Fr19 2026

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4.3 out of 5

245 votes

The document is a Remote Access Request Form from the Maryland Motor Vehicle Administration (MVA) for authorized insurance agents to electronically report Maryland Insurance Certifications (Form FR-19). It outlines the process for requesting remote access, including necessary approvals, user information, and security acknowledgments. Additionally, it includes a security advisory detailing prohibited acts related to unauthorized access and use of computer resources.

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Click ‘Get Form’ to open the FR-19 in the editor.
Begin by filling out the top section with the date of request and listing each insurer company you are authorized to issue Maryland Insurance Certifications for. Ensure you sign and date this section.
Select the appropriate action from the options provided: New Request, Account Change, Account Deletion, Add Insurer Association, or Remove Insurer Association.
Enter your USERID assigned by MVA and your Producer License Number issued by MD Ins Admin.
Complete your personal information including your name, phone number, agency name, address, and email address.
List up to six insurers you are authorized to issue certifications for, including their NAIC codes. Use an additional sheet if necessary.
Acknowledge the terms regarding remote access by signing and dating at the bottom of the form.

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Versions	Form popularity	Fillable & printable
2014	4.8 Satisfied (160 Votes)
2013	4.3 Satisfied (245 Votes)
2004	4.3 Satisfied (78 Votes)

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