NPLH Sales

Agent Sign Up
Requirements - Please read for directions

The contracting and appointment process does not begin until the following requirements are received and completed. You will be able to attach the items listed below, including your completed downloads, on the next page. Incomplete information will delay the contracting and appointment process. Upon submission, we will notify you if there are any incomplete areas. Failure to complete and return all requested items within 5 business days will result in automatic void and expiration on your sign up and you will have to re-do the sign up process.

Please Complete This Checklist:

___ Complete and sign the Agent Sign Up

___ Copy of Driver's License (DL)

___ If applicable, Copy of Articles of Incorporation

___ If applicable, Employer Identification Number (EIN) verification

___ Errors and Omission (E&O) coverage certificate with a minimum $1 million in coverage

___ Voided check

___ Current copy of your insurance license(s), resident and non resident, in states where you will solicit business

___ If applicable, verification of completed Anti-Money Laundering (AML) training

___ If applicable, Continuing Education (CE) certificates

___ Mutual Non-Disclosure Agreement (download here and complete)

___ Background Information and Authorization (download here and complete)

___ W-9 Form (download here and complete)

To signup as an authorized marketing representative, please enter the password provided to you.

Enter Your Password:

For more information, please contact:

 •  National Prosperity Life and Health Insurance Company, Inc.
 •  Contracting Department  •  Phone: 832-856-6760  •  E-MAIL: