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Office of Insurance Regulation

Company Admissions

Third Party Administrator

ALL FORMS

THIRD PARTY ADMINISTRATOR APPLICATION PACKAGE

OIR-C1-1075

APPLICATION FOR CERTIFICATE OF AUTHORITY ADMINISTRATOR

OIR-C1-903

INVOICE - REQUEST FOR PAYMENT OF FINGERPRINT CHARGES

OIR-C1-905

INSTRUCTIONS FOR FURNISHING BACKGROUND INVESTIGATIVE REPORTS

OIR-C1-938

FINGERPRINT CARD INSTRUCTIONS

OIR-C1-1298

MANAGEMENT INFORMATION FORM COMPLETE LIST OF OFFICERS, DIRECTORS AND SHAREHOLDERS (10% OR MORE)

OIR-C1-1423

BIOGRAPHICAL AFFIDAVIT