Broker Registration

AgencyEnter the name of your agency.

Commissions Payable ToEnter the payee for commission payments. This should be either your agency or the appointed broker and must be the same payee as the Tax ID Number or Social Security Number you will provide next.

Tax ID or Social Security NoEnter your TIN or SSN. This will be used to report all commission payments to the IRS so please ensure that this is for the payee named above. Do not use dashes.

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