Get Contact Notification Form Please Provide This Informational ... - Ok

This guide provides clear and supportive instructions for filling out the CONTACT NOTIFICATION FORM online. Whether you are submitting information for surplus lines registration or updating contacts, this step-by-step approach will help you complete the form accurately.

Follow the steps to complete the form successfully.

1. Click ‘Get Form’ button to access the CONTACT NOTIFICATION FORM and open it in your preferred editor.
2. Begin with the top section of the form, entering the surplus lines company name and the NAIC code in the designated spaces.
3. For each contact category—Claim Information Contact, Administrative Office, Policyholder Information, Producer Licensing, U.S. Legal Counsel, Annual Statement Contact, and Company Mailing Address—carefully fill in the contact name, title, address, phone number, fax number, and email address. Ensure all information is accurate and complete.
4. If you have additional contacts to list, attach a separate sheet with those details, ensuring clarity and proper formatting.
5. Conclude the form by filling in the signature of the preparer, along with their typed or printed name, phone number, title, and email address.
6. Review the entire form for accuracy and completeness before submitting.
7. Once all the information is filled out correctly, you can save your changes, download a copy for your records, print the form, or share it as needed.

Complete your document submissions efficiently by filling out the form online today.