Below is a list of Conditional License Application Forms:
Conditional License Application (A-1) Form Updated as of 3/23/2022
• Documents List for Conditional License Application A-1
Conditional License Application (A-2) Form Updated as of 3/23/2022
• Documents List for Conditional License Application A-2
Conditional License Cover Sheet Updated as of 3/23/2022
Below is a list of Captive Forms that can be found on this Captive website:
Form A-1 — Captive Application for Certificate of Authority
Form A-2 — Series Application
Form B-1 — Biographical Affidavit Revised 2/18/2020
Form B-2 — Declaration Affidavit of Financial Institutions as Trust Trustees
Form C-1 — Account Bank Balance Confirmation Form Revised 5/19/2022
Form C-2 — Sample Owner’s Request for Balance Confirmation
Form C-3 — Sample Surplus Note
Form C-4 — Sample Letter of Credit
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
Form E-2 — Captive Manager Authorization Application
Form E-3 — Certified Public Accountant Authorization Application
Form F-1 — Annual Report for Pure Captives, Core LLCs and Series Captive Insurance Companies Updated as of 4/28/2022
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 10/22/2021
Form H-1 — Dissolution Request Cover Sheet for Standalone Captive
Form H-2 — Dissolution Request Cover Sheet for Series Captive
Related Topics: Captive Insurance, Conditional License Application, Delaware Captive Insurance Program, DOI, forms