Applicant's name, Tax ID, license number, and state of residence must match current Producer Database (PDB) record for resident state.
Applicant must provide a valid country code and business email.
Applicant may not apply for a license in their own resident state.
Applicant must not have business address in the state of New Hampshire.
At least one (1) Designated Responsible Licensed Producer (DRLP) must have an active resident or non-resident license in New Hampshire.
The DRLPs provided on the producer and surplus lines application must cumulatively cover the lines of authority (LOAs) on the application.
Applicants with a status reason of revoked or suspended will not be allowed to apply electronically.
If applicant responds "yes" to one of the background questions please submit supporting documents electronically via NIPR's Attachments Warehouse. The documents may also be submitted to the state via mail, email, or fax. Documentation must be submitted thirty (30) days after submitting application or the application will be declined.
- A written statement explaining the circumstances.
- A copy of the official document which demonstrates the resolution of the charges or any final judgment
Please include name, tax ID, and NIPR Transaction Number on correspondence.