How to become an agent/broker
In order to become an agent/broker with Connecticut Underwriters-PA we need the following items completed and returned for review:

• Agent questionnaire
• Form W-9
• Copies of your Agency and Individual Producer Licenses

CONNECTICUT UNDERWRITERS-PA
(a division of Connecticut Underwriters, Inc.)
600 W. Germantown Pike, Suite 400, Plymouth Meeting, PA 19462-1046
Toll Free 800-736-7157 • Phone 610-260-1499 • Fax 610-828-8257
Email info@ctunderwriters.com

a division of
CONNECTICUT UNDERWRITERS, INC.
421 Wadsworth Street, P.O. Box 2784, Middletown, CT 06457-9284
Phone 860-347-9600 • Fax 860-347-9611
Toll Free 800-982-3881 (inside CT) • 800-243-3712 (outside CT)
Email info@ctunderwriters.com