Become An Atlas Agent

Agency Profile Form




FEIN or SS#: Incorrect Format. FEIN Format: xx-xxxxxxx. SS Format: xxx-xx-xxxx




Entity type not selected












Phone: Acceptable Format - xxx-xxx-xxxx




Email Address:










Top 4 Residential Property Carriers:

1.
2.
3.
4.
Are any of these markets accessed through an MGA contract?
Yes No
Why are you seeking an appointment with our company?


What factors influence where you place your residential property business?


What is your primary focus when selling a residential property policy?


How would our market fit in with the other markets you represent?


Which residential property product forms are you most familiar with? (e.g. HOB, TDP-3, ISO-3)

What marketing plans do you have in place to grow your residential property business? Must check at least 3 sources.

Use lead generation program

Use telemarketer

Agency website quoting capability

Relationship with mortgage loan officer, real estate broker or title company

Direct mail campaign

Have effective cross-sell program

Media advertising

Book roll

Have dedicated personal lines producers

Other - please describe

What production commitment can you make to Atlas General Agency?



In addition to this application, we will also require loss experience reports for your top 3 residential property carriers for the most recent 3 years, evidence of current errors & omissions insurance with a minimum $1,000,000 limit, and a current General Lines Property & Casualty license.