Oklahoma Grower Surety Bond
Once you submit this questionnaire you will receive an email from janiemeadows@striveins.com with further instructions and a payment link. Payment can also be made in office by appointment only.
Name of Person Filling Out Form
*
First Name
Last Name
Type of Flat Rate Bond Requested
*
Please Select
Option 1 Flat Rate $2400 1 Year (2-3 Business Days)
Option 2 Flat Rate $2500 1 Year (Expedited)
Option 3 Renew Bond with UCS $2500
Option 4 Flat Rate $1200 today & $1200 in 5 months (2-3 Business Days)
Option 5 Flat Rate $1250 today & $1250 in 5 months (Expedited)
Expedited Issue means within 24 hours of all completed paperwork and draft approvals--business days only. If you are currently issued a bond through UCS and wish to renew with them select Option 3. By electing the $1,200 Standard Service or $1,250 Expedited Service split payment option a separate ACH authorization form will be emailed after this form is complete. The split payment option is only available through our partnership with TSF.
Owner Name on License
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Grow License Number
*
Business Name as it Appears on OMMA License
*
Requested Effective Date *Please note: Effective dates more than 30 days in the past require approval from the surety and are not guaranteed.
*
-
Month
-
Day
Year
Date
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Years in Business
*
Business Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Owner Residence Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Years at Residence
*
List Owners of Business
*
Have their been any ownership changes to this license?
*
Yes
No
Is all information on your current bond correct-if applicable? (Excluding an updated license number)
*
Yes
No
Have you received an updated grow license number from the OMMA?
*
No, I have not received an updated license number from the OMMA.
Yes, for indoor only beginning with GAAI
Yes, for outdoor only beginning with GAAO
Please upload a picture of your OMMA Grower License.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Owner Date of Birth
*
-
Month
-
Day
Year
Date
Business EIN #
*
Input NA if you do not have an EIN #
Owner Social Security #
*
This is required for surety bonds.
The information provided in this form will be used solely to obtain the requested surety bond. By submitting, you consent to receive communications from Strive Insurance Group regarding your bond, related services, and updates. We respect your privacy and will never sell or misuse your information.
Print Name
Submit
Should be Empty: