Wisconsin Real Estate Salespersons Endorsement

WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY

WC 48 03 04

(Ed. 7-16)

WISCONSIN REAL ESTATE SALESPERSONS ENDORSEMENT

This endorsement applies only to the insurance provided by the policy because Wisconsin is shown in Item 3.A. of the

Information Page.

You have elected to name as an employee real estate salesperson(s) who are engaged in performing services as part

of your real estate business.

This election only applies where the election with regard to such real estate salesperson(s) is evidenced in writing.

This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.

(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)

Endorsement

Effective Policy No.

Endorsement No.

Insured

Premium

Insurance Company

Countersigned by __________________________________________

WC 48 03 04

(Ed. 7-16)

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