Arkansas Insurance Department

Property & Casualty Division

HELPFUL FORMS

Earthquake Coverage

AR166 Worksheet for 2006 year data due May 1, 2007. See this important notice concerning the new online entry form for this report.

ARRUA Report Entry Form

ARRUA Act 1326 Underwriting Assessment Form

Act 1345 of 2003 County Fire Loss Reporting Form Due June 1, 2007 (See Bulletin 6-2004 for details)

Consumer Credit and Credit Scoring Report (Due Annually, March 31st) (See Bulletin 14-2004 for details)

Surplus Lines Form SL-1 and SL-3

RULE 23 Required Forms

FORM UT Property & Casualty Uniform transmittal header
FORM RF‑1 Rate filing abstract
FORM A‑1 Private passenger automobile abstract
FORM H‑1 Homeowners abstract
FORM RF‑2 Reference filing adoption form
FORM RF‑WC Workers' compensation reference filing adoption form
FORM F‑1 Form filing abstract
FORM APCS Automobile survey
FORM HPCS Homeowners survey
FORM MMPCS Medical Malpractice survey
FORM HONOT Homeowners rate notice
FORM PPANOT Private passenger automobile rate notice
FORM PROMAL Professional malpractice rate increase notice to insured
FORM PRONOT Professional malpractice rate increase newspaper notice
FORM SELFCERT Arkansas Certificate of Compliance

Purchasing Group Application Form and renewal Registration Form PDF or Word

Report of Independently Procured Insurance

Uniform Product Coding Matrix for describing lines of insurance when making a rate or form filing.

 

Professional Employer Organizations

 
Rule and Regulation 58

 

 

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