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Arizona DIFI
Arizona Department of Insurance and Financial Institutions (DIFI)
100 N. 15th Avenue, Suite 261
Phoenix, Arizona 85007-2630
Governor:
Doug Ducey
Director – Evan Daniels
Chief Captive Analyst - Vincent R. Gosz -
Vincent.Gosz@difi.az.gov
Telephone:
602.364.4490
Website:
https://insurance.az.gov
Captive Insurer Certificate of Authority Application
Preparing the Management Discussion and Analysis Report
Captive Insurer Reinsurance Structure
Captive Insurer Protected Cell Supplemental Application
Captive Insurer Biographical Affidavit
Captive Insurer Management Firm Profile
Captive Insurer Irrevocable Letter of Credit - Sample Form
Captive Insurer Conflict of Interest - Directors and Officers
Amended Certificate of Authority - Line of Business Change
Insurance Fee Schedule
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