CONTACT PREFERENCE and
CONSENT FORM

I prefer to be reached using the contact information provided & methods indicated below:

Thank you for providing your phone number(s) & email address up above. We sometimes reach out to consumers by call, text and/or by email to provide helpful information about products or services. By signing & clicking "Submit" you consent to marketing calls, texts and/or emails made to you on behalf of my agency or Farmers Insurance® entities—including the Foremost®, Bristol West®, Farmers New World Life and 21st Century® Insurance companies—or their other representatives using an automated telephone dialing system and/or an artificial or pre-recorded voice, even if your telephone number is listed on a national, state or business do-not-call registry. Your consent is not a condition of purchase.

You may Opt-Out of the use of any or all contact information above by contacting our office at (972)671-7039 or by emailing us at teamadmin@cmallc-ins.com .