Bind it! It's great to know we're making a difference together! How many policies are you binding?12345678If Property Policy, do you need an EOI sent to Lender? Yes, please send EOI You must put the Request for Evidence of Insurance in EZLynx!Send Follow Up to Confirm New Address 10 Day Email to confirm Address Change on all Policies 30 Day Email to confirm Address Change on all Policies Only use this for New Purchase when their mailing address needs to be changed on other policies.Create Task to CS to apply Multi-Policy Discounts Send Discount Audit Task to CS This sends a Taks to CS to make sure Multi-Policy Discounts are applied to all policies correctly.Policy 1Policy TypeProperty (All Types)Vehicle (All Types)OtherInsurance CompanyPremium Sold*Quote # (If Known)Property (All Types)HomeCondoDP-3HO-4DICFair PlanEarthquakeFloodSecondaryMobile HomeEffective Date Date Format: MM slash DD slash YYYY Mortgagee BilledYesNoBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountVehicle TypeAutoMotorcycleMotorhomeEffective Date Date Format: MM slash DD slash YYYY How Many Autos on Policy?123456Auto 1: ModelAuto 1: OdometerAuto 2: ModelAuto 2: OdometerAuto 3: ModelAuto 3: OdometerAuto 4: ModelAuto 4: OdometerAuto 5: ModelAuto 5: OdometerAuto 6: ModelAuto 6: OdometerBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountOther TypeUmbrellaPerson Article FloaterBoatBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountPolicy 2Policy TypeProperty (All Types)Vehicle (All Types)OtherInsurance CompanyPremium Sold*Quote # (If Known)Property (All Types)HomeCondoDP-3HO-4DICFair PlanEarthquakeFloodSecondaryMobile HomeEffective Date Date Format: MM slash DD slash YYYY Mortgagee BilledYesNoBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountVehicle TypeAutoMotorcycleMotorhomeEffective Date Date Format: MM slash DD slash YYYY How Many Autos on Policy?123456Auto 1: ModelAuto 1: OdometerAuto 2: ModelAuto 2: OdometerAuto 3: ModelAuto 3: OdometerAuto 4: ModelAuto 4: OdometerAuto 5: ModelAuto 5: OdometerAuto 6: ModelAuto 6: OdometerBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountOther TypeUmbrellaPerson Article FloaterBoatBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountPolicy 3Policy TypeProperty (All Types)Vehicle (All Types)OtherInsurance CompanyPremium Sold*Quote # (If Known)Property (All Types)HomeCondoDP-3HO-4DICFair PlanEarthquakeFloodSecondaryMobile HomeEffective Date Date Format: MM slash DD slash YYYY Mortgagee BilledYesNoBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountVehicle TypeAutoMotorcycleMotorhomeEffective Date Date Format: MM slash DD slash YYYY How Many Autos on Policy?123456Auto 1: ModelAuto 1: OdometerAuto 2: ModelAuto 2: OdometerAuto 3: ModelAuto 3: OdometerAuto 4: ModelAuto 4: OdometerAuto 5: ModelAuto 5: OdometerAuto 6: ModelAuto 6: OdometerBinding InstructionsBind ImmediatelyBind after Signatures ReceivedMode of PaymentEFTDirect BillPay PlanMonthlyQuarterlyAnnuallyAuthorized First Payment AmountOther TypeUmbrellaPerson Article FloaterBoatBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountPolicy 4Policy TypeProperty (All Types)Vehicle (All Types)OtherInsurance CompanyPremium Sold*Quote # (If Known)Property (All Types)HomeCondoDP-3HO-4DICFair PlanEarthquakeFloodSecondaryMobile HomeEffective Date Date Format: MM slash DD slash YYYY Mortgagee BilledYesNoBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountVehicle TypeAutoMotorcycleMotorhomeEffective Date Date Format: MM slash DD slash YYYY How Many Autos on Policy123456Auto 1: ModelAuto 1: OdometerAuto 2: ModelAuto 2: OdometerAuto 3: ModelAuto 3: OdometerAuto 4: ModelAuto 4: OdometerAuto 5: ModelAuto 5: OdometerAuto 6: ModelAuto 6: OdometerBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountOther TypeUmbrellaPerson Article FloaterBoatBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountPolicy 5Policy TypeProperty (All Types)Vehicle (All Types)OtherInsurance CompanyPremium Sold*Quote # (If Known)Property (All Types)HomeCondoDP-3HO-4DICFair PlanEarthquakeFloodSecondaryMobile HomeEffective Date Date Format: MM slash DD slash YYYY Mortgagee BilledYesNoBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountVehicle TypeAutoMotorcycleMotorhomeEffective Date Date Format: MM slash DD slash YYYY How Many Autos on Policy?123456Auto 1: ModelAuto 1: OdometerAuto 2: ModelAuto 2: OdometerAuto 3: ModelAuto 3: OdometerAuto 4: ModelAuto 4: OdometerAuto 5: ModelAuto 5: OdometerAuto 6: ModelAuto 6: OdometerBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountOther TypeUmbrellaPerson Article FloaterBoatBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountPolicy 6Policy TypeProperty (All Types)Vehicle (All Types)OtherInsurance CompanyPremium Sold*Quote # (If Known)Property (All Types)HomeCondoDP-3HO-4DICFair PlanEarthquakeFloodSecondaryMobile HomeEffective Date Date Format: MM slash DD slash YYYY Mortgagee BilledYesNoBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountVehicle TypeAutoMotorcycleMotorhomeEffective Date Date Format: MM slash DD slash YYYY How Many Autos on Policy?123456Auto 1: ModelAuto 1: OdometerAuto 2: ModelAuto 2: OdometerAuto 3: ModelAuto 3: OdometerAuto 4: ModelAuto 4: OdometerAuto 5: ModelAuto 5: OdometerAuto 6: ModelAuto 6: OdometerBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountOther TypeUmbrellaPerson Article FloaterBoatBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountPolicy 7Policy TypeProperty (All Types)Vehicle (All Types)OtherInsurance Company*Premium Sold*Quote # (If Known)Property (All Types)HomeCondoDP-3HO-4DICFair PlanEarthquakeFloodSecondaryMobile HomeEffective Date Date Format: MM slash DD slash YYYY Mortgagee BilledYesNoBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountVehicle TypeAutoMotorcycleMotorhomeEffective Date Date Format: MM slash DD slash YYYY How Many Autos on Policy?123456Auto 1: ModelAuto 1: OdometerAuto 2: ModelAuto 2: OdometerAuto 3: ModelAuto 3: OdometerAuto 4: ModelAuto 4: OdometerAuto 5: ModelAuto 5: OdometerAuto 6: ModelAuto 6: OdometerBinding InstructionsBind ImmediatelyBind after Signatures ReceivedMode of PaymentEFTDirect BillPay PlanMonthlyQuarterlyAnnually2-Pay4-PayAuthorized First Payment AmountOther TypeUmbrellaPerson Article FloaterBoatBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountPolicy 8Policy TypeProperty (All Types)Vehicle (All Types)OtherInsurance CompanyPremium Sold*Quote # (If Known)Property (All Types)HomeCondoDP-3HO-4DICFair PlanEarthquakeFloodSecondaryMobile HomeEffective Date Date Format: MM slash DD slash YYYY Mortgagee BilledYesNoBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountVehicle TypeAutoMotorcycleMotorhomeEffective Date Date Format: MM slash DD slash YYYY How Many Autos on Policy?123456Auto 1: ModelAuto 1: OdometerAuto 2: ModelAuto 2: OdometerAuto 3: ModelAuto 3: OdometerAuto 4: ModelAuto 4: OdometerAuto 5: ModelAuto 5: OdometerAuto 6: ModelAuto 6: OdometerBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountOther TypeUmbrellaPerson Article FloaterBoatBinding InstructionsBind ImmediatelyBind after Signatures ReceivedPay PlanMonthlyQuarterlyAnnually2-Pay4-PayMode of PaymentEFT CheckingCredit CardDirect Bill by CarrierAuthorized First Payment AmountDown Payment InformationDo not enter payment if for a policy that is Mortgagee Billed.Down Payment MethodEFTCredit CardDirect Bill from CarrierBank Account NumberBank Routing NumberDraft Date Date Format: MM slash DD slash YYYY Credit Card NumberExpiration DateSecurity CodeBilling Zip CodeReocurring Payment InformationReoccurring Payment MethodEFT Credit CardEFT CheckingDirect BillDirect Bill from CarrierBank Account NumberRouting NumberDraft Date Date Format: MM slash DD slash YYYY Credit Card NumberExpiration DateSecurity CodeBilling Zip CodeInstructionsIs Mailing Address different from Physical Address?*YesNo Mailing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Do you need to send an Accord Loss Policy Release?YesNoFor which policy or policies?Send Applications By:*EZLynx E-SignEZLynx E-Sign have Client Enter Account InfoE-Sign through CompanyGive to AgentSee NotesSend to Client after Binding*ID CardsReceiptsID Cards and ReceiptDeclaration Page and ReceiptsProof of Insurance (All Policies)ID Cards/Proof/ReceiptsNothing (Just Let Me Know When Bound)Bind Notes:EZLynxAppID*Email** Bind It