Application Forms

The following documents must be completed and returned for application as a viatical settlement provider. The forms are available to be downloaded below. Note, however, that you will need an Adobe Acrobat Reader to view or print the application forms, which you can download at no cost from Adobe . If you wish to use the fill and print form, see the instructions below. The form, once filled in, can be printed. In order to save the filled in form, you will need to purchase additional software from Adobe. If you do not wish to use the fillable pdf form, click on the print version of the form, print it, and complete it.

Fill and Print Version--Application Forms

Print Version--Application Forms

Designation of Registered Agent for Service of Process

A Designation of Registered Agent for Service of Process (OCI 12-014) form is available to be downloaded below. Note, however, that you will need an Adobe Acrobat Reader to view or print the application, which you can download at no cost from Adobe .

Designation of Registered Agent for Service of Process   Fill and Print Version

Please direct questions to: financial@oci.state.wi.us (please include your name, phone number, and e-mail address).

How to use fillable pdf forms:

1. Click the link for the fill and print version of the forms above.
2. Select the Hand tool if it is not already selected.
3. Click in the first fillable field.
4. Use the mouse to select (click on) a specific field or use the Tab key to move through the fields. Shift + Tab will go to the previous field.
5. Use the space bar or click the mouse button to mark or unmark a box.
6. For forms containing more than one page, use the scroll bar at the right to move from page to page or click the next page button in the status bar at the bottom of the form to advance to the next page.
7. Once completed, print the completed form. You may want to print a copy for your records.
8. Press the Reset Form button at the top right corner of page 1 of the form to clear the form.