Applying on Paper

This page does not apply to bail recovery agents. Click here for bail recovery agent registration requirements.

You can apply online for certain licenses. Click here to determine whether you are able to apply online.

THE PAPER APPLICATION PROCESS

  1. You must have Adobe Acrobat Reader software installed on your computer to download and use the forms. Adobe Acrobat Reader software is available for free from Adobe's web site (http://www.adobe.com).
  2. Find and click on the application you need from the "Paper Application Forms and Instructions" section (below). Save the document to your computer.
  3. Read application instructions carefully. Instructions will tell you about additional forms or documents that you may need to submit based on the license authority for which you are applying and based on your circumstances. We are required to return applications that are incomplete or otherwise deficient, thereby delaying the application review process.
  4. Complete the application on your computer and then print it out.
  5. Sign and date the application where indicated, and send it to our office with the required nonrefundable fees and any additionally required forms or documents.
  6. We will review your application and mail to you one of the following:
    1. A notice telling you that your license application was approved. View your license on our web site to ensure that your license information appears correctly, and use the Insurance Professional License Update System (IPLUS) to correct or update information. NOTE: We do not produce paper license certificates - click here for details.
    2. A notice telling you that your license application was denied. The notice will tell you the reason for the denial and will provide you with instructions concerning your right to appeal the decision.
    3. A notice telling you that your license application was deficient. The notice will be accompanied by your license application. You must resubmit your license application and any additional materials identified in the deficiency notice or accompanying instructions. You must cure all identified deficiencies or we may deny your license and you will forfeit the fees you paid.

Paper Application Forms and Instructions

Application for an Individual Insurance License (Form L-169). An individual (resident or nonresident) can use this form to apply for a license as insurance producer, adjuster, bail bond agent, managing general agent, surplus lines broker, Mexican insurance surplus lines broker, or municipal risk management consultant. Form L-SSA must be used by an individual applying for a Self-service Storage Agent license.

  1. For variable life and variable annuity producer license authority, include a printout from the Financial Inudstry Regulatory Authority ("FINRA") showing you are a registered representative or principal in good standing and are associated with a FINRA-registered firm. Click here for instructions on how to get the printout.

Application for a License for a Business Entity (Form L-176). A business entity (resident or nonresident) can use this form to apply for a license as insurance producer, adjuster, bail bond agent, managing general agent, surplus lines broker, or Mexican insurance surplus lines broker. NOTE: Arizona does not license sole proprietorships as business entities. Form L-RCA must be used by a business entity applying for Rental Car Agent authority. Form L-SSA must be used by a business entity applying for a Self-service Storage Agent license.

Application for a Limited Line Business Entity Agent License (Form L-LTD). A business entity (resident or nonresident) can use this form to apply for a Portable Electronics Agent license, Rental Car Agent license, or Self Service Storage Agent license.

Application for a Temporary License (Form L-TEMP). An individual can use this form to apply for a temporary license under the conditions set forth in ARS § 20-294.

Other Licensing-related Forms

Bond Of Managing General Agent (Form L-106). A managing general agent applicant or licensee must submit and maintain a bond or deposit in the favor of the state in an amount determined from Form L-107, below. A power of attorney must accompany the bond.   

Affidavit Of Managing General Agent (Form L-107). A managing general agent must have this form completed by an officer or director of the insurance company on whose behalf the managing general agent will be acting. Submit the original, notarized form with the MGA license or renewal application.

Licensing Eligibility Requirement (Form L-152). Each individual who is an Arizona resident and each individual applying for an adjuster or bail bond license (resident or nonresident) must complete this form and attach a copy of a required for of identification to be eligible for a license.

Certificate of Assumed Business Name (Form L-193). Complete and submit this form (whether you are an individual or business entity) to engage in business using a name other than your legal name.

Bond Of Bail Bond Agent (Form L-195). A bail bond agent must maintain a $10,000 bond in favor of the state. A power of attorney must accompany the bond.

Addendum To Adjuster Application (Form L-181). A nonresident adjuster must use this form to report the location of the Arizona office accessible to the public at which the adjuster will maintain usual and customary records of transactions under the adjuster license.  

Business Entity Branch Locations (Form L-LOC). Complete and submit this form to disclose branch locations and the desiganted responsible licensed producer at each location.  


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