Efr 19 2026

1. Click ‘Get Form’ to open the efr 19 in the editor.
2. Begin by completing the top section of the form. List each 'Insurer' company you are authorized to issue Maryland Insurance Certifications (Form FR-19). Ensure you include the date of request and your signature.
3. Select the appropriate action from the options provided: New Request, Account Change, Account Deletion, Add Insurer Association, or Remove Insurer Association.
4. Fill in your USERID and Producer License Number issued by MD Ins Admin. Provide your contact details including phone number and email address.
5. List the insurers for which you are authorized to issue certifications. Include their NAIC codes and names. If necessary, use an additional sheet for more than six insurers.
6. Acknowledge that remote access is a privilege by signing and dating the acknowledgment section. Ensure you understand your responsibilities regarding security software installation.
7. Finally, have your Insurance Company or Agency Officer sign and date their authorization before submitting it as instructed.

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