Many states below require completion of surplus lines affidavits as part of transacting business with non-admitted markets.

The Surplus Lines Affidavit serves two main purposes:

  1. Confirms the agent and insured are aware that the market with which the coverage was placed is not part of that state’s insurance guarantee fund
  2. Provides a record of the collection of surplus lines taxes and state fees.

Please download the affidavit you need by clicking on the link below, or if unsure, please call us with any questions. Thank you.

Connecticut
Maine ** Affidavit is not required
Massachusetts
New Hampshire ** Affidavit is not required
New Jersey
New York
New York Affidavit Instructions
Pennsylvania
Rhode Island