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This Form is used for requesting an appeal for a healthcare decision in Arizona.
This form is used for certifying healthcare providers in Arizona who are eligible to participate in expedited medical reviews.
This form is used for fingerprint verification in Arizona. It is required for certain applications or background checks.
This Form is used for requesting information from a healthcare provider in Arizona.
This document is a request for information form that is used when trying to gather information from a health insurer in Arizona. It is used to request specific details and documentation related to health insurance coverage.
This document provides the outcome of an informal settlement teleconference in Arizona regarding a specific matter.
This Form is used for resolving disputes related to surprise out-of-network billing in Arizona.
This form is used for requesting a captive certificate in the state of Arizona.
This type of form is used in Arizona to provide prior notice of a transaction. It is important to follow the instructions provided to ensure that the transaction is properly reported.
This Form is used for submitting an Enterprise Risk Report in the state of Arizona. It provides instructions on how to fill out and submit the report, helping businesses comply with the state's risk management requirements.
This form is used for the annual registration of insurance holding companies in the state of Arizona. It provides instructions for completing the registration statement.
This Form is used for submitting a pre-acquisition notification regarding the potential competitive impact of a proposed merger or acquisition by a non-domiciliary insurer doing business in Arizona or by a domestic insurer.
This document provides instructions on how to make changes to a Form B Registration Statement in Arizona. It guides individuals or businesses through the process of updating their registration information.
This Form is used for providing a profile of a captive management firm based in Arizona.
This form is used for directors and officers of captive insurers in Arizona to disclose any conflicts of interest they may have.
This form is used for submitting a biographical affidavit for captive insurers in the state of Arizona.
This Form is used for summarizing changes made to a registration statement in the state of Arizona.
This form is used for submitting a sample Irrevocable Letter of Credit for a Captive Insurance Company in Arizona.
This form is used for applying for a Certificate of Authority for a captive line of business change in Arizona.
This form is used for applying for a license for a captive insurance company in the state of Arizona.
This Form is used for applying for an Individual Protected Cell (PC) license as part of the Protected Cell Captive Insurer (PCCI) in Arizona.
This form is used for applying to change a Life Care Provider Permit in the state of Arizona.
This Form is used for applying for a Life Care Provider Permit in the state of Arizona.
This Form is used for applying to become a Life Settlement Provider in Arizona. It is an application for a Certificate of Authority to operate as a Life Settlement Provider.
This Form is used for reporting the stockholders/owners of a life settlement provider in Arizona.
This form is used for applying for purchasing group registration in Arizona. It is used by individuals or organizations who want to register as a purchasing group in the state.
This document is used for appointing a statutory agent for a life settlement provider in the state of Arizona.
This document provides instructions for completing Form E-185CHC, which is used when making changes to the Form C Summary of Registration Statement in Arizona.
This form is used for obtaining a bond for a service company in the state of Arizona.
This form is used for transmitting the annual audited financial report for a senior residential entrance fee contract provider in Arizona.
This form is used for registering providers of senior residential entrance fee contracts in Arizona.
This Form is used for applying for the designation of a domestic surplus lines insurer in Arizona.
This form is used for renewing the service company permit in Arizona.
This form is used to assess the antifraud plan of life settlement providers in Arizona.
This form is used for creating a biographical list of service companies in Arizona.
This form is used for assigning a certificate of deposit or time deposit to the Arizona State Treasurer in Arizona.
This form is used for applying for a service company permit in the state of Arizona. It is required for businesses that provide services such as cleaning, landscaping, or home repairs.