Carrier Access Request

Direct Select Advisor Access Request

To Get Appointed with Direct Select Agencies submit the following items:

  Completed agency agreement forms

  Copy of Current E&O Dec Page

  Completed Pre-Authorization Deposit Form and a Copy of a Voided Check

  Signed & Dated Contract Page

  Signed & Completed W-9 form

  Copy of Resident & Non-Resident Agency Licenses

  Copy of Surplus Lines Resident & Non-Resident Agent(s)/Broker(s) License(s) (if applicable)

  Payment for Membership Fee



Start producing almost immediately after the execution of our agreement and supplying us with the necessary paperwork to set your agency set up in our system.