Get Confidential Data Sheet

Completing the Confidential Data Sheet is a crucial step in the appointment process for insurance agents. This guide provides clear, step-by-step instructions on how to fill out this important document online.

Follow the steps to successfully complete your Confidential Data Sheet.

1. Click the ‘Get Form’ button to access the Confidential Data Sheet and open it in your preferred document editor.
2. Begin by selecting the appropriate type of contract you are applying for by checking the relevant boxes at the top of the form.
3. In Section A, provide your personal producer information. Fill in all fields, or indicate 'N/A' where applicable, including your last name, first name, middle name, and Social Security number.
4. Complete the date of birth and email address fields in Section A. Include your FINRA CRD number if you have ever been registered.
5. Fill in your business address, including the suite or P.O. Box, city, state, zip code, and contact numbers, including the business telephone and mobile number.
6. In Section B, indicate whether you have Errors and Omissions insurance and provide the related policy number and coverage amount if applicable.
7. In Section C, if you are selling on behalf of a firm, enter the firm information, including the firm name and FEIN number.
8. If applicable, complete Section D for Broker Dealer information, filling in the broker dealer name and related numbers.
9. Continue to complete the relevant fields in Section E regarding Brokerage General Agency information.
10. In Section F, answer the questions related to new business information to confirm if you are submitting new life business.
11. For Section G, fill in the Anti-Money Laundering Certification if applicable and submit the required documentation.
12. In Section H, answer all background information questions fully. If you answer 'yes' to any questions, attach a letter of explanation.
13. At the end of the form, ensure you read and agree to the certifications required and provide your signature, printed name, and current date.
14. Once completed, save your changes. You may then download a copy of the form, print it for your records, or share it as needed.

Complete your Confidential Data Sheet online today to facilitate your appointment process.