Related Information

1620 Report Image

As required by Section 1620 of the Pennsylvania Surplus Lines Law, within thirty (30) days following the end of each month, each surplus lines licensee (by Agency Customer ID) shall file with PSLA, on Form 1620, a signed verified report of all Pennsylvania surplus lines insurance premium activity transacted during the previous month.

The total “Taxable Premium” amount reported on the 1620 Monthly Reports during a year should match the “Gross Premium Taxable” amount reported on the annual Gross Premium Tax form for the same year (“Gross Premium Taxable” is defined as Gross Premium less Returned Premium less Tax Exempt Premium).

If there was no business transacted for a given month, PSLA still recommends a report be submitted with $0 entered for Property Limit, Casualty Limit, and Tax. Note: The twelve 1620 Monthly Reports are required attachments to the surplus lines premium tax form, RCT-123 filed with the Department of Revenue.

PSLA reviews the uploaded 1620 Monthly Report image to insure it is consistent with the 1620 data entered into EFS. If discrepancies are found, the report state is set to “Filing Returned” in EFS (Electronic Filing System) and an email notification is sent to the licensee with a copy to the 1620 Monthly Report contact listed in EFS. The agency must revise/submit a corrected report with associated 1620 Monthly Report image.

Below is a list of common discrepancies with the 1620 Monthly Report image.

  1. The PSLA Customer ID on the 1620 Monthly Report image is missing or does not match the ID entered into EFS.
  2. The uploaded image is not a 1620 Monthly Report.
  3. The final page of the 1620 Monthly Report image is missing a grand total for Non-taxable Premium, Taxable Premium, or Premium Tax.
  4. The Agency Name on the 1620 Monthly Report image is different than the name associated with the PSLA Customer ID.
  5. The Agency Name and/or Address is missing on the 1620 Monthly Report image.
  6. The 1620 Monthly Report image is missing a signature from an authorized Surplus Lines Licensee.
  7. The premium amount for a transaction should only be reported as Non-taxable or Taxable; not both.
  8. The 1620 Monthly Report image is not based on the correct version of the 1620 Monthly Report. Please use the correct version on the Filing Forms page.
  9. The uploaded image includes pages for affidavits. Affidavits must be submitted separately in EFS.
  10. The amounts on the Grand Total line of the 1620 Monthly Report image do not match the amounts entered in EFS.
  11. The signature on the 1620 Monthly Report image is not an authorized Licensee for this agency.