The One Application

User Information

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Insurance Agency Information

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Below is the start of your client's information.

Customer Information

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date format xx/xx/xxxx
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Bond Type - Hover over each for more information
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Owner Info

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000-00-0000
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Personal Credit - Are you currently, or in the past 5 years:
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Consumer Authorization

I authorize Platinum Insurance and Bonds, Inc. / and the Surety and/or Surety broker of their choice to make inquiries as necessary concerning or pertaining to the Owner(s), applicant(s), and third party indemnitor(s) listed in this application financial standing, credit report, character or manner of meeting obligations to verify the accuracy of the statements made and to determine their credit worthiness.
Please click to read FCRA disclosure and Terms of Use
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Bond Information

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