Order Form for Contracts and POS Material 



PLEASE NOTE: In addition to filling out this form, you may Fax orders to SouthwestRe at 505-348-3555, or call 866-830-7066. Questions? Email us by clicking here

***Important things to know before requesting supplies***
New Agents: please request initial supplies through Client Services by clicking here.
Existing Agents: If signing up a new producer, contact Client Services before requesting supplies by clicking here.

***If requesting supplies for an existing producer***
SouthwestRe has coded all of its contracts and POS material. Underwriting assigns specific form codes to each producer. Please provide form codes and quantities for all product and pieces being requested.


Agent Information









Shipping Address (if different from Agent address)










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Order Form


Order Information:
Single Items: Brochure Holder, Claims Guide, Desk Topper, Flip Brochure, Poster.
Items packaged in multiples of 25: Brochures, Contracts, Document Holders, Mirror Hangers.

Form codes assigned to the producer can be found on the Rate Card provided by Underwriting. Form codes can be found under the stop sign, and are formatted in the following manner: ABC-XX-XX-01.








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Shipping Policy


We process and ship most orders within 24 hours of receipt. All orders placed on Monday – Friday after 3:30 p.m. MST will be processed on the following business day.

Standard Shipping (Ground 3 - 7 business days)
We ship all orders via FedEx ground. FedEx shipments are always insured. Estimated time for delivery is 3 - 7 business days unless an alternate shipping method is specified.

If an alternate method is chosen, delivery time will depend upon the type of shipping service specified and your location.

We can accommodate special express shipping requests; however, we will require your account number to honor such requests.

SouthwestRe is not responsible for the cost associated with special express shipping requests.

SouthwestRe pays for ground shipments only. If you choose any other transportation method, you will need to provide a FedEx account # for billing.



Choose FedEx Transportation Method:

Please check "Yes" in the field below, and then press the "Submit" button to complete your order.

Note: We will contact you via email if additional information is required to complete your order. 


I am authorized to request these materials.