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Get Captive Actuary Application

Oner of the Oklahoma Insurance Department, I hereby apply for authorization to certify as to the adequacy of loss reserves and loss expense reserves as required by the Captive Insurance Company Act O.S. 36 6470.1 et seq. INDIVIDUALS ONLY MAY APPLY 1. Full Legal Name: 2. Residence Address: 3. (a) Date of Birth: (b) Social Security Number: 4. Education.

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