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North Dakota Insurance Department
Adam Hamm, Commissioner
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Please contact us if you have difficulty finding a form that you need.

ndlicensing@nd.gov
State Capitol, fifth floor
Dept. 401
600 E. Boulevard Ave.
Bismarck, ND 58505-0320

701.328.2440
701.328.4880 fax
800.247.0560 toll free
800.366.6888 TTY line



Application for Administrator-Certificate of Registration
tpauniformapp.pdf

Appointment/Termination SFN 50291
http://www.nd.gov/eforms/Doc/sfn50291.pdf

Change of Address/Name SFN 50072
http://www.nd.gov/eforms/Doc/sfn50072.pdf

Course Completion Certificate SFN 10923
http://www.nd.gov/eforms/Doc/sfn10923.pdf

Electronic address change
https://pdb.nipr.com/ACR/SignIn

Electronic Appointment Renewals
https://pdb.nipr.com/html/erlWelcome.html

Electronic Non-Resident Insurance Producer License (for Individuals or Business Entities)
http://www.nipr.com/html/nrlWelcome.html

NAIC - Uniform Resident Application Forms (for individuals or business entites)
http://www.nipr.com/resident_paper_licensing.htm

National Insurance Producer Registry (NIPR)
http://www.nipr.com/

Notice of Course Subsequent Offering SFN 10926
http://www.nd.gov/eforms/Doc/sfn10926.pdf

Submit or update your email address (business entities)
http://www.statebasedsystems.com/EmailAddressMaintenance.htm

Submit or update your email address (individuals)
http://www.statebasedsystems.com/EmailAddressMaintenance.htm

Voluntary Cancellation - Insurance Producer License SFN 53881
http://www.nd.gov/eforms/Doc/sfn53881.pdf


North Dakota Insurance Department
600 E. Boulevard Ave.
Bismarck, ND 58505-0320
Phone 701.328.2440
Toll free 800.247.0560
Fax 701.328.4880

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