Complete the form to start your agent appointment with SCC

Agent/Agency Appointment Form

Agency Profile


Corporate License

Physical Address

Mailing Address

Contacts

Agency Owner/Principal


Operations/Office Manager

Accounting Manager

Compliance Manager

Compliance

Errors and Omissions


Accounting Info

Sweep Account

Checking

Commissions Account

W-9

Additional Info

Top 5 Carriers

Document Upload

TDI License

E&O

Sweep Accounts Voided Checks Upload

Commission Accounts Voided Checks Upload

Signed W-9 Upload

Final Submission

If you satisfied with your answers/selections, click the Submit button to complete