Affidavit - Captive Service Providers

Captive Company Applications

To the extent permitted by law, this application will be kept confidential by the state insurance regulatory authority.

* Please submit all required documents

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*Name of Applicant:

*Application (Form AL-C-APP):

Download Application

*Biographical Affidavits (Form AL-C-BIO):

Download Affidavit

*Feasibility Study/Business Plan:

* Articles of Incorporation:

* Statement of Benefit to Alabama (Form AL-C-BTA):

Download Statement

* Resident Agent for Service of Process (Form-AL-C-ASP):

Download Agent

* Agreement to Submit to Examination (Form AL-C-EXM):

Download Agreement

Misc. Document #1:

Misc. Document #2:

Misc. Document #3:

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Alabama Department of Insurance

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