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Texas Department of Insurance
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Agent / Adjuster Application Forms

Description File Format
Application for Texas resident insurance agent
Use this online application to apply for all license types. Learn more about the license application process by going to our Agent and adjuster licensing > click on the license type you are interested in.
Online
Electronic Non-resident Application
(Individual or Entity: Links to NIPR, at the Texas instruction page for the electronic application. That page is linked to a Use Agreement page. The "Agree" button links to the actual application.)
Online
Licensing renewal application
Renew License Online
Online
NIPR Electronic Address Change Request
(For in-state address changes, an agent or adjuster can use this tool to simultaneously provide an address change notification to all state insurance departments where the agent or adjuster is licensed. There is no charge for the service.)
Online
Application for Individual Adjuster License Online

If the form is a fillable PDF, learn how to enable all fillable form features.

TDI Form Number Description File Format Language
FIN430

License Application for a Life Settlement Provider or Broker

Original application for licensure of a life settlement broker or provider, which includes checklists for filing requirements of the initial application

PDF English
FIN431

Application for Renewal, Surrender, or Change of Information for a Life Settlement Provider or Broker

Application for renewal of a broker or provider license or to report change of information of an existing life settlement broker or provider

PDF English
FIN432

Life Agent Notification to TDI to act as a Life Settlement Broker

Required for applicants who have held a resident Texas life or life and health license for at least one year

PDF English
FIN434

Biographical Affidavit for Life Settlement Providers or Brokers

Biographical affidavit. Must be completed by all individuals specified in the instructions of FIN430 and FIN431, as adopted by rule.

PDF English
FIN505

Licensing Corporate Insurance Agents Bond (aka Insurance Agency Bond)

Method of showing proof of financial responsibility to obtain corporate license

PDF English
FIN507

Application for insurance agency license

Use for county mutual, risk manager, funeral pre-arrangement life, life and health insurance counselor, and life insurance not exceeding $25,000. For other license types, apply online at www.Sircon.com.

PDF English
FIN509

Public Insurance Adjuster Bond - Licensing

Certifies that the persons listed on the form are bound to the Texas Department of Insurance in the sum of $10,000 as specified at 28 Texas Administrative Code Section 19.705.

PDF English
FIN510

Licensing Application for Reinsurance Intermediary License

For individuals and entities to apply for a Reinsurance Intermediary License under the provisions of TIC, Chapter 4152.

PDF English
FIN511

Licensing Reinsurance Intermediary Biographical Affidavit

To register individuals to be associated to a Reinsurance Intermediary License.

PDF English
FIN512

Licensing Reinsurance Intermediary Agent For Service of Process

Nonresident Reinsurance Intermediary License applicant or licensee must use this form to appoint a Texas resident on whom a notice or order or process may be served.

PDF English
FIN513

Licensing Reinsurance Intermediary Bond

Method of showing proof of financial responsibility for a Reinsurance intermediary License.

PDF English
FIN514

Specialty Insurance License Application

Specialty Insurance License Application (fka Li004,LHL207)

PDF English
FIN535

Public Insurance Adjuster Contract

This contract form is prescribed by the Texas Department of Insurance to satisfy contract requirements for Public Insurance Adjusters effective January 01, 2014.

PDF English
FIN594

Application for Residency Change to Texas

PDF English
FIN700

Appointment certification

PDF English

For more information, contact: License@tdi.texas.gov