Broker Application Form - African Trade Insurance Agency

Broker Application Form

Step 1 of 5

  • The information contained herein is provided to ATI in order to facilitate the evaluation of a Broker as one eligible to refer business to ATI acting on behalf of clients. The application is considered complete when all other required information is provided. False or misleading statements and information provided to ATI, may result, at ATI's sole discretion, in the removal of the Broker from ATI's list of eligible Brokers. This form is duly completed and signed and is being submitted along with copies of broker's license, financial statements, professional indemnity insurance policy and the companies' business profile (containing an organization chart and brief CV of key staff). Please note, if you are registered under ATI's Broker Programme, that your continued registration under ATI's Broker Programme is, of course, contingent on your compliance with the standards for registered brokers published on ATI's website (see ATI's list of brokers).
  • 1.1 Applicant: Contact Details.

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