<<Today>>
<<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_Name>>
<<Agncy_Address>>
<<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.
Sincerely,
<<Cli_Name1>>
<<Input:Title>>