Mergers & Acquisitions

Are you the buyer or seller?

Who is the agency principal?

First Name

Middle Name

Last Name | Suffix

Resident License State | License Number

Buyer Agency Code

Buyer Progressive Home (formerly ASI) agent ID number (if applicable)

Buyer Agency Email

Buyer Agency Phone

Seller Information:

Seller Agency Name

Seller First Name

Seller Middle Name:

Seller Last Name | Suffix:

Seller Progressive Agency Code

Seller Progressive Home (formerly ASI) agent ID number (if applicable):

Seller Agency Email

Seller Agency Phone

Merger/Acquisition Details:

How many Progressive Agency codes have you purchased/acquired?

What Progressive agency code(s) have you purchased/acquired?

How many Progressive Home agent ID numbers have you purchased/acquired?

What Progressive Home agent ID number(s) (formerly ASI) have you purchased/acquired?

Will the Federal Tax ID for the code(s) being purchased change?

Yes

No

What would you like to do with the current Progressive code(s) you are purchasing?

Has the entire Progressive book of business (Personal Lines and Commercial Lines) been acquired?

Yes

No

If applicable, has the entire Progressive Home Book of Business (Property Lines) been acquired?

Yes

No

How many producer(s) currently appointed on the acquired code will be working with you once the merger is officially completed?

Any producer(s) not listed above or submitted directly to Progressive will have their current appointments terminated at the time of change.

Is the address changing on the code(s) that are being acquired?

Yes

No

Will there be more than one address change needed?

Yes

No

Will the sweep account used to accept customer payments being used on acquired code(s) need to be changed?

Yes

No

Will the new sweep account match your current sweep account in our system?

Will the direct deposit account for commissions EFT being used on the acquired code(s) need to be changed?

Yes

No

Will the new direct deposit account for commissions match your current direct deposit account for commissions in our system?

Is there any additional information or considerations that you’d like to share?

PLEASE NOTE: After acquiring a policyholder, you must immediately obtain, from the prior agent or agency, all original signed applications (including selections, exclusions and rejections of optional coverage) and all other records relating to that policy. Such records must be maintained in accordance with the terms of the Producer's Agreement and all applicable state laws. If attempts to obtain records from the prior agent or agency prove unsuccessful, you must obtain signed forms directly from the policyholder.

I agree

Welcome to the start of your Progressive journey

Mergers & Acquisition

Please note:

Mergers Questionnaire

Check all that apply

(NOTE: Not all agents will be given a property appointment)