Executive insurance consultant reviewing compliance documents and digital contracting schedules at a modern wood conference desk in a bright office

— TMG Insurance Division

Agent Appointment & Training

Welcome to Tassa Mission Group, LLC (TMG) Insurance Division. This form is for individuals selected to join TMG as independent contractors and collects information for onboarding, training, licensing verification, and carrier appointment administration.

Full Legal Name*

Personal Email Address*

Mobile Phone Number*

Home Address*

Insurance Licensing Information

Not currently licensed

Licensing in progress

Currently licensed

National Producer Number (NPN)

States Currently Licensed In

Are you currently contracted, appointed, or affiliated with another insurance carrier, agency, IMO, FMO, BGA, or distribution organization?

Yes

If yes, please list the organization(s) and carrier(s).

Appointment & Training Acknowledgment

I accept appointment with the TMG Insurance Division as an independent contractor and agree to participate in applicable training and readiness activities.

Carrier Appointment Authorization

I authorize TMG to verify my licensing status and coordinate applicable carrier contracting and appointment activity on my behalf.

Compensation & Policy Acknowledgment

I understand that TMG producer compensation is commission-based and varies by carrier, product, assigned level, and issued-and-paid business. Earnings, leads, sales, renewals, and commissions are not guaranteed, and applicable commissions may be subject to carrier rules, chargebacks, reversals, and TMG compensation terms. I agree to follow the TMG Producer & Compensation Policy and other requirements applicable to my role.

Independent Contractor Acknowledgment

I understand that I am joining TMG as an independent contractor and that leads, sales, commissions, earnings, carrier appointments, and duration of affiliation are not guaranteed.

Electronic Acceptance By typing my full legal name and the date below, I confirm that I have reviewed and agree to the acknowledgments and authorizations in this form.

/ Verification Portal

Submit Agent Onboarding Record

Provide your full legal credentials, verified residential address, licensing status, NPN, and carrier history. TMG Compliance will initiate carrier contracting review upon verification.

100%

Independent Contractor Compliance & Direct Hierarchy Setup