Quarterly statement of broker

(1) Each broker shall, within thirty (30) days of the end of each calendar quarter, file with the commissioner a verified statement of all surplus lines insurance transacted by him during the preceding calendar quarter. (2) The statement shall be on forms as prescribed by the commissioner and shall show: (a) Gross amount of each kind of insurance transacted; (b) Aggregate of gross premiums charged; (c) Aggregate of returned premiums paid insureds; (d) Aggregate of net premiums; and (e) Additional information as required by the commissioner.