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| Form Number: Citizenship Affidavit GID-276-EN |  | | Title: Citizenship Affidavit | Published: 2013 | | Description: Effective 1-1-2012, this form is required of persons making application for all licenses, permits, registrations and certifications in order to comply with the Georgia Illegal Immigration Reform And Enforcement Act. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. |
| Form Number: GID-052-NT (same as GID-052-EN) |  | | Title: Biographical Statement And Affidavit | Published: 2012 | | Description: This form is used to provide biographical information on individuals where required. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. |
| Form Number: GID-053-NT (same as GID-053-EN) | | | Title: Authority For Release Of Information | Published: 2011 | | Description: This form is submitted to authorized the Office of Commissioner of Insurance to conduct a background investigation. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. |
| Form Number: GID-054-NT (same as GID-054-EN) | | | Title: Service Of Process Consent And Agreement | Published: 2011 | | Description: This form is used to designate the person to be served for transactions that require official notification. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. |
| Form Number: GID-055-NT (same as GID-055-EN) | | | Title: Resolution Form | Published: 2011 | | Description: This form is used by a corporation to designate officers empowered to act on behalf of the corporation. The corporate seal must be affixed to the document. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us. |
| Form Number: GID-056-NT (same as GID-056-EN) | | | Title: Financial Statement | Published: 2011 | | Description: This form is used to provide annual financial information about the entity. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. |
| Form Number: GID-257-NT | | | Title: Verification of Coverage | Published: 2011 | | Description: Form includes requirements for Insurance Companies and Life Settlement Providers/Producers. |
| Form Number: GID-362-NT JAN2013 | | | Title: Filing Instructions For Life Settlement Providers Renewals And Check Sheet | Published: 2013 | | Description: Annual Statement Filing Instructions for Licensed Life Settlement Providers. This Check Sheet is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us. |
| Form Number: GID-NT-LS-1 | | | Title: New and Renewal Application for License as a Life Settlement Provider (same as GID-EN-LS-1) | Published: 2012 | | Description: This application is for new and renewal Life Settlement Provider applicants (which were previously separate forms). Refer to the instructions for new and renewal applications. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. Effective 1-1-2012, the Citizenship Affidavit Form GID-276-EN must be submitted with this application for processing. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. |
| Form Number: GID-NT-LS-1 | | | Title: Filing Instructions For Life Settlement Licensure (same as GID-EN-LS-1) Instructions For New Applicants | Published: 2011 | | Description: Contains a Cover Letter and Instructions. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. |
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