INSTRUCTIONS: CONNECTICUT NON-RESIDENT FIRM (OTHER THAN CORPORATION) REINSURANCE INTERMEDIARY POWER OF ATTORNEY

When a non-resident firm wishes to perform reinsurance transactions in Connecticut, they use the application discussed in this article to appoint the state's Insurance Commissioner with power of attorney to receive and accept services of process in all related cases. This application can be obtained from the website of the state of Connecticut.

Connecticut Non-Resident Firm (Other Than Corporation) Reinsurance Intermediary Power Of Attorney Step 1: Enter the name of the non-resident firm on the first blank line.

Connecticut Non-Resident Firm (Other Than Corporation) Reinsurance Intermediary Power Of Attorney Step 2: Enter the state of the non-resident firm on the second blank line.

Connecticut Non-Resident Firm (Other Than Corporation) Reinsurance Intermediary Power Of Attorney Step 3: Enter the street address, city and state of the non-resident firm on the third blank line.

Connecticut Non-Resident Firm (Other Than Corporation) Reinsurance Intermediary Power Of Attorney Step 4: Enter the name of the non-resident firm on the fourth blank line.

Connecticut Non-Resident Firm (Other Than Corporation) Reinsurance Intermediary Power Of Attorney Step 5: Enter the date on which you are completing this form on the fifth blank line.

Connecticut Non-Resident Firm (Other Than Corporation) Reinsurance Intermediary Power Of Attorney Step 6: Enter the month in which you are completing this form on the sixth blank line.

Connecticut Non-Resident Firm (Other Than Corporation) Reinsurance Intermediary Power Of Attorney Step 7: Enter the last two digits of the year in which you are completing this form on the seventh blank line.

Connecticut Non-Resident Firm (Other Than Corporation) Reinsurance Intermediary Power Of Attorney Step 8: Print the name of the firm on the eighth blank line.

Connecticut Non-Resident Firm (Other Than Corporation) Reinsurance Intermediary Power Of Attorney Step 9: One or two authorized officials of the firm may sign the form. On the first blank line or lines where indicated, one or both parties should enter their signature.

Connecticut Non-Resident Firm (Other Than Corporation) Reinsurance Intermediary Power Of Attorney Step 10: On the second blank line or lines where indicated, both parties should print their names.

Connecticut Non-Resident Firm (Other Than Corporation) Reinsurance Intermediary Power Of Attorney Step 11: On the third blank line or lines where indicated, both parties should give their signature. The form should then be submitted to a notary public or commissioner of a Superior court.