Application for Surrender of an Insurance Agent Licence Financial Services Commission of Ontario 5160 Yonge Street, Box 85 Toronto ON M2N 6L9 Approved by the Superintendent of Financial Services pursuant to the Insurance Act Instructions --2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your personal information, including your full legal name, agent licence number, and contact details such as telephone number and email address.
  3. Select the type of insurance agent licence you are surrendering (Life, A&S Only, General) and provide the expiry date.
  4. In the Declaration section, clearly state your reasons for surrendering the licence by selecting one or more applicable options.
  5. Complete any additional questions regarding investigations or outstanding fees as required.
  6. Review all entered information for accuracy before signing and dating the application at the bottom of the form.
  7. Once completed, save your document and send it via mail, fax, or email as instructed.

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No fee is required. You must provide your Georgia license number and designate the license type and lines to cancel. Complete the. License Cancellation Form - State of Georgia . Email to pvgainsurance@pearson.com for processing. You will receive an email with notification of the cancellation.
You must provide your Georgia license number and designate the license type and lines to cancel. License Cancellation Form - State of Georgia . Email to pvgainsurance@pearson.com for processing. You will receive an email with notification of the cancellation.
Be sponsored by a licensed insurer. Complete the OTL Agents Exam (or you have a CIP designation in good standing or passed the equivalent RIBO exam). Have an Ontario mailing address that can receive registered mail (e.g., no postal boxes). Have a personal email address that FSRA can use to contact you.
Be a suitable person to receive a licence and meet all the licensing requirements; Complete a course and pass the examination for the Life Licence Qualification Program (LLQP); Provide FSCO with an Ontario mailing address; and. Acquire the appropriate Errors and Omissions (EO)
Once you have passed the exam, you can apply to become a General Insurance agent, which are regulated by the Financial Services Commission of Ontario. You will need to provide supporting documentation and pay the $150 application fee. In addition, you must be sponsored by a licensed insurer.
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