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License Application Forms

Important: How to use fillable forms

  • Two ways to use: The documents below are 'fillable' PDF's which should be able to open in any basic Adobe Acrobat Reader. You may: (1) Print them out as blank forms, or (2) You can fill them out directly on your screen. If you experience any difficulties using the fill-in feature you can always just print out a blank copy as before.
  • Filling in the document: When filling forms out directly on your screen, in order to move from space to space you can hit the Tab key, and you can also use the cursor or space bar to move around the form as you would with any regular document.  To check a blank 'checkbox', simply click on it with your cursor.
  • How to submit: These forms cannot be submitted on-line. You must print out the completed forms, sign as needed, and mail them in. You can save your completed document on your hard drive for your records.

Application for Admission 

Application for Authorization to Certify Loss Reserves

Irrevocable Letter of Credit (This form has been recently revised and is not yet converted to a editable version. It is a regular PDF.)

2011 Premium Tax Form

Biographical Affidavit

Application for Authorization to Act as CPA for Captive Insurance Business

Approved Captive Actuaries

Approved Captive CPAs