1033 and 1034-2026

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The document is an application form from the California Department of Insurance for individuals seeking written consent to engage in the business of insurance, particularly those with felony convictions. It outlines the legal requirements under 18 U.S.C. § 1033, detailing the necessary information and documentation needed for the application process, including personal details, criminal history, and employment information. The applicant must provide truthful responses and may face legal consequences for false statements.

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Click ‘Get Form’ to open the 1033 and 1034 application in the editor.
Begin with Section I - Applicant Information. Fill in your full name, including any previous names, and provide your home and mailing addresses. Ensure all contact numbers are accurate.
Move to Section II - Criminal History. List any felonies you have been arrested for, including details such as dates and nature of offenses. Attach additional pages if necessary.
In Section III - Present/Proposed Insurance Employment, specify your current or proposed employer's name and address. Describe your position and responsibilities in detail.
Finally, complete Section IV - Attachments by ensuring you include all required documents like certified copies of your criminal history and court judgments. Review everything for completeness before submission.

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1033 and 1034-2026

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