Pacific Advisors

Are you going to assign your commission to a company you work for or receive it direct?
Assign commission       Receive it direct

If you are going to assign your commission to a company, please list the name of the company:

Are you the principal officer of the company you want to assign commission to?
Yes       No

Please list the state(s) you want to be appointed in:

Have you already taken an application from your client for this carrier?
Yes       No

If yes, what date did the client sign the application?

*Please note that all Long Term Care carriers that we work with do not require you to be pre-appointed for WA anymore. We do ask that you submit all of your contracting paperwork and requirements to Jaymie Darden before taking an application from your client to ensure the appointment and underwriting process go smoothly. Your state LTC continuing education course must be taken prior to writing an application (if applicable). Please inquire about individual state appointment and LTC continuing education guidelines.

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