Brokerage Agreement

Please have your agency's authorized representative complete and sign two (2) copies of the Brokerage Agreement below. You may fax these form to (314) 725-4317, but must return both originally signed copies to the address listed below.

ATTN: Amy K. Williams — Licensing/Compliance
International Placement Services, Inc.
101 S. Hanley Rd., Suite 700
St. Louis, MO 63105

Download the Brokerage Agreement

Also, we are in need of a current copy of your agency's E & O Dec page, as well as agency's Broker/Producer License for our file.

You may fax these forms to (314) 725-4317 or e-mail to awilliams@ipsico.com.