Get Certificate Of Disclosure Of Information

Filling out the Certificate Of Disclosure Of Information is a crucial step for companies to comply with Arizona state regulations. This guide will help users navigate the form online, ensuring all necessary information is provided accurately.

Follow the steps to complete the Certificate Of Disclosure Of Information online.

1. Click the ‘Get Form’ button to access the Certificate Of Disclosure Of Information and open it in the editing interface.
2. Enter the calendar year for the annual statement for which this certificate is filed at the top of the form.
3. Provide the complete company name as registered. It is important to ensure this matches the official records.
4. Fill in the NAIC number, which uniquely identifies your company within insurance databases.
5. Enter the home office address, including the street address, city, state, and zip code.
6. Indicate the domiciliary state of the company.
7. In Part A, answer the questions regarding any felony convictions or judicial actions for individuals in specific positions. Select 'Yes' or 'No' for items A1 to A3. If 'Yes' is selected, gather the required information and attach it.
8. Proceed to Part B and answer whether any relevant person has served in a corporation that faced bankruptcy or other significant legal issues. Again, select 'Yes' or 'No' and provide the necessary details if prompted.
9. In Part C, list the names of shareholders holding more than ten percent of any class of shares, either directly or via nominees.
10. For title insurers, answer the required question in Part D regarding corporate income tax returns and provide the filing date if applicable.
11. Complete the affidavit of verification section, ensuring that it is signed by the necessary executive officers or directors, listed on the jurat page of the annual statement.
12. Review the completed form carefully to confirm all information is accurate and complete. Once verified, you can save your changes, download, print, or share the completed document.

Complete your Certificate Of Disclosure Of Information online today to ensure compliance and avoid late fees.