Agent/Adjuster Licence Reinstatement Form

A Reinstatement Form may only be completed for individuals who have held a licence within the past 12 months and who are wishing to reinstate their licence with the same employer and/or sponsor.

This reinstatement form is only applicable if there are no required changes to your licence.  This form may not be used for transfers or amendments including change of sponsor, agency or business/trade name, where the full application is required.

Mandatory licensing documents, such as proof of continuing education credits, will be required and in some instances proof of valid professional liability insurance (E&O).  Reinstatement is subject to ICM review and approval.

Note that a reinstatement fee of $70.00 is required in addition to the annual licence fee listed on the application form.

Reinstatement Form

Where You'll Find Us

466-167 Lombard Avenue
Winnipeg, Manitoba
R3B 0T6
  • PHONE:
    (204) 988 6800
  • FAX:
    (204) 988 6801