Arizona Initial Application For Authority To Self Insure (Individual)

• Category: Arizona Workers Compensation - Accounting
• State: Arizona
• Control #: AZ-WC-6
• Format: PDF

Description

Initial Application For Authority To Self Insure (Individual) The Arizona Initial Application For Authority To Self Insure (Individual) is a document that must be completed and submitted by an individual who wishes to self-insure in the state of Arizona. The application must include the individual's name, address, and contact information, as well as the type of business or organization they are self-insuring. It must also include a description of the type of self-insurance program they are applying for and any relevant information about the plan. The application must also include evidence of financial responsibility, such as a current financial statement or a surety bond. The application must also be accompanied by a copy of the individual's driver's license, social security number, and proof of insurance, as well as a copy of any applicable business licenses. Once the application is received and reviewed, the Arizona Department of Insurance will issue a Certificate of Authority to Self Insure. There are two types of Arizona Initial Application For Authority To Self Insure (Individual): a standard application and an expedited application. The standard application takes approximately two to three weeks to be processed, while the expedited application takes only two business days.

The Arizona Initial Application For Authority To Self Insure (Individual) is a document that must be completed and submitted by an individual who wishes to self-insure in the state of Arizona. The application must include the individual's name, address, and contact information, as well as the type of business or organization they are self-insuring. It must also include a description of the type of self-insurance program they are applying for and any relevant information about the plan. The application must also include evidence of financial responsibility, such as a current financial statement or a surety bond. The application must also be accompanied by a copy of the individual's driver's license, social security number, and proof of insurance, as well as a copy of any applicable business licenses. Once the application is received and reviewed, the Arizona Department of Insurance will issue a Certificate of Authority to Self Insure. There are two types of Arizona Initial Application For Authority To Self Insure (Individual): a standard application and an expedited application. The standard application takes approximately two to three weeks to be processed, while the expedited application takes only two business days.