Commercial / Surplus Lines Sweep Account Form

Commercial / Surplus Lines Sweep Account Form
If you need assistance filling out this form, please click here for Sweep Instructions
Producer Name*

First NameLast Name
Agency Name*
Email of contact person (not insured)*
example@example.com
Insurance Carrier (Program)*
Managing General Agency (this is who issues the invoice)*
Policy Number*
Client Name as shown on Hawksoft*
Hawksoft Customer ID*
Payment Information
Date Payment Received from client
Deposit Date*
Deposit Amount*
Form of Payment Deposited*

Cash/Money OrderCashier's CheckAgency CheckWireTitle Company or Escrow Check (Made Payable to Pacific Crest Services)Insured Personal Check (Made Payable to Pacific Crest Services. Funds will be held for 5 business days.)Insured Business Check (Made Payable to Pacific Crest Services. Funds will be held for 5 business days.)Afco Direct Premium FinancingPaySimple Credit/Debit Card Payment - 3.35% Fee (takes up to 2 business days to process)PaySimple ACH Payment - .45% Fee (takes up to 5 business days to process)Payment using Zelle (use email: sweep@pacificcrestinsurance.com)Other
Please note Credit/Debit Card and ACH Payments made via Paysimple are for Surplus Lines and Commercial Payments (in full or down payments).

After you click one of the links below, a new browser tab will pop up.

Don't forget to click back to this tab where the form is and finish filling it out all the way to the bottom, and click submit.

Click Here to Access the Credit Card Payment Form

Click Here to Access the ACH Payment Form
Name of Depositing Bank*

Wells Fargo (funds from AfcoDirect and PaySimple deposit here)US BankBank of America (funds from Zelle deposit here)No bank deposit
You understand that PCS Sweep staff will be making the payment to the carrier AND that you will need to provide an invoice.*

Yes, the invoice is attached.Yes, but I don't have the invoice yet.
NET amount to pay to carrier
Payable to:
Surplus Lines Policy?*

YesNo
Premium Financed?*

YesNo
Premium Finance Company

Afco DirectOther
Broker Fee to agent (separate from commissions)*

YesNo
Agent Name and Amount*
Any Instructions on Commissions to be Withheld
Attach Invoices, premium finance agreements if applicable, and any related supporting documents. We pay most carriers through an online portal and need an Invoice to pay from.

Browse Files

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Additional Comments or Instructions
Should be Empty: