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Revised Information Regarding Surplus Lines Producers and Louisiana's Implementation of the Non-Admitted and Reinsurance reform Act (NRRA)
Frequently Asked Questions
Form 438 - Acknowledgment of Applicant for Personal Lines Insurance Coverage in the Surplus Lines Market
This form is required for any newly procured personal surplus lines policy, or for
any personal surplus lines renewal where the insurer changes.
Form 1265 - Quarterly Surplus Lines Producer Tax Statement
This form should be used only by Licensed Louisiana Surplus Lines Producers to report
surplus lines activity transacted in the State of Louisiana.
Form 1265 B - Self-Procured Unauthorized Insurance
This report must be filed by all individuals placing insurance with an unauthorized
company without involving a licensed Louisiana Producer. The contract of insurance
must be negotiated, paid, and delivered outside of Louisiana and in a state or other
sovereignty where the company providing the coverage is admitted as an insurer.
An individual other than a licensed Producer must have procured the coverage.
- Click here to file tax forms online
Approved Unauthorized Insurer List -- Surplus Lines (White List)
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