Get the free Surplus Lines Statement (Form SL8) State of Connecticut Insurance Department (Rev

... at www.ct.gov/cid. You will find surplus lines insurers among the List of Licensed Companies, Approved Reinsurers and Surplus Lines Insurers (PDF 283 KB)”.

How to fill out surplus lines statement form

1. Start by gathering all the necessary information and documents required to complete the surplus lines statement form. This may include details about the insured party, the insurance policy, and any relevant underwriting information.
2. Begin by filling out the header section of the form, which typically includes the name and contact information of the insured party, the name of the insurer, policy number, and effective dates of coverage.
3. Proceed to the main body of the form, where you will provide detailed information about the insurance policy. This may include the type of coverage, limits, deductibles, and any additional terms or conditions.
4. Be sure to accurately disclose any surplus lines taxes or fees that may be applicable to the policy. These vary depending on the jurisdiction in which the coverage is being provided.
5. If required, provide information about the surplus lines broker or agent who facilitated the placement of the policy. This may include their name, contact details, and license number.
6. Sign and date the form, certifying its accuracy and completeness. Depending on the jurisdiction, you may need additional signatures from the insured party, the surplus lines broker, or the insurer.

Who needs surplus lines statement form?

1. Insurance brokers or agents who are involved in placing insurance coverage with non-admitted insurers may need to complete the surplus lines statement form. This form serves as a record of the placement and provides important information to regulatory authorities.
2. Surplus lines insurers themselves may also need to complete the form, particularly if they are required to file periodic reports with state insurance departments.
3. State insurance departments and other regulatory authorities also utilize the surplus lines statement form to monitor and track non-admitted insurance placements within their jurisdiction.

It is important to note that the specific requirements for completing the surplus lines statement form may vary depending on the jurisdiction in which the coverage is being provided. Therefore, it is crucial to consult the relevant state laws and regulations or seek guidance from an experienced professional to ensure compliance.

For pdfFiller’s FAQs

How can I send surplus lines statement form to be eSigned by others?

When you're ready to share your surplus lines statement form, you can swiftly email it to others and receive the eSigned document back. You may send your PDF through email, fax, text message, or USPS mail, or you can notarize it online. All of this may be done without ever leaving your account.

How do I execute surplus lines statement form online?

Filling out and eSigning surplus lines statement form is now simple. The solution allows you to change and reorganize PDF text, add fillable fields, and eSign the document. Start a free trial of pdfFiller, the best document editing solution.

Can I create an electronic signature for signing my surplus lines statement form in Gmail?

You can easily create your eSignature with pdfFiller and then eSign your surplus lines statement form directly from your inbox with the help of pdfFiller’s add-on for Gmail. Please note that you must register for an account in order to save your signatures and signed documents.

What is surplus lines statement form?

The surplus lines statement form is a form used to report information about surplus lines insurance transactions.

Who is required to file surplus lines statement form?

Insurance companies and brokers 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 online or by mail, providing information about the surplus lines insurance transactions.

What is the purpose of surplus lines statement form?

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

What information must be reported on surplus lines statement form?

Information such as policyholder details, coverage amounts, premiums, and taxes must be reported on the surplus lines statement form.