Insurers and Underwriters Clause Samples

Insurers and Underwriters. The following affiliated Insurers and Underwriters are deemed to be parties to, and bound by all provisions of, the Agreement with respect to Products issued or underwritten by such parties, including each Product’s commission schedules issued to the date of execution hereof by the respective Insurer. Name: State of Domicile: Transamerica Financial Life Insurance Company Iowa Name: Business Address: Transamerica Capital Inc ▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇ ▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ Business Address: ▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇ ▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ The following affiliated Broker-Dealers and Agencies are deemed to be parties to, and bound by all provisions of, the Agreement with respect to Products distributed by such parties: (Print name of Broker-Dealer above) Contact Person at Broker-Dealer: Address: Name: Phone: Fax: Tax ID #: Email: (Print name of Agency above) Contact Person at Agency: Address: Name: Phone: Fax: Tax ID #: Email: ☐ Corporation ☐ Partnership ☐ Other: Broker Dealer/Agency General Counsel: Mailing address for General Counsel: Name: Phone: Fax: Main Office? Y or N (if yes, please list address here) Email: Branch? Y or N (if yes, enclose list of branch addresses) Broker Dealer/Agency Chief Compliance Officer: Mailing address for Chief Compliance Officer: Name: Phone: Fax: Main Office? Y or N (if yes, please list address here) Email: Branch? Y or N (if yes, enclose list of branch addresses) Contact for client policy and licensing matters (if different from above or indicate “Same”): Mailing address for client policy and licensing matters: Name: Phone: Fax: Main Office? Y or N (if yes, please list address here) Email: Branch? Y or N (if yes, enclose list of branch addresses) Contact for commissions matters (if different from above or indicate “Same”): Mailing address for commission statements and checks: Name: Phone: Fax: Main Office? Y or N (if yes, please list address here) Email: Branch? Y or N (if yes, enclose list of branch addresses)