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Please submit the following items to change the name of the company on its New Hampshire Certificate of Authority:
- Amended Application

- Amend Fee
. Send the amend fee for the company’s state of domicile.
- Power of Attorney Form

- Return the Company’s current New Hampshire Certificate of Authority (original).
- All fees are retaliatory. Fee is non-refundable. Please make payable to "Treasurer, State of New Hampshire".
Please send all documents to the New Hampshire Insurance Department Financial Examination and Analysis Division.
If you have any questions, please contact Diane Cygan .
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