Alaska Division of Insurance

Individuals (not affiliated with a firm)
(Credit, Crop, Travel, Bail Bond)

Trainee Adjuster

Unlicensed Adjuster

Resident Limited

Nonresident Limited

Individuals in a Firm
(Credit, Crop, Title, Bail Bond)

Individuals in a Firm
(Credit, Crop, Bail Bond)

Compliance Officer (Designated
Responsible Person) (Credit, Crop,
Travel,Title, Bail Bond, Car Rental)

Compliance Officer (Designated Responsible Person) (Credit, Crop, Travel,Title, Bail Bond, Car Rental)

Firm (Credit, Crop, Travel,
Bail Bond, Car Rental)

Limited Lines Licensees (Title - individuals affiliated with a firm ONLY) and Bail Bond

Title (individuals and firms ONLY)

Managing General Agent License Forms

Managing General Agent Exemption Form

Reinsurance Intermediary Manager or Broker Forms

Third Party Administrator Application Form

Third Party Administrator Exemption Form

Viatical Settlement Representative or Broker Forms

Viatical Settlement Provider Forms

Business Transaction Form for Adjuster

1033 Consent Requirements
Bulletin B98-05
(For individuals seeking licensure who have a felony conviction involving dishonesty or breach of trust.)

1033 Consent Application

Individuals NOT seeking licensure who have a felony conviction involving dishonesty or breach of trust must still apply for and receive the Director's written consent prior to working in the insurance business. Please contact the division for assistance.

Miscellaneous Application Forms

Application Forms

Business Transction Form

Change Form

Company Termination Form (for cause only)

Fee Schedule

Flood Insurance Training

NIPR ACR (Address Change Request)

Producer Address Change Request Sign In

Adjuster Information

Applications

Individuals, Individuals in a Firm, or
Compliance Officer (Designated
Responsible Person

Individuals, Individuals in a Firm, or Compliance Officer (Designated Responsible Person

Business Transaction Form for Adjuster

Trainee Adjuster

Unlicensed Adjuster

Adjuster Study Material. Please note: this is a very large pdf document, it may take a while to download.

Unlicensed Adjuster Single Loss or Catastrophe Form

Changes to License

To make the following change, click on the identified section on the Alaska Change Form and follow the instructions under that specific section.

Termination of Employment – for licensees who hold an individual or compliance officer in a firm license who are no longer employed by the firm

Cancellation of License – to cancel your license

Records Information – notification to our office that identifies where your Alaska insurance records will be maintained after your license is no longer active in this state

Residence Address Change – to change your residence physical or mailing address, telephone, or fax number

Business Address Change – to change your business physical or mailing address, telephone, or fax number

Change of Name - if the name reflected on your license has changed, you must notify our office of your new name. If you hold a firm license and the firm has changed its name, you may only use this form if the federal identification number of the firm has NOT changed

Change in State of Residency – for licensees who have changed their home state of residency

Employment – for licensees who hold an individual or compliance officer in a firm license who have changed firms (employers)

Change in Lines of Authority – a licensee who elects to add/delete lines of authority to their existing license

10.

Change in License Type (Individual, Individual in a Firm, Compliance Officer) – a licensee who elects to add/delete a license type to their license

11.

Change in License Class (i.e. Producer, Surplus Lines Broker, Adjuster, etc.) – a licensee who elects to add/delete a license class to their license

12.

Change in Designated Responsible Person (Compliance Officer)

13.

Notification of Criminal Prosecution or Administration Action by Another state or Jurisdiction

Change Form (Use this form to make changes to an existing license or notify our office of any changes as required under our laws.)

Electronic Address Change – residents and nonresidents (you will be directed to the National Insurance Producer Registry (NIPR) web site to file the electronic changes with our office).

NIPR ACR (Address Change Request)

Company Appointments

“Effective June 24, 2005, the statutory requirement for insurers or managing general agents to file company appointment with our office has been eliminated. But, insurers, managing general agents (MGAs), and producers are required to maintain a list of all of their appointments, and must be able to respond within three working days to an inquiry made by the director regarding an appointment (Alaska Statute 21.27.100). As of June 24, 2005, the division no longer maintains active records of any appointments.

Continuing Education

Bulletins

Continuing Education Advisory Committee Recruitment

Bulletin B99-10

Bulletin B96-10

Bulletin 98-02

Continuing Education Reporting Form

Frequently Asked Questions

Regulations

Credit

Applications