Please complete the following documentation and submit the information as a complete package to the attention of Chief Financial Analyst G. Lee Hill, Jr.
Please make certain the following information is indicated on the South Carolina Application for Registration as a Purchasing Group (Form 1032):
The agency shown in Item 6A is licensed in South Carolina.
The agent shown in Item 6B is licensed with the insurer or registered risk group shown in Item 12.
Broker shown in Item 6B is licensed as a broker in SC.
Show in Item 12 the licensed insurer, registered risk retention group, or approved eligible surplus lines insurer in South Carolina from which the Group intends to purchase liability insurance.
Fill out the South Carolina Appointment of Attorney to Accept Service (Form 1033).
Fees - South Carolina's fee is strictly retaliatory. Thus, if the insurer's domiciliary Department requires a fee from a South Carolina domestic Purchasing Group to make such a filing with that Department, a check, made payable to the South Carolina Department of Insurance, in the amount of that fee should be included with your filing to this Department.
Provide copy of the Certificate of Authority or registration from the state of domicile.