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Click ‘Get Form’ to open the 2019 - AP Vendor Payment Schedule in the editor.
Begin by selecting the appropriate period for your payment schedule at the top of the form. Check either 'Jan. 1 – March 31, 2019' or 'April 1 – June 30, 2019'.
Fill in your insurance company name and mailing address. If there is a new address, check the corresponding box.
Provide your contact details including city, state, zip code, email address, and website address.
Complete the financial sections by entering direct premiums, dividends, and gross premiums as specified in lines A through C.
Calculate the surcharge based on your total premiums using the provided formula and enter it in line 6.
Sign and date the form at the bottom to certify that all information is correct before submitting it.
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