Account Contact Update

Thank you for contacting us to ensure your account contact information is up-to-date. Please fill out our account update request form to update your account. If you need to make changes to your bond, please also fill out our rider request form.

Account Contact Update Form

Update your account information below.
Please note, this form is only for updating your records with Surety Solutions, A Gallagher Company. Information entered here will not be reflected on your active bonds or policies. At the end of this form, you may request our rider form to make changes to your bond(s).
Name on Account or Bond
Account Number
Current Email Address Associated with Account*
Enter Email Confirm Email
Update the primary contact information on your account?
- Yes
- No
Name of Primary Contact on Account*
First Middle Last
Primary Contact's Email*
Enter Email Confirm Email
Primary Contact's Phone*
Primary Contact's Address*
Street Address Address Line 2 City State ZIP Code
Primary Contact's Mailing Address*
Street Address Address Line 2 City State ZIP Code
Update business or employer information on your account?*
- Yes
- No
Are you updating information for your business or employer?
- Business
- Employer
Business Name*
Business Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Business Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Is the primary contact also the primary billing contact for this account?*
- Yes
- No
Update the primary billing contact information?*
- Yes
- No
Name of Billing Contact on Account*
First Last
Billing Contact's Email*
Enter Email Confirm Email
Billing Contact's Phone
Do you need to update your bond(s)?*
The information you submit in this form is used to update your account information, not your bond(s). If you need to update your bond(s), we'll send you a rider request form.
- Yes
- No
Enter your email address to receive our rider request form to update your bond(s)*
Enter Email Confirm Email

Bonds by Type
Bonds by State
Insurance Products
Resources
About Us