New Agents

New agents sub header.

Vintage Underwriters welcomes new partners!

If you are interested in writing business with Vintage Underwriters please complete the online Agency Information Form below, or you may download the PDF form here and email the completed form to

Along with this form, you will need to submit the following information:

  • Copy of Insurance License for each licensed agent/broker in your office as required by the State Insurance Department. Please Note: If you are signing up under a business name, that entity must be licensed with the Department of Insurance otherwise you must sign the agreement in your personal name.
  • Contact Roster for all agents/brokers in your office, as well as any additional staff with whom we would conduct business (CSRs, accounting, claims, etc)
  • Copy of your complete E&O Policy showing E&O coverage in place with minimum limits of $1,000,000 and clearly stated Retroactive Date
New Agents

Names of Owners

Maximum upload size: 5MB

Total Number of Staff

% of Business by Line

List Main General Agencies with whom you place business

List Standard companies represented

Maximum upload size: 2MB
Maximum upload size: 2MB

Thank you for your interest in Vintage Underwriters.

If you have any questions, please contact us at (713) 773-6400 x 104 or (800) 488-5771.

Contact Information for Texas Department of Insurance:
Texas Department of Insurance
PO Box 149104
Austin, TX 78714-9104
Phone: (800) 252-3439 / Fax: (512) 475-1771