Get Agent Of Record Change Form Fillable 2020-2025

The Agent Of Record Change Form Fillable allows users to efficiently change their independent agent or broker on an insurance policy. This guide provides clear instructions for completing each section of the form online to ensure a smooth submission process.

Follow the steps to accurately complete the form online.

1. Click the ‘Get Form’ button to access the form and open it in your preferred online editor.
2. Begin filling in the necessary details in the designated fields. Start with the policyholder name by clearly writing your name as it appears on your insurance policy.
3. Next, enter your policy number accurately in the provided field. It is essential to ensure that this number matches the one associated with your account.
4. Provide the details for the new agent you are assigning. In the ‘Agency name’ field, enter the name of the agency you are designating as your new agent.
5. If applicable, fill in the ‘Agency code’ provided by your new agent or broker for identification purposes.
6. Enter the name of the new agent in the designated ‘Agent name’ field. Ensure the spelling is correct to avoid any processing issues.
7. Then, complete the address section by filling in the complete address of the new agent or agency, including street, city, state, and zip code.
8. Provide the new agent’s phone number. This contact detail is vital for any follow-up required regarding the change.
9. Finally, ensure you sign the form in the ‘Policyholder Signature’ section. Include your printed name and date to confirm your request.
10. Once completed, save any changes made to the form. You can then download, print, or share the form as needed for submission.

Complete your documents online today for a seamless experience.