Get Naic Forms

Filling out the Naic Forms online is a straightforward process that ensures your compliance with insurance regulations. This guide will provide you with detailed instructions on how to accurately complete each section of the forms.

Follow the steps to complete the Naic Forms online.

1. Press the ‘Get Form’ button to access the form and open it in your preferred online editor.
2. Begin by filling in the applicant name at the top of the form. Ensure that the name matches the entity as registered.
3. Enter the NAIC number and the Federal Employer Identification Number (FEIN) in the corresponding fields.
4. Indicate whether this is an original designation or an amended designation by checking the appropriate box.
5. Provide the insurer's name and, if applicable, the previous name in the designated spaces.
6. Fill out the home office address, including city, state, zip code and NAIC CoCode.
7. Complete the section authorizing the appointment of an agent for service of process by providing the necessary details as outlined in Exhibit A.
8. Ensure that one of the officers of the applicant signs the certification and attestation section, including their printed name and the date.
9. If applicable, complete Exhibit A by marking an 'X' next to each state for which you are appointing a designated agent.
10. Fill out Exhibit B for each state indicated in Exhibit A, providing details such as the name of the entity, contact numbers, email address, and mailing address.
11. Once every section is filled out correctly, review the form for accuracy before proceeding to save, download, print, or share the completed document.

Complete your Naic Forms online today for a smooth filing process.