Form 207f Esa - Estimated Insurance Premiums Tax Payment Coupon Foreign And Nonresident Insurance Companies

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207F ESA
- First Installment
Organized Under Laws of
________________
Department of Revenue Services
Estimated Insurance Premiums Tax Payment Coupon
For Calendar Year Ending
Foreign and Nonresident Insurance Companies
State of Connecticut
PO Box 2990 Hartford CT 06104-2990
(Rev. 12/01)
CT Insurance Premiums Tax Reg. No.
1
Tax shown on 2001 Form 207F, Line 15
1
2
Multiply the tax that will be shown on 2002 Form 207F by 90% (.90)
2
Date Received (DRS USE ONLY)
3
Required annual payment (Enter the lesser of Line 1 or Line 2)
3
Federal Employer ID Number
4
Multiply Line 3 by 30% (.30)
4
5
Overpayment from prior year applied to this estimate
5
6
Payment due with this coupon (Subtract Line 5 from Line 4)
6
Please change
DueDate:
March 15
name or
Make Checks Payable To:
mailing
Commissioner of Revenue Services
address, or
both,
Mail To:
Department of Revenue Services
if shown
Processing Section
incorrectly
PO Box 2990
at right
Hartford CT 06104-2990
207F ESB
- Second Installment
Organized Under Laws of
________________
Department of Revenue Services
Estimated Insurance Premiums Tax Payment Coupon
For Calendar Year Ending
Foreign and Nonresident Insurance Companies
State of Connecticut
PO Box 2990 Hartford CT 06104-2990
(Rev. 12/01)
CT Insurance Premiums Tax Reg. No.
1
Tax shown on 2001 Form 207F, Line 15
1
2
Multiply the tax that will be shown on 2002 Form 207F by 90% (.90)
2
Date Received (DRS USE ONLY)
3
Required annual payment (Enter the lesser of Line 1 or Line 2)
3
Federal Employer ID Number
4
Multiply Line 3 by 60% (.60)
4
Amount paid with Form 207F ESA plus overpayment from prior year applied to
5
estimated tax for current year
5
6
Payment due with this coupon (Subtract Line 5 from Line 4)
6
Due Date:
June 15
Please change
name or
Make Checks Payable To:
mailing
Commissioner of Revenue Services
address, or
both,
Mail To:
Department of Revenue Services
if shown
Processing Section
incorrectly
PO Box 2990
at right
Hartford CT 06104-2990
207F ESC
- Third Installment
Organized Under Laws of
________________
Department of Revenue Services
Estimated Insurance Premiums Tax Payment Coupon
For Calendar Year Ending
Foreign and Nonresident Insurance Companies
State of Connecticut
PO Box 2990 Hartford CT 06104-2990
(Rev. 12/01)
CT Insurance Premiums Tax Reg. No.
1
Tax shown on 2001 Form 207F, Line 15
1
2
Multiply the tax that will be shown on 2002 Form 207F by 90% (.90)
2
Date Received (DRS USE ONLY)
3
Required annual payment (Enter the lesser of Line 1 or Line 2)
3
Federal Employer ID Number
4
Multiply Line 3 by 80% (.80)
4
Amount paid with Forms 207F ESA and 207F ESB plus overpayment from prior
5
year applied to estimated tax for current year
5
6
Payment due with this coupon (Subtract Line 5 from Line 4)
6
Please change
Due Date:
September 15
name or
mailing
Make Checks Payable To:
address, or
Commissioner of Revenue Services
both,
Mail To:
Department of Revenue Services
if shown
Processing Section
incorrectly
PO Box 2990
at right
Hartford CT 06104-2990

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