Reinstatement Application

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Verified
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IT Resubission?
Have you contacted RIBO Licensing to confirm the specific requirements of your reinstatement? If not, please email licensing@ribo.com before continuing*
- YES
Have you obtained an original current-dated police record check or "Criminal Record Verification" letter from the local police department or from Sterlingback Check? *(The document must be dated within 60 days of the date RIBO receives the application. Applications will not be processed without this document).*
- Yes
- No
You must obtain an original current-dated police record check or "Criminal Record Verification" letter from the local police department or from Sterlingbackcheck. (The document must be dated within 60 days of the date RIBO receives the application. Applications will not be processed without this document).(Please note that we do not accept third party checks).
Please do not proceed any further until you have completed your Criminal Record Check. A Criminal Record Check is a requirement for reinstatement.
Please visit Sterling Backcheck to conduct your Criminal Record Check, then return to this form.
Please attach a copy of the Criminal Record Check*
Max. file size: 300 MB.
Have you filled out the Consent and Notification form agreeing to electronic exchange and communications with RIBO?*
YES
Please upload the completed Consent and Notification form*
Max. file size: 300 MB.
Have you obtained an Employment Confirmation form signed by the Principal Broker or Deputy Principal Broker at your sponsoring brokerage? (MUST BE SIGNED WITHIN LAST 2 WEEKS OR WILL NOT BE PROCESSED)*
YES
Please upload the Employment Confirmation form signed by the Principal Broker or Deputy Principal Broker at your sponsoring brokerage (MUST BE SIGNED WITHIN LAST 2 WEEKS OR WILL NOT BE PROCESSED)*
Max. file size: 256 MB.
Have you completed the required Continuing Education credits as outlined in your confirmation from RIBO?*
YES
Please upload your continuing education certificate as outlined in your confirmation from RIBO? NOTE: Anything other than continuing education certificates will not be accepted.*
Max. file size: 256 MB.
I confirm that the hours submitted are being used for the previous term as outlined in the specific requirements received from RIBO and am aware that I need to complete additional hours for this term before next renewal of license.*
Yes

Name*
First Middle Last
Previous RIBO Number (5 digits max)*

Enter '0' in front if your license number is less than 5 digits. Example 04321
Ontario Mailing Address (you must have an Ontario mailing address to register)*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please check "YES" if your Residential Address is different than above*
YES
NO
Residential Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mobile Phone Number*
Work or Other Phone Number (if applicable)
Personal Email*

Business Email*

1) Will you have any employment or business other than an insurance broker, life agent?*

Yes

No
Have you completed the Secondary Business Exemption form?*

Yes

No
Please upload a copy of your completed Secondary Business Exemption Form*
Max. file size: 256 MB.
Please attach a one page letter of request explaining in detail the secondary occupation*
Max. file size: 256 MB.
Please attach a letter from the Principal Broker of your firm advising that they do not feel this activity will interfere with your insurance responsibilities and fully support your request for an exemption.*
Max. file size: 256 MB.
Please obtain the Secondary Business Exemption form here. Once it is completed you may return to this form to upload it
2) Do you have a previously granted exemption and wish to apply?*

Yes

No
Please provide details*
Please upload the Principal Broker support letter*
Max. file size: 256 MB.
3) Do you hold a current Life Licence? If yes, please attach a copy*

Yes

No
Please upload a copy of your current Life License
Max. file size: 256 MB.
4) Have you declared bankruptcy /consumer proposal or are you in the process of declaring bankruptcy / consumer proposal that has not been previously disclosed to RIBO?*

Yes

No
Please provide the reason and details of the bankruptcy*
Please attach your consumer proposal or plan of arrangement*
Max. file size: 256 MB.
Please attach your most recent Statement of Affairs along with copy of discharge*
Max. file size: 256 MB.
5) Have you had any license or registration (other than RIBO) refused, suspended, cancelled or had any disciplinary action taken against you that has not been disclosed to RIBO?*

Yes

No
Please provide details on the action taken against you along with a detailed description of circumstances surrounding the case.*
6) Has there been any claim made or pending in any civil proceeding or has any judgment or garnishment been rendered against you?*

Yes

No
Please provide details below:*
7) Have you been charged or found guilty of a criminal offence not previously reported to RIBO? This would include absolute or conditional discharges*

Yes

No
Please provide details of the charges along with detailed description on the circumstance surrounding the conviction
Feel free to upload any other supporting documents
Max. file size: 256 MB.

Please select the appropriate Reinstatement Fee as confirmed by RIBO. You MUST select the appropriate amount as per RIBO to complete your submission*
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