Financial Affairs Division Arizona Department of Insurance Reset100 North 15th Avenue, Suite 102, Phoenix, Arizona 850072624 Phone: (602) 3643999 Web: https://insurance.az.gov/APPLICATION AND ORDER.
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How to fill out the AZ Form E126XS online
This guide provides a clear and supportive approach to filling out the AZ Form E126XS online. Follow the steps to ensure a complete and accurate submission for the release of excess deposit funds with the Arizona Department of Insurance.
Follow the steps to fill out the AZ Form E126XS correctly.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Enter the name of the company in the designated section labeled 'Name of Company.' Make sure to print the name exactly as registered.
- Input the NAIC number in the corresponding field. This number is essential for identifying your corporation within the insurance industry.
- In the section for funds deposited, fill in the total amount, ensuring it reflects the face value of the funds to be released.
- Complete the next field by entering the required deposit amount. If applicable, state the amounts in the placeholders provided.
- Certify the information by signing your name in the ‘Signed’ field and noting the date in the ‘Dated’ section.
- Indicate your capacity within the organization in the 'In my capacity as:' field.
- If relevant, attach the properly completed and signed Release Form E126CD for each Certificate of Deposit to be released.
- Specify the mailing address where a copy of this Order should be sent in the section labeled 'Please mail our copy of this Order to:.'
- Review all information entered for accuracy. Save the form, and then choose to download, print, or share as needed for your records.
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