Request for Contract Hierarchy Correction / Comp Level Increase / Release

Complete this form to ask for a change to your contract. Fields marked with * are required.

First name

Last name

Phone *

Email *

Sub agency

Carriers of discussion

Type ALL if this pertains to all contracts. If the contract is currently terminated due to lack of production, a NEW contracting request must be submitted.

Please describe what is needed *

Comp level increase Change of advance method Transfer to another LTL upline Release of contract Something else (describe in notes)

Notes

Briefly describe the request if more details are needed.

For a promotion, include the promotion method used, the new level, and email the Contract Level Change form and the Promotion Tracker form found in the back office under Promotion Guidelines.

LTL Financial Group