APPLICATION FOR INSURANCE BROKER’S INDIVIDUAL REGISTRATION FORM 2A
(INDIVIDUAL APPLYING FOR LICENSING MUST BE THE ONE COMPLETING THIS APPLICATION)
PLEASE NOTE: Individuals with Insurance Institute exam results will have their applications automatically rejected if their results are less than two weeks old
Please be advised all applications will be processed in the order they are received. Due to seasonal volumes, requests may take 5-10 business days to process.
Failure to submit current employment confirmation form, criminal record verification and official results letter and any additional documentation as required within the application will result in further delays in processing times.
GENERAL INSTRUCTIONS – PLEASE READ CAREFULLY
1. This form must be completed by all individuals seeking registration as an insurance broker in the province of Ontario. Pursuant to Section 26 of the Registered Insurance Brokers Act, the information provided in this form is privileged and confidential. Once registered, the individual is a member of the corporation.
2. It is an offence under the Registered Insurance Brokers Act to knowingly make a false representation or declaration on this application and/or attachments, and doing so may be sufficient grounds under the Registered Insurance Brokers Act to reject the application or revoke a licence.
3. The application must be signed and all questions answered. Failure to do so may cause delays in the processing of the application.
4. You will also be prompted to submit a Criminal Background check via local police department or Sterling Back Check (please note we do not accept third party checks). License registrations will not be processed without this document. Please ensure that this includes all current and previous names (including any maiden names or aliases), otherwise a new Criminal Record will be required
5. All sections must be fully completed.