You may apply to be an Agent for Patriot National Underwriters, Inc.
by completing and submitting an Agency Profile form,
which we have provided for your convenience.
We have also provided a PNU contract for your use if you would like to
complete the contract process prior to writing new business. This is
not a requirement to submit business; if you prefer, the contract process
can be completed after a policy is bound.
In addition to the signed contract, we require copies of the
agency license(s), E&O certificate or declarations page, and a W-9
form, also provided below for your convenience.
You may email the completed forms to Jimmy Holland,
Marketing Manager, or you may fax the forms to (972) 233-3487.
Thank you for your interest in Patriot National
Underwriters, Inc.