Welcome to the start of your Progressive journey

Tell us about your agency.

Please note:

We’d like to inform you that Progressive is limiting new Progressive appointments in some areas of Florida. If you sell or transfer your book of business to any agent or business who is not currently appointed with Progressive, there is no guarantee we will approve the new business relationship.

Please consider the impact on your customers when choosing to sell or move your book of business to a non-appointed Progressive agent, as that entity or customer will have to call Progressive directly for all servicing needs.

Agency Legal Name (agency name on license/tax forms):

Does your agency use a DBA?

Yes

DBA Name:

Agency Federal Tax ID:

Please verify your Federal Tax ID:

What is your agency background?

First Name:

Middle Name:

Last Name | Suffix:

Is this person licensed?

Yes

Resident State | Resident License

Is this person the sole owner of the agency?

Yes

First Name

Middle Name

Last Name

Suffix

Resident State

Resident License #

All agency owners must be listed above or submitted directly to Progressive.

Are there business entities that have an ownership interest in this agency?

Yes

Please list business entities one per line.

Company

Position Title

Job Description

Employment Dates: (start - end)

Company

Position Title

Job Description

Employment Dates: (start - end)

Company

Position Title

Job Description

Employment Dates: (start - end)

Business Phone Number:

Fax Number:

Cell Phone Number (optional):

Primary Email Address (one that you check often):

Street Address Line 1

Sorry, no P.O. Boxes

i.e. 555 Agency Ave.

Street Address Line 2

optional

i.e. Suite 100

City | State | Zip Code

County

Mailing Address:

Same as physical address

Street Address Line 1

i.e. 555 Agency Ave.

Street Address Line 2

optional

i.e. Suite 100

City | State | Zip Code

What type of office do you have?

What type of appointment are you interested in?

Check all that apply

Personal Lines

Commercial Lines

How many Producers work in the agency?

How many Customer Service Representatives work in the agency?

Are you buying or selling Progressive policies or merging with a Progressive agency?

Yes

Are you the buyer or seller?

Buyer

Seller

If you are unable to complete the questionnaire, you will be able to save and return later. Incomplete questionnaires will be saved for 90 days. All questions are mandatory unless noted otherwise. If you have any questions regarding your application, please call 1-877-776-2436. If you are returning to complete your questionnaire, please login.

Tell us about your agency.

[account login user name]

Check all that apply