Form S-1, Surety Company Annual Report Instructions

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This form contains 102 fields organized into 16 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Additional Information
Item16 Text
Enter any additional information or comments related to Item 16.
Date Information
Item15.a.Month Text
Enter the month (MM) of the date related to Item 15.a.
Max length: 2 characters
Item15.a.Day Text
Enter the day (DD) of the date related to Item 15.a.
Max length: 2 characters
Item15.a.Year Text
Enter the year (YYYY) of the date related to Item 15.a.
Max length: 4 characters
Alt.Month Text
Enter the month of the alternative date.
Alt.Day Text
Enter the day of the alternative date.
Alt.Year Text
Enter the year of the alternative date.
ERISA Bond Experience
PartIII.9.ERISA.Honesty Text
Enter the bond experience data related to ERISA Honesty for Part III, Section 9.
Max length: 9 characters
PartIII.10.ERISA.Honesty Text
Enter the bond experience data related to ERISA Honesty for Part III, Section 10.
Max length: 9 characters
PartIII.11.ERISA.Honesty Text
Enter the bond experience data related to ERISA Honesty for Part III, Section 11.
Max length: 9 characters
PartIII.12.ERISA.Honesty Text
Enter the bond experience data related to ERISA Honesty for Part III, Section 12.
Max length: 9 characters
PartIII.9.ERISA.Faithful Text
Enter the bond experience data related to ERISA Faithful for Part III, Section 9.
Max length: 9 characters
PartIII.10.ERISA.Faithful Text
Enter the bond experience data related to ERISA Faithful for Part III, Section 10.
Max length: 9 characters
PartIII.11.ERISA.Faithful Text
Enter the bond experience data related to ERISA Faithful for Part III, Section 11.
Max length: 9 characters
PartIII.12.ERISA.Faithful Text
Enter the bond experience data related to ERISA Faithful for Part III, Section 12.
Max length: 9 characters
ERISA Data
PartII.5.ERISA.Honesty Text
Enter the bond experience data related to ERISA Honesty for Part II, Section 5.
Max length: 9 characters
PartII.6.ERISA.Honesty Text
Enter the bond experience data related to ERISA Honesty for Part II, Section 6.
Max length: 9 characters
PartII.7.ERISA.Honesty Text
Enter the bond experience data related to ERISA Honesty for Part II, Section 7.
Max length: 9 characters
PartII.5.ERISA.Faithful Text
Enter the bond experience data related to ERISA Faithful for Part II, Section 5.
Max length: 9 characters
PartII.6.ERISA.Faithful Text
Enter the bond experience data related to ERISA Faithful for Part II, Section 6.
Max length: 9 characters
PartII.7.ERISA.Faithful Text
Enter the bond experience data related to ERISA Faithful for Part II, Section 7.
Max length: 9 characters
Form Actions
Submit Button
Click this button to submit the completed form.
btnClearSignatures Button
Click this button to clear all signatures from the form.
Sign/Print Button
Click this button to sign or print the form.
Temp Button
This button is for temporary actions related to the form.
Tempx Button
This button is for temporary actions related to the form.
btnPrint Button
Click this button to print the form.
btnItem15 Button
Click this button to submit the information for Item 15.
Form Controls
btnResetFields Button
Click this button to reset all fields in the form.
Assess the quality of this form Button
Click this button to assess the quality of the form.
Get Spawn Page Details Button
Click this button to get details about the spawned pages.
SpawnBox ListBox
This list box is used to display details about the spawned pages.
btnSpawnedNames Button
Click this button to get the names of the spawned pages.
btnRenumberPages Button
Button to renumber the pages of the form.
btnReset Button
Button to reset the form to its default state.
btnCourierFont Button
Button to change the font to Courier.
Form Information
PageNumber1 Text
This field displays the page number of the form.
CoverPage Text
This field is for the cover page text of the form.
PageNumber2 Text
Displays the page number of the form.
Hidden Fields
FormName:THIS FIELD SHOULD NOT BE VISIBLE Text
This field should not be visible. It contains the form name.
ProgramName:THIS FIELD SHOULD NOT BE VISIBLE ComboBox
This field should not be visible. It contains the program name and allows selection from a predefined list.
BL OLMS WH DFEC EEOICP LS OWCP OFCCP
Identification Details
Filer.FileNumber Text
Enter the file number assigned to the filer. This is a unique identifier for the surety company.
Max length: 5 characters
Filer.Name Text
Enter the name of the filer, which is the surety company submitting the report.
Filer.BuildNum Text
Enter the building number of the filer's address.
Max length: 35 characters
Filer.Street Text
Enter the street name of the filer's address.
Max length: 35 characters
Filer.City Text
Enter the city of the filer's address.
Max length: 22 characters
Filer.State ComboBox
Select the state of the filer's address from the dropdown list.
AR FL ID PA SC GU AL NH NJ WV MS VI WY CO OH WA SD WI CA ME PR OR IN MN AK TN HI MT KY AZ KS NM LA VT IL ND VA NE AS NC DE OK CT IA MA TX ZZ DC GA MO NV MI NY UT MD RI
Filer.ZipCode Text
Enter the ZIP code of the filer's address. Use a five or nine-digit format.
Max length: 10 characters
Pres.Title ComboBox
Select the title of the President from the provided options.
S M P E O
Treas.Title ComboBox
Select the title of the Treasurer from the provided options.
C F O T
Pres.Phone Text
Enter the phone number of the President.
Max length: 25 characters
Treas.Phone Text
Enter the phone number of the Treasurer.
Max length: 25 characters
Pres.Other Text
Enter the name of the President or other authorized officer of the surety company.
Max length: 35 characters
Treas.Other Text
Enter the name of the Treasurer or other authorized officer of the surety company.
Max length: 35 characters
Item15.b.State ComboBox
Select the state from the dropdown list where the surety company is located.
AR FL ID PA SC GU AL NH NJ WV MS VI WY CO OH WA SD WI CA ME PR OR IN MN AK TN HI MT KY AZ KS NM LA VT IL ND VA NE AS NC DE OK CT IA MA TX ZZ DC GA MO NV MI NY UT MD RI
Item15.b.ZipCode Text
Enter the ZIP code of the surety company's location. Maximum length is 10 characters.
Max length: 10 characters
Item15.c Text
Enter the name of the surety company's contact person or department. Maximum length is 35 characters.
Max length: 35 characters
Item15.d Text
Enter the street address of the surety company's contact person or department. Maximum length is 35 characters.
Max length: 35 characters
Item15.e Text
Enter the city of the surety company's contact person or department. Maximum length is 35 characters.
Max length: 35 characters
Item15.f Text
Enter the state of the surety company's contact person or department. Maximum length is 35 characters.
Max length: 35 characters
Item15.g Text
Enter the ZIP code of the surety company's contact person or department. Maximum length is 35 characters.
Max length: 35 characters
Filer.AltOrgName Text
Enter the alternative organization name if applicable.
Filer.AltOrgNum Text
Enter the alternative organization number if applicable.
LMRDA Bond Experience
PartIII.11.LMRDA.Honesty Text
Enter the bond experience data related to LMRDA Honesty for Part III, Section 11.
Max length: 9 characters
PartIII.12.LMRDA.Honesty Text
Enter the bond experience data related to LMRDA Honesty for Part III, Section 12.
Max length: 9 characters
PartIII.9.LMRDA.Faithful Text
Enter the bond experience data related to LMRDA Faithful for Part III, Section 9.
Max length: 9 characters
PartIII.10.LMRDA.Faithful Text
Enter the bond experience data related to LMRDA Faithful for Part III, Section 10.
Max length: 9 characters
PartIII.11.LMRDA.Faithful Text
Enter the bond experience data related to LMRDA Faithful for Part III, Section 11.
Max length: 9 characters
PartIII.12.LMRDA.Faithful Text
Enter the bond experience data related to LMRDA Faithful for Part III, Section 12.
Max length: 9 characters
PartIII.13.LMRDA.Honesty Text
Enter the bond experience data related to LMRDA Honesty for Part III, Section 13.
Max length: 9 characters
LMRDA Data
PartII.5.LMRDA.Honesty Text
Enter the bond experience data related to LMRDA Honesty for Part II, Section 5.
Max length: 9 characters
PartII.6.LMRDA.Honesty Text
Enter the bond experience data related to LMRDA Honesty for Part II, Section 6.
Max length: 9 characters
PartII.7.LMRDA.Honesty Text
Enter the bond experience data related to LMRDA Honesty for Part II, Section 7.
Max length: 9 characters
PartII.5.LMRDA.Faithful Text
Enter the bond experience data related to LMRDA Faithful for Part II, Section 5.
Max length: 9 characters
PartII.6.LMRDA.Faithful Text
Enter the bond experience data related to LMRDA Faithful for Part II, Section 6.
Max length: 9 characters
PartII.7.LMRDA.Faithful Text
Enter the bond experience data related to LMRDA Faithful for Part II, Section 7.
Max length: 9 characters
PartIII.9.LMRDA.Honesty Text
Enter the bond experience data related to LMRDA Honesty for Part III, Section 9.
Max length: 9 characters
PartIII.10.LMRDA.Honesty Text
Enter the bond experience data related to LMRDA Honesty for Part III, Section 10.
Max length: 9 characters
Loss Data
PartIII.14.LMRDA.Honesty Text
Enter the total amount of losses paid for LMRDA Honesty bonds in Part III, Section 14.
PartIII.14.LMRDA.Faithful Text
Enter the total amount of losses paid for LMRDA Faithful Performance bonds in Part III, Section 14.
PartIII.14.ERISA.Honesty Text
Enter the total amount of losses paid for ERISA Honesty bonds in Part III, Section 14.
PartIII.14.ERISA.Faithful Text
Enter the total amount of losses paid for ERISA Faithful Performance bonds in Part III, Section 14.
Organization Information
Item15.b.OrgName Text
Enter the name of the organization related to Item 15.b.
Item15.b.BuildNum Text
Enter the building number of the organization's address related to Item 15.b.
Max length: 35 characters
Item15.b.Street Text
Enter the street name of the organization's address related to Item 15.b.
Max length: 35 characters
Item15.b.City Text
Enter the city of the organization's address related to Item 15.b.
Max length: 22 characters
Premium Data
PartIII.13.LMRDA.Faithful Text
Enter the total amount of premiums received for LMRDA Faithful Performance bonds in Part III, Section 13.
Max length: 9 characters
PartIII.13.ERISA.Honesty Text
Enter the total amount of premiums received for ERISA Honesty bonds in Part III, Section 13.
Max length: 9 characters
PartIII.13.ERISA.Faithful Text
Enter the total amount of premiums received for ERISA Faithful Performance bonds in Part III, Section 13.
Max length: 9 characters
PartII.8.LMRDA.Honesty Text
Enter the total amount of premiums received for LMRDA Honesty bonds in Part II, Section 8.
PartII.8.LMRDA.Faithful Text
Enter the total amount of premiums received for LMRDA Faithful Performance bonds in Part II, Section 8.
PartII.8.ERISA.Honesty Text
Enter the total amount of premiums received for ERISA Honesty bonds in Part II, Section 8.
PartII.8.ERISA.Faithful Text
Enter the total amount of premiums received for ERISA Faithful Performance bonds in Part II, Section 8.
Report Date
Item2.Month Text
Enter the month when the report is being filed. Use a two-digit format (e.g., 01 for January).
Max length: 2 characters
Item2.Day Text
Enter the day when the report is being filed. Use a two-digit format (e.g., 01 for the first day of the month).
Max length: 2 characters
Item2.Year Text
Enter the year when the report is being filed. Use a four-digit format (e.g., 2023).
Max length: 4 characters
Signatures
Pres.Date Text
Enter the date when the President signed the form.
Max length: 25 characters
Treas.Date Text
Enter the date when the Treasurer signed the form.
Max length: 25 characters
TreasSignature Signature
Provide the signature of the Treasurer or other authorized officer of the surety company.
PresSignature Signature
Provide the signature of the President or other authorized officer of the surety company.
hiddenPresidentSignatureCover Text
This field indicates whether the President's signature is ready to be signed.
hiddenTreasurerSignatureCover Text
This field indicates whether the Treasurer's signature is ready to be signed.