Ameritas Life Insurance Corp.

Please complete and return theĀ Ameritas Appointment Application

The completed form can sent to Ameritas by:

An appointment is required for both you and your agency. (Only one set of paperwork is required.)

IMPORTANT: Please note on the front page of the application that your request for appointment is for CBIA business.

There are no fees for new or renewing appointments.

A lapsed appointment automatically terminates appointment with the state. Agents will be notified if this occurs.

CBIA IS FIGHTING TO MAKE CONNECTICUT A TOP STATE FOR BUSINESS, JOBS, AND ECONOMIC GROWTH. A BETTER BUSINESS CLIMATE MEANS A BRIGHTER FUTURE FOR EVERYONE.