GM Elite Account GM Elite Cover Sheet To Attend the event in person, fill out the form below to register. Limited to first 30 registrants.Marketer Name* Request Type*New AppointmentLevel Change HierarchyChange Add a stateJITSureLC CompleteSureLC Not CompleteAgent Name* JIT: Clients Name First Last JIT Client: Date Written MM slash DD slash YYYY States to appoint in:Agent contract as:IndividualCorp (must be the signing principal, complete agency info below)Subagent/LOA (indicate who agent assigns to below)Agency name: Commission Level: Advance commissions: Yes No Will the agent be recruiting agents under them: Yes No (Principal/Agency must also be appointed and licensed in all states as agent)Override paid to:(Who receives an override on this agent) LOA/Assigns commissions to: Uplines agent number: Attachments: Upload below License E&O Cert/AML Code of Conduct Debt agreement Has GM E&O Yes No Carriers to appoint: 3 MaxAppoint for: Life Annuity Senior LTC Health Notes/Special Instructions:Upload AttachmentsMax. file size: 128 MB. If you have any questions please reach out to Robin@gordonmarketing.com
