Below are some useful forms that may be required when issuing a new policy or changing payment details.
We recommend that when dealing with sensitive information like credit card or account information that proper care is taken to shred these documents once you have confirmed they have been received by your broker.
Client Consent Form
The Client Consent Form is intended to acknowledge the collection, dissemination, and retention of information about the client by the broker during a policy renewal. Additionally, the form may be used to request:
To review personal information maintained by the Broker pertaining to the Client’s application, policy or policies;
To obtain copies of the Broker’s privacy policies or standards; or
To make other inquiries to express concerns, the Client may do so by contacting the Broker Privacy Officer.
Click below to download the Client Consent Form
Credit Card & Payment Forms
The following Credit Card and Payment Forms are used to authorize credit card payments for your policy. Please ensure that after sending this information to your insurer or broker that appropriate documents are shredded to prevent against identity theft.