Step 1 of 4 — Review the disclosures below, accept all items, then complete your pre-application. Dawn will reach out personally to schedule your Discovery Call.
This pre-application is collected and processed by DC Financial (Dawn Cole), an independent contractor affiliated with Biz To Biz Insurance Solutions LLC. By submitting this form, you expressly authorize DC Financial to collect and securely transmit your application information to Biz To Biz Insurance Solutions LLC on your behalf, exactly as you have entered it. Your Social Security Number is not collected on this form and will only be entered by you, directly into the Biz To Biz Insurance Connect portal, at the contracting stage.
No Compensation for Recruiting: DC Financial does not receive — and neither you nor any other Associate will receive — any compensation, bonus, override, or payment of any kind solely for recruiting or sponsoring other individuals into Biz To Biz Insurance Solutions LLC. All compensation is earned exclusively through commissions or referral fees on sales of products and services to the general public. No specific level of income is guaranteed or implied. Results depend entirely on individual sales effort and activity.
This is not an offer of employment with DC Financial or any affiliated entity. If approved, you will be engaged as an independent contractor. See the required disclosures below for complete terms from Biz To Biz Insurance Solutions LLC.
🔒 All information submitted is collected by DC Financial and transmitted to Biz To Biz Insurance Solutions LLC on your behalf. Collection and use of your information is governed by our Privacy Policy and the Terms and Conditions of Biz To Biz Insurance Connect.
All fields are required unless otherwise noted.
Have you ever been previously terminated by, or denied contracting through, Biz To Biz Insurance Solutions LLC OR any of its affiliate or subsidiary companies?
Have you ever been convicted of, or plead guilty or no contest, in a domestic, foreign, or military court to committing or conspiring to commit a MISDEMEANOR OR FELONY involving any of the following: insurance, investments or a related business, fraud, theft, breach of trust, false statements or omissions, wrongful taking of property, bribery, forgery, counterfeiting, robbery, or extortion?
Within the past 10 years, have you, or any organization or business in which you are or were an owner, partner, or officer, filed a personal or corporate bankruptcy petition or been the subject of an involuntary bankruptcy petition?
Has any State Insurance Department, State or Federal Regulatory Agency, Foreign financial regulatory authority, or any Self-Regulatory Organization ever filed a complaint against you, suspended your registration or license, disciplined you, or prevented you from associating with a financial services-related business or restricted your activities?
Do you have any debit balances with another insurance agency or insurance company, OR any unsatisfied court judgments or liens (including tax liens and liens for delinquent child support) against you?
Have you or any business in which you are or were an owner, partner, or officer ever been found liable in any civil lawsuit or arbitration proceeding involving allegations of fraud, misappropriation or conversion of funds, misrepresentation, or breach of fiduciary duty?
Have you or any business entity in which you are or were an owner, partner, or officer ever had an insurance producer or insurance agency contract or any other business relationship with an insurance company or insurance agency terminated involuntarily for any reason other than lack of sales?
Are you currently an employee, officer, or director of any insurance carrier, investment adviser firm, FDIC insured bank, thrift, or credit union?
Are you now the subject of any complaint, investigation, or proceeding that could result in a "yes" answer to questions A–H?
By typing my name below, I certify that all information provided in this pre-application is true and correct to the best of my knowledge. I understand that this is an initial pre-application only, and that my Social Security Number and other sensitive personal information will be submitted directly and securely by me into the Biz To Biz Insurance Connect portal at a later stage — not through this website.
I understand and acknowledge that this pre-application is collected by DC Financial (Dawn Cole), an independent contractor affiliated with Biz To Biz Insurance Solutions LLC, and that the information I have provided herein will be submitted to Biz To Biz Insurance Solutions LLC on my behalf solely for the purpose of initiating my Associate Application. I further understand that no information will be altered or misrepresented in the submission process.
By typing my name below, I hereby: (1) authorize DC Financial to collect, securely store, and transmit the information in this pre-application to Biz To Biz Insurance Solutions LLC and its authorized affiliates for the purpose of processing my application; (2) authorize Biz To Biz Insurance Solutions LLC and its affiliate companies to use and/or release the information provided in this pre-application to authorized employees and/or contractors for the purpose of processing my application, addressing licensing and compliance matters, and for other reasonable and necessary business purposes; and (3) acknowledge that my information may be retained by DC Financial in accordance with its Privacy Policy until no longer needed for the purposes described herein.
