Below is a list of Captive Forms that can be found on this Captive website:

Form A-1 — Captive Application for Certificate of Authority Revised 3/28/2024

Form A-2 — Series Application Updated as of 3/27/2024

Form B-1 — Biographical Affidavit Revised 9/25/2024

Form B-2 — Declaration Affidavit of Financial Institutions as Trust Trustees Revised 7/25/2023

Form C-1 — Account Bank Balance Confirmation Form Revised 7/25/2023

Form C-2 — Sample Owner’s Request for Balance Confirmation

Form C-3 — Sample Surplus Note

Form C-4 — Sample Letter of Credit Revised 7/25/2023

Form D-1 — Designation for Receipt of Delaware Documents

Form D-2 — Designation for Receipt of Service of Process Updated as of 6/7/2021

Form E-1 — Actuarial Authorization Application Revised 7/11/2024

Form E-2 — Captive Manager Authorization Application Revised 4/13/2023

Form E-3 — Certified Public Accountant Authorization Application Revised 4/13/2023

Form F-1 — Annual Report for Pure Captives, Core LLCs and Series Captive Insurance Companies Updated as of 3/31/2025

• Form F-1 Instructions Updated as of 3/31/2025

Form F-2 — Annual Report for Other Captive Entities Updated as of 4/8/2020

Form F-3 — Quarterly Captive Report Updated as of 2/25/2019

Form G-1 — Dormant Status Request Form Updated as of 11/02/2023

Form H-1 — Dissolution Request Cover Sheet for Standalone Captive Updated as of 11/16/2023

Form H-2 — Dissolution Request Cover Sheet for Series Captive Updated as of 11/16/2023