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Question 3: Who must submit the NAIC Biographical Affidavit? Answer: The NAIC Biographical Affidavit is required to be submitted by an applicant in connection with pending or future application(s) for licensure or a permit to organize with a department of insurance in one or more states. The NAIC Biographical Affidavit.
28 Dec 2017 NAIC Form 11: Biographical Affidavit. Must be completed by each partner, officer, and director, and each other individual owning 10% or more of a TPA applicant. ARS § 20-485.12(B)(5). PDF icon NAIC_Form_11_Biographical_Affidavit_ 20140818.pdf
The NAIC Biographical Affidavit is used to evaluate the suitability of the Affiant in connection with an applicant's pending or future application(s) for licensure or a permit to organize with a department of insurance in one or more states.
28 Sep 2011 (602) 364-3999 to request fingerprint cards and instructions. Expansion: NAIC Biographical Affidavit and Third-Party Verification. NAIC biographical affidavit is not required for new officers or directors. Arkansas. NAIC Biographical Affidavit and Third-Party Verifications. NAIC biographical affidavit is not
NAIC Biographical Affidavit and Fingerprint Cards. Affidavit must be originally executed. Contact the Financial Affairs Divisions at: (602) 364-3999 to request fingerprint cards and instructions. Expansion: NAIC Biographical Affidavit and Third-Party Verification. NAIC biographical affidavit is not required for new officers or
The National Association of Insurance Commissioners (NAIC) website is the source for uniform state requirements and forms for Primary, Expansion, or Corporate Amendments applications. To file an Expansion or Corporate Amendments application, visit the Uniform Certificate of Authority Application (UCAA) system
Items 1 - 14 a contact person or a link to a state specific format or RBC requirements and instructions. 4. . The applicant must submit an NAIC Biographical Affidavit on behalf of all officers, directors and key B. The NAIC Biographical Affidavit requests information with respect to your employment history, education,.
The agency, when contacted by an insurer requesting an independent verification report, shall receive a completed copy of the individual's NAIC Biographical Affidavit and Authority for Release of Information form. These forms shall be sworn to by the affiant, notarized and dated not more than one year prior to the date of
NAIC No. FEIN: BIOGRAPHICAL AFFIDAVIT. To the extent permitted by law, this affidavit will be kept confidential by the state insurance regulatory authority. The affiant may be required to provide additional information during the third-party verification process if they have attended a foreign school or lived and worked
15 Sep 2017 NAIC Biographical Affidavit and Independent Third- Party Verification. NAIC biographical affidavit is required for new President's only, within 30 days. LA Licensure: Complete biographical affidavits (Form 11) on most current form for all officers and directors.

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March 2018