| This page provides state-specific checklists, application forms and contacts for paper resident and non-resident licensing in the State of Louisiana. |
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| Requirements |
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Attach a check* or money order in the amount of $75 for each line applying. You may apply for more than 1 line of authority on one application.
* Checks payable to Louisiana Dept of Insurance |
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The individual signing on behalf of the corporation must hold a license in Louisiana for the same lines of authority the corporation is applying for and be listed on the first page as the designated/responsible producer.
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If applying for variable line of authority, CRD/U4 Status report for corporation or the broker/dealer the corporation is affiliated with must be provided. |
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Sign and date application certification page |
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Appointment Requirements After Licensing
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Appointment must be received within 30 working days of effective date of contractual agreement with company. |
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| Requirements |
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Attach a check* or money order in the amount of $75 for each line applying. You may apply for more than 1 line of authority on one application.
* Checks payable to Louisiana Dept of Insurance |
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Supply U4 status report if applying for a variable annuity license |
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Sign and date application certification page |
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| Back to Top |
|
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| Requirements |
|
Attach a check* or money order in the amount of $75 for each line applying. You may apply for more than 1 line of authority on one application.
* Checks payable to Louisiana Dept of Insurance |
|
The individual signing on behalf of the corporation must hold a license in Louisiana for the same lines of authority the corporation is applying for. |
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If applying for variable line of authority, CRD/U4 Status report for corporation must be provided |
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Sign application |
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| Back to Top |
|
 |
| Requirements |
|
Attach a check* or money order in the amount of $75 for each line applying. You may apply for more than 1 line of authority on one application.
* Checks payable to Louisiana Dept of Insurance |
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Supply U4 status report if applying for a variable annuity license |
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Sign application |
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| Back to Top |
DISCLAIMER
The National Insurance Producer Registry ("NIPR") populates the State Matrix of Business Rules ("State Matrix") with information provided directly from participating state insurance departments. Participating states are encouraged to provide updated information when appropriate. NIPR does not guarantee the completeness, accuracy or adequacy of the information in the State Matrix. The information in the State Matrix does not constitute legal advice and use of this information is at user's own risk and responsibility. Any questions regarding the interpretation of the rules or the accuracy of the information should be directed to the appropriate state insurance department.
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Uniform Application for Business Entities
[PDF] [Word] |
Uniform Application for Individuals
[PDF] [Word] |
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| Louisiana Web Site |
Mail Applications to:
Louisiana Department
of Insurance
P.O. Box 94214
Baton Rouge, LA 70804-9214 |
Non-Resident Contacts
Business and Individual
Agent Licensing Division
225-342-0860
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Resident Contacts
Business and Individual
Agent Licensing Division
225-342-0860
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