Broker Bond

A broker bond can cover a wide variety of occupations including real estate sales, mortgage providers and freight brokers. The bond is required in most areas of the United States by law as a way to assist in ensuring that all local, state and federal laws are followed during all transactions between businesses and clients.

The broker bond is normally required before you apply for a license to set up a brokerage company of any type. State laws and local ordinances are in play for each different bond policy that is applied for meaning that you may pay more or less for your bond dependant on the state you reside in.

The Broker bond is a legal guarantee that the consumer is protected should the business that owns the policy fail to live up to laws and standards imposed upon them by the industry. Should your business be found to be negligent in any way, or to have purposefully committed acts of fraud, your bond is in place to be able to reimburse those that may have been financially affected by your decisions. The bond will also cover any unlawful acts committed by your employees.

After all is said and done, the bond is just a temporary means to an end. Your business committed the act and so should be liable. The bond only covers you for immediate payments; your business must return any money that your bond policy has paid for you as well as any legal costs incurred.


Application for


Current or expiring quote we are looking to beat:


Name of previous surety company writing to the bond:


Section I: Bond Applied for

Type of Bond

Effective Date

Expiration Date


Type of Company

CORP

LLC

DBA

Partnership

Bond Amount


(Obligee)


Obligee Address


Section II: General Information

Applicant's Name

Spouse Name


SS#

Spouse SS#

Home Phone


Residence Address

City

State

Zip


Status of Residency

Own

Rent

At Current Address Since


Date of Birth

Spouse Date of Birth

Business License Number


Business Name


Business Phone

Business Fax

Business Email


Business Address

City

State

Zip


Date Business BEGAN Under Present Individual or Firm Name

Business Tax ID


Has any company refused to issue bonds for any purpose?

Yes

No

Do you have any liens, claims or judgements against you?

Yes

No


Has applicant ever failed in business?

Yes

No

Has applicant filed bankruptcy in the last 10 years?

Yes

No


If yes, Chapter 7?

Yes

No

Chapter 11?

Yes

No

Chapter 13?

Yes

No


Date Filed for Bankruptcy?


Date of Discharge?


If yes to any, please explain:


Section III: Additional Parties

Name

Spouse Name


SS#

Spouse SS#

Home Phone


Home Address

City

State

Zip


Personal Financials

(if more than one owner, each has to fill out this app)

Statement of assets and liabilities as of


Assets Liabilities
Cash in Bank Notes Payable to Banks
Cash on Hand Notes to Others(excl. of equipment)
Stocks and Bonds Accounts Payable
Accounts Receivable Federal and State Income Tax Due
Notes Receivable All Other Taxes
Inventory Accruals, Payrolls, Etc.
Cash Value Life Insurance    
Equipment Due on Equipment
Real Estate Due on Real Estate
Other Assets Other Liabilities
    Surplus and Undivided Profits
    Capital Stock(if a corporation)
       
Total Assets Total Liabilities

Net Worth


Name of Owners

Name and Title of Officers

% of Ownership


Are you an insurance agent?

Yes

No

Agent License #

Agent State

Completion of this form constitutes permission for Cal Society Insurance Services to obtain customer information which will be used to determine bonding eligibility. This information will be held in the strictest confidence.