Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. Begin with the proposed effective date section by entering the date you wish the agreement to take effect.
3. In the applicant information section, fill in your name, mailing address, and contact information. Ensure that the federal employer ID number is accurate.
4. Specify your business structure by selecting the appropriate option, such as sole proprietor or corporation.
5. Complete the general information section, detailing your corporate employee payroll and the number of employees involved.
6. If applicable, fill out the table for contract/temporary employee payroll projections, ensuring the percentages total 100%.
7. In the corporate overview section, answer questions regarding staffing certifications, background checks, and the existence of an employee manual.
8. Proceed to the liability coverages section, checking the boxes for the types of insurance you wish to include and filling out the corresponding limits and deductibles.
9. In the crime section, provide the details regarding employee theft and any other relevant coverages.
10. Answer questions in the loss history section, ensuring to provide explanations where necessary.
11. Review the statement from the applicant, ensuring all information is correct and true to your knowledge.
12. Finalize the form by signing and dating where indicated, and ensure any agents involved also complete their sections.
13. Once completed, save your changes, and use options to download, print, or share the form as needed.

Be proactive and complete your documents online to ensure a smooth process.