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Title 3 . Commerce, Community, and Economic Development
Chapter 21 . Miscellaneous
Section 10. Forms; general requirements

3 AAC 21.010. Forms; general requirements

(a) Forms A - E are intended to be guides in the preparation of the statements required under AS 21.22. They are not intended to be blank forms that are to be filled in. A statement filed must contain the numbers and captions of all items indicated on a form, but the text of the items may be omitted if the answers to them are prepared to indicate the coverage of the items without the necessity of referring to the text of the items or the instructions to them. All instructions, whether appearing under the items of the form or elsewhere in it, are to be omitted. Unless expressly provided otherwise, if an item is not applicable or the answer to it is in the negative, an appropriate explanation to that effect must be made.

(b) A complete copy of a statement required under AS 21.22, including exhibits and all other papers and documents filed as a part of it, must be filed with the director by personal delivery or mail addressed to: Director, division of insurance of the State of Alaska, P.O. Box 110805, Juneau, Alaska 99811-0805. Each copy must be manually signed in the manner prescribed on the form. If the signature of a person is affixed under a power of attorney or other similar authority, a copy of the power of attorney or other authority must also be filed with the statement. If the commissioner or director of the insurance department or division of a state in which an insurer is authorized to do business has submitted a written request for a copy of a statement filed under this section, the insurer shall file a copy of the statement in that state within 10 days of receipt of the request.

(c) A statement should be prepared on paper 8-1/2" x 11" in size and preferably bound at the top or the top left-hand corner. An exhibit or financial statement, unless specifically prepared for the filing, may be submitted in its original size. All copies of a statement, financial statement, or exhibit must be clear, easily readable, and suitable for photocopying. Debits in credit categories and credits in debit categories must be designated so they are clearly distinguishable on photocopies. A statement must be in the English language and monetary value must be stated in United States currency. If an exhibit or other paper or document filed with the statement is in a foreign language, it must be accompanied by a translation into the English language and a monetary value normally shown in a foreign currency must be converted into United States currency.

(d) A person may request prefiling conference with division personnel.

History: Eff. 6/30/77, Register 62; am 10/21/92, Register 124; am 1/12/95, Register 133; am 3/11/98, Register 145

Authority: AS 21.06.090

AS 21.22.130


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If it is critical that the precise terms of the Alaska Administrative Code be known, it is recommended that more formal sources be consulted. Recent editions of the Alaska Administrative Journal may be obtained from the Alaska Lieutenant Governor's Office on the world wide web. If any errors are found, please e-mail Touch N' Go systems at E-mail. We hope you find this information useful. Copyright 2006. Touch N' Go Systems, Inc. All Rights Reserved.

Last modified 7/05/2006