UCAA PRIMARY APPLICATION



FOR PRIMARY APPLICATION ONLY FLORIDA SPECIFIC INFORMATION

NOTE: The Office of Insurance Regulation is now receiving applications electronically. Please submit online at www.floir.com, select Companies, Industry Portal and iApply Online Company Admissions or directly at https://apps.fldfs.com/wecaa/SignOn.aspx, unless Applicant elects to utilize the UCAA Electronic Application. The requirements otherwise remain unchanged.

Insurers are required to provide a copy of the Articles of Incorporation of any firm involved in the financing or formation of the insurer certified by the public official with whom the originals are on file in the state of domicile.
Florida requires a statement of the method to be used in the financing of the insurer and verification of funds. To print or download the items to be included (click here). There are additional financial requirements for mutual insurers. To print or download a copy of Section 628.161, Florida Statutes (click here).
For mutual insurers only, provide a copy of a fidelity bond or insurance policy per Section 628.171, Florida Statutes. To print or download a copy of Section 628.171, Florida Statutes (click here).
Florida requires fingerprinting of all individuals for which biographical affidavits or business character reports are being submitted. To print or download a copy of the fingerprint card instructions (click here). To print or download a copy of the fingerprint charges invoice form (click here). The fingerprint cards can be obtained from the Applications Coordinator by calling (850) 413-2575 or at their email address appcoord@floir.com.

OIR-C1-1522
5/2002