Vermont Department of Financial Regulation Forms

This document is used for the adoption of rate service organization prospective loss costs reference filing in Vermont by an insurer.

This document provides information on how to calculate the Company Loss Cost Multiplier with Expense Constants in Vermont. It explains the process and formulas used to determine the multiplier, which is used in the calculation of insurance premiums.

This Form is used for obtaining an Irrevocable Letter of Credit for a Captive Insurance Company in Vermont.

This document is used for providing information about an individual's personal background and history in the state of Vermont.

This form is used for providing information and obtaining consent for HIV testing in Vermont.

This document provides a calculation method for finding the least common multiple (LCM) of numbers without incurring any additional expenses. This applies specifically to residents of Vermont.

This form is used for notifying individuals in Vermont who have tested positive for HIV.

This document is used for applying for authorization to certify loss reserves and loss expense reserves for captive insurance companies in Vermont.

This Form is used for submitting audited financial statements and actuarial opinions in Vermont. It provides instructions on how to complete and submit the necessary forms.

This form is used for submitting audited financial statements and actuarial opinions in the state of Vermont. It is required for certain organizations to ensure compliance with financial regulations.

This document is used for applying to be authorized as an independent certified public accountant for captive insurance business in the state of Vermont.

This document is used for a Vermont resident director to provide their biographical information and affirm its accuracy.

This Form is used for applying as a Risk Purchasing Group in Vermont.

This document is an application form for an insurance company to apply for admission to the state of Vermont.

This form is used for filing consumer complaints with the Vermont Banking Division in Vermont.

This document is an application for Affiliated Reinsurance Company (ARC) to be admitted to the state of Vermont. It is a form that ARC needs to complete in order to seek approval for operating in Vermont.

This document is used for submitting Vcar, Premium Tax (Copy), Audit, and Actuarial filings in the state of Vermont.