MAKE CHANGES TO YOUR LICENSE

Please Note: Reporting of member/officer/director changes effective October 1, 2019, entities no longer need to report these changes; this change does not pertain to the following license types: LSP, MDP, PBM, PPN, Premium Finance Company, RRG, Surety Bail Bonds or TPA.

(C.G.S. 38a-771)

ADDRESS CHANGE 

You can now update your address online by visiting NIPR’s website:

Note: You cannot use this online process if you are changing your resident state or if any part of your address change involves a change in state.

  1. Navigate to the Licensing Center and choose "Change Contact Info."
  2. Proceed to the Online Application.
  3. Select Product Type "Contact Change Request (Change Address, Phone, Email)."
If online submission is not possible, kindly fill out the Address Change Request form and send it via email to the department at cid.licensing@ct.gov.

DESIGNATED HOME STATE (DHS)  

If you are requesting CT DHS or changing your current DHS status to another state for your existing CT Adjuster license. Please complete the respective form and email the department at cid.licensing@ct.gov

DESIGNATED RESPONSIBLE LICENSED PRODUCER (DRLP) 

To change Designated Responsible Licensed Producer (DRLP) please complete the respective form and email the department at cid.licensing@ct.gov

DOING BUSINESS AS (DBA) 

To change Doing Business As (DBA) please complete the respective form and email the department at cid.licensing@ct.gov

FOI – REPORT GENERATOR 

Freedom of Information: to obtain a list of individual and/or business entity licensees.

LETTER OF CERTIFICATION 

Use this link if you have moved to another state and need proof of your standing in Connecticut.

LETTER OF CLEARANCE REQUEST 

Use this form if you are a previous Connecticut resident agent who is applying for a resident license in a new state.

LINE OF AUTHORITY (LOA) REMOVAL REQUEST  

If you are only trying to REMOVE LINES OF AUTHORITY from your PRODUCER or FRATERNAL AGENT license (not canceling the license). Please complete the respective form and email the department at cid.licensing@ct.gov

NAME CHANGE 

You can now update your name online by visiting NIPR’s website:
  1. Navigate to the Licensing Center and choose "Change Contact Info."
  2. Proceed to the Online Application.
  3. Select Product Type “Demographic Update.”
If online submission is not possible, please email the department at cid.licensing@ct.gov.

RESIDENCY CHANGE REQUEST 

This form is only to be used if moving into or out of the state of Connecticut. Please complete the respective form and email the department at cid.licensing@ct.gov

VOLUNTARY SURRENDER REQUEST 

Please complete the respective form and email the department at cid.licensing@ct.gov