* BrokerName

String

50

Broker/Agent company name

Contact

String

50

Contact for broker/agent

Title

String

50

Contact's title

Address1

String

50

Broker/Agent address

Address2

String

50

Broker/Agent address 2

City

String

50

Broker/Agent city

State

String

20

Broker/Agent state

Zipcode

String

20

Broker/Agent zip code

Phone

String

20

Contact phone number

Fax

String

20

Contact fax number

Email

String

50

Contact email address

Followupmode

String

1

Followup method for letters (E -email, P -Phone)