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INACAP-1109AccountantsApp.doc

INACAP-1109AccountantsApp.doc 2025

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The document is an application form for accountants seeking professional liability insurance on a claims-made basis. It requires detailed information about the applicant's firm, including its history, staff, services provided, insurance coverage history, and any past claims or disciplinary actions. The form emphasizes the importance of accuracy in the information provided and outlines potential legal consequences for fraudulent statements.

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Click ‘Get Form’ to open the INACAP-1109AccountantsApp.doc in the editor.
Begin by entering your firm’s name and address in the designated fields. Ensure accuracy as this information is crucial for identification.
Indicate whether your firm operates full-time or part-time. If part-time, provide details of your other employment.
List all predecessor firms if applicable, including their establishment dates and nature of changes. This section is vital for coverage consideration.
Fill in the total staff count, including branch offices, and provide details about owners and partners using the provided format.
Complete the insurance history section by indicating if you currently carry professional liability insurance and providing relevant details.
Report gross fees for the last two fiscal years and projections for the current year in cash basis format as specified.
Finally, review all sections for completeness before submitting your application to ensure a smooth processing experience.

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