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Marcia Hultman

Cabinet Secretary

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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 • Information Fee

Producer Licensing (Individual and Business Entity)

Electronic Application:

Sircon (Vertafore) or NIPR

$25.00 Resident; $30 Non-Resident

Bail Bonds Application $30.00 Application Fee (payable to the Division of Insurance) and
$43.25 Background Check (payable to Division of Criminal Investigations)
Bail Bond Runner Application $30.00 Application Fee (payable to the Division of Insurance) and
$43.25 Background Check (payable to Division of Criminal Investigations)
Bail Bond Runner Appointment Form $10.00 per appointment
Appointment Form  
Business Entity Renewal Sircon (Vertafore) or NIPR
Certificate of Authority*  
Certificate of Authority for Foreign Limited Liability Companies*  
Corporation Name Change $10.00

Managing General Agents (Application Information)

Access Electronic Application: Sircon (Vertafore)

$25.00 Resident
$30 Non-Resident

 

NAIC Uniform Business Entity Application  
NAIC Uniform License Application  

Portable Electronic License Application (Paper App.lication)

Access Electronic Application: Sircon (Vertafore)

$25.00 Resident
$30 Non-Resident

 

Rental Car Producer License - Resident or Non-Resident (Paper Application)

Access Electronic Application: Sircon (Vertafore)

$25.00 Resident
$30 Non-Resident

 

Rental Car Quarterly Report of Employees N/A
Rental Car Agency Annual Certification N/A
Insurer Certification for Rental Car Agent N/A
Termination of Company Appointment N/A

Third Party Adminstrator

Access Electronic Application: Sircon (Vertafore)

$500.00

* South Dakota Secretary of State forms

Please contact the Division with any questions regarding certificates of insurance.

Contact the Division of Insurance