Arizona Department of Insurance and Financial Institutions Forms

This document is used for filing a complaint against a property tax agent for a violation in Arizona.

This document provides instructions for applying to become a trust company in the state of Arizona. It outlines the steps and requirements for the application process.

This document for ensuring that parties in a legal proceeding can be served with court papers. It is used in Arizona.

This form is used for filing escrow rates in the state of Arizona. It is required for companies and individuals who provide escrow services.

This form is used for submitting a public records request in Arizona. It allows individuals to request access to government records and information.

This document is used for applying for consent to engage in the business of insurance in the state of Arizona, under 18 U.S.C. 1033.

This form is used for verifying the coverage of life insurance policies in Arizona.

This form is used for providing disclosures to the owner and provider of a life settlement broker in Arizona.

This type of document is used for applying for an individual professional license or registration in Arizona.

This form is used for life settlement providers and brokers in Arizona to disclose their affiliations with other companies involved in life settlements.

This document is a checklist used by life settlement providers in Arizona to ensure that all necessary components are included in a contract.

This Form is used for individuals in Arizona who are applying for a temporary insurance license.

This Form is used for voluntarily surrendering an insurance license in the state of Arizona.

This form is used for Life Settlement Brokers in Arizona to notify the regulatory authority about their activities.

This form is used for creating a biographical list of life and health insurance administrators in Arizona.

This document lists the branch locations of L-LOC in Arizona.

This form is used for individuals or businesses in Arizona who have lost their certificate of registration and need to provide a sworn statement confirming the loss.

This Form is used for reporting premium receipts taxes for industrial insureds in Arizona.

This Form is used for requesting an appeal for a healthcare decision in Arizona.

This form is used for certifying healthcare providers in Arizona who are eligible to participate in expedited medical reviews.

This form is used for fingerprint verification in Arizona. It is required for certain applications or background checks.

This Form is used for requesting information from a healthcare provider in Arizona.

This document is a request for information form that is used when trying to gather information from a health insurer in Arizona. It is used to request specific details and documentation related to health insurance coverage.

This document provides the outcome of an informal settlement teleconference in Arizona regarding a specific matter.

This Form is used for resolving disputes related to surprise out-of-network billing in Arizona.

This form is used for requesting a captive certificate in the state of Arizona.

This type of form is used in Arizona to provide prior notice of a transaction. It is important to follow the instructions provided to ensure that the transaction is properly reported.

This Form is used for submitting an Enterprise Risk Report in the state of Arizona. It provides instructions on how to fill out and submit the report, helping businesses comply with the state's risk management requirements.

This form is used for the annual registration of insurance holding companies in the state of Arizona. It provides instructions for completing the registration statement.

This Form is used for submitting a pre-acquisition notification regarding the potential competitive impact of a proposed merger or acquisition by a non-domiciliary insurer doing business in Arizona or by a domestic insurer.

This document provides instructions on how to make changes to a Form B Registration Statement in Arizona. It guides individuals or businesses through the process of updating their registration information.

This Form is used for providing a profile of a captive management firm based in Arizona.

This form is used for directors and officers of captive insurers in Arizona to disclose any conflicts of interest they may have.

This form is used for submitting a biographical affidavit for captive insurers in the state of Arizona.

This Form is used for summarizing changes made to a registration statement in the state of Arizona.

This form is used for submitting a sample Irrevocable Letter of Credit for a Captive Insurance Company in Arizona.

This form is used for applying for a Certificate of Authority for a captive line of business change in Arizona.

This form is used for applying for a license for a captive insurance company in the state of Arizona.