Welcome to the FLOW e-contracting!

❗TO PROCEED WITH TO THE NEXT PAGE, PLEASE ENSURE THAT YOU HAVE COMPLETED ALL THE FOLLOWING THREE STEPS❗

2. Get your E&O Insurance (by the carriers to start the e-contracting process)
• Select newly licenced < 2 years life & health Agent E&O
• Policy effective date should be the 1st of the current month
• Choose "Option A" as your coverage option
• Download your Certificate

3. Complete your Anti Money Laundering AML Training (required by the carriers to start the e-contracting process.)
• Pass the course
• Download your Certificate

Once you completed all three steps above, please click on "Next" to finish your e-contracting.

E&O and AML Certificate (Required)

Errors and Omissions (E&O) Certificate *

Please upload your existing E&O Certificate, or you can obtain your E&O here: https://www.napa-benefits.org/insurance/errors-and-omissions-eando-insurance

AML (Anti Money Laundering) Training Certificate *

Please upload a proof of your Anti-Money Laundering (AML) training - or - you can complete training here: https://www.webce.com/catalog/courses/course-information/aml-training/course/206954/

If you have completed your Anti-Money Laundering (AML) training with LIMRA, it's not necessary to attach a certificate.

Agent Contracting Form (Individual)

Thank you for your interest in representing National Life Group and Fidelity and Guaranty Life Insurance Company. Please read carefully and complete the following details.

First Name *

Middle Name

Last Name *

Please Upload Your Best Professional Picture *

This will help us create your profile

Mailing Address:

Address *

City *

State *

Postal code *

Resident License Information

National Producer Number (NPN) *

Need Help? Look up your NPN here: https://nipr.com/help/look-up-your-npn

Resident State *

Resident License Number *

Banking Information for ACH/Direct

Commission Deposit

Bank Name *

Account Type *

Checking

Saving

Account Number *

ACH/Routing Number - (Lower left corner of your check) *

Please Upload a Voided Check Proof *

We're excited to learn more about you.

Could you please share with us about at least three things? 😊

Dream Vacation Destinations (U.S.) 🇺🇸 *

Dream Vacation Destinations (Worldwide) 🌎 *

Favorite Sport/Outdoor Activity 🤾‍♀️

Cuisine/Restaurant Preference 👨‍🍳

Favorite Perfume or Scent

Favorite Brand

❗PLEASE READ CAREFULLY BEFORE CLICKING ON SUBMIT❗

After submitting this form, - in the next 24 hours - you will receive the e-mail below from the National Life Group e-contracting department from NLGecontracting@nationallife.com.

Open that email and complete the National Life Group internal e-contracting paperwork. Also, check your spam folder for any email related to the completion of the e-contracting process.

Initials *

Signature *

Clear

By clicking on submit, you agree FLOW International's Terms and Conditions, Agent Agreement, including Independent Contractor Terms, Lead Usage Policy, Non-Solicitation Clause, Non-Compete Agreement, and Transparency on Carrier No-Releases Policy.