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Premium Finance - Company Licensing and Registration Forms

For more information regarding any of the topics below, go to the Company Licensing and Registration Premium Finance home page.

Premium Finance - Company Licensing and Registration Forms
TDI Form Number Description File FormatLanguage
FIN139
Annual Operations Report
Form required to be filed annually by premium finance company, due April 1.
PDF English
FIN160, PF1
Application for An Insurance Premium Finance Company License (Form PF1)
Premium Finance application for initial license to operate in Texas
PDF English
FIN161, PF1A
Supplemental Application for a Premium Finance Company (Form PF1A)
Form premium finance company completes to notify TDI of changes, such as an additional location, relocation, name change and/or ownership change
PDF English
FIN162, PF1B
Application for an Insurance Premium Finance License by a Bank or Savings and Loan Association (Form PF1B)
Application for a bank or savings and loan to be a licensed premium finance company
PDF English
FIN163, PF1C
Premium Finance Renewal Application (Form PF1C)
Premium Finance Renewal Application Form, required if renewing or not renewing
PDF English
FIN164, PF2
Premium Finance List of Principals
List all officers, directors and contact persons of Premium Finance Company
PDF English
FIN165, PF3
Questionnaire - Premium Finance Applicant (Form PF3)
Questionnaire to be completed by those wishing to obtain a premium finance company license
PDF English
FIN166, PF4
Biographical Affidavit - Premium Finance Applicant (Form PF4)
Form to be completed by each individual named on Form PF2.
PDF English
FIN167, PF5
List of Other States of Licensure - Premium Finance Applicant (Form PF5)
List of other states where Premium Finance Company is licensed
PDF English
FIN168, PF6
Appointment of Statutory Agent and Consent to Service - Premium Finance Applicant (Form PF6)
Form to be completed by premium finance company, appointing statutory agent for service of process who resides in the state of Texas
PDF English
FIN169, PF7
Premium Finance Premium Comparison Disclosure Form
Disclosure form/notice regarding interest charges incurred when purchasing liability insurance through the Texas Automobile Insurance Plan Association (TAIPA), if paid through a monthly installment plan.
PDF English / Spanish
FIN170, PF Schedule A
Filings Required for Premium Finance Application for Additional Location (Schedule A)
Checklist outlining the documents required when Premium Finance Company is adding a location
PDF English
FIN171, PF Schedule B
Filings Required for Premium Finance Application for Relocation (Schedule B)
Checklist outlining documents required when a Premium Finance Company is relocating
PDF English
FIN172, PF Schedule C
Filings Required for Premium Finance Application for Name Change (Schedule C)
Checklist outlining documents required for a Premium Finance Company to change its name
PDF English
FIN173, PF Schedule D
Filings Required for Premium Finance Application for Change of Ownership (Schedule D)
Checklist outlining requirements for Premium Finance Company to change ownership
PDF English

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