Please rate Application Insurance License 01-2023
If required, you must first pass your license examination before submitting this license application.
Background questions: if you answer yes to any of these questions, you must submit a signed statement, with your original signature summarizing the details of each event.
Addresses: business and mailing addresses are public record and are available to the public.
Prelicensing certificate: if no, your prelicensing education must be completed prior to taking your examination.
Name: enter full legal name; if no middle name, enter (NMN).
Change of address: it is the applicant's/licensee's responsibility to immediately notify the department of any change in address.
| Question | Answer |
|---|---|
| Form Name | LIC-441-9 |
| Form Length | 6 pages |
| Fillable? | Yes |
| Fillable fields | 131 |
| Avg. time to fill out | 22 min |
| Edition | 01/2023 |
| Issuing agency | California Department of Insurance |
| Where to send | Department of Insurance, 300 Capitol Mall, 16th Floor, Sacramento, CA 95814-4313 |
| Matches the agency's file | Yes, checked October 2, 2026 |
| Other names | LIC-441-9, LIC 441-9, LIC441-9, LIC 441 9, Individual Application For Insurance License, California Insurance License Application |
| Official source | LIC-441-9 (Rev 01/2023), California Department of Insurance |
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