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Agent Registration
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Agent Information
Enter your State of Florida Agent License Number (DFS License#) and Social Security Number (Social Security Number). After entering DFS License# and Social Security Number, click on Appointment Lookup button to retrieve a list of authorized property and casualty insurers you are appointed with as per the Florida Department of Financial Services (DFS). Select one or more insurance companies from the appointment lookup that you intend to use for FMAP referrals. Following selection of appointed companies, enter the Agency Name you represent and supply a minimum number of days needed to solicit and provide offer of coverage (lead time).
*DFS License#:
*Social Security Number:
*
   eg: 123456789
*Re-enter Social Security Number:
*
   eg: 123456789
*Appointed with:
*Agency Name:
*Minimum number of days needed to solicit and provide offer of coverage (lead time):    days

Agent Contact Information
Enter your name, email address and phone number(s). The email address you enter will be used to alert you when consumer requests match your saved eligibility criteria, as well as remind you of your login ID and password in the event you lose it.
*First Middle *Last
*Name:
*Email: *Re-enter Email Address:
*Work Phone: ()   - Extn:
 Mobile: ()   -
 Fax: ()   -

Agent Mailing Address
Enter your address in address line 1 and address line 2 fields. FMAP system verifies/corrects the address when you hit Save button. If the address is not recognized, alternate choices may be presented. If the alternate choice(s) presented do not match your address, and the address you supplied is correct, please check Ignore address verification/correction checkbox, enter the county where the address is located, and the address verification will be skipped. * symbol represents mandatory fields.
*Address Line1:
Address Line2:
*Country:
City:
*State:
*Zip:  -

FMAP Login Information
Select a user ID and a password. Select a user ID that is between 6 and 15 letters/digits only. Select a password between 6 and 15 letters/digits only. Re-enter the password in the Confirm Password: field. This is to prevent typographical errors. You may use this user ID/password to login to the FMAP system. The security question is to help us remind you in future about your password in case you forget it. Please note that your password is case sensitive. All fields in this section are mandatory.
User Id:
*Password: *Confirm Password: 
*Question:
*Answer: