Domestic Uniform Application Requirements.
Last update: 04/01/2024
Updates to the information will be noted with a “*” next to the state name and edits will be italicized and bolded.
| State | Biographical Affidavit | Form 12 | ||||||
| Required: Yes or No | Additional Outside of Electronic Signature | State Specific Form | Background Report Required | Required: Yes or No | Additional Outside of Electronic Signature | State Specific Form | Forwarding Address/Resident Agent | |
| AL | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes New Officer/ Update: Yes |
Contact state | Contact state | Contact state | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes |
Contact state | Contact state | Commissioner of Insurance # and Resident Agent* |
| AK |
Primary App: Yes |
No | No | Yes |
Primary App: Yes |
No | No | Director of Insurance # |
| *AZ | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: No New Officer/ Update: Yes |
Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: No New Officer/ Update: No |
Not Applicable to AZ domiciled insurers | |||||
| AR |
Primary App: Yes |
Rule 7 | No | Yes |
Primary App: Yes |
No | No | Resident Agent |
| *CA |
Primary App: Contact State |
Form A & New Officer/Update: Yes |
Form A & New Officer/Update: No | Primary: State Performs Form A & New Officer/Update: No |
Primary App: Yes |
Contact state* |
CDI-021 |
Resident Agent, Optional |
| *CO |
Primary App: Yes (NAIC biographical affidavit, is required) |
An original signature and notarization are required; however, electronic signatures are acceptable if generated using an approved electronic signature platform. For Form 15 - original/wet signature is required. |
No | Primary App: Yes (Fingerprints, and independent third-party verification are required) Redomestication App: Yes (Fingerprints, and independent third-party verification are required) Form A App: Yes (Fingerprints, and independent third-party verification are required) Corp Amend App: No, (Bios are required for Merger) New Officer/ Update: Yes - for New domestic Company and mergers. After Licensure: Biographical affidavits are required for changes in Officers, Directors or Key Managerial Personnel. |
Primary App: Yes |
An original signature is required; however, electronic signatures are acceptable if generated using an approved electronic signature platform. |
No | Resident Agent* |
| CT | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes New Officer/ Update: Yes |
No | None | Yes | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes |
No | None | Commissioner of Insurance # |
| *DE | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes, if new officers New Officer/ Update: Yes |
No | No | Yes - for Primary App, Redomestication and Form A | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes, if changing from current |
No | No | Commissioner of Insurance # |
| *DC | Primary App: Yes Redomestication App: Yes Form A App: Contact State Corp Amend App: Contact State New Officer/ Update: Contact State |
Contact State | Contact State | Yes | Primary App: Yes Redomestication App: Yes Form A App: Contact State Corp Amend App: Contact State |
Contact State | Contact State | Commissioner of Insurance, Securities and Banking # or Resident Agent* |
| FL | Contact state for requirements | Contact state for requirements | Chief Financial Officer # ^ | |||||
| GA | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes New Officer/ Update: Yes |
No | No | Yes | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes |
No | Yes | Commissioner of Insurance and Safety Fire # and Resident Agent* |
| HI | Contact state for requirements | Contact state for requirements | ||||||
| ID |
Primary App: Yes |
Electronic or Wet including Notary | No | Yes |
Primary App: Yes |
No | No | Director of Insurance # ^ |
| IL | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: No New Officer/ Update: Yes |
Yes, current NAIC Bio Affidavit bearing original signatures and being notarized. | No | Yes | Primary App: No Redomestication App to Illinois: No Form A App: No Corp Amend App: No |
No | No | Domestic being served in an Illinois matter is served to any officer or director at company's mailing address unless Articles of Incorporation name a specific Registered Agent at an office in Illinois. |
| *IN |
Primary App: Yes |
No | No | Primary, Redom, & Form A: No Corp Amend & New Office Update: No |
Indiana Domestic companies are not required to appoint agent for service of process | N/A | N/A | Served upon the company directly unless company has provided resident agent for service. |
| IA | Primary App: Yes Redomestication App: Contact IID Form A App: Yes Corp Amend App: Yes New Officer/ Update: Contact IID |
Yes | Yes, must comply with IA Code Chapter 554D | Contact IID | Primary App: Yes Redomestication App: Yes Form A App: Contact IID Corp Amend App: Yes |
Yes | Yes, must comply with IA Code Chapter 554D | Commissioner of Insurance # |
| KS | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: No New Officer/ Update: Yes |
N/A | No | Yes | Contact state | N/A | No | Commissioner of Insurance ^ |
| KY | Contact state for requirements | Contact state for requirements | Secretary of State # | |||||
| LA | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes New Officer/ Update: Yes |
Contact state | See LDI website for additional forms required | Yes | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes |
Contact state | See LDI website | Registered Agent |
| ME | Contact state for requirements | Contact state for requirements | Resident Agent* ^ | |||||
| MD | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes New Officer/ Update: Yes |
No | No | Yes | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes |
No | No | Insurance Commissioner # |
| MA | Contact state for requirements | Contact state for requirements | ||||||
| MI | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: No New Officer/ Update: Yes |
Electronic signature acceptable if completed using an approved electronic signature platform. | No | Yes | Primary App: Yes Redomestication App: Yes Form A App: No Corp Amend App: No |
Electronic signature acceptable if completed using an approved electronic signature platform. | No | Resident Agent * |
| MN | Primary App: Yes, with third party affidavits Redomestication App: Contact state department for requirements at insurance.commerce@state.us. Form A App: Contact state department for requirements at insurance.commerce@state.us. Corp Amend App: Contact state department for requirements at insurance.commerce@state.us. New Officer/ Update: Contact state department for requirements at insurance.commerce@state.us. |
Contact state | N/A | Primary: Yes | Primary App: Yes Redomestication App: Yes Form A App: Contact state department for requirements at insurance.commerce@state.us. Corp Amend App: Contact state department for requirements at insurance.commerce@state.us. |
No state specific form for SOP | Resident Agent~ | |
| MS |
Primary App: Yes |
Contact state | No | Primary & Form A: Yes Redomestication, Corp Amend; and New Office/Update: No |
Primary App: Yes |
Only required for a Form A and Corp Amendment if the Service of Process is changing. | No |
Commissioner of Insurance and Resident Agent* BOTH are required. |
| MO | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Depends New Officer/ Update: Yes |
Contact state | No | Yes | Primary App: No Redomestication App: No Form A App: No Corp Amend App: No |
Contact state | Contact state | Company's statutory home address or Registered Agent |
| MT | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes New Officer/ Update: Yes |
Contact state | No | Primary, Redomestication, Form A: Yes Corp Amend & New Officer/ Update: No |
Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes |
Contact state | No | Resident Agent* |
| NE |
Primary App: Yes |
No | No |
Primary App: Yes |
Primary App: Yes |
No | No | Officer of Company* or Resident Agent* |
| NV | Contact state for requirements | Contact state for requirements | Commissioner of Insurance Commission # ^ | |||||
| NH | Contact state for requirements | Contact state for requirements | Commissioner of Insurance # | |||||
| *NJ | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes New Officer/ Update: Yes |
No | No |
Life/Health:
Non Life/Health: Form A App: Yes |
Primary App: Yes Redomestication App: Yes Form A App: Yes, If any changes to NAIC Form 12 Corp Amend App: Yes, If any changes to NAIC Form 12 |
No | No | Commissioner of Banking and Insurance #^ |
| NM | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes New Officer/ Update: Yes |
Yes | No | Yes | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes |
Yes | No | Superintendent of Insurance # |
| *NY |
Primary App: Yes |
Contact State | No | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: No New Officer/ Update: Yes |
Contact state for requirements | Superintendent of Financial Services # | ||
| NC | Contact state for requirements | Contact state for requirements | Commissioner of Insurance | |||||
| ND | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: No New Officer/ Update: Yes |
No | No | Yes | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes |
No | No | Commissioner of Insurance # ^ |
| OH | Contact state for requirements | Contact state for requirements | Resident Agent* | |||||
| OK | Contact state for requirements | Contact state for requirements | Commissioner of Insurance # | |||||
| OR | Contact state for requirements | Contact state for requirements | Resident Agent* | |||||
| PA | Contact state for requirements | Contact state for requirements | ||||||
| PR | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes New Officer/ Update: Yes |
No | No | Yes | Contact State | Commissioner of Insurance # | ||
| RI | Contact state for requirements | Contact state for requirements | Superintendent of Insurance ^ | |||||
| SC |
Contact state for requirements |
Yes | No | Yes |
Contact state for requirements |
Yes | No | Director of Insurance # |
| SD | Contact state for requirements | No | Contact state | Contact state | Contact state for requirements | Yes | Yes | Director of Insurance # ^ |
| TN |
Primary App: Yes |
No | No | Yes |
Primary App: Yes |
No | No | Commissioner of Insurance # |
| TX | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Only if there's been an officer/director change New Officer/ Update: Yes |
Contact state | Contact state | Contact state | Primary App: No Redomestication App: No Form A App: No Corp Amend App: No |
Contact state | Contact state | Resident Agent* |
| UT | Contact state for requirements | Contact state for requirements | ||||||
| VT | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes New Officer/ Update: Yes |
No | No | Primary, redomestication, Form A is required. Corp Amendment or New Officer/director maybe required | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes |
No | No | Resident Agent* |
| VA | Contact State | No | No | Yes | Contact State | No | Yes | Resident Agent |
| WA | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes New Officer/ Update: Yes |
No | No | Yes | Primary App: Yes Redomestication App: Yes Form A App: Yes Corp Amend App: Yes |
No | No | Insurance Commissioner # |
| *WV | Primary App: Yes Redomestication App: Yes Form A App: No Corp Amend App: No, unless amended New Officer/ Update: Yes |
Contact state | No | Yes | Primary App: Yes Redomestication App: Yes Form A App: No Corp Amend App: No, unless amended |
Contact state | No | Secretary of State # |
| WI | Contact state for requirements | No | Contact state for requirements | |||||
| *WY | Primary App: Yes # Redomestication App: Yes # Form A App: Yes # Corp Amend App: Yes # New Officer/ Update: Yes # |
Contact state | Contact state | Contact state | Primary App: Yes # Redomestication App: Yes # Form A App: Yes # Corp Amend App: Yes # |
No | No | Commissioner of Insurance # |
Biographical Affidavit and Uniform Consent to Service of Process
*Reserves the right to request originals
**Will accept copies if originals are on file with the state of domicile
#Will accept electronic signatures
^ If filed in hard copy “wet signatures” required but if submitted through the electronic application, electronic signatures or copies accepted.
Uniform Consent to Service of Process
# For the forwarding of Service of Process received by a State Officer complete Exhibit B listing by state the entities (one per state) with full name and address where service of process is to be forwarded. Use additional pages as necessary. Exhibit not required for New Jersey, and North Carolina. Florida accepts only an individual as the entity and requires an email address. New Jersey allows but does not require a foreign insurer to designate a specific forwarding address on Exhibit B. SC will not forward to an individual by name; however, it will forward to a position, e.g., Attention: President (or Compliance Officer, etc.). Washington requires an email address on Exhibit B.
* Attach a completed Exhibit B listing the Resident Agent for the Applicant Company (one per state). Include state name, Resident Agent’s full name and street address. Use additional pages as necessary. (DC* requires an agent within a ten- mile radius of the District), (MT requires an agent to reside or maintain a business in MT).
* (CA) ALL - Board Resolution - A certified copy of the applicant's board resolution authorizing the amendment and application. California Corporations Code § 300(a).
^ Initial pleadings only.
@ MA will send the required form to the Applicant Company when the approval process reaches that point.
~ Minnesota does not forward Service of Process. Service of Process must be accomplished using the procedures set forth in MN Stat. § 45.028. Applicant Company should complete Exhibit B to provide a resident agent address that Commerce will keep on file. Resident agent must have a Minnesota address.