National Insurance Producer Registry

This page provides state-specific checklists, application forms and contacts for paper resident and non-resident licensing in the State of Maine.

* Question #25: The responsible individual must hold a Maine license. Please name only one responsible individual.

* Question #26: Maine law requires a list of all affiliated producers, state of domicile, and Maine license # (or SSN) be provided, in addition to a list of owners, partners, officers and directors.

* Question #27: If license type is to be other than a Producer Business Entity, please be sure to specify whether the entity is an adjusting firm or a consulting firm.

Other Requirements

Checks should be made payable to Treasurer, State of Maine. Please see fee schedule for appropriate fees.

Sign application - Application must be signed by the Responsible Individual

A business entity establishing more than one place of business must register each branch location by submiting a branch registration form. The form is located on the Bureau's website at MaineInsurancereg.org, under Producer/Business Entity Information, Licensing and Registration/Forms & Information, Agencies.

Other Requirements

Checks should be made payable to Treasurer, State of Maine. Please refer to the fee schedule.

If an individual works for a business entity, the business entity will also need to apply for a license in Maine. This can be done separately or simultaneously.

Submit NASD U-4 status report or CRD printout if applying for variable contracts authority

Please be sure that a business entity name is included in any business address submitted

Licensee must also hold or apply for a producer license in order to apply for independent producer (broker) authority.

Sign application

* Question #25: The responsible individual must hold a Maine license. Please name only one responsible individual.

* Question #27: If license type is to be other than a Producer Business Entity, please be sure to specify whether the entity is an adjusting firm or a consulting firm.

Other Requirements

A business entity establishing more than one place of business must register each branch location by submitting Maine's branch registration form. The form is located on the Bureau's website at MaineInsuranceReg.org, under Producer/Business Entity Information, Licensing and Registration/Form & Information, Agencies.

Checks should be made payable to Treasurer, State of Maine. Please refer to the fee schedule.

Sign application - Application must be signed by the Responsible Individual

Other Requirements

Available limited lines in Maine are Credit, Auto Rental Supplemental Liability, Mechanical Breakdown, Title, and Travel & Baggage.

Checks should be made payable to Treasurer, State of Maine. Please refer to the fee schedule.

Submit NASD U-4 status report or CRD printout if applying for variable contracts authority

Licensee must also hold or apply for a producer license in order to apply for independent producer (broker) authority.

Sign application

If an individual works for a business entity, the business entity will also need to apply for a license in Maine. This can be done separately or simultaneously.

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.

Uniform Application for Business Entities
[PDF] [Word]

Uniform Application for Individuals
[PDF] [Word]