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AGENT/BROKER OF RECORD CHANGE. DATE (MM/DD/YYY). Nevada Restaurant Insurance Services. I Insure Direct LLC. 1500 E Tropicana Ave #114- A.

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1. Individuals or organizations that are undergoing a record change process may require the agentbbrokerb information. This could include updating or modifying personal or contact details, such as changing a broker associated with a particular record.
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For pdfFiller’s FAQs

What is agent/broker of record change?

The agent/broker of record change is a process in which a client decides to switch their insurance agent or broker to another firm.

Who is required to file agent/broker of record change?

Either the client or the new agent/broker is required to file the agent/broker of record change form.

How to fill out agent/broker of record change?

The form typically requires information about the client, the new agent/broker, and reasons for the change.

What is the purpose of agent/broker of record change?

The purpose is to officially notify the insurance company about the change in representation for the client.

What information must be reported on agent/broker of record change?

The form usually requires details such as client name, policy number, effective date of change, and signatures of all involved parties.

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