Agent/Broker Update Request

Need your password reset? Please select the platform.

Agency Link
Agent Interact
Both quoting platforms

Agency link password reset instructions
For password resets with Agency Link, please contact Customer Service at (800) 587-1440.

Agent interact password reset instructions
For password resets with Agent Interact, please contact Customer Service at the state-specific numbers below.
CT, GA, TX Customer Service (844) 872-7785
NY Customer Service (877) 369-0304
HI Customer Service (877) 596-1872

Password reset instructions
For password resets with Agency Link, please contact Customer Service at (800) 587-1440.
For password resets with Agent Interact, please contact Customer Service at the state-specific numbers below.
CT, GA, TX Customer Service (844) 872-7785
NY Customer Service (877) 369-0304
HI Customer Service (877) 596-1872

For all other updates, please complete the form below.

Agency/Broker name

Agency/Broker code

Change requested by

First name

Last name

Requestor's email

Please select the state your agency/brokerage is located in

Please specify what update is needed

Upload copy of signed buy-sell agreement

Are you the buyer or seller?

Buyer
Seller

Selling agency/broker name

Selling agency/broker code(s)

Purchasing agency/broker name

Purchasing agency principal agent name

Does the buy/sell include all UPC business associated to seller?

Please upload a list of policies that have been sold

Will the selling location remain open?

Will the selling agency be changing names?

Update Agency/Broker name

Please upload updated W-9

Will the selling agency’s employees transfer to the buying agency?

Is the purchaser appointed with UPC Insurance?

Please list purchaser agency/broker UPC code(s)

Please fill out the Appointment Request Form and indicate that this is part of a Buy/Sell in the comments section.

Will the seller's book of business merge into the purchaser's code or would you like us to create a new code for the business to transfer to?

Merge
Create new code

If this is a new location, has the purchaser completed the LexisNexis application for the new location?

What is the LexisNexis Node for this location?

Update Agency/Broker name

Please upload updated W-9

Address to update

Location address

Street address

Address line 2

City

State

ZIP code

Mailing address

Select a choice

Same as location address

Street address

Address line 2

City

State

ZIP code

Agency/Broker phone

Primary contact name

First

Last

Primary contact email

Primary is principal

Primary contact is agency principal

Principal confirmation

By checking this box, you agree that you have received your principal's approval to make changes to the following user's roles.

User administrator name

First

Last

User administrator phone

User administrator email

Principal confirmation

By checking this box, you agree that you have received your principal's approval to make changes to the following user's roles.

User's name

First

Last

User's login ID

User email

User's NEW Role/Permissions (check all that apply)**Click <a href="https://upcinsurance.com/docs/default-source/default-document-library/agent-interact-roles-10-2018.pdf?sfvrsn=11e1a1d9_2" target="_blank">here</a> for Role and Permissions Definitions.**

Access to Agency Commission Statement
Agency User Administration
Agent Support Role (View Only Access)
Agent Licensed to Bind - Access to Agency Book
Agent Licensed to Bind - User Book Access Only
Bind on behalf of Licensed Agent
Quote without Binding User
Service Multiple Agencies/Locations
My Sub Agency Commission

Upload documents

Special instructions/requests

Request Your Agency/Broker Update