About Agency Buyers Group

Your Name:
Contact Phone: *
Contact Fax Number: *
Contact Email Address: *
Your relation to the agency or book: *
Agency Name: *
How many years have you been in business: *
Agency Address: *
Agency Website *
Reason for selling: *
Time frame you are looking to sell: *
Gross Annual Commissions *
Percentage of Commercial Lines: *
Percentage of Personal Lines: *
What is your current agency retention ratio: *
Who are the top three carriers you represent: *
Total Annual Premium you have with this carrier: *
Are you trying to sell real estate with your agency?
- Yes
- No
If "yes" is it a required part of this transation: *
- Yes
- No
Please explain any other requests or requirements you may have (retain agency name, key employees etc). *
- By submitting this form you agree that a representative of our company may contact you via the methods in the form above in regards to the sale of your insurance book of business or agency. Furthermore you certify that you are interested in the sale of your insurance agency or book of business and that you are the decision-maker of this transaction. You also agree that any and all information shared by both parties (you, your firm and it's representatives and employees, and Agency Buyers and their representatives and employees) is both proprietary and strictly confidential. Our information as well as your own will not be disclosed to any persons or entities without prior consent.