| CCRC02/FIN383
|
CCRC Form 2 - Application for Commissioner approval to release excess loan reserve escrow fund amounts under Health and Safety Code Section 278.078
|
PDF |
English |
| CCRC05/FIN387
|
CCRC Form 5 - Delivery of disclosure statement
|
PDF |
English |
| CCRC06/FIN388
|
CCRC form 6 - Format for disclosure statement for continuing care facility
|
WORD |
English |
| CCRC06a/FIN389
|
CCRC Form 6A - Instructions for preparation a continuing care retirement community disclosure statement for filing with TDI
|
PDF |
English |
| CCRC06b/FIN605
|
CCRC form 6B - Format for disclosure statement for continuing care facility
|
WORD |
English |
| CCRC08/FIN391
|
CCRC Form 8 - Certification of changes to disclosure statement
|
PDF |
English |
| CCRC09/FIN392
|
CCRC Form 9 - Notice of request to release entrance fee escrow funds
|
PDF |
English |
| CCRC10/FIN393
|
CCRC Form 10 - Notice of request to release funds from the reserve fund escrow account
|
PDF |
English |
| CCRC11/FIN394
|
CCRC Form 11 - Notice by provider of re-payment of previously released funds to the reserve fund escrow account
|
PDF |
English |
| CCRC12/FIN395
|
CCRC Form 12 - Affidavit of re-payment of previously released funds to the reserve fund escrow account
|
PDF |
English |
| CCRC13/FIN396
|
CCRC Form 13 - Notice of lien
|
PDF |
English |
| CCRC14/FIN397
|
CCRC Form 14 - Calculations concerning conditions
|
PDF |
English |
| CCRC14a/FIN607
|
CCRC Form 14a - Provider request for release of continuing care residence entrance fee escrow funds
|
PDF |
English |
| CCRCRE/FIN403
|
CCRC Release Escrow Checklist
|
PDF |
English |
| FIN111
|
Health Entities Checklist
Filing requirements
|
PDF |
English |
| FIN116
|
HMO Supplement - Annual Information
|
PDF |
English |
| FIN117
|
TDI Instructions for Filing CPA Audited Financial Reports
|
PDF |
English |
| FIN119
|
Life, Accident and Health Insurers
Filing requirements
|
PDF |
English |
| FIN122
|
Property & Casualty Insurers Filing Requirements Checklist
Filing requirements
|
PDF |
English |
| FIN123
|
TDI Supplement Form for County Mutuals
|
PDF |
English |
| FIN127
|
Title Checklist
Filing requirements
|
PDF |
English |
| FIN128
|
Annual Statement Blank - Farm Mutual Companies
|
EXCEL |
English |
| FIN128
|
Annual Statement Blank - Farm Mutual Companies
|
PDF |
English |
| FIN138
|
Texas Supplemental A for County Mutuals Form
Texas Supplemental "A" for County Mutuals Form
|
PDF |
English |
| FIN145
|
Notice of intent to relocate books and records outside of Texas
Form TDI BR-93
|
PDF |
English |
| FIN150
|
Texas Negotiated Deductible Workers' Compensation Form
|
PDF |
English |
| FIN202
|
Texas Policyholder Dividend Disbursement Notification/Application
FIN 202 Texas Policyholder Dividend Disbursement Notification Application
|
PDF |
English |
| FIN244
|
CPA Audited Financial Report - Intent Form
Register a CPA to file an audited financial report
|
PDF |
English |
| FIN246
|
Affidavit for Exemption from Filing CPA Audited Financial Report
CPA Exemption Form
|
PDF |
English |
| FIN251
|
Annual Statement Blank - Mutual Assessments, Burials, LMAs
|
EXCEL |
English |
| FIN251
|
Annual Statement Blank - Mutual Assessments, Burials, LMAs
|
PDF |
English |
| FIN252
|
HMO Quarterly Supplement
|
PDF |
English |
| FIN483
|
Transactions Cash Receipts Transmittal Form
|
PDF |
English |
| FIN584
|
Form D Application - Prior Notice of Transaction
|
PDF |
English |
| FIN585
|
Service Agreement Checklist
Management, Service, Cost Sharing, Tax Allocation, Rental, Lease Agreement Checklist
|
PDF |
English |
| FIN586
|
MGA Contract Review Checklist
Managing General Agency Contract Review Checklist
|
PDF |
English |
| FIN587
|
TPA Contract Review Checklist
Third Party Administrator Contract Review Checklist
|
PDF |
English |
| FIN588
|
Custodial Agreement Review Checklist
|
PDF |
English |
| FIN590
|
Financial Analysis Fee Transmittal Form
for MEWAs and CCRCs
|
PDF |
English |
| FIN599
|
Cybersecurity Checklist
|
PDF |
English |
| FIN609
|
Annual Verification of Fidelity Bond Coverage (HMO Employee)
|
PDF |
English |
| FIN610
|
Annual Verification of Fidelity Bond Coverage (management contractor employees)
|
PDF |
English |
