The following items must be completed to amend the Third Party Administrator license (please note that only those items listed below that have changed need to be submitted):
- Amended Application
- $25.00 Amendment Fee – Make check payable to "Treasurer, State of NH." **Fee is non-refundable.
- Surety Bond Form
- NAIC Biographical Form
- Amended By-Laws
- Amended Articles of Incorporation
- Certificate of Good Standing from State of Domicile’s Secretary of State’s office and State of New Hampshire’s Secretary of State’s office (603) 271-3242.
- Return the current original New Hampshire Certificate of Authority.
Please mail information to the New Hampshire Insurance Department, Financial Regulation Division.
If you have any questions please contact Diane Cygan .
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