Electronic Filing
Related Information
Electronic Filing Forms
PSLA requires signed copies of the following forms before issuing a Customer ID and/or an EFS Login ID. Please contact AgencyServices@pasla.org if you have questions.
The Pennsylvania Insurance Department requires signed copies of the following items. Please scan and upload a signed image to the Electronic Filing System. Refer to the Procedures Manual for instructions.
- 1609-PR (PDF or Word formats): Per Section 1609 of the Surplus Lines Law, "Within 30 days after the surplus lines licensee has placed insurance with an eligible surplus lines insurer, the producing broker must execute and forward to the surplus lines licensee a written statement, in a form prescribed by the department..." The form is the 1609-PR and the licensee must upload the completed signed form to EFS when submitting a 1609-SLL filing.
- 1620 Monthly Report (PDF or Excel formats): Per Section 1620 of the Surplus Lines Law, "Within thirty (30) days following the end of each month, each surplus lines licensee shall file with the department, on forms prescribed by the department, a verified report in duplicate of all surplus lines insurance transacted during the preceding month".
- RCT-123 Annual Tax Report: The 2009 Tax Form and instructions are available. The completed form and payment must be sent to the Pennsylvania Department of Revenue. A complete copy of this form must also be uploaded to PSLA via the Electronic Filing System by February 1. Please contact the PA Department of Revenue at 717.783.6031 if you have questions on the RCT-123.
After the above images are uploaded to EFS, PSLA reviews the images for discrepancies. Please review your image before uploading it to EFS to minimize your discrepancies.