AUTHORIZED INDEPENDENT AGENCY APPLICATION (PAGE 1) Name of Brokerage or Agency as Licensed Date Address (street, city, state, zip) Telephone Mailing Address or "Trade Name" if Different than Above Appointment is for: Commercial Only Appointment Date Personal Only Individual Partnership Corporation Marketing Area is: Urban Suburban Rural Code Number All Lines Commission Does the brokerage or agency have a written Marketing Plan? Standard 15% Average % Special Yes No Copy Provided? Yes.
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How to fill out the KBIC Agency Application Forms Package online
Filling out the KBIC Agency Application Forms Package online can streamline your application process and ensure you provide all necessary information. This guide will walk you through each section and field of the form, making it easier for you to complete your application accurately and efficiently.
Follow the steps to fill out the KBIC Agency Application Forms Package online.
- Click ‘Get Form’ button to access the KBIC Agency Application Forms Package and open it in the editor.
- Begin by entering the name of your brokerage or agency as it is licensed. Add the date, address including street, city, state, and zip code, followed by your telephone number. If your mailing address or trade name is different, include that in the relevant field.
- Detail the appointment type you are applying for by indicating whether it is for commercial only, personal only, or both. Specify the appointment date and the type of entity applying, such as individual, partnership, or corporation.
- Indicate the marketing area by selecting urban, suburban, or rural and include the code number. Provide details on the lines of business you will represent and any special commission arrangements; include a brief description if applicable.
- List the names and titles of all principals, partners, and key personnel, noting their licensing status and years of industry experience, along with comments on their qualifications. Attach necessary documentation, such as degrees or designations.
- For the business portfolio section, provide information on your company's insurance volume, including standard and non-standard premiums across various business lines. Outline any areas of specialization.
- Detail your company's representation with different insurers and mention any formal underwriting authority or financial assistance programs. Include the type of computer systems used and whether you are interfacing with other carriers.
- Fill in the agency or broker legal name, identification number, tax ID, and contact information for key personnel. Ensure all contact details are accurate.
- Conclude by reviewing the Application Check List to confirm all required documents are attached, including licenses and proof of errors and omissions coverage. Sign and date the application.
- Once you have filled out all sections, review your responses for accuracy. You can save changes, download, print, or share the completed form as needed.
Complete your KBIC Agency Application Forms Package online today to ensure a smooth application process.
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