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Forms - Insurance Intermediaries

Licence Application Forms

For how long it will take the IA to process a licence application, please visit our Licence Application webpage.

Form	Form Details	View
A1	Individual Licence Application (Individual Insurance Agent/TR(A)/TR(B)) Applicants are required to submit licence application via Insurance Intermediaries Connect (“IIC”). Important Notes: Please read "Notes on Application for Insurance Intermediary Licence" before completing Form A1. Before submission, please also check the Register of Licensed Insurance Intermediaries to ensure the applicant is not holding an active licence with the Insurance Authority. If the applicant is holding an active licence and he/she/it is not going to change his/her/its licence type under a new appointment, then a Form N2 should be used to notify the IA of the new appointment instead of Form A1. Please note that a new appointment of an active licensee is NOT a new application.	IIC
A2	Online Portal – Application for Opening of Supervisor Account Authorized insurers, licensed insurance agencies and licensed insurance broker companies are required to submit an originally signed Form A2 to apply for opening of a Supervisor Account of Insurance Intermediaries Connect for e-submission of applications for individual licence. For more information about the Insurance Intermediaries Connect, please refer to the following user guides: User Guide of the Insurance Intermediaries Connect for Individual Applicants to Submit an Individual Licence Application User Guide of the Insurance Intermediaries Connect for Principals Demonstration Video - Opening of Supervisor Account of the Insurance Intermediaries Connect Demonstration Video – Activation of Individual Account Demonstration Video – Completion and Submission of Application Form Demonstration Video – Amendment to Application Form Introduction Video - Licensing and Related Fees IIC Leaflet
A3	Application for Proposed Appointment of a Responsible Officer Existing agency and broker company applicants are required to download and submit a duly-filled application form via Insurance Intermediaries Connect. Application being made as part of a new licence application for an insurance agency or insurance broker company, should be submitted by paper application.
A4	Application for Insurance Broker Company Licence Please submit an application in paper form. Please provide the Insurance Authority with the documents specified in the following checklist when submitting the insurance broker company licence application. Checklist of Documents for Insurance Broker Company Licence Application
A5	Application for Insurance Agency Licence Please submit an application in paper form. Please provide the Insurance Authority with the documents specified in the following checklist when submitting the insurance agency licence application. Checklist of Documents for Insurance Agency Licence Application
A6	Application for Approval of the Varying Line(s) of Business by Individual Insurance Agent/TR(A)/TR(B) Applicants are required to submit licence application via Insurance Intermediaries Connect. Application for Approval of the Varying Line(s) of Business by Insurance Agency and Insurance Broker Company Please submit an application letter in paper for approval of the varying line of business.	IIC

Licence Renewal Form

Form	Form Details	View
R1	Application for Renewal of Licence (Individual Insurance Agent/TR(A)/TR(B)) Licensees are required to submit licence renewal application via Insurance Intermediaries Connect. Important Notes: Under Section 64ZV of the IO, renewal application of a licensed insurance intermediary may only be made no later than 45 days before the licence is due to expire. Otherwise, IA will not be able to guarantee that such application will be processed before the expiry date. Online Portal - Insurance Intermediaries Connect Licensed individual insurance agents, licensed technical representatives (agent) and licensed technical representatives (broker) are required to activate an Individual Account of Insurance Intermediaries Connect for e-submission of applications for renewal of licence. For more information about the Insurance Intermediaries Connect, please refer to the following user guides: User Guide of the Insurance Intermediaries Connect for Individuals - Licence Renewal Application User Guide of the Insurance Intermediaries Connect for Principals - Licence Renewal Application	IIC
R4	Application for Renewal of Licence (Insurance Broker Company) Licensees are required to submit licence renewal application via Insurance Intermediaries Connect. Important Notes: Under Section 64ZV of the IO, renewal application of a licensed insurance intermediary may only be made no later than 45 days before the licence is due to expire. Otherwise, IA will not be able to guarantee that such application will be processed before the expiry date.	IIC
R5	Application for Renewal of Licence (Insurance Agency) Licensees are required to submit licence renewal application via Insurance Intermediaries Connect. Important Notes: Under Section 64ZV of the IO, renewal application of a licensed insurance intermediary may only be made no later than 45 days before the licence is due to expire. Otherwise, IA will not be able to guarantee that such application will be processed before the expiry date.	IIC

Notification Forms

Form	Form Details	View
N1	Notification of Termination of Appointment Principals are required to submit the notification via Insurance Intermediaries Connect. Under section 64R of the IO, within 14 days after the day on which an authorized insurer, a licensed insurance agency or a licensed insurance broker company (collectively, “Appointing Principal”) terminates the appointment of a licensed insurance agency, a licensed individual insurance agent, a licensed technical representative (agent), a licensed technical representative (broker) or a responsible officer (as the case may be), the Appointing Principal should notify the IA in submitting of the termination.	IIC
N2	Notification of Appointment Principals are required to submit the notification via Insurance Intermediaries Connect. Under section 64Q of the IO, at least 14 days before an authorized insurer, a licensed insurance agency, or a licensed insurance broker company (collectively, “Appointing Principal”) appoints a licensed insurance agency, a licensed individual insurance agent, a licensed technical representative (agent), a licensed technical representative (broker) (as the case may be), to carry on regulated activities in one or more lines of business as an agent of the Appointing Principal, the Appointing Principal should notify the IA in writing of the intended appointment.	IIC
N3	Notification of Change in Particulars (Individual Insurance Agent/TR(A)/TR(B)) Under section 64P of the IO, a licensed insurance intermediary must notify the IA of any change of particulars (i.e. name, business or residential business, telephone number or email address) within 14 days after the date on which the change takes place. Important Notes: The IA only accepts paper notification of change in mobile number or email address to retrieve Insurance Intermediaries Connect login details. Other than that, licensees are required to submit notification via Insurance Intermediaries Connect.
N4	Notification of Change in Particulars (Insurance Agency/Insurance Broker Company) Licensees are required to submit the notification via Insurance Intermediaries Connect. Under section 64P of the IO, a licensed insurance intermediary must notify the IA of any change of particulars (i.e. name, business address, telephone number or email address) within 14 days after the date on which the change takes place. For change of name and business address, please also submit the new business registration certificate and the notification forms filed with the Companies Registry as the supporting documents.	IIC
N5	Notification of Change in Partners, Directors or Controllers of a Licensed Insurance Agency or Licensed Insurance Broker Company Under section 64ZZD of the Insurance Ordinance, a licensed insurance intermediary must notify the IA in writing of any change in partners, directors or controllers within 1 month after the date on which the change takes place.

Supplemental Forms

Form	Form Details	View
S1	Supplemental Form – Information on Other Licence(s)
S2	Supplemental Form – Information on Bankruptcy, Liquidation or Similar Proceedings
S3	Supplemental Form – Information on Criminal Record
S4	Supplemental Form – Information on Disciplinary Action Record
S5	Supplemental Form – Information on Director/Controller (Individual)
S6	Supplemental Form – Information on Director/Controller (Body Corporate)

Other Forms

Form	Form Details	View
--	Continuing Professional Development (CPD) Declaration Form for the CPD Assessment Period of 2024 - 2025	New
O1	Request for Licence Revocation by Licensed Insurance Intermediary Licensees are required to submit licence revocation request via Insurance Intermediaries Connect.	IIC