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Counselor Forms

 


Form #GID-101B-AL This is in the Adobe Portable Document format (pdf)\nDivision: Agents LicensingPublished: 2015
Title: Individual License Renewal Application
This form is used for renewal by Georgia resident and non-resident agent licensees. If you are a non-citizen / alien of the USA, you must include the GID-276-EN Citizen Affidavit Form with this renewal. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us.
PID:1073-SID:2783-FN:GID-101B-AL.pdf

Form #GID-103-AL This is in the Adobe Portable Document format (pdf)\nDivision: Agents LicensingPublished: 2018
Title: Resident Insurance License Application
Effective 1-1-2012, the Citizenship Affidavit Form GID-276-EN must be submitted with this application for processing. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us.
PID:135-SID:24-FN:GID-103-AL.pdf

Form #GID-112-AL This is in the Adobe Portable Document format (pdf)\nDivision: Agents LicensingPublished: 2015
Title: Insurance Counselor Bond
This form requires a seal to be affixed to the document. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us.
PID:377-SID:534-FN:GID-112 Insurance Counselors Bond.pdf

Form #GID-276-EN This is in the Adobe Portable Document format (pdf)\nDivision: Agents LicensingPublished: 2015
Title: Citizenship Affidavit
Effective 1-1-2012, this form is required of persons making application for all licenses, permits, registrations and certifications in order to comply with the Georgia Illegal Immigration Reform And Enforcement Act. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal.
PID:788-SID:1643-FN:GID-276-EN.pdf

Form #GID-390-AL This is in the Adobe Portable Document format (pdf)\nDivision: Agents LicensingPublished: 2018
Title: Request for Name and Address Change
Request for Name and Address Change for Producer and Agency. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal.
PID:65-SID:23-FN:GID-390-AL Request For Name Address Change For Individual and Agency Lic.pdf

Form #GID-391-AL This is in the Adobe Portable Document format (pdf)\nDivision: Agents LicensingPublished: 2018
Title: Request for Clearance Letter (same as GID-AL-6)
Request for Clearance Letter. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us.
PID:374-SID:795-FN:GID-391-AL.pdf

Form #GID-433-AL This is in the Adobe Portable Document format (pdf)\nDivision: Agents LicensingPublished: 2018
Title: Uniform Application for Non-Resident Individual Producer License
Includes instructions, application form and Citizenship Affidavit. Effective 1-1-2012, the Citizenship Affidavit Form GID-276-EN must be submitted with this application for processing. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal.
PID:358-SID:796-FN:GID-433-AL.pdf

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