G9039 form 2025

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  1. Click ‘Get Form’ to open the g9039 form in the editor.
  2. Begin by entering your agency name, phone number, and email address in the designated fields. If you wish for your email to be published on the Agent Locator, check the corresponding box.
  3. Fill out your street address, city, state, zip code, and county. If your mailing address differs from your physical address, complete that section as well.
  4. Provide details about your agency structure by selecting whether you are an individual, partnership, corporation, or LLC. Attach any necessary documents such as licenses and insurance information.
  5. In the 'Agency Volume' section, input last year’s written premium across various categories like personal auto and commercial lines. Be sure to project anticipated volumes for the next 12 months.
  6. Complete the 'Company Appointments' section by detailing years represented and earned loss ratios for each company you are associated with.
  7. Finally, review all entries for accuracy before signing and dating the authorization section at the end of the form.

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