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Applicant Name Company NAIC No. FEIN BIOGRAPHICAL AFFIDAVIT To the extent permitted by law this affidavit will be kept confidential by the state insurance regulatory authority. Print or Type Full Name Address and telephone number of the present or proposed entity under which this biographical statement is being required Do Not Use Group Names. In connection with the above-named entity I herewith make representations and supply information about myself as hereinafter set forth. Attach addendum...

How to fill out regulatory affidavit biographical form

How to fill out NAIC Biographical Affidavit

1. Obtain a copy of the NAIC Biographical Affidavit form from the NAIC website or your state insurance department.
2. Fill in your personal information such as name, address, date of birth, and Social Security number.
3. Provide information about your employment history, including employers, positions held, and dates of employment.
4. Disclose any criminal history, financial issues, or regulatory actions as required by the form.
5. Sign the affidavit in the designated area to affirm that the information provided is accurate.
6. Submit the completed affidavit to the appropriate regulatory authority as instructed.

Who needs NAIC Biographical Affidavit?

1. Individuals applying for a license to operate in the insurance industry.
2. Officers and directors of insurance companies.
3. Certain key employees at insurance firms who are involved in management or oversight.

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People Also Ask about naic biographical affidavit form

What is the NAIC and what is its purpose?

The National Association of Insurance Commissioners (NAIC) provides expertise, data, and analysis for insurance commissioners to effectively regulate the industry and protect consumers.

Is the insurance industry regulated by the federal government?

Insurance is regulated by the states. This system of regulation stems from the McCarran-Ferguson Act of 1945, which describes state regulation and taxation of the industry as being in “the public interest” and clearly gives it preeminence over federal law. Each state has its own set of statutes and rules.

Is the NAIegulator?

The National Association of Insurance Commissioners (NAIC) is the regulatory body that governs all things insurance — it sets standards, establishes best practices, and conducts oversight of the insurance industry.

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What is NAIC Biographical Affidavit?

The NAIC Biographical Affidavit is a form used by the National Association of Insurance Commissioners to collect biographical information about individuals seeking to become licensed insurance professionals or to hold certain positions within an insurance company.

Who is required to file NAIC Biographical Affidavit?

Individuals who are applying for a license to operate in the insurance industry, including executives, directors, and certain other key personnel, are typically required to file a NAIC Biographical Affidavit.

How to fill out NAIC Biographical Affidavit?

To fill out the NAIC Biographical Affidavit, applicants must provide required personal information, employment history, education details, and any legal disclosures as instructed. The form needs to be completed accurately and thoroughly.

What is the purpose of NAIC Biographical Affidavit?

The purpose of the NAIC Biographical Affidavit is to ensure that individuals in key positions in the insurance industry meet certain standards of character and competence, thereby safeguarding the integrity of the insurance system.

What information must be reported on NAIC Biographical Affidavit?

The NAIC Biographical Affidavit requires reporting of personal identification details, educational background, employment history, professional affiliations, and disclosure of any criminal history or regulatory actions, among other pertinent information.