Get Or 440-5379 2022-2026

Filling out the OR 440-5379 form is a crucial step in demonstrating compliance with Oregon regulations regarding errors and omissions insurance. This guide will provide you with clear, step-by-step instructions to assist you in accurately completing this form online.

Follow the steps to complete the OR 440-5379 form

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the 'Name of applicant or licensee' in the designated field. Ensure that the information matches official records for accuracy.
3. In the next section, provide the 'Licensee IA no. or CRD no.' This number is essential for identifying your license within state records.
4. Fill in the 'Name of insurer' as it appears on your insurance documents. This is the company providing your errors and omissions insurance.
5. Enter the 'Policy number' in the specified field. This number is unique to your insurance policy and is crucial for verification.
6. Indicate the 'Policy amount' which reflects the coverage limit of your insurance policy.
7. Input the 'Start date of policy' and 'End date of policy' to specify the duration of your coverage. Ensure these dates align with your policy documents.
8. In the certification section, read the statement carefully. Then, provide your signature, printed name, title, and date to certify the information provided.
9. Finally, review the form for any errors or omissions. Once confirmed, you can save the changes, download, print, or share the completed form as required.

Complete your documents online now to ensure compliance and avoid delays.