Please be advised that there are no provisions in the New Hampshire Statutes that provide for automatic transfer in the event of a merger. Pursuant to New Hampshire Law RSA 405:14-a, if a company undergoes a substantial change in financial or managerial control a new license is required. To assure that there will be no interruption of service to policyholders, it will be necessary for the Company to submit the following items:

• http://www.naic.org/industry_ucaa.htm. Complete form 2C Corporate Amendments Applications.
• Submit Retaliatory Statement with UCAA Application --NEW--
• Filing fee* Fee is the higher of New Hampshire's fee of $25 or company's state of domicile. Make check payable to "Treasurer, State of New Hampshire." *All fees are retaliatory and non-refundable.
• Pro forma balance sheet of acquiring party, prior to and subsequent to the merger of the company.
• Form E – If the change of control of an insurer licensed in New Hampshire results in the merger or affiliation with one or more New Hampshire licensed insurers that were not previously affiliated, Form E is required. Otherwise, send a statement that there is no such affiliation.
• Copies of the State Approvals.
• Current New Hampshire Certificate of Authority (original).
• Business plan for surviving entity.

Mail the above items to the New Hampshire Insurance Department Financial Regulation Division.

If you have any questions, please contact Linda.m.zalinskie@ins.nh.gov .

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