Agent Onboarding | Our 365 Financial Solution

Step 1 of 5 — Personal Info

Personal

License

Agency

Banking

Sign

Personal Information

All fields marked * are required. This information will be used to create your agent profile.

First Name * Required

Last Name * Required

Email Address * Valid email required

Phone Number * Required

Date of Birth * Required

Home Address * Required

Last 4 of SSN * Used for identity verification only 4 digits required

License & Credentials

Enter your active insurance license information exactly as it appears on your license.

License Number * Required

License State * Required

License Type * Required

License Expiry Date * Required

NPN (National Producer Number) * Find yours at nipr.com Required

Years of Experience

Lines of Authority *

Life Insurance Health Insurance (ACA / Medicare) Fixed Annuity Variable Annuity (Series 6 required)

Select all that apply to your active license. Select at least one

States Where You Hold Active Appointments *

Check every state where you currently have an active appointment. Select at least one state

Agency & Background

Tell us about your agency background and professional credentials.

Referring Agent / Broker

E&O Insurance Carrier * Errors & Omissions coverage is required to be appointed with carriers. Required

E&O Policy Number

E&O Expiry Date

Required disclosure: Please answer accurately. A "yes" answer does not automatically disqualify you — omitting information may.

Have you ever had a license suspended, revoked, or been subject to regulatory action? *

No Yes

Please select one

Please explain * Explanation required when Yes is selected

Commission Direct Deposit

Enter your full banking details for commission payments via direct deposit.

Secure & Encrypted: Your banking information is collected solely for commission direct deposit setup and transmitted securely. It is never shared with third parties.

Bank Name * Required

Account Type *

Checking Savings

Please select account type

Full Routing Number * 9 digits — found at the bottom left of your check Must be exactly 9 digits

Full Account Number * Enter your complete account number Required

Confirm Account Number * Account numbers do not match

Name on Account * Required

Review & Electronic Signature

By signing below, you acknowledge all information is accurate and agree to Our 365 Financial Solution's Independent Contractor Agreement and Agent Handbook.

Type Your Full Legal Name * Full legal name required

Draw Your Signature *

Signature not yet drawn

By clicking Submit Application, I certify that all information is complete and accurate. I understand that falsification of any information is grounds for immediate termination of my contract. I consent to be contacted regarding my application via the phone and email provided.

✅

Application Submitted!

Thank you for applying to Our 365 Financial Solution.
Your application is under review.

What Happens Next

✅ Our team will review your application within 1–2 business days
✅ You'll receive an email with your portal login credentials once approved
✅ Log in, set your permanent password, and complete carrier contracting
✅ Start receiving leads through the Agent Marketplace

Questions? Call (844) 687-3653 or email onboarding@our365financialsolution.net