Blank Texas Fin533 PDF Template
Form Example
FIN533 | 0421
Agent/adjuster name or address change request
You must fill out and send us this form within 30 days of a change to your name or address.
Notes: If you’ve moved from Texas to another state, contact the department of insurance in your new state before submitting this form. You must have a license in your new state of residence before we can change your Texas license to a nonresident license.
If you’re a licensed agent or adjuster in another state who has moved to Texas, you must fill out form FIN594.
TDI license number
First name |
Middle name |
Last name |
Suffix |
►Fill out this section if you changed your name:
New legal name
First name |
Middle name |
Last name |
Suffix |
📎📎Attach a copy of an official document showing that your name changed. For example, send a copy of a marriage certificate or divorce decree.
►Fill out all parts of this section if your address changed:
Phone numbers
Personal ( )
Business ( )
Email addresses
Personal
Business
FIN533 | 0421
Business address |
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Street address ________________________________ |
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City |
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State |
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ZIP |
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Mailing address |
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Street address or P.O. Box |
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📎📎 A P.O. Box will be accepted only for a mailing address.
Resident address
Street address
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State |
_ ZIP |
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📎📎 Attach a copy of a Letter of Certification from your resident state.
►Sign here:
The answers I gave on this form are true and correct:
Licensee signature |
Date |
Print name
►Contact us if you have questions:
You can: (1) email License@tdi.texas.gov, or (2) call
►Know your rights:
You can request information we have about you by emailing OpenRecords@tdi.texas.gov or writing to: Public Information Coordinator, Texas Department of Insurance, PO Box 12030 (mail code GC- ORO) Austin, Texas
Texas Department of Insurance |
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Common mistakes
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Neglecting to Submit Within the Deadline: One common mistake is failing to send the form within the required 30 days after a name or address change. This can lead to complications with your licensing status.
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Inaccurate Personal Information: Some individuals mistakenly provide incorrect details such as their TDI license number or personal information. This can delay the processing of the form.
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Omitting Required Documentation: Applicants often forget to attach necessary documents, like a marriage certificate or divorce decree when changing their name. Without these, the form may be rejected.
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Improper Address Formatting: Another frequent error is not formatting the address correctly. For example, using a P.O. Box for the resident address instead of the mailing address can lead to confusion.
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Ignoring Signature Requirements: Some people overlook the need to sign the form. Without a signature, the submission is incomplete and cannot be processed.
Key takeaways
- Timely Submission: Submit the Texas Fin533 form within 30 days of any change to your name or address to ensure compliance with state regulations.
- Out-of-State Moves: If you’ve relocated from Texas to another state, contact your new state's department of insurance before filling out this form.
- Documentation Required: Attach an official document, such as a marriage certificate or divorce decree, to verify any name changes.
- Multiple Addresses: Fill out all relevant sections if your address has changed, including personal, business, and mailing addresses.
- License Verification: If you are moving to Texas from another state and are a licensed agent or adjuster, you must complete form FIN594 instead.
- Contact Information: For questions, you can email License@tdi.texas.gov or call 512-676-6500 for assistance.
Steps to Using Texas Fin533
To update your name or address with the Texas Department of Insurance, you need to complete the Texas Fin533 form. This process ensures that your information remains current and accurate. Follow the steps below carefully to fill out the form correctly.
- Obtain the Texas Fin533 form from the Texas Department of Insurance website or any authorized source.
- Locate your TDI license number at the top of the form and enter it in the designated space.
- Fill in your first name, middle name, last name, and suffix as they appear on your current license.
- If you have changed your name, provide your new legal name in the specified fields. Include your first name, middle name, last name, and suffix.
- Attach a copy of an official document that verifies your name change, such as a marriage certificate or divorce decree.
- If your address has changed, fill out the phone numbers section with your personal and business phone numbers.
- Provide your personal and business email addresses in the appropriate fields.
- Complete the business address section with your new street address, city, state, and ZIP code.
- For the mailing address, enter either your street address or P.O. Box, along with the city, state, and ZIP code. Remember, a P.O. Box is only acceptable for mailing addresses.
- Fill out your resident address with the street address, city, state, and ZIP code.
- Attach a copy of a Letter of Certification from your resident state if applicable.
- Sign and date the form in the designated area, confirming that the information provided is true and correct.
- Print your name below your signature.
- Review the completed form for accuracy before submission.
- Send the form and all attachments to the Texas Department of Insurance using the address provided on the form.