Form L - SSA - Arizona Department of Insurance - azinsurance 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin with Section I: Operator Information. Clearly indicate whether you are applying as a business entity or an individual. Fill in your full name, address, and contact details accurately.
3. Proceed to Section II: Additional Branch Locations. If applicable, list any additional locations where you will conduct business under your license, ensuring all addresses are complete.
4. In Section III: Additional Information, answer all questions truthfully. If you have any 'YES' responses, prepare the required documentation as specified.
5. Complete Section IV: Authorization and Release by signing the appropriate affidavit based on your application type (business entity or individual).
6. Review all sections for completeness and accuracy before submitting your application materials along with the required fee to the designated address.

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