Download insurance licensing forms

Submit one complete and signed form per appointment. An incomplete form will be rejected and returned to appointer. To confirm that an appointment was approved please see our web site, www.ehawaii.gov/serv/hils. Effective March 1, 2005, the Hawaii Insurance Division will no longer mail confirmation letters. Old forms will not be accepted after April 1, 2005.
• Form APPT (6/19/2008)
  Notice of Appointment
• Form APPTMGA (6/19/2008)
  Notice of Appointment (Insurer to MGA only)
• Form BEPL (9/24/08)
  Uniform Application for Business Entity Producer License
• Form BKRPT-NR (09/2003)
  Bankruptcy Affidavit - Nonresident
• Form BKRPT-RES (09/2003)
  Bankruptcy Affidavit - Resident
• Form FRS (Revised 03/10/2008)
  Service Contract Provider's Financial Responsibility Statement
• Form HPL (7/15/2008)
  Hawaii Application for Individual Insurance Producer License (Resident/Non-Resident)
• Form HPLNAC (01/2005)
  Address / Name Change Notification
• FORM LSB/LSP (Revised 08/03/08)
  Life Settlement Broker or Provider Application.
• Form SCP (03/2008)
  Registration Form - Service Contract Provider
• Form T (01/2005)
  Notice of Termination of Appointment
• Form VPPW (03/2008)
  Vehicle Protection Product Warrantor