Industry Information

Forms under the Automobile Insurance Premiums Regulation

The AIRB has a new address and fax number effective January 13, 2011. Our forms below have been updated accordingly.  Click here for our updated contact information.

Fillable PDFs:  * These pdf forms are "fillable".  The instructions are available on the upper right corner of each form.  You will need Acrobat Reader 6.0 or higher to complete these forms online.  If you don't have Acrobat Reader or need to upgrade, click here to download this free program.

Name of Form (pdf)
and Section of Regulation if applicable

Date Updated
(mm/dd/yyyy)

Rating Profile Forms for Private Passenger Rating Programs
See Bulletin 03-2010 for more information. Contact AIRB to obtain the Excel version of profile forms.

10/15/2010

Section 5 - Notice of Offset Adjustments *
Private Passenger Automobile


01/05/2011

Section 6 - Superintendent Review *
Application for Review of Rating Program for Basic Coverage - Private Passenger Automobile

01/05/2011

Section 9 - Notice of Changes in Additional Coverage *
Private Passenger Automobile


01/05/2011

Section 10 - New Insurer Application *
Application Information for New Entrant
Private Passenger

01/05/2011

Section 19 - Application Information for Changes *
Non-Private Passenger Automobile

01/05/2011

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