Follow the steps to accurately complete the application.

1. Click ‘Get Form’ button to obtain the form and open it in the editing interface.
2. Check the appropriate box for the type of license you are requesting, whether it is a resident or non-resident license.
3. Fill in your home state and the corresponding license number if applicable.
4. Provide your demographic information including your last name, first name, middle name, date of birth, residence address, and contact information such as your home phone number.
5. Indicate your gender and confirm your citizenship status by selecting 'Yes' or 'No'. If 'No', provide proof of eligibility to work in the U.S.
6. If you own a business, fill in the business entity name and address, along with the business phone number and any additional contact details.
7. List any assumed names you have utilized in the past as well as any trade names you use currently.
8. Complete the agency or business entity affiliations section if you are licensed as an active member of a business entity.
9. Document your employment history for the past five years, including all relevant experiences and details.
10. Indicate the jurisdictions and license types for which you are applying by checking the appropriate boxes.
11. Carefully answer all background information questions, providing attachments where necessary for any 'Yes' responses.
12. Review the applicant certification and attestation section, ensuring you agree with the statements provided before adding your signature, full legal name, and date.
13. Attach any required documentation as indicated, ensuring all information is complete to avoid delays in processing.
14. Once all sections are complete, save your changes, and choose to download or print the form for your records.

Start completing your Fillable Naic Uniform Application online today!