Agent Documents

If you’d like to join our JIBNA team, please download and complete the JIBNA Agency Application and Questionnaire and submit it, along with the additional requested documentation, to:
     JIBNA
     Fax: 215-701-8719 
     Email: underwriting@insure-jewelry.com

The following agent documents are in PDF format and may be downloaded.

• JIBNA Agency Application and Questionnaire
• JIBNA Broker Agreement
• JIBNA Jewelry Application (If you complete this form in Acrobat Reader, you cannot save the data with the form. Please print the completed form and fax or mail it to JIBNA.)
• W-9 form
• Sample JIBNA Policy

FOR AGENTS

• JIBNA Program Overview
• Jewelry Insurance Rates
• JIBNA Agent Documents:
  - Agency Application
  - Broker Agreement
  - Policy Application
  - W-9 form
• JIBNA Sample Policy
• JIBNA Claims Procedures