Hawaii Insurance Division SCP Application Renewal
This file is an application for the Service Contract Provider in Hawaii. It includes detailed information required for the registration or renewal process. Users must provide accurate business and contact information as prescribed by the Hawaii Insurance Division.
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How do I fill this out?
Filling out the SCP application requires accuracy and attention to detail. Begin by providing your business details as outlined in the form. Ensure you have all required documents and information ready before starting.

How to fill out the Hawaii Insurance Division SCP Application Renewal?
1
Read the application instructions carefully.
2
Fill in all required fields accurately.
3
Provide necessary attachments as specified.
4
Review the completed application for accuracy.
5
Submit the application along with applicable fees.
Who needs the Hawaii Insurance Division SCP Application Renewal?
1
Business owners seeking to register as Service Contract Providers.
2
Renewing providers needing to maintain their valid registration.
3
Insurance agents looking to ensure compliance with state regulations.
4
Legal entities managing service contracts in Hawaii.
5
Individuals coordinating services under a service contract.
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What are the instructions for submitting this form?
To submit the completed SCP application, you may email it to inslic@dcca.hawaii.gov or fax it to 808-586-2788. Additionally, if you prefer physical submission, mail your application to the Hawaii Insurance Division at 335 Merchant Street - Room 213, Honolulu, Hawaii 96813. Ensure all applicable fees are included with your submission to avoid processing delays.
What are the important dates for this form in 2024 and 2025?
For 2024, the renewal application period begins on January 1st and ends on December 31st. In 2025, be prepared to submit your applications within the same timeframe. Staying aware of these dates ensures compliance with state regulations.

What is the purpose of this form?
The purpose of this form is to facilitate the registration or renewal process for service contract providers in Hawaii. This ensures that all providers meet the necessary requirements set forth by the state, which helps in regulating the service contract business. Proper submission contributes to consumer protection and industry transparency.

Tell me about this form and its components and fields line-by-line.

- 1. Provider Name: The full legal name of the service contract provider.
- 2. Business Address: Complete business mailing address excluding P.O. Box.
- 3. Contact Person: Designated contact for communication regarding the application.
- 4. Hawaii Agent for Service of Process: Agent's details if different from the provider.
- 5. Executive Officers: Identity of responsible officers managing the service contract business.
- 6. Administrators: Names of designated administrators responsible for contracts.
- 7. Signature: Signature of the authorized officer indicating approval.
What happens if I fail to submit this form?
Failing to submit this form can lead to penalties and loss of the ability to legally operate as a service contract provider. It’s essential to ensure timely submission to maintain compliance with state regulations. Providers risk facing legal actions and loss of consumer trust.
- Legal Penalties: Non-compliance can result in fines and legal actions against the provider.
- Business Shutdown: Failure to register can lead to suspension or closure of business operations.
- Consumer Trust: Inability to operate legally can damage reputation and consumer relationships.
How do I know when to use this form?

- 1. Initial Registration: To apply for the first time as a service contract provider.
- 2. Renewal of Provider Status: To maintain your registration status without interruptions.
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