The Oregon Insurance Division no longer accepts paper applications.

Apply and renew through NIPR. Non-resident adjusters with no home state and third-party administrators renew through SBS.

Address/Name Change Form (1996):
Word | PDF
Affiliation/Unaffiliation of Producer, Adjuster, or Insurance Consultant (2139):
Word | PDF
Continuing-Education Credit for an Unregistered Course (2179):
Word | PDF 
Continuing-Education Proctor Certification (3128):
Word | PDF 
Continuing-Education Proctor Registration (3127):
Word | PDF 
Insurance Experience Qualification Form (2492):
Word | PDF 
Life Settlement Broker Appointment/Affiliation Notice (3025):
Word | PDF
Pre-examination Training Exemption Request (2493):
Word | PDF 
Temporary Adjuster Permit Application (3901):
Word | PDF 
Termination of Appointment Notice (3003):
Word | PDF 
Voluntary Surrender of Oregon License (5054):
Word | PDF 
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Helpful hints

Contact us

503-947-7981
Fax: 503-378-4351
web.insagent@oregon.gov​​​​

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