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Brokerage General Agent/Broker Name Firm Name (DBA) Last Name: First Name: MI: Social Security/TIN #: Email: Resident Life & Health Insurance License #: State: Business Phone: Fax: Cell: Driver s

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What is brokerage general agent/broker name?

The brokerage general agent/broker name is the name of the agent or broker responsible for providing brokerage services.

Who is required to file brokerage general agent/broker name?

Any individual or business entity that is acting as a brokerage general agent or broker is required to file their name.

How to fill out brokerage general agent/broker name?

To fill out the brokerage general agent/broker name, you simply need to provide the full legal name of the agent or broker.

What is the purpose of brokerage general agent/broker name?

The purpose of providing the brokerage general agent/broker name is to identify the agent or broker responsible for the brokerage services provided.

What information must be reported on brokerage general agent/broker name?

The information that must be reported on the brokerage general agent/broker name includes the full legal name of the agent or broker.

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