Admitted Company Transactions Forms and Checklists
This is one of several pages linking to a central repository of forms used by TDI customers. Use the search or Forms by Type links on the Forms Home Page or scan through our form listings.
| TDI Form Number | Description | File Format | Language |
|---|---|---|---|
| FIN300 | Company Name Application Application to reserve a company name |
English | |
| FIN301 | Life/Health Application for Certificate of Authority Compliance with statutes |
English | |
| FIN303 | P&C Application for Certificate of Authority Compliance with statutes |
English | |
| FIN304 | Standard Coverages Page Declares property and casualty lines of business to be listed on Certificate of Authority |
English | |
| FIN305 | Assumed Name Certificate Indicates what the assumed name will be |
English | |
| FIN306 | Officers and Directors Page Complete Listing of all Current Officers and Directors - compliance with statutes |
English | |
| FIN307 | Attorney-in-Fact and Underwriters Page Lists the Attorney-in-Fact and Underwriters of Lloyds and Reciprocals |
English | |
| FIN308 | Budget Projection Form for Life Company Assists in financial review for admission/licensure of a Life Company |
English | |
| FIN309 | Budget Projection Form for P&C Company Assists in financial review for admission/licensure of a P&C Company |
English | |
| FIN311 | Biographical Affidavit Compliance with statutes |
English | |
| FIN313 | Company License Customer Survey Feedback from Applicants |
English | |
| FIN316 | Mortgage Guaranty Affidavit Affidavit that verifies monoline authority |
English | |
| FIN317 | Reinsurer Affidavit Verify applicants understanding of TDI rules |
English | |
| FIN318 | Trust Agreement (U.S. Branch) Agreement between US branch and Texas bank establishing trust |
English | |
| FIN320 | Capital Changes Worksheet Worksheet |
English | |
| FIN321 | Consent Order Waiver Signature page for Commissioner's Order |
English | |
| FIN325 | State of Texas Statement of Retaliatory Fees and Requirements Requirements for insurers, including Capital and Surplus Requirements; Fees; Deposit and Bonds; Premium Tax Requirements; and Additional Taxes |
English | |
| FIN326 | Businesss Plan Outline for Life, Accident & Health Company Filing instruction |
English | |
| FIN327 | Business Plan Outline for P&C Company Filing instruction |
English | |
| FIN328 | Abbreviated Business Plan Filing instruction |
English | |
| FIN329 | Group Hospital Service Corporation Guideline/Checklist |
English | |
| FIN330 | Mexican Casualty Admission Checklist Filing instruction |
English | |
| FIN331 | Domestication of US Branch Filing instruction |
English | |
| FIN332 | Domestic Life & Health Charter Amendment Checklist Checklists for a Texas Life & Health Company Needing to Amend their Articles of Incorporation for Transactions such as Capital Increase/Decrease, Name Change, Home Office Change, and Adding or Deleting a Line of Business |
English | |
| FIN333 | Domestic P&C Charter Amendment Checklists Checklists for a Texas P&C Company Needing to Amend their Articles of Incorporation for Transactions such as Capital Increase/Decrease, Name Change, Home Office Change, and Adding or Deleting a Line of Business |
English | |
| FIN334 | County Mutual Charter Amendment Checklist Filing instruction |
English | |
| FIN335 | Farm Mutual Charter Amendment Checklist Filing instruction |
English | |
| FIN336 | Local Mutual Aid or Burial Association Charter Amendment Guidelines Filing instruction |
English | |
| FIN337 | Increase Authorized or Stated Capital Filing instruction |
English | |
| FIN338 | Adding Variable Annuity Authority Checklist Filing instruction |
English | |
| FIN339 | Adding Variable Life Authority Checklist Filing instruction |
English | |
| FIN340 | Application to Amend Certificate of Authority Filing instruction |
English | |
| FIN341 | Merger involving at least one Domestic Insurer Filing instruction |
English | |
| FIN342 | Conversion of a Domestic Mutual Insurance Company Filing instruction |
English | |
| FIN343 | Foreign Demutualization or Conversion Checklist Filing instruction |
English | |
| FIN345 | Total and Partial Assumption Reinsurance for Domestic Companies Checklist for Total and Partial Assumption Reinsurance Agreements involving at least one Texas domestic insurance company |
English | |
| FIN346 | Checklist for Total and Partial Reinsurance Agreements involving two Foreign Companies Filing instruction |
English | |
| FIN347 | Reinsurance of Mutual Assessment Company into a Stipulated Premium Company Filing instruction |
English | |
| FIN348 | Assumption Certificate Guidelines for Life, Accident, and/or Health Business Filing instruction |
English | |
| FIN349 | Withdrawal checklist Filing instruction for an insurer wanting to withdraw or cease writing a line or lines of insurance |
English | |
| FIN350 | Re-enter Texas Market Subsequent to Withdrawal Guidelines Filing instruction |
English | |
| FIN351 | Voluntary Dissolution Checklist Instructions for a Texas-Domestic Company wanting to Dissolve and Cancel its Certificate of Authority |
English | |
| FIN352 | CCRC Biographical Affidavit Requirements Biographical Affidavit requirements for Continuing Care Retirement Communities (CCRCs) |
English | |
| FIN353 | Texas-Domestic Insurers Biographical Affidavit and Fingerprint Requirements Biographical Affidavit and Fingerprint requirements for Texas-Domestic Insurers |
English | |
| FIN354 | Foreign Insurers Biographical Affidavit and Fingerprint Requirements Biographical Affidavit and Fingerprint requirements for foreign insurers |
English | |
| FIN356 | Texas Lloyds Insurers and Reciprocals Biographical Affidavit and Fingerprint Requirements Biographical Affidavit and Fingerprint Requirements for Texas Lloyds Insurers and Reciprocals |
English | |
| FIN367 | Form A-212 (Reciprocal) Reciprocal companies complete for new or amended Certificate of Authority |
English | |
| FIN368 | Lloyds Incorporation Checklist Filing instruction |
English | |
| FIN369 | Form A-211 (Lloyds) Lloyds companies complete for new or amended Certificate of Authority |
English | |
| FIN370 | Charter Amendment Checklist for a Lloyds Plan Instruction for Lloyds amendments, including Underwriter Substitution, Attorney-in-Fact Change, Name Change or Home Office Change, or Increase in Guaranty Fund or Surplus Contribution |
English | |
| FIN371 | Attorney-in-Fact Change for Foreign Lloyds or Reciprocals Change checklist |
English | |
| FIN372 | Conversion of Lloyds to Stock P&C Insurer Filing instruction |
English | |
| FIN373 | MEWA Application for Initial and Permanent Certificate of Authority Filing instructions |
English | |
| FIN374 | MEWA Application to Do Business Checklist |
English | |
| FIN375 | MEWA Application Form for Initial Certificate of Authority Application Form |
English | |
| FIN376 | MEWA Officers, Directors, and Trustees Page Form |
English | |
| FIN377 | MEWA Service of Process Acknowledgment Form |
English | |
| FIN378 | MEWA Annual Filing Checklist Filing instruction |
English | |
| FIN381 | CCRC Filing Requirements for Certificate of Authority Filing instruction |
English | |
| FIN382 | CCRC 1 - Application for Certificate of Authority to do Business in Texas CCRC Application for Certificate of Authority to do business in Texas |
English | |
| FIN383 | CCRC 2 - Application for Approval by the Commissioner for Release of Loan Reserve Fund Escrow Account Amounts In Excess of that Allowed by Rule Application for Commissioners Approval to Release Loan Reserve Fund Escrow Amounts in Excess of that Allowed by rule |
English | |
| FIN384 | CCRC 3 - Officers and Directors Page CCRC Officers and Directors Page |
English | |
| FIN385 | CCRC 4 - Biographical Data Form for a For-Profit CCRC Biographical Data Form for a For-Profit CCRC |
English | |
| FIN386 | CCRC 4A - CCRC Biographical Affidavit for a Not-For-Profit CCRC CCRC Biographical Affidavit for a Not-For-Profit CCRC |
English | |
| FIN387 | CCRC 5 - Acknowledgement of Delivery of Disclosure Statement CCRC Acknowledgement of Delivery of Disclosure Statement |
English | |
| FIN388 | CCRC 6 - Format for Disclosure Statement Detailed instruction/format for submitting Disclosure Statement |
English | |
| FIN389 | CCRC Form #6A - CCRC Instructions for Preparation of Disclosure Statement Outline of Instructions for Preparation of CCRC Disclosure Statement |
English | |
| FIN390 | CCRC 7 - Change of Control Statement Guidelines and Statement |
English | |
| FIN391 | CCRC 8 - Certification of Changes to Disclosure Statement Certification form |
English | |
| FIN392 | CCRC 9 - Notice of Request to Release Entrance Fee Escrow Funds Attestation form |
English | |
| FIN393 | CCRC 10 - Notice of Request to Release Funds from the Reserve Fund Escrow Account Attestation form |
English | |
| FIN394 | CCRC 11 - Notice by Provider of Re-Payment of Previously Released Funds to the Reserve Fund Escrow Account Filing form |
English | |
| FIN395 | CCRC 12 - Affidavit of Re-payment of Previously Released Funds to the Reserve Fund Escrow Account Filing form |
English | |
| FIN396 | CCRC 13 - Notice of Lien Filing form |
English | |
| FIN397 | CCRC 14 - Calculations Concerning Conditions Filing form |
English | |
| FIN398 | CCRC Name Change Checklist CCRC Charter Amendment Checklist - Name Change |
English | |
| FIN399 | Joint Underwriting Association (JUA) Licensing (Initial or Renewal) Filing instruction |
English | |
| FIN400 | Joint Underwriting Association (JUA) Application for Certificate of Authority Filing form |
English | |
| FIN401 | Joint Underwriting Association (JUA) Supplemental Information (JUA-2A) Filing checklist JUA-2A |
English | |
| FIN402 | Joint Underwriting Association (JUA) Application for Amended Certificate of Authority (JUA-2B) Filing form JUA-2B |
English | |
| FIN403 | Continuing Care Retirement Community (CCRC) Release of Funds from Escrow Filing instructions |
English | |
| FIN435 | Initial Statutory Deposit Checklist Checklist |
English | |
| FIN436 | Name Change for Securities on Deposit Checklist Checklist |
English | |
| FIN437 | Substituting Securities on Deposit Checklist Checklist |
English | |
| FIN438 | Withdrawal of Statutory Deposit Checklist Withdrawal Checklist |
English | |
| FIN439 | Texas Comptroller's Wiring Instructions Instructions |
English | |
| FIN440 | Instructions for Completing Securities Deposited Form 120 Instructions |
English | |
| FIN441 | Deposit Form 120 (FIN 441) Form for companies |
English | |
| FIN443 | Deposit Form 120 (FIN443) Form for LLoyds companies |
English | |
| FIN444 | Instructions for Completing Form 121 Instructions |
English | |
| FIN445 | Securities Withdrawal Form 121 (FIN445) Form for companies |
English | |
| FIN447 | Securities Withdrawal Form 121 (FIN447) Form for LLoyds |
English | |
| FIN448 | Instructions for Lloyds Placing Securities in Joint Control Instructions |
English | |
| FIN450 | Joint Control Agreement Agreement |
English | |
| FIN454 | Declaration of Trust 1.10 (Policyholders or Creditors) Declaration |
English | |
| FIN460 | Declaration of Trust 861.252a (Domestic P&C Companies), formerly 8.05-1 Declaration |
English |
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