The Ohio surplus line broker license lets a licensed insurance producer place coverage with insurers that are not admitted in Ohio, and you apply for it using the Individual Surplus Line Broker License Application (INS3245) or the Business Entity Surplus Lines Broker License Application (INS3223) filed with the Ohio Department of Insurance Licensing Division. This license exists because some risks are too large, too unusual, or too risky for standard “admitted” carriers, so the state needs a trained broker to handle the placement and protect the public.
Both forms carry the revision date (Rev. 02/2021) in the footer, so check that you are using the current version before you start. Surplus lines is not a small corner of the market either; the surplus lines industry wrote more than $98 billion in premium across the United States in 2023, which shows how often these brokers step in when the standard market says no. A single skipped attachment, like the $25,000 bond for resident applicants, can get your whole packet returned unprocessed and cost you weeks.
Here is what you will learn in this guide:
- 📝 How to complete every box on the INS3245 and INS3223 line by line, using the exact field names printed on the form.
- 💵 The exact $100 fee, where to send it, and the proof of filing you should keep.
- 🛡️ When you need the $25,000 surplus lines bond and how to fill out the Ohio Specific Bond Form.
- 🚫 The most common mistakes that get applications returned, and the direct consequence of each one.
- ❓ Field-level answers to the questions brokers ask most, from background questions to non-resident proof.
What the Form Is and Who Must File It
The Ohio surplus line broker license application is the form you send to the Ohio Department of Insurance (ODI) Licensing Division to get state permission to place business with non-admitted (surplus lines) insurers. A surplus lines insurer is a carrier that is not licensed in Ohio but is allowed to write certain risks the admitted market will not take. Without this license, placing that business is illegal, and you can face fines and license action under Chapter 3905 of the Revised Code.
You must file if you want to procure or place insurance with these non-admitted carriers in Ohio. Individuals use the INS3245 form. Agencies, corporations, partnerships, and limited liability companies use the INS3223 form. You first need an active Ohio property and casualty producer license, because surplus lines is an added authority, not a starting license.
The license is required by Section 3905.30 of the Revised Code, which sets who may act as a surplus line broker. The bond is required by Section 3905.35, and the broker’s duties are spelled out in rule 3901-1-08 of the Administrative Code. The Superintendent of Insurance, who heads ODI, is the official who receives the application and issues or denies the license. Each piece links together: the statute creates the license, the bond protects the public, the rule sets the conduct standards, and the Department enforces all three.
The penalty for placing surplus lines business without this license is real. You can be ordered to stop, fined, and have your underlying producer license suspended or revoked. There is no grace period, so the license must be in hand before you place the first policy.
Before You Start: Documents and Information You Need
Gather everything below before you open the application, because a missing item is the top reason packets come back marked deficient. The form has no “save and finish later” forgiveness on paper, so a complete file the first time saves you weeks.
- Your Social Security Number (individual) or FEIN (business entity). ODI cross-checks this against producer records, and a wrong number stalls the match.
- Your National Producer Number (NPN). This ties your surplus lines authority to your existing producer license; without it the link may fail.
- Your active Ohio property and casualty producer license. Surplus lines is an add-on authority, so you cannot get it without the base license.
- Home state and home state license number (non-residents). ODI verifies you are licensed and in good standing at home before granting reciprocity.
- A $25,000 surety bond (resident applicants only). This is required by Section 3905.35; without it your resident application is incomplete.
- A completed Ohio Specific Bond Form. This is page four of the application and must be signed by your surety, with the power of attorney attached.
- State (BCI) and Federal (FBI) background check results (resident applicants only). ODI uses these to screen for disqualifying history.
- Five years of employment history. You must account for all time, including gaps, so have dates and employer names ready.
- A $100 check or money order payable to the “State of Ohio Treasurer.” The fee is non-refundable, so confirm the amount before you write it.
- Court or administrative documents for any “Yes” background answer. A “Yes” without the required attachments triggers a deficiency notice.
If any one item is missing, the Department may return the packet unprocessed, and you start the clock over. Treat this checklist as a gate you must clear before writing a single answer.
Where to Get the Form and How to Access It
You can get the official Individual Surplus Line Broker License Application from the Ohio Department of Insurance forms page, and the business version, the Business Entity Surplus Lines Broker License Application, sits in the same forms library. Always download the current PDF rather than reusing an old copy, since the footer revision date is how ODI confirms you used the right version.
Most producers apply electronically through the National Insurance Producer Registry, known as NIPR. NIPR is the online gateway that sends your application straight to ODI and lets you upload attachments to the NAIC/NIPR Attachments Warehouse. The state fee is the same, but NIPR adds a small transaction fee on top.
You can still file on paper by mailing the printed form to the Licensing Division, 50 W Town Street, 3rd Floor – Suite 300, Columbus, OH 43215. The phone line for questions is 1-614-644-2665. Paper filing makes sense when you have a complex background file or a bond original that is easier to mail than to scan.
The form itself runs four pages. Pages one through three are the application, and page four is the surplus lines broker bond. Read all four pages before you write anything, so you know what attachments you will owe at the end.
Step-by-Step: How to Fill Out the Ohio Surplus Line Broker License Line by Line
The walkthrough below follows the Individual Surplus Line Broker License Application (INS3245), page by page, and flags where the Business Entity (INS3223) form differs. Use the exact field labels printed on the form, and print or type your answers, since handwriting that cannot be read is a common reason for a returned packet.
License Type: Resident or Non-Resident
At the top of page one, the form asks you to check a box for the license requested: Resident License or Non-Resident License. Pick the box that matches where you hold your home producer license, not where you happen to work. To answer, check one box only, and if you choose Non-Resident, also fill in Identify Home State and Identify Home State License #.
For example, Carlos Mendez, a licensed agent who lives and is licensed in Ohio, checks Resident License and leaves the home state lines blank. A nuance many miss: a producer who recently moved to Ohio but still holds a home license in another state is usually a non-resident until they switch their residency on file. A common mistake here is checking Resident while listing an out-of-state home license, which sends mixed signals and triggers a review hold. The misconception is that “resident” means “where my office is,” when it really means the state that issued your home producer license.
Demographic Information: Social Security Number and NPN
This box asks for your Social Security Number and, If assigned, National Producer Number (NPN). ODI uses these to match the application to your existing producer record. Enter your nine-digit SSN with no dashes if the box has no separators, and enter your NPN exactly as it appears in your producer file.
For example, Carlos Mendez writes his SSN and his NPN 18472639 in the matching boxes. A nuance: brand-new producers may not have an NPN yet, in which case you leave it blank and ODI assigns one. A common mistake is transposing two digits of the SSN, which breaks the cross-check and freezes the application until staff catch the error. The misconception is that the NPN and your license number are the same; they are not, and using the wrong one causes a mismatch.
Demographic Information: Name and Date of Birth
The form asks for your Last Name, First Name, Middle Name, the JR./SR. etc suffix, and Date of Birth (M/D/YY). Write your full legal name exactly as it appears on your existing producer license, because ODI cross-checks names against its records. Enter the date of birth in the month, day, year format shown.
For example, Maria Lopez writes Lopez as last name, Maria as first name, and 03/14/85 for date of birth. A nuance: if you go by a middle name or a shortened first name, still use your legal first name here and list the other name in the assumed-names box later. A common mistake is entering a nickname, which does not match SSA or license records and stalls the file. The misconception is that the name on the form can match your business cards; it must match your legal license record instead.
Demographic Information: Residence and Contact
This section asks for your Residence/Home Address (Physical Street), City, State, Zip or Foreign Country, Mobile Phone Number, Home Phone Number, and Individual Applicant Email Address. ODI uses the physical home address to confirm residency and to mail official notices. Enter a real street address, not a P.O. Box, in the residence line.
For example, Carlos Mendez enters 842 Maple Ridge Dr, Dublin, OH 43017 and a working email he checks daily. A nuance: if you truly have no street address, the form provides a separate mailing address block with a P.O. Box line for that purpose. A common mistake is putting a P.O. Box in the physical street line, which makes the Department question your residency claim. The misconception is that email is optional; ODI often sends deficiency notices by email, so a missing or wrong address means you may never see the request and your file dies.
Demographic Information: Citizenship
The form asks Are you a Citizen of the United States? with Yes and No boxes, and if No, it asks of which country you are a citizen. Check one box honestly. If you check No and are applying for a Resident License, you must supply proof of eligibility to work in the U.S.
For example, Aisha Rahman, a lawful permanent resident applying as a resident, checks No, names her country of citizenship, and attaches a copy of her work authorization. A nuance: non-citizens can still qualify, so a “No” answer does not block the license by itself. A common mistake is checking “No” but forgetting the eligibility proof, which makes a resident application deficient. The misconception is that only U.S. citizens can hold the license, which is false.
Business Entity and Agency Affiliations
This block asks for your Business Entity’s Name, Business Address, Business Phone, Business E-Mail, and your Insurance Agency Affiliations with each agency’s FEIN, NPN, and Name of Agency. Complete the affiliation lines only if you will be licensed as an active member of an agency. List each agency on its own line with all three identifiers.
For example, Carlos Mendez lists Buckeye Surplus Partners LLC, its FEIN, and its NPN, because he will place business through that agency. A nuance: a solo broker with no agency leaves the affiliation lines blank. A common mistake is listing an agency name without its FEIN and NPN, which leaves ODI unable to link the records. The misconception is that you must belong to an agency to get the license; you do not, and many brokers hold it individually.
Assumed, Fictitious, and Trade Names
The form has two lines: list any assumed, fictitious, alias, maiden or trade names which you have used in the past, and any trade names under which you are currently doing business or intend to do business. These let ODI connect your record to past names and approve any business name. Write each name clearly, and note that current trade names may be subject to state approval.
For example, Maria Lopez lists her maiden name Maria Vega in the past-names line because her old license was under that name. A nuance: if you have never used another name, write “N/A” rather than leaving it blank, so staff know you did not skip it. A common mistake is hiding a former name, which can look like concealment when records surface during the background check. The misconception is that a trade name is automatically yours; in Ohio it may need approval first.
Employment History (Past Five Years)
This section says Account for all time for the past five years, listing each employer’s Name, City, State, the Position Held, and the From and To month and year. ODI uses this to verify your work record and spot unexplained gaps. List jobs in reverse order, starting with your current employer and working back, and include part-time work, self-employment, military service, unemployment, and full-time education.
For example, Carlos Mendez lists Buckeye Surplus Partners LLC, Dublin, OH, Producer, 06/2022 to Present, then his prior carrier job before that. A nuance: a six-month gap of unemployment must be written in, not left blank, with “Unemployed” as the position. A common mistake is leaving gaps unexplained, which the Department reads as missing information and sends back. The misconception is that only insurance jobs count; you must account for all time, including non-insurance work and school.
Page 2 Background Question 1: Criminal History
Question 1 splits into 1a (MISDEMEANOR), 1b (FELONY), and 1c (MILITARY OFFENSE), each with Yes and No boxes, plus a 1033 consent question for felonies involving dishonesty or breach of trust. Read the exclusions carefully, then check Yes or No for each. If you answer Yes to any, attach a written statement of the circumstances, a copy of the charging document, and a copy of the document showing how the charges resolved.
For example, Daniel Pierce, who had one misdemeanor theft conviction, checks Yes on 1a and attaches his court records and an explanation. A nuance: you may exclude minor traffic items like DUI, reckless driving, and juvenile adjudications, so those do not need a “Yes.” A common mistake is answering “No” to save trouble, then having the background check reveal the charge, which is grounds for denial for false information. The misconception is that an old, expunged-feeling case does not count; “convicted” here includes guilty pleas, no contest pleas, probation, and even fines.
Page 2 Background Questions 2 Through 4
Question 2 asks about administrative or FINRA proceedings on any professional license, Question 3 asks about money judgments or bankruptcy involving funds held for others, and Question 4 asks about delinquent tax obligations not under a repayment plan. Each has Yes and No boxes. Answer each honestly, and attach the statements and documents the form lists for any “Yes.”
For example, Janet Cole, who once had a license placed on probation, checks Yes on Question 2 and attaches the notice of hearing and the final order. A nuance: you may exclude license terminations that were only about missed continuing education or an unpaid renewal fee. A common mistake is treating a withdrawn application as a “No,” when withdrawing to avoid a denial counts as “involved” and must be reported. The misconception is that a personal bankruptcy always counts; it only counts here if it involved funds you held on behalf of others.
Page 3 Background Questions 5 Through 8
Question 5 covers lawsuits or arbitration involving fraud or breach of fiduciary duty, Question 6 covers a carrier contract terminated for alleged misconduct, Question 7 covers child support arrearage, and Question 8 asks whether you are a service member, veteran, or military spouse. Check Yes or No for each. Attach the required statements for any “Yes,” and for Question 7 give the months in arrearage and your repayment status.
For example, Carlos Mendez checks No on 5 through 7 and Yes on 8 because he is an Army veteran, which can speed his processing. A nuance: Question 8 is not a penalty box; it can qualify you for expedited service under Ohio’s veteran provisions. A common mistake is ignoring a small child support arrearage, which can block the license entirely until resolved. The misconception is that Question 6 only covers firings “for cause”; any termination tied to alleged misconduct must be reported.
Page 3 Certification and Signature
The certification block lists eight statements you certify under penalty of perjury, including that your answers are true, that you appoint the Superintendent as your agent for service of process, and that non-residents are licensed and in good standing at home. Then you provide your Original Applicant Signature, the Date, and your Full Legal Name (Printed or Typed). Read all eight statements, then sign in ink if filing on paper.
For example, Maria Lopez signs her name, dates it 05/30/26, and prints Maria Lopez below the line. A nuance: an electronic signature is accepted through NIPR, but a mailed form needs a wet, original signature. A common mistake is sending a photocopied signature, which the form warns may make the application deficient. The misconception is that signing is a formality; you are swearing under perjury, so a false answer above the line is a crime, not just a denial.
Page 4 Surplus Lines Broker Bond (Resident Applicants)
Page four is the Surplus Lines Broker Bond as provided by Section 3905.35, which asks for the Bond Number, Effective Date, the Principal (you), the Surety, and signatures and addresses for both. This bond promises the State of Ohio up to $25,000 that you will follow the surplus lines laws. Your surety company fills in the bond details and signs, and you sign as principal.
For example, Carlos Mendez lists himself as principal, his surety as Acme Surety Co., and the $25,000 sum stated in the bond language. A nuance: a copy of the power of attorney proving the signer can bind the surety must be attached, or the bond is invalid. A common mistake is sending an unsigned or undated bond, which makes a resident application incomplete. The misconception is that non-residents need the bond too; the form says the bond is for resident applicants only.
Business Entity Form (INS3223) Key Differences
The business form mirrors the individual form but swaps personal fields for entity fields. Instead of your SSN, it asks for the Business Entity’s Name, Incorporation/Formation Date, FEIN, State of Domicile, and whether the entity is affiliated with a financial institution/bank. Enter the entity’s legal name exactly as registered with the Ohio Secretary of State.
For example, Buckeye Surplus Partners LLC enters its FEIN, a formation date of 04/01/2022, and checks No for bank affiliation. A nuance: you must name at least one Designated/Responsible Licensed Producer who is accountable for the entity’s compliance, plus all owners with 10% interest, partners, officers, and directors. A common mistake is leaving out a 10% owner, which makes the ownership disclosure false. The misconception is that the entity license replaces the individual one; the responsible producer still needs an individual surplus lines license.
Three Filled-Out Examples Using Real Scenarios
Below are three common filers walked through the most important sections of the form. Sample entries are shown so you can see what an answer looks like in practice.
Scenario 1: Carlos Mendez, a resident Ohio agent getting his first surplus lines license (INS3245).
| Form Section | What Carlos Enters |
|---|---|
| License Type | Checks Resident License |
| Social Security Number / NPN | His SSN and NPN 18472639 |
| Name / Date of Birth | Mendez / Carlos, 07/22/88 |
| Residence Address | 842 Maple Ridge Dr, Dublin, OH 43017 |
| Citizenship | Checks Yes |
| Agency Affiliation | Buckeye Surplus Partners LLC, with FEIN and NPN |
| Background Questions 1–7 | Checks No to each |
| Question 8 (Military) | Checks Yes (Army veteran) |
| Bond (Page 4) | Lists Acme Surety Co., $25,000, attaches power of attorney |
| Attachments | $100 check, bond form, BCI/FBI results |
Scenario 2: Maria Lopez, a non-resident broker licensed in Indiana (INS3245).
| Form Section | What Maria Enters |
|---|---|
| License Type | Checks Non-Resident License |
| Home State / License # | Indiana / IN-554120 |
| Name / Date of Birth | Lopez / Maria, 03/14/85 |
| Past Names | Maiden name Maria Vega |
| Residence Address | Her Indianapolis home street address |
| Citizenship | Checks Yes |
| Background Questions 1–8 | Checks No to each |
| Certification | Certifies she is in good standing in Indiana |
| Bond (Page 4) | Left blank (non-residents are exempt) |
| Attachments | $100 check only |
Scenario 3: Buckeye Surplus Partners LLC, a resident agency (INS3223).
| Form Section | What the Agency Enters |
|---|---|
| License Type | Checks Resident License |
| Business Entity’s Name | Buckeye Surplus Partners LLC |
| Formation Date / FEIN | 04/01/2022 / its nine-digit FEIN |
| State of Domicile | Ohio |
| Bank Affiliation | Checks No |
| Designated Responsible Producer | Carlos Mendez, with SSN and NPN |
| 10% Owners / Officers | Carlos Mendez (60%), Lena Park (40%) |
| Background Questions 1–6 | Checks No to each |
| Signature | Signed by Carlos Mendez, Managing Member |
| Attachments | $100 check, bond form, power of attorney |
How to File the Completed Form
Ohio gives you two filing channels, and you should pick the one that fits your file. Keep proof of whichever route you choose, because that proof is your only record if the application is lost.
Online through NIPR. Submit at the NIPR Ohio licensing center, which routes the application to ODI. The state fee is $100 plus a small NIPR transaction fee, paid by credit card or electronic check. Processing usually takes a few business days to a couple of weeks, and you should save the confirmation email and transaction receipt as proof of filing. Upload any background attachments to the NAIC/NIPR Attachments Warehouse and link them to the matching question number.
By mail. Send the printed form and attachments to the Licensing Division, 50 W Town Street, 3rd Floor – Suite 300, Columbus, OH 43215, with a $100 check or money order payable to the “State of Ohio Treasurer.” Paper processing takes longer, often several weeks, so mail with tracking and keep the certified mail receipt as proof of filing. Resident applicants must include the signed bond, the power of attorney, and the BCI/FBI results.
There is no separate fax channel for the full application, though the Department lists a fax line at 1-614-387-0096 for the individual division and 1-614-387-0087 for the business division for follow-up documents. If you have questions during filing, call 1-614-644-2665. Whichever channel you use, never send your only original of the bond without keeping a copy.
What Happens After You File
After ODI receives your application, the Licensing Division reviews it for completeness and runs your background and license checks. If everything matches and your fee and attachments are in order, the Department issues the surplus lines authority on your producer record. You can then verify the new line of authority through your NIPR or ODI account.
If something is missing, ODI sends a deficiency notice asking for the item, often by email, and your file waits until you respond. This is why a working email address on the form matters so much. A non-resident application can move faster because it relies on your home state’s good standing rather than a fresh bond and background check.
Once licensed, your duties begin. Under the bond language, you must annually file in March a statement of the gross premiums on surplus lines insurance you placed during the prior year ending December 31, and pay the state a tax equal to five percent of the net premiums. Missing this filing can put your bond and license in jeopardy, so calendar it the moment you are licensed.
Mistakes to Avoid When Filling Out the Form
- Checking the wrong residency box. Marking Resident with an out-of-state home license triggers a review hold that delays your file.
- Transposing your SSN or NPN. A single wrong digit breaks the record match and freezes processing until staff catch it.
- Using a nickname instead of your legal name. A name that does not match license records stalls the cross-check.
- Putting a P.O. Box in the physical residence line. This makes ODI question your residency and can return the packet.
- Leaving your email blank or wrong. You may never see the deficiency notice, and your application can quietly die.
- Skipping employment gaps. Unexplained time reads as missing information and gets the form sent back.
- Answering “No” to a background question that is really “Yes.” The background check will reveal it, and false answers are grounds for denial.
- Forgetting attachments for a “Yes” answer. A “Yes” without the statement and court documents makes the file deficient.
- Sending an unsigned or photocopied signature on a mailed form. Paper filings need an original, wet signature.
- Omitting the bond or power of attorney (residents). A resident application without the $25,000 bond is incomplete and returned.
- Writing the wrong fee amount. The fee is $100, non-refundable, and a short check stops processing.
- Leaving out a 10% owner on the business form. This makes the ownership disclosure false and can void the application.
Do’s and Don’ts
Do’s
- Do use the exact field names and the current (Rev. 02/2021) form, so your version matches what ODI expects.
- Do print or type every answer, because unreadable handwriting is a frequent reason for returns.
- Do account for all five years of work history, since gaps must be explained, not hidden.
- Do attach the full set of documents for any “Yes” background answer, as the form lists each one.
- Do keep a copy of your fee, bond, and confirmation, because that proof protects you if the file is lost.
- Do confirm your home state good standing before filing as a non-resident, since ODI verifies it.
Don’ts
- Don’t guess on a background question; an honest “Yes” with documents beats a “No” the check disproves.
- Don’t use a P.O. Box in the physical address line, because it undermines your residency claim.
- Don’t mail your only original bond, since you need a copy if it goes missing.
- Don’t skip the power of attorney with the bond, or the bond is treated as invalid.
- Don’t assume the entity license covers individuals, because the responsible producer still needs a personal license.
- Don’t forget the March premium tax filing, since missing it endangers your bond and license.
Pros and Cons of Filing on Your Own vs. With Help
| Filing on Your Own | Filing With Professional Help |
|---|---|
| Pro: You save the cost of a service or attorney, keeping fees to the $100 state amount. | Pro: A licensing service catches missing attachments before they cause a return. |
| Pro: You control the timeline and submit the moment you are ready. | Pro: Help is valuable when you have a “Yes” background answer that needs careful documentation. |
| Pro: You learn your own record deeply, which helps at renewal. | Pro: A service often handles the bond and power of attorney for you. |
| Con: A small error like a wrong SSN can cost you weeks of delay. | Con: Services charge fees on top of the $100 state fee. |
| Con: You must track the bond, background check, and attachments alone. | Con: You still must give accurate personal answers, so help does not remove your duty. |
| Con: Misreading a background question can lead to a denial you handle yourself. | Con: You may rely on the service and miss learning the renewal duties yourself. |
FAQs
Do I need an Ohio property and casualty license first?
Yes. Surplus lines is an added authority, so you must already hold an active Ohio property and casualty producer license before the Department will grant the surplus lines authority.
Do non-resident applicants need the $25,000 bond?
No. The form states the bond and the Ohio Specific Bond Form are for resident applicants only; non-residents instead certify good standing in their home state.
Do I write my legal name or my nickname in the name boxes?
Yes, use your full legal name exactly as it appears on your producer license, because ODI cross-checks names and a nickname stalls the match.
Do I list a P.O. Box in the Residence/Home Address line?
No. The residence line needs a physical street address; the form gives a separate mailing address block with a P.O. Box line for mail.
Do I report a DUI under Background Question 1a?
No. The form lets you exclude DUI, DWI, reckless driving, driving without a license, and similar traffic items, so those do not require a “Yes.”
Do I have to list non-insurance jobs in the employment history?
Yes. You must account for all time over the past five years, including non-insurance work, self-employment, military service, unemployment, and full-time education.
Do I need to fill in the NPN if I do not have one yet?
No. New producers without an NPN leave that box blank, and the Department assigns a number; only enter an NPN if one is already assigned.
Do I need a separate license for my agency?
Yes. A business entity uses the INS3223 form for its own surplus lines license, and it must still name a responsible individual licensed producer.
Do I have to attach documents for a “Yes” background answer?
Yes. Each “Yes” requires the written statement and court or administrative documents the form lists, or the application is considered deficient.
Do I pay the $100 fee if my application is denied?
No refund is given, because the form states the fee is non-refundable, so the $100 is lost whether or not the license issues.
Do I sign the bond myself?
Yes, you sign as the principal, and your surety company also signs and attaches a power of attorney proving the signer can bind the surety.
Do I owe Ohio a premium tax after I am licensed?
Yes. You must file a gross premium statement each March and pay a tax equal to five percent of net surplus lines premiums from the prior year.
Do I check the military box even though it is not a crime?
Yes. Background Question 8 is a benefit question, not a penalty, and answering “Yes” can qualify you for expedited processing as a veteran or military spouse.
Do I need to report a license I voluntarily surrendered?
Yes. Surrendering a license to resolve an administrative action counts as “involved” under Question 2 and must be reported with the supporting documents.
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