Official Government Website

Licensing Services – Forms and Links

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.

All Forms (alphabetical order)

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All Forms

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1033

 

A

Add a Branch Office

Add a Designated Responsible Producer: Portable Electronics

Add a Designated Responsible License Producer

Add a ‘Doing Business As’ Name

Add a Line of Authority

Add an Alias

Addendum to Title Insurance Agent License Application, Title

Address Change Involving a State Change

Agency Renewal Application

Annual Report: Third Party Administrator

Annual Report: Travel

Appendix A-1 (LSB)

Appendix A-2 (LSB)

Appendix A-3 (LSB)

Appendix A-4 (LSB)

Appendix B(LSB)

Appendix C (LSB)

Appendix D (LSB)

Application: Business Entity

Application: Business Entity, Adjuster

Application: Independent Review Organization

Application: Individual Adjuster

Application: Individual

Application: Life Settlement Broker

Application: Life Settlement Provider

Application: Managing General Agent Designation

Application: Registration as a Pharmacy Benefit Manager

Application: Registration as a Reinsurance Intermediary Exemption

Application: Registration as an Administrator

Application: Registration as a Pharmacy Benefit Manager

Application: Reinsurance Intermediary Manager

Application: Third Party Administrator, Home-State

Application: Third Party Administrator, Non-Resident

Application: Third Party Administrator, Registered

Appointment of Authority to Act Under a Company License

Appointment of Title Insurance Agent/Escrow Officer, Title

Audited Financial Statement Exception Application

Authority for a Bail Agent to Act Under a Bail Agency License

 

B

Bail Agent Advisory

Bail Agent: Late Renewal Application

Bail Renewal Fingerprint Packet, Non-Resident

Bail Renewal Fingerprint Packet, Resident

Biographical Affidavit, NAIC

Bond of Administrator (TPA)

Bond of Bail Agent

Bond of Managing General Agent

Bond of Public Adjuster

Bond of Title Insurance Agent

Branch Office, Add

Bulletin 06-5

Bulletin 07-1

Bulletin 09-06

Bulletin 11-08

Bulletin 15-05

Business Entity: Name Change

Business Entity: Late Renewal Application

Business Entity License, Voluntary Surrender

 

C

Cancellation of a Line of Authority

Certification of Active Bond-Bail

Change Name: Business Entity

Change Name: Individual

Change of Officers Notification

Change of Ownership Notification

CHRI FBI Request Release Form

Contact Change: Business Entity

Contact Change: Individual

Continuing Education Coordinator Update

Contact Change: Continuing Education Provider

Contact Change: State to State

Continuing Education: Exhibit C: Sample Certificate of Completion

Continuing Education: Exhibit D: Sample Roster Form

Continuing Education: Exhibit E

Continuing Education Provider, Contact Change

Continuing Education: Sample Course Sign-in Sign-out Form

Custodial Agreement, Title

Custody Agreement, Title

 

D

Designated Responsible Licensed Producer (DRLP), Add

‘Doing Business As’ (DBA) Name, Add

 

 

E

Endorsement by Title Insurance Company, Title

Exam Pass Rate: 2015

Exam Pass Rate: 2016

Exam Pass Rate: 2017

Exam Pass Rate: 2018

Exam Pass Rate: 2019

Exam Pass Rate: 2020

Exam Pass Rate: 2021

Exhibit A: Information regarding Title Plant, Title

 

F

Fingerprint Packet: Bail Renewal, Non-resident

Fingerprint Packet: Bail Renewal, Resident

Flyer: Bail, Non-resident

Flyer: Bail, Resident

Flyer: Business Entity

Flyer: Continuing Education

Flyer: Independent Adjuster, Non-resident

Flyer: Independent Adjuster, Resident

Flyer: Independent Review Organization

Flyer: Life Settlements Broker

Flyer: Life Settlements Provider

Flyer: Managing General Agent

Flyer: Personal Electronics

Flyer: Producer, Non-resident

Flyer: Producer, Resident

Flyer: Public Adjuster, Non-resident

Flyer: Public Adjuster, Resident

Flyer: Surplus Lines

Flyer: Third Party Administrator, Licensed

Flyer: Third Party Administrator, Registered

Flyer: Title

Flyer: Travel

Flyer: Variable Line

 

 

G

 

H

Hard Card Fingerprint Instructions

How to Apply for a Resident Bail Bond License

How to Apply for a Resident Independent Adjuster License

How to Apply for a Resident Producer License

How to Apply for a Resident Public Adjuster License

How to Change Your Contact information

How to Check Your CE Transcript

How to Find a CE Course

How to Renew a License

How to Use SBS for Organizations

 

I

Idaho Filing Submission Documentation for Life Settlements

Idaho License Coverage Chart

Independent Review Organization, Application

Independent Review Organization: Late Renewal Application

Independent Revie Organization Renewal Application

Individual License: Late Renewal Application 

Individual: Name Change

Individual Renewal Application

Individual License, Voluntary Surrender

Instructions for IRO Registration Process

Insurance Producer Fee Disclosure Form

 

L

Late Renewal Application: Bail Agent

Late Renewal Application: Business Entity

Late Renewal Application: Individual

Late Renewal Application: Independent Review Organization

Late Renewal Application: Managing General Agent

Letter of Clearance Request

Life Settlement Broker Application

Life Settlement Provider Application

Limited Lines Producer Pre-Licensing Manual

Line of Authority, Add

Line of Authority, Cancelation

Long Term Escrow Rates, Title

 

M

Managing General Agent Designation Application

Managing General Agent Renewal Application

 

N

NAIC Uniform Application: Business Entity

NAIC Uniform Application: Business Entity, Adjuster

NAIC Uniform Application: Individual Adjuster

NAIC Uniform Application: Individual

NAIC-Biographical Affidavit

Name Change Request: Business Entity

Name Change Request: Individual

Notice to Life Annuities Insurers and Producers

Notification of Officer Change

Notification of Change of Ownership

 

O

Officer Change Notification

Ownership Change Notification

 

P

Plant Information

Producer Fee Disclosure

Q

 

R

Registration: Bail Agent to Bail Agency

Registration as a Pharmacy Benefit Manager Application

Registration as a Reinsurance Intermediary Exemption Application

Registration as an Administrator Application

Registration as a Pharmacy Benefit Manager Application

Reinsurance Intermediary Manager Application

Reinsurance Intermediary Exemption, Voluntary Surrender

Renewal Application: Agency

Renewal Application: Independent Revie Organization

Renewal Application: Individual

Renewal Application: Managing General Agent

Renewal Application: Third Party Administrator, Licensed

Renewal Application: Third Party Administrator, Registered

Renewal Packet, Title

Request for a Letter of Clearance

 

S

Secretary of State Registration Information

Short Term Escrow Rates, Title

Standards for Life Settlement Contracts

 

T

Temporary Resident Producer License Request Form

Termination of a Bail Agent’s Authority to Act Under a Bail Agency License

Termination of a Producers Authority to Act Under a Company or Business Entity License

Third Party Administrator Filing Extension Request

Third Party Administrator, Home-State Application

Third Party Administrator, Licensed Renewal Application

Third Party Administrator, Non-Resident Application

Third Party Administrator, Registered Application

Third Party Administrator, Registered Renewal Application

Third Party Administrator: Termination of Agreement

Third Party Administrator, Voluntary Surrender

Title: Addendum to Title Insurance Agent License Application

Title: Appointment of Title Insurance Agent/Escrow Officer

Title: Custodial Agreement

Title: Custody Agreement

Title: Endorsement by Title Insurance Company

Title Exhibit A: Information regarding Title Plant

Title Financial Interest Notice

Title: Long Term Escrow Rates

Title Renewal Packet

Title: Short Term Escrow Rates

Travel License Annual Report

 

U

Uniform Continuing Education Reciprocity Course Filing Form

Update Address, State to State

Update Name, Business

Update Name, Individual

Update Officers/Directors

Update Ownership

 

V

Voluntary Surrender: Business Entity License

Voluntary Surrender: Individual License

Voluntary Surrender: Reinsurance Intermediary Exemption

Voluntary Surrender: Third Party Administrator

All Links (alphabetical order)

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K

L

M

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Q

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X

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Z

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All Forms

A

Add a Line of Authority

Address Change, Business Entity

Address Change, Individual

Address Update, Business Entity

Address Update, Individual

Address, Phone, or Email Changes

Apply for a License: Bail Agent

Apply for a License: Independent Adjuster, Individual

Apply for a License: Life Settlement Broker

Apply for a License: Life Settlement Provider

Apply for a License: Portable Electronics Vendor

Apply for a License: Producer Individual

Apply for a License: Producer, Business Entity

Apply for a License: Public Adjuster, Business Entity

Apply for a License: Public Adjuster, Individual

Apply for a License: Surplus Lines Broker

B

Biographical Affidavit

Business Entity, Address Change

Business Entity, Contact Change,

Business Entity, Update Phone Number

C

Change Address, Business Entity

Change Address, Individual

Change Email Address, Business Entity

Change Email Address, Individual

Change Phone Number, Business Entity

Change Phone Number, Individual

Check Your Continuing Education Transcripts

Contact Change: Individual

D

Deadline for Renewal of TPA license or Registration

E

Email Address Update, Business Entity

Email Address Update, Individual

F

Filing Forms, Surplus Lines

G

H

Health Exchange Certification 

I

Idaho Secretary of State

Idaho Surplus Lines Organization

Immunization Assessment

Individual Address Change

Individual Contact Change

Individual Email Address Change

Individual Phone Number Change

Introduction to the Surplus Lines Market

J

K

L

M 

N

NIPR

O

Other States DOI’s

P

Phone Number Change, Business Entity

Phone Number Change, Individual

Print a License

R

Renew a License: Bail Agent

Renew a License: Independent Adjuster, Individual

Renew a License: Life Settlement Broker

Renew a License: Life Settlement Provider

Renew a License: Portable Electronics Vendor

Renew a License: Producer Individual

Renew a License: Producer, Business Entity

Renew a License: Public Adjuster, Business Entity

Renew a License: Public Adjuster, Individual

Renew a License:  Surplus Lines Broker

S

SBS License Manager

Self-Funded Health Plan Survey

State Based Systems

Surplus Lines Filing Forms

T

U

Update Address, Business Entity

Update Address, Individual

Update Contact Information, Business Entity

Update Contact Information, Individual

Update Email Address, Business Entity

Update Email Address, Individual

Update Phone Number, Business Entity

Update Phone Number, Individual

Updated to Surplus Line Rule

V

W

X

Y

Z

Resources by License Type

<a href=”https://doi.idaho.gov/industry/licensing-services/licensing-services-forms-links/?accordion=ui-id-3#advgb-tabs-tab3″><strong>IRO</strong></a>
<a href=”https://doi.idaho.gov/industry/licensing-services/licensing-services-forms-links/?accordion=ui-id-3#advgb-tabs-tab5″><strong>Limited Lines</strong></a>
<a href=”https://doi.idaho.gov/industry/licensing-services/licensing-services-forms-links/?accordion=ui-id-3&tab=advgb-tabs-tab5#advgb-tabs-tab6″><strong>Portable Electronics</strong></a>
<a href=”https://doi.idaho.gov/industry/licensing-services/licensing-services-forms-links/?accordion=ui-id-3&tab=advgb-tabs-tab8#advgb-tabs-tab8″><strong>Producer, Individual</strong></a>
<a href=”https://doi.idaho.gov/industry/licensing-services/licensing-services-forms-links/?accordion=ui-id-3&tab=advgb-tabs-tab9#advgb-tabs-tab9″><strong>Surplus Lines Broker</strong></a>

Flyers

<a href=”https://doi.idaho.gov/industry/licensing-services/licensing-services-forms-links/?accordion=ui-id-3&tab=advgb-tabs-tab1#advgb-tabs-tab1″><strong><strong>Non-Resident Flyers</strong></strong></a>

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