The State of New Jersey
 NJ Department of Banking and Insurance
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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:
Crosby Sherman
Chief of Captive Insurance 		John Talley
Assistant Chief of Captive Insurance

NJ Department of Banking & Insurance
20 W. State St.
PO Box 325
Trenton, NJ 08625-0325

E-mail: crosby.sherman@dobi.state.nj.us E-mail: john.talley@dobi.state.nj.us
Telephone: 609-292-5350, ext. 50503 Telephone: 609-292-5350, ext. 50220
Forms
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
NJ DOBI
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
 OPRA is a state law that was enacted to give the public greater access to government records maintained by public agencies in New Jersey.
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New Jersey Department of Banking and Insurance