Insurers: GID Form Inventory

Office of Insurance and Safety Fire Commissioner

Ralph T. Hudgens

Commissioner

Home

All Insurance Forms

ATTENTION: TO ALL NEW APPLICANTS - EFFECTIVE 1/1/2012.

In accordance with state law, beginning January 1, 2012, the Office of Insurance and Safety Fire Commissioner will be changing its procedures regarding the verification of lawful presence of persons applying for all licenses, permits, registrations and certificates. Please click HERE for more information.

ATTENTION:

We have NEW IMPORTANT payment procedures. Please view them HERE.

Form #: Captive Insurance Company $This is in the Adobe Portable Document format (pdf)\n$	Division: Regulatory Services	Published: 2012
Title: Filing Requirements Memo
Provides the requirements for filing as a Captive Insurance Company,

Form #: CHECKLIST - Fraternal Societies $This is in the Adobe Portable Document format (pdf)\n$	Division: Regulatory Services	Published: 2012
Title: Fraternal Societies Checklist
Provides a guide to the requirements for the 2012 annual filing.

Form #: CHECKLIST - Health Entities $This is in the Adobe Portable Document format (pdf)\n$	Division: Regulatory Services	Published: 2012
Title: Health Entities Checklist
Provides a guide to the requirements for the 2012 annual filing.

Form #: CHECKLIST - Life, Accident and Health Insurers $This is in the Adobe Portable Document format (pdf)\n$	Division: Regulatory Services	Published: 2012
Title: Life, Accident and Health Insurers Checklist
Provides a guide to the requirements for the 2012 annual filing.

Form #: CHECKLIST - Property and Casualty Insurers $This is in the Adobe Portable Document format (pdf)\n$	Division: Regulatory Services	Published: 2012
Title: Property and Casualty Insurers Checklist
Provides a guide to the requirements for the 2012 filing.

Form #: CHECKLIST - Title Companies $This is in the Adobe Portable Document format (pdf)\n$	Division: Regulatory Services	Published: 2012
Title: Title Companies Checklist
Provides a guide to the requirements for the 2012 annual filing.

Form #: Citizenship Affidavit GID-276-EN $This is in the Adobe Portable Document format (pdf)\n$	Division: Enforcement	Published: 2012
Title: Citizenship Affidavit
Effective 1-1-2012, the Citizenship Affidavit Form GID-276-EN, is required of persons making application for all licenses, permits, registrations and certifications in order to comply with the Georgia Illegal Immigration Reform And Enforcement Act. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal.

Form #: GID-001-IL with GID-004-IL $This is in the Adobe Portable Document format (pdf)\n$	Division: Industrial Loan	Published: 2012
Title: Corporation Application for License to Operate Business under Georgia Industrial Loan Act
Effective 1-1-2012, submit with the application the Citizenship Affidavit Form GID-276-EN which is required of persons making application for all licenses in order to comply with the Georgia Illegal Immigration Reform And Enforcement Act. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal.

Form #: GID-002-IL with GID-004-IL $This is in the Adobe Portable Document format (pdf)\n$	Division: Industrial Loan	Published: 2012
Title: Partnership Application for License to Operate Business under Georgia Industrial Loan Act
Effective 1-1-2012, submit with the application the Citizenship Affidavit Form GID-276-EN which is required of persons making application for all licenses in order to comply with the Georgia Illegal Immigration Reform And Enforcement Act. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal.

Form #: GID-003-IL with GID-004-IL $This is in the Adobe Portable Document format (pdf)\n$	Division: Industrial Loan	Published: 2012
Title: Proprietorship Application for License to Operate Business under Georgia Industrial Loan Act
Effective 1-1-2012, submit with the application the Citizenship Affidavit Form GID-276-EN which is required of persons making application for all licenses in order to comply with the Georgia Illegal Immigration Reform And Enforcement Act. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. Replaces GID-FO-IL-3.

Form #: GID-003-RS $This is in the Adobe Portable Document format (pdf)\n$	Division: Regulatory Services	Published: 2010
Title: Appointment of Attorney-in-fact by Insurer
This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us.

Form #: GID-003-RS Memo $This is in the Adobe Portable Document format (pdf)\n$	Division: Regulatory Services	Published: 2009
Title: Appointment of Attorney-in-fact by Insurer (Memo)
Memo regarding Appointment of Attorney-in-fact by Insurer

Form #: GID-004-IL $This is in the Adobe Portable Document format (pdf)\n$	Division: Industrial Loan	Published: 2011
Title: Convenience and Advantage Documentation
Convenience and Advantage Documentation. Effective 1-1-2012, submit with the application the Citizenship Affidavit Form GID-276-EN which is required of persons making application for all licenses in order to comply with the Georgia Illegal Immigration Reform And Enforcement Act. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal.

Form #: GID-004-RS $This is in the Adobe Portable Document format (pdf)\n$	Division: Regulatory Services	Published: 2010
Title: Appointment of Commissioner as Attorney-in-fact by Insurer
This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us.

Form #: GID-006-AL $This is in the Adobe Portable Document format (pdf)\n$	Division: Agents Licensing	Published: 2011
Title: Request for Clearance Letter (same as GID-AL-6)
Request for Clearance Letter

Form #: GID-006-IL $This is in the Adobe Portable Document format (pdf)\n$	Division: Industrial Loan	Published: 2012
Title: Annual Georgia Industrial Loan License Renewal
Annual Georgia Industrial Loan License Renewal Application. Effective 1-1-2012, submit with the application the Citizenship Affidavit Form GID-276-EN which is required of persons making application for all licenses in order to comply with the Georgia Illegal Immigration Reform And Enforcement Act. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us.

Form #: GID-006A-AL $This is in the Adobe Portable Document format (pdf)\n$	Division: Agents Licensing	Published: 2011
Title: Request for Status Letter (same as GID-AL-6A)
GID-AL-6A Request for Status Letter

Form #: GID-007-IL $This is in the Adobe Portable Document format (pdf)\n$	Division: Industrial Loan	Published: 2008
Title: Annual Georgia Industrial Loan Report
Annual Georgia Industrial Loan Report This is an Adobe Interactive Form. You may fill it out on-line, print it and send it to us. This is an Adobe Interactive Form.

Form #: GID-007-NT $This is in the Adobe Portable Document format (pdf)\n$	Division: Regulatory Services	Published: 2012
Title: Vehicle Protection Warrantor - Notice and Registration - Annual Renewal Registration (same as EN-7)
This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. Effective 1-1-2012, the Citizenship Affidavit Form GID-276-EN is required of persons making application for all licenses, permits, registrations and certifications in order to comply with the Georgia Illegal Immigration Reform And Enforcement Act. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal.

Form #: GID-007-RS $This is in the Adobe Portable Document format (pdf)\n$	Division: Regulatory Services	Published: 2001
Title: Official Having Supervision Of Insurance In The State Of Domicile
Form is to be completed by the supervising insurance official.

Form #: GID-007A-IL $This is in the Adobe Portable Document format (pdf)\n$	Division: Industrial Loan	Published: 2008
Title: Annual Georgia Industrial Loan report Addendum
This is an Adobe Interactive Form. You may fill it out on-line, print it and send it to us.

Form #: GID-007B-IL $This is in the Adobe Portable Document format (pdf)\n$	Division: Industrial Loan	Published: 2008
Title: Statement of Income and Expenses
This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us.

Form #: GID-010-RS $This is in the Adobe Portable Document format (pdf)\n$	Division: Regulatory Services	Published: 2012
Title: Application for Renewal of Certificate of Authority
Effective 1-1-2012, the Citizenship Affidavit Form GID-276-EN must be submitted with this application for processing. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us.

Form #: GID-011-RS Memo $This is in the Adobe Portable Document format (pdf)\n$	Division: Regulatory Services	Published: 2001
Title: Memo regarding Insurance company
Memo regarding Insurance company's Annual Statement for Publication

Form #: GID-011-RS with Reference Guide $This is in the Adobe Portable Document format (pdf)\n$	Division: Regulatory Services	Published: 2010
Title: Insurance Company Annual Statement for Publication
This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us.

Form #: GID-012 $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2005
Title: Annual Premium Tax Return (Rev 10-05)
Annual Premium Tax Return (Rev 10-05)

Form #: GID-012 $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2007
Title: Annual Premium Tax Return
Annual Premium Tax Return (Rev 10-07)

Form #: GID-012 Instructions $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2007
Title: GID-012 Instructions
Instructions (GID-12) (Rev 10-07)

Form #: GID-012 Instructions $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2006
Title: GID-012 Instructions
GID-012 Instructions

Form #: GID-012 Instructions $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2007
Title: GID-012 Instructions
GID-012 Instructions (Rev 10-07)

Form #: GID-012 Instructions $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2004
Title: GID-12 Instructions (Rev 10-04)
GID-12 Instructions (Rev 10-04)

Form #: GID-012 Instructions $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2005
Title: GID-12 Instructions (Rev 10-05)
GID-12 Instructions (Rev 10-05)

Form #: GID-012 Instructions $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2006
Title: GID-12 Instructions
GID-12 Instructions (Rev 10-06)

Form #: GID-012 Instructions $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2007
Title: GID-12 Instructions (Rev 10-07)
GID-12 Instructions (Rev 10-07)

Form #: GID-012-IL $This is in the Adobe Portable Document format (pdf)\n$	Division: Industrial Loan	Published: 2011
Title: Quarterly Insurance and Loan Report
This is an Adobe Interactive Form. You may fill it out on-line, print it and send it to us.

Form #: GID-012-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Regulatory Services	Published: 2004
Title: Annual Premium Tax Return
Annual Premium Tax Return. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal.

Form #: GID-012-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2009
Title: 2009 ANNUAL PREMIUM TAX RETURN (Rev 09-09)
2009 ANNUAL PREMIUM TAX RETURN (Rev 09-09). Same as GID-12.

Form #: GID-012-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2011
Title: ANNUAL PREMIUM TAX RETURN
ANNUAL PREMIUM TAX RETURN

Form #: GID-012-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2010
Title: ANNUAL PREMIUM TAX RETURN
2010 ANNUAL PREMIUM TAX RETURN(Rev 10-10). Same as GID-12.

Form #: GID-012-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2008
Title: Annual Premium Tax return
GID-12-PT 2008 ANNUAL PREMIUM TAX RETURN (Rev 10-08). Same as GID-12.

Form #: GID-012A $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2006
Title: Statement of Quarterly Premium Tax
Statement of Quarterly Premium Tax (Rev 10-06)

Form #: GID-012A $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2007
Title: Statement of Quarterly Premium Tax
Statement of Quarterly Premium Tax (Rev 10-07)

Form #: GID-012A $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2004
Title: Statement of Quarterly Premium Tax
Statement of Quarterly Premium Tax (Rev 10-04)

Form #: GID-012A $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2005
Title: Statement of Quarterly Premium Tax
Statement of Quarterly Premium Tax (Rev 10-05)

Form #: GID-012A-IL $This is in the Adobe Portable Document format (pdf)\n$	Division: Industrial Loan	Published: 2011
Title: Statement Of Estimated Monthly Loan Tax Report
This is an Adobe Interactive Form. You may fill it out on-line, print it and send it to us.

Form #: GID-012A-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2012
Title: STATEMENT OF QUARTERLY PREMIUM TAX
STATEMENT OF QUARTERLY PREMIUM TAX

Form #: GID-012A-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2011
Title: STATEMENT OF QUARTERLY PREMIUM TAX
Form is provided for quarterly filings.

Form #: GID-012A-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2008
Title: Statement of Quarterly Premium Tax
STATEMENT OF QUARTERLY PREMIUM TAX (Rev 10-08)

Form #: GID-012A-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2009
Title: Statement of Quaterly Premium Tax
Statement of Quaterly Premium Tax

Form #: GID-013 $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2004
Title: Georgia Retaliatory Tax Computation
Georgia Retaliatory Tax Computation (O.C.G.A. §33-3-26) (Rev 10-04)

Form #: GID-013 $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2005
Title: Georgia Retaliatory Tax Computation
Georgia Retaliatory Tax Computation (O.C.G.A. §33-3-26) (Rev 10-05)

Form #: GID-013 $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2006
Title: Georgia Retaliatory Tax Computation - 2006
Georgia Retaliatory Tax Computation (O.C.G.A. §33-3-26) (Rev 10-06)

Form #: GID-013 $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2007
Title: Georgia Retaliatory Tax Computation
Georgia Retaliatory Tax Computation (O.C.G.A. §33-3-26) (Rev 10-07)

Form #: GID-013 Instructions $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2004
Title: GID-013 Instructions
GID-013 Instructions

Form #: GID-013 Instructions $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2005
Title: Georgia Retaliatory Tax Computation
Georgia Retaliatory Tax Computation Instructions (O.C.G.A. §33-3-26) (Rev 10-05)

Form #: GID-013 Instructions $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2006
Title: Georgia Retaliatory Tax Computation
Georgia Retaliatory Tax Computation (O.C.G.A. §33-3-26)

Form #: GID-013 Instructions $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2007
Title: GID-013 instructions
GID-013 instructions (Rev1007)

Form #: GID-013 instructions $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2004
Title: GID-13 instructions (Rev 10-04)
GID-13 2004 Georgia Retaliatory Tax Computation (O.C.G.A. 33-3-26) (Rev 10-04).pdf

Form #: GID-013 instructions $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2005
Title: GID-13 instructions (Rev 10-05)
GID-13 2005 Georgia Retaliatory Tax Computation (O.C.G.A. 33-3-26) (Rev 10-05)

Form #: GID-013-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2011
Title: GEORGIA RETALIATORY TAX COMPUTATION
GEORGIA RETALIATORY TAX COMPUTATION

Form #: GID-013-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2011
Title: GEORGIA RETALIATORY TAX COMPUTATION
GEORGIA RETALIATORY TAX COMPUTATION

Form #: GID-013-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2010
Title: 2010 Georgia Retaliatory Tax Computation (Rev 10-10).
2010 Georgia Retaliatory Tax Computation (Rev 10-10). Same as GID-13.

Form #: GID-013-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2009
Title: 2009 Georgia Retaliatory Tax Computation (Rev 09-09)
2009 Georgia Retaliatory Tax Computation (Rev 09-09). Same as GID-13.

Form #: GID-013-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2008
Title: Georgia Retaliatory Tax Computation
Georgia Retaliatory Tax Computation (Rev 10-08)

Form #: GID-014 $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2004
Title: Calculation for Abatement of Gross Premium Tax for the Year Ending 2004
Calculation for Abatement of Gross Premium Tax for the Year Ending DECEMBER 31, 2004 (Rev 10-04)

Form #: GID-014 $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2005
Title: Calculation for Abatement of Gross Premium Tax for the Year Ending 2005
Calculation for Abatement of Gross Premium Tax for the Year Ending DECEMBER 31, 2005 (Rev 10-05)

Form #: GID-014 $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2006
Title: Calculation for Abatement of Gross Premium Tax for the Year Ending 2006
Calculation for Abatement of Gross Premium Tax for the Year Ending DECEMBER 31, 2006 (Rev 10-06)

Form #: GID-014 $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2007
Title: Calculation for Abatement of Gross Premium Tax for the Year Ending 2007
Calculation for Abatement of Gross Premium Tax for the Year Ending DECEMBER 31, 2007 (Rev1007)

Form #: GID-014 $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2004
Title: Calculation for Abatement of Gross Premium Tax Calculation for Abatement of Gross Premium Tax for the Year Ending DECEMBER 31, 2006
Calculation for Abatement of Gross Premium Tax for the Year Ending DECEMBER 31, 2003

Form #: GID-014 Instructions $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2004
Title: GID-014 Instructions
GID-014 Instructions (Rev 10-04)

Form #: GID-014 Instructions $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2006
Title: GID-014 Instructions
GID-014 Instructions (Rev 10-06)

Form #: GID-014 Instructions $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2007
Title: Instructions
Instructions (Rev 10-07)

Form #: GID-014 Instructions $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2004
Title: GID-014 Instructions
GID-014 Instructions

Form #: GID-014 Instructions $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2005
Title: GID-14 Instructions (Rev 10-05)
GID-14 Instructions (Rev 10-05)

Form #: GID-014-IL $This is in the Adobe Portable Document format (pdf)\n$	Division: Industrial Loan	Published: 2009
Title: Licensee Request to Relocate
Licensee Request to Relocate. Same as IL-14.

Form #: GID-014-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2008
Title: 2008 Calculation for abatement of Gross Premium Tax
2008 Calculation for abatement of Gross Premium Tax (Rev 10-08)

Form #: GID-014-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2011
Title: CALCULATION FOR ABATEMENT OF GROSS PREMIUM
CALCULATION FOR ABATEMENT OF GROSS PREMIUM

Form #: GID-014-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2010
Title: 2010 Calculation For Abatement Of Gross Premium Tax
2010 Calculation For Abatement Of Gross Premium Tax (Rev 10-10). Same as GID-14.

Form #: GID-014-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2009
Title: 2009 Calculation For Abatement Of Gross Premium Tax (Rev 09-09)
2009 Calculation For Abatement Of Gross Premium Tax (Rev 09-09). Same as GID-14.

Form #: GID-014-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2008
Title: 2008 Calculation For Abatement Of Gross Premium Tax
2008 Calculation For Abatement Of Gross Premium Tax (Rev 10-08)

Form #: GID-014-PT $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2008
Title: Calculation for Abatement of Gross Premium Tax
Calculation for Abatement of Gross Premium Tax (Rev 10-08)

Form #: GID-015 $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2006
Title: Statement in Support of Claim for Retaliatory Tax Credits
Statement in Support of Claim for Retaliatory Tax Credits (Rev 10-06)

Form #: GID-015 $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2007
Title: Statement in Support of Claim for Retaliatory Tax Credits
Statement in Support of Claim for Retaliatory Tax Credits (Rev 10-07)

Form #: GID-015 $This is in the Adobe Portable Document format (pdf)\n$	Division: Premium Tax	Published: 2005
Title: Statement in Support of Claim for Retaliatory Tax Credits
Statement in Support of Claim for Retaliatory Tax Credits (Rev 10-05)

Form #: GID-015-IL $This is in the Adobe Portable Document format (pdf)\n$	Division: Industrial Loan	Published: 2012