Advantage Partners Application

Agent Appointment Application
Agency Name*
As listed on your W-9
Agency NPN*
Please verify on NIPR: https://nipr.com/help/look-up-your-npn
Agent Name*

First NameLast Name
Agent NPN *
Please verify on NIPR: https://nipr.com/help/look-up-your-npn
Email*
example@example.com
Resident State*
Agency Management Info
IVANS Y-Account*
Input N/A if you don't have an IVANS account
IVANS User ID*
Input N/A if you don't have an IVANS account
Which Rater do you use?*

EZLynxPL RaterITC TurboraterNo RaterOther
What is your entity's tax classification?*

Sole proprietorC CorporationS CorporationPartnershipLimited Liability Company
Should be Empty:

Agent Appointment Application