Please provide the following information in a three (3) ring binder and in the order requested herein.  Please include a table of contents for the packet and tab each of these items with the listed numbers.  For any items not applicable, please include a page in the packet; numbered accordingly, explaining the reason the item is not included.  The application requirements listed herein are pursuant to Chapter 77 of Title 23 on the Arkansas Code Annotated.


1.)                Completed admission application (form enclosed) and all applicable fee.  The admission fees, subject to Ark. Code Ann 23-63-102, retaliatory provisions, are:

(a)                Reviewing all documents for admission ……………….$250.00


2.)                A certified copy of the Charter or Articles of Incorporation, with all amendments thereto, certified by the public officer with whom all the originals are on file in the state of domicile.


3.)                A certified copy of the company’s by-laws, with amendments, by the company’s secretary


4.)                A full & true statement of the company’s financial condition, transactions, and affairs as of the Dec. 31 next preceding the date of the application.  The statement shall be certified by the Automobile Club or Association President, or Vice-President and secretary. Financial statements that are consolidated with other affiliates or subsidiaries of the applicant are not acceptable, except for good cause and subsequent approval by the commissioner. Beginning after December 31, 2002, each applicant shall file an audited financial statement for three (3) calendar years prior to the date of its application in this state.


5.)                Current Biographical Affidavits for all the officers and directors of the company. (form attached)


6.)                Appointment of Commissioner as agent to receive service of process (form attached).


7.)                A letter giving the name and address of the official agent for service of process, to whom the service of process should be forwarded to, after receipt by the Commissioner.


8.)                A complete summary of your proposed plan of operation including a list of services, insurance plans if any, and other membership privileges offered.  (List services included in membership fee separately from those offered at extra cost).


A.C.A 23-77-101(2) states that four (4) or more of the following services must be rendered, furnished or procured towing service, emergency road service, insurance service, bail bond service, legal service, discount service, financial service, buying & selling service, theft service, map service and touring service.


9.)                Copies of all literature, membership applications, membership certificates, cards, contracts for service, and advertising materials.


10.)            Rates, dues and fees.


11.)            Certificate of Good Standing with corporate seal affixed (form attached).


12.)            Provide references as to the character, ability, and integrity of the organizers, manager, agent and any other person through whom the applicant proposes to issues contracts, membership certificates, membership cards, or other documents in return for membership fees or dues.


13.)            Certification that upon full licensure it shall deposit the sum of twenty thousand dollars ($20,000) in cash or securities as approved by the commissioner and having at all times a market value of not less than twenty thousand dollars ($20,000) this is required AFTER admission to the state.  PLEASE DO NOT SUBMIT UNTIL NOTIFIED BY DEPARTMENT PERSONNEL.


ACA 23-77-106(b)(1) states that no foreign or alien automobile club or association shall be authorized to operate in Arkansas which has not furnished the commissioner with evidence that it has been organized and actively engaged in the automobile club or association business in the state of its incorporation for a period of three (3) years prior to the date of its application to be admitted and authorized to do business in the State of Arkansas.




Submit all Applications to the Attention of:


Kimberly Johnson, PIR, Insurance Examiner

Arkansas Insurance Department/Finance Division

1200 West Third Street, Little Rock, AR 72201-1904

501-371-2680      fax 501-371-2747