Oklahoma Insurance Department State of Oklahoma SURPLUS LINES INSURANCE BROKER FORM SL3c Quarter and - ok 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the quarter and year submitted at the top of the form. This is essential for proper record-keeping.
3. Fill in your name as the broker, along with your license number, mailing address, agency name (if applicable), city, state, and zip code.
4. In section 1, certify that insurance cannot be procured from authorized insurers by checking the appropriate box.
5. Provide details of procurement from unauthorized insurers in section 2. Fill in policy or certificate number, effective dates, and name/address of the unauthorized insurer.
6. Complete sections G through I with information about the insured's mailing address, location and description of risk, kind/class of coverage, and amount of coverage.
7. Ensure you confirm that the coverage was not knowingly placed with an unauthorized insurer in unsound financial condition.
8. Calculate surplus tax as outlined in section 5. Input gross premium charges and any applicable federal/state taxes before calculating the total tax due.

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