Forms for Insurance Licensing
| Title | Description |
|---|---|
| Form AC (03/24/2017) | Notice of Address Change for Hawaii Insurance Division licensees and registrants only |
| Form ADR (08/23/2013) | Adding a Designated Representative from the Business Entity’s License |
| Form APPT (8/20/2013) | Notice of New Appointment |
| Form APPTMGA (8/23/2011) | Notice of New MGA Appointment |
| Form ARC | Adding / Removing Classes of Insurance from a Hawaii Insurance License |
| Form BEPL (06/2015) | Hawaii Application for Business Entity Insurance License / Registration |
| Form CN & FBI PAS (07/2016) | State and National Criminal History Record Check Consent & Notification |
| Form DLC (9/16/2009) | Request for Duplicate License |
| Form FRS (Revised 01/12/2016) | Service Contract Provider’s Financial Responsibility Statement |
| Form HPL (07/2016) | Hawaii Application for Individual Insurance License |
| Form LC (06/02/2009) | Request for Letter of Certification / Letter of Clearance |
| Form LSB LSP | Hawaii Application for Individual or Legal Entity – Life Settlement Broker or Provider Insurance License |
| Form NTA (01/26/2017) | Notice of Name Change – Adding/Removing Trade Name – Adding Assumed Name |
| Form PBM (06/26/2017) | Pharmacy Benefit manager Application / Renewal |
| Form RDR (08/23/2013) | Removing a Designated Representative from the Business Entity’s License |
| Form SCP (03/2008) | Service Contract Provider Registration Form |
| Form T (9/10/2009) | Notice of Termination of Appointment |
| Form VPPW (03/2008) | Vehicle Protection Product Warrantor Registration Form |
| Form VS (05/29/2009) | Voluntary Surrender of License |