New Jersey Department of Banking and Insurance - Division of Insurance

Please Note

We are a service company that can help you file with the New Jersey Department of Banking and Insurance - Division of Insurance. We are not associated with this nor any other government agency. We offer paid services and software to help you file. You are not required to purchase our service to file - you may file directly with this agency without using our service.

Contact Information

Mailing address:
20 West State Street
PO Box 325
Trenton, NJ 08625

Phone: 609-292-7272

Web: Home Name search Forms
Email: inslic@dobi.nj.gov

Licenses

We track the following licenses with the New Jersey Department of Banking and Insurance - Division of Insurance in order to provide compliance services to our clients. As a client, you see this and other reference data in License Manager in-line with your licenses.

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New Jersey Charitable Gift Annuity Registration

Agency:	New Jersey Department of Banking and Insurance - Division of Insurance
Law:	NJ Rev. Stat. § 17B:17-13.1
Foreign Qualification is Prerequisite:	Not Set
Audit Requirements:	Audited financial statements are required with the annual permit renewal.
Exam Required?	Not Set
Registered Agent (Special Agency) Required?	Not Set

Form:	Application for Special Permit
Agency Fee:	$100
Notarize:	Required
Notes:	Proof of entity registration and charitable registration are required with the application. Charities must maintain a segregated reserve fund that covers the current value of all outstanding annuity payments plus the greater of $100,000 or 10% of the reserve fund.

Form:	Annual Statement
Agency Fee:	$0
Due:	Within 120 days of the end of the calendar year. Permission may be granted for the filing to be made on a fiscal year basis.
Notes:	An annual statement should be filed even if the organization did not issue annuities.

Filing Method:	Online
Agency Fee:	Either $95 or $170 depending on which lines of authority the applicant selects.

Form:	TPA Registration Application
Filing Method:	Email Tim.Stroud@dobi.nj.gov or mail.
Agency Fee:	$0
Required Attachments:	The completed Application Cover Sheet. A copy of the applicant’s basic organizational documents, which shall include articles of incorporation, articles of association, partnership agreement, management agreement, trust agreement or other documents governing the operation of the applicant that are applicable to the applicant’s form of business organization. A copy of the executed bylaws, rules and regulations, or other documents relating to the operation of the applicant’s internal affairs. A list of the names, addresses and official positions of the persons responsible for the conduct of the affairs of the applicant, including, but not limited to if applicable: a) the members of the board of directors, executive committee or other governing boardor committee; b) the principal officers or partners; c) shareholders owning or having the right to acquire 10% or more of the voting securities of the corporation or partnership interest of a partnership, or equity interest, in thecase of another from of business organization; and d) any person or entity who has loaned funds to the applicant for the operation of the business. A fully completed and notarized Biographical Affidavit for each of those persons identified in response above. A statement of any criminal convictions and civil, regulatory or enforcement action, including actions related to professional licensing, taken or pending against any principal officer or owner of the applicant; and the relationship with any other business entity, including a parent corporation. A copy of the applicant’s most recent financial statements audited by an independent certified public accountant. If the financial affairs of the applicant’s parent company are audited by an independent certified public accountant, but those of the applicant are not, then a copy of the most recent audited financial statement of the applicant’s parent company, audited by an independent certified public accountant, shall be sub-mitted. A consolidated financial statement of the applicant and the parent company shall satisfy this requirement unless the Commissioner determines that additional or more recent information is required for the proper administration of the Act. If providing a consolidated financial statement, include a consolidating income statement clearly showing the applicant’s activity. Please note that once approved, annual audited financial statements must be filed on a calendar year basis. A copy of the applicant’s business plan.

Form:	Annual Third Party Administreator Financial Report
Filing Method:	Mail
Agency Fee:	$100
Due:	Annually by June 1.
Due Date Extension:	Extension request must be made by May 15.

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New Jersey Department of Banking and Insurance - Division of Insurance

Please Note

Contact Information

Licenses

New Jersey Charitable Gift Annuity Registration

Initial Registration

Registration Renewal

New Jersey Insurance Agency License

Initial Registration

Registration Renewal

New Jersey Insurance Agent License

Initial Registration

Registration Renewal

New Jersey Insurance Producer License - Non-Resident

Initial Registration

Registration Renewal

New Jersey Insurance Producer License - Non-Resident

Initial Registration

Registration Renewal

New Jersey Insurance Producer License - Resident

Initial Registration

Registration Renewal

New Jersey Insurance Producer License - Resident

Initial Registration

Registration Renewal

New Jersey Portable Electronics Insurance License - Non-Resident

Initial Registration

Registration Renewal

New Jersey Portable Electronics Insurance License - Resident

Initial Registration

Registration Renewal

New Jersey Public Adjuster License - Non-Resident

Initial Registration

Registration Renewal

New Jersey Public Adjuster License - Non-Resident

Initial Registration

Registration Renewal

New Jersey Public Adjuster License - Resident

Initial Registration

Registration Renewal

New Jersey Public Adjuster License - Resident

Initial Registration

Registration Renewal

New Jersey Temporary Producer License - Resident

Initial Registration

Renewal Not Required

New Jersey Third Party Administrator License

Initial Registration

Registration Renewal

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