Rudnik Surety, Inc. ~ MLM Bond Application

Apply for MLM Bond
Minnesota Lawyers Mutual Insurance Company

Please complete thoroughly the fields below to submit an on-line bond application.
If you wish, you may print off a form and complete and fax by clicking HERE.
Fields in red are required

Business
Legal Business Name:
Dba (if any):
Date Formed:
Type of Business:
Street Address 1:
Street Address 2:
City:
State:		Zip:
Email address:
Business Phone:
Business Fax:
Federal Tax ID Number:

Owner
Owner Name:
Owner SSN:	**
Owner Spouse Name:
Owner Spouse SSN:	**
Owner Address 1:
Owner Address 2:
Owner City:
Owner State:		Owner Zip:
** If you feel uncomfortable with providing this information on-line, please call our office to provide the information as credit reports are run as part of the underwriting

Owner #2
Owner 2 Name:
Owner 2 SSN:	**
Owner 2 Spouse Name:
Owner 2 Spouse SSN:	**
Owner 2 Address 1:
Owner 2 Address 2:
Owner 2 City:
Owner 2 State:		Owner 2 Zip:
** If you feel uncomfortable with providing this information on-line, please call our office to provide the information as credit reports are run as part of the underwriting

Owner #3
Owner 3 Name:
Owner 3 SSN:	**
Owner 3 Spouse Name:
Owner 3 Spouse SSN:	**
Owner 3 Address 1:
Owner 3 Address 2:
Owner 3 City:
Owner 3 State:		Owner 3 Zip:
** If you feel uncomfortable with providing this information on-line, please call our office to provide the information as credit reports are run as part of the underwriting

Bond
Please also forward any available copies of petitions, motions, or court orders to assist us in putting your bond in place
Type of Bond Requested:
Amount of Bond:
Desired Effective Date:		Expiration Date:
Court File Number:
Caption:
Court District Number:
Court State:		County:
Attorney Firm:
Attorney:
Attorney Address 1:
Attorney Address 2:
Attorney City:
Attorney State:		Attorney Zip:
Attorney Phone:
Attorney Fax:

Comments
Comments:

To process your bond we require a completed and signed
CREDIT INVESTIGATION AUTHORIZATION FORM
Click on the above to open (or download) the PDF form
Print, complete and mail it to:
Rudnik Surety, Inc
7191 Knollwood Dr.
Mounds View MN 55112

Questions? Problems?
Rather use another method to apply?
Call or e-mail:

Nick Newton, Vice President
(763)-786-9666, Ext. 15
email: nick@rudniksurety.com
or
Chelsea Bremer, Assistant Underwriter
(763)-786-9666, Ext. 11
e mail: chelsea@rudniksurety.com