Broker appointment request · California

Tell us about your agency.

A team member will review your application and reach out within two business days to schedule an introductory call.

Step 1 of 8 Welcome

What's the best email to reach you?

We'll send a confirmation here and keep you in the loop.

Your agency.

The legal entity Stand will be appointing.

Agency name Branch / Legal name / DBA (optional) Phone Website (optional)

Where are you located?

Physical office address. Mailing address only if different.

Physical address My mailing address is different from my physical address

Ownership & legal structure.

For our records and for issuing your 1099 at year-end.

Business entity type

Sole Proprietor LLC Corporation Partnership

Federal Tax ID (EIN) Format: 12-3456789

W-9 form (optional, PDF or image)

Choose file…

You can also email a signed W-9 to appointments@standinsurance.com after submitting.

Principal agent-in-charge.

The licensed agent who'll be the primary point of contact. California license number (Broker-Agent or Personal Lines Agent).

Full name Title License number License class Email

Errors & Omissions coverage.

We need proof of E&O coverage at appointment.

Carrier Policy number Renewal date

Dec page (optional, PDF or image)

Choose file…

A few more (optional) details.

Helps us configure your account faster. Skip anything that doesn't apply.

Agency Management System (optional) Comparative Rater (optional) IVANS inbox ID (optional)

Training contact

Who should we reach when onboarding new producers or rolling out new products?

Name (optional) Email (optional) Phone (optional)

Review & submit.

Check everything looks right, then send it our way.

We've got it.

Thanks — a confirmation just landed in your inbox. A team member will review your application and reach out within two business days.