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How to use or fill out part c affidavit with our platform
- Click ‘Get Form’ to open the part c affidavit in the editor.
- Begin by filling in the Producing Broker Information section. Enter your Affidavit Number, License Number, Name, Address, City, State, and Zip Code accurately.
- In the Risk Information section, ensure that the Name of the Insured matches exactly with the declarations page or confirmation of coverage.
- Proceed to the Disclosure Information section. Indicate whether you provided a written Notice of Excess Line Placement by selecting 'Yes' or 'No'.
- For Declination Information, answer question (a) regarding Superintendent determinations. If applicable, skip to the Affirmation section based on your answers.
- 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.
- Finally, sign and date the Affirmation section to confirm that all information is true to your knowledge.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2011 | 4.8 Satisfied (81 Votes) |
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