Click the link below to view and verify the PDF report. You will need to save the PDF report on your computer prior to uploading the report through the Annual License Renewal and Finanical Filing Submission Portal. Click "Return to Previous Screen" should you need to make changes.
WARNING: Save the PDF to your computer prior to leaving this page or closing the browser window. Failure to do so will result in the loss of all changes made and will reset all values to their original values.
After completing Step 1, go to the Company Renewal Portal (this link will open in a new browser window) to upload the saved report. Directions will be available to assist you in submitting your report via the portal.
To complete and save another Purchasing Group Demographic and Carrier Information form, go to Enter Another License Number.