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Ohio Department of Insurance Agent / Agency Services

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Home State Certification Letter Request
  • Complete all required fields below. Required fields are marked with an *.
  • A Home State Certification Letter(s) for an agent or agency may now be requested electronically by completing the fields below and submitting this request. The $2.00 fee for each letter will be charged to the account selected and an invoice will be sent.
    • * Name of Agent / Agency 
    *SSN / FEIN Number 
    *No. of Letters Requested 
       Mail Certification Letter(s) To:
    *Address 1 
    Address 2 
    *City 
    *State 
    *Zip 
    *Phone Number 
    *Email Address 
       
      Select Form of Payment  - (Certification Letters $2.00 Each)
     
     
    		  Bill Licensed Agency / Company
    *FEIN Number 
    *Agency / Company Name 
       
    - OR -
    		  
       
     
    		  Bill Agent
    *SSN Number 
     
       Mail Invoice To:
    *Address 1 
    Address 2 
    *City 
    *State 
    *Zip 
     
     

    The State of Ohio is an Equal Opportunity Employer

    50 W. Town Street, Third Floor - Suite 300   Columbus, Ohio   43215
    General Info: 614-644-2658  |  Consumer Hotline: 800-686-1526  |  Fraud Hotline: 800-686-1527  |  OSHIIP Hotline: 800-686-1578