Marcia Hultman

Cabinet Secretary

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Division of Insurance


Producer Applications, Forms, Reports and Related Fees

 

The forms and reports listed below are provided in Adobe .pdf format* unless otherwise noted.

Application • Form • Report Fee

Online Producer Licensing through:

Sircon or NIPR

$25.00 Resident; $30 Non-Resident

Bail Bonds Application $30.00 Application Fee (payable to the Division of Insurance) and
$43.25 Background Check (payable to Division of Criminal Investigations)
Bail Bond Runner Application $30.00 Application Fee (payable to the Division of Insurance) and
$43.25 Background Check (payable to Division of Criminal Investigations)
Bail Bond Runner Appointment Form $10.00 per appointment
Business Entity Application  
Appointment Form  
Certificate of Authority*  
Certificate of Authority for Foreign Limited Liability Companies*  
Corporation Name Change $10.00
Managing General Agents - Resident $25.00
Managing General Agents - Non-Resident $30.00
NAIC Uniform License Application  
Portable Electronic License Application $25.00 Resident; $30 Non-Resident
Rental Car Resident Producer License $25.00
Rental Car Non-Resident Producer License $30.00
Rental Car Quarterly Report of Employees N/A
Rental Car Agency Annual Certification N/A
Insurer Certification for Rental Car Agent N/A
Termination of Company Appointment N/A
Third Party Administrator Application (Sircon) $500.00

* South Dakota Secretary of State forms

Please contact the Division with any questions regarding certificates of insurance.

 

 

*Opening and printing Adobe .pdf files requires Adobe Acrobat Reader. Click here as needed to download the free Adobe Acrobat Reader.

 

Contact the Division of Insurance