Uniform application for business entity insurance license (348 KB). Completed on behalf of the company or by every producer that is financing premiums or signing contracts/agreements.

IMPORTANT: There are additional instructions for completing the uniform application in Washington state. See additional form instructions.

Each authorized individual will need to complete a Uniform application for individual insurance producer license (295 KB).

IMPORTANT: There are additional instructions for completing the uniform application in Washington state. See additional form instructions.

If the authorized individual is not already licensed, they also need to submit a fingerprint card and fingerprint fee.
For corporations or LLCs, send a copy of your articles of incorporation or formation.
For firms, file your trade name with the Department of Licensing, 360-664-1400. A firm includes a partnership or sole proprietorship.

Make checks payable to: Washington Insurance Commissioner. You may combine all fees on one check.

Form Instructions:
Uniform applications for individual or business entity insurance license

For Individual application

For Business Entity applications

At the top of the, "Jurisdiction and type of License Requested" page there is a key for abbreviations in the grid.
Just below these abbreviations, there are categories for License Type, Major Lines of Authority and Limited Lines of Authority.

Find the WA grid line in the, "Jurisdiction" column.
In the, "Limited Lines of Authority" section, on the WA grid line, please write, "Premium Finance" in the, "Other" column.

There are two, "Jurisdiction and Type of License Requested" pages. One is for Major Lines of Authority. The other is for Limited Lines of Authority. At the top of each, there is a key for abbreviations in the grid.
Just below the abbreviations, there are categories for Legal Business Type, License/Registration Type and Lines of Authority.
On the Limited Lines of Authority page

Find the WA grid line in the, "Jurisdiction" column.
In the, "Limited Lines of Authority" section, on the WA grid line, please write, "Premium Finance" in the, "Other" column.

Questions?

Phone: 360-725-7144
Email: Licinfo@oic.wa.gov

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