Licensing Requirements and Forms
Reminder: The Office of the NC Department of Insurance will be closed December 24 – 26, 2019
Please find all forms and filing requirements for the licensing of North Carolina Captive Insurance Companies including domestic Risk Retention Groups below
- Requirements for Captive Insurer License and Redomestication Applications
- Captive Manager Application
- Captive Insurer License Application
- Captive Insurer Redomestication Application
- Form C-101 Biographical Affidavit
- Form C-103 Captive Consent to Service of Process
- Form C-104 Financial Statement Attestation
- Form C-105 Special Purpose Financial Captive Insurer Affidavit
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