Obie Agency Onboarding

Complete this secure form to set up your agency in Obie’s system and enable you to start writing business. Please ensure all information is accurate.

Agency Information
Please provide Name, Email, and NPNAgency name*

Agency email address*

Agency phone number*

Agency Address

Address line 1*

Address line 2

City*

State*

Zipcode*

Ivans mailbox number

Upload W9*

Upload File

Max file size 10MB.

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Upload E&O policy*

Upload File

Max file size 10MB.

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Agents requiring access
Please provide Name, Email, and NPN

Principal agent

Agent name*Agent email address*Agent NPN*Resident state license*

Upload File

Max file size 10MB.

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Which states are you licensed in?*
Please note the only States we are in currently are AZ, CA, IA, NV, NM, MI, MN, OR, UT, IL, IN, OH, PA, and WI

Additional Agents

If any additional agents besides the principal require access, add them below.

Agent name*Agent email address*Agent NPN*Resident state license*

Upload File

Max file size 10MB.

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Delete agent

Add new agent

Agency Banking Details
Please provide Name, Email, and NPN

Please provide your agency banking details in the secure form below.

Bank name*

Account holder first name*

Account holder last name*

Account holder business name

Account number*

ABA number*

Billing Address

Address line 1*

Address line 2

City*

State*

Zipcode*

Billing email*

Agency data securely submitted

Your entry has been successfully submitted to the team at Obie.

Be on the lookout for an email containing a unique link to the Obie Self-guided Agent training. Once this training is complete, you will receive another email that your appointment is live and you can start quoting!

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