Get the free E-167-2 Surplus Lines Broker Semi-Annual Statement & Premium Tax Form

ARIZONA DEPARTMENT OF INSURANCE Financial Affairs Division COMPLIANCE SECTION 2910 NORTH 44TH STREET, SECOND FLOOR Phoenix, Arizona 850187256 Phone: (602) 9128427 Fax: (602) 9128421 ARIZONA SURPLUS

How to fill out e-167-2 surplus lines broker

How to fill out e-167-2 surplus lines broker

1. Step 1: Gather all necessary information and documents required to fill out the e-167-2 form. This may include details about the surplus lines broker, the insured party, the policy details, and any supporting documentation.
2. Step 2: Access the e-167-2 surplus lines broker form on the designated platform or website.
3. Step 3: Begin filling out the form by entering the required information in each corresponding field. Make sure to accurately and thoroughly provide all the necessary details.
4. Step 4: Review the filled-out form for any errors or missing information.
5. Step 5: Once you are confident that all the information is accurate and complete, submit the e-167-2 form electronically or as per the provided instructions.
6. Step 6: Keep a copy of the submitted form for your records.
7. Step 7: Await any further communication or confirmation regarding the submission of the e-167-2 form. Follow up if necessary.

Who needs e-167-2 surplus lines broker?

1. Any individual or entity operating as a surplus lines broker and engaging in the surplus lines insurance market.
2. Insurance agencies or companies looking to expand their services to include surplus lines insurance coverage.
3. Those involved in the placement, procurement, or negotiation of surplus lines insurance policies and contracts.
4. Individuals or businesses seeking non-standard or high-risk insurance coverage that is not available through traditional insurance markets.
5. Professionals in the insurance industry with expertise in surplus lines who want to provide specialized brokerage services.
6. Insurance brokers who wish to access a wider range of insurance options and policies for their clients.

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What is e-167-2 surplus lines broker?

E-167-2 surplus lines broker refers to a form used to report surplus lines insurance transactions.

Who is required to file e-167-2 surplus lines broker?

Surplus lines brokers are required to file the e-167-2 form.

How to fill out e-167-2 surplus lines broker?

The e-167-2 form can be filled out online or submitted by mail, following the instructions provided by the regulatory authority.

What is the purpose of e-167-2 surplus lines broker?

The purpose of the e-167-2 form is to report surplus lines insurance transactions to the appropriate regulatory authority.

What information must be reported on e-167-2 surplus lines broker?

Information such as policy number, premium amount, insured name, and type of coverage must be reported on the e-167-2 form.