Agent appointment

Agent appointment application

Please use the application below to add new agents to your Agency or Brokerage account.

If you do not yet have an account, please see the New Agency (Brokerage) form. If you are a sole proprietor or independent agent, please see the Sole Proprietor application form. Processing time for agent applications can take up to two weeks. You will receive a welcome email notifying you when your appointment is complete.

Required attachments to be uploaded with application

  • State insurance license(s)

 Have questions or need help? Email us at or call us toll-free at 1-877-317-3046

Application form


Please include dates, persons and  government entities involved, and attach relevant documentation, such as court decrees or findings of investigation.
Required: copy of insurance license from each state in which you are seeking appointment.
Please use a mouse or your finger to sign your name in the box above.