Alaska Division of Insurance

> Licensing Forms

As of January 2007, there are approximately 31,172 licenses issued. All forms must be viewed/printed with Adobe Acrobat Reader.

ANY APPLICANT
BIENNIAL LICENSES
Required Forms by License Class & Type
	Individual		Individual in a Firm		Firm
	Resident	Nonres.	Resident	Nonres.	Resident	Nonres.
Insurance Producer (Any or All Lines)	NAIC Uniform Application	NAIC Uniform Application	NAIC Uniform Application	NAIC Uniform Application	NAIC Uniform Business Entity Application	NAIC Uniform Business Entity Application
Independent Adjuster	08-240	08-240	08-240	08-240	08-241	08-241
Surplus Lines Broker	NAIC Uniform Application	NAIC Uniform Application	NAIC Uniform Application	NAIC Uniform Application	NAIC Uniform Business Entity Application	NAIC Uniform Business Entity Application
Exemption from Licensure Under AS 21.27.010(j)	08-311	08-311	08-311	08-311	08-311	08-311
Managing General Agent (Any or All Lines)	08-226	08-226	08-240	08-240	08-226	08-226
Managing General Agent Exemption Form	08-260	08-260			08-260	08-260
Reinsurance Intermediary Manager	08-237	08-237	08-240	08-240	08-237	08-237
Reinsurance Intermediary Broker	08-237	08-237	08-240	08-240	08-237	08-237
VIATICAL SETTLEMENT REPRESENTATIVE, BROKER AND PROVIDER INFORMATION
Viatical Settlement Representative or Broker	08-240	08-240	08-240	08-240	08-241	08-241
Viatical Settlement Provider	08-239	08-239			08-239	08-239
Bond Form for Viatical Settlement Provider	08-217	08-217			08-217	08-217
For Cause Termination	08-250
TRAINEE LICENSES
Required Forms by License Class & Type
	Individual		Individual in a Firm		Firm
	Resident	Nonres.	Resident	Nonres.	Resident	Nonresident
Trainee Independent Adjuster	N/A	N/A	08-240	N/A	N/A	N/A
LIMITED LICENSES
Required Forms by License Class & Type
	Individual		Individual in a Firm		Firm
	Resident	Nonres.	Resident	Nonres.	Resident	Nonres.
Bail Bond	NAIC Uniform Application	NAIC Uniform Application	NAIC Uniform Application	NAIC Uniform Business Entity Application	NAIC Uniform Business Entity Application
Credit	NAIC Uniform Application	NAIC Uniform Application	NAIC Uniform Application	NAIC Uniform Application	NAIC Uniform Business Entity Application	NAIC Uniform Business Entity Application
Travel	NAIC Uniform Application	NAIC Uniform Application	NAIC Uniform Application	NAIC Uniform Application	NAIC Uniform Business Entity Application	NAIC Uniform Business Entity Application
Title	Contact Division	N/A	08-240	N/A	08-219	N/A
Motor Vehicle Rental	NAIC Uniform Application	NAIC Uniform Application	08-213	08-213	NAIC Uniform Business Entity Application	NAIC Uniform Business Entity Application
REGISTRATIONS
Required Forms by License Class & Type
	Individual		Individual in a Firm		Firm
	Resident	Nonres.	Resident	Nonres.	Resident	Nonres.
Third Party Administrator	08-232	08-232	N/A	N/A	08-232	08-232
TPA Exemption Form					08-243	08-243
Unlicensed Nonresident Adjuster	N/A		N/A	08-227	N/A	N/A

FEES
Fee Schedule Form	08-214

OTHER
Continuing Education Reporting Form	This is a pdf.
Change Form	08-1245 may be used by all licensees to amend an existing class and type of license.
Business Transaction Form	08-270
Business Transaction Form for Adjusters	08-307


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