"Pledge of Certificate" - Oklahoma

Pledge of Certificate is a legal document that was released by the Oklahoma Insurance Department - a government authority operating within Oklahoma.

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Download "Pledge of Certificate" - Oklahoma

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PLEDGE OF CERTIFICATE
I, the undersigned, do hereby represent ___________________________________________________, of
________________________________________, ____________________________________________,
____ ____________, and agree as follows:
1. I am authorized to bind the Organization named ______________________________________
(the “Insurer”) pursuant to the terms Oklahoma Title 36 § 613 including the terms of this Pledge;
2. The Insurer has deposited funds in the financial institution named in this report (the “Institution”) and
such funds are evidenced by the certificate of deposit (the “Certificate”) described in this Pledge;
3. The Insurer hereby pledges and conveys to the Oklahoma Insurance Department the Certificate, for
the benefit of the Oklahoma Insurance Department, pursuant to the requirements of Oklahoma Title
36 § 613 for the benefit of all policy holders;
4. The Insurer agrees that it will not withdraw, transfer, pledge, or otherwise hypothecate the Certificate
or funds represented by the Certificate without notice to, and approval from, the Oklahoma
Insurance Department;
5. The Insurer agrees that the Institution named in the Certificate and Agreement with the Institution
may comply with instructions originated by the Oklahoma Insurance Department directing the
disposition of the funds in the Certificate without further consent by the Insurer;
6. The provisions of this Pledge will continue in full force and effect and apply to any renewal or
continuation of the Certificate, or to any other deposit funds that may be proceeds of the Certificate;
7. This Pledge pertains to Certificate _______________ from _____________________________
(“Financial Institution”) in the amount of $_______________.
The undersigned also authorizes and directs the Financial Institution:
1. To reflect this pledge in its records.
2. To provide such verification and information regarding the account to the Oklahoma Insurance
Department as it may reasonably require from time to time.
3. To hold the sum above stated for the benefit of the Oklahoma Insurance Commissioner and to
prohibit its withdrawal by the undersigned or any other person, unless and until written release
hereof is given by the Oklahoma Insurance Department.
4. Upon the written demand of the Oklahoma Insurance Department to pay the above stated sum or
any portion thereof as may be demanded, to the Oklahoma Insurance Department.
The undersigned understands and agrees that, in the event that demand is made for the payment of any
sum pursuant hereto, any provisions under the Certificate for penalty in the event of early withdrawal shall
continue to apply, and such penalty will be assessed against the remaining balance of the account; if any
remaining balance is not sufficient for the payment of any such penalty, then to the extent necessary, the
penalty will be deducted from the amount payable to the Oklahoma Insurance Department.
The Certificate shall remain subject to this pledge until released in writing by the Oklahoma Insurance
Department. This pledge shall apply to any and all renewals, extensions, or other changes in the form of
deposit of the Certificate, whether or not the account number is changed as a result thereof.
Dated this ________ day of ______________________________, ________.
by __________________________________ ____________________________________________
Print Name
Signature
Signed or attested to before me this ________ day of ______________________________, ________.
(Seal)
__________________________________________ #____________
Notary Public
PLEDGE OF CERTIFICATE
I, the undersigned, do hereby represent ___________________________________________________, of
________________________________________, ____________________________________________,
____ ____________, and agree as follows:
1. I am authorized to bind the Organization named ______________________________________
(the “Insurer”) pursuant to the terms Oklahoma Title 36 § 613 including the terms of this Pledge;
2. The Insurer has deposited funds in the financial institution named in this report (the “Institution”) and
such funds are evidenced by the certificate of deposit (the “Certificate”) described in this Pledge;
3. The Insurer hereby pledges and conveys to the Oklahoma Insurance Department the Certificate, for
the benefit of the Oklahoma Insurance Department, pursuant to the requirements of Oklahoma Title
36 § 613 for the benefit of all policy holders;
4. The Insurer agrees that it will not withdraw, transfer, pledge, or otherwise hypothecate the Certificate
or funds represented by the Certificate without notice to, and approval from, the Oklahoma
Insurance Department;
5. The Insurer agrees that the Institution named in the Certificate and Agreement with the Institution
may comply with instructions originated by the Oklahoma Insurance Department directing the
disposition of the funds in the Certificate without further consent by the Insurer;
6. The provisions of this Pledge will continue in full force and effect and apply to any renewal or
continuation of the Certificate, or to any other deposit funds that may be proceeds of the Certificate;
7. This Pledge pertains to Certificate _______________ from _____________________________
(“Financial Institution”) in the amount of $_______________.
The undersigned also authorizes and directs the Financial Institution:
1. To reflect this pledge in its records.
2. To provide such verification and information regarding the account to the Oklahoma Insurance
Department as it may reasonably require from time to time.
3. To hold the sum above stated for the benefit of the Oklahoma Insurance Commissioner and to
prohibit its withdrawal by the undersigned or any other person, unless and until written release
hereof is given by the Oklahoma Insurance Department.
4. Upon the written demand of the Oklahoma Insurance Department to pay the above stated sum or
any portion thereof as may be demanded, to the Oklahoma Insurance Department.
The undersigned understands and agrees that, in the event that demand is made for the payment of any
sum pursuant hereto, any provisions under the Certificate for penalty in the event of early withdrawal shall
continue to apply, and such penalty will be assessed against the remaining balance of the account; if any
remaining balance is not sufficient for the payment of any such penalty, then to the extent necessary, the
penalty will be deducted from the amount payable to the Oklahoma Insurance Department.
The Certificate shall remain subject to this pledge until released in writing by the Oklahoma Insurance
Department. This pledge shall apply to any and all renewals, extensions, or other changes in the form of
deposit of the Certificate, whether or not the account number is changed as a result thereof.
Dated this ________ day of ______________________________, ________.
by __________________________________ ____________________________________________
Print Name
Signature
Signed or attested to before me this ________ day of ______________________________, ________.
(Seal)
__________________________________________ #____________
Notary Public