Agency Affiliations & Terminations
Assumed Business Name
Individual Producer DBA
Business Entity
License Renewal
License Surrender
Managing General Agent
- Instructions for Forms AID-LI-MGA 40-43 and 45
- Form AID-LI-MGA 40 – Managing General Agent Insurance License Application (Corporation, LLC, LLP, and Partnership)
- Form AID-LI-MGA 41 – Company Appointment of Managing General Agent
- Form AID-LI-MGA 42 – Termination of Company Appointment of Managing General Agent
- Form AID-LI-MGA 43 – Managing General Agent Bond
- Form AID-LI-MGA 45 – Managing General Agent’s Contract
Motor Club
Name Change
Producer
Includes Adjuster, Consultant and Surplus Lines
- PSI Testing & License Handbook
- Arkansas Adjuster Affidavit Form
- Criminal Background Check (INA)
- Change from Non-Resident to Resident (Moving to Arkansas) Form
- Emergency Temporary License Instructions
Provider Information
Regulatory Health Link
Includes IPA Guide, Navigator, Certified Application Counselor and Exchange Producer.
Additional information is available from the Regulatory Health Division.
Reinsurance Intermediary
- Checklist of Necessary Information for Reinsurance Intermediary Broker
- Checklist of Necessary Information for Reinsurance Intermediary Manager
Rental Car
Surplus Lines Business Entity
- AID-LI-SLBB Surplus Lines Insurance Broker/Producer Bond Form
- Filing forms and instructions via OPTIns
Self Funded
Third Party Administrator
- Third Party Administrator Application for Registration Instructions & Form
- AID-LI-TPA – Third Party Administrator Bond Form
Title Agency
- License Fee $250
- Late Fee $100
- Total if late $350
Title Insurance
Title Insurance Agents
Title Insurance Agencies
- Instructions for New Title Insurance Agency License
- AID-LI-ARF-AGY-R – Arkansas Agency Replacement Renewal Form for Title Agencies
- Instruction for Title Agency Title Agent Affiliation & Termination
- AID-LI-AGY-ADD-TI – Producer Addition to Title Agency Form
- AID-LI-AGY-TERM-TI – Title Agency Producer Termination of Affiliation Form