Follow the steps to successfully fill out the form online.

1. To begin, click the ‘Get Form’ button to access the form and open it in your preferred document editor.
2. Identify whether you are a new agent or updating an existing agent by marking the appropriate selection on the form.
3. In the first section, print the license holder’s name as required.
4. Next, fill in the business name in the designated area.
5. Authorize your agent by printing their legal name in the corresponding space.
6. Provide your agent's license number where indicated.
7. Specify the time period for the agent's authorization by filling in the start and end dates (MM/DD/YYYY). Ensure this time frame does not exceed one year.
8. Review the statement indicating your understanding of the responsibility for any permits submitted by your agent.
9. Sign the form in the space designated for the license holder’s signature.
10. Arrange for the form to be notarized, including the notary’s signature and stamp.
11. Fill out the identification information of the notary, indicating how the notary acknowledged the license holder.
12. Lastly, complete the agent's contact information, including their phone number, fax number, mailing address, and email.

Complete your forms online for a smoother licensing process today!