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Get Producer License / Verification Form
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How to fill out the PRODUCER LICENSE / VERIFICATION FORM online
This guide provides you with a clear and supportive approach to completing the PRODUCER LICENSE / VERIFICATION FORM online. Whether you are a seasoned professional or new to the process, you will find step-by-step instructions to help you navigate the form with ease.
Follow the steps to fill out the form accurately.
- Click ‘Get Form’ button to access the PRODUCER LICENSE / VERIFICATION FORM and open it in the online editor.
- In the first section, fill in the date and your file or broker number as assigned by your agency.
- In the 'Insurance Broker' section, provide the name of your agency, ensuring that it matches the name on your license.
- Complete the mailing address section, indicating whether the mailing address is residential or commercial. Be precise in your details.
- In the physical street address section, fill out your office's actual location.
- Provide your office number, fax number, email address, and cell phone number in the designated fields.
- Enter your Social Security number and IRS/EIN number as requested.
- Review all filled information for accuracy. Confirm that it is correct and complete.
- Sign and date the form at the bottom to validate your submission.
- Once completed, save your changes, download a copy for your records, and share the form as needed.
Complete your documents online today and ensure your submissions are timely and accurate.
Insurance License Fees & Schedule of Fees & Charges Effective March 3, 2019 License TypeFiling FeesExamination FeeCasualty Broker-Agent (CA)$188$55Credit Insurance Agent (CI)$449N/ACrop Insurance Adjuster (CJ)$311N/AInsurance Adjuster (AJ)$311 (per qualified manager)$79 ($32 fee for Re-Examination)32 more rows
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