There are two ways to get appointed by Empire Underwriters:

  1. Complete the Brokerage Agreement completely online
  2. Fill out the forms, then submit them by email or in the form provided

Option #1

Submit Brokerage Agreement Online

Option #2

Fill Out Forms and Submit

1.) Download The Required Forms:
Download Broker/Marketing Agreement +
2.) Provide the following documents:
  • Broker Application
  • Broker Agreement
  • W-9
  • License and E & O
  • Broker Bond for CA
3.) Provide the following documents:

Please submit documents on the next page. Contact your
Empire representative with any questions.

Fill out Forms and Submit