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LICENSE INACTIVATION REQUEST FORM (USED FOR CLEARANCE LETTER OR VOLUNTARY SURRENDER) PENNSYLVANIA INSURANCE DEPARTMENT BUREAU OF PRODUCER SERVICES ROOM 1209 STRAWBERRY SQUARE HARRISBURG, PA 17120

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What is license inactivation request form?

A license inactivation request form is a document used to request the deactivation or cancellation of a license or permit. This form is typically submitted to the relevant licensing authority or regulatory body.

Who is required to file license inactivation request form?

Any individual or entity that wants to deactivate or cancel their existing license or permit is required to file a license inactivation request form. This could include businesses, professionals, or any other party holding a valid license.

How to fill out license inactivation request form?

To fill out a license inactivation request form, you need to provide certain information as required by the licensing authority. This may include details such as your name, contact information, license number, reason for deactivation, and any supporting documentation. The specific instructions for filling out the form will be provided by the licensing authority.

What is the purpose of license inactivation request form?

The purpose of a license inactivation request form is to formally request the deactivation or cancellation of a license or permit. This allows individuals or entities to notify the licensing authority of their intention to no longer engage in the activities covered by the license.

What information must be reported on license inactivation request form?

The information required on a license inactivation request form may vary depending on the specific licensing authority and the type of license being deactivated. Generally, you will need to provide details such as your name, contact information, license number, reason for deactivation, and any supporting documentation as required.

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