Deactivate Agent
Your Email
*
example@example.com
Agency Name
*
Location
(optional)
Your position in the agency
Name of agent to be deactivated
*
First Name
Last Name
Email address of agent to be deactivated
*
example@example.com
Reason for deactivation
Email address of the agent who will be assigned the deactivated agent's policies
*
(This agent must have a current login)
PolicyNumber
*
Submit
Should be Empty: