Application Submission

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Important Submission & Compliance Notice* This field is required.PSI Groups provides centralized recordkeeping to support your business with secure documentation, easy access for client service, and regulatory compliance. By reporting your applications here, you’ll have a reliable backup for audits, reviews, and future reference. 📥 Paper Applications If you complete a paper application, please report it through this platform. PSI Groups will upload it directly to the appropriate carrier on your behalf, ensuring faster processing and accurate tracking. Do not send paper applications directly to the carrier unless specifically instructed. 🌐 Electronic Applications If you complete an electronic application, you are required to submit it directly through www.myequisfinancial.comwithin 24 hours of writing the application to receive full bonus credit and production recognition. PSI Groups does not forward or submit electronic applications—this must be done by the licensed writing agent. We encourage you to also report your electronic application here for your own compliance records and future access. All submissions reported to PSI Groups are retained in accordance with your state’s insurance laws. 📧 Need a copy of a submitted application? Email Sonya@psigroups.net and allow 48–72 business hours for processing. After submitting this form, you will be redirected to www.myequisfinancial.com to complete your official electronic submission.
Please click “Accept” below to confirm that you have read, understood, and agree to the above requirements.
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Agent Information* This field is required.
Agents EF Number
Agents Email Address
Agents First Name
Agents Last Name
Please Select
Please Select
Yes
No
Do you have a writing number for this carrier?
Please Select
Please Select
Jerrod Ewing
Eric Boling
Darren Willis
Nate Maddox
David Schneider
Ryan Dovner
Jim Glascott
Charles Knox
Richard Hazouri
Regional Managers Name
Please Select
Please Select
E-App without illustration to upload
E-App with Illustration to upload
Paper Application
Application Type
Please Select
Please Select
No
Yes
Will this sale be split?
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Split Agents InformationPlease make sure you complete all fields
Agents Name
Agents EF#
% of sale given to agent listed
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Clients Information* This field is required.
Clients First Name
Clients Last Name
Please Select
Please Select
Male
Female
Gender
Clients Date of Birth
Clients Address (Please add complete address including zip code)
Clients Email Address
Clients Phone Number
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Policy Information* This field is required.
Insurance Provider
Please Select
Please Select
Term
Whole Life
Children's Whole Life Policy
Universal Life
Indexed Universal Life
Accidental Life
Guaranteed Issue
Annuity
Final Expense
Single Premium Whole Life
Type of policy
Product Name
Please Select
Please Select
10 yr
15 yr
20 yr
25 yr
30 yr
Whole Life
Universal Life
Other
Length of Coverage
Coverage Face Amount
Please Select
Please Select
Monthly
Quarterly
Semi-Annual
Annual
1 Time (For Single Premiums)
Premium Frequency
Monthly Premium
Date Application Was Written
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E-App Illustration Upload* This field is required.If you do not have the Illustration with ALL POLICY details please hit the back button and mark NO
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Paper Application Upload* This field is required.All pages must be present to submit to carrier any missing page will cause complete app to be returned
Drag and drop files here
Select files to upload
Cancelof
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Target PremiumOnly for UL Policies
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Is this SDICPlease leave blank if you do not know
Yes
No
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Additional Information For ApplicationOnce submitted you will be redirected back to this link to submit additional applications.
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Email
example@example.com
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Do you need a walk through of how to report your application to Equis financial?* This field is required.
YESNO
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For a comprehensive walkthrough of the application submission process on EquusFinancial.com, please watch the instructional video at the following link: https://youtu.be/ccKyFObMTTg.
Have you completed the walkthrough video for the application process?
Should be Empty: