Plan 2 Security Deposit Forms

​​General Disclaimer - Department Forms Require Exact Wording

You may fill out the forms electronically. We do require a hard copy of the forms with original signatures.

Book Entry

General information on book entry deposits on government securities such as treasury notes. Please see related information in Corporate Resolution, Irrevocable Assignment, and Trust Agreement.

Certificate Deposit Agreement

Department form required for Certificate of Deposits.

Corp Resolution

All Plan 2 Carriers must complete this form upon initial application. You may substitute your own corporate resolution with approval of the department.

Irrevocable Assignment

The Irrevocable Assignment of Securities provides a detailed description of the security including the CUSIP number. Once your trust account is established, this is the only document you must submit when replacing a maturing security. This is for government securities such as Treasury Notes. Please see related information in book entry general information.

Letter Credit

E​xact wording required for banking institutions. Please​ see related information in the Memorandum of Understanding.

Memorandum of Understanding

The Memorandum of Understanding Letter of Credit must be completed by the carrier and returned to the department.

Our security file is not complete until both the Letter of Credit and the Memorandum of Understanding are returned to our office.

Trust Agreement​

​The Trust Agreement establishes a trust account with the self-insured employer and the Trust Company. Please see related information in book entry general information.