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503 N Division Street

Carson City, NV 89703

​

(775) 283-4275

 

Email info@nvcic.com

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    FORMS

    Nevada Captive Forms

    Division of Insurance Forms

    • Captive Filing Requirements for Domestic Captive Insurance Companies

    • Captive Filing Requirements for Domestic Risk Retention Groups (RRG)

    • Captive Application for Certificate of Authority

    • Protected Cell Application

    • Irrevocable Letter of Credit

    • Biographical Affidavit

    • Uniform Consent to Service of Process

    • Captive Insurance Premium Tax Return

    • Captive Annual Report

    • Nevada Business Plan - RRG

    • Nevada Pro Froma Template - RRG

    • Corporate Governance Annual Disclosure - RRG

    • Non-RRG Captive Dividend Request

    • Insurer Change of Address 

    • NV DOI Bulletins

    Secretary of State Captive Forms

    • Initial Formation Corporation Filing

    • Annual/Amended List and State Business License Application

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    ​
    ​​NEVADA CAPTIVE INSURANCE COUNCIL

    503 N. Division Street, Carson City, NV 89703   ·   775-283-4275   ·   www.nvcic.com   ·   info@nvcic.com

    All Rights Reserved 2020

    • HOME

    • MEMBERSHIP

      • Application
    • CONFERENCE

    • LEADERSHIP

    • PROVIDERS

      • Actuaries
      • Attorney's
      • Captive Insurance Consultants
      • Captive Managers
      • Certified Public Accountants
    • RESOURCES

      • Captive Types
      • Nevada Business Report
      • Nevada Forms and Filings
      • Application and Fees
    • NEWS

    • CONTACT

    • More

      Use tab to navigate through the menu items.