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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling out the 'General Agency Information' section. Enter your agency name, I.R.S. Business Name, Employer ID #, and contact details including phone and email.
  3. Proceed to the 'Branch Information' section. If applicable, provide details about any branch offices, including their names and addresses.
  4. In the 'E & O Coverage' section, indicate whether your agency has E&O coverage and provide the necessary policy information.
  5. Complete the 'Staff Information' section by listing all staff members along with their roles and licensing details.
  6. Finally, review all sections for accuracy before submitting your completed form through our platform.

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