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Admitted Companies - Company Licensing and Registration

Admitted Companies - Company Licensing and Registration
TDI Form Number Description File FormatLanguage
FIN300
Company Name Application
Application to reserve a company name
PDF English
FIN307
Attorney-in-Fact and Underwriters Page
Lists the Attorney-in-Fact and Underwriters of Lloyds and Reciprocals
PDF English
FIN310
Application For A License As An Advisory Organization
Submit application to be licensed as an Advisory Organization
PDF English
FIN311
Biographical Affidavit
Biographical Affidavit form to be completed by certain officers and directors of insurance companies; compliance with statute
PDF English
FIN312
Attorney for Service form
Attorney for Service form
PDF English
FIN321
Company Licensing Fee Transmittal Form
Company Licensing and Registration Fee Transmittal Form to be submitted with filings.
PDF English
FIN322
Articles of Incorporation for a Texas Domestic P&C Company
Submitted as Articles of Incorporation for a Texas Domestic Property and Casualty Company
PDF English
FIN323
Articles of Incorporation for a Texas Domestic Life, Health and Accident Company
Submitted as Articles of Incorporation for a Texas Domestic Life, Health and Accident Company
PDF English
FIN324
Biographical Affidavit Update
submitted as notification of changes to biographical affidavit
PDF 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
PDF English
FIN332
Articles of Incorporation Amendments for Texas Stock Property and Casualty or Life, Health and Accident Insurance Companies
Amendments to Articles of Incorporation for Texas Domestic Company
PDF English
FIN341
Merger Checklist
Checklist for filing a merger between two stock insurance companies where at least one of the companies is domiciled in Texas
PDF 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
PDF English
FIN346
Checklist for Total and Partial Reinsurance Agreements Involving Foreign Insurance Companies
Checklist for Total or Partial Assumption Reinsurance Agreements involving two foreign insurance companies
PDF English
FIN349
Withdrawal Checklist
Filing instruction for an insurer wanting to withdraw or cease writing a line or lines of insurance in the state of Texas
PDF English
FIN350
Guidelines to Re-enter Texas Market Subsequent to Withdrawal
Filing instruction for insurance companies wishing to re-enter the Texas insurance market subsequent to filing a withdrawal plan
PDF English
FIN351
Voluntary Dissolution Checklist
Instructions for a Texas-Domestic Company wanting to Dissolve and Cancel its Certificate of Authority
PDF English
FIN352
CCRC Biographical Affidavit Requirements
Biographical afffidavit requirements for Continuing Care Retirement Communities (CCRCs)
PDF English
FIN353
Biographical Affidavit and Fingerprint Requirements for Texas-Domestic Insurers
Requirements and instructions for submitting biographical affidavits and fingerprints for Texas-domestic insurers
PDF English
FIN354
Biographical Affidavit and Fingerprint Requirements for Foreign Insurers
Instructions and requirements for submitting biographical affidavit and fingerprints for foreign insurers
PDF English
FIN356
Biographical Affidavit and Fingerprint Requirements for Texas Lloyds and Reciprocal Insurers
Instructions and requirements for submitting biographical affidavit and fingerprints for Texas Lloyds and Reciprocal insurers
PDF English
FIN367
Reciprocal or Inter-Insurance Exchanges (Form A-212)
Application to transact business as a reciprocal or inter-insurance exchange
PDF English
FIN369
Form A-211 (Lloyds)
Form for Lloyds companies to complete for a new or amended Certificate of Authority
PDF English
FIN370
Charter Amendment Guidelines for a Lloyds Plan
Instructions for Lloyds amendments, including Underwriter Substitution, Attorney-in-Fact Change, Name Change or Home Office Change, or Increase in Guaranty Fund or Surplus Contribution
PDF English
FIN372
Conversion of Lloyds to Stock P&C Insurer
Filing instructions for a Lloyds insurer to convert to a stock property and casualty insurer
PDF English
FIN373
Instructions for Certificate of Authority for Multiple Employer Welfare Arrangement
Filing instructions for preparing the application to become licensed as a Multiple Employer Welfare Arrangement (MEWA)
PDF English
FIN374
MEWA Application to Do Business
Application form to do business as a Multiple Employer Welfare Arrangement (MEWA)
PDF English
FIN375
Application for Initial Certificate of Authority (MEWA)
Multiple Employer Welfare Arrangement (MEWA) application for a temporary, or initial certificate of authority
PDF English
FIN376
MEWA Officers, Directors, and Trustees Page
Listing of all officers, directors, and trustees associated with the Multiple Employer Welfare Arrangement (MEWA)
PDF English
FIN377
Service of Process (MEWA)
Multiple Employer Welfare Arrangement (MEWA) Service of Process form
PDF English
FIN378
MEWA Annual Filing Checklist
Instructions for submitting annual filing for a Multiple Employer Welfare Arrangement (MEWA)
PDF English
FIN381
CCRC Filing Requirements for Certificate of Authority
Instructions for an entity wishing to operate as a Continuing Care Retirement Community (CCRC) in Texas
PDF English
FIN382
CCRC 1 - Application for Certificate of Authority to do Business in Texas
Continuing Care Retirement Community (CCRC) application for Certificate of Authority to do business in Texas, CCRC From #1
PDF 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 Commissioner's approval to release loan reserve fund escrow amounts in excess of that allowed by rule (CCRC Form #2)
PDF English
FIN384
CCRC 3 - Officers and Directors Page
Continuing Care Retirement Community (CCRC) listing of all associated officers and directors, CCRC Form #3
PDF English
FIN385
CCRC 4 - Biographical Data Form for a For-Profit CCRC
Continuing Care Retirement Community (CCRC) biographical data form to be completed by any person serving as a board member for a for-profit CCRC, CCRC Form #4
PDF English
FIN386
CCRC 4A - CCRC Biographical Affidavit for a Not-For-Profit CCRC
Continuing Care Retirement Community (CCRC) biographical data form to be completed by any person serving as a board member for a Not-for-Profit CCRC, CCRC Form #4a
PDF English
FIN387
CCRC 5 - Acknowledgement of Delivery of Disclosure Statement
Continuing Care Retirement Community (CCRC) resident's acknowledgement of delivery of Disclosure Statement, CCRC Form #5
PDF English
FIN388
CCRC 6 - Format for Disclosure Statement
Continuing Care Retirement Community (CCRC) detailed instructions and format for submitting Disclosure Statement, CCRC Form #6
PDF English
FIN389
CCRC Form #6A - CCRC Instructions for Preparation of Disclosure Statement
Continuing Care Retirement Community (CCRC) instructions for preparing Disclosure Statement filing, CCRC Form #6a
PDF English
FIN390
CCRC 7 - Change of Control Statement
Continuing Care Retirement Community (CCRC) instructions including content and format in preparing statement regarding a change of control, CCRC Form #7
PDF English
FIN391
CCRC 8 - Certification of Changes to Disclosure Statement
Continuing Care Retirement Community (CCRC) certification of changes made to the Disclosure Statement, CCRC Form #8
PDF English
FIN392
CCRC 9 - Notice of Request to Release Entrance Fee Escrow Funds
Continuing Care Retirement Community (CCRC) written notice of request to release entrance fee escrow funds, CCRC Form #9
PDF English
FIN393
CCRC 10 - Notice of Request to Release Funds from the Reserve Fund Escrow Account
Continuing Care Retirement Community (CCRC) written notice of request to release funds from the reserve funds escrow account, CCRC Form #10
PDF English
FIN394
CCRC 11 - Notice by Provider of Re-Payment of Previously Released Funds to the Reserve Fund Escrow Account
Continuing Care Retirement Community (CCRC) Provider's affidavit for repayment of previously released funds to the Reserve Fund Escrow Account, CCRC Form #11
PDF English
FIN395
CCRC 12 - Escrow Agent's Affidavit of Re-payment of Previously Released Funds to the Reserve Fund Escrow Account
Continuing Care Retirement Community (CCRC) escrow agent's affidavit for repayment of previously released funds to the Reserve Fund Escrow Account, CCRC Form #12
PDF English
FIN396
CCRC 13 - Notice of Lien
Continuing Care Retirement Community (CCRC) written notice of lien, CCRC Form #13
PDF English
FIN397
CCRC 14 - Calculations Concerning Conditions
Continuing Care Retirement Community (CCRC) calculations concerning conditions, CCRC Form #14
PDF English
FIN398
CCRC Name Change Checklist
Continuing Care Retirement Community (CCRC) charter amendment checklist to effect a name change
PDF English
FIN403
Continuing Care Retirement Community (CCRC) Release of Funds from Escrow
Continuing Care Retirement Community (CCRC) instructions relating to written notice for a request of release of funds from the entrance fee escrow
PDF English
FIN405
Company Licensing and Registration Open Records Request
Open Records Request form for the Company Licensing and Registration Office
PDF English
FIN406
Statutory Deposit Fee Transmittal Form
Fee transmittal form submitted with statutory deposit filings
PDF English
FIN407
Statutory Deposit Transaction Form
Statutory Deposit Transaction Form is submitted when a securities is deposited or withdrawn.
PDF English
FIN435
Initial Statutory Deposit Checklist
Checklist for an insurance company to initially place security funds on deposit
PDF English
FIN436
Name Change for Securities on Deposit Checklist
Checklist outlining documents required for an insurance company to change the name for which securities are held
PDF English
FIN437
Substituting Securities on Deposit Checklist
Checklist outlining documents required for an insurance company to substitute securities held on deposit
PDF English
FIN438
Withdrawal of Statutory Deposit Checklist
Instructions outlining documents required for an insurance company to withdraw securities on deposit, due to a reduction, dissolution, merger, or cancellation of company's Certificate of Authority
PDF English
FIN440
Instructions for Completing Securities Deposited Form 120
PDF English
FIN441
Securities Deposit Form 120 (FIN 441)
Securities Deposit Form 120, to be used by insurance companies. Refer to FIN440 for instructions in completing this form.
PDF English
FIN444
Instructions for Completing Securities Withdrawn Form 121
Instructions for completing securities withdrawn Form 121
PDF English
FIN445
Securities Withdrawn Form 121 (FIN445)
Securities Withdrawn Form 121, to be used by insurance companies. Refer to FIN444 for instructions in completing this form.
PDF English
FIN450
Joint Control Agreement
Form to be executed by Lloyds plan when placing required net assets as required by statute
PDF English
FIN453
Declaration of Trust
Form to be executed for securities held on deposit
PDF English
FIN482
Notification that an Insurer or HMO will be acting as an Administrator
Form notifying TDI than an Insurer or HMO will be acting as an Administrator (TPA)
PDF English

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