Form FMS-2208 License Sheet

DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE HYATTSVILLE, MD 20782 *** LICENSE SHEET ***
Name of Company
State Of Incorporation
NAIC Company Code
NAIC Group Code
Contact Name
Contact Title
Contact Phone Number
Contact E-Mail
Date
Please indicate by an (X) the states and other areas in which your company is licensed to transact SURETY business as a DIRECT WRITER. NOTE: If any restrictions have been imposed by states checked, include an explanation on an attached sheet. The explanation should include the type, reason for and time period of the imposed restriction.
	AL Alabama			KY Kentucky			OK Oklahoma
	AK Alaska			LA Louisiana			OR Oregon
	AS Am. Samoa			ME Maine			PA Pennsylvania
	AZ Arizona			MD Maryland			PR Puerto Rico
	AR Arkansas			MA Massachusetts			RI Rhode Island
	CA California			MI Michigan			SC South Carolina
	CO Colorado			MN Minnesota			SD South Dakota
	CT Connecticut			MS Mississippi			TN Tennessee
	DE Delaware			MO Missouri			TX Texas
	DC District of Columbia			MT Montana			UT Utah
	FL Florida			NE Nebraska			VT Vermont
	GA Georgia			NV Nevada			VA Virginia
	GU Guam			NH New Hampshire			VI Virgin Islands
	HI Hawaii			NJ New Jersey			WA Washington
	ID Idaho			NM New Mexico			WV West Virginia
	IL Illinois			NY New York			WI Wisconsin
	IN Indiana			NC North Carolina			WY Wyoming
	IA Iowa			ND North Dakota
	KS Kansas			OH Ohio