Financial Division Forms
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Fraternal Life, Accident and Health Property and Casualty |
Title Other
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- Accredited Reinsurers Instructions
- Accredited Reinsurers Checklist
- Accredited Reinsurers Remittance Voucher
- Accredited Reinsurers Agreement and Application Form
- Accredited Reinsurers Certificate of Assuming Insurer (AR-1)
- Oklahoma Health Insurance High Risk Pool
- Captive CPA Application
- Captive Actuary Application
- Captive Application
- Captive Management Firm Application
- OK Captive Annual Report blank 2012
- Annual Report Instructions
CEMETERY MERCHANDISE TRUST FORMS
- Allocation of Fees
- Cemetery Merchandise Annual report
- Application for Cemetery Merchandise Permit
- Renewal of Cemetery Merchandise Permit
- Oklahoma Quarterly Report of Cemetery Merchandise
- Surety Bond
- Sellers Notice to Commissioner (CMT)
- Application for Purchase of Cemetery
- UCAA Forms, Applications and Checklists
- UCAA Form 12 Uniform Consent to Service of Process (Fee $10)
- UCAA Form 11 Biographical Affidavit
- Foreign Redomestication Instructions
- Merger/Acquisition Instructions
- Name Change Instructions
- Surrender LOA Instructions
- Add LOA Instructions
DISCOUNT MEDICAL PLAN ORGANIZATION FORMS
- Discount Medical Plan Organization Registration Checklist
- Discount Medical Plan Organization Application
- Discount Medical Plan Organization Surety Bond
- Discount Medical Plan Organization Listings
- Notice of Audited Financial Statement
- Notice of Quarterly Marketer Listing
- Annual Report and Instructions for Pre-Paid Funeral Benefits
- Instructions for Completing Irrevocable Letter of Credit
- Irrevocable Pre-Paid Funeral Benefits Contract
- Bond Form
- Trust Agreement Form
- Funeral Home Application for Original Permit
- Application for Renewal of Permit
- Non-Specified Contract For The Deposit Of Money
- Guaranteed Contract for Merchandise and Service
- Assumption Affidavit
- Sellers Notice to the Insurance Commissioner
- Prepaid Funeral Frequently Asked Questions
- Insurance Assignment Form
- Termination of Contract/Withdraw of Funds
- Application to Transfer Pre-need Funds
- Request for Withdrawal of Accrued Interest
- Application to Withdraw Funds Deposited for Prepaid Funeral Benefits
Lincoln Memorial LIC / National Prearranged Services
- Death Claim Instructions
- Verified Statement of Performance
- LMLIC Change of Bank Form
- LMLIC Death Claims Submission Guide
- Next of Kin/Personal Representative Form
HEALTH MAINTENANCE ORGANIZATION (HMO)
HOME SERVICE CONTRACT PROVIDERS
- HSC Provider Registration Application
- HSC Provider Registration Application Checklist
- HSC Contractual Liability Policy Checklist
- Quarterly Administrative Fee Statement HSCP
- HSCP Surety Bond
- Motor Service Club Licensing Requirements
- Motor Service Club Checklist and Application - New Company
- Motor Service Club License Renewal Application & Checklist
- Motor Service Affidavit
- Declaration of Liability as Surety on Guaranteed Arrest Bond Certificates
- Motor Service Club Bond
- Motor Service Club Bond Questionnaire
ORDERING CERTIFICATES, QUARTERLY & ANNUAL STATEMENTS
- Identification form for Allocation of Fees
- Cemetery Perpetual Care Fund Certificate of Deposit Report
- Perpetual Care Annual Report (for use with Perpetual Care Fund Certificate of Deposit Accounts)
- Perpetual Care Annual Report (for use with Perpetual Care Fund Trust Accounts)
- Application for Purchase of Cemetery
PROFESSIONAL EMPLOYER ORGANIZATIONS
- Exemption PEO Application/Renewal Registration
- Full PEO Application/Renewal Registration
- Group PEO Application/Renewal Registration
- What is a PEO
- PEO Bond Form
- Oklahoma Registered PEOs
- Biographical Affidavit Template
- Bulletin 2012-01
- Bulletin 2012-01 Addendum
- Security Deposit Requirements
- Authorized Signature Update
- Sample Securities Notice to Bank Institutions
- CD Certification and Agreement by Financial Institution
- CD Pledge Insurers Form
- Service Warranty Exemption Memo
- Exemption Request Checklist
- Service Warranty Association Checklist
- Service Warranty Application
- Contractual Liability Policy Checklist
- Surety Bond Form
- Quarterly Administrative Fee Statement
- Service Warranty License Renewal Form
- Annual Financial Statement Filing Instructions
- Service Warranty Annual Statement
- Service Warranty Exemption Form
- Biographical Questionnaire
- Service Warranty Guarantee Agreement Form
- Reduced Admin Fee Voucher - 2013
- Application Checklist for a Surplus Lines Carrier Approval
- Application and Agreement for Approval as a Surplus Lines Carrier
- Annual Surplus Lines Carrier's Filing Requirements
- List of Oklahoma Approved Surplus Lines Companies
- Annual Surplus Line Brokers Filing Requirements and Forms
- Contact Notification Form
Broker Quarterly Summary Reports
- Instructions for Filing Surplus Lines Broker Quarterly Summary Reports
- Surplus Lines Insurance Broker Quarterly Summary Report (SL-3a)
- Surplus Lines Broker Quarterly Summary of Operations (SL-3b)
- Surplus Lines Insurance Broker Form (SL-3c)
- Surplus Lines Insurance Broker Credit or Refund Form (SL-3d)
Direct Placement Summary Reports
- Instructions for Filing Surplus Lines Direct Placement Summary Reports
- Surplus Lines Insurance Direct Placement Summary Report (DSL-3a)
- Surplus Lines Direct Placement Summary of Operations (DSL-3b)
- Insured's Form Regarding Direct Placement (DSL-3c)
- Surplus Lines Insurance Direct Placement Credit or Refund Form (DSL-3d)
Third Party Administrator Licensing Packet (TPA1 & TPA2) (12/06)
- Third-Party Administrator Checklist
- Third-Party Administrator Individual Application
- Third-Party Administrator Corporate Application 2
- Third-Party Administrator Bond Form
- Third-Party Administrator License Renewal Form (for license renewal only)
- Third-Party Administrator License Surrender Form
Third Party Annual Report Packet
