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Texas Department of Insurance
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Admitted Companies - Company Licensing and Registration

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TDI Form Number Description File Format Language
FIN382 CCRC Form 1 - Application for certificate of authority to do business in the State of Texas under Health and Safety Code Section 246.022
PDF English
FIN604 CCRC Form 1a - Application for authority to offer continuing care in residence in Texas under Health and Safety Code Section 246.0025(b).
PDF English
FIN384 CCRC Form 3 - Officers and directors page
PDF English
FIN385 CCRC Form 4 - Biographical data form
PDF English
FIN386 CCRC Form 4A - Biographical data form for a not-for-profit CCRC board members
PDF English
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
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 Capital Changes Amendment for Texas Stock Property and Casualty or Life, Health and Accident Insurance Companies
Requirements for a capital increase requiring a charter amendment
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
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
FIN367 Application for Reciprocal or Inter-Insurance Exchanges
Application to transact business as a reciprocal or inter-insurance exchange
PDF English
FIN369 Application for Certificate of Authority for a Texas Lloyds
Form for Lloyds companies to complete for a new or amended Certificate of Authority
PDF English
FIN370 Checklist for Charter Amendment for Texas Lloyds
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
PDF English
FIN398 CCRC Name Change Checklist
PDF English
FIN407 Statutory Deposit Transaction Form
Statutory Deposit Transaction Form is submitted when a securities is deposited or withdrawn.
PDF English
FIN435 Checklist for Placing an Initial Statutory Deposit
Checklist for an insurance company to initially place security funds on deposit.
PDF English
FIN436 Checklist for a Name Change or Merger of Securities on Deposit
Checklist outlining documents required for an insurance company to change the name for which securities are held.
PDF English
FIN437 Checklist for Substituting Securities on Deposit
Checklist outlining documents required for an insurance company to substitute securities held on deposit.
PDF English
FIN438 Checklist for Withdrawal of Statutory Deposit
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
FIN450 Joint Control Agreement for Lloyds
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

For more information, contact: CompanyLicense@tdi.texas.gov