Licensing Applications/Forms

Adjuster

• Application for Adjuster's License - Form 90
• Registration for Emergency Adjusters - (Form AL-EAD1)
  
  • Attachment to Form AL-EAD1 - (Form AL-EAD2)

Business Entity

• Alabama Domiciled Entities: Application for Business Entity Producer License - Form AL-70
• * Non-Residents: Uniform Application for Business Entity Non-Resident License/Registration - NAIC

  *Mail application & $120.00 fee to:
  Alabama Department of Insurance
  P O Box 830704
  Birmingham, Alabama 35283-0704

  *Please make checks payable to Commissioner of Insurance, State of Alabama.

• Online Business Entity Non-Resident Application (For Initial Licensing Only - Have Held No Previous Alabama License)
• Change of Designated Producer - Form AL-DP-1

Company

• Company Authorization - Form AL-CAL-1
• Multiple Renewals Authorization - Form AL-CAL-2
• Notice Of Producer Appointments:
  • * One Insurer/Multiple Producers - Form AL-2A
  • * One Producer/Multiple Insurers - Form AL-2B
• Notice of Cancellation:
  • * One Insurer/Multiple Producers - Form AL-3A
  • * One Producer/Multiple Insurers - Form AL-3B

* These forms are used for individual producers and business entities.

Continuing Education

• Continuing Education Course Application
• Continuing Education Provider Application

Managing General Agent

• Managing General Agent Appointment - Form AL-MGA-1
• Managing General Agent's Contract - Form AL-MGA-2
• Managing General Agent (MGA) Termination - Form AL-MGA-3
• Managing General Agent (MGA) Certification - Form AL-MGA-4

Miscellaneous Forms

• Request for Address Change - Form AL-A
• Request for Name Change - Form AL-B
• Request Letter of Certification
• Request for Letter of Clearance - Form AL-E
• Request to Voluntarily Surrender or Cancel License - Form AL-F

Prelicensing

• Prelicensing Provider Application

Producer

• Alabama Residents: NAIC Uniform Application for Individual Producer License
• **Non-Alabama Residents: Uniform Application for Individual Non-Resident License - NAIC

  **All first time (initial) licensees must apply for license online.

• Online Individual Non-Resident Application (For Initial Licenses Only - Have Held No Previous Alabama License)

  **All others mail application and $60.00 fee to:
  Alabama Department of Insurance
  P O Box 830704
  Birmingham, Alabama 35283-0704

  **Please make checks payable to Commissioner of Insurance, State of Alabama.

Reinsurance Intermediary

• Reinsurance Intermediary License Application - Form AL-RI-1

Service Representative

• Individual's Application for Service Representative License/Appointment, Resident/Non-Resident - Form AL-1-TSR

  Note: This is also the form used for Temporary Producer Licenses.

Surplus Line Broker

• Application for Individual Surplus Line Broker's License - Form AL-SLB-1
• Uniform Application for Business Entity License/Registration

**Uniform Application mailed to:
Alabama Department of Insurance
P O Box 303351
Montgomery, AL 36130-3351

• Surplus Line Broker Bond - Form AL-SLB-13

Temporary Producer

• Individual's Application for Temporary Producer License/Appointment, Resident/Non-Resident - Form AL-1-TSR

  Note: This is also the form used for Service Representative Licenses.

Title Insurance Agent

• Application for Title Agent Certificate of Authority - Form AL-T-1