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Agent Representation Authorization

Assistance with completing your application. For certified agents and brokers only

You can choose an authorized representative.

You can give a trusted person permission to talk about this application with us, see your information, and act for you on matters related to this application, including getting information about your application and signing your application on your behalf. This person is called an “authorized representative.” If you’re a legally appointed representative for someone on their application, submit proof with the application.


Authorized Representative:
Lion's Pride Insurance
851 North 100 East,
Spanish Fork, UT 84660

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