South Dakota
2012 Insurance for Individual
Licensees
Enrollment Form
(Prorated): 
Please use this form if you are an individual (rather than a
firm) licensee and want to purchase insurance through the
group program.
Reinstatement Form:
Individual (rather than firm) licensees who want to request
an effective date in a month prior to the date of purchasing
insurance through the group program
must use this
form.
If approved, the effective date may be backdated up to 90
days. Please note that backdating the effective date of
your insurance does not cure any failure to comply with the
state’s mandatory insurance requirements.
Endorsement
Request Form for Current Insureds:
Individual
(rather than firm) licensees who have purchased insurance through the
current group program and wish to add an endorsement(s) to their existing
policy
must use this form.
Upon applying for your real
estate license, you should send your E&O premium payment, made payable to the
South Dakota Real Estate Commission, along with your license application or
renewal to the South Dakota Real Estate Commission. If you have any
additional questions regarding purchasing coverage, please contact our
offices at the following:
Phone
(502) 897-1876
(800) 637-7319 Toll free
Email
Policy questions: policyadministrator@risceo.com
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