Arizona Department of Insurance
100 North 15th Avenue, Suite 261
Phoenix, AZ 85007-2630
Starting July 1, 2020, we became the
Department of Insurance and Financial Institutions (DIFI).
To make your application process faster and easier, use NIPR.COM and apply online instead of completing, printing and mailing this application
This form is to be used by individuals who are required to submit fingerprints as part of an insurance license application. The form includes detailed instructions that must be exactly followed for fingerprints to be accepted by the Department of Insurance and Financial Institutions.
Self Service Storage Agents and Rental Car Agents must specify all office locations from which the entity may transact insurance business.
Complete and file this form with the life settlement broker license fee within the first 30 days of operating as a life settlement broker.
Only use this form to apply for a license as a portable electronics vendor, rental car agent, self-service storage agent, or travel insurance producer.
The document contains detailed instructions and forms to apply to become a navigator or certified application counselor.
You can use this form to ask the Department of Insurance to determine whether a criminal conviction disqualifies you for a license.
Only use this form to permanently surrender license authority. If you wish to clear a license to allow you to become licensed in another state, use Form L-CLR.
Must be completed by each partner, officer, and director, and each other entity owning 25% or more of a Service Company applicant.