insurance - Agent Licensing Bureau
Insurance Home :: Insurance Bureaus :: Agent/Producer Search :: Business Entity Search :: Company Search :: Insurance Statutes
Healthcare Reform :: Insurance Bulletins :: Frequently Asked Questions :: Consumer Alerts :: Contact Us

 

Insurance Bureaus >> Agent Licensing Bureau >> Forms & Applications

 

Forms & Applications

 

RESIDENT and NON-RESIDENT Applications

 

Please click on links below for applicable Forms/Applications/Instructions, or scroll down to view the entire list.

 

  • Application Instructions
    Important Information regarding Application Instructions
  • License Exam. Testing with PSI
    Here you will find all forms pertaining to Exam testing with PSI, including instructions, registration form, application, agent and solicitor appointment forms.
  • Business Entity Applications

    Listing of all Business Entity Applications including additions, deletions, address change, Bail Bond Agency, Communication Seller, FraternalAgency, Rental Car, Surplus Lines, Title Guaranty, and TPA.

  • Individual Applications
    Listing of all Individual Applications, including AGENTS, BAIL, BROKER, FRATERNAL, ADJUSTER, ADDRESS CHANGE, INSURANCE CONSULTANT, LIMITED LICENSE, MOTOR CLUB REPRESENATIVE, SOLICITOR, SURPLUS LINE BROKER, TEMPORARY LICENSE, TITLE AGENT OR SOLICITOR, THIRD PARTY ADMINISTRATOR, AND VIATICAL SETTLEMENT BROKER
  • Miscellaneous Forms

    Listing of all miscellaneous forms, including list request, letter of certification, letter of clearance, application for written consent

 

 

Application Instructions

 

Form Instructions

The following general instructions shall be followed when completing Producer Licensing Forms. ANY FORM THAT IS INCOMPLETE, ILLEGIBLE OR DOES NOT COMPLY WITH THESE INSTRUCTIONS WILL BE RETURNED UNPROCESSED. NO EXCEPTIONS.

Counter checks will NOT be accepted. All checks shall include an account number, routing number and address. Acceptable forms of payment include personal checks, money order, cashier's checks, or certified checks. Currency, cash or coin will NOT be accepted.

Submit form(s) with the appropriate fee(s) to avoid delays in processing. Refer to Article 6's fee schedule of the New Mexico Insurance Code, NMSA 1978, §59A-6-1, for a listing of all applicable charges. This can be found here.

All filing fees accepted are non-refundable or non-transferable, whether or not the application, renewal or continuing education is granted or denied.

DO NOT STOP PAYMENT AND RESUBMIT ANOTHER FILING. THIS WILL NOT EXPEDITE PROCESSING OF YOUR FILING.

The Agents Licensing Section will ONLY accept checks or money orders made payable to the "New Mexico Public Regulation Commission Insurance Division." No checks or money orders more than six (6) months old will be accepted, no exceptions.

Company Appointments: Confirmation letters are mailed out to the sponsoring Insurance Company every Monday. Confirmation is given for all additions or cancellations of appointments from the previous week.

Corporate Affiliations: Confirmation letters are mailed out to the sponsoring Corporation every Monday. Confirmation is given for affiliations or cancellation of affiliation from the previous week.

If you need assistance, contact the Insurance Division's Agents Licensing Section at (505) 827-4601 or 1-888-427-5772, or by email at agents.licensing@state.nm.us.

PDB: NAIC (National Association of Insurance Commissioners) I-Site Internet browser-based application that is used to report producer information housed on the NAIC database. You can log onto the PDB web site at http://I-site.naic.org

NIPR (National Insurance Producer Registry): Information includes: Appointments, Terminations, and Non-Resident Licensing, and Appointment Renewals. You can log onto to the NIPR web site at www.licenseregistry.com

 

 

Exam/Testing with PSI

 

http://www.psiexams.com/


NOTICE TO BAIL BOND AGENT AND SOLICITOR APPLICANTS - FINGERPRINT CARDS (Please read before downloading and filling form)

 

Form Name Form Number
Exam Application Instructions
Exam Registration Form
License Application Form 210
Agent Appointment Form 204
Bail Bond Property Agent Appointment Form 224C
Bail Bond Property Solicitor Appointment Form 204B
Limited Surety Solicitor Appointment Form 241B
Solicitor Appointment Form 214B

 

Business Entity Applications

Form Name Form Number
Additions to Agency/Business Entity FORM 202-B
Please read instructions for FORM 202 before downloading and completing the form.
Uniform Application for Business Entity Insurance License Registration
NAIC Uniform Application
Adjusting Firm Application FORM 207A
Agency/Business EntityAddress Change Etc. FORM 203
Bail Bonding Agency Application W/Affiliation Additions & Deletions -Business Entity FORM 224-C w 224-D
Communication Sellers Application FORM 240
Fraternal Agency/Business Entity Application W/Affiliationadditions &Deletions FORM 228 & 228-B
Limited Lines Agency/Business Application W/Affiliation Additions & Deletions FORM 229 & 229-B
Rental Car Limited Appointment FORM 235
Surplus Lines Agency/Business Entity Application W/Affiliation Additions & Deletions FORM 213 & 213-B
Title Guaranty Agency/Business Application W/Affiliation Additions & Deletions FORM 230 & 230-B
TPA Business Entity Application Instructions Application Form 216 
Add/Cancel Form
TPA Annual Report ANNUAL REPORT

 

Individual Applications

 

Form Name Form Number
AGENTS
Agent Application Instructions  
Agent Application Uniform Application for Individual Producer License/Registration
Agent Appointment FORM 204
Agent Appointment Cancellation FORM 206-A
BAIL
All Bail Bondsmen and Solicitors are required to file fingerprint impressions
Bail Bonding Property Individual Application W/Appointment FORM 224-A&B&C
Limited Surety License Application FORM 241A
Agent Appointment FORM 204
Limited Surety Solicitor Appointment FORM 241-B
Tax Packet Financial Audit

Premium Tax Instructions
Quarterly Form 306 
Casualty Final Form 301
BROKER
Application Instructions  
Broker Application Uniform Application for Individual Producer License/Registration
FRATERNAL
Fraternal Individual Application w/Appointment FORM 227
ADJUSTER - INDEPENDENT
Independent Adjuster Application Instructions <- IMPORTANT, Please read this first.
Independent Adjuster Affiliation Form
Independent Adjuster Application
Adjuster Surety Bond
ADJUSTER - STAFF
Staff Adjuster Application Instructions <- IMPORTANT, Please read this first.
Staff Adjuster Application
Staff Adjuster Appointment Form
ADDRESS CHANGE
Individual Address Change Etc. FORM 210-C
   
INSURANCE CONSULTANT
Insurance Consultant Application FORM 250
   
LIMITED LICENSE
Limited Individual Application W/Appointment FORM 225 & 225-A
   

MOTOR CLUB REPRESENTATIVE

Motor Club Representative Application FORM 223
   
SOLICITOR
Solicitor Appointment FORM 214B
Solicitor Application FORM 214
Solicitor Appointment Cancellation FORM 206-S
SURPLUS LINE BROKER
Surplus Line Broker Application Instructions  
Surplus Lines Broker Application Uniform Application for Individual Producer License/Registration
Surplus Line Broker Tax Filings  
   
TEMPORARY LICENSE
Temporary License Application FORM 232
TITLE AGENT OR SOLICITOR
Title Guaranty Individual Application W/Appointment FORM 230 & 231-A
THIRD PARTY ADMINISTRATOR
TPA Individual Application FORM 217
VIATICAL SETTLEMENT BROKER
Viatical Settlements Broker Application FORM 222

 

Miscellaneous Forms


Form Name Form Number
List Request FORM 220
Letter Of Certification FORM 200
Letter Of Clearance FORM 201
Application for written consent to engage in the business of Insurance FORM 1033



 
Home - Corporations - Consumer Relations - Utilities - Chief of Staff - Insurance - Transportation - Admin Services - State Fire Marshal - Contact Us