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Below you will find a listing of every form that applies to county mutual insurance companies under Financial Reporting and Tax Requirements section of the North Dakota Insurance Department website. Please refer to the general information under the Filing Requirements for Licensed Companies section.

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Renewal Statement for Admitted Companies

The Renewal Statement for Admitted Companies must be submitted using OPTins.

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Forms

County Mutual Abstract of Statement (SFN 4805)

County Mutual Annual Statement

  • An electronic version of the County Mutual Annual Statement should be filed as an email attachment addressed to colicexam@nd.gov.
  • The County Mutual Annual Statement is a fillable Excel spreadsheet. Do not open this file directly but rather download the file to your computer. Click on the file below. Select the "Save" or "Save Target As" option. Save the file to your computer. When opening the file, a pop-up box will ask about updating the file's links, select "Don't Update." A second pop-up box will ask about disabling macros, click "OK." If you have problems using this file, please contact the Department.

County Mutual Annual Statement Instructions

County Mutual Companies Checklist

County Mutual Interim Financial Statement

  • An electronic version of the County Mutual Interim Financial Statement should be filed as an email attachment addressed to colicexam@nd.gov.

Fire District Electronic Filing