10210 N. Central Expressway
Dallas, Texas 75231
Phone: (800) 232-5830
Fax: (214) 265-4976
Thank you for your interest in U. S. Risk. In order to be considered for an appointment
with us, we will need the following documents completed and sent to us:
Producer Profile (can be filled out on-line and then printed) – see below
Producer Agreement – see below
Completed W9 form – see below
Copy of your agency’s home state license
Copy of your agency’s E&O declaration page
Please either fax, mail or email these completed documents to us (noted above).
It takes approximately 3 business days for received paperwork to be reviewed
If approved, a copy of the executed Agreement will be returned to you for your
For more information, please contact us at 1-800-232-5830.
We look forward to working with you!
Word Format: Producer Profile and Agreement
(This document can be completed online, the W-9 must be downloaded below)
Adobe Acrobat Format: Producer Profile, Agreement and W-9
(This document is intended to be filled in by hand and includes the W-9 form)
Download W-9 Form (PDF)