Office of Insurance and Safety Fire CommissionerRalph T. Hudgens
Home Agents Agencies Captives Insurers Fire Marshal Industrial Loan Consumer Services Premium Tax Legal Fraud

Surplus Line Broker Forms

ATTENTION: We have NEW IMPORTANT payment procedures. Please view them here.

Form #GID-212-PT This is a Microsoft Excel Aplication\nDivision: Premium TaxPublished: 2013
SURPLUS LINE BROKER’S QUARTERLY PREMIUM TAX AFFIDAVIT WORKBOOK. Use this form for multi-state or single state placements. This is an Excel workbook that must be SAVED to your files before completing. This form requires the broker’s signature witnessed by a Notary Public with a notary seal. Instructions for completing the Excel workbook and filing the affidavit may be found at the first tab within the workbook.

Form #Surplus Lines Insurance Regulation (120-2-89) This is in the Adobe Portable Document format (pdf)\nDivision: Premium TaxPublished: 2008
Title: Surplus Lines Insurance Regulation (120-2-89)
Surplus Lines Insurance Regulation (120-2-89)
PID:350-SID:257-FN:Surplus Lines Insurance Regulation (120-2-89).pdf

EmploymentE-VerifyTechnical Contact2/25/2017 10:57:41 AM- UsPrivacy PolicyLaws & Regs