Fillable p&c state of domicile form

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ARKANSAS INSURANCE DEPARTMENT Accounting Division 1200 WEST THIRD STREET LITTLE ROCK, AR 72201-1904 PHONE: (501) 371-2605 www.insurance.arkansas.gov 2009 FORM AID AC FPRF-Q ESTIMATED FPRF PREMIUM TAX PROPERTY/CASUALTY INSURANCE COMPANY ___ ORIGINAL FILING ___ AMENDED FILING STATE OF DOMICILE COMPANY NAME MAILING ADDRESS NAIC COMPANY CODE (5 digit code) CONTACT PERSON TELEPHONE NUMBER EMAIL ADDRESS EXT TITLE...
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