For a Resident Agent license, you will need to submit to Agent Licensing:
- Form LA3 (Revised 6/1997)
Part I Completed by applicant; must be signed & notarized.
Part II Completed and signed by Appointing Official for the insurance company.
Acknowledgment of issuance of license will be mailed to the insurance company. License card will be mailed directly to the Agent's residence address. Selfaddressed envelope must be submitted with every application. - Original prelicensing Course Completion Certificate (Form PL789E)
- Original testing service score report.
- Clearance letter(s) from any other state(s) applicant held resident license. If you have an approved Waiver (from prelicensing education and part I of exam), submit the original approved Waiver form with your application.
- License fee $25.00 Checks made payable to WEST VIRGINIA INSURANCE COMMISSIONER
Residents applying for a Variable Annuity License must hold a life license or be applying for a life license and must submit:
Form LA3 (Revised 6/1997)Part I completed and signed by Agent.
Part II completed and signed by Appointing Official.
Copy of NASD registration (Series 6 or Series 7 AND Series 63).
License fee$25.00 if applying for a Life license.
No fee if already licensed for Life and only applying for Variable Annuity.
No insurance department exam required.
Selfaddressed envelopeAcknowledgment will be mailed to requesting insurance company.
For individuals selling credit life/credit accident & sickness coverage through auto dealerships, financial institutions or any other business where credit life/credit accident & sickness is offered in connection with products offered by these facilities, no prelicensing education or exam is required. Please submit:
Form CLA1completed and signed by Agent and Company.
Affidavit regarding child support obligation.
License fee$25.00 per company.
Make check payable to WEST VIRGINIA INSURANCE COMMISSONER.
Selfaddressed envelopeAcknowledgment will be mailed to requesting insurance company.
