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Naic form 11 2026

The document is a Biographical Affidavit required for applicants seeking licensure or permits in the insurance industry. It collects personal and professional information about the affiant, including citizenship, occupation, education, employment history, licenses held, and any legal or regulatory issues. The affidavit emphasizes confidentiality and includes sections for background checks and disclosures regarding previous names and residences. It also contains authorization for the company to obtain background reports as part of the application process.

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Click ‘Get Form’ to open NAIC Form 11 in our editor.
Begin by entering the Applicant Company Name and NAIC No. at the top of the form. Ensure that you provide accurate information as this is crucial for identification.
Proceed to fill out the Biographical Affidavit section. Enter your full name, address, and telephone number. Remember to print or type your responses clearly.
Answer the citizenship questions carefully. Indicate whether you are a U.S. citizen and provide details if you hold citizenship in another country.
Complete the sections regarding your occupation, business address, and contact information. This helps establish your professional background.
List your educational qualifications, including colleges attended and degrees obtained. If applicable, include foreign education details.
Fill in your employment history for the past twenty years, ensuring to list positions chronologically with relevant details about each role.
Review all sections for accuracy before signing and dating the document at the end of the form.

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What does NAIC mean on insurance?

The National Association of Insurance Commissioners (NAIC) provides expertise, data, and analysis for insurance commissioners to effectively regulate the industry and protect consumers.

What does NAIC mean for insurance?

The National Association of Insurance Commissioners (NAIC) is the U.S. standard-setting and regulatory support organization created and governed by the chief insurance regulators from the 50 states, the District of Columbia, and five U.S. territories.

Is NAIC the same as payer ID?

Sometimes NAIC codes are referred to as Payer IDs but their formal term is NAIC numbers.

What is a biographical affidavit?

The NAIC Biographical Affidavit is used to evaluate the suitability, competency, character and integrity of the Affiant in connection with an Applicant Companys pending or future application(s) for licensure or a permit to organize with a department of insurance in one or more states.

Is NAIC the claim number?

The NAIC number identifies your insurer and the policy you have. If you file an insurance claim, you must provide the NAIC number. Without it, the claim is incomplete. The NAIC number is a common requirement at the Department of Motor Vehicles (DMV) to register a vehicle or to complete other paperwork.