(a)

1. (1) A proposed captive insurance company shall make application to the Insurance Commissioner for authority to conduct insurance business on the “Captive Insurance Company Application”, which is adopted as part of this part.
2. (2) The application and its accompanying forms and attachments are intended to be used by the applicant in the preparation of the statements and information required by the act and this part.

3. (3) The applicant may use the application, forms, and attachments as:

   1. (A) Blank forms that are to be filled in by the applicant; or
   2. (B) A guide in the preparation of the statements and information required by the act.

(b)

1. (1) Two (2) complete copies of the application including forms, attachments, exhibits, and all other papers and documents filed as a part thereof, accompanied by the appropriate filing fee, shall be filed with the commissioner by personal delivery or mail addressed to: Insurance Commissioner of the State of Arkansas Attention: Legal Division One Commerce Way, Suite 102 Little Rock, AR 72202

2. (2)

   1. (A) At least one (1) of the copies shall be manually signed in the manner prescribed on the application.
   2. (B) Unsigned copies shall be conformed.
   3. (C) If the signature of any person is affixed pursuant to a power of attorney or other similar authority, a copy of such power of attorney or other authority shall also be filed with the statement.