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SURPLUS LINES TAX AFFIDAVIT NAMED INSURED: POLICY TERM: CARRIER: Please note a Surplus Lines Filing must be made and Taxes paid on the captioned Insured. We require the name of the broker making the

How to fill out surplus lines tax affidavit

How to fill out surplus lines tax affidavit:

1. Obtain the necessary form: Begin by obtaining the surplus lines tax affidavit form from the appropriate regulatory authority, such as the state's insurance department. This form may also be available on their website for download.
2. Provide basic information: Fill in the required information in the designated fields. This typically includes the insured's name, address, and contact details. Additionally, you may need to provide information about the insurance broker or agent involved in the transaction.
3. Specify the insurance policy details: Under the policy section, provide accurate information about the insurance coverage being obtained. This includes the effective date of the policy, the type of coverage, and any relevant policy numbers.
4. Determine premium, taxes, and fees: Calculate the premium paid for the insurance coverage and the associated taxes and fees. Ensure that all applicable taxes and fees are accounted for, as required by the specific state regulations. This may include state taxes, stamping fees, and any other surcharges.
5. Complete jurisdiction-specific sections: Some surplus lines tax affidavits may have jurisdiction-specific sections that require additional information. Be sure to fill out these sections accurately, as failure to do so may lead to delays in the processing of the affidavit.
6. Attach supporting documentation: In some cases, supporting documentation may need to be attached to the surplus lines tax affidavit. This documentation may include a copy of the insurance policy, premium payment receipts, or any other relevant documents. Make sure to include all necessary attachments as specified by the regulatory authority.

Who needs surplus lines tax affidavit?

1. Insurance brokers and agents: Surplus lines tax affidavits are typically required to be filled out by insurance brokers or agents who are facilitating insurance transactions for clients. These professionals must ensure that they correctly fill out the affidavit and submit it to the relevant regulatory authority.
2. Insured individuals or businesses: Depending on the specific state regulations, insured individuals or businesses may also be required to submit a surplus lines tax affidavit directly. This is usually the case when the insurance policy is obtained without the involvement of an insurance broker or agent.
3. Regulatory authorities: Surplus lines tax affidavits are a crucial tool for regulatory authorities to monitor and enforce compliance in the surplus lines insurance market. These affidavits provide important information about the insurance coverage being obtained, the parties involved, and the taxes and fees paid.

Overall, it is important to understand the specific requirements and regulations of the state in which the surplus lines tax affidavit needs to be submitted. By following the instructions provided by the regulatory authority and accurately completing the form, one can fulfill their obligations and ensure compliance in the surplus lines insurance market.

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What is surplus lines tax affidavit?

Surplus lines tax affidavit is a document that must be filed to report and remit surplus lines tax on insurance transactions that involve out-of-state insurance companies.

Who is required to file surplus lines tax affidavit?

Insurance agents or brokers who place insurance with non-admitted insurers are required to file surplus lines tax affidavit.

How to fill out surplus lines tax affidavit?

Surplus lines tax affidavit can be filled out online or through the submission of paper forms provided by the state insurance department.

What is the purpose of surplus lines tax affidavit?

The purpose of surplus lines tax affidavit is to ensure that surplus lines tax is properly reported and remitted on insurance transactions that involve non-admitted insurers.

What information must be reported on surplus lines tax affidavit?

Information such as policy details, premium amounts, taxes due, and the surplus lines insurer must be reported on surplus lines tax affidavit.