Form AID-LI-CAR "Rental Car Company Application" - Arkansas

What Is Form AID-LI-CAR?

This is a legal form that was released by the Arkansas Insurance Department - a government authority operating within Arkansas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2020;
  • The latest edition provided by the Arkansas Insurance Department;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form AID-LI-CAR by clicking the link below or browse more documents and templates provided by the Arkansas Insurance Department.

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Download Form AID-LI-CAR "Rental Car Company Application" - Arkansas

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FORM AID-LI-CAR (5/20)
ARKANSAS INSURANCE DEPARTMENT
LICENSE DIVISION
1 COMMERCE WAY, SUITE 104
LITTLE ROCK, AR 72202
PHONE: 501-371-2750
FAX: 501-683-260
RENTAL CAR COMPANY APPLICATION
Business Entity Name
Incorporation/Formation Date (month/day/year)
FEIN
List any name under which you are doing business
State of Domicile
Country of Domicile
Business Address
City
State
Zip or Foreign Country
Phone Number
Fax Number
Business Web Site Address
Business E-Mail Address
Mailing Address
P.O. Box
City
State
Zip or Foreign Country
Location of Rental Offices doing business in Arkansas (attach sheet if addition space is needed)
Name of Office
Phone Number
Address
Name of Office
Phone Number
Address
Name of Office
Phone Number
Address
Name of Office
Phone Number
Address
Name of Office
Phone Number
Address
Name of Office
Phone Number
Address
I,
hereby state under oath that all the information in the application is true and
correct to the best of my knowledge.
Must be signed by an officer, director, principal
or partner of the business entity:
Date:
Signature
(month/day/year)
Typed or Printed Name
Title
Social Security Number
Address
City State Zip
FORM AID-LI-CAR (5/20)
ARKANSAS INSURANCE DEPARTMENT
LICENSE DIVISION
1 COMMERCE WAY, SUITE 104
LITTLE ROCK, AR 72202
PHONE: 501-371-2750
FAX: 501-683-260
RENTAL CAR COMPANY APPLICATION
Business Entity Name
Incorporation/Formation Date (month/day/year)
FEIN
List any name under which you are doing business
State of Domicile
Country of Domicile
Business Address
City
State
Zip or Foreign Country
Phone Number
Fax Number
Business Web Site Address
Business E-Mail Address
Mailing Address
P.O. Box
City
State
Zip or Foreign Country
Location of Rental Offices doing business in Arkansas (attach sheet if addition space is needed)
Name of Office
Phone Number
Address
Name of Office
Phone Number
Address
Name of Office
Phone Number
Address
Name of Office
Phone Number
Address
Name of Office
Phone Number
Address
Name of Office
Phone Number
Address
I,
hereby state under oath that all the information in the application is true and
correct to the best of my knowledge.
Must be signed by an officer, director, principal
or partner of the business entity:
Date:
Signature
(month/day/year)
Typed or Printed Name
Title
Social Security Number
Address
City State Zip
Instructions:
1. The application must be typed or printed.
2. The fee for a car rental license is $35.00 on company check made payable to the Arkansas Insurance
Department Trust Fund.
3. List all Rental Offices located in Arkansas on the application or you may attach a listing if the listing includes
all the information requested on the application.
4. Completed Application and fee should be mailed to the:
Arkansas Insurance Department
Attn: License Division
1 Commerc Way, Suite 104
Little Rock AR 72202
5. The license must be renewed January 1 of each year.
If you have any questions regarding a Car Rental License, please contact the License Division at 501-371-2750.
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