Arizona Administrative Code › Title 20 - COMMERCE, FINANCIAL INSTITUTIONS, AND INSURANCE › Chapter 06 - DEPARTMENT OF INSURANCE AND FINANCIAL INSTITUTIONS - INSURANCE DIVISION › Article 14 - INSURANCE HOLDING COMPANY › Appendix G - Instructions on Forms A, B, C, D, E and F

Current through Register Vol. 30, No. 28, July 12, 2024
INSTRUCTIONS ON FORMS A, B, C, D, E AND F
FORMS - GENERAL REQUIREMENTS
Forms A, B, C, D, E and F are intended to be guides in the
				  preparation of the statements required by A.R.S. §§ 20481.02,
				  20-481.09, 20-481.12 and 20-481.25. They are not intended to be blank forms
				  which are to be filled in. The statements filed shall contain the numbers and
				  captions of all items, but the text of the items may be omitted provided the
				  answers thereto are prepared in such a manner as to indicate clearly the scope
				  and coverage of the items. All instructions, whether appearing under the items
				  of the form or elsewhere therein, are to be omitted. Unless expressly provided
				  otherwise, if any item is inapplicable or the answer thereto is in the
				  negative, an appropriate statement to that effect shall be made.
One original paper statement excluding exhibits, and all
				  other papers and documents shall be filed with the Director. The statement
				  shall be signed in the manner prescribed on the form. If the signature of any
				  person is affixed pursuant to a power of attorney or other similar authority, a
				  copy of such power of attorney or other authority shall also be filed with the
				  statement. All paper filings shall be by personal delivery or mail addressed
				  to: Arizona Department of Insurance and Financial Institutions, Insurance
				  Financial Affairs Division.
In addition to the filed paper statement, a copy of the
				  statement, including exhibits, and all other papers and documents filed as a
				  part thereof, shall be filed electronically.
All filed documents shall be easily readable and suitable for
				  review and reproduction. Debits in credit categories and credits in debit
				  categories shall be designated so as to be clearly distinguishable as such on
				  photocopies. Statements shall be in the English language and monetary values
				  shall be stated in United States currency. If any exhibit or other paper or
				  document filed with the statement is in a foreign language, it shall be
				  accompanied by a translation into the English language and any monetary value
				  shown in a foreign currency normally shall be converted into United States
				  currency.
If an applicant requests a hearing on a consolidated basis
				  under A.R.S. §
									20-481.07, in addition to filing
				  the Form A with the Director, the applicant shall file a copy of Form A with
				  the National Association of Insurance Commissioners (NAIC) in electronic
				  form.
FORMS - INCORPORATION BY REFERENCE, SUMMARIES AND
				  OMMISSIONS
Information required by any item of Form A, Form B, Form D,
				  Form E or Form F may be incorporated by reference in answer or partial answer
				  to any other item. Information contained in any financial statement, annual
				  report, proxy statement, statement filed with a governmental authority, or any
				  other document may be incorporated by reference in answer or partial answer to
				  any item of Form A, Form B, Form D, Form E or Form F provided the document is
				  filed as an exhibit to the statement. Excerpts of documents may be filed as
				  exhibits if the documents are extensive. Documents currently on file with the
				  Director which were filed within three years need not be attached as exhibits.
				  References to information contained in exhibits or in documents already on file
				  shall clearly identify the material and shall specifically indicate that such
				  material is to be incorporated by reference in answer to the item. Matter shall
				  not be incorporated by reference in any case where such incorporation would
				  render the statement incomplete, unclear or confusing.
Where an item requires a summary or outline of the provisions
				  of any document, only a brief statement shall be made as to the pertinent
				  provisions of the document. In addition to the statement, the summary or
				  outline may incorporate by reference particular parts of any exhibit or
				  document currently on file with the Director which was filed within three years
				  and may be qualified in its entirety by such reference. In any case where two
				  or more documents required to be filed as exhibits are substantially identical
				  in all material respects except as to the parties thereto, the dates of
				  execution, or other details, a copy of only one of the documents need be filed
				  with a schedule identifying the omitted documents and setting forth the
				  material details in which the documents differ from the documents, a copy of
				  which is filed.
FORMS - INFORMATION UNKNOWN OR UNAVAILABLE AND
				  EXTENSION OF TIME TO FURNISH
If it is impractical to furnish any required information,
				  document or report at the time it is required to be filed, there shall be filed
				  with the Director as a separate document:
(1) Identifying the information, document or report in
				  question;
(2) Stating why the filing thereof at the time required is
				  impractical; and
(3) Requesting an extension of time for filing the
				  information, document or report to a specified date. The request for extension
				  shall be deemed granted unless the Director within 60 days after receipt
				  thereof enters an order denying the request.
FORMS - ADDITIONAL INFORMATION AND
				  EXHIBITS
In addition to the information expressly required to be
				  included in Form A, Form B, Form C, Form D, Form E and Form F, the Director may
				  request such further information, if any, as may be necessary to make the
				  information contained therein not misleading. The person filing may also file
				  such exhibits as it may desire in addition to those expressly required by the
				  forms. The exhibits shall be so marked as to indicate clearly the subject
				  matters to which they refer. Changes to Forms A, B, C, D, E or F shall include
				  on the top of the cover page the phrase: "Change No. (insert number) to" and
				  shall indicate the date of the change and not the date of the original
				  filing.