Compensation disclosure form
Our optional compensation disclosure form (PDF, 53KB) can help you keep compliant records. If you decide to use our form, remember:
If the only compensation you receive is a commission from an insurer, there is no need to complete a compensation disclosure form.
- If the only compensation you receive is from the fee being charged (you do not receive any commission), you need only complete Part 1 of the form.
- If you charge a fee and receive a commission from an insurer, you need to complete Parts 1 and 2 of the form. If you will offset some or all of the fee, provide an explanation of how the offset works under Part 2.
- If you charge a fee, receive an initial commission and could possibly receive contingent commissions in the form of awards, bonuses, etc., you need to complete Parts 1, 2 and 3 of the form.
- Always make sure both the writing producer and the insured/client sign and date the form. The completed form should be retained by the writing producer for five years.