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CA Department of Insurance

Checklist of Application Filing Requirements

Materials Links Do I have this Completed?
Written Application Organization - Form 441-11*
Individual - Form 441-9
*Note:  The Notice of Appointment on this form cannot be used for the Self-Service Storage Agent License.  Please use Self-Service Storage Agent Appointment Form SSA 2.
Certification of Authorized Endorsees SSA 1  
Training Material The training for the self-service storage agent and the endorsee must cover the areas described in form SSA 3.  These materials must accompany the application when filing for the self-service storage agent license.  
Application Filing Fee $250  
Where to File: California Department of Insurance
P.O. Box 1139
Sacramento, CA 95812-1139

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