Forms and Information for Prospective Agents

PROSPECTIVE AGENTS

Requirements

  • Completed Agent Profile
  • Completed W-9
  • Current General Lines License
  • Current Errors and Omissions coverage
  • NO MINIMUM premium Volume commitment required

Forms

WGA Agency Profile Click to download pdf

Producer Agreement  Click to download pdf

W9 Form — Request for Taxpayer ID Click to download pdf

To become a contracted agent with WGA, complete the Agent Profile, Producer Agreement, and W9 forms and submit the forms along with a copy of your E&O insurance and agent license by email to [email protected] or by fax to 636.391.2115.

A signed contract by both parties will be required upon appointment. For additional information about products and services please contact:

Contact Representative

Debbie Schwent
Phone: 636.391.4841 ext. 101
Fax: 636-391-2115
Email: [email protected]