CERTIFIED APPLICATION COUNSELOR: License Compliance

Among other requirements, a certified application counselor must remain in compliance with the following licensing-related requirements:

All insurance professionals (both residents and nonresidents) can apply for licenses, renew licenses, and update addresses and phone numbers online through the National Insurance Producer Registry (NIPR), at www.nipr.com.

NIPR license and renewal applications are easy to complete, and we can usually process them faster than applications that are mailed to us. NIPR charges a small transaction fee (around $5 to $7) to process a license application and fee payment. Many people have found that overall, the added convenience plus the time and postage savings are worth paying the fee.

USE NIPR FOR FREE to change an address, e-mail address or phone number!

REPORT CHANGES TO YOUR NAME, ADDRESS OR PHONE NUMBER

Arizona Revised Statutes (ARS) § 20-286(C) requires an insurance professional (insurance producers and others) to report each of the following within 30 days:

A change to the licensee's residential, mailing or business address, e-mail address or telephone number.
An individual must use the NIPR Contact Change Request, which is offered by the National Insurance Producer Registry at no charge.
A business entity must submit Form L-CHG report a change the business entity's principal business address, or Form L-LOC to report changes to branch locations and associated designated responsible licensed producers. A business may mail or email completed forms.
The addition, change or removal of a business-entity licensee's members, directors, officers or designated producer.
Complete Form L-177 to report a new member, officer or director (regardless of whether the business entity is licensed as an Arizona resident or non-resident).
Complete Form L-CHG to report a new designated responsible licensed producer/adjuster.
For an Arizona-resident business entity, each new member, officer or director must submit fingerprints to the Department of Insurance in accordance with the procedures outlined in Form L-FPV.
A change to the licensee's name.
An Arizona resident must submit Form L-CHG with a copy of both sides of the newly issued Arizona Driver License or Arizona Non-operating Identification showing the new name.
A nonresident must first execute the name change with the insurance department in the licensee's home state, and then submit Form L-CHG to the Arizona Department of Insurance.

Assumed Name / DBA

If you intend to do business under a name other than your legal name (called an "assumed name" or "DBA name"), complete and submit Form L-193 (Certificate of Assumed Business Name). Send completed forms by mail or by fax. Protect your assumed name by also registering it as a trade name with the Arizona Secretary of State. If you do not register a trade name, another person may register the name, which will force you to stop using the name.

License Expiration vs. License Surrender

If you no longer wish to be licensed as an insurance professional in Arizona, or if you are no longer involved in a particular line of insurance business, you can either allow your license or the line of authority expire and decide to not renew it; or, you can surrender your license or a line of authority on your license.

IMPORTANT! If you surrender license authority, you will not be able to apply for the surrendered license authority for at least one year. Surrendering a license is irrevocable - you cannot decide that it was a mistake. Arizona law does not provide an exception that will allow a person who surrendered license authority to reapply for the surrendered authority within one year.

REPORT ADMINISTRATIVE OR CRIMINAL PROSECUTION

Arizona Revised Statutes ("ARS") § 20-301 directly, or by reference from other statutes, requires insurance license holders (producers and most other insurance professionals) to report each

administrative action taken against the licensee, whether outside Arizona or by any governmental agency within Arizona, within 30 days of the final disposition of the matter, and must include copy of the order, consent to order or other relevant dispositive document;
criminal prosecution of the licensee in any jurisdiction within 30 days after the initial pretrial hearing date, and must include a copy of the initial complaint filed, the order resulting from the hearing and all other relevant legal documents.

Submit your documents online using the National Insurance Producer Registry (NIPR) Attachments Warehouse or mail them to the Department of Insurance Licensing Section.

IF YOU WISH TO TERMINATE A LICENSE...

If you no longer wish to be licensed as an insurance professional in Arizona, or if you are no longer involved in a particular line of insurance business, you can either

allow your license or the line of authority to expire and decide to not renew it; or,
surrender your license or a line of authority on your license.

IMPORTANT! If you surrender your license or license authority, you will not be able to apply for the surrendered license or license authority for at least one year. Surrendering a license or license authority is irrevocable - you cannot decide that it was a mistake. Arizona law does not provide an exception that will allow a person who surrendered a license or license authority to reapply for the surrendered license or authority within one year.


Form L-193: Certificate of Assumed Name	Use this form for each name, other than your genuine legal name, that you intend to use in conjunction with your insurance business. If you have established a business entity and want to use the name of the business entity in conjunction with your insurance transactions, the business entity must also hold an insurance license.
Form L-CHG: License Information Change	Individuals needing to update address, phone and e-mail information must use the NIPR Contact Change Request (www.nipr.com) instead of using this form. An individual may use this form to report a name change, and a business entity may use this form to report a change of Designated Producer, name, address, phone number or e-mail information.
Form L-CLR: Clearance Letter Request	Use this form if: A. You are relocating to another state and need to provide a clearance letter from Arizona, OR B. You want to permanently surrender insurance license authority. *Be careful!* If you surrender insurance license authority, Arizona law prevents you from reapplying for the surrendered authority for one year.

ARS § 41-1030(G) requires most Arizona government agencies to prominently print the provisions of ARS § 41-1030(B), (D), (E) and (F) on all license applications. The following is the language in ARS § 41-1030(B), (D), (E) and (F):

B. An agency shall not base a licensing decision in whole or in part on a licensing requirement or condition that is not specifically authorized by statute, rule or state tribal gaming compact. A general grant of authority in statute does not constitute a basis for imposing a licensing requirement or condition unless a rule is made pursuant to that general grant of authority that specifically authorizes the requirement or condition.

D. This section may be enforced in a private civil action and relief may be awarded against the state. The court may award reasonable attorney fees, damages and all fees associated with the license application to a party that prevails in an action against the state for a violation of this section.

E. A state employee may not intentionally or knowingly violate this section. A violation of this section is cause for disciplinary action or dismissal pursuant to the agency’s adopted personnel policy.

F. This section does not abrogate the immunity provided by section 12-820.01 or 12-820.02.

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CERTIFIED APPLICATION COUNSELOR: License Compliance

COMPLETE TRAINING AND CERTIFICATION REQUIREMENTS

REPORT CHANGES TO YOUR NAME, ADDRESS OR PHONE NUMBER

Assumed Name / DBA

License Expiration vs. License Surrender

REPORT ADMINISTRATIVE OR CRIMINAL PROSECUTION

IF YOU WISH TO TERMINATE A LICENSE...

Please Provide Your Feedback

LICENSING DIVISION

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