Mutual of OmahaContracting Checklist • March 17th, 2014 • Nebraska
□ Special Agent Agreement – Required for all License Only Agent or Signer Principal Officer of a corporation. Agreement does not need to be returned
To expedite the contracting process, please follow the steps below:Contracting Checklist • August 25th, 2009 • Nebraska
Step 1: Complete and Sign the Following Items □ Contract Information and Signature Form- Complete as directed □ E&O Coverage – Required for all products except Medicare Supplement, Final Expense, Term Life Express □ Direct Deposit Information (optional) □ Individual Fair Credit Reporting Act Authorization □ General Agent Agreement- Agreement does not need to be returned □ Special Agent Agreement – Required for a License Only Agent or Signer/Principal Officer of a corporation. Agreement does not need to be returned. □ Commission Advance (optional) □ Debt Verification Authorization Form (required if requesting commission advance for Life products) Step 2: Submit Copies of Applicable State Licenses Step 3: Please Include State Requirements as Noted Below California - LTC Continuing Education Colorado - LTC Continuing. Education Connecticut - Partnership Certificate Hawaii - 2 Original State Forms Illinois - LTC Continuing Education Indiana - LTC Con