Louisiana Department of Insurance Forms

This form is used for submitting a complaint report in the state of Louisiana.

This document is for surrendering a license and obtaining a letter of clearance from the state of Louisiana. It is used when someone wants to voluntarily surrender their license and obtain a letter stating that they have no outstanding obligations or violations.

This document is an application form for insurance companies to become certified reinsurers in the state of Louisiana.

This Form is used for applying as a resident or non-resident managing general agent in the state of Louisiana.

This form is used for registering as a Professional Employer Organization (PEO) in the state of Louisiana.

This type of document, called a Surety Bond, is used in the state of Louisiana. It is a form of guarantee that ensures the completion of a contract or the fulfillment of certain obligations.

This document is for risk purchasing groups in the state of Louisiana who need to renew their registration on an annual basis.

This form is used for the Louisiana Standardized Credentialing Application process in Louisiana. It is designed to collect information from individuals seeking professional credentials in various industries.

This type of document is used for transferring state residency from Louisiana to another state.

This document is used to provide proof of the publication of a public notice in the state of Louisiana. It confirms that the notice has been published in a newspaper or other approved publication as required by law.

This form is used for applying for and obtaining a Certificate of Certified Reinsurer in the state of Louisiana. The certificate is issued to insurance companies that meet certain financial criteria and allows them to provide reinsurance services in the state.

This document exhibits the experience that supported the rate revision filing in Louisiana.

This document provides examples of how private passenger automobile insurance is rated in the state of Louisiana.

This document provides information regarding the operating results of companies in Louisiana. It may include financial data, statistics, and other relevant information.

This document is a questionnaire used in Louisiana to revise rates by territory. It is used to gather information and make adjustments to rates in different areas of the state.

This document provides rating examples for homeowners in Louisiana. It helps determine the appropriate premium rate for different coverage options.

This Form is used for changing the name or trade name on record in Louisiana.

This type of document is an agreement that is used in Louisiana to ensure compliance with rates, rules, and regulations.

This Form is used for individuals to apply for an Individual Navigator License in the state of Louisiana.

This Form is used for applying for an Entity Navigator License in Louisiana.

This form is used for obtaining insurance certification when applying for a limited license for self-storage in Louisiana.

This form is used for accepting requests to access records in the state of Louisiana.

This form is used for withdrawing from UCAA registration in the state of Louisiana, and includes a specific addendum for Louisiana requirements.

This document is an application form to register as a non-navigator in the state of Louisiana. It is used by individuals or organizations who wish to assist others in navigating the healthcare system, but are not licensed insurance agents or brokers.

This form is used for applying to become a licensed insurance company in the state of Louisiana.

This Form is used for renewing the vehicle mechanical breakdown insurer license in Louisiana on an annual basis.

This document is used for attesting to the accuracy of data submitted in compliance with Act No. 262 of the 2019 Regular Session of the Louisiana Legislature in Louisiana.

This document is an application form for individuals or organizations seeking to act as an Independent Review Organization in the state of Louisiana. The form must be completed to request authorization and provide relevant information about the entity or individual applying for this role.

This form is used for acknowledging the applicant's request for personal lines and health and accident insurance coverage in the surplus lines market in Louisiana.

This document is used for swearing under oath regarding the accuracy of data submitted in compliance with Act No. 427 of the 2014 Regular Session of the Louisiana Legislature in Louisiana.