Fillable Online NAIC Uniform Application for - Department 2026

1. Click ‘Get Form’ to open the Fillable Online NAIC Uniform Application in the editor.
2. Begin by checking the appropriate box for your license type: Resident or Non-Resident, and indicate if it’s a new application or reinstatement.
3. Fill in your demographic information, including your Social Security Number, National Producer Number (if applicable), and personal details such as name, date of birth, and address.
4. Complete the Employment History section by detailing your work experience over the past five years, ensuring to include all relevant positions held.
5. Carefully answer all background questions regarding any convictions or administrative proceedings. Attach necessary documentation if you answer 'Yes' to any questions.
6. Review the Applicant’s Certification and Attestation section. Ensure that you understand and agree to the terms before signing electronically.

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