New York Codes, Rules and Regulations
Title 11 - INSURANCE
Chapter II - Agents, Brokers And Adjusters
Part 29 - Special Prohibitions
Section 29.5 - Disclosure statement required

(a) Except as provided in subdivision (c) of this section, any licensee who receives any fees and/or commissions, or shares thereof, in connection with any insurance services rendered to, or insurance coverages placed or serviced on behalf of, a governmental unit, shall file, with the department and the most senior official of the governmental unit who ordered the insurance services or coverages, a completed Governmental Insurance Disclosure Statement, affirmed by the licensee as true under penalties of perjury, on the prescribed form set forth in Exhibit B in section 29.6 of this Part, which statement after filing shall be a public record.

(b) Every statement required by subdivision (a) of this section shall be filed with the department on or before April 15 in each year with respect to fees and/or commissions, or shares thereof, received as of the preceding December 31. A general agent, as defined in this Part, shall not be required to file a Governmental Insurance Disclosure Statement with respect to insurance coverages placed in his, her, or its capacity as a general agent, or on account of which commissions or shares thereof are paid to another insurance agent or insurance broker who ordered such coverages from said general agent.

(c) Pursuant to Insurance Law section 2128(b), a title insurance agent shall not be required to file a Governmental Insurance Disclosure Statement if an industrial development agency, state of New York mortgage agency or its successor, or any similar type of entity, is the named insured under the policy and is a mortgagee with respect to the property insured.