Fillable REQUEST FOR RELEASE OF LETTER OF CREDIT REQUEST (Arizona)

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REQUEST FOR RELEASE OF LETTER OF CREDIT REQUEST (Arizona)

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Form E126LOC (v 20210707)
REQUEST FOR RELEASE OF LETTER OF CREDIT
REQUEST IS MADE FOR RELEASE OF THE FOLLOWING LETTER OF CREDIT FROM SAFEKEEPING
WITH THE ARIZONA DEPARTMENT OF INSURANCE AND FINANCIAL INSTITUTIONS WHO IS
HOLDING THE LETTER OF CREDIT FOR:
(Name of company) (NAIC #)
LETTER OF CREDIT DESCRIPTION:
Name of Financial Institution:
Face Amount:
$
Expiration Date:
Letter of Credit Number:
INSTRUCTIONS FOR DELIVERY OF THE RELEASED LETTER OF CREDIT ARE:
A.
The Company authorizes
of
to pick up the Letter of Credit from the Arizona Department of Insurance and Financial Institutions.
OR
B.
Ordinary U.S. mail delivery directed to:
Recipient Name and Title:
Company or Firm Name:
Street Address:
City, State, Zip:
OR
C.
FEDEX Send Shipping Label including
Account Number
BY THIS AUTHORIZED REPRESENTATIVE OF THE COMPANY: (authorizing resolution may be required)
Name:
Title:
Signature:
Date:
CONTACT PERSON:
Title:
Telephone
Email
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REQUEST FOR RELEASE OF LETTER OF CREDIT REQUEST (Arizona)

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Completed 1 July 2022

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