Nevada Captive Forms

Division of Insurance Forms

• Captive Filing Requirements for Domestic Captive Insurance Companies

• Captive Filing Requirements for Domestic Risk Retention Groups (RRG)

• Captive Application for Certificate of Authority

• Protected Cell Application

• Irrevocable Letter of Credit

• Biographical Affidavit

• Uniform Consent to Service of Process

• Captive Insurance Premium Tax Return

• Captive Annual Report

• Nevada Business Plan - RRG

• Nevada Pro Froma Template - RRG

• Corporate Governance Annual Disclosure - RRG

• Non-RRG Captive Dividend Request

• Insurer Change of Address 

• NV DOI Bulletins

Secretary of State Captive Forms

• Initial Formation Corporation Filing

• Annual/Amended List and State Business License Application