Get Surplus Line And/or Special Lines' Surplus Line Certification

Filling out the Surplus Line And/or Special Lines' Surplus Line Certification is a crucial step in obtaining or changing the status of your surplus line broker license in California. This guide provides clear, step-by-step instructions to help you successfully complete the form online.

Follow the steps to fill out the Surplus Line Certification correctly.

1. Click ‘Get Form’ button to obtain the certification form and open it in the online editor.
2. Begin by entering your full name in the certification section, certifying that you understand and will comply with the applicable insurance codes.
3. Indicate your understanding of the bond requirements, specifying whether you will file a bond of $50,000 and/or $10,000. Ensure you check the relevant boxes.
4. List all insurers that are not admitted to California with whom you have arrangements to accept surplus line business. Ensure that each entry is clear and accurate.
5. If you will be transacting on behalf of a licensed business entity, mark the appropriate option and enter the name and license number of that entity.
6. Sign and date the certification at the bottom of the form, ensuring that your printed name and license number, if applicable, are clearly written.
7. Before submitting, review all entries for accuracy, then save your changes. You can download the completed form, print it, or share it as needed.

Complete your Surplus Line and/or Special Lines Certification online today!