1. (1)(a) A form is a file and use filing.

   1. (b) A form shall be submitted in PDF format.
   2. (c) A form shall be in final printed form and may not be submitted as a draft.
   3. (d) Blank spaces within a form shall be labeled accurately to represent purpose and use.
2. (2) A filing shall be submitted as an electronic filing via email at pcforms@utah.gov.

3. (3) A complete filing shall contain the following information, in the sequence listed.

   1. (a) The title of the email shall display the individual public adjuster or the public adjuster organization's name and that it is a public adjuster contract filing.

   2. (b) The filer shall certify that a filing is complete and compliant.

      1. (i) To certify, the following statement shall be included in the email: "BY SUBMITTING THIS FILING I CERTIFY THAT THE ATTACHED FILING HAS BEEN COMPLETED IN ACCORDANCE WITH UTAH ADMINISTRATIVE RULE R590-274 AND IS IN COMPLIANCE WITH APPLICABLE UTAH LAWS AND RULES."
      2. (ii) A filing may be rejected if the certification is false, missing, or incomplete.
      3. (iii) A false certification may subject the licensee to administrative action.

   3. (c) Provide a description of the filing, including:

      1. (i) the intent of the filing; and
      2. (ii) the purpose of each document within the filing.

   4. (d) Indicate if the filing:

      1. (i) is new; or
      2. (ii) is replacing or modifying a previous filing, describing the changes made, the reasons for the previous rejection, and the previous filing's Utah filed date.
   5. (e) Identify any provision that is unusual, innovative, controversial, or that was previously objected to or prohibited, and explain why the provision is included in the filing.

   6. (f) If the filing is being made on behalf of a resident or nonresident public adjuster organization, the email shall list each public adjuster individual conducting business on behalf of the public adjuster organization, including:

      1. (i) name;
      2. (ii) contact information; and
      3. (iii) license number.

KEY: insurance, public adjusters

Date of Last Change: June 23, 2026

Notice of Continuation: August 22, 2022

Authorizing, and Implemented or Interpreted Law: 31A-26-401; 31A-26-403