Resumes for Principal Management and Major Shareholders: Changes in Principal Management and Major Shareholders

BULLETIN NO. 01-1 To: All Maryland Domestic Companies Companies Applying for Admission to Maryland Re: Resumes for Principal Management and Major Shareholders; Changes in Principal Management and Major Shareholders Date: January 8, 2001 Please Note: All Principal Management and Major Shareholders’ resumes (biographical affidavits) submitted to Maryland in accordance with Code of Maryland Regulations 31.04.02.02 (1) & (2) must now be accompanied by an “Authorization for Release of Information” form. See copy of form attached. ______________________________ Steven B. Larsen Insurance Commissioner AUTHORIZATION FOR RELEASE OF INFORMATION I, _________________________________, hereby give authorization to the Maryland Insurance Administration or its authorized agent to conduct any and all inquiries deemed necessary for the completion of a background investigation to ensure that the information supplied in the application for a “Certificate of Authority “ is accurate and that my qualifications and character are consistent with the requirements of the Insurance Article of the Annotated Code of Maryland. ________________________________ SIGNATURE ________________________________ DATE