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Procurement Forms

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Form #GID-214-PT This is in the Adobe Portable Document format (pdf)\nDivision: Premium TaxPublished: 2019
Title: Report of Person(s) Procuring Insurance from Unauthorized Insurers
Report of Person(s) Procurring Insurance from Unauthorized Insurers. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us.
PID:1050-SID:2708-FN:GID-214-PT-13.pdf

Form #GID-214-PT This is a Microsoft Excel Aplication\nDivision: Premium TaxPublished: 2019
Title: Report of Person(s) Procuring Insurance from Unauthorized Insurers Affidavit Workbook
Report of Person(s) Procuring Insurance from Unauthorized Insurers Affidavit Workbook. Use this form for multi-state and single-state placements. This is an Excel workbook that must be SAVED to your files before completing. This form requires the signature witnessed by a Notary Public with a notary seal. Instructions for completing the workbook and filing the affidavit are found at the first tab within the workbook. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal.
PID:1238-SID:3230-FN:GID-214-PT-2019.xls

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