Acord Agent Broker Of Record Change Form - Please secure a signed form prior to submitting your request. Agent/broker of record change please be advised that we wish to name as our exclusive representative effective. Agent/broker of record (acord 36) is now agent retained.
Agent/broker of record (acord 36) is now agent retained. Please secure a signed form prior to submitting your request. Agent/broker of record change please be advised that we wish to name as our exclusive representative effective.