Agency Registration
Please enter your information below.
Please note that this screen can only be completed once you have received a PIN number.
If you do not have a PIN, someone at your agency will need to add you using the "Personnel Changes" page on our agency portal. If you have any questions, please contact your Marketing Representative for clarification.
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PIN Number
Forgot PIN?
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Birth Date (MM/DD) - don't forget the "/"
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User id (create one, up to 10 chars)
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Password (up to 10 chars)
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Re-type Password
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Password Hint Type
Maiden name
Pet's Name
Birth City
Father's Middle Name
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Password Hint
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Position in the Agency
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Controller
Principal
Office-Mgr
Agent-PL
Agent-CL
Agent-Farm
Agent-Marine
Agent-General
CSR-PL
CSR-CL
CSR-Farm
CSR-General
Acctg-EFT
Claims
IT-Coord
Receptionist
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Yes! Send me bulletins and news letters. (Strongly recommended)
Yes
No
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I agree to use the Fremont Insurance Company electronic services in accordance with the Agency Contract,
Company Systems and Network Access
section. Violation is cause for cancellation.
Yes
No
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Indicates required fields
Fremont Insurance Company respects your privacy. We consider your information private and will not release it past this point. For additional detail, please refer to our
Privacy Practices Notice.
