Get Printable Fis 0200 Doc

The Printable Fis 0200 Doc is essential for disclosing and updating affiliations within an insurance business entity. This guide provides clear, step-by-step instructions to help users complete the form accurately and effectively.

Follow the steps to successfully complete the Printable Fis 0200 Doc.

1. Click ‘Get Form’ button to obtain the Printable Fis 0200 Doc and open it in your chosen document editor.
2. In Part 1, enter the business entity's name, Tax ID Number (EIN), System ID Number, and National Producer Number. Mark whether this is a new business entity name by selecting ‘Yes’ or ‘No’. Provide a valid business entity email address and phone number, and optionally, a fax number.
3. In Part 1a, indicate if there is a new mailing or business address. If ‘Yes,’ fill in the new mailing and/or business address, including city, state, ZIP code, and country if outside the United States.
4. In Part 2, list any additions or changes to affiliates, Licensed Producers, members, owners, officers, or directors. Include their names and corresponding Social Security Numbers (SSN) or Federal Employer Identification Numbers (FEIN). Mark whether you are adding or canceling their status.
5. In Part 3, answer the questions regarding any criminal convictions or administrative proceedings related to the affiliates. If answering ‘Yes,’ provide necessary details and attach required documentation.
6. In Part 4, if adding a new Designated Responsible Licensed Producer (DRLP), ensure they sign the section acknowledging their compliance responsibilities.
7. In Part 5, have the form signed by a DRLP, officer, director, or partner who certifies the truthfulness of the information provided. Provide the printed name, title, and date.
8. After completing all sections, save the changes made to the document, and finalize it by downloading, printing, or sharing the form as needed.

Complete your Printable Fis 0200 Doc online today to ensure your insurance business entity remains compliant.