North Carolina Department of Insurance, Wayne Goodwin Commissioner
 
Agent Services Division
APPLICATIONS AND FORMS
 
How To Fill Out This Application:
 
In field 38 of this application, Surplus Lines license applicants would choose the following license type:
 
SLP – Surplus Lines Producer
 
In field 38 of this application, Risk Retention Group Agent and Risk Purchasing Group Agent license applicants would choose the following license type:
 
O – Other: Specify Type
 
And write in Risk Retention Group Agent OR Risk Purchasing Group Agent.