N.M. Code R. § 13.12.4.9 – Contents of Application

A. An application for a certificate of self-insurance shall be made on the form prescribed by the superintendent. The application shall contain full and specific answers to all questions.
B. The application shall be signed, under oath, by:
(1) the applicant if the applicant is an individual or a sole proprietorship;
(2) a general partner if the applicant is a partnership;
(3) an officer of the applicant if the applicant is a corporation.
C. The application must be accompanied by a non-refundable filing fee of two hundred dollars ($200.00), made payable to the insurance division.
D. The superintendent may request additional information regarding any of the evaluation factors enumerated in this rule and any other information the superintendent deems relevant or necessary.
[4/1/99; Recompiled 11/30/01]