PUBLIC PROTECTION
CABINET
PPC Agencies
PPC Services
Open Records
Leadership
Internships
PPC News
Contribute to the Team Eastern Kentucky Flood Relief Fund at
TeamEKYFloodReliefFund.ky.gov
DEPARTMENT OF INSURANCE
Consumers
Licensees
Insurers
eServices
Resources
Contact the Department of Insurance
Agent Licensing Forms and Documents
Important Announcements
Eastern Kentucky Flooding - CAT # 2249 - *UPDATED*
- 202K
Unlicensed Adjuster Information for Insurers - Wind and Thunderstorm Event - May 17-19 2022 CAT 2236
- 69K
CE Extension Announcement 2022
- 139K
Unlicensed Adjuster Information for Insurers - Tornado - December 10, 2021 - Catastrophe Serial No. 2176
- 68K
Pharmacy Benefit Manager: Frequently Asked Questions
- 954K
Agent Licensing Frequently Asked Questions
- 684K
Surplus Lines Broker Marketing Practices
- 14K
Examination Schedule & Testing Sites
- 122K
Online Licensing Services
NIPR Non-Resident Licensing Application/Registration
[
]
NIPR Resident Licensing Application/Registration
[
]
NIPR Resident License Renewal Application/Registration
[
]
NIPR Non-Resident Licensing Renewal Application/Registration
[
]
Adjuster/Apprentice Licensing
Adjuster Designation of Home State Form
- 212K
Public Adjuster HB 232
- 84K
Examination Study Outline - Adjuster
- 462K
Examination Study Outline - Crop Adjuster
- 215K
Examination Study Outline - Workers' Comp Adjuster
- 213K
Fee Schedule
- 452K
Form 8303 - Change of Address/Name (Form Only)
- 367K
Form 8304 - Exam Retake Form
- 224K
Form VS - Voluntary Surrender of License
- 114K
Insurer Address Change - Form 14 (NAIC)
[
]
DOI Sponsoring Adjuster Form
- 106K
Form 8307-Request for Unlicensed Adjuster Representing and Insurer to Adjust Losses resulting from a Catastrophe
- 42K
Public Adjuster Contract Checklist
- 147K
Public Adjuster Intent to Contract letter
- 90K
Public Adjuster 806 KAR 9 400
- 74K
Form 8301-BGC - Background Check ONLINE
[
]
Examination Schedule & Testing Sites
- 122K
Individual Licensing
Agent - Individual - Resident - Electronic
[
]
Form 8301- Individual Application 2021
- 279K
NAIC Uniform Individual Non-Resident Application
[
]
Prohibited Names for Business Entity or Individual
- 61K
Form - Self-Service Storage Space Insurance Locations
- 201K
Form for Travel Locations
- 200K
Form 8301-BGC - Background Check ONLINE
[
]
Form 8301-BE Application 2021
- 261K
Form 8302- Appointment 2021
- 241K
Form 8302- Termination 2021
- 222K
Form 8303- Record Correction 2021
- 367K
Agent Licensing Frequently Asked Questions
- 684K
Business Entity Licensing
Form 8305 - Business Entity Designation or Termination of Designation Form
- 23K
NAIC Uniform Business Entity Non-Resident Application
[
]
Prohibited Names for Business Entity or Individual
- 61K
Form - Self-Service Storage Space Insurance Locations
- 201K
Form for Travel Locations
- 200K
Form 8301 – TPA Administrator Applicant Certification And Attestation
- 117K
Form 8302- Appointment
- 241K
Form 8301- Business Entity Application 2021
- 261K
Pharmacy Benefit Manager Review Guide
- 319K
Pharmacy Benefit Manager Annual Report
PBM License Application 2021
- 329K
Form 8302-TE Termination Form
- 354K
Pharmacy Benefit Manager FAQ
- 264K
Education Provider Information
Affidavit Restrictions and Withdrawal Information
- 314K
Affidavit for Active Military Duty - Form MLW-01
- 41K
Form 304 - Affidavit For Exemption From Continuing Education
- 114K
Form CE/PL 100 - CE or Pre-Licensing Course Approval Request
- 130K
Prometric Provider Information Packet for Continuing Education and Pre-Licensing Education
- 840K
Form KYP-01 - CE or Pre-Licensing Provider Approval Request
- 131K
NAIC Uniform CE Course Approval Application
- 167K
Long-Term Care Partnership Frequently Asked Questions
- 188K
KY Commission on Proprietary Education – New Providers
[
]
Form CE/PL 200 - CE or Pre-Licensing Instructor Approval Request
- 30K
Laws, Administrative Regulations and Bulletins
Advisory Opinion 2004-07 Acting as Agent; Termination of Appointment (clarification of 2001-08)
- 191K
Laws and Regulations
Bulletin 2001-8 -Acting as Agent Exception to Appointment Termination of Appointment
- 241K
Licensing and General Information
Form 8304 - Exam Retake Form
- 224K
CE Extension Announcement 2022
- 139K
Prohibited Names for Business Entity or Individual
- 61K
Form 8301-RV - Rental Vehicle License Supplemental Application
- 85K
Affidavit for Active Military Duty - Form MLW-01
- 41K
Form 8301-TPA - Administrator Applicant Certification and Attestation
- 28K
Certification/Clearance Request Form
- 52K
Application for Written Consent to Engage in the Business of Insurance Pursuant to 18 U.S.C. 1033
- 129K
Adjuster Designation of Home State Form
- 143K
Form for Travel Locations
- 200K
Insurer Address Change - Form 14 (NAIC)
[
]
Form FI-03
- 60K
FI-02 Free Choice of Agent 2020
- 91K
Fee Schedule
- 452K
Agent Licensing Frequently Asked Questions
- 684K
Form 8303 - Change of Address/Name (Form Only)
- 367K
Form VS - Voluntary Surrender of License
- 114K
Loss of License
Loss of License - Military Active Duty
- 41K
Pre-Licensing and Examination Information
Examination Study Outline - Life & Health Consultant
- 185K
Examination Schedule & Testing Sites
- 122K
Examination Study Outline - Crop Adjuster
- 9M
Examination Study Outline - Crop Agent
- 122K
Agent Licensing Frequently Asked Questions
- 684K
Examination Study Outline - Adjuster
- 462K
Examination Study Outline - Casualty
- 130K
Examination Study Outline - Health
- 43K
Examination Study Outline - Life
- 38K
Examination Study Outline - Life Settlement (individuals not licensed as Life Agents)
- 19K
Examination Study Outline - Personal Lines
- 106K
Examination Study Outline - Property
- 108K
Examination Study Outline - Travel
- 84K
Examination Study Outline - Workers' Comp Adjuster
- 83K
Form 8304- Exam Retake
- 283K
Examination Study Outline - Property & Casualty Consultant
- 225K
VISIT OTHER PPC AGENCIES