Application Form to issue Variable Products Contracts to be completed and returned with the fee. The fee is retaliatory and is non-refundable.
Please make check payable to "Treasurer, State of New Hampshire," and mail to the New Hampshire Insurance Department Examination Division.
Pursuant to RSA 408:27-36, a life company licensed to do business in the State of New Hampshire must obtain an additional license for the issuance of Variable Products Contracts.
Please submit the separate accounts statement (green book) along with the application.
If you have any questions, please contact Diane Cygan .
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