TDI Forms

• Application Forms | Continuing Education Forms | Information Update Forms
  
  
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Web Enabled Agent/Adjuster Application Forms

TDI Form Number	Description	File Format
	Electronic Non-resident Application - fill in and send on-line. (Links to NIPR, at the Texas instruction page for the electronic application. That page is linked to a Use Agreement page. The "Agree" button links to the actual application.)	Web Enabled
	Licensing Application to Renew License Renew License Online	Web Enabled

Agent/Adjuster Application Forms

TDI Form Number	Description	File Format
LHL202	Licensing Corporate Insurance Agents Bond (AKA Insurance Agency Bond) Method of showing proof of financial responsibility to obtain corporate license.	PDF
LHL206	Licensing - Individual Application for Insurance License Used by individuals not required to qualify by examination. Previously, form number LI011.	PDF
LHL236	Request for Letter(s) of Certification Agents, Adjusters, & Entities	PDF
LHL249	Licensing Application for Insurance Agency License Used by corporations, partnerships, depository institions and other business entity eligible for an insurance agency license under the provisions of the Texas Insurance Code.	PDF
LHL250	Annual Nonresident Public Insurance Adjuster Affidavit Fill-in On Screen and Print	PDF
LHL256	Licensing Public Insurance Adjuster Bond Certifies that the persons listed on the form are bound to the Texas Department of Insurance in the sum of $10,000 as specified at 28 Texas Administrative Code §19.705.	PDF
li004	Speciality Insurance License Application	PDF
TDIFastForm	Fingerprint Applicant Services of Texas (FAST) form	PDF

 

Continuing Education Forms

TDI Form Number	Description	File Format
LHL212	Application for Provider Registration Application to become a CE provider.	PDF
LHL213	Application for Course Certification Application for certification of CE course.	PDF
LHL216	CE Exemption or Extension Application for licensee CE Exemption or Extension.	PDF
LHL240	Course Assignment Form Allows an existing provider to assign the right to give its course to another existing provider. Both must have active provider registrations.	PDF
LHL257	CE Automatic Fines Transmittal Continuing Education Fines	PDF
LHL367	Provider Renewal and Information Change Form Application for Provider Renewal or Change of Contact Information.	PDF
LHL386	Provider Audit Affidavit Used only by continuing education providers	PDF

Additional Continuing Education Forms

TDI Form Number	Description	File Format
	CE Example Course Evaluation	PDF

 

Information Update Forms

TDI Form Number	Description	File Format
LHL203	Registration of Assumed Name/Branch Locations/Entity Name Change Commonly known as form LDTL	PDF
LHL208	ISR Transfer/Cancel Employment Form	PDF
LHL238	Biographical Form Entity/Change of Control	PDF
LHL388	Branch Office Address Change Request	PDF
LHL389	Licensee Name/Address Change Request Form	PDF

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For more information contact: License@tdi.state.tx.us