
APPLICATION FOR COVERAGE NORTH DAKOTA INSURANCE DEPARTMENT STATE BONDING FUND SFN 54369 10-2013 1. GENERAL INFORMATION Name of Obligee Insured Entity County Contact Person Position Mailing Address City Telephone Number Fax Number Bond Number State ZIP Code 2.
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How to fill out the Sfn54369 online
Filling out the Sfn54369 form online can streamline your application for coverage with the North Dakota Insurance Department. This guide will provide you with step-by-step instructions to ensure accuracy and efficiency while completing the necessary information.
Follow the steps to complete the Sfn54369 form online.
- Press the ‘Get Form’ button to obtain the Sfn54369 form and open it in your editor.
- Begin with section one, 'General Information.' Here, input the name of the obligee (the insured entity), the county, the contact person's name, their position, mailing address, city, telephone number, fax number, bond number, state, ZIP code, and email address.
- Proceed to section two, 'Underwriting Information.' Specify the number of Class I employees and their physical locations. Include the total number of other staff and use a separate sheet if necessary.
- Move to section three, 'Audits.' Complete one of the three parts: Part A for audits sent to the state auditor, Part B for internal audits, or Part C if you are using an independent CPA. Provide the necessary details about each audit type.
- In section four, 'Inventory Control,' indicate whether a complete inventory has been made. If so, provide the information on who completed the inventory and how often it occurs.
- Follow with section five, 'Bank Account Control.' Answer the questions regarding employees who reconcile monthly bank statements and their roles to assess any weaknesses.
- In section six, 'Computer Control,' confirm whether pre-authorization passwords are maintained and if duties of operators are separated. Also, indicate if output is reconciled by individuals not involved in the input process.
- Continue to section seven, 'Revenue and Securities.' Record the total revenue from all sources over the past year and specify the total amount of negotiable securities held.
- In section eight, 'Coverage Requested,' determine the limit requested based on the revenue and securities as per the guidelines provided.
- Finally, complete section nine, 'Declaration and Signature.' Ensure that the signature is provided along with the date. After completing the form, save your changes and choose an option to download, print, or share the form as required.
Complete your Sfn54369 form online today for a seamless application process.
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APPLICATION FOR COVERAGE. NORTH DAKOTA INSURANCE DEPARTMENT. STATE BONDING FUND. SFN 54369...
Get answers to your most pressing questions about US Legal Forms API.
What is the surplus line tax in North Dakota?
Surplus lines tax: 1.75% if the insured's home state is ND. Properties, risks, or exposures located or to be performed in this state or another state.
What are the four types of insurance required by the state of North Dakota?
The TNC or the driver must provide primary insurance coverage which includes: At least $1 million of coverage for death, bodily injury, and property damage. Uninsured, underinsured, and PIP coverage, which is primary coverage in amounts that meet the requirements under state law.
Who is the insurance commissioner of the United States?
Led by Insurance Commissioner Ricardo Lara, the California Department of Insurance is the consumer protection agency for the nation's largest insurance marketplace and safeguards all of the state's consumers by fairly regulating the insurance industry.
Who is the insurance commissioner of North Dakota?
Commissioner Jon Godfread | North Dakota Insurance Department.
What does DOI regulated mean?
Department of Insurance (DOI means the State agency or regulatory authority that, among other things, licenses, oversees, and regulates Issuers, Agents, and Brokers, as applicable.
Who is the director of the South Dakota Division of insurance?
Larry Deiter - Director - State of South Dakota | LinkedIn.
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