Fraternal Life Property & Casualty and Title Insurance Companies or Risk Retention Groups

Below are items needed for the review of a company requesting to re-domesticate to Indiana. Items #1 - #10 are to be filed in conjunction with the Uniform Certificate of Authority Primary Application.

Uniform Certificate of Authority Primary Application

1. Most recent Annual Statement filing - Basket Clause (investment listing) in accordance with IC 27-1-12-2(b)(20) for life or fraternal or IC 27-1-13-3(c)(20) for property and casualty and title insurance companies, and risk retention groups.
2. All affiliated agreements currently in effect.
3. Return the Company's current Indiana Certificate of Authority.
4. Provide the Company's reason(s) for re-domestication to Indiana.
5. A non-objection letter from the Company's current state of domicile, regarding re-domestication to Indiana.
6. Board of Directors' resolution approving the Company's re-domestication to Indiana.
7. Notice of Intention - publication.
8. Three (3) copies of the Company's Articles of Incorporation for re-domestication.
9. The Company's By-Laws (if applicable).
10. Oath of Office by the directors and officers originally signed and notarized.
11. Indiana Biographical Affidavit

The information requested in the preceding should be delivered to the following:
Admissions Coordinator
Indiana Department of Insurance
311 West Washington Street, Suite 300
Indianapolis, Indiana 46204-2787

Once the Department completes its review, we will prepare a certificate of authority and send it to the contact person listed on the application.