Filing of Corporate Amendments and
Information Updates

Fraternal Benefit Society

Designation of Persons to Contact (for New Staff, New Address, New Phone, New E-mail Address)

Form 08-280 or UCAA Form 14 should be submitted to change the designated company person to contact for the areas listed on the form. The Form should be sent to:

Company Amendments
Alaska Division of Insurance
P. O. Box 110805
Juneau, AK 99811-0805

Name Change

The Alaska Division of Insurance has adopted the NAIC Uniform Certificate of Authority Application (UCAA) Corporate Amendments Application as its process for submitting changes to the Certificate of Authority. The fee to reissue the Certificate of Authority is $100. The UCAA can be found at http://www.naic.org/industry_ucaa.htm

Questions: Jeff Bodine
jeff.bodine@alaska.gov
907-465-4609

Please make check payable to: Alaska Division of Insurance

Amended Articles of Incorporation

The Alaska Division of Insurance has adopted the NAIC Uniform Certificate of Authority Application (UCAA) Corporate Amendments Application as its process for submitting changes to the Certificate of Authority. The fee is $100. The UCAA can be found at http://www.naic.org/industry_ucaa.htm

Questions: Jeff Bodine
jeff.bodine@alaska.gov
907-465-4609

Please make check payable to: Alaska Division of Insurance

Amended Bylaws

The Alaska Division of Insurance has adopted the NAIC Uniform Certificate of Authority Application (UCAA) Corporate Amendments Application as its process for submitting changes to the Certificate of Authority. The fee is $100. The UCAA can be found at http://www.naic.org/industry_ucaa.htm

Questions: Jeff Bodine
jeff.bodine@alaska.gov
907-465-4609

Please make check payable to: Alaska Division of Insurance

Designation of Person to Receive Service of Process

One of the following Forms, UCAA Form 12 or Form 08-253 and Form 08-254, should be submitted to change the designated company person to whom legal process documents accepted by the director are to be forwarded. The Form should be sent to:

Company Amendments
Alaska Division of Insurance
P. O. Box 110805
Juneau, AK 99811-0805

Redomestication

The Alaska Division of Insurance has adopted the NAIC Uniform Certificate of Authority Application (UCAA) Corporate Amendments Application as its process for submitting changes to the Certificate of Authority. The fee is $100. The UCAA can be found at http://www.naic.org/industry_ucaa.htm

Questions: Jeff Bodine
jeff.bodine@alaska.gov
907-465-4609

Please make check payable to: Alaska Division of Insurance

Other Amendments (for Changes to Other Information)

To submit other changes in company information, a letter giving the new information should be sent to the following address:

Company Amendments
Alaska Division of Insurance
P. O. Box 110805
Juneau, AK 99811-0805

Surrender of Fraternal Benefit Society Certificate of Authority

Form 08-290 should be printed on company letterhead and sent to:

Company Amendments
Alaska Division of Insurance
P. O. Box 110805
Juneau, AK 99811-0805