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Captives - Company Licensing and Registration Forms

Captives - Company Licensing and Registration Forms
TDI Form Number Description File FormatLanguage
FIN179
Guidelines for the formation of a Texas Captive Insurance Company
Guidelines for the formation of a Texas Captive Insurance Company
PDF English
FIN180
Certificate of Authority Application for a Captive Insurance Company
Certificate of Authority Application for a Captive Insurance Company, either a Texas start up or a company wishing to redomesticate to Texas
PDF English
FIN181
Biographical Affidavit for Captive Insurance Company
Biographical Affidavit form for individuals that oversee management of the Captive Insurance Company
PDF English
FIN182
Financial Projections for Captive Insurance Company
Financial Projections Excel Workbook for Captive Insurance Company
EXCEL English
FIN183
Guidelines for captive insurance company who wishes to relocate to Texas, including optional pre-filing process.
Redomestication Guidelines for Captive Insurance Companies
PDF English
FIN184
Appointment of Agent for Service of Process for a Captive Insurance Company
Notarized form appointing an agent for service of process for a captive insurance company
PDF English
FIN185
Moving a Captive Insurance Company's Books and Records Out of the State of Texas Under Texas Insurance Code, Section 803
Form and requirements for a captive insurance company wishing to move its books, records, accounts, and/or principle office(s) outside the state of Texas
PDF English
FIN186
Captive Insurance Company Officers' Certification and Attestation Certificate of Filing
Certification by a Captive Insurance Company's Officers in regards to true and accurate information submitted with application
PDF English
FIN321
Company Licensing Fee Transmittal Form
Company Licensing and Registration Fee Transmittal Form to be submitted with filings.
PDF English
FIN405
Company Licensing and Registration Open Records Request
Open Records Request form for the Company Licensing and Registration Office
PDF English

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