In addition to applications and required forms for a large number of carriers, this page includes other documents we may require, or you may need. We require a completed and signed version of the Producer Profile for each agent writing business through CPS - complete, sign, and send in a copy of this form today. We ask that you use the Case Submission Worksheet as a guide when completing an application, please attach a completed copy with each submission. The documents titled Writing A Good Cover Letter and Questions To Ask Your Client include tips and reminders, which when used, will help the application process go as smoothly as possible. The Informal Inquiry or Informal Inquiry 15-Point Type (required in CA) needs to be completed, signed and submitted to CPS when APS(s) need to be acquired prior to shopping an impaired risk case. Also available are CPS’ Privacy Policy (for review) and the Request For Medical Information Form (when applicable).

3207 Magnolia St, Ste 306 / Pascagoula, MS 39567 Phone 800.295.8864 Fax 228.762.1601

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The CPS Gulf States Brokerage web site is maintained exclusively for active producers contracted with carriers through CPS GSB, and is intended for agent use only. All information is intended for use as a guide, or as reference, and is believed to be current as of the date of its posting. Any misrepresentation of the information contained in the CPS Gulf States Brokerage web site by its users is strictly prohibited.