Final Step
An annual charitable donation can be made by simply submitting a broker of record letter appointing us as your representative.
1.
Policy Number
Carrier (prefilled)
Please enter your policy number here
2.
Click to download the form
Please review the form. Check your name and the policy number. You can email this to us, fax it or mail it to us.
3.
Sign the form and get it back to us:
Click here to e-mail the file
Click here to re-UPLOAD the file
FAX to: 818 337 2405
Mail to:
Givesurance Insurance Services, Inc.
21900 Burbank Blvd., Suite 3077
Woodland Hills, CA 91367
