Marcia Hultman

Cabinet Secretary

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Division of Insurance


Uniform Certificate of Authority Application (UCAA) Corporate Amendment Requirements

Add Lines to a Certificate of Authority
Merger of Companies
Name Change of Company
Redomicile of a Company

Click here for a printable version of the UCAA Corporate Amendments Application Requirements. (in Adobe .pdf format*)

Add Lines to a Certificate of Authority

Submit the following:

  • UCAA Corporate Amendments Application, Form 2C.
  • $25.00 - issuance of new Certificate of Authority (or retaliatory fee).
  • UCAA add lines of authority, Form 3C.
  • Certificate of Compliance from home state.
  • Return original Certificate of Authority. A new one will be issued.

Merger of Companies

Submit the following:

  • UCAA Corporate Amendments Application, Form 2C.
  • No fee is required but is retaliatory.
  • Copy of the merger between the named companies.
  • Return the original Certificate of Authority of the non-surviving company.
  • If premium was received by non-surviving company prior to merger, then a 'FINAL' premium tax return must be submitted and tax paid accordingly.

Name Change of Company

Submit the following:

  • UCAA Corporate Amendments Application, Form 2C.
  • $25.00 - Issuance of new Certificate of Authority (or retaliatory fee).
  • $10.00 - Copy of amended articles, if applies (or retaliatory fee).
  • $5.00 - Copy of amended bylaws, if applies (or retaliatory fee).
  • Certificate of Compliance or copy of COA from home state DOI reflecting new name.
  • Return the original Certificate of Authority. A new one will be issued.

Redomicile of a Company

Submit the following:

  • UCAA Corporate Amendments Application, Form 2C.
  • Certificate of Compliance or copy of COA from new state of domicile.
  • $25.00 - Issuance of new Certificate of Authority (or retaliatory fee).
  • $10.00 - Copy of amended articles, if applies (or retaliatory fee).
  • $5.00 - Copy of amended bylaws, if applies (or retaliatory fee).
  • Return the original Certificate of Authority. A new one will be issued.


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