"Clearance Letter Request" - New Hampshire

Clearance Letter Request is a legal document that was released by the New Hampshire Insurance Department - a government authority operating within New Hampshire.

Form Details:

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  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the New Hampshire Insurance Department.

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Download "Clearance Letter Request" - New Hampshire

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The State of New Hampshire
Insurance Department
21 South Fruit Street, Suite 14
Concord, NH 03301
Christopher R. Nicolopoulos, Esq.
Alexander K. Feldvebel
Commissioner
Deputy Commissioner
PRODUCERS----ADJUSTERS----BUSINESS ENTITIES
CLEARANCE LETTER REQUEST
(A request for a clearance letter terminates your resident license in NH)
Please fax to 603-271-7029 or email to
producerquestions@ins.nh.gov
This form is to be completed by NH Licensees who are moving from NH to another state and said state
requires verification of termination of resident license in NH in the form of a clearance letter.
The status of all NH licenses is reported daily to the NIPR database. The cancellation of the NH license
will appear in the national database the following day. This is sufficient verification for most states.
Most states no longer require clearance letters. Check with your new resident state to make sure they
actually require a letter. If a clearance letter is not required, submit a surrender of license request.
Should you wish to maintain a NON-RESIDENT license in NH, you have 30 days from termination of
your NH Resident license to provide us with an address change form and $10 fee.
NH License # _______________________________________
NPN
_______________________________________
Name: ______________________________________________________
Current address________________________________________________
______________________________________________________
Moving to what State? ________________
Licensee Signature and Date_________________________________________
EMAIL address to send clearance letter: ___________________________________________________
If you wish to maintain a non-resident license in NH you must obtain a Resident license in your new state within 30
days.
Notify the NH Insurance Dept by submitting a complete a contact change request via the NIPR website
www.nipr.com
or submit a written request or utilize the address change form on our website and submit the
required $10 fee or within 30 days of this clearance letter
The State of New Hampshire
Insurance Department
21 South Fruit Street, Suite 14
Concord, NH 03301
Christopher R. Nicolopoulos, Esq.
Alexander K. Feldvebel
Commissioner
Deputy Commissioner
PRODUCERS----ADJUSTERS----BUSINESS ENTITIES
CLEARANCE LETTER REQUEST
(A request for a clearance letter terminates your resident license in NH)
Please fax to 603-271-7029 or email to
producerquestions@ins.nh.gov
This form is to be completed by NH Licensees who are moving from NH to another state and said state
requires verification of termination of resident license in NH in the form of a clearance letter.
The status of all NH licenses is reported daily to the NIPR database. The cancellation of the NH license
will appear in the national database the following day. This is sufficient verification for most states.
Most states no longer require clearance letters. Check with your new resident state to make sure they
actually require a letter. If a clearance letter is not required, submit a surrender of license request.
Should you wish to maintain a NON-RESIDENT license in NH, you have 30 days from termination of
your NH Resident license to provide us with an address change form and $10 fee.
NH License # _______________________________________
NPN
_______________________________________
Name: ______________________________________________________
Current address________________________________________________
______________________________________________________
Moving to what State? ________________
Licensee Signature and Date_________________________________________
EMAIL address to send clearance letter: ___________________________________________________
If you wish to maintain a non-resident license in NH you must obtain a Resident license in your new state within 30
days.
Notify the NH Insurance Dept by submitting a complete a contact change request via the NIPR website
www.nipr.com
or submit a written request or utilize the address change form on our website and submit the
required $10 fee or within 30 days of this clearance letter