Arizona Department of Insurance
100 North 15th Avenue, Suite 261Phoenix, AZ 85007-2630
Starting July 1, 2020, we will be the
Department of Insurance and Financial Institutions (DIFI).
Must be completed by each partner, officer, and director, and each other entity owning 25% or more of a Service Company applicant.
To make your application process faster and easier, use NIPR.COM and apply online instead of completing, printing and mailing this application