Get the free Surplus Lines Statement (Form SL-8) - Agency

Cancel Reset Save Form Control No. Surplus Lines Statement (Form SL8) State of Connecticut Insurance Department (Rev. 07/2013) 1. Name and Address of Surplus Lines Broker Coastal Agents Alliance(A

How to fill out surplus lines statement form

How to fill out surplus lines statement form

1. To fill out the surplus lines statement form, follow these steps:
2. Begin by writing your name and contact information at the top of the form.
3. Specify the period or date range that the form covers.
4. Provide the details of the surplus lines insurance policy, including the policy number, insurer name, and coverage amount.
5. Indicate the type of insurance being covered by the surplus lines policy.
6. Report any premium taxes or other fees associated with the policy.
7. Include any additional information or comments that may be required.
8. Sign and date the form to attest to its accuracy.
9. Keep a copy of the completed form for your records.

Who needs surplus lines statement form?

1. Various parties may need to complete a surplus lines statement form, including:
2. - Insured individuals or businesses that have obtained a surplus lines insurance policy.
3. - Insurance agents or brokers who handle surplus lines policies on behalf of clients.
4. - State insurance departments or regulatory authorities that require the form to track surplus lines activity.
5. - Compliance officers or internal auditors within insurance companies who need to report on surplus lines business.

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What is surplus lines statement form?

The surplus lines statement form is a document used to report surplus lines insurance transactions to the appropriate regulatory authorities.

Who is required to file surplus lines statement form?

Insurance companies or entities that place surplus lines insurance coverage are required to file the surplus lines statement form.

How to fill out surplus lines statement form?

The surplus lines statement form can be filled out electronically or by mail, and must include detailed information about the surplus lines transactions.

What is the purpose of surplus lines statement form?

The purpose of the surplus lines statement form is to ensure compliance with regulations and to provide transparency in surplus lines insurance dealings.

What information must be reported on surplus lines statement form?

Information such as policyholder name, insured amount, premium charged, and commission paid must be reported on the surplus lines statement form.