Affiliations
This screen is used to review and complete any insurance agency affiliations associated with the provided licensee:
This screen is used to provide any insurance agency affiliations used by this licensee. This screen should only be completed if the licensee is being licensed as an active member of the associated business entity.
For each affiliation, the following information can be provided:
Agency Name: The name of the agency affiliated with this licensee.
Agency FEIN: The agency's Federal Employer Identification Number.
Agency NPN: The agency's National Producer Number.
State: The agency's home state.
This screen is not a required screen.
When you have completed this form (if applicable), click the Main button to return to the Uniform Application main menu, or click the Next button to go to the next screen.