OAR 836-027-0030
Forms; General Requirements

(1) Forms A, B, C, D, E and F are intended to be guides in the preparation of the statements required by ORS 732.517 (Purpose of ORS 732.517 to 732.546) to 732.592 (Recovery from parent corporation or holding company if domestic insurer ordered into liquidation or rehabilitation), including but not limited to the registration provisions thereof. The forms are not intended to be blank forms that are to be filled in. The statements filed shall contain the numbers and captions of all items, but the text of the items may be omitted if the answers to the items are prepared so as to indicate clearly the scope and coverage of the items. All instructions, whether appearing under the items of the form or elsewhere, are to be omitted. Unless expressly provided otherwise, if any item is inapplicable or the answer to any item is in the negative, an appropriate statement to that effect shall be made.
(2) One complete copy of each statement, including exhibits and all other papers and documents filed as a part of the statement, shall be filed with the director of the Department of Consumer and Business Services by personal delivery or mail. A copy of Form C shall be filed in each state in which an insurer is authorized to do business if the commissioner of that state has notified the insurer of its request in writing. An insurer who has been so notified shall file the form not later than the 30th day after the date of receipt of the notice. At least one of the copies shall be manually signed and certified in the manner prescribed on the form. Unsigned copies shall be conformed. If the signature of any person is affixed pursuant to a power of attorney or other similar authority, a copy of such power of attorney or other authority shall also be filed with the statement.
(3) If an applicant requests a hearing on a consolidated basis under ORS 732.527 (Approval of acquisition by chief insurance regulatory officials of two or more jurisdictions), in addition to filing the Form A with the director, the applicant must file electronically a copy of Form A with the National Association of Insurance Commissioners.
(4) Statements must be prepared on paper 8-1⁄2“ X 11” in size and bound along the left edge or securely fastened at the top left corner. Exhibits and financial statements, unless specifically prepared for the filing, may be submitted in their original size. All copies of any statement, financial statements or exhibits shall be clear, easily readable, and suitable for photocopying. Debits in credit categories and credits in debit categories shall be designated so as to be clearly distinguishable as such on photocopies. Statements shall be in the English language and monetary values shall be stated in United States currency. If any exhibit or other paper or document filed with the statement is in a foreign language, it shall be accompanied by a translation into the English language and any monetary value shown in a foreign currency shall be converted into United States currency.

Source: Rule 836-027-0030 — Forms; General Requirements, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=836-027-0030.

Last Updated

Jun. 8, 2021

Rule 836-027-0030’s source at or​.us