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CA Department of Insurance

Applicable Forms

License Information

Applicable Forms

Individual Applicants

  • Application for Insurance License: Use the Fast Licensing Application Service is Here (FLASH) Online Application. When an initial application is made to the California Department of Insurance, applicants may apply for what was known as a "fire and casualty broker-agent license" by selecting both the property broker-agent and casualty broker-agent license types on their application. Applicants checking both the property broker-agent and casualty broker-agent license types on the application will pay one filing fee.
  • Request for Live Scan Service, form LIC 442-39A

Additional Documents:

The Insurance Commissioner may require such other documents as will aid in determining whether the applicant meets the qualifications for a license.

A casualty broker-agent is not required to have an appointment with an insurance company to have the license issued. Upon application approval the license can be downloaded or printed by using the CDI's Print or Download your License online service. However, the licensee may not transact, solicit, or negotiate the sale of insurance until after one of the following documents are completed and submitted to the California Department of Insurance.

  • Bond of Insurance Broker, form LIC 417-5, executed in California by a California admitted surety, completed in the name of the applicant and signed by the applicant authorizes the licensee to act as an insurance broker.
  • Action Notice of Appointment, with $26 filing fee completed by the sponsoring insurance company admitted to California, authorizing the person to act as a Casualty agent. Pursuant to Section 2190.22 of Title 10 of the California Code of Regulations, the Action Notice of Appointment must be submitted electronically. To submit appointments electronically contact the National Insurance Producer Registry (NIPR) and its authorized business partners for a list of approved partners.
  • The sponsoring business entity licensed in California completes a Business Entity Endorsement, which must besubmitted through the CDI's Business Entity Endorsement and Termination Online Service.
  • Action Notice of Solicitor, form LIC 417-31, with $26 filing fee, completed by the sponsoring casualty employer licensed in California authorizes the person to act as an insurance solicitor.

Business Entity Applicants

Additional Documents:

The Insurance Commissioner may require such other documents as will aid in determining whether the applicant meets the qualifications for a license.

A casualty broker-agent is not required to have an appointment with an insurance company to have the license issued. Upon application approval the license can be downloaded or printed by using the CDI's Print or Download Your License online service. However, the licensee may not transact, solicit, or negotiate the sale of insurance until after one of the following documents are completed and submitted to the California Department of Insurance.

  • Action Notice of Appointment, with $26 filing fee, completed by the sponsoring insurance company admitted to California, authorizing the person to act as a Casualty agent. Pursuant to Section 2190.22 of Title 10 of the California Code of Regulations, the Action Notice of Appointment must be submitted electronically. To submit appointments electronically contact the National Insurance Producer Registry (NIPR) and its authorized business partners for a list of approved partners.
  • Bond of Insurance Broker, form LIC 417-5, executed in California by a California admitted surety, completed in the name of the applicant and signed by the applicant authorizes the licensee to act as an insurance broker.

All filing fees submitted are not refundable, whether or not the application is acted upon or the examination taken.

For specific questions regarding this license type, please e-mail the Producer Licensing Bureau at Producer Licensing Bureau E-mail or call the CDI's Producer Licensing Toll Free Hotline at (800) 967-9331. Please be sure to include your name, telephone number, license number and e-mail address in all correspondence with the CDI.

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