Do you want payment for your individual sales to be made out to your agency or to you as an independent agent? Must match how you are set up with WebInsure.
Name and SSN/TIN must match what is on file with the IRS in order to complete registration:
Under penalties of perjury, I certify that:
- The number shown on this electronic form is my correct Taxpayer Identification Number (or I am waiting for a number to be issued to me), and
- I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and
- I am a U.S. citizen (including a U.S. resident alien).
Please review the Agent Agreements.