Department of Labor and Regulation

<Title - Division of Insurance email the Division of Insurance

Producer Applications, Forms, Reports and Related Fees

The forms and reports listed below are provided in Adobe .pdf format* unless otherwise noted.

Application - Form - Report
Bail Bonds Application $30.00
$24 for Department criminal investigations
Business Entity Application  
Appointment Form  
Certificate of Authority*  
Certificate of Authority for Foreign Limited Liability Companies*  
Corporation Name Change $10.00
Managing General Agents - Resident $25.00
Managing General Agents - Non Resident $30.00
NAIC Uniform Application
Portable Electronic License Application $25 resident
$30 non-resident
Rental Car Resident Producer License $25.00
Rental Car Non-Resident Producer License $30.00
Rental Car Quarterly Report of Employees NA 
Rental Car Agency Annual Certification NA
Insurer Certification for Rental Car AgentĀ  NA
Termination of Company Appointment NA
Third Party Administrator $500.00
*South Dakota Secretary of State forms

Please contact us with any questions regarding certificates of insurance.

Contact Us

Division of Insurance
SD Department of Labor and Regulation
124 S. Euclid Ave., 2nd Floor
Pierre, SD 57501
Phone: 605.773.3563
Fax: 605.773.5369

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Division of Insurance
124 S. Euclid Ave., 2nd Floor
Pierre, SD 57501
Tel. 605.773.3563
Fax. 605.773.5369