Form T-71 - Insurance Companies Tax Return Of Gross Premiums - 2010
ADVERTISEMENT
1
2State of Rhode Island and Providence Plantations
Form T-71
INSURANCE COMPANIES TAX RETURN OF GROSS PREMIUMS
INSURANCE
for Calendar Year Ending December 31, 2009
2010
Due on or before March 1, 2010
NAME
ADDRESS
CITY
STATE
ZIP CODE
FEDERAL IDENTIFICATION NUMBER
.
STATE OR COUNTRY OF INCORPORATION OR ORGANIZATION
COMPANY TYPE: STOCK, MUTUAL OR PARTICIPATING
NOTE ATTACH LEGIBLE COPY OF SCHEDULE T AND SCHEDULE OF DIRECT BUSINESS IN THIS STATE FROM THE ANNUAL
STATEMENT SUBMITTED TO THE INSURANCE COMMISSIONER
Schedule A - Computation of Tax
a. Direct Premiums (Gross less return premiums from Schedule T, Part 1 of Annual
1a.
1.
Statement to Insurance Commissioner) ..................................................................................
b. Reinsurance assumed from companies not authorized to do business in Rhode Island
1b.
(covering property and risks in RI) .........................................................................................
2.
2.
TOTAL PREMIUMS - Add lines 1a and 1b ......................................................................................................................
Deductions
.
.
3
a. Dividends paid or credited to policyholders - Direct (Mutual & Mutual Plan Companies Only)
3a
b. Direct Ocean Marine Premiums (Gross less return premiums) .........................................
3b.
c. Capital Investments Deduction ...........................................................................................
3c.
4.
TOTAL DEDUCTIONS - Add lines 3a, 3b and 3c ...........................................................................................................
4.
Tax and Fee
5.
Net taxable premium (Line 2 minus line 4) .....................................................................................................................
5.
Amount
6.
a. Rhode Island Tax - 2% - Multiply Line 5 times 2% (0.02) ..................................................
6a.
6b.
b. Retaliatory Tax from page 2, Schedule B, Line 3 ...............................................................
7.
7.
FEES under Retaliatory Provisions from Page 2, Schedule C, Line 3 ...................................
8.
TOTAL TAX AND FEES DUE - ADD LINES 6a, 6b AND 7 ............................................................................................
8.
Credits and
.
.
9
RI Credits: Form #__________ $________ Form #__________ $__________ Form #__________ $____________
9
Payments
10.
TAX AFTER CREDITS - LINE 8 LESS LINE 9 ...............................................................................................................
10.
11.
a. Payments made on 2009 Declaration of Estimated Tax ....................................................
11a.
b. Other Payments .................................................................................................................
4.
11b.
12.
TOTAL PAYMENTS - Add lines 11a and 11b ..................................................................................................................
12.
Balance Due
13.
Net Tax Due - Line 10 minus Line 12 .............................................................................................................................
13.
14.
Interest Due ....................................................................................................................................................................
14.
15.
Total due with return - Add lines 13 and 14 ....................................................................................................................
15.
Refund
16.
Overpayment - Line 12 minus Line 10 ............................................................................................................................
16.
17.
Amount of overpayment to be applied to Estimated Tax for 2010 Calendar Year ..........................................................
17.
18.
Amount to be refunded - Line 16 minus Line 17 ............................................................................................................
18.
CERTIFICATION: This certification must be executed or the return must be sworn before some person authorized to administer oaths.
Under penalties of perjury, I hereby certify that I have personal knowledge of the statements and other information constituting this return, that the same are true, correct
and complete to the best of my knowledge and belief.
Date
Signature of authorized officer
Title
Date
Signature of preparer
Address of preparer
MAY THE DIVISION CONTACT YOUR PREPARER ABOUT THIS RETURN? YES
NO
Phone number
key #13
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form T-71 - Insurance Companies Tax Return Of Gross Premiums For Calendar Year Ending - Department Of Administration - Division Of Taxation - 2000
Legal
Related Categories
Parent category: Financial