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How to fill out the Application for Agency License online
Filling out the Application for Agency License online can be straightforward when you know the steps to follow. This guide provides a clear and comprehensive approach to successfully complete the application.
Follow the steps to fill out the application correctly.
- Click the ‘Get Form’ button to obtain the application form and open it in the online editor.
- Begin with Section I: Agency Information. Select the type of agency you are applying for (Class “A”, “B”, or “R”). Enter the proposed agency name and, if applicable, an alternate name. Make sure to provide the full street address of the main location and ensure it's not a P.O. Box.
- In Section II, input your business structure (sole proprietorship, partnership, or corporation) and list the names and titles of sole proprietor, partners, or corporate officers.
- For Section III, complete your personal information. If you have prior agency licensure in any state, detail this in Section VI, including any actions taken against the license.
- Proceed to fill out Part Two of the application. Each partner, corporate officer, or the sole proprietor must provide their personal information, including residence address, contact details, and history of addresses for the last five years.
- Continue with your employment history for the past five years in Section III, including all relevant employment details.
- In Section IV, answer questions regarding your military history, followed by a criminal history check in Section V. Disclose any felony or misdemeanor charges, and include necessary court documentation.
- Fill in Section VII regarding aliases, if applicable, and continue with personal history questions in Section VIII.
- In Section IX, indicate whether you wish to have any information kept confidential as an exemption from public records disclosure.
- Finalize the application by certifying your understanding of the waiver and notarizing the application in Section XI.
- After completing the form, review all sections for accuracy before submitting your application online.
Take the next step toward obtaining your license by completing your application online today.
Licensees must mail or email the request to change your name, date of birth, or social security number. You must attach LEGIBLE supporting documentation (marriage certificate, articles of incorporation, driver's license, social security card, etc.) to one of the locations below.
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