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Bajaj Allianz Agency Application Form

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This is a Bajaj Allianz Agency Application Form, which is used when you want to apply to join Allianz Bajaj a life insurance company as an insurance agent. This form contains all the details that you need to fill out, the company can screen you as a candidate and decide if they want to call in for an interview. Please note that this form must be filled in block letters. You will also have affix a recent passport size photograph of yours in the space provided for it.


How to fill this Bajaj Allianz Agency Application Form?

In this form you must enter the following details in the spaces provided for them:

  • Your personal details like:
    • Your full name.
    • Your nationality.
    • The languages you read, write and speak.
    • The Marital status.
    • Your father’s/husbands name.
  • Next you must fill in details about your bank account like:
    • Bank account number.
    • Date of opening the account.
    • Name of the bank.
    • Location of the bank.
  • Then you must enter your academic qualification details, and if you have any insurance qualification you must enter the details as well.
  • The name and address of your present occupation.
  • Your personal address, telephone number, mobile/page number and email address.
  • Next you must answer the questions given in this Bajaj Allianz Agency Application Form truthfully. The questions are as follows:
    • If you have sales/marketing experience.
    • If you have any time insurance agency for any life or general insurance company.
    • You must also disclose if you have applied for a general insurance agency in the same company.
  • You must also answer the following questions with a yes or no answer, your answer is yes you have two provide details as well:
    • Whether you have ever declared a pronounced of unsound mind by a court.
    • Whether you have been found guilty of criminal misappropriation or criminal breach of trust or cheating or forgery.
    • You have knowingly participated in a can I at any fraud, dishonesty or misrepresentation.
    • Whether you have ever declared insolvent/applied for insolvency.
  • The next question asks if any time in the past as your location for grant of license been rejected or license been cancelled by this insurance company.
  • Are you related to any agent from this company or any of the life insurance company Corporation?
  • Are you an employee or spouse of an employee of Central or any State government?
  • Have you ever been employed by the Bajaj group.
  • Then you must also said if you are interested in a full time job or a part-time agency.
  • Lastly in number 21 you must give the name and address of references who are not related to you.

Once you are feeling all these details you must then enter your name and date place and sign the declaration, states that you declare that you read all of these questions and giving the answers after understanding everything. And all the information given by you in this Bajaj Allianz Agency Application Form is true to the best of your knowledge and belief. Once you’re done completing this document you must attach copies of relevant testimonials, age proof, work experience proof, qualification proof, and qualification proof. You can download this application form by clicking on the link below.


Bajaj Allianz Agency Application Form

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