AMS Fill Out Form

Policy download request

This agency policy download request form is for ACORD AL3 Compatible Agency Management Systems.

Let's get you set up! Just submit this form (it takes just a few minutes) and we'll handle the rest. We'll verify your info and in about 5 business days, your agency will be added to our system. If you need help, contact us: systemsupport@amig.com or (866) 527-9583.

cancel

Ensure required field and formatting are correct.

Scroll through and fix the highlighted fields before clicking next again

cancel

Your request could not be completed due to a technical issue. Please try again in a few minutes. If this message persists, please use live chat or send an email to systemsupport@amig.com.

Your agency

To set up your account, tell us about your agency.

American Modern agency code(s) *

(If you have multiple codes separate them by commas)

Your agency name *

General agent code

General agent name

Street address 1 *

Street address 2 (Optional)

City *

ZIP Code *

Email *

Agency phone *

Ext (Optional)

Policy download contact

Who in your agency manages the policy download process?

Contact full name *

Contact email *

Contact phone *

Ext (Optional)

Agency management system

What software package do you use?

Software vendor *

Product (Optional)

Agency IVANS information

Policy information is sent to your agency system via IVANS. Please enter the following information about your IVANS account.

Do you have an active IVANS account for policy downloads? *

Yes No Please select a value.

Y account number *

Batch ID

Machine address

Agency commission information

Would you like to see commission information as part of the policy download? Just enter the codes your agency uses. (If you receive commission from a GA, this feature is unavailable.)

You must enter all of the codes used by your agency (Maximum 5 codes).

Agency code

Please enter a valid agency code.

Authorization consent