Get the free Surplus Lines Affidavit Form SL-8 State of Connecticut
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Affidavit Control No. Surplus Lines Affidavit (Form SL8) State of Connecticut Insurance Department (Rev. 09/2012) 1. Name and Address of Surplus Lines Broker 2. Producing Agent (not agency) 2a. CT
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How to fill out surplus lines affidavit form
How to fill out surplus lines affidavit form:
01
Start by carefully reading the instructions provided on the form. This will ensure that you understand the purpose of the form and the information required to be filled out.
02
Provide your personal information in the designated fields. This typically includes your name, address, contact information, and any relevant identification numbers.
03
Indicate the date of the transaction for which the surplus lines affidavit form is being filled out. This is important for accurately documenting the timeline of the transaction.
04
Fill out the details of the insurance policy involved in the transaction. This may include the insurer's name, policy number, coverage details, and any other relevant information.
05
If applicable, provide information about the insured party or parties. This may include their names, addresses, and any other relevant details.
06
Specify the type of surplus lines coverage being sought or provided. This could include property insurance, liability insurance, or any other specific types of coverage.
07
Include information about the insurance broker or agent involved in the transaction. This may include their name, license number, and contact information.
08
Sign and date the surplus lines affidavit form to confirm the accuracy and completeness of the information provided.
09
Keep a copy of the completed form for your records, and submit the original form to the appropriate regulatory authority or party as required.
Who needs surplus lines affidavit form:
01
Insurance brokers or agents who are involved in surplus lines insurance transactions typically need to fill out the surplus lines affidavit form.
02
Insured parties who are seeking surplus lines coverage or are parties to a surplus lines insurance policy may also be required to fill out this form.
03
The regulatory authorities responsible for overseeing surplus lines insurance may require the surplus lines affidavit form to be submitted for compliance and record-keeping purposes.
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What is surplus lines affidavit form?
Surplus lines affidavit form is a document used to report details of surplus lines insurance transactions.
Who is required to file surplus lines affidavit form?
Insurance companies, brokers, and agents are required to file surplus lines affidavit form.
How to fill out surplus lines affidavit form?
Surplus lines affidavit form can be filled out by providing information about the insured, policy details, premium amounts, and other relevant information.
What is the purpose of surplus lines affidavit form?
The purpose of surplus lines affidavit form is to ensure compliance with state regulations regarding surplus lines insurance.
What information must be reported on surplus lines affidavit form?
Information such as insured name, policy number, premium amount, and transaction details must be reported on surplus lines affidavit form.
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