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Titlesort ascending Last updated Attachments
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-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-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-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-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-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-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-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-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-LR.I: Annual Statement Filing Instructions 08/05/2019 (Fri)
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PDF icon Life and Disability Reinsurer Annual Instructions E-LRI (2).pdf125.13 KB
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-LIFECARE: Annual Report Form 12/01/2019 (Tue)
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PDF icon Life Care Provider Annual Report E-LIFECARE.WebVersion.pdf3.5 MB
Form E-LIFECARE.AS: Annual Report Filing Checklist 12/01/2019 (Tue)
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PDF icon Life Care Provider Annual Report Filing Checklist E-LIFECARE.AS_.WebVersion.pdf815.79 KB
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-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 10/01/2019 (Fri)
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PDF icon Form E-II (v. 20190118)1.26 MB
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-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-DIRCOMWAIVER: Arizona Domestic Insurers Board of Directors and/or Committees Waiver Application 08/07/2018 (Thu)
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PDF icon Holding Company Directors Committees Waiver E-DIRCOMWAIVER.pdf58.58 KB
Form E-CR-S Instructions 03/06/2018 (Tue)
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PDF icon Form E-CR-S Instructions56.67 KB
Form E-CR-INFO: Certified Reinsurer Information 10/06/2019 (Wed)
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PDF icon Certified Reinsurer E-CR-INFO Information 20190518.pdf159.4 KB
Form E-CR-I: Certified Reinsurer Instructions 02/06/2018 (Tue)
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PDF icon Certified Reinsurer CR-I Instructions.pdf57.17 KB
Form E-CR-F Instructions 03/06/2018 (Tue)
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PDF icon Form E-CR-F51.96 KB
Form E-CR-C: Uniform Application Checklist for Certified Reinsurers 09/07/2018 (Fri)
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PDF icon Certified Reinsurer E-CR-C Application Checklist.pdf1.24 MB
Form E-CR-1: Certificate of Certified Reinsurer 08/07/2018 (Thu)
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PDF icon Certified Reinsurer E-CR-1 Certificate.pdf1.84 MB
Form E-CERTREQ: Certificate Request Form 10/07/2018 (Tue)
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PDF icon Certificate Request Form964.81 KB
Form E-AR-1: Certificate of Assuming Insurer 08/07/2018 (Thu)
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PDF icon Reinsurer E-AR-1 Certificate of Assuming Insurer.pdf1.49 MB
Form E-AMEND: Summary to Changes to Taxes and Fees 12/01/2018 (Sat)
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File e-amend.xlsx69.07 KB
Form E-AHCCCS: AHCCCS Contractor Quarterly Premium Tax Report 09/01/2019 (Fri)
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File Form E-AHCCCS56.59 KB
Form E-AFR.OHE: Audited Financial Report Organizational Hardship Exemption Guidelines and Sample Affidavit 03/11/2018 (Tue)
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PDF icon Audited Financial Report Organizational Hardship Exemption E-AFR-OHE.pdf3.68 MB
Form E-AFR.IC: Audited Financial Report Internal Control Filings Transmittal 02/06/2019 (Thu)
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PDF icon Audited Financial Report Internal Control Filings E-AFR.IC_.WebVersion.pdf760.83 KB
Form E-AFR.IC.RE: Audited Financial Report Internal Control Filings Transmittal Reinsurer 02/06/2019 (Thu)
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PDF icon Audited Financial Report Internal Control Filings E-AFR.IC_.RE_.pdf594.89 KB
Form E-AFR.GFE: Audited Financial Report Exemption Guidelines 03/11/2018 (Tue)
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PDF icon Audited Financial Report Guidelines for Exemptions E-AFR-GFE.pdf3.8 MB
Form E-ACTOP: Actuarial Opinion Exemption Guidelines 12/01/2019 (Tue)
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PDF icon Actuarial Opinion Financial Hardship Exemption E-ACTOP.WebVersion.pdf747.73 KB
Form E-857: Bond of Service Company 03/06/2018 (Tue)
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PDF icon Form E-857 Bond of Service Company.pdf707.69 KB
Form E-820: Service Company Application Checklist 11/08/2018 (Tue)
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PDF icon Form E-820 Service Company Review Checklist817.73 KB

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Warning - Phishing Scam

We are aware of a phishing scam targeting insurance professionals claiming that the National Association of Insurance Commissioners received a complaint that the professional submitted a falsified claim. This fraudulent email displays the NAIC and CIPR logos, can originate from what appears to be an naic.org or gmail.com email account, and instructs the recipient to click on a link to download the complaint notification.

Certain antivirus products will detect this as a malicious email.  If you receive a similar email and have any concerns, contact the NAIC Service Desk at (816) 783-8500 or [email protected].