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CA Department of Insurance

Notices & Forms 2013/2014 Annual and Quarterly Filings

The following section contains filing instructions and forms for you to view and download.  All filings, unless otherwise noted, must be submitted using the Online Assistance System for Insurer Submittals (OASIS).

For any document requiring original signatures, please mail the signature page(s) to:

California Department of Insurance
Financial Analysis Division
300 South Spring Street, South Tower, 13th Floor
Los Angeles, CA 90013
Attention: Financial Records Unit

For questions or inquiries, please contact:

Phone: (213) 346-6409 or (213) 346-6447 for G&A Annual Statement 
Phone: (213) 346-6451 for G&A Annuity Agreement

Form No.


 Special Instructions


G&A - Annuity Agreement Filing Instructions, Transmittal .doc 

G&A - Annuity Agreements Summary Page(s) .xls

Letter to Societies .doc

To be used for agreements entered into on or after 1/1/06. 

Print Format: Letter size; Orientation: Portrait


G&A Annual Statement Blank .xls

G&A Annual Statement Instructions .doc

G&A Annual Statement Blank is updated annually.  Please download and use the current version of the Annual Statement Blank.  Do not add or delete any cells, rows, or columns on any pages or make any changes to the format of the Annual Statement Blank.   

G&A Annual Statement in both Excel and PDF formats must be submitted through OASIS.  Please do not password protect document submitted through OASIS.  A copy of the Segregated Trust Account's Investment Summary must be submitted as part of the Annual Statement PDF file.

Print Format: Legal size; Orientation: Portrait


Authorization for Disclosure of Financial Records.xls

Signed original document must be sent to the Corporate Affairs Bureau at the address provided in the form. 

Print Format: Letter size; Orientation: Portrait

List of G&A Society Assigned California Company Codes

Back to Annual/Quarterly Statement Notices Menu 

Updated date: 10/14/14


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