You've Found What Most People Spend Years Looking For. Now You Have to Decide What to Do With It.

Larry Penny's agency is built on one product that changes lives — IUL — and one model that changes careers. If you're serious about building real, residual income through a system that's already working, the application is below.

No Experience Required Multiple A-Rated Carriers Full System Provided MML Biz To Biz Network

Larry Penny — Agent Associate Application

Complete both steps below to submit your application to join the agency.

Step 1 — Review & Accept
Instructions for Completing Your Application
  1. Complete the Associate Application Provide all requested personal and contact information, then answer the questions in the Background Questionnaire. You can save or exit at any time and return to finish later.
  2. Accept the Terms of Use for Biz To Biz Insurance Connect Review and accept the platform terms of use before your application can be processed.
  3. Enrollment Processing Fee — $0.00 Your application will not be submitted until you click "Submit and Complete My Application." Your card will not be charged unless your application is accepted and an account is created.
Have the Following Ready Before You Proceed:
  1. Your Social Security Number. Biz To Biz Insurance and its affiliates are required by Federal law to obtain your SSN for tax reporting purposes. The number must correspond to your legal name.
  2. Your Personal and Contact Information. This includes your current address, email address, phone number, and date of birth.
  3. Credit Card Information. You will be asked to pay a non-refundable $0.00 enrollment processing fee. Please have your card details ready. (There is no charge unless your application is accepted.)
Important Disclaimers — Please Read Carefully

All information submitted is subject to our Privacy Policy.

2

Create Your Application

Please fill out all fields below. An application will be created for you.
All fields are required unless otherwise noted.

A. Basic Information
First Name
Middle Name (optional)
Last Name
Suffix (optional)
Nickname (optional, first name only)
E-mail Address
Retype E-mail Address
B. Background Information
1. Recruiter Information
Recruiter Agent Code
2. Personal Information
All fields are required unless otherwise noted.
Social Security Number
Retype SSN
Date of Birth
National Producer Number (optional)
Click here to find your National Producer Number
3. Contact Information
All fields are required unless otherwise noted.
Street Address
City
State
Zip Code
Phone Number
4. Background Questionnaire
If you answer "Yes" to any question below, you will need to submit a detailed explanation. Please contact us to provide supporting documentation before proceeding.
A.

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?

B.

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?

C.

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?

D.

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?

E.

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?

F.

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?

G.

Have you or any business entity in which you are or were an owner, partner, or officer ever had an insurance producer or agency contract with an insurance company terminated involuntarily for any reason other than lack of sales?

H.

Are you currently an employee, officer, or director of any insurance carrier, investment adviser firm, FDIC insured bank, thrift, or credit union?

I.

Are you now the subject of any complaint, investigation, or proceeding that could result in a "yes" answer to questions A through H above?

5. Certification and Authorization

By typing my name below, I certify that all data in this application, including my Social Security Number, is true and correct to the best of my knowledge.

In addition, by typing my name below, I authorize Biz To Biz Insurance Solutions LLC and its affiliate companies to use and/or release the information provided in this 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.

Your Full Name
Today's Date