Surplus Lines Broker Certificate of Qualification

• complete and submit the NAIC Uniform Application.
• pay the applicable fee of $100 or $200, depending on the expiration date of the underlying producer license;
• resident applicants must submit a $10,000 Surety Bond. The surety bond or continuation certificate must clearly state:
    - bond company and bond amount
    - bond coverage period
    - show the State of Maryland as the obligee
    - duly executed by the principal/producer and bond company/attorney-in-fact
  Nonresidents are exempt from this requirement.
• business entity renewal application: submit the updates to Owners, Partners, Officers, Directors, Members listing the individual names and corresponding offices. (Note: “No changes” is not an acceptable response.)

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Applications may be submitted via:

• online through NIPR ( www.nipr.com). A confirmation email will be sent to the email address provided on the application when your online application has been received. Make note of the transaction number so you may reference this when sending additional documents or inquiring for status.
• or paper application, along with any additional documents, should be mailed to:

The Maryland Insurance Administration
Attn: Producer Licensing
200 Saint Paul Place, Suite 2700
Baltimore, Maryland 21202

* Payments should be in the form of a check, money order, or cashier’s check made payable to: Maryland Insurance Administration.

Note: Regardless of who completes the application, the license applicant is ultimately responsible for the contents of the application and must provide accurate and complete information (if the application was completed by someone other than the applicant, the person who completes an application may also be held responsible for the contents of the application). An application that fails to disclose or fails to provide accurate information may result in the DELAY and/or DENIAL of the application. If your license has already been issued and it is later discovered that the information contained in your application is not true, correct, or complete, your license may be REVOKED and you may be subject to monetary PENALTIES (if the application was completed by someone other than the applicant, the person who completed the application may also be subject to administrative action). If in doubt, disclose.