|
Agency Licensing
Interested
in becoming licensed with American Sentinel? We’ve made it easier to
get the process started. Please complete the two forms below - the
Agency/Agent Application Form and the W-9 Form.
The
forms may be completed electronically, printed and sent to us for
review. Once we receive the forms a Marketing Representative from our
Company will contact you with further information regarding our products
and licensing requirement.
Please
note: The Application Form and the W-9 will need to be printed, signed and
mailed or faxed with copies of your State Agency License and Personal
License to:
American Sentinel Insurance Company
P.O. Box 61140
Harrisburg, PA 17106-1104
Fax Number: (717) 657-9499
The
forms available for download are in Portable Document Format (PDF). In
order to download and view these files you must have a version of Adobe Acrobat Reader. Click here to download Adobe Acrobat
Reader.
 Agency/Agent
Application Form
W-9 Form
For
assistance in completing these forms please call 1-800-692-7338.
|
