Form 210c 2026

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4.8 out of 5

46 votes

The document is a request form from the New Mexico Public Regulation Commission's Insurance Division for agents to change their address, obtain a duplicate license, or change their name. It outlines the fees associated with each request, the necessary documentation required, and provides contact information for the agency.

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Click ‘Get Form’ to open it in the editor.
Select the appropriate checkbox for your request: Address Change, Duplicate License, or Name Change. Ensure you understand any fees associated with your choice.
Fill in your Social Security Number and the name as it appears on your license in the designated fields.
If applicable, provide the new name you wish to change to and attach any required legal documents for a name change.
Enter your residence mailing address where the license will be sent, including city, state, and zip code.
Complete the business address section if relevant, along with your email address and telephone number.
Sign and date the form at the bottom before submitting it through our platform.

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Versions	Form popularity	Fillable & printable
2004	4.8 Satisfied (46 Votes)

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