Application Procedures Individual Non-Residents

Please follow the steps noted below to complete an application:

Step 1 - Fingerprint impressions are required for unlicensed applicants and can be submitted at any time prior to submitting the license application. Unlike insurance producer applicants, non-resident public insurance adjuster applicants must be fingerprinted regardless of whether they were fingerprinted in their resident state. Refer to our non-resident fingerprint page for instructions.

Step 2 - 1033 Application for Written Consent - Any person who has been convicted of felony crimes of dishonesty or breach of trust in a state or federal jurisdiction, or who has been convicted of any violation of Title 18 U.S.C. Section 1033 (the "Act"), must first obtain the written consent of the Commissioner prior to engaging or continuing to engage in the business of insurance in California.

Step 3 – Application: Apply for a public insurance adjuster license online at Sircon, NIPR to include a California business address pursuant to (Cal. Ins. Code 15011(d)), before a Public Adjuster license can be issued, both, residents and non-residents of California must have a business address location in the state of California, with public access during regular business hours.

Step 4 - Fees: License two year filing fee: $264.

All filing fees submitted are not refundable, whether or not the application is acted upon or an exam taken (Cal. Ins. Code 1751.5). 

Step 5 - Attach completed form LIC 0100A Public Adjuster Authorization Application to application.

Step 6 - Bond: Complete a Bond of Public Insurance Adjuster, form LIC 94A in the penal sum of $20,000, by a California admitted surety, in the name of the applicant and signed by the applicant authorizing the person to act as a public insurance adjuster.

Step 7 - Attach two electronic (in color) passport type photos, not older than 6 months.

Step 8 - Contract: Pursuant to (Cal. Ins. Code 15027), no licensee shall, directly or indirectly, act within this state as a public insurance adjuster without having first entered into a business contract, in writing, on a form approved by the insurance commissioner and executed in duplicate by the public adjuster and the insured or a duly authorized representative. One original contract shall be kept on file by the licensee, available at all times for inspection, without notice, by the commissioner or his or her duly authorized representative, and one original contract shall be given to the insured.

CDI has provided a sample contract for Public Insurance Adjusters to follow when developing their business contract. Please submit a new or revised business contract to the following address: California Department of Insurance, Attention: Adjuster Unit; 300 Capitol Mall, 16th Floor, Sacramento, CA 95814-4313. Using the sample contract will satisfy the requirements of (Cal. Ins. Code 15027) of the CIC although the applicant or licensee is not required to use the sample contract. However, all contract forms must meet the requirements of (Cal. Ins. Code 15027) and must be approved by the CDI's legal division prior to use. Consequently, following the sample contract should expedite the approval process.

Note: Pursuant to (Cal. Ins. Code 15027(v)) of the CIC prior to the signing of the contract, the licensee shall provide the insured with a separate printed disclosure document that bears the name and license number of the licensee.