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FORM B INSURANCE HOLDING COMPANY SYSTEM ANNUAL REGISTRATION STATEMENT Filed with the Insurance Department of the State of BY Name of Registrant 1 On Behalf of The Following Insurance Companies: NameAddressDate:,
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The name of registrant 1 is the official name of the individual or entity registering.
Individuals or entities who are required by law to register their business or personal name must file name of registrant 1.
To fill out name of registrant 1, provide the complete legal name of the registrant as it appears on official documents.
The purpose of name of registrant 1 is to officially recognize the individual or entity as the owner of the registered name.
The information that must be reported includes the legal name, contact information, and any relevant identification numbers.
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