Commonly used forms for agents
Access forms used frequently by independent insurance agents.
- ERM-14 Form (Minnesota) – Confidential Request for Ownership Information
- ERM-14 Form (NCCI) – Confidential Request for Ownership Information
- ERM-14 Form (Wisconsin) – Confidential Request for Ownership Information
- Minnesota Workers’ Compensation Assigned Risk Plan Application
- Minnesota Workers’ Compensation Election of Coverage
- Iowa Workers’ Compensation Election of Coverage
- Iowa Workers’ Compensation Rejection of Coverage
- Nebraska Workers’ Compensation Election of Coverage
- Nebraska Workers’ Compensation Election of Coverage for Corporations
- Nebraska Workers’ Compensation Rejection of Coverage
- SFM Agency Manager (SAM) Registration Form
- SFM Authorization for Insurance Payments Via ACH
- South Dakota Workers’ Compensation Election of Coverage
- South Dakota Workers’ Compensation Rejection of Coverage
- Wisconsin Supplementary Election of Coverage
- Wisconsin Supplementary Non-Election of Coverage
- Supplemental Application — Allied Health
- Supplemental Application — Contractors
- Supplemental Application — Farms
- Supplemental Application — Health care: COVID-19
- Supplemental Application — Home Health
- Supplemental Application — Schools
- Supplemental Application — Trucking
