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NORTH CAROLINA DEPARTMENT OF INSURANCE FINANCIAL EVALUATION DIVISION COMPANY ADMISSIONS SECTIONCERTIFICATE OF CAPITALIZATIONACompanyBSource of Initial Capitalization This certificate is pursuant to
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How to fill out formcompanyreceivedanddepositedinformcompanysaccountcashoracceptablesecuritiesinformprincipalamountof receivedfromformsourcenamedinbabovewhereasformsaidcashorsecuritiesamounthasbeenallocatedasorallocatedtoforminitialcapitalizationofformcompany

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Locate the form and gather all necessary information such as the company's name, account details, source name, and allocated amount.
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Fill in the company's name in the designated field on the form.
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Specify whether the received amount is in cash or acceptable securities.
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Any person or entity involved in initial capitalization of form company and receiving and depositing cash or acceptable securities into the company's account would need formcompanyreceivedanddepositedinformcompanysaccountcashoracceptablesecuritiesinformprincipalamountof receivedfromformsourcenamedinbabovewhereasformsaidcashorsecuritiesamounthasbeenallocatedasorallocatedtoforminitialcapitalizationofformcompany. This includes company representatives, financial officers, or individuals responsible for compliance and record-keeping.
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Please note that the specific requirements and regulations may vary depending on the jurisdiction and the purpose of the form. It is recommended to consult legal or financial professionals for accurate guidance.

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The form is used to record the receiving and depositing of cash or securities into the company's account from a specified source for initial capitalization of the company.
The individuals responsible for managing the company's finances or those involved in the initial capitalization process are required to fill out the form.
The form must be completed with accurate details of the cash or securities received, the source of the funds, and how the amount is allocated towards the initial capitalization of the company.
The purpose of the form is to document the receipt and deposit of cash or securities into the company's account for the purpose of initial capitalization.
The form must include details such as the amount received, the source of the funds, and how the amount is allocated towards the initial capitalization of the company.
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