Insurance Adjuster

Public Adjuster (Resident and Non-Resident) Application Forms

Application Type # of pages

Public Adjuster - Individual - Original/Relicensing Application Form and Instructions (PDF)

17 Pages

Public Adjuster - Entity Public - Original/Relicensing Application and Instructions (PDF)

18 Pages

Public Adjuster - Supplemental Statement to add a Sub-Licensee to a Partnership/Corporation/Limited Liability Company License (PDF)

11 Pages

Public Adjuster - Statement of Employer Form (PDF)

2 Pages

Independent Adjuster (Resident and Non-Resident) Applications and Forms

Application Type # of pages

Independent Adjuster - Original/Relicensing Application Form and Instructions (PDF)

15 Pages

Partnership/Corporate/Limited Liability Company Independent Adjuster - Original/Relicensing Application and Instructions (PDF)

16 Pages

Supplemental Statement to add a Sub-Licensee to a Partnership/Corporation/Limited Liability Company Independent Adjuster License (PDF)

12 Pages

Temporary Independent Adjuster's Permit (for Catastrophes)

Temporary Independent Adjuster Permit requests are for authorized insurers only.

A designated person of an authorized insurer must establish an account with this Department. To establish the required account, the information below must be provided by email to: [email protected].

Name and date of birth of each officer(s) or managing agent(s) authorized to request the temporary permit on behalf of the insurer(s) along with a 4 digit pin of your choice. The insurer name(s) and NAIC number(s) for all insurers for which the officer/managing agent is authorized to submit temporary adjuster permit requests must also be included.

As soon as you have been sent the login ID information, visit the DFS Portal to process the Temporary Adjuster Permit request. instructions are available within the application: