In order to take full advantage of the forms provided by the Department of Insurance you will need to open them in a PDF reader such as Adobe Acrobat.
Resources by License Type
- Adjuster, Independent
- Adjuster, Public
- Bail
- IRO
- Life Settlement
- Limited Lines
- Portable Electronics
- Producer, Business Entity
- Producer, Individual
- Surplus Lines Broker
- Third Party Administrators
- Title Agent
- Other
Links
Apply for a License – Individual via NIPR
Apply for a License – Individual via Sircon
Apply for a License – Business Entity via NIPR
Apply for a License – Business Entity via Sircon
Check Your Continuing Education Transcripts
Renew an Existing License via NIPR
Renew an Exsisting License via Sircon
Update Contact Information via NIPR
Update Contact Information – Individual via Sircon
Update Business Entity Address via Sircon
Update Business Entity Email via Sircon
Printable Forms
Application Form, Independent Adjuster
Continuing Education, Resident Flyer
Reinstatement Form, Business Entity, Resident
Reinstatement Form, Business Non-Resident
Reinstatement Form, Individual, Non-Resident
Reinstatement Form, Individual, Resident
Update Address Form, State to State
Update Address, Phone, or Email Form
Voluntary Surrender Form, Individuals
Links
Apply for a License – Individual via NIPR
Apply for a License – Individual via Sircon
Apply for a License – Business Entity via NIPR
Apply for a License – Business Entity via SIRCON
Check Your Continuing Education Transcripts
Renew an Existing License via NIPR
Renew an Exsisting License via Sircon
Update Contact Information via NIPR
Update Contact Information – Individual via Sircon
Update Business Entity Address via Sircon
Update Business Entity Email via Sircon
Printable Forms
Appointment, Producer Authority to Act Under Agency License
Application Form, Business Entity Adjuster
Continuing Education, Resident Flyer
Registration (Individual to an Agency)
Reinstatement Form, Business Entity, Resident
Reinstatement Form, Business Non-Resident
Reinstatement Form, Individual, Non-Resident
Reinstatement Form, Individual, Resident
Termination Form, for a Registration or Appointment
Update Address Form, State to State
Update Address Form, Business Entity Form
Update Address, Phone, or Email Form
Voluntary Surrender Form, Individuals
Links
Add or Remove Associations and Affiliations via Sircon
Apply for a License – Individual via NIPR
Apply for a License – Individual via Sircon
Apply for a License – Business Entity via NIPR
Apply for a License – Business Entity via Sircon
Check Your Continuing Education Transcripts
Renew an Existing License via NIPR
Renew an Exsisting License via Sircon
Update Contact Information via NIPR
Update Contact Information – Individual via Sircon
Update Business Entity Address via Sircon
Update Business Entity Email via Sircon
Printable Forms
Application Form, Business Entity
Continuing Education, Resident Flyer
Fingerprint Packet, Bail Agent (Non-Resident)
Fingerprint Packet, Bail Agent (Resident)
Idaho State Police Fingerprint Form, Resident
Registration (Individual to an Agency)
Reinstatement Packet Bail Agency
Reinstatement Packet, Bail Agent
Termination Form, for a Registration or Appointment
Termination of Appointment, Producer
Update Address Form, State to State
Update Address Form, Business Entity Form
Update Address, Phone, or Email Form
Voluntary Surrender Form, Individuals
Links
Update Contact Information via NIPR
Update Contact Information – Individual via Sircon
Printable Forms
Application Form, Independent Review Organization
Renewal Form, Independent Review Organization
Reinstatement Form, Independent Review Organization
Update Address Form, State to State
Links
Update Contact Information via NIPR
Update Contact Information – Individual via Sircon
Letters of Certification Request for Non-Resident States
Letter of Clearance Request from the State of Idaho
License Renewal Online via NIPR or Sircon
Printable Forms
Application Form, Life Settlement Broker License
Application Form, Life Settlement Provider
Letter of Certification Request
Life Settlements Filing Submission Documentation Form
Life Settlements, Broker Flyer
Life Settlements, Provider Flyer
Limited Lines Producer Pre-Licensing Manual
Update Address Form, State to State
Update Address Form, Business Entity Form
Update Address, Phone, or Email Form
Voluntary Surrender Form, Individuals
Links
Add or Remove Associations and Affiliations via Sircon
Apply for a License – Business Entity via NIPR
Apply for a License – Business Entity via SIRCON
Update Business Entity Address via Sircon
Update Business Entity Email via Sircon
Printable Forms
Appointment, Producer Authority to Act Under Agency License
Reinstatement Form, Business Entity, Resident
Reinstatement Form, Business Entity, Non-Resident
Termination Form, for a Registration or Appointment
Termination of Appointment, Producer
Links
Add or Remove Associations and Affiliations via Sircon
Apply for a License – Business Entity via NIPR
Apply for a License – Business Entity via Sircon
Renew an Existing License via NIPR
Renew an Exsisting License via Sircon
Update Contact Information via NIPR
Update Business Entity Address via Sircon
Update Business Entity Email via Sircon
Printable Forms
Appointment, Producer Authority to Act Under Agency License
Application Form, Business Entity
Change of Officers/Directors Form
Registration (Individual to an Agency)
Reinstatement Form, Business Entity, Resident
Reinstatement Form, Business Entity, Non-Resident
Termination Form, for a Registration or Appointment
Termination of Appointment, Producer
Links
Apply for an Individual License via NIPR
Apply for an Individual License via Sircon
Add a Line of Authority via NIPR
Add a Line of Authority via Sircon
Check Your Continuing Education Transcripts
Renew an Existing License via NIPR
Renew an Exsisting License via Sircon
Update Contact Information via NIPR
Update Contact Information – Individual via Sircon
Printable Forms
Cancelation of a Line of Authority Form
Continuing Education, Resident Flyer
Reinstatement Form, Individual, Non-Resident
Reinstatement Form, Individual, Resident
Voluntary Surrender Form, Individuals
Voluntary Surrender Form, Retirement Reasons
Links
Update Contact Information via NIPR
Update Contact Information – Individual via Sircon
Introduction to the Surplus Lines Market
Filing forms can be found at www.idahosurplusline.org
Idaho Surplus Lines Organization
Printable Forms
Reinstatement Form, Individual, Non-Resident
Reinstatement Form, Individual, Resident
Update Address Form, State to State
Links
Self-Funded Health Plan Survey
Deadline for renewal of TPA license or registration
Address, Phone, or Email Changes
Forms
Change of Officers/Directors Form
Application Form, Idaho Home State Third Party Administrator
Application Form, TPA, Non-Resident
Audited Financial Statement Exception Application
Change of Officers If Officer Changes are in connection with an Idaho Home State License, please include Biographical Affidavits for each new officer
Application Form, Title Insurance Agent
Appointment Form, Title Insurance Agent
LLC Addendum, Title Insurance Agent Entities
Title Insurance Agent Endorsement
Title Insurance Agent Exhibit A
Title Insurance Final Interest Notice
Renewal Packet, Title Insurance Agent
Title Insurance Agent Entities
Update Address Form, State to State
Continuing Education Resources
Continuing Education, Resident Flyer
Notice to Life/Annuities Insurers and Producers
Continuing Education Exhibit, A
Continuing Education E Exhibit B
Continuing Education E Exhibit C
Continuing Education E Exhibit D
Sample Course Sign-in Sign-out Form
Flyers
All Forms (alphabetical order)
A
Application, Business Entity License
Application, Business Entity Adjuster License
Application and Renewal for Registered TPA
Application, Idaho Home State Third Party Administrator
Application, Independent Review Organization
Application, Independent Adjuster License
Application, Individual Producer License
Application, Life Settlement Broker License
Application, Life Settlement Provider
Application, Title Insurance Agent
Application , TPA, Non-Resident
Application Packet, Managing General Agent
Application Packet, Reinsurance Intermediary
Appointment Form- Authority to Act Under Company License
Appointment , Title Insurance Agent
Audited Financial Statement Exception Application
B
Bond Form, Managing General Agent
Bond Form, Title Insurance Agent
Business Entity Instructions form the DOI
Business Entity SOS Information Sheet
C
Cancellation of a Line of Authority
Change Address, Business Entity
Change Address , State to State Form
Change Contact Information, Individual
Continuing Education Exhibit, A
Continuing Education E Exhibit B
Continuing Education E Exhibit C
Continuing Education E Exhibit D
Continuing Education Instructor Approval
Continuing Education, Resident Flyer
D
‘Doing Business As’ Updates or Addtions
E
F
Fingerprint Packet, Bail Agent (Non-Resident)
Fingerprint Packet, Bail Agent (Resident)
I
Idaho State Police Fingerprint Form, Resident
L
Letter of Certification Request
Life Settlements Filing Submission Documentation
Life Settlements, Broker Flyer
Life Settlements, Provider Flyer
Limited Lines Producer Pre-Licensing Manual
N
O
P
Provider Contact Change Request Form
R
Reactivation Packet, Bail Agent
Registration, Authority to Act Under Agency License
Registration, Pharmacy Benefit Manager
Reinstatement, Business Entity, Resident
Reinstatement, Business Entity, Non-Resident
Reinstatement, Individual, Non-Resident
Reinstatement, Individual, Resident
Reinstatement, Independent Review Organization
Reinstatement Packet Bail Agency
Reinstatement Packet, Bail Agent
Reinsurance Intermediary Exemption and Registration Form
Renewal Packet, Title Insurance Agent
Renewal, Independent Review Organization
S
Sample Course Sign-in Sign-out Form
T
Termination Form, for a Registration or Appointment
Termination of Appointment, Producer
Third Party Administrator Flyer
Title Insurance Agent Entities
Title Insurance Agent Endorsement
Title Insurance Agent Exhibit A
Title Insurance Final Interest Notice
TPA Filing Extension Application
Travel Limited Lines Reporting Portal
U
Uniform Continuing Education Reciprocity Course Filing Form
Update Address , Business Entity
Update Address , State to State
Update Contact Information, Individual
V
Vertafore for Education Providers Brochure
Voluntary Surrender, Individuals
Voluntary Surrender, Business Entities
Voluntary Surrender, Retirement Reasons
Links
Add a Line of Authority via NIPR
Add a Line of Authority via Sircon
Add or Remove Associations and Affiliations via Sircon
Apply for a License – Individual via NIPR
Apply for a License – Individual via Sircon
Apply for a License – Business Entity via NIPR
Apply for a License – Business Entity via Sircon
Application – Adjuster, Individual Printable
Application – Adjuster, Agency Printable
Application – Producer License, Business Entity, Printable
Application – Producer License, Individual, Printable
Application – Producer Individual Paper
Check Your Continuing Education Transcripts
Renew an Existing License via NIPR
Renew an Existing License via Sircon
Update Contact Information via NIPR
Update Contact Information – Individual via Sircon
Have more questions?
Contact the Licensing Team