ALL Property & Casualty Insurers must complete this form and submit it to the Michigan Basic Property Insurance Association on or before March 1. Groups must submit a separate form for each company. The information submitted on this form is a statement of each company's Assessable Premiums as defined in Section 2901 (d) of the Michigan Insurance Code.
Companies will be assessed based on the amounts reported. Please read the instructions and notes carefully.
Complete the entire form by filling in all fields.