Additional License Applications
Any instructions needed to complete the licensing forms are included with each form. If you have questions concerning these forms or other licensing matters, you can e-mail the Licensing Division, DOI.Licensing@nebraska.gov. If you have problems accessing these forms, e-mail the Webmaster, DOI.firstname.lastname@example.org.
Form 9110 - Change Request Form for Individuals – This form can be used for address and name changes, line of authority changes, and correcting SSN information.
Form 9002A- Designated Responsible Licensed Producer Amendment Form