Agent Appointment Form

Agent Appointment Form

 

Select the link below to download and fill out the “Agent Appointment Form” and send to Lexington
Agent Appointment Form Download

OR, USE THE WEB BASED FORM BELOW

ON-LINE AGENT APPOINTMENT ENTRY

Note, A valid copy of both your Driver’s and Bail License will need to be provided to Lexington by fax or EMail along with filling out the application






































    Background Check Authorization

    By my typing my name below, I certify the information I provided on and in connection with this form is true, accurate and complete and I am authorizing Lexington National to run a criminal background check pertaining to me.



    I Acknowledge

    ***MUST INCLUDE COPY OF BAIL LICENSE & DRIVER'S LICENSE***

    EMail or Fax a copy of your to Driver’s and Bail License to Lexington National at:

     

    Email : Jarre Weinstein at "JWeinstein@lexingtonnational.com"

    Fax : 410-625-0865