For Insurers

Service contract providers

Service contract providers sell warranties to repair, replace or maintain motor vehicles or consumer electronics (such as appliances and computers) and must submit annual financial filing statements.

Do not sign electronically. This form must be signed and notarized in the presence of a notary public. This form is only needed if the company is NOT filing audited financial statements.

Protection Product Guarantee (PPG) only

PPG providers repair, replace, or pay incidental costs for the failure of a protection product to perform under the terms of the product protection guarantee.