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SURPLUS LINES FILING INFO SHEET DUE AT BINDING EMAIL TO: Alistair clementsinsurance.com Name of Insured: Address: City, State, Zip: Policy Number #1 Carrier Information: Policy Number Name: Address
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How to fill out az surplus lines due
How to fill out az surplus lines due
01
To fill out AZ surplus lines due, follow these steps:
02
Obtain the surplus lines due form from the Arizona Department of Insurance.
03
Fill in the policyholder's name, address, and contact information.
04
Provide the policy number and effective date of the surplus lines policy.
05
Specify the type of coverage provided by the surplus lines policy.
06
Indicate the premium amount and method of payment.
07
Attach any required supporting documents, such as proof of policy.
08
Sign and date the form.
09
Submit the completed form along with the payment to the Arizona Department of Insurance.
10
Keep a copy of the filled out form for your records.
Who needs az surplus lines due?
01
Any individual or organization operating as a surplus lines broker or insurance producer in Arizona needs to fill out AZ surplus lines due.
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What is az surplus lines due?
Arizona surplus lines due refers to the tax that must be paid on insurance policies that are placed with non-admitted insurers.
Who is required to file az surplus lines due?
Insurance producers or brokers who place insurance with non-admitted insurers in Arizona are required to file Arizona surplus lines due.
How to fill out az surplus lines due?
Arizona surplus lines due can be filled out online through the Arizona Department of Insurance website or by submitting a paper form with the required information.
What is the purpose of az surplus lines due?
The purpose of Arizona surplus lines due is to ensure that tax is collected on insurance policies that are placed with non-admitted insurers in the state.
What information must be reported on az surplus lines due?
Information such as the name of the insured, the premium amount, the type of insurance coverage, and the name of the non-admitted insurer must be reported on Arizona surplus lines due.
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