Get Equitrust Contracting

This guide provides clear, step-by-step instructions for filling out the EquiTrust Contracting form online. Whether you are undertaking this process for the first time or need a refresher, these detailed explanations will help ensure your application is completed accurately.

Follow the steps to successfully complete the EquiTrust Contracting form.

1. Click the ‘Get Form’ button to access the EquiTrust Contracting form and open it in your preferred text editor.
2. Begin by entering your name as it appears on your insurance license, followed by your date of birth and sex. Ensure all personal identifiers match official documents.
3. Input your business name and email address, checking the box to indicate your mailing address accurately reflects your location.
4. Fill in your business address, including street, city, county, state, and zip code, followed by your residential address if differing from your business.
5. Provide your residence phone number, business phone number, and fax number for contact purposes.
6. Enter your Social Security number and Taxpayer Identification number. Ensure accuracy to prevent any issues with processing.
7. If you hold a securities license, include your CRD number and Broker/Dealer name.
8. List the states for which you wish to obtain a non-resident appointment, ensuring to attach the required state license copies.
9. Disclose if you currently have a debit balance with any insurance company. If yes, provide the name and a brief explanation.
10. Answer any questions regarding prior legal issues or complaints as indicated. For any 'yes' responses, attach detailed explanations on a separate sheet.
11. Attach a copy of your Errors and Omissions coverage declaration page as this is required with your submission.
12. Complete the Agent’s Declaration and Authorization, certifying that your answers are true and accurate. Be aware this application is part of your contract.
13. Sign and date the application. Ensure all information is filled out before submitting your application.
14. Once completed, save your changes, download a copy for your records, and return the form per the instructions provided, either via fax or by mail.

Complete all necessary documents online to ensure a streamlined application process.