OKIVS
 

Insurance Company Registration Form

Please fill out this form only if your company is licensed to provide automobile liability insurance in the State of Oklahoma.

General Information
Insurance Company Name: NAIC Number:
Street Address: City:
State: Zip Code:
 
Oklahoma Policies
                     Does your company currently write automobile insurance in OK?
            Does your company issue ONLY commercial automobile policies in OK?
                                 Does your company cover less than 500 vehicles in OK? 
Main/Functional Contact Details
First Name: Last Name:
Middle Initial: Phone Number:
Fax Number: Email Address:
    Do you want to add a technical contact?
Do you want to add a compliance contact?
Web Login Information
User Name:
(Same as your Naic No)
 Password:
(8-20 characters including one number,
one upper case, one lower case, and one special character)
Secret Question: Secret Question Answer:
 

 
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