weblogo


License Forms and Electronic Filings

Instructions and Applications are provided in Word and PDF format.  You can view and download any of the listed documents by selecting the WORD or PDF link to the right of the document name.

                               Name

Number

Link

ADDRESS:

Address Change Form

AID-LI-AC

WORD

PDF

On-line Address Change Form 

National Insurance Producer Registry (NIPR)

 

ADJUSTER:

Application and Instructions

AID-LI-ADJ

WORD

PDF

Limited Lines Crop Adjuster Application and Instructions

AID-LI-CROP/ADJ

WORD

PDF

 

APPOINTMENTS:

NAIC Uniform Appointment/Termination Instructions

 

WORD

PDF

NAIC Uniform Agent Appointment/Termination Form

AID-LI-APT-TERM

WORD

PDF

On-line Agent/Agency (Electronic) Appointments

Leo Online Services

Agency Appointment/Amended Appointment Instructions

 

WORD

PDF

Agency Appointment

AID-LI-I48-AGENCY

WORD

PDF

Amend Agency Appointment

AID-LI-I48-A

WORD

PDF

Agency Appointment Termination Instructions

 

WORD

PDF

Agency Appointment Termination Form and

Agent Appointment Termination Under Agency Form

AID-LI-I71

WORD

PDF

 

ASSUMED BUSINESS NAME:

Filing Form

AID-LI-ANF

WORD

PDF

 

BUSINESS ENTITY (AGENCY):

Resident Business Entity Instructions

 

WORD

PDF

Resident Business Entity Uniform License Application

AID-LI-UBE

WORD

PDF

Non-Resident Business Entity Instructions

National Insurance Producer Registry (NIPR)

Non-Resident Business Entity Uniform License (Paper) Application

National Insurance Producer Registry (NIPR)

Addition and Termination Instructions

 

WORD

PDF

     Producer Addition

AID-LI-AGY-ADD

WORD

PDF

     Producer Termination

AID-LI-UBE-TERM

WORD

PDF

Business Entity Name Change Instructions

 

WORD

PDF

 

LICENSE (ARF) REPLACEMENT FORMS:

Replacement License Renewal for Producers, Adjusters, and Consultants

AID-LI-ARF-RP

WORD

PDF

Replacement License Renewal for Business Entities

AID-LI-ARF-RBE

WORD

PDF

 

MANAGING GENERAL AGENT:

License Instructions

 

WORD

PDF

License Application

AID-LI-MGA40

WORD

PDF

Company Appointment

AID-LI-MGA41

WORD

PDF

Termination of Company Appointment

AID-LI-MGA42

WORD

PDF

Bond

AID-LI-MGA43

WORD

PDF

Contract

AID-LI-MGA45

WORD

PDF

 

PRODUCER (Agent, Broker, Consultant):

Resident Testing and License Instructions

Handbook

WORD

PDF

Testing Calendar

Resident Limited Lines License Instructions

 

WORD

PDF

Resident License Application

AID-LI-RP

WORD

PDF

On-line Resident and Non-Resident License Renewal

New    Read About New Leo Online Services    New

Leo Online Services

Non-Resident Uniform License Instructions

National Insurance Producer Registry (NIPR)

Non-Resident Uniform (Paper) License Application

National Insurance Producer Registry (NIPR)

On-line Non-Resident (Electronic) License Application

National Insurance Producer Registry (NIPR)

On-line Non-Resident (Electronic) License Renewal

National Insurance Producer Registry (NIPR)

 

RENTAL CAR:

Rental Car Company Application

AID-LI-CAR

WORD

PDF

 

SURPLUS LINES:

Broker/Producer Testing and License Instructions

Testing Calendar

WORD

PDF

Broker/Producer License Application

AID-LI-SLB

WORD

PDF

Producer for Business Entity Application

AID-LI-SLBE

WORD

PDF

Broker/Producer Bond

AID-LI-SLBB

WORD

PDF

Producer for Business Entity License Instructions

 

WORD

PDF

Producer for Business Entity Application

AID-LI-SLBE

WORD

PDF

Filing Forms and Instructions

FILING FORMS

 

SELF, TRUST, MET, MEWA:

Registration  Instructions

 

WORD

PDF

Self-Funded Single Employer Plans, Collectively Bargained Welfare Benefit Plans, Multiple Employer Trusts and Multiple Employer Welfare Arrangements Registration Form

AID-LI-SELF

WORD

PDF

 

THIRD PARTY ADMINISTRATOR:

Registration  Instructions

 

WORD

PDF

Registration Application

AID-LI-TPA

WORD

PDF

Bond

AID-LI-TPA-BOND

WORD

PDF

 

TITLE:

Summary of Fees

 

WORD

PDF

New Title Agent Instructions

 

WORD

PDF

Title Agent Application

AID-LI-TA

WORD

PDF

New Title Agency Instructions

 

WORD

PDF

Title Agency Application

AID-LI-TAGY

WORD

PDF

Title Agency Replacement Renewal

AID-LI-ARF-TI-AGY-R

WORD

PDF

Addition and Termination Instructions

 

WORD

PDF

Producer Addition

AID-LI-AGY-ADD-TI

WORD

PDF

Producer Termination

AID-LI-AGY-TERM-TI

WORD

PDF

Title Insurance Continuing Education

List of Courses and Providers

 

VIATICAL:

Instructions

 

WORD

PDF

Broker License Application

AID-LI-VIA

WORD

PDF

Provider License Application

AID-LI-VIA-P

WORD

PDF