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CA Department of Insurance
CA Department of Insurance
CA Department of Insurance

Prelicensing Continuing Education Forms

Education Forms - The following Prelicensing/Continuing Education forms are available in Adobe's Portable Document Format (PDF). To view and complete these PDF forms on your browser you must have Adobe Acrobat Reader on your computer. A copy of the Adobe Acrobat Reader can be downloaded from our Document Readers Web Page. Additional forms will be added or revised periodically, so keep checking back. Prelicensing/Continuing Education Forms Producer Licensing Bureau Education Forms Alphabetical Listing

Prelicensing/Continuing Education Forms in interactive PDF format

Form Number PDF Format Form Name
LIC 001B Bail Course Application/Renewal Application
 
LIC 446-2 Provider Certification/Renewal Application
 
LIC 446-2A Prelicensing / Continuing Education Program Provider Certification / Renewal Application
 
LIC 446-3 Course Approval Application
 
LIC 446-4 Instructor Qualification Form
 
LIC 446-4A  List of Instructor(s)/Subject Matter Experts Form
 
LIC 446-5 Course Attendance Record and Verification Form
 
LIC 446-8 Prelicensing Education Requirements
 
LIC 446-9 California Long-Term Care, California Partnership, Annuities, and Workers' Compensation Continuing Education Requirements
 
LIC 446-12 Class Presentation Schedule
 

LIC 446-13

Provider Roster

LIC 446-32  Stipulation to Maintain Records Outside of California
 
  
LIC 446-38 Online Provider Course Renewal Letter
 
LIC 446-40 Out-of-State Provider Jurisdiction Agreement
 
LIC 446-42 Education Provider - Change of Address
 

Information & Filing Form

NAIC Uniform Continuing Education Reciprocity (CER) Course Filing Form
 

Provider Summary Parties Interested in the Prelicensing & Continuing Education Program Provider Summary Notice
 

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Producer Licensing Bureau Education Forms-Alphabetical Listing in interactive PDF format

Form Name Form Number PDF Format
Bail Course Approval/Renewal Application
 
LIC 001B 
California Tax Qualified Long Term Care, California Partnership, Workers Compensation  Continuing Education Requirements

 
LIC 446-9     
Class Presentation Schedule
 
LIC 446-12
Course Approval Application

  
LIC 446-3
Course Attendance Record and Verification Form
 
LIC 446-5
Education Provider - Change of Address
 
LIC 446-42
Instructor Qualification Form
 
LIC 446-4 
NAIC Uniform Continuing Education Reciprocity (CER) Course Filing Form Information Filing Form
Online Provider Course Renewal Letter LIC 446-38
Out-of-State Provider Jurisdiction Agreement
 
LIC 446-40
Parties Interested in the Prelicensing & Continuing Education Program Provider Summary Notice
 
Provider Summary
Prelicensing Education Requirements
 
LIC 446-8
Provider Certification/Renewal Application
 
LIC 446-2
Provider Roster

Education Provider Online Programs

LIC 446-13
Stipulation to Maintain Records Outside of California
 
LIC 446-32

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Frequently Asked Questions If you need further assistance, please call CDI's Education Unit at (916) 492-3064. Please be sure to include your name, telephone number, license number and e-mail address in all correspondence with the California Department of Insurance. 

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