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Partner Form

RPM Managing General Agency Inc appreciates your interest it Independent Agency Partner opportunities. To get started please complete the below online application and agency profile.

RPMMGA Questionaire
Agency Ownership Names
KEY PERSONNEL / CONTACTS:
TOP 3 DIRECT APPOINTED COMPANIES: (EXCLUDE BROKERAGE)
TOP 3 WHOLESALE / MGUS:
ADDITIONAL REQUIRED INFORMATION:
I understand that the information provided herein is essential and material to the agency/broker relationship and hereby certify the above answers are truthful and accurate, to the best of my knowledge. IF YOU HAVE ANY QUESTIONS, PLEASE CALL (800) 394-2767
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To finalize the application process please click on below, print and complete

RPMMGA Appointment Agreement

IRS W 9 Tax Form

In addition, scan a copy of your agency Errors and Omissions (E&O) deck page
Send the above to Partner@RPMMGA.com or Fax 800-441-2667

Be a Star Partner. Encourage your agency commercial account manages/executives register at the Star Partner link below.

Star Partner Program

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