Surplus Lines Brokers Premium Report Forms

All policies where the home state is Alaska, the tax will be calculated on 100% of the policy premium at Alaska's tax rate of 2.7% and filing fee of 1% regardless of whether the policy is multi-state or not.

• Reporting Instructions for Surplus Lines Brokers
• Quarterly Report (Updated 9/5/2012)
• Report of Surplus Lines Transaction
• Statement of Exempt Premiums
• Unauthorized Insurer's Tax Form (rev. 1/13)

Useful Links

• Eligible Surplus Lines Insurers
• Line Codes for Surplus Lines Transaction Reports
• Broker Fees and the Appointment of Insurance Producers as Brokers
• Order R12-06 - Surplus Lines Placement List
• Stamping Requirements
• Premium Tax Audits – Surplus Lines Brokers
• Affidavit of Due Diligence
• Quarterly Listing of Alien Insurers

Questions:

Jeff Bodine - Filings
jeff.bodine@alaska.gov
(907) 465-4609

or

Rebecca Nesheim - Payments
rebecca.nesheim@alaska.gov
(907) 465-2584