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
• 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 — Contractors
• Supplemental Application — Farms
• Supplemental Application — Home Health
• Supplemental Application — Allied Health
• Supplemental Application — Schools