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INSURERS: Title Insurance Company - Notices and Forms 2011 Annual/2012 Quarterly
Annual/Quarterly Statement Financial Filing Requirements and Instructions

The following sections contain Filing Instructions and California specific forms for you to view and download. All required documents must be submitted electronically in PDF, MS-Excel and/or MS-Word format(s), utilizing the (OASIS) Online Assistance System for Insurance Submittals. Additionally, please submit the original signature pages by the reporting deadline. 

Mail to:

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

Questions or Inquiries contact:
Financial Records
Phone: (213) 346-6423
E-mail: Financial_Records@insurance.ca.gov

Note: Please adjust your left and right margins to zero (0) before selecting the Print button in order to see all text. All filings must be submitted online before 12:00 midnight of the required due date. A required filing maybe subject to a late assessment fee, if submitted after the required filing date.

View Annual/Quarterly Statement Notices

Form No.

Description

Due Date

Printing and Special Instructions

 

 

 Annual Statement and Others Requirements Checklist (doc - 212 kb)

 

 

Print Format: Legal size; Orientation: Portrait
Note: If MS-Word-password screen pops up, please click on the [Read Only] button to open the file.
26 Notice and Disclosure of Material Transactions (xls - 54 kb)  When applicable Print Format: Letter size; Orientation: Portrait

105

 CA Affidavit - Declaration to Valuation of Property & Securities/Verification (xls - 727 kb) 03-01-2012

Print Format: Legal size; Orientation: Portrait

107

 Authorization for Disclosure of Financial Records Print Format: Letter size; Orientation: Portrait 03-01-2012 Print Format: Legal size; Orientation: Portrait

135

 Schedule-LS (4 pages) - For California domestic companies
(xls - 1.42 Mb)		 03-01-2012 Print Format: Select Entire workbook, Legal size; Orientation: Page 1: Portrait; Pages 2-3: Landscape

161

 Controlled Escrow Companies
(xls - 727 kb)		 03-01-2012 Print Format: Legal size; Orientation: Portrait

162

 Schedule of California Direct Premiums Written
(xls - 728 kb)		 03-01-2012 Print Format: Legal size; Orientation: Portrait
163

CA Supplement to the MDA for the Title Insurers
(xls - 727kb)

 04-01-2012 Print Format: Letter size; Orientation: Portrait
490 Trusteed Surplus
(Must submit to both NAIC (xls ) and CA (xls) -Department)

03-01-2012

 Print Format: Legal size; Orientation: Portrait

 

 Report of Dividend - CA (xls - 85.5 kb)
Bulletin 93-6

 

 Print Format: Letter size; Orientation: Portrait

Updated Date: 3/29/2012

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