(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.