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IS 0200 (12/09) Office of Financial and Insurance Regulation Page 1 of 2 Insurance Business Entity Affiliate Disclosure Use a separate form for each individual affiliate or Designated Responsible
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What is use this form to?
This form is used to report financial information to the IRS.
Who is required to file use this form to?
Individuals or entities with certain financial transactions or income are required to file this form to the IRS.
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What is the purpose of use this form to?
The purpose of this form is to provide the IRS with necessary financial information for tax purposes.
What information must be reported on use this form to?
Information such as income, expenses, deductions, and other financial transactions must be reported on this form.
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