Renewal Questionnaire

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Company/Client Name*
Who is your Agent?*
Have you moved to a new location? If yes, please provide the new address.*
Has the number of your employees changed?*
Are offering new goods or services? If yes, please describe.*
Have your business practices or operations changed significantly? If yes, please describe.*
What are the estimated sales figures for the current year?*
What are the estimated sales figures for next year?*
Name
First Last
Email
Consent*
I certify all information is true and correct to the best of my knowledge

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