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Texas diligent effort form

Diligent effort form 2026

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The document is a Statement of Diligent Effort (Form SL-1904) required for surplus lines insurance in Delaware. It confirms that the insured has been informed about the use of an unauthorized insurer and that the insurance is not covered by the Delaware Insurance Guaranty Association. The form must be signed by a licensed producing agent and retained by the surplus lines broker, documenting efforts to secure coverage from licensed insurers before resorting to unlicensed companies.

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Click ‘Get Form’ to open the diligent effort form in the editor.
Begin by entering the insured's name and mailing address in the designated fields. Ensure accuracy as this information is crucial for processing.
Fill in the details of the surplus lines insurer, including their name and NAIC number. This identifies the insurance provider involved.
In the 'Reason for Declining' section, provide a clear explanation for why coverage could not be secured from licensed insurers.
Complete the policy term information, including effective date and expiration date, using MM/DD/YYYY format for clarity.
Sign and date the form where indicated. Ensure that your signature is legible and matches your printed name.

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