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Reinsurance Intermediary Broker or Manager

IC 27-6-9 and 760 IAC 1-51

All RIM and RIB applications are to be submitted electronically at www.sircon.com/Indiana.  Once the application is approved applicant can print license from the Sircon website.  IDOI will no longer email the license.  The following items need to be attached to the electronic application.  Items marked with an "*" are only required for RIMs.  Within the electronic application there will be additional items to attach that  a specific form isn't required.

Broker Checklist 

Manager Checklist*

Uniform Consent to Service of Process

Biographical Affidavit*

If you have any questions regarding the submission of renewal, please contact Connie Wright, Admission Coordinator at cowright1@idoi.in.gov .