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


Schedule a License Examination:

(PearsonVue)

 


$25.00 Resident; $30 Non-Resident

Annuity Best Interest Standards Forms  
Appointment Form  
Bail Bonds Application $30.00 Application Fee (Payable to the Division of Insurance) and
$43.25 Background Check (Payable to Division of Criminal Investigations. See additional background check requirements and instructions on online payment/electronic fingerprint submission option.)
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. See additional background check requirements and instructions on online payment/electronic fingerprint submission option.)
Bail Bond Runner Appointment Form $10.00 per appointment
Business Entity Renewal Sircon (Vertafore) or NIPR
Certificate of Authority*  
Certificate of Authority for Foreign Limited Liability Companies*  
Business Entity 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 Application)

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
Rental Car - Insurer Certification for Rental Car Agent N/A
Surplus Lines Information  
Termination of Company Appointment N/A

Third Party Administrator

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