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Retail Agents

WHY IS USPF PREFERRED BY AGENCIES NATIONWIDE?

We give our agents a competitive advantage by offering – professional and courteous service, easy-access software, creative financing solutions, and great rates and terms; all supported by the most experienced sales and service teams in the industry.

WHY DO THE BEST AGENTS WORK WITH USPF?

It’s our service! We work with the largest Property and Casualty agencies in North America, but our tradition of personalized service is that of a boutique company. We deliver a user-friendly, path of least resistance finance option to our agent-clients along with competitive rates. Pricing and terms are best in the industry. YOU’LL SEE!

AGENT REGISTRATION

Primary Contact Name
Primary Contact Email
Primary Contact Phone Number
Agency Name
Agency Physical Address
Agency City
Agency State
Agency Zip Code
Years in Business
Number of Employees
Estimated Total Annual Premiums
Estimated Annual Finance Volume
Class of Business/Specializations
(Hold CTRL to section multiple options)
If OTHER, Indicate Class of Business/Specializations
Estimated Annual Number of Contracts
Current Finance Vendor
If OTHER, Indicate Current Finance Vendor
Percentage of your business is commercial?
Does your agency do business with any Carrier/Managing General Agent in which you have over 5% ownership?
If YES, Indicate the Carrier/Managing General Agent Name
Agency Management System
Would you like to automate finance agreements from within your agency management system?
Electronic Notice Selection
By checking this box and signing below, you understand that you OPT IN to receive electronic notices from US Premium Finance. You knowingly and voluntarily give up and waive all rights to receive written notices delivered by U.S. Mail and agree that receipt of said notices delivered by electronic transmission satisfies any legal notice requirements. Consent to receive electronic notices may be withdrawn in writing at any time.By checking this box and signing below, you understand that you OPT OUT of receiving electronic notices. You will only receive notices from US Premium Finance in written form delivered via U.S. mail.
Market References
Name of Insurance Company/General Agent
City
State
Direct Contact Name
Direct Contact Number
Direct Email
Name of Insurance Company/General Agent
City
State
Direct Contact Name
Direct Contact Number
Direct Email
Please upload your Agency State License
Please upload your Producer State License
Please upload your Agency W-9 Form

Please upload your Errors & Omissions Document
Other
Other
How did you hear about us?
If OTHER, what lead you to us?
CERTIFICATION: The undersigned Agent/Broker, hereinafter referred to as “Agent”, hereby represents and warrants that all information listed in this agreement has been accurately represented. US Premium Finance reserves the right to amend any terms or rates provided based on inaccurate information. Agent further agrees to indemnify US Premium Finance against any damages, costs or expenses incurred in connection with any untrue, misleading or fraudulent representation or warranty made by Agent hereunder.

Name of Form Completer

For questions or assistance, give us a call at 770-446-8773

8 Important Advantages of Being an Agent with US Premium Finance

Exclusive
Pricing

Continuous Product Innovation

Flexible
Terms

Just A Phone
Call Away

Powerful
Customized Software

No Bureaucracy

 

Personalized
Customer Service

Industry Knowledge & Experience

At US Premium Finance, we understand that our agent
partnerships are the foundation of our success.

CREDIT CARD E-PAY BY CHECK
PAY BY FAX PAY BY PHONE

NOTICE: We have made a change in our credit card and echeck/ACH processing. The process is more user friendly and simplified. We hope you like the upgrades and thank you for your continued support. Please CONTACT US if you have any questions, or call 866-246-9691 option 3.