PRE-LICENSING EDUCATION PROVIDER APPROVAL APPLICATION - insurance ohio 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the 'Provider Name' and 'FEIN' in the designated fields. Ensure accuracy as this information is crucial for identification.
3. Fill in the 'Provider Address' section, including street, city/state/zip, and phone number. This helps establish your location for correspondence.
4. Select the type of provider by marking one option from the list provided, such as 'Insurance Company' or 'College/University'.
5. Indicate the course method type by marking only one option: 'Classroom Only', 'Self-Study/Online Only', or 'Self-Study with Prep'.
6. List the subject matter categories for which approval is sought, ensuring you check all that apply.
7. Complete the sections regarding course material title and author/edition if applicable, especially for online courses.
8. Detail any school fees associated with tuition and study materials, providing a clear breakdown of costs.
9. In the authorized personnel section, list individuals who can certify/sign necessary forms along with their signatures and positions.
10. Finally, review and certify your application by typing your name, date, and signature before submitting it through our platform.

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