APPLICATION AND ORDER FOR RELEASE OF EXCESS DEPOSIT: Fill out & sign online

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Click ‘Get Form’ to open the APPLICATION AND ORDER FOR RELEASE OF EXCESS DEPOSIT in the editor.
In Section A, enter the name of the insurer and its NAIC number. Ensure that you also specify the domicile state of the corporation.
Fill in the total amount of funds deposited with the Arizona State Treasurer in par/face value. This is crucial for processing your application.
Certify that these funds exceed the required deposit amount by entering that figure as well. Make sure to double-check your calculations.
Indicate the remaining amount of funds on deposit, ensuring it meets either the par/face value or current market value requirement.
Sign and date the application, including your title to validate your authority as an officer completing this form.
For Section B, leave it blank as it will be completed by the Department of Insurance and Financial Institutions after approval.

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