Miss. Code Ann. § 83-33-5: Declaration under oath.

Such subscribers so contracting among themselves shall, through their attorney, file with the Commissioner of Insurance a declaration verified by the oath of such attorney or, where such attorney is a corporation, by the oath of the proper officer thereof, setting forth:

(a) The name of the reciprocal, which name shall not be so similar to any name adopted by any insurance organization authorized to write the same class of insurance in this state as to confuse or deceive.

(b) The address of the reciprocal’s principal office;

(c) The name of the attorney and address of its principal office;

(d) The kind or kinds of insurance to be effected or exchanged.

(e) A copy of the form of policy contract or agreement under or by which such insurance is to be effected or exchanged.

(f) A copy of the form of power of attorney or other authority of such attorney under which such insurance is to be effected or exchanged.

(g) The location of office or offices from which such contracts or agreements are to be issued.

(h) That applications have been made for indemnity upon at least ten (10) separate risks aggregating not less than One Million Five Hundred Thousand Dollars ($1,500,000.00), as represented by executed contracts or bona fide applications to become concurrently effective; or in case of employers’ liability or similar classes of insurance, covering a total payroll of not less than Two Million Five Hundred Thousand Dollars ($2,500,000.00).

(i) That there is in the possession of such attorney and available for the payment of losses, assets conforming to Section 83-33-11.

(j) A financial statement in form prescribed for the annual statement.