702-906-0888 [email protected]

Become a Producer

In order to become a producer and maintain an on-going relationship we require the following information.

  • A completed and signed broker application / questionnaire – click here to download
  • A copy of your brokers bond (if required in your state)
  • A copy of your errors and omissions insurance declarations page, reflecting limits of at least $1,000,000/$1,000,000
  • A copy of your brokers license for each state in which you may be writing business
  • W-9 Form Click here – complete the required fields online; print; sign and date; scan the signed document to your file, then upload as part of your appointment submission

You can request and return your documents in several ways: