Matchmaker Interested Buyer

Tell us more about your agency.

Please complete the entire form and click Submit.

Responding to Matchmaker Profile #

This is the number located at the top of the Matchmaker email announcement

Name of Your Agency

Is your agency currently an IIAT member?

First Name

Last Name

Email

Work Phone

Address

City

State

Zip Code

Year Agency Was Established:

Has the Agency Principal(s) been licensed more than 3 years?

Premium Volume Past 12 months / Projected Premium Volume

P&C Commission Past 12 Months / Projected Commission Income:

Life, A&H Commission Past 12 Months/ Projected Commission Income:

Top 5 Carriers

Please list the top 5 carriers you place business with

Any niche markets or specialties?

Percentage of Business Placed:

% Commercial Lines

% Personal Lines

% Life & Health

Agency Staff Size

Anything else you would like the seller to know?

Communications Director