A. Twenty-five or more persons domiciled in this Commonwealth and designated as subscribers may organize a domestic reciprocal and apply to the Commission for a license to transact the business of insurance. The original subscribers and the proposed attorney shall execute and file with the Commission a declaration setting forth:
1. The name of the attorney, and the name of the reciprocal;
2. The location of the reciprocal’s principal office, which shall be the same as that of the attorney, and shall be in this Commonwealth;
5. The designation and appointment of the attorney, and a copy of the power of attorney and subscriber’s agreement;
6. The names and addresses of the officers and directors of the attorney if a corporation, or of its members if not a corporation;
7. The powers of the subscribers’ advisory committee, and the names and terms of office of its members;
8. A statement that each of the original subscribers has in good faith applied for insurance of the class proposed to be written and that the reciprocal has received from each original subscriber the anticipated premium or premium deposit for a term of not less than six months for the policy for which application is made;
9. A statement of the financial condition of the reciprocal including a schedule of its assets;
10. A statement that the reciprocal has the surplus to policyholders required by § 38.2-1206; and
11. A copy of each policy, endorsement and application form it proposes to issue or use.
B. The declaration shall be acknowledged by each original subscriber and by the attorney in the manner required for the acknowledgment of deeds in § 55.1-612.