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Provisional agency notification Agent Details Agent: Address: Tel: Fax: E-mail: Website: Approx GWP; Staff Numbers; Personal Lines Motor Commercial Lines Total Key Commercial Staff Name Position Duties/Responsibilities
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The provisional agency form is a document used to apply for temporary agency status.
Only agencies seeking temporary status need to file the provisional agency form.
To fill out the provisional agency form, you must provide all the required information accurately and completely.
The purpose of the provisional agency form is to inform and apply for temporary agency status.
The provisional agency form requires information such as agency details, contact information, intended temporary status duration, and reasons for seeking temporary agency status.
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