CAPTIVE INSURANCE
(NEW)Business Plan Change Form for Addition of Protected Cells - including general instructions and guidance
Actuary Application - to become approved for Vermont Captives
CPA Application - to become approved for Vermont Captives
Biographical Affidavit - including general instructions
Please note that the "Abbreviated Biographical Affidavit" is to be used to submit significant changes to Biographical Affidavit Forms already on file. The form is available upon request to DFR Captive Insurance as required.
(NEW)Audit and SAO Submital Form - New mandatory fillable PDF for all captive filers (General Instructions for reference only)
Biographical Affidavit - Vermont Resident Directors ONLY - including general instructions
CPA Certification of Review of Audit Work Papers- required for all audit filings
Letter of Credit- required content with 7 provisions
RRG Independence Certification- sample WORD template to be filed annually
Vermont Captive Annual Report (VCAR) General Instructions - IMPORTANT please read
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Vermont Captive Annual Report (VCAR) - Long Form (current template) - To be used by all Vermont licensed 12/31 year-end captives and by fiscal year-end captives at time of their year-end.
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Vermont Captive Annual Report (VCAR) - Short Form (current template) - To be used by all Vermont licensed fiscal year-end captives to file required 12/31 reporting, dormant captives and those with prior approval.
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Vermont Captive Annual Report (VCAR) - Supplemental Form (current template) - To be used for required separate reporting by Vermont licensed captives filing supplemental insurance subsidiaries or cells by contract.
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Vermont Captive Annual Report (VCAR) - Incorporated Protected Cell (IPC) Form (current template) - To be used for required separate reporting by the incorporated protected cells (IPC) of Vermont licensed sponsored captives.
