Get Staff Adjuster Application - Office Of The Superintendent Of Insurance

This guide provides step-by-step instructions on how to successfully complete the Staff Adjuster Application form required by the Office Of The Superintendent Of Insurance. It is designed to assist users of all experience levels in navigating the form efficiently and effectively.

Follow the steps to complete your application smoothly.

1. Click ‘Get Form’ button to access the application form and open it in the editor.
2. Begin with personal details. Enter your last name, first name, and middle name. Include your date of birth, social security number, and National Producer Number if applicable. Make sure to provide a legible residence address, email address, and home phone number.
3. Indicate your license type by checking the appropriate box for either Resident Staff Adjuster License, Staff Adjuster License, or Non-Resident license. For Non-Resident, you will need to input your designated home state and license number.
4. Provide your business information if applicable. Fill in the name of your business entity, business address, contact information, and business email. Ensure all the fields are complete, including the Foreign Country details if relevant.
5. If you have used any other names, list those in Section 2.a and 2.b. This includes any maiden names or trade names.
6. Answer questions regarding your qualification for the license type, including whether you have passed an adjuster examination, and provide details regarding the exam and scope.
7. For apprentice adjusters, identify your supervising licensed adjuster by entering their National Producer Number and State Identification Number.
8. Complete your employment history, listing past positions held along with the corresponding dates and locations. This information is important for establishing your experience.
9. Go through the series of background questions carefully. Answer each question truthfully, especially those regarding any criminal history, administrative proceedings, and financial obligations.
10. Read the applicant's certification and attestation section carefully. Provide your signature and the date of submission.
11. Attach all required documents and ensure your application is complete to avoid any processing delays.
12. Once all sections are filled out accurately, you can save your changes. You may download, print, or share the completed form as necessary.

Begin your application process online today and ensure your submission is accurate and complete.