CITIZENSHIP AFFIDAVIT SUBMISSION INSTRUCTIONS

BULLETIN 20-EX-14 TO: ALL INSURANCE AGENTS LICENSED BY OR APPLYING FOR LICENSING BY THE STATE OF GEORGIA FROM: JOHN F. KING INSURANCE AND SAFETY FIRE COMMISSIONER DATE: NOVEMBER 16, 2020 RE: CITIZENSHIP AFFIDAVIT SUBMISSION INSTRUCTIONS ____________________________________________________________________________________ Due to the passage of the Illegal Immigration Reform and Enforcement Act of 2011, the Georgia Office of Commissioner of Insurance and Safety Fire is required to verify the lawful presence of all new applicants and any non-U.S. citizens on renewal subject to licensure by our office. This includes Agents and Agencies for new submissions. Your license application cannot be processed if this information is not submitted correctly. We have received a large number of applications, particularly non-resident applications, that have NOT attached the Citizenship Affidavit Form and secure verifiable identification documents as required by law. Failure to submit these documents will create a delay in receiving approval for licensure. Submission Requirements and Process 1. Print, complete, sign, and notarize the Citizenship Affidavit Form 2. Make a copy of the FRONT and BACK of one of the secure and verifiable identification documents from the list provided 3. Submit the form and the copy of the front and back of the acceptable identification document 4. Submission can be done after completing and paying for your application online via NIPR (https://nipr.com/) or Sircon (https://www.sircon.com/landingPages/states/georgia/content.jsp) Be sure to review the step-by-step submission process for NIPR or Sircon. Your application CANNOT be processed for approval until this form and attachments are received. _____________________________________________ JOHN F. KING INSURANCE AND SAFETY FIRE COMMISSIONER STATE OF GEORGIA