Get the free Captive Annual Statement Form - tn

STATE OF TENNESSEE DEPARTMENT OF COMMERCE AND INSURANCE Captive Insurance Section 500 James Robertson Parkway, 7th Floor Nashville, Tennessee 37243 (615) 7413805 Annual Statement Package ANNUAL STATEMENT

How to fill out captive annual statement form

How to fill out a captive annual statement form:

1. Begin by carefully reading the instructions provided with the form. This will give you a clear understanding of what information is required and how to properly fill out the form.
2. Start by entering the necessary identifying information on the form, such as your name, address, and contact details. Double-check to ensure that this information is accurate and up to date.
3. Next, carefully review the sections related to the financial information of your captive. This may include details on income, expenses, investments, and assets. Gather all relevant documents and records to accurately complete these sections.
4. If required, provide information on the ownership structure of your captive. This may involve specifying the names and ownership percentages of the captive's shareholders or members.
5. Complete any additional sections or questions that are relevant to your captive's specific circumstances. This may include information on insurance policies, claims, or any changes to the captive's operations during the reporting period.
6. Once you have filled out all the necessary sections, review the form for any errors or omissions. Make sure all information is legible and accurate.
7. If required, attach any supporting documentation or statements that are requested by the form. This may include financial statements, audited reports, or any other relevant documents.
8. Sign and date the form in the designated area to certify the accuracy of the information provided.

Who needs a captive annual statement form:

1. Captive insurance companies or captives often need to fill out an annual statement form. These are entities that provide insurance coverage for themselves or their affiliated companies, rather than purchasing insurance from traditional insurers.
2. Businesses or organizations that have established captives to manage their insurance risks may be required by regulatory authorities or governing bodies to submit a captive annual statement form.
3. Owners, shareholders, or members of captives may also need the annual statement form to maintain compliance with reporting requirements or to assess the financial health and performance of their captive.

In summary, filling out a captive annual statement form involves carefully following the provided instructions, accurately completing each section related to financial information and ownership structure, reviewing for errors or omissions, attaching required documentation, and signing and dating the form. This form is typically required by captive insurance companies, their owners or shareholders, and regulatory authorities to ensure compliance and assess the financial status of the captive.

For pdfFiller’s FAQs

How can I get captive annual statement form?

The premium version of pdfFiller gives you access to a huge library of fillable forms (more than 25 million fillable templates). You can download, fill out, print, and sign them all. State-specific captive annual statement form and other forms will be easy to find in the library. Find the template you need and use advanced editing tools to make it your own.

Can I create an electronic signature for signing my captive annual statement form in Gmail?

With pdfFiller's add-on, you may upload, type, or draw a signature in Gmail. You can eSign your captive annual statement form and other papers directly in your mailbox with pdfFiller. To preserve signed papers and your personal signatures, create an account.

How can I fill out captive annual statement form on an iOS device?

Make sure you get and install the pdfFiller iOS app. Next, open the app and log in or set up an account to use all of the solution's editing tools. If you want to open your captive annual statement form, you can upload it from your device or cloud storage, or you can type the document's URL into the box on the right. After you fill in all of the required fields in the document and eSign it, if that is required, you can save or share it with other people.

What is captive annual statement form?

The captive annual statement form is a required document that captive insurance companies must file annually to report their financial information.

Who is required to file captive annual statement form?

Captive insurance companies are required to file the captive annual statement form.

How to fill out captive annual statement form?

The captive annual statement form can be filled out online or manually by providing detailed financial information about the captive insurance company.

What is the purpose of captive annual statement form?

The purpose of the captive annual statement form is to provide regulators and stakeholders with an overview of the financial status of the captive insurance company.

What information must be reported on captive annual statement form?

The captive annual statement form typically requires information on assets, liabilities, income, expenses, and other financial details of the captive insurance company.