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The Bentley Agency has made sure that our family and property are protected against.

-- J. Showers – Harrisburg NC

They showed me how to cover my commercial building and business for a fraction of what I was paying before while increasing my coverages.

-- L. Jameson - Concord NC


Your time is very important to us, so our standard forms are provided online for your convenience.

Select the needed form (call our office for assistance), download and print it. Once you have completed the form it can be faxed to our office or brought in with your next visit.

Certificate of Property Insurance

Certificate of Liability

Workers Comp

Umbrella/Excess Form

Bank Card Form

Change of Owner

EFT Form

EZ Check Authorization

Flood Waiver - Personal Property

Loan Request

Partial Surrender Request

Surrender Request

Paperless Billing Form



Fax: 704-855-1440
eFax: 1-800-399-7974

1435 N. Main St.
China Grove, NC 28023.