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Go to vaccinate.dc.gov or call 1-855-363-0333 to pre-register and then help us spread the word. #DCHOPE
Read Mayor Bowser’s Presentation on DC’s COVID-19 Situational Update: April 12

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Biographical Affidavit

Friday, September 28, 2012

 A biographical affidavit must be completed by each director, officer, and service provider, including the captive manager, attorney, CPA, actuary, managing general underwriter, managing general agent, organizer, sponsor or promoter, including such persons who will own more than 10 percent of the outstanding shares of the applicant, or who will be providing more than 25 percent of the applicant’s initial capital or surplus.  Answer each question on this application and provide a detailed explanation where necessary.  Do not leave a question blank.  Incomplete applications will be returned.