<<Input:Name of Insuance Carrier>>

RE:                   <<Cli_NamedInsureds>>
Effective:          <<Input:Insert Effective date>>

                         <<Input:Policy 1 and  Number>>
                         <<Input:Policy 2 and  Number>>
                         <<Input:Policy 3 and  Number>>
                         <<Input:Policy 4 and  Number>>
                         <<Input:Policy 5 and  Number>>

To whom it may concern:

I am writing this letter to confirm that effective immediately, please recognize the <<Agncy_Name>> as our exclusive retail agent for the purpose of providing insurance through your company.  The official address of the agency follows:

                                    <<Agncy_City>>, <<Agncy_State>> <<Agncy_Zip>>    

This letter supercedes any and all agent of record letters that may be submitted to your company and shall remain irrevocable unless cancelled in writing.