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  4. Iowa Captive Insurance

Captive Insurance Applications and Forms

  • Application to Form a Captive Company

  • Iowa Captive Biographical Affidavit Form

  • Iowa Captive Management Firm Application

  • Iowa Captive Actuary Authorization Form

  • Iowa Captive CPA Authorization Form

  • Iowa Captive Irrevocable Letter of Credit Required Wording

  • Iowa Captive Premium Tax Return

  • Uniform Consent to Service of Process

  • Iowa Captive Company Annual Statement

Annual Calendar Dates for Reporting, Tax Payments, and Fees:

Iowa Insurance Division

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Iowa Insurance Division

1963 Bell Avenue, Suite 100
Des Moines, IA 50315

Phone

515-654-6600

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