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New Hampshire Domestic Uniform Certificate of Authority Application.
Please note that before submitting the application, the Company needs to meet with the Department to go over its business plan.
The following are the filing requirements for a domestic company for admission in the State of New Hampshire:
- UCAA Application (Primary Application). Send 1 original and 1 copy, Chapter 401 - List of New Hampshire Paragraphs
 If applying for paragraph VIII, Other Casualty Risks, refer to the NAIC Uniform P&C Product Coding Matrix.
- $1,000.00 Application Fee. Make check payable to "Treasurer, State of New Hampshire." **Fee is non-refundable.
- New Hampshire Guaranty Association information (Life Forms) (P&C Forms, Guaranty Assoc. Acknowledgement) . Please include proof of payment, made to the New Hampshire Guaranty Association (proof of payment: cancelled check or a letter from the association).
- Insurance Company formed as a New Hampshire Corporation, by ten or more incorporates, all of whom must be residents of the state. RSA 401:2
- Three original copies of the proposed charter must be submitted to the Insurance Commissioner for approval. RSA 401:6
- Three original copies of the by-laws and articles of incorporation must be submitted. A $100.00 check needs to be submitted with the articles for the Secretary of State’s fee. Make check payable to the NH Secretary of State and submit to the New Hampshire Insurance Department.
- Submit a listing of the applicant’s legal, accounting and actuarial representatives by name and address.
- Submit evidences of fidelity bond coverage of all officers and employees entrusted with the handling of funds for the applicant.
- Security Deposit information
Please forward the above to the New Hampshire Insurance Department, Financial Examination and Analysis Division.
If you have any questions, please contact Patricia Gosselin .
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