Adjuster Non-Resident Application with a Designated Home State (DHS)

If your residence state does not offer insurance adjuster licenses, and you already hold a non-resident adjuster license from a "designated home state," use the Adjuster Non-Resident Application with a Designated Home State (DHS) service to apply for one or multiple additional non-resident adjuster licenses.

The process involves the following steps:

Select Applicant's Designated Home State

Identify the state in which the applicant holds a "designated home state" non-resident license, so that the system can determine other non-resident adjuster license types for which the applicant may be eligible.

Required. From the Designated Home State dropdown menu, select the applicant's designated home state in which he or she holds a non-resident adjuster license. The page will update to show basic information data entry fields.

Enter Basic Information

Enter basic identifying information about the applicant and select the state(s) to which you wish to submit a non-resident adjuster license application.

Required. In the Last Name field, enter the applicant's last name.
Required. In the SSN field, enter the applicant's Social Security Number.
Required. In the DHS License Number field, enter the license number of the applicant's non-resident adjuster license in his or her designated home state.
Required. In the Preparer field, click the Authorized Submitter radio button if you are applying for this license on behalf of an applicant. Or, click the Applicant radio button if you are applying for this license on your own behalf.
Required. In the States section, click to checkmark the checkboxes corresponding to one or multiple non-resident states to which you want to submit a license application. Or, click the Check All button to checkmark the checkboxes corresponding to all states.
If desired, to check the types of licenses available in any state, click a [StateName] link. A separate page will open displaying all license types in the selected state that are available through the service.
When you are ready to proceed, click the Continue button. The system will check the applicant's licensure and other information on the national Producer Database (PDB).

Select Licenses

The page displays license types available in the selected non-resident state(s), grouped by state. Select the licenses in each state for which you want to apply.

In the License Information section, click to checkmark the License Type checkbox that corresponds to each type of license you want to apply for.
In the Previously licensed? field, click the Yes radio button if the applicant has been previously licensed in the state; click the No radio button if the applicant has never been licensed in the state.
From the Cost Center dropdown menu, select the accounting cost center to which you want to assign the fees for the license application.
If desired, click the Click here to view state requirements link to open a new browser window containing detailed information about applying to the state for the available license types.
Repeat the preceding steps for each state displaying in the License Information section.
Click the Continue button to proceed.

Select LOA

The Qualifications section displays the qualifications (license lines or LOA) available in the selected non-resident state(s) that are supported by the selected license type, grouped by state. Qualifications that are not reciprocal to the license lines on the applicant's designated home state license display but are non-selectable. Select the qualifications for which you want to apply.

Click to checkmark the Qualification Code checkbox that corresponds to each license line or LOA you want to apply for.
Repeat the preceding steps for each state displaying in the Qualifications section.
Click the Continue button to proceed.

Enter Applicant Information

The Individual Information section collects additional personal and professional information that the system needs in order to prepare the applicant's license application(s) for state processing. The system already may have collected some of this information from the national Producer Database (PDB), sparing some data entry, but you must enter data in all of the remaining required fields before you can continue the license application process.

Required. From the Gender dropdown menu, select either Male or Female.
Required. From the Citizen Country Code dropdown menu, select the nation or principality that the applicant is a legal citizen of.
May be required, if available. From the Affiliated With a Bank? dropdown menu, select Yes or No.
Required. In the Business Email Address field, enter the applicant's business email address.
Required. In the Applicant Email Address field, enter the applicant s personal email address. (It may be identical to the Business Email Address.)
If desired, in the Business Web Address field, enter the applicant's business's web address.
May be required if applying for a variable line of authority. In the FINRA CRD Identifier field, enter the applicant's Central Registration Depository (CRD) number.
In the Individual Alias Information section, if applicable, enter an unlimited number of the applicant's aliases or former business, personal, or alternate identities. Select the type of alias from the Type dropdown menu and enter alias information in the name fields.
Required. In the Individual Residence Address fields, enter the applicant's home address information.
Required. In the Individual Business Address fields, enter the applicant's business address information.
Required. In the Individual Mailing Address fields, enter the applicant's mailing address information.
Required. In the Residence Phone Number field, enter the applicant's home phone number.
Required. In the Business Phone Number field, enter the applicant's work phone number.
If desired, in the Business Fax Number field, enter the applicant's work fax number.
Click the Continue button to proceed.

Enter Employment History Information

In the Employment History section, enter the applicant's employment history or education background for the past five years.

Use the following guidelines:

Begin with the most recent position.
If the applicant still holds the most recent position, enter the current month and year in the Ending Date field for that position.
Include full- and part-time work, self-employment, military service, unemployment, and full-time education.
You are required to enter at least one employment history entry.
Employment or education history must go back at least five years before the current month and year.

Use the following steps:

Required. Enter the month and year the applicant started the position in the Beginning Date field. Use the mm-yyyy date format. (e.g., for March 2015, enter "03-2015").
Required. Enter the month and year the applicant vacated the position in the Ending Date field. Use the mm-yyyy date format (e.g., for March 2015, enter "03-2015"). If the applicant is still employed in this position, enter the current month and year in the Ending Date field.
Required. Enter the name of the applicant's employer in the Employer Name field. If submitting education background, enter the name of the college or university.
Required. Enter the city location of the applicant's employer in the City field. If submitting education background, enter the city location of the college or university.
Required. Select from the State dropdown menu the state location of the applicant's employer. If submitting education background, enter the state location of the college or university.
Required if value of Country field is Canada. Select from the Province dropdown menu the Canadian province location of the applicant's employer. If submitting education background, enter the Canadian province location of the college or university.
Required. Select from the Country dropdown menu the country location of the applicant's employer. If submitting education background, enter the country location of the college or university.
Required. In the Position Description field, enter the applicant's job title with the employer, or enter "Student" if the employment history entry reflects education history.
Repeat the preceding steps in succeeding employment history fields as necessary.
If desired, click the Add More Employment History Information button to enable fields to enter information about an additional position.

Enter Agency Affiliation Information

In the Affiliation Information section, you may enter information about the applicant's affiliation or association with an agency or brokerage. If you are unsure of the affiliation information, leave this section blank.

Required only if entering affiliation information. Enter the name of the agency in the Agency Name field.
Required only if entering affiliation information. Enter the agency's federal Employer Identification Number in the Agency EIN field.
Required only if entering affiliation information. Enter the agency's National Producer Number (NPN) in the National Producer Number field.
Repeat the preceding steps in succeeding agency affiliation fields, up to three, as necessary.

Enter Submitter Information

The Submitter Information section is required only if you selected the Authorized Submitter radio button in the Preparer field in the Basic Information section. Much of the information is obtained from information contained in the staff member's user account in AgencyEDGE. (For more information, see Edit My User Profile.) Enter all required fields.

Required. In the First Name field, enter the submitter's first name.
In the Middle Name field, enter the submitter's middle name.
Required. In the Last Name field, enter the submitter's last name.
In the Suffix field, enter the submitter's name suffix.
Required. In the Title field, enter the submitter's job position title.
Required. In the Firm Name field, enter the name of the submitter's company.
Required. In the Line One field, enter the first line of the submitter's company's address.
In the Line Two field, enter the second line of the submitter's company's address.
Required. In the City field, enter the city of the submitter's company's address.
Required. From the State dropdown menu, select the state of the submitter's company's address.
Required. In the Postal Code field, enter the postal or ZIP code of the submitter's company's address.
Required. In the Phone Number field, enter the submitter's telephone number, including area code.
In the Extension field, enter the submitter's telephone extension.
Required. In the Email Address field, enter the submitter's or your department's email address.
Click the Continue button to proceed.

View screen capture

Answer Background Questions

The Background Questions section contains uniform and/or state-specific questions pertaining to the applicant's personal and professional background and ethical conduct. You are required to answer all of the background questions.

Use the following guidelines:

It is in your best interest to answer all background questions honestly and to provide additional information to the state when necessary. In some cases, you will need to submit additional documentation to the state insurance department to support your answers. (Read each question carefully to determine if your answer will require you to send supporting documentation.)
If your response to any question requires you to submit supporting documentation, you may elect later in the license application process to upload electronic files to support or explain your answer (court papers, etc.) directly to your license application. The attached documentation will be submitted to the state department of insurance together with your license application for review by the insurance department. (You also may mail or fax your supporting documentation to the insurance department separate to your license application; however your application will remain in pending status until the state receives the supporting documentation.)

Use the following steps:

Click to select either the Yes or No radio button to respond to each question. Depending on your response to a background question, a free text field may become enabled, allowing you enter an explanation or other related information.
The NAIC/NIPR Attachments Warehouse question is available only depending on your answer to a uniform background questions requiring you to submit documentation in support of your license application to certain states. (For more information, see Upload Documentation to the NIPR Document Warehouse.)

If you need to submit additional documentation to support answers to background questions, you may either submit the documentation as an electronic attachment to your license application or mail or fax the documentation to the state department of insurance.

Click to select the Yes radio button if you intend to upload or have already uploaded supporting documentation to the NAIC/NIPR Attachments Warehouse, or click to select the No radio button if you will send supporting documentation separately.

If you answered Yes to the NAIC/NIPR Attachments Warehouse question, and you have already uploaded documentation to the NAIC/NIPR Attachments Warehouse, you can associate your license application to the existing supporting documentation rather than upload new documentation.

If you wish to link your license application to previously filed documents, click to select the Yes radio button, or click to select the No radio button if you will be uploading new supporting documentation.

When you are finished, click the Continue button to proceed.

Attest to the Application

You must swear that the information you are submitting with the license application is complete, truthful, and accurate and that the applicant's resident state license is in good standing.

Read the attestation carefully.
Required. When you are finished, if you submit to the terms of the attestation, click to checkmark the I Agree checkbox.
Click the Continue button to proceed.

Acknowledge the State License Application Fee

For your information, the system may calculate the state fee for the license application you are submitting.

Review the fee information.
Click the Continue button to proceed.

Submit the License Application

Review the summary details of the license application transaction in the License Application Summary section.

Review the basic applicant information at the top of the page.
If you need to return to the application and update information you entered earlier, click the Review License Application link.
In the Electronic Applications section, review the fee totals for the state to which you are applying, including the state license application fee and the fee for using this service to prepare and electronically submit your license application.
In the Fee Summary section, review the fee grand totals, including state fees, service fees, and credit card processing fees (if applicable).
Click the Click here to view additional state requirements link to open a new browser window containing detailed information about concluding the application process in the state to which you are applying.
When you are ready to submit the license application, click the Submit button.

Complete the Process

Review the confirmation and receipt information for your license application transaction and perform follow-up tasks on the License Application Confirmation page.

Review the confirmation message and basic applicant information at the top of the page.
If desired, click the Print link at the top of the page to open a printable view of the License Application Confirmation page.
If you need to send supporting documentation to the state department of insurance, choose one of the following:
- Click the Attach Documents link at the top of the page to open a separate window with instructions on attaching electronic files to your license application and transmitting them at no charge to certain states. (For more information, see Attach Supporting Documents to Sircon States.)
- If the Attach Documents link is not available, click the Click here to view additional state requirements link below the Fee Summary section to access the NAIC/NIPR Attachments Warehouse, where you may attach electronic files to your license application and transmit them for a fee to other states. (For more information, see Upload Documentation to the NIPR Document Warehouse.)
- If you do not wish to transmit supporting documentation electronically, click the state name link displaying in the Dest. State field in the Electronic Applications section. A separate window will open with follow-up information for the selected state, including where to mail or fax supporting background question documentation, how to review the status of the license application, and what to do if there are delays or errors.

In the Electronic Applications section review the details of the electronic license application transactions per state. If desired, click the Snapshot button () or number link displaying in the Confirmation ID field. A separate window will open displaying a printable, HTML-format version of your completed license application for that state.
In the Fee Summary section, review the fee grand totals, including state fees, service fees, and credit card processing fees (if applicable).
Click the View Result Details button to open the License Application Result Details page to review additional information about the license application transaction. (For more information about the License Application Result Details page, see License Application/Renewal Status Inquiry.)
When you are finished, click the Done button. The License Application MenuTransactions List page will open.

To check the ongoing processing status of one or multiple submitted license applications, use the License Application/Renewal Status Inquiry.

Before being able to use this service, an applicant already must hold a non-resident adjuster license from his or her "designated home state." The designated home state must be a state other than the applicant's state of residence. If you do not currently hold an adjuster license at all and your resident state does not offer adjuster licenses, you can apply for a non-resident adjuster license from a "designated home state." Use the Other Licenses service on the Apply for a License page.

Do not use the Adjuster DHS Application service to apply for a resident adjuster license or to apply for a non-resident adjuster license if the applicant already holds a resident adjuster license. Instead, use the Individual Resident License Application service or the Individual Non-Resident License Application service.

For more notes and tips specific to applying for a non-resident license, please see Individual Non-Resident License Application.