Forms

All New Applicants using Form(s) 1, 2, 3 or 9 Must provide a Security Clearance (Criminal Record Check) with their application. Applications submitted without this document will not be processed.
ALL APPLICATIONS MUST INCLUDE YOUR CIPR# PLEASE ADD IT IN THE SPACE PROVIDED AT THE TOP OF THE APPLICATION FORM BEFORE YOU SEND IT TO THE AIC.

All of the applications below except those using the Form 5 must be accompanied by a fully completed and signed Errors & Omissions Reporting Form.

  • Applications received without this form will not be processed until the required information is provided.
  • We will accept signed, scanned copies of the Errors and Omissions Reporting Form by email.

Restricted Certificate applicants continue to enter this information on the Form 5.

Form 1 – Designated Representative for General, Life and Accident and Sickness Insurance recommended by an Insurer, must be accompanied by Corporate Form 6 application.

Form 3 – Designated Representative for Adjusting Firms, must be accompanied by Corporate Form 6 application.

Form 6 – Corporate application, required by all business other than Restricted holders and Limited Adjusters.

Form 5 – Restricted certificate holders such as Automobile Dealers, Marine Dealers, Recreational Dealers, Farm Implement Dealers, Construction Equipment Dealers,Travel Agency, Transportation Company, Deposit Taking Institutions, Sales Finance Company, Customs Broker and Freight Forwarder.

Form 8 – Limited Corporate Adjuster application, required by all business that operate as limited Adjusters ( Hail, Travel & Equipment Warranty) .

Form 9 – Limited Adjuster Application, required by all individuals that act as limited adjuster ( Hail, Travel & Equipment Warranty).