Instructions:
In accordance with District of Columbia Municipal Regulation 26-A3711.1, every captive insurance company shall report to the Commissioner within thirty (30) days after any change in its executive officers or directors, including in its report a statement of the business and professional affiliations of any new executive officer or director. The notification should include:
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The name of the new director or officer
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The new position with the captive insurer
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The effective date of the appointment
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The current primary employer of the new director or officer and the principal occupation/position with that employer
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The name of the person the new director or officer is replacing
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The effective date of the separation of the person being replaced
Use this online form to report changes in executive officers and directors.
NOTE: For risk retention groups (RRGs), in addition to the notification of any change in its executive officers or directors, a biographical affidavit must be completed by the new officer or director and submitted to the Department. Biographical affidavits are not required for officers and directors of non-RRG captive insurers. New directors and officers for non-RRG captives should be vetted by the captive owners and captive managers.