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Captive Forms & Filings
Licensing Forms
- SCDOI Captive Application - Updated June 4, 2018
- SCDOI Captive Application Instructions - Updated June 4, 2018
- Captive Biographical Affidavit - Updated June 27, 2018
- SPFC Biographical Affidavit (latest version can be found on the NAIC's
UCAA page) - Consent to Service of Process for Captive Insurance Companies
- SPFC Consent to Service of Process (latest version can be found on the NAIC's
UCAA page)
- 2017 Captive Annual Report (Excel)
- Captive Annual Report General Instructions
- 2017 Attestation Report (Excel) - Updated January 30, 2018
- SPFC Attestation Report
- Direct Economic Impact Report (Excel)
- Actual to Actual Comparison (Excel) - Updated February 21, 2018
- Form A - Acquisition of Control or Merger (Word)
- Form B - Insurance Holding Company Annual Registration (Word)
- Form C - Summary of Registration Statement (Word)
- Form D - Prior Notice of a Transaction (Word)
- Form F - Enterprise Risk Report
- LOC Instructions and Sample
- For more information on completing NAIC yellow or blue blank annual statements, please see the NAIC's Financial Statement Filing page.
- CPA Application
- Captive Actuarial Application
- SPFC Actuarial Application
- Captive Manager Application - Updated June 4, 2018