AGENCY APPOINTMENTS

To become an appointed agent with RSI, download the forms below to complete the Agency Profile, Online Questionnaire, Producer Agreement, and W9 forms online.

 

Submit the forms along with a copy of your E&O insurance and Agent License by email to:

cholzkamper@rsimga.com

Or you can fax them to:

817-524-1361

Download Blank Forms

RSI Agency Profile Form

RSI_Agency_Profile.JPG

RSI Online Questionnaire

RSI_Retail_Agency_Questionnaire.JPG

RSI Producer Agreement

RSI_Producer_Agreement.JPG

IRS W9 2018 Form

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