We certify that the information provided above is true and correct and that we have read the eligibility requirements and do qualify as an independent insurance agency as outlined.
We agree to observe the bylaws and ruled of IIAT and to pay dues based on our agency personnel lead count at all locations as of the date of this application. Failure to report accurate head count at all locationscould cause IIAT to decline your application. We understand that in case of any questions concerning the head count, the IIAT board of directors reserves the right of verification.
Please allow 2-3 business days for review of your membership application.
I hereby submit this completed IIAT Agency membership application.