| This page provides state-specific checklists, application forms and contacts for paper resident and non-resident licensing in the State of Michigan. |
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| Organizational Documents |
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Include Articles of Incorporation, Articles of Organization, or Partnership Agreement if the business is not licensed in the home state |
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| Appointment Requirements |
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The appointment must be submitted by the company electronically through NIPR within 15 days from the date the agency contract is executed or the first insurance application is submitted. |
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Other Requirements
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Attach a business check or money order for $10 ($110 for Surplus Lines or $110 if applying for producer and Surplus lines on one application) made payable to State of Michigan |
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Include FIS 0223 Fee Processing Card ( www.michigan.gov/ofis Path: Forms - Insurance Forms) |
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Michigan checks the PDB for home state verification of license status, making a certification unnecessary. |
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List the licensed agents, officers, directors and shareholders of 10% or more on page one of the application. There must be at least one licensed responsible producer holding the same license, lines of authority, and appointments as the business entity. |
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Title applicants-Indicate "Title" on page 3, in "Other" column.
Limited life applicants-Indicate “Limited Life” on page 3, in “Other” column. |
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| Appointment Requirements |
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The appointment must be submitted by the company electronically through NIPR within 15 days from the date the agency contract is executed or the first insurance application is submitted. |
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| Other Requirements |
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Attach a business check or money order for $10($110 for Surplus Lines or $110 if applying for producer and Surplus lines on one application) made payable to State of Michigan |
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Include FIS 0223 Fee Processing Card ( www.michigan.gov/ofis Path: Forms - Insurance) |
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Michigan checks the PDB for home state verification of license status, making a certification unnecessary. |
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Sign application |
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Title applicants pleae indicate "Title" on page 2, in "Other" column.
Limited life applicants-Indicate “Limited Life” on page 2, in “Other” column. |
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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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| Michigan does not accept the Uniform Licensing Application for resident business entities and individuals. |
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| Michigan Web Site |
Mail Applications to:
Prometric
1701 S Waverly Rd, Ste 104
Lansing MI 48917-4300 |
Non-Resident Contacts
Business and Individual
Licensing
877-999-6442
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