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Our records indicate that you are no longer contracted under our hierarchy for one or more of the carriers that you are receiving overwrite from our office for and, effective 1/1/2023, you will be required to provide us with proof of your 2023 certification completion in order to continue to receive these overwrites. 

 

Please submit your proof by uploading it using the form below.

You can download a blank W-9 here and the Direct Deposit Authorization Agreement here.

Agent RTS Certificate Submissions
Agent Name
Agent Name
First
Last

Documentation you are required to upload in order to continue receiving commissions: W-9, EFT form, image of voided check, and certification certificate.

Maximum file size: 314.57MB

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