American Modern Insurance

TERMINATE USER’S MODERNLINK CREDENTIALS

In order to ensure confidentiality when staff leaves your agency, please notify American Modern^® immediately by filling out the following modernLINK^® Access Termination Form.

Termination Form

Agency Information

Allstate Agency Number:	A Enter your agency number.
Agency Name:	Please enter your agency name.
Requestor Name:	Please enter your name.
Requestor Phone:	Please enter your phone number.

Terminate Users

After entering the data for each person click the Terminate User button.
Click the Submit button below to submit the list of users to American Modern.

First Name:	Please enter a first name.
Last Name:	Please enter a last name.

Prior to clicking SUBMIT, all Agency Users of the modernLINK system you want to delete should be listed in red text under TERMINATE AGENCY USERS. If all users are not displayed, just add them.

In order for American Modern to process this request, please click the Submit button below.