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Fees:
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Application Fee
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10.00
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License Fee
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5.00
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Processing Fee
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2.45
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Total Fees Paid:
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17.45
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Credit Card Confirmation:
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320385868
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Screening Questions:
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In the last three years, have you held a resident license in any state for the same lines of insurance, and was that license valid for a minimum of one year?
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Yes/No
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No
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Are you an attorney duly admitted to practice law in this state and in good standing with the Florida Bar?
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Yes/No
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No
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Did you complete a 40-hour pre-license title agent classroom course for this license type that was approved by the Department, AND was it completed within the last four years?
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Yes/No
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No
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Have you completed at least one year of responsible title insurance duties within the last four years, and was the experience as a full-time bona fide employee of a title insurer, title agency, title agent or an attorney who conducts real estate closing transactions and issues title insurance policies?
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Yes/No
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Yes
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Are you a United States Citizen?
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Yes/No
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Yes
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If you have held a license in another state in prior years, you may be exempt from the exam. Have you held a license in another state for a minimum of one (1) year immediately preceding the date you became a resident of this state and have not been a resident of Florida for more than 90 days from today's date.
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Yes/No
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No
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I understand that failure to disclose my complete criminal history and/or my failure to provide accurate answers on this application will result in the denial of my application and I have read and understand all of the information provided above.
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Yes/No
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Yes
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Felonies: Have you ever pled nolo contendere or no contest or guilty to or have you ever had adjudication withheld for, or have you ever been convicted of or been found guilty of any felony crime under the laws of any municipality, county, state, territory or country? (You must answer "Yes" even if adjudication of guilt was withheld, even if your civil rights were restored, even if you received a pardon and whether or not the records are sealed or expunged.)
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Yes/No
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No
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Misdemeanors: Within the past 10 years have you pled nolo contendere or no contest or guilty to or had adjudication withheld for, or been convicted of, or been found guilty of a misdemeanor crime related to the financial services business as defined in Administrative Code 69B-211.042(3)(b) under the laws of any municipality, county, state, territory or country? (You must answer "Yes" even if adjudication of guilt was withheld, even if your civil rights were restored, even if you received a pardon and whether or not the records are sealed or expunged.)
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Yes/No
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No
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Have you ever had a judgment withheld, been convicted or had a judgment deferred for a military offense, or are you currently charged with committing a military offense?
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Yes/No
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No
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Are you currently on probation, serving community control, participating in pre-trial intervention or any other diversion program, or are you currently serving any sentence for any felony, or any misdemeanor related to the financial services business taken against you or threatened to be taken against you?
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Yes/No
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No
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In the past 12 months, have you been arrested, jailed, indicted, or had an Information filed against you or have you been otherwise charged with a crime by ticket/notice to appear or other formal charging document by any law enforcement authority anywhere in the United States or its possessions or any other country? You may exclude the following misdemeanor convictions or pending misdemeanor charges: traffic citations, driving under the influence (DUI), driving while intoxicated (DWI), driving without a license, reckless driving or driving with a suspended or revoked license.
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Yes/No
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No
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Are there any charges or allegations currently pending against you in any criminal, administrative (including FINRA) or civil jurisdiction?
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Yes/No
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No
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Are there any criminal, administrative(including FINRA) or civil charges or allegations currently pending against any entity for which you are an owner, partner, manager, director, or officer, or any entity you control in any way?
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Yes/No
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No
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Have you ever been named in an administrative proceeding/action by any state agency or public authority or any other regulatory authority (including FINRA)?(This would include fines, probation, restitution, restricted or probationary licenses, cease and desist orders, suspension, revocation, or denial.)
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Yes/No
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No
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Has any company or agency for which you are a owner, partner, manager, director, or officer, ever been named in an administrative proceeding by any state agency or public authority or any other regulatory authority (including FINRA)? (This would include fines, probation, restitution, restricted or probationary licenses, cease and desist orders, suspension, revocation, or denial.)
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Yes/No
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No
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Have you failed to comply with any civil, criminal, or administrative action taken by a child support enforcement program under Title IV-D of the Social Security Act, 42 U.S.C. ss. 651 et seq., to determine paternity or to establish, modify, enforce, or collect support?
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Yes/No
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No
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I understand that I must be fingerprinted through the Department's vendor, IdentoGO by IDEMIA.
You can register, find locations, and pay for fingerprinting by visiting IdentoGO by IDEMIA or by calling 1-800-528-1358. The fingerprinting is $50.75, plus local Florida county sales tax.
If you currently hold a valid license with the Department and have submitted fingerprints within the last 48 months you will not be required to submit fingerprints.
If you have submitted fingerprints within the last 12 months you will not be required to submit fingerprints.
I also understand that if I am applying for a Home Warranty (2-51), Service Warranty (2-52) or Automobile Warranty (2-53) license, that I am not required to be fingerprinted.
Please click YES if you understand these instructions.
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Yes/No
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Yes
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Deficiencies:
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In order to be exempt from the pre-licensing requirement, you must provide a detailed account of your experience in the lines of insurance indicated on your application. You must also include the dates of your experience. Please email it to AgentLicensing@MyFloridaCFO.com and include your application ID number in the subject line of the email.
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To obtain any required forms, please visit the Forms section of the Insurance Agent and Agency Services website.
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