California Code of Regulations
Title 10 - Investment
Chapter 5 - Insurance Commissioner
Subchapter 3 - Insurers
Article 1.3 - Standards for Approval of Insurer Names
Section 2278.59 - Form N-1
Current through Register 2024 Notice Reg. No. 38, September 20, 2024
REQUEST FOR NAME APPROVAL AND RESERVATION
(FORM N-1)
To: Name Reservation Unit
Legal Division
Department of Insurance
1901 Harrison Street, 3rd Floor Mailroom
Oakland, CA 94612
...............................................................................
SECTION 1 -- PROPOSED NAME(S)
| Requested Name: | ___________________________ |
| 1st Alternative Name : | ___________________________ |
| 2nd Alternative Name: | ___________________________ |
...............................................................................
SECTION 2 -- BACKGROUND INFORMATION
| Contact Person: | Name | ___________________________ |
| Title | ___________________________ | |
| Address | ___________________________ | |
| ___________________________ | ||
| direct phone | ___________________________ | |
| fax | ___________________________ | |
| Applicant Name and Address: | _______________________________________________________ | |
| _______________________________________________________ | ||
| _______________________________________________________ | ||
| _______________________________________________________ | ||
| _______________________________________________________ | ||
| Applicant's State of Domicile: | _______________________________________________________ | |
| Applicant's Federal Employer Identification Number: | _______________________________________________________ | |
| Applicant's NAIC Number: | _______________________________________________________ | |
| Applicant's NAIC Group Name and NAIC Group Number (if applicable): | _______________________________________________________ | |
| If Applicant is not an | _______________________________________________________ | |
| Affiliate (see, § 2278.51(c)), | _______________________________________________________ | |
| name(s) of Applicant's | _______________________________________________________ | |
| owners or proposed owners: | _______________________________________________________ | |
|
(attach separate page if needed) |
||
| Organizational Chart: Attach organizational chart that identifies all Affiliates (see, § 2278.51(c)), including parent companies and subsidiaries. If Applicant has not yet been formed, the organizational chart must specify the proposed position of Applicant on the organizational chart upon completion of Applicant's formation | ||
| Classes of Insurance (per | _______________________________________________________ | |
| Insurance Code) transacted or | ||
| to be transacted in California: | _______________________________________________________ | |
| _______________________________________________________ | ||
| _______________________________________________________ | ||
| _______________________________________________________ | ||
| Specialty lines (per Insurance | _______________________________________________________ | |
| Code) transacted or to be | ||
| transacted in California | _______________________________________________________ | |
| _______________________________________________________ | ||
| _______________________________________________________ | ||
| _______________________________________________________ | ||
| _______________________________________________________ | ||
| _______________________________________________________ | ||
| _______________________________________________________ | ||
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SECTION 3 -- APPLICANT SEEKING A NAME CHANGE
If the Applicant is seeking approval of a proposed name change, state the reason for the proposed name change.
..........................
SECTION 4 -- APPLICANT -- UNDERWRITTEN TITLE COMPANY
If Applicant is, or will be, an underwritten title company, state the following:
..........................
SECTION 5 -- PENDING APPLICATIONS (ALL APPLICANTS)
List every application or filing that is pending with the Commissioner, filed either by or pertaining to Applicant, or filed by or pertaining to an Affiliate (see, § 2278.51(c)), regarding transaction of its (or its Affiliate's) business in California. This includes, but is not limited to, applications for a certificate of authority, an amended certificate of authority, a securities permit, applications or filings required by Insurance Code 1011(c), and applications pursuant to Insurance Code §§ 1215 et seq. The foregoing does not include applications pertaining to dividends or pertaining to property and casualty rate and form filings.
..........................
SECTION 6 -- APPLICANTS -- FOREIGN OR ALIEN COMPANY
An Applicant that is, or will be, a foreign or alien insurer or other entity that proposes to use a fictitious business name or operating name in California, must submit a certified copy of a resolution by its board of directors (or if its form of business organization does not have a board of directors, then its governing body) authorizing the use of the fictitious business name or operating name in California.
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SECTION 7 -- APPLICANT TO WHICH REGULATION SECTION 2303.15(q) APPLIES
An applicant to which the requirements of California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Article 1 § 2303.15(q) applies shall submit a formal commitment, as set forth in regulation § 2303.15(r), that it shall comply with regulation § 2303.15(q).
1. New section
filed 10-11-2010; operative 11-10-2010 (Register 2010, No. 42).
2. Change
without regulatory effect amending section filed 8-27-2020 pursuant to section
100, title 1, California Code of
Regulations (Register 2020, No. 35).
Note: Authority cited: Sections 700, 720 and 790.10, Insurance Code; CalFarm Ins. Co. v. Deukmejian, (1989) 48 Cal.3d 805; and 20th Century Ins. Co. v. Garamendi, (1994) 8 Cal. 4th 216. Reference: Sections 742.42, 790.02, 790.03, 880, 881, 881.1, 881.2, 881.5, 882, 882.5, 883, 10970, 12162, 12389 and 12743, Insurance Code.
