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

Information Update Forms
TDI form number	Description	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