Get the free SURPLUS LINES BROKER'S AFFIDAVIT - S & H Underwriters, Inc.

STATE OF DELAWARE INSURANCE DEPARTMENT 841 Silver Lake Boulevard Dover, Delaware 19904 (302) 7394251 SURPLUS LINES BROKER AFFIDAVIT In accordance with 18 Del. C., 1905, the following is a DECLARATION

How to fill out surplus lines broker39s affidavit

How to fill out a surplus lines broker's affidavit:

1. Begin by reading the instructions provided with the surplus lines broker's affidavit form. It is important to understand the requirements and steps involved in filling out the affidavit accurately.
2. Provide the necessary information on the affidavit form, such as your name, address, contact details, and agency information. Ensure that all the required fields are completed accurately and legibly.
3. Indicate the specific insurance transactions for which you are submitting the affidavit. This may include information such as the insured's name, policy number, effective dates, and the type of coverage provided.
4. Include any relevant supporting documents that may be required, such as copies of insurance policies, endorsements, or any other relevant paperwork. Make sure to attach these documents securely to the affidavit to avoid any misplacements.
5. Review the affidavit thoroughly before submitting it. Double-check all the information provided to ensure its accuracy and completeness. Any errors or missing information could lead to delays or the rejection of the affidavit.
6. Sign the affidavit using your legal signature. This confirms that the information provided in the affidavit is true and accurate to the best of your knowledge.

Who needs a surplus lines broker's affidavit:

1. Surplus lines brokers are required to fill out and submit the surplus lines broker's affidavit. This affidavit is commonly used in the insurance industry, particularly for transactions involving non-admitted insurance carriers or policies.
2. Insurance agents or brokers who work with surplus lines insurance may also be required to complete and submit the surplus lines broker's affidavit. It serves as a declaration of the insurance transactions carried out by the broker or agent.
3. Some states or jurisdictions may have specific requirements regarding surplus lines insurance and the use of the affidavit. It is essential to consult the local regulations and licensing authorities to determine if a surplus lines broker's affidavit is necessary in a particular jurisdiction.

Remember, the specific requirements and processes for filling out a surplus lines broker's affidavit may vary depending on your jurisdiction and the purpose of the affidavit. It is crucial to carefully review the instructions provided with the form and seek guidance from regulatory authorities or legal professionals if needed.

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What is surplus lines broker's affidavit?

Surplus lines broker's affidavit is a sworn statement provided by a surplus lines broker to the regulatory authority, indicating compliance with state laws regarding surplus lines insurance.

Who is required to file surplus lines broker's affidavit?

Surplus lines brokers are required to file surplus lines broker's affidavit as per state regulations.

How to fill out surplus lines broker's affidavit?

Surplus lines broker's affidavit can be filled out by providing accurate information about the surplus lines transactions and ensuring compliance with state laws.

What is the purpose of surplus lines broker's affidavit?

The purpose of surplus lines broker's affidavit is to ensure that surplus lines brokers are conducting business in compliance with state regulations and guidelines.

What information must be reported on surplus lines broker's affidavit?

Surplus lines broker's affidavit must include information on surplus lines transactions, premiums, insured parties, and other relevant details as required by state regulations.