California Code of Regulations
Title 10 - Investment
Chapter 5 - Insurance Commissioner
Subchapter 1 - Production of Insurance
Article 11 - Portable Electronics Insurance Agent Licensing Regulations
Section 2194.7 - Forms

Universal Citation: 10 CA Code of Regs 2194.7

Current through Register 2024 Notice Reg. No. 38, September 20, 2024

The specific forms required to be filed with the Commissioner by license applicants and licensees are as follows:

(a) The written application for licensure shall be made on Form 441-9 (Rev 01/2003) for individuals and on Form 441-11 (Rev 01/2003) for organizations.

(b) The initial certification of authorized employees shall be made on form Lic. CV 1 (Rev 12/2002).

(c) The annual certification of authorized employees shall be made on form Lic. CV 2 (Rev 12/2002).

(d) The insurer certification shall be made on form Lic. CV 3 (Rev 9/2004).

(e) Training materials submitted to the Commissioner shall contain all of the elements set forth in form Lic. CV 4 (Rev 12/2002).

(f) The list of authorized endorsees shall be made on form Lic. CV 5 (Rev 9/2004). The list shall be maintained in a format capable of transmission to the Commissioner or a designee of the Commissioner electronically and in hard copy or diskette, however requested by the Commissioner or a designee of the Commissioner pursuant to Section 2194.6(c) above. The electronic version shall be transmitted in commercial word-processing or spreadsheet form. When requested, the list shall be updated to include endorsees newly authorized up to thirty (30) days before the mailing date of the request, and shall include the dates upon which each endorsee's authorization began and, if relevant, terminated. It shall then be transmitted as an attachment to e-mail or by regular mail in hard copy or diskette, as requested. The appropriate e-mail and regular mailing addresses shall be posted by the Department on its website at http://www.insurance.ca.gov.

(g) All forms set forth in this section are incorporated herein by reference in their entirety and are available upon request, by telephone or in writing, to the Department of Insurance or on the website of the Department of Insurance at www.insurance.ca.gov.

1. New section filed 7-11-2003 as an emergency; operative 7-11-2003 (Register 2003, No. 28). A Certificate of Compliance must be transmitted to OAL by 11-10-2003 or emergency language will be repealed by operation of law on the following day.
2. New section refiled 11-7-2003 as an emergency; operative 11-10-2003 (Register 2003, No. 45). A Certificate of Compliance must be transmitted to OAL by 3-9-2004 or emergency language will be repealed by operation of law on the following day.
3. New section refiled 3-8-2004 as an emergency; operative 3-9-2004 (Register 2004, No. 11). A Certificate of Compliance must be transmitted to OAL by 7-7-2004 or emergency language will be repealed by operation of law on the following day.
4. New section refiled 7-7-2004 as an emergency; operative 7-7-2004 (Register 2004, No. 28). A Certificate of Compliance must be transmitted to OAL by 11-4-2004 or emergency language will be repealed by operation of law on the following day.
5. Certificate of Compliance as to 7-7-2004 order, including amendment of subsections (d) and (f), transmitted to OAL 11-2-2004 and filed 12-17-2004 (Register 2004, No. 51).

Note: Authority cited: Sections 1758.6 and 1758.693, Insurance Code. Reference: Sections 1758.62 and 1758.63, Insurance Code.

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