Arizona Department Of Insurance Form L 193

Make sure no one else is using a name that is substantially similar to the name you wish to use.

Arizona department of insurance form l 193. Arizona department of insurance 100 north 15th avenue suite 261 phoenix az 85007 2630 starting july 1 2020 we became the department of insurance and financial institutions difi. Thu 09 11 2014 12 15. A nonresident must first execute the name change with the insurance department in the licensee s home state and then submit form l chg to the arizona department of insurance. Certificate of assumed name.

Assumed name dba if you intend to do business under a name other than your legal name called an assumed name or dba name complete and submit form l 193 certificate of assumed business name. Tpa registration team arizona department of insurance arizona form l chg. Renewal application for life and health arizona form l clr. Visit the producers page of the arizona department of insurance website for form l 193 and additional information about this requirement.

Certificate of assumed business name. Use the license search feature on the department of insurance web site https insurance az gov to see if another licensee is using a substantially similar name. If you have established a business entity and want to use the name of the business entity in conjunction with your insurance transactions the business entity must also hold an insurance license. Arizona department of insurance 100 north 15th avenue suite 261 phoenix az 85007 2630 starting july 1 2020 we will be the department of insurance and financial institutions difi.

File form l 193 to use any name other than applicant s genuine name when engaging in business under an arizona insurance license. Certificate of assumed name use this form for each name other than your genuine legal name that you intend to use in conjunction with your insurance business. Arizona department of insurance 100 north 15th avenue suite 261 phoenix az 85007 2630starting july 1 2020 we became the department of insurance and financial institutions difi. A nonresident must first execute the name change with the insurance department in the licensee s home state and then submit form l chg to the arizona department of insurance.