§ 27-6-6-3 — Declaration of subscribers

Such subscribers so contracting among
themselves shall, through their attorney, file with the insurance
department a declaration verified by the oath of such attorney, or where
such attorney is a corporation, by the oath of a chief officer thereof,
setting forth the following:
(a) The name or title adopted by such subscribers proposing to
exchange such indemnity contracts. Such name or title shall not
be so similar to any other name or title previously adopted by a
similar organization or by any insurance corporation or
association as in the opinion of the insurance department is likely
to result in confusion or deception.
(b) The kind or kinds of insurance to be effected or exchanged.
(c) A copy of the form of policy contract or agreement under or by
which such insurance is to be effected or exchanged.
(d) A copy of the form of power of attorney or other authority of
such attorney under which such insurance is to be effected or
exchanged; provided, that a copy of any amendment to or
substitution of such form shall be filed with the insurance
department prior to its use.
(e) The location of the office or offices from which such contracts
or agreements are to be issued.
(f) That applications have been made for indemnity upon at least
one hundred (100) separate risks aggregating not less than one
and one-half million dollars ($1,500,000) as represented by
executed contracts or bona fide applications to become
concurrently effective in the case of fire insurance, and in the case
of automobile insurance, executed contracts or bona fide
applications for indemnity upon two hundred and fifty (250)
separate risks aggregating not less than one and one-half million
dollars ($1,500,000) or any or all classes of automobile insurance
effected by said subscriber through said attorney.
(g) That there is in the possession of such attorney and available
for the payment of losses, assets conforming to the requirements
of section 6 of this chapter.
(h) A financial statement under oath in form prescribed for the
annual statement.
(i) The instrument authorizing service of process as provided for
in this chapter.
Formerly: Acts 1919, c.102, s.3; Acts 1963, c.315, s.1; Acts
1967, c.232, s.2. As amended by P.L.252-1985, SEC.217.