Agent Appointment Information

In order to write business with RLI, your agency needs to be appointed. Please complete the agent appointment forms below. Pay particular attention to the last page (page 5) of the Agency/Broker Profile for additional information we need. All agents to be appointed should fill out the Producer License Application and attach their personal license. Please send the agency’s license for each state in which you want to be licensed. We only license agencies in those states where RLI business will be written.

RLI Agent Appointment Forms

All three forms must be completed. For your convenience, the three forms have been combined into one document:
Agent Appointment Forms (PDF, 846kb)

Individual agent appointment forms:
Agency/Broker Profile (PDF, 443kb)
Form W-9 (PDF, 246kb)
Producer License Application (PDF, 435kb)

Submit all agent appointment forms to: David.Williams@rlicorp.com or fax to 404-315-5586 or mail to RLI Transportation.

If you need a copy of the Adobe Acrobat Reader, you can get it free of charge from the Adobe site. Get the Adobe Acrobat Reader.