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Alpaca Applications / Forms
Applications and forms are available to view and download at your
convenience from this page or from the Alpaca menu on the left.
All forms require various signatures. They must be printed from your
computer, signed as appropriate, and mailed or faxed to Prairie
States Insurance Agency Inc. Please contact us for we are glad to
answer any questions and provide any help with completing
applications and forms.
Alpaca Declaration of Heath Form
Alpaca Veterinarian
Certification Form
Alpaca Insurance Application
XL Insurance Payment
Options
Instructions:
Click on a .pdf
file above, it will automatically open Adobe Reader on your
computer.* Click on the printer icon in the menu bar and print a
copy of the form. After completing the form and signing please fax
it to 405-235-5225 or scan the completed and signed form and email
it to Deborah at
Deborah_Gale@prairiestatesinsurance.com .
*If you do not have the free Adobe Reader Program click on the image
above to download the virus free, industry standard program to your
computer.
Cattle Applications / Forms
Applications and forms are available to view and download at your
convenience from this page or from the Cattle menu on the left.
All forms require various signatures. They must be printed from your
computer, signed as appropriate, and mailed or faxed to Prairie
States Insurance Agency Inc. Please contact us for we are glad to
answer any questions and provide any help with completing
applications and forms.
Applications and forms are available to download at your
convenience. Please, use Adobe Acrobat Reader for .pdf files and
Microsoft Word for .doc files.
Cattle Declaration of Health
Form
Cattle Veterinarian
Certification Form
Cattle Insurance
Application
Payment Options
Instructions:
Click on a .pdf
file above, it will automatically open Adobe Reader on your
computer.* Click on the printer icon in the menu bar and print a
copy of the form. After completing the form and signing please fax
it to 405-235-5225 or scan the completed and signed form and email
it to Deborah at
Deborah_Gale@prairiestatesinsurance.com .
*If you do not have the free Adobe Reader Program click on the image
above to download the virus free, industry standard program to your
computer.
Horse Applications / Forms
Applications and forms are available to view and download at your
convenience from this page or from the Horse menu on the left.
All forms require various signatures. They must be printed from your
computer, signed as appropriate, and mailed or faxed to Prairie
States Insurance Agency Inc. Please contact us for we are glad to
answer any questions and provide any help with completing
applications and forms.
Horse (Mortality Forms)
Equine Mortality Insurance Application
Equine Veterinary Certificate of Examination
Horse Mortality Informational forms
AEIG
Mortality Coverages description
AEIG
Mortality Coverages description04.01.09.
AEIG $7500 Maj Med
End
Horse (Liability Forms)
Commercial Equine Liability Application
Instructions:
Click on a .pdf
file above, it will automatically open Adobe Reader on your
computer.* Click on the printer icon in the menu bar and print a
copy of the form. After completing the form and signing please fax
it to 405-235-5225 or scan the completed and signed form and email
it to Deborah at
Deborah_Gale@prairiestatesinsurance.com .
*If you do not have the free Adobe Reader Program click on the image
above to download the virus free, industry standard program to your
computer.
Exotic Animals
Since this coverage is breed and value specific, it will be best for
you to call or email
Deborah_gale@prairiestatesinsurance.com with details of the
risk, or complete and email the Animal Mortality Application and
we’ll respond within 24 hours.
Animal Mortality Insurance Application - AEIG Mortality Coverage
description
Animal Veterinary Certificate of Examination - Veterinary
Certificate of Examination
Instructions:
Click on a .pdf
file above, it will automatically open Adobe Reader on your
computer.* Click on the printer icon in the menu bar and print a
copy of the form. After completing the form and signing please fax
it to 405-235-5225 or scan the completed and signed form and email
it to Deborah at
Deborah_Gale@prairiestatesinsurance.com .
*If you do not have the free Adobe Reader Program click on the image
above to download the virus free, industry standard program to your
computer.
Farm & Ranch Applications / Forms
EquiFarm
Application
Personal Horse Owners Liability
Commercial Equine Insurance Liability
Application
Horse
Club Liability Application.
Prairie States Livestock Quick Quote
Prairie States Liability Quick Quote
Instructions:
Click on a .pdf
file above, it will automatically open Adobe Reader on your
computer.* Click on the printer icon in the menu bar and print a
copy of the form. After completing the form and signing please fax
it to 405-235-5225 or scan the completed and signed form and email
it to Deborah at
Deborah_Gale@prairiestatesinsurance.com .
*If you do not have the free Adobe Reader Program click on the image
above to download the virus free, industry standard program to your
computer.
Auto Insurance
Automobile Insurance, we have recently been afforded the opportunity
to place business with GMAC Insurance. Program offers discounts for
up to 30% of your auto insurance premium through various
affiliations please contact us for further details.
GMAC_quote_form.pdf
Instructions:
Click on a .pdf
file above, it will automatically open Adobe Reader on your
computer.* Click on the printer icon in the menu bar and print a
copy of the form. After completing the form and signing please fax
it to 405-235-5225 or scan the completed and signed form and email
it to Deborah at
Deborah_Gale@prairiestatesinsurance.com .
*If you do not have the free Adobe Reader Program click on the image
above to download the virus free, industry standard program to your
computer.
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