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

Reset Form Control No. Surplus Lines Statement (Form SL8) State of Connecticut Insurance Department (Rev. 07/2013) 1. Name and Address of Surplus Lines Broker Diane Lesser, 13790 E Rice Pl, Aurora

How to fill out surplus lines statement form

How to fill out surplus lines statement form

1. To fill out a surplus lines statement form, follow these steps:
2. Start by entering the title of the form at the top of the page.
3. Provide the date of the statement form next to the title.
4. Fill in the name and contact information of the insured party.
5. Specify the policy number and effective dates of the surplus lines policy.
6. Include details about the insurance company providing the surplus lines coverage.
7. Provide a brief description of the insured risk and the insured's operations.
8. Indicate the total premium, taxes, fees, and other charges associated with the policy.
9. If applicable, include any endorsements or special provisions associated with the policy.
10. Sign and date the form to certify its accuracy and completeness.
11. Keep a copy of the filled-out surplus lines statement form for your records.

Who needs surplus lines statement form?

1. The surplus lines statement form is typically needed by insurance agents, brokers, and policyholders who are involved in obtaining surplus lines coverage.
2. Surplus lines insurance is typically purchased when coverage is not readily available in the standard insurance market.
3. Therefore, individuals or businesses seeking specialized or unique insurance coverage may require a surplus lines statement form to fulfill regulatory requirements or provide necessary documentation.

For pdfFiller’s FAQs

How do I edit surplus lines statement form in Chrome?

Adding the pdfFiller Google Chrome Extension to your web browser will allow you to start editing surplus lines statement form and other documents right away when you search for them on a Google page. People who use Chrome can use the service to make changes to their files while they are on the Chrome browser. pdfFiller lets you make fillable documents and make changes to existing PDFs from any internet-connected device.

Can I create an eSignature for the surplus lines statement form in Gmail?

When you use pdfFiller's add-on for Gmail, you can add or type a signature. You can also draw a signature. pdfFiller lets you eSign your surplus lines statement form and other documents right from your email. In order to keep signed documents and your own signatures, you need to sign up for an account.

How do I edit surplus lines statement form straight from my smartphone?

The best way to make changes to documents on a mobile device is to use pdfFiller's apps for iOS and Android. You may get them from the Apple Store and Google Play. Learn more about the apps here. To start editing surplus lines statement form, you need to install and log in to the app.

What is surplus lines statement form?

Surplus lines statement form is a report that provides information on insurance coverage that is obtained from non-admitted insurers.

Who is required to file surplus lines statement form?

Insurance agencies and brokers who place insurance with non-admitted insurers are required to file surplus lines statement forms.

How to fill out surplus lines statement form?

Surplus lines statement forms can be filled out electronically or in paper form by providing information on the insurance coverage placed with non-admitted insurers.

What is the purpose of surplus lines statement form?

The purpose of surplus lines statement form is to monitor and regulate the placement of insurance coverage with non-admitted insurers.

What information must be reported on surplus lines statement form?

Information such as the name of the insured, policy number, coverage amount, premium amount, and non-admitted insurer details must be reported on the surplus lines statement form.