Get Nd Sfn 61675 2019-2026

The ND SFN 61675 is a crucial application for discount plan organizations seeking approval from the North Dakota Insurance Department. This guide provides clear instructions to help users conveniently fill out the form online.

Follow the steps to complete your discount plan organization application.

1. Click ‘Get Form’ button to access the application and open it in the online editor.
2. Begin by entering the name of the discount plan organization in the designated field. Make sure to provide the full legal name as registered.
3. Fill in the mailing address, ensuring to include the city, state, and ZIP code correctly.
4. If your principal place of business is different from the mailing address, provide that address along with the corresponding city, state, and ZIP code.
5. Enter the web address of your organization, if applicable.
6. If operating under a doing business as (DBA) name, fill in that name in the corresponding field.
7. Indicate the states in which your organization operates.
8. Input your federal identification number for identification purposes.
9. Enter the date of incorporation or organization correctly.
10. Provide the name and mailing address of the parent company, if applicable.
11. Respond to the general interrogatories by checking 'yes' or 'no' for each question regarding licenses, permits, and bankruptcy.
12. List the officers of the organization by entering their names, addresses, and titles/occupations. Ensure to provide accurate contact information.
13. If needed, attach additional pages for additional officers or directors.
14. Designate a compliance officer by entering their name, address, and title/occupation.
15. Ensure that all required documents are attached as part of your application, including a compliance certificate, application fee, affidavits, contracts, marketing materials, complaint procedures, and other necessary forms.
16. Finally, review all the information you entered for accuracy. Save changes, then download, print, or share the completed form as needed.

Start your application process by filling out the ND SFN 61675 online today!