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

Checklist for Application Filing Requirements

Checklist for Application and Renewal Filing Requirements
Credit Insurance Agent License

Application Checklist

Materials Links Do I have this requirement completed?
For the Individual Application:
Written Application for Individual Individual Application Form LIC 441-9*   
Credit Insurance Agent Notice of Appointment Form LIC CI 20*   
Fingerprint Impression* Live Scan Request form BCIA 8016 and the Licensing Applicant Instructions form LIC 442-39A*   
Application Fee $449   
Where to File: California Department of Insurance
P.O. Box 1139
Sacramento, CA 95812-1139
For the Business Entity Applicant:
Written Application for Employer Business Entity Application - Form LIC 441-11*   
Fingerprint Impression* Live Scan Request form BCIA 8016 and the Licensing Applicant Instructions form LIC 442-39A*    
and
Written Application for Employee (for each endorsee) Individual Application - Form LIC 441-9*    
Credit Insurance Agent Notice of Appointment Form LIC CI 20*    
Employee Affidavit of Training and Knowledge (for each endorsee) Form LIC CI 50*    
Training Material Form LIC CI 30*   
Applicant Fee $449   
Application Fee for Endorsee $45    
Where to File: California Department of Insurance
P.O. Box 1139
Sacramento, CA 95812-1139

*These forms are in PDF format. To view these forms, your browser must have Adobe Acrobat Reader on your computer. A free copy of the Adobe Acrobat Reader can be downloaded from the Adobe website.

License Renewal Checklist
Credit Insurance Agent License

Materials Links Do I have this requirement completed?
For the Individual and Business Entity Applicant:

Renewal form for the individual and business entity licensee

 CDI emails licensees a renewal notification to their email address on record. The email notification includes the license number, license term, license type, and information regarding any continuing education requirements. You can update your e-mail address using Sircon.com - Change Address Online.

  • Individuals and business entities who do not receive the email notification will still be able to renew their license online by following the prompts on CDI's Online Renewal Service at the following website link: Sircon.com - Renewal and Reinstatement Service. 

  • Sircon.com - Renewal and Reinstatement Service is available to insurance agents, brokers, and adjusters who want to renew their licenses after the license expiration date has passed.  Additionally, Sircon.com - Renewal and Reinstatement Service is available to insurance agents, brokers, and adjusters who previously used the online renewal service as an on-time renewal but were not able to renew their license because not all of the requirements to renew were met prior to the license expiration date.  Sircon.com - Renewal and Reinstatement Service allows these licensees, once their requirements has been met, to complete the renewal of their license by paying the 50 percent late penalty fee.

    Sircon.com - Renewal and Reinstatement Service for late renewals is not available to bail agents, who by law must reapply as a new applicant if their license is not renewed prior to the expiration date.

    Any licensees that renew their licenses late will be required to pay a 50 percent penalty fee and file new company appointments and/or business entity endorsements or solicitor appointment (if applicable). "Late" is defined as any renewal for which the requirements to renew (for CA residents this includes completing the ethics and continuing education hours) are not met until after the expiration date of the previous license term. Use this link, Sircon.com - Renewal and Reinstatement Service, to find out how to late renew your license.

     
   
Renewal Fee $410    
Endorsee Renewal Fee $8 per Endorsee.   
Endorsee List The California Department of Insurance's Producer Licensing Bureau will send a list of the endorsees to the business entity to review and confirm the list of endorsees. 

If the endorsee is not to be renewed, mark "no" in the box provided on the list. 

Likewise, if the endorsee is to be renewed, mark "yes" on the endorsee list.

   
Annual Training Material Submission Form Form LIC CI 10   
Annual Certificate of Compliance and Listing of Authorized Endorsees Form LIC CI 40   
Where to File: California Department of Insurance
P.O. Box 1139
Sacramento, CA 95812-1139

*These forms are in PDF format. To view these forms, your browser must have Adobe Acrobat Reader on your computer. A free copy of the Adobe Acrobat Reader can be downloaded from the Adobe website.

If you have any questions about the Credit Insurance Agent License information you are reviewing, please read the most commonly asked questions in our Credit Insurance Agent License Questions and Answers section. If you need further assistance, please call CDI's Licensing Hotline at (800) 967-9331 or send an e-mail to Producer Licensing Bureau. 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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