Nebraska Department of Insurance Forms

This form is used for obtaining a bond for Managing General Agents (MGAs) in the state of Nebraska. The bond is required to ensure financial responsibility and compliance with state regulations.

This form is used for surplus lines agencies in Nebraska to establish affiliation with an insurance company.

This document is for submitting a complaint or inquiry regarding pre-need funeral services in Nebraska.

This type of document is used to report fraud contact and suspected fraudulent claims in the state of Nebraska. It provides a means for individuals to alert authorities about any suspicious activity or claims related to fraud.

This form is used for reporting and paying quarterly premium taxes in the state of Nebraska.

This document provides a cost proposal for producer licensing examinations in the state of Nebraska. It outlines the expenses and fees associated with the examinations.

This Form is used for notifying the transfer of assumption reinsurance in the state of Nebraska.

This Form is used for applying for a certificate of registration for a discount medical plan in Nebraska.

This document is used for signing the signature page of the annual tax return in the state of Nebraska.

This document is used for providing an annual statement for third party administrators in Nebraska. It contains financial and operational information related to the administration of insurance policies.

This document for a Viatical Settlement Provider Report in Nebraska. It is used to report information about companies that buy life insurance policies from terminally ill individuals.

This document provides information on the mortality rates of viatical settlement providers in Nebraska. It is used to track the lifespan of individuals involved in viatical settlements.

This document is used to provide an annual statement for pre-need individual accounts in Nebraska. It outlines the financial information and progress of the account.

This document is a sample pre-need annual report for a master trust in Nebraska. It provides information on the financial status and performance of the trust.

This form is used for filing consumer complaints in Nebraska. It is available in both English and Spanish.