This page provides information about ADDRESS AND PHONE NUMBER CHANGES, NAME CHANGES, ASSUMED NAMES and BUSINESS ENTITY PRINCIPALS and DESIGNATED PRODUCER.
ADDRESS AND PHONE NUMBER CHANGES
Individuals should use the NIPR Address Change Request (ACR) to report changes to email, addresses or phone numbers. IPLUS and NIPR-ACR are easy to use and promptly updates your license.
- IPLUS will only change your address with the Arizona Department of Insurance. If you are licensed in other states, use the NIPR-ACR to report your address change to multiple states.
- A week after submitting changes, view your license to make sure the changes are correctly reflected on your license.
Business entities must report changes to their primary business address and telephone number using Form L-CHG. Use Form L-LOC to report changes to your branch locations and to the designated producer within each location. Send completed forms by mail or by fax.
If you are an Arizona resident, you must complete and submit Form L-CHG with a photocopy of both sides of your newly issued Arizona Driver License or Arizona Non-operating Identification showing your new name.
If you are a nonresident, you must change your name with the insurance department in your home state, and then complete and submit Form L-CHG to the Arizona Department of Insurance.
ASSUMED NAME / DBA
If you intend to do business under a name other than your legal name (called an "assumed name" or "DBA name"), complete and submit Form L-193 (Certificate of Assumed Business Name).
Send completed forms by mail or by fax.
Protect your assumed name by registering it as a trade name with the Arizona Secretary of State. If you do not register a trade name, another person may register the name, which will force you to stop using the name.
BUSINESS ENTITY PRINCIPALS AND DESIGNATED PRODUCER
Complete and submit Form L-177 (the original - copies not accepted) to report a new member, officer or director (regardless of whether the business entity is licensed as an Arizona resident or non-resident).
Arizona resident business entity: In addition to Form L-177, provide a completed fingerprint card and the per-card fingeprint card processing fee (see FEES section of our home page) for each principal who has not provided us a fingeprint card and processing fee within the past year.
Complete and submit Form L-LOC to report a change to your designated producer.