<<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>>