Get Ucaa Form 11. Uniform Certificate Of Authority Application Biographical Affidavit - Form 11 - Doi Nv

Filling out the UCAA Form 11 is a critical step for individuals and organizations seeking authorization in the insurance sector. This guide provides clear, step-by-step instructions to help users complete the form accurately and efficiently online.

Follow the steps to successfully complete your application.

1. Press the ‘Get Form’ button to access the UCAA Form 11 and open it in your chosen editor.
2. Begin by entering the applicant name, along with the NAIC number and FEIN at the top of the form.
3. Provide your full name, address, and telephone number in the designated fields. Ensure that this information is up-to-date and correctly formatted.
4. Answer the questions regarding citizenship, occupation, and business address. Be as thorough and accurate as possible.
5. Fill out the education and training section. List your college/university names, locations, dates attended, and degrees obtained.
6. Complete the list of memberships in professional societies and associations. Ensure to include the name, contact information, and your position within these organizations.
7. Detail your complete employment history for the last twenty years, providing necessary information for each position held, including dates, employers, positions, and supervisory contacts.
8. Respond to the inquiries about fidelity bonds, including any claims made, and address any previous denials or revocations of bonds if applicable.
9. List any professional licenses held in the specified section, including licensing authority information. If you have held licenses that may include your social security number, be cautious about how you report that information.
10. Answer all background questions truthfully, providing details for any affirmative responses regarding legal or regulatory actions against you or your entities.
11. Sign and date the affidavit section at the end of the form, ensuring your signature is legible and matches the printed name.
12. Prepare for notarization by filling in the required details and seeking a notary public to acknowledge your signature.
13. Once completed, save your changes. You may also download, print, or share the form as needed for your records or submission.

Begin filling out the UCAA Form 11 online today to secure your Uniform Certificate of Authority.