Independent Adjuster (Resident and Non-Resident) Forms Download

The layout of this page has changed.
*** The Submission Requirements & Fees are available within the forms and instructions. ***
The application kits are available in PDF format. Please note that you will need the free Adobe Acrobat Reader to view or print PDF files. If you do not have the free Reader, you will need to download and install it.
The Adobe Acrobat Reader can be obtained by selecting the Adobe icon link below. Please read the software license agreement before downloading the program.

Application Type	# of pages
Independent Adjuster - Original/Relicensing Application Form and Instructions	14 Pages
Partnership/Corporate/Limited Liability Company Independent Adjuster - Original/Relicensing Application and Instructions	15 Pages
Supplemental Statement to add a Sub-Licensee to a Partnership/Corporation/Limited Liability Company Independent Adjuster License	11 Pages

Updated 05/02/2013