Personal Lines New Business Cover Sheet

Jack Bradley Agency

Personal Lines New Business

JBA Staff Member Name

Account Formal Name

Account Informal Name

Activity #1 APOL

LPR Send Request

Policy Number

If Property/Location Address

Effective Date

Reason for Cancellation

If Other Reason

E-Sign should be sent to this email

How is Customer Expecting to Receive LPR for Signature?

Activity #3 – Please Select an Option

App has been signed

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Missing Signature

Carrier E-Sign

Date sent to Client

RightSignature

Date sent to Client

Client Mailing

Date sent to Client

Client In Office

Office Location for Signature

Mailing Address

Process an Address Change

New Mailing address

Date of Address Change

Agency Defined Categories

Account Profile

Age Group of Client

Christmas Card

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