Get Company Enforcement, Final Order - 02-04-021. Western Grocers Employee Benefits Trust - Cbs State Or

Filling out the Company Enforcement, Final Order - 02-04-021 is an essential step for compliance and resolution of administrative proceedings. This guide offers step-by-step instructions for effectively completing the form online, ensuring clarity and accuracy in your submissions.

Follow the steps to fill out the form correctly.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Review the fields carefully. Start with the 'Stipulation' section, where Western Grocers must confirm their willingness to conclude administrative proceedings by signing the form. Ensure the representative is authorized to act on behalf of the organization.
3. Provide accurate information regarding licensing. Fill in the details about Western Grocers' licensing status, including the Oregon Insurance Division company number and NAIC identification number.
4. In the 'Facts and Conclusions' section, detail any previous administrative actions taken against Western Grocers. This includes information about market conduct examinations and the corresponding findings.
5. Follow the recommendations outlined in the report. Each recommendation must be addressed clearly, indicating whether steps have been taken to comply. Provide specifics on actions taken in response to previous findings by the Insurance Division.
6. Complete the 'Action' section by specifying the civil penalty amount and providing details for payment, including the method of payment and where it should be sent.
7. Finalize the form by signing it. Ensure that the printed name and title of the representative are included, as well as the date when the form is signed.
8. After completing all sections, review the document for accuracy. Save all changes to ensure no information is lost, then download, print, or share the completed form as necessary.

Complete your documents online today to ensure compliance and resolve any outstanding issues promptly.