Insurance Law

How Do I Change My Name Or Address?

Each licensed agent is required by law to notify the Department in writing within 30 days of any change of residence or name. When notifying the Department of such changes, please submit a completed Service Request Form . Please be certain to include the following information:

  • Social Security number;
  • old address/name;
  • new address/name;
  • copy of divorce decree, if applicable (e.g. you are changing your current name to a previous name); and
  • copy of certificate from Clerk of the Court, Department of Vital Statistics, or other official document when making formal name change.

Any licensed resident agent who has moved his or her residence from the state of Indiana shall have all licenses terminated by the Department.