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Securities Agent Simultaneous Licensure Disclosure Application {ASIM}. Last Update: September 21, 2020.Form DOSASIM​ is the Simultaneous Agent Registration Application. Each broker-dealer the agent will represent must complete this form. 830-X-3-.01 Application For Registration As A Dealer. 830-X-3-.02 Application For Registration As An Agent. 830-X-3-. (A) Issuers must file the following with the commissioner for all agent registration applications: (i) A completed Form U4;. The application should be completed in its entirety, stating "NONE" where appropriate. Filing fee. Cal. Ins. E. a broker-dealer registered under the Securities Exchange Act of 1934,. f.