Insurance License Application

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Please correct the fields below:

Applicant
 *
Applicant
Payment Method:
Payment Method:
By signing below, I understand that there is a $150.00 fee per office location and that the fee is due by January 31st annually.
 
 *
The fee can be paid online by credit or debit card after processing is complete at www.roswellgov.com/GeneralBilling.

Alternatively, checks can be mailed to:
City of Roswell
38 Hill Street, Suite 210
Roswell, GA 30075
If you have any questions, please contact Financial Services Division at fsd@roswellgov.com or 770-641-3759.
  1. To receive a copy of your submission, please fill out your email address below and submit.