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General Information for RCT-121B

RCT-121B-I (1-15)

Page 2 of 6

Report Due Date

This report is due April 15 for the preceding year ended Dec. 31. If April 15 falls on a Saturday, Sunday or holiday, the report is due the

next business day. The penalty imposed for failure to file timely reports is now a minimum of $500, regardless of the determined tax liabil-

ity, plus an additional 1 percent of any determined tax liability over $25,000.

Address Change

Enter “Y” in the block on Page 1 if the address of the corporation has changed from prior tax periods. The current mailing address should

be reflected on the report.

Correspondence to Preparer

Enter “Y” in the block on Page 1 if all correspondence (notices and requests for additional information) is to be sent to the preparer’s address.

If “Y” is entered, the address recorded on Page 2 will be used.

Amended Report

Enter “Y” in the block on Page 1 if you are filing an amended report to add, delete or adjust information. Provide documentation to support

all changes being made. An amended report should only be filed if an original report was filed previously for the same period.

An amended report must be filed within three years of the filed date of the original report. The department may adjust the tax originally

reported based on information from the amended report. The taxpayer must consent to extend the assessment period. If the amended report

is timely filed and the taxpayer consented to extend the assessment period, the time period in which to assess tax will be the greater of

three years from the filed date of the original report or one year from the filed date of the amended report.

Regardless of the tax year being amended, taxpayers must use the most current non-year-specific tax form, completing all sections of the

report. This includes those sections originally filed and those sections being amended. All tax liabilities should be recorded on Page 1.

Taxpayers must check the Amended Report check box on Page 1 and include Schedule AR, REV-1175, with the report

First Report

Enter “Y” in the block on Page 1 if this is the taxpayer’s first PA gross premiums tax filing.

Electronic Payment

Enter “Y” in the block on Page 1 if the taxpayer has made any electronic payments using e-TIDES.

KOZ/EIP Credit

Enter “Y” in the block on Page 1 if the corporate taxpayer is claiming the Keystone Opportunity Zone Credit, the Keystone Opportunity

Expansion Zone Credit or the Employment Incentive Payment Credit. For these and all other restricted credits, complete Line 4 on Page 1.

The following credits are available against gross premiums tax:

• Neighborhood Assistance Program Tax Credit

• Educational Improvement Tax Credit

• Employment Incentive Payment Credit

° Employment incentive payment credits are not posted to the account prior to assessment, therefore the account review state-

ment will reflect a debit balance until the credit is approved. Schedule W must be attached to claim this credit. Check the appro-

priate box if the corporate taxpayer is claiming the employment incentive payment credit.

• PA Life and Health Insurance Guaranty Association Credit

° To claim a credit for a PA life and health insurance guaranty association assessment, submit a copy of all pages of the assess-

ment invoice certificate of contribution for the first year the credit is claimed. Include a copy of the cancelled check indicating

that the assessment was paid. Include a copy of the Pennsylvania Business Page and Schedule T for the year immediately

preceding the year of the assessment and a schedule of all credits claimed for each type of assessment (i.e. life insurance,

accident and health annuity).

NOTE: This credit is only available for policies that guarantee premium rates without an increase

• Research Enhancement and Protection Tax Credit

Retaliatory Information Schedule

Retaliatory fees are imposed on foreign insurance companies under Section 212 of the Insurance Company Law of 1921 (P.L. 682, No.

284). Such fees are reported and remitted to the Department of Revenue.

Foreign insurance companies must complete the Retaliatory Information Schedule on Page 3 of RCT-121B, furnishing sufficient detail

to enable the Department of Revenue to calculate the retaliatory fee. For each premiums-based tax, show the tax rate and all items

used in determining the taxable amount, including gross premiums, return premiums and dividends to policyholders. Include reinsur-

ance assumed from unlicensed insurers if your state of domicile imposes a base tax on net direct premiums plus reinsurance assumed

from unlicensed insurers.

Any retaliatory fee in excess of the amount submitted and due with the filing of the report is due when the debtor receives a copy of

the assessment. If your state of incorporation imposes a franchise or income tax, submit a copy of the tax report as filed in your

state, along with a copy of the tax report on which Pennsylvania totals are substituted for your state totals. Please submit this infor-

mation to Pennsylvania within 30 days of filing in your state.

Payment for renewal of certificate of authority and filing fees should be made using a separate check only after a bill is received from

the Pennsylvania Insurance Department.

Include with the Retaliatory Information Schedule, a copy of the Pennsylvania Business Page, Schedule T filed with the Pennsylvania

Insurance Department and all supporting documentation.

Instructions For Form Rct-121b - Gross Premiums Tax Report For Foreign Life Or Foreign Title Insurance Companies Page 2

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