Forms

Each Service Contract Provider who intends to use a reimbursement insurance policy to meet their financial security requirement must obtain a Texas endorsement. The endorsement must be filed with the Texas Department of Insurance (TDI) for approval. Once the endorsement has been approved, a copy of the approval letter from TDI must be submitted to the department before issuance of the license. The Texas endorsement is required for each policy.

SCP-LIC-002 — Service Contract Provider Registration Application (PDF)

Form SCP 005 — Sample Letter of Credit (PDF)

SCP-LIC-007 — Service Contract Provider Administrator Application(PDF)

SCP-LIC-009 — Service Contract Provider Personal Information Form (PDF)

SCP-LIC-010 — Identity Recovery Service Contract Quarterly Report (PDF)

Form #012 SCP, Funded Reserve and Security Deposit Financial Security Calculation Form (PDF)

SCP-LIC-014 — Service Contract Provider Transition Form (PDF)

SCP 030 — Texas Endorsement Form (PDF)

Social Security Number Status Certification(PDF)

Order a Duplicate License Online

Form #002 LIC, Criminal History Questionnaire (PDF)

Criminal History Evaluation Letter

Disciplinary Action Questionnaire (PDF)

Request to Executive Director for Expired License Renewal Form (PDF)

Military Service Member, Military Veteran, or Military Spouse Supplemental Application (PDF) - see Military Spouse Frequently Asked Questions

TDLR Complaint Sign (PDF)

Form AP-152, Texas Application for Payee Identification Number (pdf, will open in a new window)

Voluntary License Surrender Form (PDF)