Available form formats
For best results, download and open this form in Adobe Reader. See General information for details.
You can view this form in:
|Form title:||Request for Licensee Information from FSRA|
Licensing - Insurance
|Purpose of form:||This form is used to: 1. request a certificate confirming the licence status of an individual, partnership, corporation, company; or 2. request the licensing history of an individual, partnership, corporation, company; or 3. request the licensing history of a mortgage agent or mortgage broker be submitted to another regulator for the purpose of reciprocal licensing.|