Missouri Code of State Regulations
Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE
Division 200 - Insurance Solvency and Company Regulation
Chapter 20 - Captive Insurance Companies
Section 20 CSR 200-20.020 - Forms

Universal Citation: 20 MO Code of State Regs 200-20.020

Current through Register Vol. 49, No. 6, March 15, 2024

PURPOSE: This rule sets out the forms which may be used in the regulation of captive insurance companies in this chapter.

(1) The following forms are suggested, not mandatory, for filing with the department:

(A) Captive Application for Admission (Form CI-1), revised on October 1, 2007, or any form which substantially comports with the specified form;

(B) Captive Irrevocable Letter of Credit (Form CI-2), revised on October 1, 2007, or any form which substantially comports with the specified form;

(C) Captive Application for Authorization as an Independent Certified Public Accountant (CPA) (Form CI-3) revised on October 1, 2007, or any form which substantially comports with the specified form;

(D) Captive Application for Authorization to Certify Reserves (Form CI-4), revised on October 1, 2007, or any form which substantially comports with the specified form; and

(E) Missouri Captive Insurance Premium Tax Return (Form CI-5), revised on October 1, 2007, or any form which substantially comports with the specified form.

(2) Availability of Forms. The forms are available at the department's office in Jefferson City, Missouri, on the department website, www.insurance.mo.gov, or by mailing a written request to the Missouri Department of Insurance, Financial Institutions and Professional Registration, PO Box 690, Jefferson City, Missouri 65102.

*Original authority: 374.045, RSMo 1967, amended 1993, 1995; 379.1328, RSMo 2007; and 379.1421, RSMo 2007 .

Disclaimer: These regulations may not be the most recent version. Missouri may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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