836-071-0101 Adjuster and Insurance Consultant License Application; Required Information (1) An applicant for an adjuster or insurance consultant license, or for a temporary adjuster permit under ORS 744.555, shall submit an application in the form and manner set forth on the department’s Division of Financial Regulation website at dfr.oregon.gov. In addition to information required under Oregon Laws 2019, chapter 151, sections 5 and 12, an applicant for an adjuster or insurance consultant license shall provide the following information relating to the applicant, as applicable on the application form: (a) Date and place of birth; (b) Duration of employment in insurance. Include the beginning and ending dates and the names and addresses of each employer and prior places of business in the insurance industry; (c) All states and provinces of Canada in which the applicant currently holds a license to engage in the transaction of insurance, or has held such a license within ten years prior to the date of the application; (d) Any assumed business name or alias ever used; (e) Whether any firm or corporation of which the applicant is or has been a member, officer or director has ever filed for bankruptcy or been adjudged a bankrupt; (f) The Social Security or other federally-issued identification number of the applicant; and (g) If the applicant is a firm or corporation, the name of all current officers, directors and stockholders who own more than ten percent of any class of equity security of the applicant. (2) An applicant for a resident adjuster or insurance consultant license who is or has been licensed as a resident producer, adjuster or insurance consultant in another state or a province of Canada within five years prior to the date of application shall include with the application a statement that the resident license is inactive or no longer valid from the insurance department of the state or province in which the applicant is or was last authorized to transact insurance. (3) An applicant for a non-resident adjuster or insurance consultant license who is licensed as a resident producer, adjuster or insurance consultant in another state or province of Canada shall include with the application a statement of current licensure from the insurance department of the state or province in which the applicant was authorized to transact insurance as a resident licensee. The statement must indicate that the applicant has a current license for the class or classes of insurance that are being applied for in Oregon. The statement must be dated not earlier than the 90th day prior to the date of application. (4) The director may collect Social Security numbers submitted in applications under this rule and may use a Social Security number of an individual when authorized to do so for the purposes specified in this section. In addition to the governmental uses for which a Social Security number is required in an application under federal and state law, when authorized by the holder of a Social Security number, the director may use a Social Security number for any of the following purposes: (a) As an identification number in maintaining records and reporting grades or examination scores; (b) For licensing purposes; and (c) For use by other government agencies to carry out their statutory duties. (5) An applicant may voluntarily allow the director to use the Social Security number of the applicant, as the director may request in the application form, for the purposes specified in section (4) of this rule. Refusal to voluntarily allow such use of the Social Security number will not result in the denial of any individual right, benefit or privilege provided by law. The use authorized by an applicant is in addition to uses authorized by state and federal law for which collection of Social Security numbers is mandatory. Statutory/Other Authority: ORS 731.244 & Or Laws 2019, ch 151 Statutes/Other Implemented: Or Laws 2019, ch 151, sections 5 and 12 & ORS 744.555 History: ID 10-2019, amend filed 11/27/2019, effective 01/01/2020 ID 2-2010, f. 1-8-10, cert. ef. 2-1-10 ID 9-2002, f. & cert. ef. 3-18-02 ID 15-1996, f. & cert. ef. 11-12-96 ID 3-1990, f. & cert. ef. 1-19-90