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The Difference Between

A Done Deal vs. Deals Undone

Become An Agent

Tell us a little bit about yourself below.

  • General
    Information
  • Agency
    Information
  • Agency
    Production
  • Review
    & Submit

General Information


  • General
    Information
  • Agency
    Information
  • Agency
    Production
  • Review
    & Submit

Agency Information


  • General
    Information
  • Agency
    Information
  • Agency
    Production
  • Review
    & Submit

Agency Production


Has your agency ever applied for appointment or been appointed by AmTrust?



How many Commercial Lines Producers at this agency? 


What is your agency’s Total Commercial Volume? 


Please list your top 2 Commercial Insurance Carriers by total written premium volume:


Does your agency currently have premium with AmTrust placed through another agency, broker, or aggregator?


  • General
    Information
  • Agency
    Information
  • Agency
    Production
  • Review &
    Submit

Review & Submit


I understand that completion of this form does not guarantee an appointment with AmTrust or any affiliated companies. A formal application, carrier financial and loss statements and background checks on any/all agency employees may be required as part of the appointment process before a formal determination is made.

General Information

Name

Email

Phone #

Title

Agency Information

Company Name

FEIN

Address

Zip

City

State

Agency Production

Has your agency ever applied for appointment or been appointed by AFSI?

$ Total Premium

Commercial Line %

Does your agency currently have premium with AmTrust placed through another agency, broker, or aggregator?

First Commercial Carrier

$ Total written Premium

 

Second Commercial Carrier

$ Total written Premium