Financial - Company Licensing and Registration Forms Listing
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Premium Finance - Company Licensing and Registration Forms
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| TDI form number | Description | Format | Language |
|---|---|---|---|
| FIN139 |
Annual Operations Report Form FIN139 required to be filed annually by premium finance company, due April 1. Rev. 3/2021 |
English | |
| FIN160, PF1 |
Application for An Insurance Premium Finance Company License (Form PF1) Premium Finance application for initial license to operate in Texas |
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 |
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 |
English | |
| FIN164, PF2 |
Premium Finance List of Principals List all officers, directors and contact persons of Premium Finance Company |
English | |
| FIN165, PF3 |
Questionnaire - Premium Finance Applicant (Form PF3) Questionnaire to be completed by those wishing to obtain a premium finance company license |
English | |
| FIN166, PF4 |
Biographical Affidavit - Premium Finance Applicant (Form PF4) Form to be completed by each individual named on Form PF2. |
English | |
| FIN167, PF5 |
List of Other States of Licensure - Premium Finance Applicant (Form PF5) List of other states where Premium Finance Company is licensed |
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 |
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. |
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 |
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 |
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 |
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 |
English |
For more information, contact: CompanyLicense@tdi.texas.gov