Send Us Email
Producer Info
In order for to Patriot to provide superior service, we will need the following items completed and returned to our office. During the process, should you have any questions, please feel to contact us for guidance,
Applications
Insurance Agency Agreement:
In order to be appointed, the following items need to be returned to Patriot Underwriting for Processing:
- Fully executed Insurance Agency Agreement;
- Copy of your current agency license for you home state along with a copy of your personal license for those states that only require personal licenses. For surplus lines business, the requisite surplus lines license needs to be sent.
- Completed W-9 form ( see attached)
- A copy of your current E & O declaration page.
