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Wi oci 029 authority form

Wi oci 029 authority form 2026

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The document is an application for a Certificate of Incorporation and Certificate of Authority for profit plans in Wisconsin, specifically for entities wishing to operate as insurance providers under Chapter 611 of the Wisconsin Statutes. It includes sections for applicant information, authorization for inquiries by the Commissioner of Insurance, and biographical forms for key executives. The application requires signatures from executive officers and detailed personal and professional information about the affiants.

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Click ‘Get Form’ to open the wi oci 029 authority form in the editor.
Begin by entering the 'Name of Plan' and 'Street Address' in the designated fields. Ensure that all information is accurate and complete.
Select the type of insurer from the provided options, such as 'Traditional Service Insurance Corporation' or 'Health Maintenance Organization'.
Fill in the 'Federal Employer ID #' and confirm that you have filed all necessary materials with the Office of the Commissioner of Insurance.
Have both executive officers sign and date the form where indicated, ensuring their names are printed clearly.
Complete the 'Authority of Commissioner to Make Inquiry' section by providing details about the applicant and signatures from both the President and Secretary.
Finally, review all entries for accuracy before submitting your completed form to ensure a smooth application process.

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