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Please follow the instructions listed in the Application Package Instructions section. If you have any questions please feel free to contact the Licensing Department at 216-787-5100.

• Complete Agent Application kit

The Agent Application kit consists of the individual forms listed below. If you would like to download an individual section, click on the links below.

• Agent Application Instructions Form Updated 4/08
• Agent Application Form Updated 4/08
• W-9 with instructions
• EFT Form Updated 5/06(Electronic Funds Transfer)
• Indemnification Agreement Updated 4/08
• Authorization to Release Criminal RecordNew 5/06

You can choose to have your criminal record check performed at a local post of the Ohio Highway Patrol, or through one of the six Ohio Lottery locations listed below. To use these locations, you must have been a resident of Ohio for the past 5 years. Otherwise, you will need to use the Highway Patrol locations. These locations are:

Cleveland – (216) 787-3311
Columbus – (800) 589-6445
Cincinnati – (800) 589-9882
Canton – (800) 589-6467
Toledo – (800) 589-6442
Athens – (800) 589-6466

If you decide to have your criminal record check performed through the Ohio Highway Patrol, please call your local Ohio Highway Patrol post to schedule an appointment.

You will be required to bring a copy of the Authorization to Release Criminal Record form with you, to have your criminal record check performed.

Please mail the completed application package to: