Where the Agents and Agencies are First and Formost.

Become an Agent

Become an Agent Application

Thank you for your interest in applying to become one of our agents! Please fill out this form and we will get in touch with you shortly.
  • Personal Information

  • Please enter a value between 0 and 100.
  • Please enter a value between 0 and 100.
  • Bail Bond Information

  • Please enter a value between 0 and 100.
  • Please enter a value between 0 and 100.
  • General Power of Attorney Information

  • Company/Employer Information

  • Please enter a value between 0 and 100.
  • Employment History (Last 5 Years)

  • Education Information

  • Please enter a value between 0 and 25.
  • Please enter a value between 0 and 25.
  • Please enter a value between 0 and 25.
  • References

  • Please enter a value between 0 and 100.
  • Please enter a value between 0 and 100.
  • To make the transition to Palmetto Surety Corporation as simple as possible, the following information is needed.

  • Financial Statement

  • Assets

  • Liabilities

  • I hereby affirm, under penalty of perjury, that the foregoing declarations made and answers given are the truth without reservation. I authorize you to verify the information on this application and to receive and exchange information about me, including requesting reports from consumer reporting agencies, criminal reports, driving records and any other relevant source. I authorize Palmetto Surety Corporation to submit any information from this application to the South Carolina Department of Insurance or any business partner of the NIPR for licensing or information change purposes. If my application is approved, I authorize you to contact these sources for information at any time, to use information about me, including information from this application and from consumer reports.