Search Results: "entity"
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Forms
| Action | Form Name |
|---|---|
| Change Name Correct SSN or FEIN Trade Name Notification Clearance Letter (moving out of Virginia) |
Form 5001 |
| Individual License Cancellation Request Form | Individual Cancellation |
| Agency License Cancellation Request Form | Agency Cancellation |
| Request for List of Resident Agents for Continuing Education Mailings | Guidelines and Form |
| Lines of Authority - Full Lines | Form Name |
| Life & Annuities Variable Contract Health Personal Lines Property & Casualty Title Title Instructor Certification and Affidavit of Course Completion |
Form 3001 (initial) Certification and Affidavit |
| Lines of Authority - Limited Lines | Form Name |
| Limited Lines Credit Limited Lines Life & Health Limited Lines Property & Casualty Motor Vehicle Rental Contract |
Form 3001 (initial) |
| Lines of Authority - Temporary | Form Name |
| Temporary Life & Health Temporary Life & Health (Debit Only) Temporary Property & Casualty |
Form 3001 (initial) |
| Lines of Authority - Non-Standard | Form Name |
| Consultant (Life & Health) Consultant (Property & Casualty) Public Adjuster Viatical Settlement Broker |
Form 3001 (initial) Form 3001REN (renewal) |
| Surplus Lines Broker | Form 3001 (initial) Form 3001REN (renewal) SLB-2 |
| Lines of Authority - Business Entity (Agency) | Form Name |
| Life & Annuities Variable Contracts Health Property & Casualty Title Limited Property & Casualty – Portable Electronic Insurance Limited Property & Casualty – Travel Insurance Limited Property & Casualty – Self Storage Insurance |
Form 4052 (initial) |
| Lines of Authority - Non-Standard Business Entity (Agency) | Form Name |
| Consultant (Life & Health) Consultant (Property & Casualty) Public Adjuster Viatical Settlement Broker |
Form 4052 (initial) Form 4052REN (renewal) |
| Surplus Lines Broker | Form 4052 (initial) Form 4052REN (renewal) SLB-2 |
| License Type - Reinsurance Intermediary | Form Name |
| Initial Application | RI-app |
| Renewal Application | RI-renew |
| Appointment | Form Name |
| Appointment Form | Form 4151 |
| Appointment Cancellation Form | Form 4921 |
| Non-Licensed 1033 Consent Waiver Form | Form Name |
| Non-Licensed 1033 Consent Waiver Form | Form 1033 |
| RESA Forms | Form Name |
| Title Settlement Agent and Agency Financial Responsibility Certification Form | TSA Form |
| Title Settlement Agent Surety Bond | TSA Surety Bond |
| Waiver of Blanket Fidelity Bond or Employee Dishonesty Insurance Policy for Title Insurance Settlement Agents | TSA Waiver |
| Settlement Agent Official Registration Form - Individual | RESA Individual |
| Settlement Agent Registration Form - Corporation or Other Legal Entity | RESA Corp |
| Annuity Suitability | Form Name |
| Insurance Agent (Producer) Disclosure for Annuities | Form CN01 |
| Consumer Refusal to Provide Information | Form CN02 |
| Consumer Decision to Purchase an Annuity NOT Based on a Recommendation | Form CN03 |
| Unlicensed Ocean Marine Disclosure Form | Form Name |
| Unlicensed Ocean Marine Disclosure Form | Unlicensed Ocean Marine Disclosure Form |
| Annual Certification of Anti-Fraud Initiatives Form | Form Name |
| Annual Certification of Anti-Fraud Initiatives Form | Annual Certification of Anti-Fraud Initiatives Form |
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Investment Advisor/Representative Registration
The Registration section is charged with administering the registration provisions of the Virginia Securities Act (“Act”), and it’s promulgated Rules. The goal of the Act is to protect the investing public by requiring all broker-dealers, agents, investment advisors, and investment advisor representatives to register before conducting business in the state of Virginia. The registration provisions of the Act require that each applicant submit relevant information to ensure that individuals and firms dealing with Virginia investors meet a high standard of conduct, have passed required securities examinations, and are financially solvent. In addition to registration, registrants must continuously update their records as changes occur.
Who Must Register?
Any person engaged in the business of selling any type of security for the account of others or for his/her own account, and any person advising others as to the value of securities and charging a fee, is required to register. Every entity that performs such duties in the Commonwealth must register unless exempted from registration by the Act.
Investment Advisor & Representative Registration Instructions
Conversions
Virginia Limited Partnerships:
Virginia limited partnerships may convert to a Virginia stock corporation, limited liability company, or business trust. A Virginia limited partnership may not convert to any other foreign business entity type.| Convert to | Required Forms | Fee |
| Stock Corporation |
|
$25 + any additional charter fees |
| Limited Liability Company | $100 File Online |
|
| Business Trust |
|
$100 File Online |
Foreign Limited Partnerships:
Foreign limited partnerships may convert to a Virginia stock corporation.| Convert to | Required Forms | Fee |
| Stock Corporation |
|
$25 + any additional charter fees |
Conversions
Virginia limited liability companies:
Virginia limited liability companies may convert to a Virginia stock corporation or a business trust. A Virginia limited liability company may not convert to any other foreign business entity type.| Convert to | Required Form | Fee |
| Stock Corporation |
|
$25 + any additional charter fees File Online |
| Business Trust |
|
$100 File Online |
Foreign limited liability companies:
Foreign limited liability companies may convert to a Virginia stock corporation.| Convert to | Required forms | Fee |
| Stock Corporation |
|
$25 + any additional charter fees |
Conversions
Virginia Business Trusts:
Virginia business trusts may convert to a Virginia stock corporation or limited liability company. A Virginia business trust may not convert to any other foreign business entity type.
| Convert to | Required Forms | Fee |
| Stock Corporation |
|
$25 + any additional charter fees |
| Limited Liability Company |
|
$100 File Online |
Foreign Business Trusts:
Foreign business trusts may convert to a Virginia stock corporation.
| Convert to | Required Forms | Fee |
| Stock Corporation |
|
$25 + any additional charter fees |
Pharmacy Benefits Mgmt
Any individual or entity providing pharmacy benefits management services or otherwise acting as a pharmacy benefits manager in Virginia on or after October 1, 2020, is required to obtain a license unless otherwise covered by a carrier’s license. Beginning April 1, 2022, all license applications must be filed electronically through Sircon using the application link below.
Apply for a License:
To apply, submit an application for an initial license or renewal license and pay the specified application fee. For an initial license, the fee is $250; to renew a license, the fee is $100. Licenses may be renewed beginning 90 days prior to the October 1 annual effective date.
Initial Licensure:
When completing an application for initial licensure via Sircon, resident applicants must select “New Insurance Licenses” and non-resident applicants must select “Other Licenses.”
License Renewal:
When completing an application for license renewal via, select "Renew Insurance Licenses".
Existing licenses not renewed by October 1, will be processed as an initial license and require payment of the $250 license fee.
View Administrative Letter 2020-04 (Revised 6/27/2023) for further information.
