Part c affidavit 2026

1. Click ‘Get Form’ to open the part c affidavit in the editor.
2. Begin by filling in the Producing Broker Information section. Enter your Affidavit Number, License Number, Name, Address, City, State, and Zip Code accurately.
3. In the Risk Information section, ensure that the Name of the Insured matches exactly with the declarations page or confirmation of coverage.
4. Proceed to the Disclosure Information section. Indicate whether you provided a written Notice of Excess Line Placement by selecting 'Yes' or 'No'.
5. For Declination Information, answer question (a) regarding Superintendent determinations. If applicable, skip to the Affirmation section based on your answers.
6. If required, complete questions (b) and (c) regarding Exempt Commercial Purchaser status and submission details. Fill in any necessary information about authorized companies declining the risk.
7. Finally, sign and date the Affirmation section to confirm that all information is true to your knowledge.

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