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 Linda M. Zalinskie.
Adobe Acrobat Reader format. You can download a free reader from Adobe.
|