Thank you for your interest in working with J.E. Brown. First, we need to know a little bit about you and your agency.
If you know your J.E. Brown Producer Code enter it here. Entering the code makes sign up much faster.
The common name for your business.
Provide the name exactly as it appears on your last federal income tax return.
Provide the name exactly as it appears on your current E&O declarations page.
Provide information for your main branch's physical location. Do not use a P.O. Box or mail service address.
EIN (12-3456789) / SSN (123-45-6789)
As reported on the federal income tax return.
Use the license number for your primary state of business.