Information Collection and Access
Section 1798.17 of the California Civil Code requires the following information to be provided when collecting information from individuals to determine compliance with the group and corporate practice provisions of the law, and to establish positive identification, to match the names of the certified list provided by the Department of Child Support Services to applicants and licensees, and of responding to requests for this information made by child support agencies.
AGENCY: California Department of Insurance
ADDRESS: 320 Capitol Mall, Sacramento, CA 95814-4309
TELEPHONE NUMBER: (800) 967-9331 or (916) 322-3555
TITLE OF OFFICIAL RESPONSIBLE FOR INFORMATION MAINTENANCE: Chief, Producer Licensing Bureau
AUTHORITY WHICH AUTHORIZES THE MAINTENANCE OF THE INFORMATION: California Insurance Code, Chapters 5, 6, 7, 8-Part 2, Division 1
THE CONSEQUENCES, IF ANY, OF NOT PROVIDING ALL OR PART OF THE REQUESTED INFORMATION: It is mandatory that you provide all information requested. Omission of any item of requested information will result in the application being rejected as incomplete.
THE PRINCIPAL PURPOSE(S) FOR WHICH THE INFORMATION IS TO BE USED: The information requested will be used to determine qualifications for licensure or certification, to determine compliance with the group and corporate practice provisions of the law and to establish positive identification.
EACH INDIVIDUAL HAS THE RIGHT TO REVIEW FILES MAINTAINED ON THEM BY THE AGENCY, UNLESS THE INFORMATION IS CLASSIFIED AS CONFIDENTIAL UNDER SECTION 1798.3(a) OF THE CIVIL CODE.
- Return to Industry Notice
- Title 18 U.S.C. Section 1033
- Authority (Complete text)*
- Application/Fingerprint Requirements, Fees
- 1033 Short Form Application for Written Consent
- Factors Considered for Granting Written Consent
- Termination of Written Consent
- Frequently Asked Questions
*Important note: Sections 2175.6 through 2175.9 and 2178 are under review by the Office of Administration Law and, therefore, are pending approval.
If you need further assistance, please call CDI's Licensing Background Bureau at (916) 492-3650. Please be sure to include your name, telephone number, license number (if applicable), and reference the 1033 Application filing requirement.