2013 Mississippi Code
Title 83 - INSURANCE
Chapter 33 - RECIPROCAL INSURANCE
§ 83-33-5 - Declaration under oath

Such subscribers so contracting among themselves shall, through their attorney, file with the insurance commissioner a declaration verified by the oath of such attorney or, where such attorney is a corporation, by the oath of the proper officer thereof, setting forth:

(a) The name of the attorney and the name or designation under which such contracts are issued, which name or designation shall not be so similar to any name or designation adopted by any attorney or by an insurance organization in the United States writing the same class of insurance prior to the adoption of such name or designation by the attorney as to confuse of deceive.

(b) The kind or kinds of insurance to be effected or exchanged.

(c) A copy of the form of policy contract or agreement under or by which such insurance is to be effected or exchanged.

(d) A copy of the form of power of attorney or other authority of such attorney under which such insurance is to be effected or exchanged.

(e) The location of office or offices from which such contracts or agreements are to be issued.

(f) That applications have been made for indemnity upon at least seventy-five (75) separate risks aggregating not less than One and One-half Million Dollars ($ 1,500,000.00), as represented by executed contracts or bona fide applications to become concurrently effective; or in case of employers' liability or similar classes of insurance, covering a total payroll of not less than Two and One-half Million Dollars ($ 2,500,000.00).

(g) That there is in the possession of such attorney and available for the payment of losses, assets conforming to Section 83-33-11.

(h) A financial statement in form prescribed for the annual statement.