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Texas Department of Insurance
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Information Update Forms

Online Address Changes
Description File Format
Sircon
There is no charge to create a Sircon account. You can use Sircon to change certain demographic and address information online. To learn more, go to the Vertafore Texas Portal.


NIPR Electronic Address Change Request for Agents and Adjusters - fill in and send online
(For in-state address changes, an agent or adjuster can use this tool to simultaneously provide an address change notification to all state insurance departments where the agent or adjuster is licensed. There is no charge for the service.)
Web Enabled

If the form is a fillable PDF, learn how to enable all fillable form features.

TDI Form Number Description File Format Language
FIN434 Biographical Affidavit for Life Settlement Providers or Brokers
Biographical affidavit. Must be completed by all individuals specified in the instructions of FIN430 and FIN431, as adopted by rule.
PDF English
FIN501 Appointment Cancel for Cause
Use this form to submit notification of appointment cancellation for cause. All other appointment transactions must be completed electronically using National Insurance Producer Registry or Sircon.
PDF English
FIN528 Entity Name Change/ Assumed Name (DBA) Request
Use this form to update an official entity name change or register an assumed name (DBA) with TDI.
PDF English
FIN530 Voluntary Surrender of Texas Insurance License
PDF English
FIN531 Biographical Form and Certification of License Qualification Following a Change of Control
Use this form to report changes to control of a licensed insurance agency; or to report new individuals to be associated with or disassociated from a currently licensed insurance agency.
PDF English
FIN533 Agent / Adjuster name or address change request form
PDF English
FIN540 Agency address change request form
PDF English

For more information, contact: License@tdi.texas.gov