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One Exchange Plaza
55 Broadway
29th Floor
New York, NY 10006

Phone:
(646) 292-5500
Electronic Filing System Requirements/Instructions (EFS)
Please visit the new EFS Resources page.

Part A: Affidavit by Excess Line Broker
Part A: Affidavit by Excess Line Broker PDF
Part A: Affidavit by Excess Line BrokerMS Word
Part A: Tax Allocation Report (DFS Form EL-3)PDF
Part A: Tax Allocation Report (DFS Form EL-4)PDF


Part C: Affidavit by Producing Broker
Part C: Affidavit by Producing BrokerPDF
Part C: Affidavit by Producing Broker MS Word


Notice of Excess Line Placement/Total Cost Form
Notice of Excess Line Placement/Non Tax Allocated Total Cost FormMS Word
Notice of Excess Line Placement/Non Tax Allocated Total Cost FormPDF
Notice of Excess Line Placement/Tax Allocated Total Cost FormMS Word
Notice of Excess Line Placement/Tax Allocated Total Cost FormPDF


Batch Filing Report
Batch Filing ReportPDF
Batch Filing ReportMS Word


Membership Information Form
Membership Information FormPDF


Broker of Record
ELANY Broker of Record PDF


Producing Brokers On-Line Affidavit Registration
Producing Brokers Online Affidavit Registration FormPDF


Direct Procurement Tax Form - CT33D
Form for Taxable Insurance Contracts effective prior to 7/21/2011PDF
Instructions PDF
Form for Taxable Insurance Contracts efffective 7/21/2011PDF
InstructionsPDF


2011 Year End Report Cover Letter
2011 Year End Report Cover LetterMS Word


Consent to Service of Process
Consent to Service of ProcessPDF


Qualified Exempt Commercial Purchaser Form (ECP)
ECP Written Disclosure FormPDF