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 NJ Department of Banking and Insurance
 
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Third Party Administrator - Certificate of Compliance


In order to issue a Certificate of Compliance the Department will need the following information:

  Name of Third Party Administrator (TPA)
  Home Address of the TPA
  Date of Formation
  Domestic State
  Number of Certificates needed
  Name of the person requesting the Certificate
  Phone number or e-mail of requestor in case the Department needs to contact you
  Address or e-mail where the Certificate(s) should be sent (If Certificate is e-mailed, there will not be a raised Seal)
  Do you want the Certificate mailed, e-mailed or both?

There is no fee for a Certificate(s) of Compliance.

The request can be sent in by e-mail to Tim.Stroud@dobi.nj.gov or requested by phone at 609-940-7452.


 
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State of New Jersey
New Jersey Department of Banking and Insurance