WEST VIRGINIA
Offices
of the
Insurance Commissioner
About Us
Contact Us
About Us
Contact Us
Search
Allan L. McVey
Insurance Commissioner
Toggle navigation
About Us
Divisions
Legal Authority
Resources
Workers' Compensation
Contact Us
Search
Surety Insurer Bail Bond Reporting Form
Please report required bond information by the 15th day after each calendar year quarter end.
1st Quarter - Aggregate Bond Liabilities as of March 31; report due to the OIC by April 15.
2nd Quarter - Aggregate Bond Liabilities as of June 30; report due to the OIC by July 15.
3rd Quarter - Aggregate Bond Liabilities as of September 30; report due to the OIC by October 15.
4th Quarter - Aggregate Bond Liabilities as of December 31; report due to the OIC by January 15.
Surety Insurer Bail Bond Quarterly Reporting Form
Insurer Name
NAIC Company Code
Insurer Contact First Name
Insurer Contact Last Name
Insurer Contact E-Mail
Insurer Contact Phone Number
Quarter Report for
January - March
April-June
July-September
October-December
Aggregate Number of Outstanding Bonds
Aggregate Bond Liability for all Outstanding Bonds
Attestation
I state that I have fully read and understand this monthly bail bond statement and that the answers supplied therein are true and correct to the best of my knowledge and belief and I further state that I recognize the applicable insurance laws of the State of West Virginia and the rules and regulations of the West Virginia Insurance Commissioner governing this quarterly statement - Title 114-CSR103.
Submit
Cancel