Form FS Form 2208 FS Form 2208 License Sheet

	DEPARTMENT OF THE TREASURY						OMB 1530-0009
	BUREAU OF THE FISCAL SERVICE						FS Form 2208
	WASHINGTON, DC 20227
*** LICENSE SHEET ***
Name of Company
State of Incorporation
NAIC Company Code
NAIC Group Code
Contact Name
Contact Title
Contact Phone Number
Contact E-Mail
Reporting Period
Date Prepared
Please indicate by selecting the check mark in the box beside the states and other areas in which your company is licensed to transact SURETY business as a DIRECT WRITER.
Upon completion, this form should be submitted to Treasury as an EXCEL file type.
	AL Alabama		KY Kentucky		OH Ohio
	AK Alaska		LA Louisiana		OK Oklahoma
	AS Am. Samoa		ME Maine		OR Oregon
	AZ Arizona		MD Maryland		PA Pennsylvania
	AR Arkansas		MA Massachusetts		PR Puerto Rico
	CA California		MI Michigan		RI Rhode Island
	CO Colorado		MN Minnesota		SC South Carolina
	CT Connecticut		MS Mississippi		SD South Dakota
	DE Delaware		MO Missouri		TN Tennessee
	DC District of Columbia		MP Northern Mariana Islands		TX Texas
	FL Florida		MT Montana		UT Utah
	GA Georgia		NE Nebraska		VT Vermont
	GU Guam		NV Nevada		VA Virginia
	HI Hawaii		NH New Hampshire		VI Virgin Islands
	ID Idaho		NJ New Jersey		WA Washington
	IL Illinois		NM New Mexico		WV West Virginia
	IN Indiana		NY New York		WI Wisconsin
	IA Iowa		NC North Carolina		WY Wyoming
	KS Kansas		ND North Dakota
NOTES:
1. If state licenses were added during the current year, provide a copy of the state certificate of authority.
2. If any restrictions have been imposed by states checked, include an explanation below. The explanation should include the type, reason for and time period of the imposed restriction.
3. Please disclose any additional details below as necessary.
Updated 12/31/2024