• Agent’s full legal name (if they have a nickname, make a note of it in the “notes” section)
• Contract Level
• Direct Upline
• Agency Manager

• Last & first name
• Social Security Number
• Gender
• Birthdate
• Cell Phone
• Email
• Move-In Date
• Resident Address (street address, city/state, zip)
• Resident Insurance License # & State
• Individual or Business Entity
• If applying as a business entity, all the business entity information MUST be filled out.
• If applying as a business entity, an active business insurance license MUST be provided.
• If applying as a business entity, the business Articles of Incorporation MUST be provided.

• Fill out name at the top of the sheet
• ALL questions and sub-questions must be answered.
• If a MAIN question is answered “yes”, then one or more of the sub-questions MUST also be answered yes. If the MAIN question is answered “no”, answer all the sub-questions “no” and skip to the next main question, regardless of whether they think a sub-question pertains.

**IF THE MAIN QUESTION IS ANSWERED “NO”, THEN ALL THE SUB-QUESTIONS MUST BE ANSWERED “NO.” If they are not, then you need to fix this before it is sent to our corporate office. Page 3 (Legal Questions, Page 2):

• Legal questionnaire must be signed and dated.

• Need to list ALL employers for the past 7 years.
• Each employer MUST have a FULL start & end date (month/day/year). If they are still currently employed there, just write in “Current” in the end date spot.
• Each employer MUST have a full address, even if it was overseas. If they’ve gone out of business, then we need the address they were located at during their time employed there.
• A job title MUST be listed for each employer.
• If there are any gaps in employment that are longer than 2 months, we need an explanation for the gap(s).
• If it’s been over 2 months since their last employer listed ended, please make a note that they are “currently unemployed”.
• If they have more employers than fit on the sheet, have them list any additional employers on additional employment sheets.

• Need to list ALL residences for the past 7 years.
• Each residence MUST have a FULL move-in and move-out date, in exception of their current residence. Please list their current residence on the address history sheet, as well as the general information page of the contract & fill in the move-out spot as “Current.” **MAKE SURE THAT THE MOVE-IN DATE ON THE ADDRESS HISTORY SHEET AND THE 1^STPAGE OF THE CONTRACT MATCH!**
• There needs to be a FULL numbered street address, city/state and zip code listed for EVERY
• There can be NO gaps between residences AT ALL.
• If there are times when they were between moves, staying with friends or in hotels, then you need to make a note of that on the bottom of the address history sheet.
• If they have more residence addresses than will fit on one sheet, please have them list any additional residences on additional address sheets.

• There MUST be a birth city AND state filled in for the agent.
• There MUST be a current resident COUNTY (NOT country) filled in for the agent.
• They MUST answer whether or not they own their home.
• Anti Money Laundering training MUST be completed through either LIMRA or American Amicable. These are the only 2 that our carriers accept. If it’s completed through LIMRA, we just need a completion date filled out. If it’s through AmAm, then we need the completion date filled out, as well as a copy of the completion certificate.

**The name on the AML certificate MUST match the name printed on the agents license!!!**

• Print the agents name in the space at the top of the sheet.
• The signature inside of the box MUST be a wet signature.
• The signature inside of the box MUST be completely INSIDE and NOT TOUCHING the borders of the signature box.
• The signature should be in black ink. No light colored ink. No pencil. No thick markers.

**We electronically lift these signatures, so they MUST be dark, legible, good quality scans.**

• The background of this sheet MUST be all-white. Any signature authorization sheets that are off-white, shadowy, grainy, etc will not be accepted, and you will be asked to re-submit them. 99% of the time, camera phone scans are not good enough quality.

• Account holder name MUST be filled out & MUST match the account holder information printed on the check. If it’s a business check, then fill in the business name that’s printed on the check.
• Bank routing number and account number MUST be filled in legibly and MUST match the routing/account information printed on the accompanying document you’ve provided to us.
• MUST have a wet signature. If the account holder is different from the agent being contracted, that person must also sign their wet signature, in addition to the agent.
• Must be dated.

• If agent completed AML through American Amicable, they must provide a copy of their completion certificate. The name printed on this certificate needs to match the name printed on their license EXACTLY or you will be asked to re-submit it. Also, make sure their completion date is filled out on the BCO/AML sheet.
• If agent completed AML through LIMRA, make sure their completion date is filled out on the BCO/AML sheet.

• Must provide a copy of their resident license of the state they currently reside in. Their full legal name must be printed on it & it must be currently active.
• “Life” MUST be listed as a line of authority of ANY license submitted, resident & non-resident.
• If contracting as a business entity, an active business insurance license AND articles of incorporation also need to be provided.

• Please insert any E&O documentation here in their packet.

• If they have no legal explanations, they DO NOT have to sign and date this sheet & it can be discarded. It does not have to be submitted with their new producer packet.
• Each legal explanation MUST have a FULL date (month/day/year) of when the incident occurred.
• Each legal explanation MUST cite which question the explanation is in response to.
• Each legal explanation MUST include a detailed explanation.
• If the legal explanation is pertaining to bankruptcy, we need to know whether or not it has been discharged.
• If the legal explanation is referring to any felony charges, the agent MUST provide court documents to be included along with the detailed explanation. We would need a notice of hearing that states the charges/allegations, as well as an official court document that shows the resolution or final judgment of the charge.
• This sheet MUST be signed and dated.

• Any pages where anything has been filled in by the agent should be included in their new producer packet.
• All the pages of typed contract without anything written on them by the agent can be removed from the packet before submitting it to corporate.
• The last page of the contract MUST be signed and dated by the agent.