Online Licensing Instructions

Please complete the form below via the “Click Here” link. You can save and then email us the form or print and then email or fax us the form. Please make sure to follow these instructions,

  1. Complete all sections of the form
  2. Include a copy of your insurance license
  3. Include a copy of your E&O declarations page
  4. Include a voided check for automatic deposit of your commissions
  5. For long term care, include an update-to-date copy of your Partnership Certification
  6. For annuities, include a copy of your 4 hour annuity CE
  7. Make sure your AML training is up to date

Once we receive your forms we will process and fax you the completed carrier appointment forms for your signature. Thank you for choosing Diversified Brokerage Specialists!

We make selling insurance fast and easy!

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Diversified Brokerage Specialists, Inc.

In looking to grow my business I have had no greater ally and business partner than Diversified Brokerage Specialists. This relationship has given me access to competitive products and the expertise to bring the right options to my clients quickly. If I was to look back at the past few years Diversified has been one of my greatest and most profitable partnerships. There is no greater ally to the independent agent looking for life, DI and Long Term Care in the industry.
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