Contracting

Complete this short form to begin carrier contracting for the AmSuisse Life & Annuity Program. Our Contracting & Licensing team will follow up with your full contracting packet.

Contract Type

Are you setting up an agency, or contracting as an individual agent?

Individual Contract I’m contracting as an individual licensed agent.

Agency Setup I’m setting up an agency (entity contract), with agents contracting under it.

Both I’m setting up an agency and contracting as an individual under it.

Which best describes your situation?

I do not work under any agency — I am an independent agent.

The agency has already been set up, and I will be placed under the agency I listed below.

The agency is not set up yet, and I will be under that agency.

Agency Principal’s Name

DBA Name (if different)

Approximately how many agents will contract under the agency? (optional)

Agents to be contracted under this agency (add as many as you like)

List the agents who will be placed under this agency. You can always send more names later.

Your Contact Information

First Name

Last Name

Email Address

Phone Number

Resident State (optional)

National Producer Number (NPN) (optional)

Speeds up license verification if you have it handy.

Agency Affiliation

Name of the Agency You’re Part Of

The AmSuisse-affiliated agency you belong to (or the agency being set up).

Who referred or invited you? (optional)

Anything else we should know? (optional)

Something went wrong sending your form. Please try again in a moment — or email your information directly to [email protected].

Your information goes directly to the Kuorum Partners Wealth Contracting & Licensing team and is used only to begin the contracting process.

Step 2 — Complete Your Contracting Forms

Complete Your Contracting in SureLC (SuranceBay)

This link unlocks after you hit the Submit button above. Submit your registration first — then click here to fill out your contracting forms in SureLC.

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Thank You — We’ve Got It

Your intake has been sent to our Contracting & Licensing team. You’ll hear from us shortly with your contracting packet.

Your Next Step

We’ve also emailed this link to the address you provided, so you can come back to it anytime.