This opportunity is not an employment opportunity directly with Allstate Insurance Company but rather employment with an Allstate Exclusive Agency Owner who is an independent contractor.

For internal use only — not for use with or distribution to the public.

Confidential and proprietary to Allstate Insurance Company. ©2016 R57632

AGENCY STAFF

Pre-screenHow did they hear about this opportunity?

NOYES

Based on this information, are you still interested in the position?

This position is located at . Office hours are am to pm.

This agency may conduct a comprehensive background check, which includes a criminal check.(If appointed, the background check must be completed. Contact Human Resources to complete a background check.)

Have you ever worked for one of our competitors?

What was your position? Dates of employment

Have you ever worked for Allstate or one of our subsidiaries or affiliates?

Dates of employment Name of company/agency Reason for leaving

Are you authorized to work in the United States on a full-time basis for any employer?

What position are you looking to fill?

For Agency Owners: You can use this form during a pre-screen interview to guide your conversation and record information.

You’ll help keep our business running smoothly by creating and enforcing policies and procedures for a team of insurance professionals.

You may be authorized to solicit and write new Property and Casualty policies for both existing customers and prospects.

Your duties may include researching and resolving problems and complaints, making changes to policies, taking initial claims and providing quotes. This position may also involve some limited selling.

Telemarketer

You’ll help improve sales of the agency by prospecting for customer leads. Licensing requirements are state-specific.

Requires a Property and Casualty insurance license. Requires a Property and Casualty insurance license.

Requires a Property and Casualty insurance license.

Office Manager

Sales Professional Customer Care Professional

Telemarketer

This opportunity is not an employment opportunity directly with Allstate Insurance Company but rather employment with an Allstate Exclusive Agency Owner who is an independent contractor.

For internal use only — not for use with or distribution to the public.

Confidential and proprietary to Allstate Insurance Company. ©2016

NOYES

Do you have any bilingual skills?

What languages?

Do you have any professional designations?

What designations?

What is your current income? What are your income expectations?

What is the highest level of education you have received?

Advanced degree (master’s degree or higher) Some college but no degree

4-year bachelor’s degree High school degree or GED

2-year associate’s degree No high school and no GED

Windows Beginner Intermediate Advanced

Beginner Intermediate Advanced

Beginner Intermediate Advanced

Beginner Intermediate Advanced

Beginner Intermediate Advanced

Word/Word Perfect

Excel, Lotus 123

Outlook

Social media

COMPUTER SKILLS

Have you ever been convicted, pled guilty or pled nolo contendere to a criminal offense, either a felony or misdemeanor, that has not been annulled, expunged, vacated, diverted, discharged, erased and/or sealed by court?

AGENCY STAFF PRE-SCREEN

The use of these processes and samples is strictly voluntary. You have the sole and exclusive control over the manner, method and means by which you operate your agency.

This opportunity is not an employment opportunity directly with Allstate Insurance Company but rather employment with an Allstate Exclusive Agency Owner who is an independent contractor.

For internal use only — not for use with or distribution to the public.

Confidential and proprietary to Allstate Insurance Company. ©2016

AGENCY STAFF PRE-SCREEN

Describe the major responsibilities of your prior positions.

What were your reasons for leaving your prior positions? Please explain any gaps in employment.

What insurance or financial services licenses do you currently hold?

Other comments:

How many years of insurance or sales experience do you have?