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Licensing & Application Forms

Click on a Insurance Company below to view their various forms and info
or
Use our simple TheUSBroker EZ Appointment Process to have our Call Center help you complete the an appointment over the phone or to complete several appointments for you at once.

   
AIG Life (American General)
  
Fax appointment to USFMG @ (315) 655-4784

All AIG products (life & annuity) can be appointed through the contract below:

AIG Broker Appointment, Contracting Paperwork & Instructions

AIG Product Portfolio   
AIG How to Submit Business

TheUSBroker AIG info, fax numbers and COVER SHEET

AIG Premium Financing: Providing premium dollars for illiquid clients

FOLLOW THESE STEPS TO GET PAID

USFMG Marketing Contact
Jim Griffin, CEO
phone: 1-877-341-3342 (toll-free) / fax: 1-315-655-4784
jgriffin@theusbroker.com
Insurance Carrier Information Contact Info

General info: www.aiglifebrokerage.com

Application Forms -
www.virtualcd.com/americangeneral

Allianz Life Insurance Company & Products
  
Fax appointment to USFMG @ (315) 655-4784

Allianz New Broker Appointment

Allianz NY New Broker Appointment

How to Get Paid - everything you need to know about this company to submit new business and make more money.

Allianz Life™ Instant Commissions (pdf doc)

USFMG Marketing Contact
Van Albanese, CLU, ChFC
phone: 1-877-341-3342 (toll-free) / fax: 1-315-655-4784

van@theusbroker.com
Allianz Life Product Information

Allianz Life LTC State Approvals (pdf doc)
Allianz Life Generation Protector Underwriting Guide
Allianz Life LTC Rate Booklet (pdf doc)
Generation Protector Sample Policy (pdf doc)

Dominator Guide
Dominator Brochure
Power 5 Guide
Power 5 Brochure

Insurance Carrier Contact Info

Visit www.accessallianz.com for a current consumer application that's approved for your state (opens in a new internet browser window)

AvivaUSA Life Insurance Company & Products
  
Fax appointment to USFMG @ (315) 655-4784

AvivaUSA Life Insurance Company

Company Info: (888) 284-8287

National Appointment Papers:
Aviva Agent Appointment - required
Aviva Agent Contract - for personal files

New York Appointment Papers:
Aviva NY Agent Appointment - required
Aviva NY Conf. Data Form - required
IRS W9 tax form - required

USFMG Marketing Contact
Thomas W. Bodine, CLU, ChFC
TheUSBroker Aviva Representative

phone: 1-877-341-3342 (toll-free)
fax: (315) 655-4784
sfp@theusbroker.com
AvivaUSA Life Product Information

Aviva Single Premium Immediate Annuity 2 (SPIA2)
SPIA quote request - download form & fax to us for quotes
Aviva SPIA 2 Brochure

Aviva SPIA 2 Underwriting Guidelines

Aviva Progressive Index Annuity (EIA)
Aviva EIA Break Through Analysis
Aviva Progressive EIA Upside Potential
Aviva Progressive EIA Client Flyer
Aviva Progressive EIA Consumer Brochure
Aviva Progressive EIA Disclosure Document
Aviva Progressive EIA Specimen Contract

Aviva Asset Builder
Aviva Asset Builder Brochure
Aviva Asset Builder Historical Interest Rates
Aviva Asset Builder High Yield Strategy Kit
Aviva Asset Builder Specimen Contract

Aviva Consumer Annuity
Aviva Consumer Annuity 5 7 9 Client Brochure

Aviva Saver's Advantage 6 Annuity
Aviva Saver's Advantage 6 Client Brochure

Aviva Keepsake Wealth Transfer
Aviva Keepsake Wealth Transfer Broker PDF advertisement
Aviva Keepsake 201 SPL Consumer Brochure
Aviva Keepsake 200 Survivorship SPL Consumer Brochure
Aviva Keepsake 200 Survivorship SPL Policy Details
Aviva Keepsake Wealth Transfer Case Study
Aviva Keepsake Wealth Transfer Death Benefits
Aviva Keepsake Agent Flyer

Insurance Carrier Contact Info

Visit www.avivausa.com for a current consumer application that's approved for your state (opens in a new internet browser window)

Company Info: (888) 284-8287


Old Mutual Financial Network (OMFN)
  
Fax appointment to USFMG @ (315) 655-4784

Download, Complete & Fax back -
OMFN Appointment / Contracting Paperwork

Download & Read OMFN Agent Guide

Check OMFN Product Availability & Rates

TheUSBroker Contact
Jim Griffin
TheUSBroker
phone: 1-877-341-3342 (toll-free)
fax: 1-315-655-4784
jgriffin@theusbroker.com
OMFN Product Information

Download April Interest Rates
Check OMFN Product Availability & Rates

Compare OMFN & Allianz NY EIA Products

Insurance Carrier Contact Info

www.fglife.com
www.omfn.com


FARMERS AND TRADERS Life Insurance Company, Syracuse, NY
Fax appointment to USFMG @ (315) 655-4784
Marketing Contact
Van Albanese, CLU, ChFC
phone: 1-877-341-3342 (toll-free) / fax: 1-315-655-4784

van@theusbroker.com
Consumer Information

Sr. Protector Brochure
Sr. Protector Flyer
Sr. Protector State Approvals
Sr. Protector Common Forms

Sr. Protector Life (20-203) CT, DE, IL, KS, MA, MO, SC
Sr. Protector Life II (20-209) New Jersey
Sr. Protector Life II (20-209 Pennsylvania
Sr. Protector Life III (20-382) West Virginia
Sr. Protector Life III (20-320) AL, DC, FL, GA, IN, MD, ME, MI, NC, NH, NY, OH, OK, RI, TN, VA, VT, WI

All new business applications need to be mailed to the home office. Originals will only be accepted by F&T Life

          Farmers & Traders Insurance Co.
          960 James Street
          P.O. Box 1056
          Syracuse, NY 13201-1056

F&T Life Marketing Telephone:
315-471-5656 ext 306  MARGARET OTTER

F&T Sr. Protector Applications
Generic Application
(17-090)
Florida Application (17-090)
Missouri Application (17-090)
New Jersey Application (17-090)
New York Application (17-093)
Ohio Application (17-090)
Pennsylvania Application (17-090)
South Carolina Application (17-090)
West Virginia Application (17-090)

F&T Underwriting Guidelines

Voyager Life Insurance Application (required for life app)
Voyager Electronic Funds Transfer of Premium Application (required for life app)
Voyager NAIC Model Illustration Disclaimer (required for life app)
Voyager NY Replacement Form (required for life app)
Voyager Annuity Replacement Disclosure Form (required for life app)
Voyager AIDS (HIV) Testing and Authorization to Test Form (required for life app)

Life I & Life II (1 Pg Adobe Reference Sheets)
Voyager 1 Page Product Overview

MEC Comparison page - see other companies' policies for MEC situations

Guide "What is an (Annuity Alternative) MEC and How to Sell It" (416 kb Adobe PDF)

Newsletters "Expanded Inheritance: Annuity Alternative" & "Sr Wealth Transfer"

F&T Voyager Illustrations:
•$100,000 65yr Female Illustration
•$100,000 Male/Female 25 Year Death Benefit & Cash Values

F&T Annuity Alternative: Documents (#'s) Required for New Business

Flagship Life I & II Voyager: "An Annuity Alternative"
- Senior Protection Life Insurance

Consumer Information:
Life I
& Life II (1 Pg Adobe Reference Sheets)


FIDELITY & GUARANTY LIFE (F&G)
  - Equity Index Annuity
Fax appointment to USFMG @ (315) 655-4784

F&G Broker Appointment Paperwork - REQUIRED

F&G Assignment of Commissions to Corporation (156 KB PDF) - only required for agents who require their commissions to be paid to a corporation

Consumer & Marketing Information

NATIONAL FORMS (NON-FLORIDA)
Loyalty Rewards Consumer Application - 470kb
Loyalty Rewards 1035 Form - 31kb
Loyalty Rewards 1035 Instructions - 132kb

FLORIDA FORMS
Loyalty Rewards FL Consumer Application - 3mb
Loyalty Rewards FL 1035 Form - 31kb
Loyalty Rewards FL 1035 Instructions - 132kb

Loyalty Rewards 1pg Marketing Ad - 100kb

NATIONAL FORMS (NON-FLORIDA)
Loyalty Rewards Consumer Brochure -1kb
Loyalty Rewards Agent Guide - 1.8mb
Loyalty Rewards Agent Manual - 500kb

FLORIDA FORMS
Loyalty Rewards FL Consumer Brochure- 769kb
Loyalty Rewards FL Agent Guide - 3.3mb
Loyalty Rewards FL Agent Manual- 500kb

www.fglife.com - Corporate HQs website

Marketing Contact
Van Albanese, CLU, ChFC
phone: 1-877-341-3342 (toll-free) / fax: 1-315-655-4784

van@theusbroker.com

FIDELITY & GUARANTY LIFE (F&G)
  - MoneyGuard Flex 1: The Alternative to MG - Medically Underwritten Immediate Annuities
Fax appointment to USFMG @ (315) 655-4784

F&G Broker Appointment Paperwork (62 KB PDF) - REQUIRED

F&G Assignment of Commissions to Corporation (156 KB PDF) - only required for agents who require their commissions to be paid to a corporation.

Steps to Get Paid - instructions, fax numbers & premium estimates - REQUIRED

Consumer & Marketing Information

www.fglife.com - Corporate website has all agent and broker forms.

Marketing Contact
Van Albanese, CLU, ChFC
phone: 1-877-341-3342 (toll-free) / fax: 1-315-655-4784

van@theusbroker.com

INDIANAPOLIS LIFE
  - Modified Endowment Contract
  - High Net Worth Clients

      (Pension Rescue & Retained Earnings Rescue)
  - Vista Elite Equity Indexed UL
  - Vista Select Equity Indexed UL

Fax appointment to USFMG @ (315) 655-4784

Indy Life Broker Licensing Kit (1098 KB PDF)

Pension Rescue RFP (55 KB PDF)

Retained Earnings Rescue RFP (56 KB PDF)

FOLLOW THESE STEPS TO GET PAID for MEC and Pension Rescue*

Broker Information for Vista Elite and Vista Select Equity Indexed Universal Life Policies

Indexed UL Broker Licensing Kit (712 KB PDF)

FOLLOW THESE STEPS TO GET PAID for Equity Indexed UL* (50 KB PDF)

Vista Elite Equity Indexed Universal Life - Fast Facts (460 KB PDF)

Vista Select Equity Indexed Universal Life - Fast Facts (460 KB PDF)

Equity Index Life Insurance Brochure (1,680 KB PDF)

Indy Equity Index Life Underwriting Guidelines (460 KB PDF)

Consumer Information

FOLLOW THESE STEPS TO GET PAID for MEC and Pension Rescue*

Application for Life Insurance:

*REQUIRED

USFMG MarketingContact
Van Albanese, CLU, ChFC
phone: 1-877-341-3342 (toll-free) / fax: 1-315-655-4784

van@theusbroker.com

LIFE SETTLEMENT ALLIANCE
  - Life Settlements
Fax appointment to USFMG @ (315) 655-4784

Agent Agreement (93 KB PDF)

Agent Brochure (489 KB PDF)

Consumer Information Application Release
(90 KB PDF)
Marketing Contact
Van Albanese, CLU, ChFC
phone: 1-877-341-3342 (toll-free) / fax: 1-315-655-4784

van@theusbroker.com

LINCOLN NATIONAL LIFE   - Moneyguard*
Fax appointment to USFMG @ (315) 655-4784

MoneyGuard Appointment Packet
- become contracted to sell MoneyGuard products

TheUSBroker Lincoln Info & Cover Sheet

Steps to Get Paid* - everything you need to know to submit new business and get paid fast

* now available in New York

By Email: Contracting@LFG.com
By Email: LicensingStatus@LFG.com
Phone: 1-800-238-6252, select option 1, then option 2

Consumer Information

MoneyGuard Ad Slick
New*MoneyGuard Ad Slick

Application for Life Insurance - Forms can be downloaded from www.lfd.com after becoming appointed

Sales Information Lincoln National Sales Desk
877-533-0114, option 2
Marketing Contact
Van Albanese, CLU, ChFC
phone: 1-877-341-3342 (toll-free) / fax: 1-315-655-4784

van@theusbroker.com

Lincoln National Life & Lincoln NY - GTO Term
Fax appointment to USFMG @ (315) 655-4784
  • Steps to Get Paid* - everything you need to know to submit new business and get paid fast

By Email: Contracting@LFG.com
By Email: LicensingStatus@LFG.com
Phone: 1-800-238-6252, select option 1, then option 2

Product Information
Marketing Contact
Van Albanese, CLU, ChFC
phone: 1-877-341-3342 (toll-free) / fax: 1-315-655-4784

van@theusbroker.com

Penn Treaty
Fax appointment to USFMG @ (315) 655-4784

› Download, Complete & Fax back - Penn Treaty (PT) Appointment & Contracting forms

› Download - Penn Treaty (PT) How to Get Paid

Penn Treaty’s quote engine - https://www.penntreaty.com/ProdpenntreatyV2/  

→ Use Penn Treaty agent website to submit cases through: FAST APPLICATION

PT Agent & Marketing Department and Support Center at 1.800.362.0700 ext. 5020 / email marketing@penntreaty.com

Product Information
› Download - PT Product Availability
› Download PT Competitive Analysis
› Download - PT Underwriting Guide
› Download PT Product & Broker Info, Additional Broker Info Sheets
› Download - PT NY Rates, CA Rates
› Download PT Total Broker Kit (lg download)
› Download - PT NY Application Supply Form , FL Application Supply Form
Marketing Contact
Jim Griffin
TheUSBroker
phone: 1-877-341-3342 (toll-free)
fax: 1-315-655-4784
jgriffin@theusbroker.com

Security Financial Life Insurance Co.
Fax appointment to USFMG @ (315) 655-4784
Download, complete and fax appointment
Security Financial Appointment

Product Information
  • Standard Life Insurance Company product literature:
  • Click here to view video stream summary of this fantastic article about MECs and the reason you absolutely should consider single premium whole life insurance for your senior clients! - video clip opens in a new browser window
  • Click here to for a Vista Wealth Product overview video clip
    - video clip opens in a new browser window

Marketing Contact
Van Albanese, CLU, ChFC
phone: 1-877-341-3342 (toll-free) / fax: 1-315-655-4784

van@theusbroker.com

Standard Life Insurance Company of Indiana
Fax appointment to USFMG @ (315) 655-4784
Please call Van Albanese to get Appointment Paperwork
877-341-3342

Product Information
Marketing Contact
Van Albanese, CLU, ChFC
phone: 1-877-341-3342 (toll-free) / fax: 1-315-655-4784

van@theusbroker.com



PDF forms require Adobe Acrobat Reader Software.

ZIP file requires WinZIP Archive Software. It can be downloaded here.

Please print, complete, and fax forms to 315-655-4784.

For forms not listed here, or for any other questions, please contact TheUSBroker at 877-341-3342 or help@theusbroker.com.

^^ AIG is the leading U.S.-based international insurance and financial services organization and the largest underwriter of commercial and industrial insurance in the United States. Its member companies write a wide range of commercial and personal insurance products through a variety of distribution channels in approximately 130 countries and jurisdictions throughout the world. AIG's global businesses also include financial services and asset management, including aircraft leasing, financial products, trading and market making, consumer finance, institutional, retail and direct investment fund asset management, real estate investment management, and retirement savings products. American International Group, Inc.'s common stock is listed on the New York Stock Exchange, as well as the stock exchanges in London, Paris, Switzerland and Tokyo.



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