Agency Forms
Managing your agency with Texas Mutual
| Form |
Format |
| New Agency Application (View instructions) |
|
Online |
| Communication Preferences and Agency Administrator |
|
PDF |
| Agency Book of Business Transfer – Full |
|
PDF |
| Agency Book of Business Transfer – Partial |
|
PDF |
Policy Forms
Common forms to manage your policy
| Form |
Format |
| Agent's Request for Policy Change |
DOC |
PDF |
| Coverage Options for Corporate Executive Officers |
DOC |
PDF |
| Contractor Questionnaire |
|
PDF |
| Ownership Changes - ERM-14 |
|
ONLINE |
| Temp Employee Data Worksheet & Client List |
DOC |
PDF |
| Supplemental Applications |
| Aircraft Operations Information |
DOC |
PDF |
| Employee Data Worksheet |
DOC |
PDF |
| Farm or Ranch |
DOC |
PDF |
| Jones Act |
|
PDF |
| Longshore and Harbor Workers' Compensation Act |
DOC |
PDF |
| Outer Continental Shelf |
DOC |
PDF |
| Start Program |
DOC |
PDF |
| Transportation Industry |
DOC |
PDF |
| Volunteer Emergency Service Organization |
|
PDF |
| TDI Division of Workers' Compensation Forms |
| DWC-81, Agreement Between General Contractor and Subcontractor to Provide Workers' Compensation Insurance |
|
PDF |
| DWC-82, Agreement Between Motor Carrier and Owner Operator to Provide Workers' Compensation Insurance Coverage / Agreement to Require Owner Operator to Act as Employer |
|
PDF |
| DWC-83, Joint Agreement to Affirm Independent Relationship for Certain Building and Construction Workers / Agreement to Establish Employer-Employee Relationship for Certain Building and Construction Workers |
|
PDF |
| DWC-84, Exception to Application of Joint Agreement to Affirm Independent Relationship for Certain Building and Construction Workers |
|
PDF |
| DWC-85, Agreement Between General Contractor and Subcontractor to Establish Independent Relationship |
|
PDF |
| Professional Employer Organization (PEO) Documents |
| Client Authorization |
DOC |
PDF |
| Client-Executive Data |
EXCEL |
|
| Client-Maintained Coverage |
DOC |
PDF |
| New Client Form |
|
PDF |
| Pre-Approval and Exclusion |
|
PDF |
| Questionnaire |
DOC |
|
| Requirements |
DOC |
PDF |
