You are currently using an older browser, you experience may not be optimal. Please consider upgrading.

Your Information

Join our network for the simplest solution to manage your life insurance business
First Step: Please provide us with your Broker and Agency information.
A broker with this email already exists. Please use a different email. A user with this email already exists. Please use a different email. Email is required. Email Address is incorrect. Please use the Avantax Email address.
First Name is required.
Last Name is required.
Phone is required. Invalid Phone Number.
State is required.
Password is required.
Confirm Password is required. Passwords do not match. Passwords must be at least 8 characters in length and contain at least 0 non-alphanumeric characters.
Security Question is required.
Security Answer is required.
Next Step: In order to confirm your licensing, please enter your National Producer ID and State OR your Social Security number and Date of Birth.
National Producer ID is required.
Please Attach State License.
Invalid SSN.
SSN is required.
Date of Birth is required.
Invalid date.
Age should be in 18 to 85.
Lastly: Complete the process by downloading the signature authorization form, print, sign, upload the form, and click submit.
Broker Signature Authorization
Please Attach Signed Authorization Form.

Your password should contain
  • 1 lower case
  • 1 Number
  • 8 Characters Minimum