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Agency Checklist for Appointment

Agency Agreement
Agency Information Sheet
W-9 Form
Copy of E & O Declarations Page
Copy of Agent’s 2-20 License
Please complete the form to the right and press submit. Once we receive the initial form we will send you the above documents via email attachment for completion.
Agency Information

Agency Information

Taxpayer Identification Number

Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter.
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Agent Information - Agent to Appoint