State of Nevada -

Division Sections

above photo provided courtesy of the Nevada Commission on Tourism

The Nevada Captive Insurance Association, a non-profit organization, is an excellent resource for Captive Insurers, companies that want to form a Captive, and anyone interested in this developing industry. Click Here to view its Web site.

Licensing Requirements

You will need to download a free copy of Adobe Acrobat Reader to view the Captive Insurer Application, the Annual Captive Insurance Premium Tax Return and NRS 694C.

Biographical Affidavit - Frequently Asked Questions

Insurer Change of Address Form

NRS 694C.450 Taxes on Premiums

Captive Insurer Application	PDF Format	MS Word Format
Irrevocable Letter of Credit	PDF Format	MS Word Format
Captive Annual Statement: Pure	PDF Format	MS Word Format
Captive Insurance Premium Tax Return 2008	PDF Format	MS Excel Format
Uniform Consent to Service of Process	PDF Format	MS Word Format
Biographical Affidavit	PDF Format	MS Word Format

*Captive Approved Lists*
Licensed Captive Companies	Approved Actuaries	Approved Attorneys
Approved Captive Managers	Approved Captive Reviewers	Approved CPAs

Captive Contact Information
Michael Lynch Deputy Commissioner of Captive Programs (775) 687-4270 Ext. 265 mlynch@doi.state.nv.us	Nevada Division of Insurance 788 Fairview Drive, Suite 300 Carson City, Nevada 89701