Licensing Services Division
Request for Licensing Information
Please complete the following information. Although not all items are required, the more information you provide us, the better we can answer your question.
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First Name:
(Value Required)
Middle Initial:
Last Name:
(Value Required)
Email Address:
(Value Required)
(This is where we will email our response)
Telephone Number:
(Value Required)
(###-###-####)
Alternate Telephone Number:
(###-###-####)
Licensee Name:
(First, Middle Initial, Last)
Subject of Inquiry:
To ensure that your request for information is being referred to the appropriate staff for processing, please select a topic from the drop down menu below that most closely relates to the subject of your inquiry.
Adjuster/Bail inquiries:
Select "Adjuster" or "Bail" from the drop down box for ANY information pertaining to that license type, including licensing information, status of pending applications or renewals, and any training or educational requirements.
Business Entity (Agencies)
: Select "Business Entity" from the drop down box for ANY information regarding the licensing of corporations, partnerships, or limited liability Companies, including information on the status of pending applications. Also select this topic if you are inquiring about information pertaining to the use of a fictitious name or DBA.
Request for Licensing Information pt2
Subject of Inquiry:
(Value Required)
- Please Select -
Add Endorsee
Address change
Adjuster (public/independent)
Application status (individual)
Bail and Bail Fugitive Recovery Agent questions
Business Entity Applications and DBA requests
Education (prelicensing/continuing education)
Examination scheduling
Fingerprint processing
Name change (individual)
Non-Resident to Resident
Remove/Terminate Endorsement
Renewals
Resident to Non-Resident
Variable authority
License/
Application Number:
FEIN or Last Four of SSN:
Comments/Questions
/Complaints (please
be specific)
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