Carrier Intake Review

    Download and Commission Information

    Items marked with a asterisk are required fields.

    The form has three steps. General information, download information (if applicable), and commission information. Please complete all required fields.


    Step 1

    Contact Information

    Submitter Information

    Carrier Name*

    First name of person submitting this form*

    Last name of person submitting this form*

    Phone of person submitting this form*

    Email of person submitting this form*

    A submission receipt will be sent to this address.



    ASNOA/Allegiance's Main Contact Information

    Is our main contact same the person submitting this form?*

    Main contact's first name*

    Main contact's last name.*

    Main contact's email*

    Main contact's phone*


    Please share the link (URL) to your main website.*

    Is there an agent portal ASNOA should use?*

    Link (URL) to Agent Portal*

    Are ASNOA/Allegiance's credentials admin-level for managing other agents within our network?*

    ASNOA/Allegiance's login credentials:*


    Additional General Information

    Do you have scheduled or one-on-one trainings for the agents?*

    What is your carrier's appetite?


    Step 2


    Download Information

    Which options are available for download?*



    Download Contact Information

    Is the download support contact same as the main contact?*

    ASNOA/Allegiance's Download Contact Information

    Download support contact's first name*

    Download support contact's last name.*

    Download support contact's email*

    Download support contact's phone




    Download Instructions

    Please share the instructions to set up downloads for new codes with our team in the textbox below.

    You can also submit a file with instructions or additional information.




    How are the codes to be entered as contract numbers into Applied Epic to ensure the downloads match with the correct branch?*

    For example, if an agency's code is "1-234", would it be entered into Epic's contract number field as "1-234"?

    Or would the format be adjusted to match downloads, like "1234", "001234", "234", etc.?

    Please describe how the codes should be entered to ensure downloads match correctly and include an example.*

    If a master code needs to be included, please note that in your example.

    Do you use IVANS or Team-Up?*

    Can you send an Initial Load when a subcode's download is set up?*

    Which transaction types is Initial Load available for?*

    Please provide additional detail.


    Master code information

    Does ASNOA/Allegiance have a master code?*

    ASNOA/Allegiance's master code:*

    How do you send over subcodes in downloads?*





    Step 3

    Commission Information


    Commission Contact Information

    Is the commissions support contact same as the main contact?*

    ASNOA/Allegiance's Commission Contact Information

    Commission support contact's first name*

    Commission support contact's last name.*

    Commission support contact's email*

    Commission support contact's phone




    Commission Statement and Payment Method Information

    How can we obtain commission statements?*

    What type do you send commission statement files as?*

    Please provide additional detail.

    How do you pay commission?*

    Commission Payment Timing Information

    When will Allegiance be paid commission?*

    Day of the month Allegiance will be paid commission*:

    When will Allegiance be paid commission if the month only has up to 28 days?*

    Please identify when Allegiance will be paid commission*:

    Rater Information

    Are you in EZLynx, Applied Rater, Epic Quotes, or TurboRater?*

    Please provide additional detail.

    How should the agency code be entered into the rater?*

    For example, if an agency's code is "1-234", would it be entered into the rater as "1-234"?

    Or would the format be adjusted, like "1234", "001234", "234", etc.?

    Please describe how the agency code should be entered into the rater and include an example.*