The State of New Jersey
NJ Department of Banking and Insurance


Home > Insurance Division > Captive Corner > Registered Service Providers
Registered Service Providers

Business entities currently registered in New Jersey to service captive insurance companies:
Actuaries/Actuarial Firms
Captive Managers
Certified Public Accountants
Interested in becoming a NJ registered service provider? Submit an application to:
William P. White
Assistant Commissioner, Office of Captive Insurance
NJ Department of Banking & Insurance
20 W. State St.
PO Box 325
Trenton, NJ 08625-0325
Telephone: 609-292-0844, ext. 50028  
Note: The documents below are "fillable" PDFs which can be opened with Adobe Acrobat Reader and filled out directly on the screen. Please print the completed forms and sign as needed.   Captive Insurance
20 W. State St.
PO Box 325
Trenton, NJ 08625-0325
Actuaries/Actuarial Firms: Application and Biographical Affidavit
Captive Managers: Application and Biographical Affidavit
Certified Public Accountants: Application and Biographical Affidavit
OPRA is a state law that was enacted to give the public greater access to government records maintained by public agencies in New Jersey.
Adobe Acrobat
You will need to download the latest version of Adobe Acrobat Reader in order to correctly view and print PDF (Portable Document Format) files from this web site.
state seal
Copyright © 2011, State of New Jersey
New Jersey Department of Banking and Insurance