Our optional compensation disclosure form (PDF, 97KB) can help you keep compliant records. If you decide to use our form, remember to 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.
Instructions for completing the form
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):
- Complete Part 1 of the form.
If you charge a fee and receive a commission from an insurer:
- Complete Part 2 of the form.
If you charge a fee, receive an initial commission and could possibly receive contingent commissions in the form of awards, bonuses, etc.:
- Complete Parts 2 and 3 of the form.