Sales & Service Forms
All forms may be submitted electronically. If you are unable to find what you are looking for, contact us at (800) 617-2861 or email the Structured Settlements team.
Sales Information
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United of Omaha’s Underwriting Guidelines
United of Omaha’s Underwriting Guidelines (PDF)The Structured Settlement Annuity Underwriting Guidelines contain company and product information, licensing & appointment, administration options, cases accepted, and more.
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Annuity Contract Rate Commitment Form
RPD968 (PDF)After completing the form, including agent signature, please submit with valid quote for processing to: structuredsettlements@mutualofomaha.com or fax to 402-351-2176.
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Structured Settlement Payment By Check Instructions
RPD1034 (PDF)Instructions for remitting premium payments via check.
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Structured Settlement Payment Wire Transfer Instructions
RPD1033 (PDF)Instructions for remitting premium payments via wire transfer.
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IRS Form W-9 for Mutual of Omaha Structured Settlement Company
IRS Form W-9 for Mutual of Omaha Structured Settlement Company (PDF)For Assigned Cases
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IRS Form W-9 for United of Omaha Life Insurance Company
IRS Form W-9 for United of Omaha Life Insurance Company (PDF)For Unassigned Cases