Existing Agent Commission Change Request

"*" indicates required fields

Person Completing Form First/Last Name*
Agent First/Last Name*
First/Last Name (Who Recieves Lead Bill)*
Choose all carriers that need to be changed

Hierarchy & Commission Info

See Photo Example of how we need each hierarchy for EACH CARRIER. We will no longer accept "Bump agent 5 points" we need actual levels as we will no longer assume any information
Please list out all hierarchy and commission information. We can no longer assume any information. Please list hierarchy with Executive members at the top and New Agents toward the bottom.