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Get and Sign DECLARATION by PRODUCER Bpaslaorgb 2008 Form
And in the event of the insolvency of the insurer losses will not be paid by the Pennsylvania Property and Casualty Insurance Guaranty Association. ALL applicable provisions of ARTICLE XVI of the Insurance Company Law 40 P. COMMONWEALTH OF PENNSYLVANIA INSURANCE DEPARTMENT 1609-PR REV. 09/08 Must be included with SLL Affidavit type 1609-SLL/1609-PR Pennsylvania Surplus Lines Association 180 Sheree Blvd. Suite 3100 Exton PA 19341 Customer ID Policy Binder Report of transactions with unlicensed...
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