II: Industrial Insured Premium Receipts Tax Report 10/01/2019 (Fri)
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    PDF icon Form E-II (v. 20190118)1.26 MB
    Form E-INSTALL: Tax Installment Report 11/01/2018 (Wed)
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    File Form E-INSTALL3.62 MB
    Form E-LIFECARE.AMEND: Amendment to Annual Report 12/01/2019 (Tue)
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    PDF icon Life Care Provider Annual Report Amendment E-LIFECARE.AMEND_.WebVersion.pdf703.64 KB
    Form E-LIFECARE.AS: Annual Report Filing Checklist 01/11/2019 (Tue)
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    PDF icon Life Care Provider Annual Report Filing Checklist E-LIFECARE.AS_.pdf870.89 KB
    Form E-LIFECARE: Annual Report Form 01/11/2019 (Tue)
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    PDF icon Life Care Provider Annual Report E-LIFECARE.pdf3.56 MB
    Form E-LR.AS: Annual Statement Filings Worksheet 03/12/2018 (Tue)
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    PDF icon Form L-RA.AS Worksheet1.11 MB
    Form E-LR.I: Annual Statement Filing Instructions 11/11/2019 (Thu)
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    PDF icon Life and Disability Reinsurer Annual Instructions E-LRI (3).pdf125.75 KB
    Form E-LRTF: Local and Regional Taxes and Fees; Survey of Arizona Domestic Insurers 12/01/2019 (Fri)
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    File Form E-LRTF (v. 20190118)1.02 MB
    Form E-LSP1: Life Settlement Provider Application for Certificate of Authority 08/07/2018 (Thu)
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    PDF icon Life Settlement Provider E-LSP1.pdf98.9 KB
    Form E-LSP2: Life Settlement Provider Report of Stockholders/Owners 08/07/2018 (Thu)
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    PDF icon Life Settlement Provider E-LSP2.pdf98.87 KB
    Form E-LSP3: Life Settlement Provider Report of Officers, Directors, Members, Partners and Designated Employees 08/07/2018 (Thu)
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    PDF icon Life Settlement Provider E-LSP3.pdf98.12 KB
    Form E-LSP4: Life Settlement Provider Statutory Agent Appointment and Acceptance 08/07/2018 (Thu)
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    PDF icon Life Settlement Provider E-LSP4.pdf112.27 KB
    Form E-LSPF: Life Settlement Provider Anti-fraud Plan Checklist 08/07/2018 (Thu)
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    PDF icon Life Settlement Provider E-LSPF.pdf584.2 KB
    Form E-LSPI: Life Settlement Provider Application for Certificate of Authority - Instructions 08/07/2018 (Thu)
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    PDF icon Life Settlement Provider E-LSPI.pdf160.25 KB
    Form E-LSPS: Life Settlement Provider Annual Statement 08/07/2018 (Thu)
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    PDF icon Life Settlement Provider Annual Statement E-LSPS.pdf1.36 MB
    Form E-MG.CEDE: Supplementary Schedule F-3 09/04/2019 (Mon)
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    PDF icon Mortgage Guaranty Cede E-MG.CEDE (2).pdf167.38 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_.pdf1.24 MB
    Form E-MRR.05: Annual Report of Policy and Loss Reserves and Application for Certificate of Authority Renewal 03/11/2018 (Tue)
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    PDF icon Form E-MRR.05787.98 KB
    Form E-MRR.AS: Annual Statement Filings Worksheet 09/12/2018 (Thu)
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    PDF icon Form E-MRR.AS 1.11 MB
    Form E-MRR.I: Annual Statement Filing Instructions 08/05/2019 (Fri)
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    PDF icon Mechanical Reimbursement Reinsurer Annual Instructions E-MRRI (3).pdf143.37 KB
    Form E-NAIC.HEALTH: Annual Filing Checklist 08/11/2019 (Mon)
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    PDF icon E-NAIC.HEALTH (1).pdf234.52 KB
    Form E-NAIC.LD: Annual Filing Checklist 12/11/2019 (Mon)
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    PDF icon E-NAIC.LD (1).pdf271.77 KB
    Form E-NAIC.LD: Annual Filing Checklist 08/11/2019 (Mon)
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    PDF icon E-NAIC.LD (1).pdf271.77 KB
    Form E-NAIC.PC: Annual Filing Checklist 08/11/2019 (Mon)
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    PDF icon E-NAIC.PC (1).pdf263.02 KB
    Form E-NAIC.TITLE: Annual Filing Checklist 08/11/2019 (Mon)
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    PDF icon E-NAIC.TITLE (1).pdf214.28 KB
    Form E-PC.350: Producer-controlled Property and Casualty Insurance Report 12/01/2019 (Tue)
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    PDF icon Producer Controlled Report E-PC.350.WebVersion.pdf700.07 KB
    Form E-PC.INDINS: Report of Policies Issued to Industrial Insureds 03/11/2018 (Tue)
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    PDF icon Indistrial Insured E-PC.INDINS.pdf724.32 KB
    Form E-RE-A: Reinsurer Annual Instructions 03/06/2018 (Tue)
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    PDF icon Reinsurer RE-A Instructions.pdf51.71 KB
    Form E-RE-A: Reinsurer Annual Instructions 10/09/2018 (Thu)
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    PDF icon Reinsurer E-RE-A Instructions.pdf51.71 KB
    Form E-RE-I: Reinsurer Initial Instructions 02/06/2018 (Tue)
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    PDF icon E-RE-I (Instructions)52.68 KB
    Form E-RT: Retaliation Report 10/01/2019 (Fri)
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    File Form E-RT (v. 20181211)78.62 KB
    Form E-SGHI: Accountable Health Plan Small-employer Group Health Insurance Plan Premium 11/01/2019 (Fri)
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    File Form E-SGHI (v. 20190117)416.73 KB
    Form E-SR.AFR: Sr. Residential Entrance Fee Contracts: Provider Annual Audited Financial Report Transmittal Form 08/07/2018 (Thu)
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    PDF icon Sr. Residential Entrance Fee Contract Provider Annual AFR Transmittal E-SR.AFR_.pdf159.17 KB
    Form E-SR.INSTR: Sr. Residential Entrance Fee Contracts: Provider Compliance With A.R.S. Title 44, Chapter 25, Article 1 08/07/2018 (Thu)
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    PDF icon Sr. Residential Entrance Fee Contract Provider E-SR.INSTR_.pdf54.07 KB

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