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Ohio Department of Insurance ODI Services

Invoice Address Change Request
  • Complete all required fields below. Required fields are marked with an *.
  • Please submit one form per company
  • Please contact Diane Wiggins in the Fiscal Operations Division at (614)644-3266 or email diane.wiggins@insurance.ohio.gov if you have any questions regarding this form

By submitting this form, I understand and agree that ALL Ohio Department of Insurance invoices will be mailed to this address including appointments / cancellations, filing fees, certification letter fees, yearly fees (annual statement, renewal company certificate of authority), license renewal fees and any other charges requested from the Department.


Company Name: *
NAIC Number: 
New Billing/Invoice Address (include "attention to" line, if applicable): *
  The following is for informational purposes only and will not
appear on the invoice.
Your Name: *
Phone: *
Email Address: *

The State of Ohio is an Equal Opportunity Employer

50 W. Town Street, Third Floor - Suite 300   Columbus, Ohio   43215
General Info: 614-644-2658  |  Consumer Hotline: 800-686-1526  |  Fraud Hotline: 800-686-1527  |  OSHIIP Hotline: 800-686-1578