Form 800ES 2018 Insurance Premiums License Tax Estimated Tax Payment Vouchers - Virginia

Form 800ES is a Virginia Department of Taxation form also known as the "Insurance Premiums License Tax Estimated Tax Payment Vouchers". The latest edition of the form was released in November 1, 2017 and is available for digital filing.

Download a fillable PDF version of the Form 800ES down below or find it on Virginia Department of Taxation Forms website.

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2018
Form 800ES
VIRGINIA DEPARTMENT OF TAXATION
INSURANCE PREMIUMS LICENSE TAX
ESTIMATED TAX PAYMENT VOUCHERS
GENERAL INFORMATION
Online Services
The Department’s website, www.tax.virginia.gov, has information to help you with your tax filing responsibilities.
eForms: File and pay your estimated tax online for free. Simply complete the online version of the paper estimated
voucher by entering the tax information as you would if you were completing a paper form.
Business iFile: An online version of the estimated voucher allows you to enter tax information as you would if you were
completing a paper form and schedule your date of payment.
EFT Credit: Electronically send your tax payment. See our Electronic Payment Guide for details.
Email Updates: Sign up to receive email updates on topics you select. You can even get reminders about upcoming
return due dates.
PDF Forms: Virginia tax forms are available to print or download.
Secure Email: Use our iFile Secure Message Center.
INSTRUCTIONS FOR 2018 FORM 800ES
DECLARATION OF ESTIMATED TAX FOR THE INSURANCE PREMIUMS LICENSE TAX
FILING REQUIREMENTS - Any company with annual direct gross premiums license tax liability that is expected to exceed
$3,000 (after tax credits) is required to file estimated payments. Declarations must be dated and signed by a company officer.
For more information, call (804) 404-4163.
WHERE TO FILE AND PAY - You can file and pay online at www.tax.virginia.gov. For paper filing, file the declaration with
the Virginia Department of Taxation, P.O. Box 26179, Richmond, VA 23260-6179. The declaration must be accompanied
by a check or money order made payable to the Virginia Department of Taxation for the amount of the installment due.
WHEN TO FILE AND PAY - Insurance companies should follow the declaration and payment schedule shown in the table
below.
FAILURE TO PAY - Underpayment of estimated insurance premiums license tax will generally result in an addition to the
tax from the due date of the install ment until paid, or until the due date for filing the annual return, whichever is earlier. If the
company has an underpayment of estimated tax and believes an addition to the tax should not be assessed, Form 800C,
Underpayment of Virginia Estimated Premiums License Tax, must be enclosed with the company’s premiums license tax
return along with schedules that support the applicable exception.
OTHER INQUIRIES - Call (804) 404-4163 or write Virginia Department of Taxation, P.O. Box 715, Richmond, VA
23218-0715. Do not mail returns to this address.
DECLARATION AND PAYMENT SCHEDULE
The date the declaration is to be filed and the number and amount of installments to be paid is determined in accordance with
the following table.
The following percentages of the estimated tax must be
The number of
If the requirements are first
The declaration must be
paid on or before the 15th day of —
installments to be paid
met—
filed on or before—
is—
April
June
September
December
before the 1st day of the 4th
4
April 15
25%
25%
25%
25%
month of the taxable year
after the last day of the 3rd month
3
and before the 1st day of the 6th
June 15
.......
33 1/3%
33 1/3%
33 1/3%
month of the taxable year
after the last day of the 5th month
2
and before the 1st day of the 9th
September 15
.......
.......
50%
50%
month of the taxable year
after the last day of the 8th month
1
and before the 1st day of the 12th
December 15
.......
.......
.......
100%
month of the taxable year
Va. Dept. of Taxation 2616001 Rev. 11/17
Page 1
2018
Form 800ES
VIRGINIA DEPARTMENT OF TAXATION
INSURANCE PREMIUMS LICENSE TAX
ESTIMATED TAX PAYMENT VOUCHERS
GENERAL INFORMATION
Online Services
The Department’s website, www.tax.virginia.gov, has information to help you with your tax filing responsibilities.
eForms: File and pay your estimated tax online for free. Simply complete the online version of the paper estimated
voucher by entering the tax information as you would if you were completing a paper form.
Business iFile: An online version of the estimated voucher allows you to enter tax information as you would if you were
completing a paper form and schedule your date of payment.
EFT Credit: Electronically send your tax payment. See our Electronic Payment Guide for details.
Email Updates: Sign up to receive email updates on topics you select. You can even get reminders about upcoming
return due dates.
PDF Forms: Virginia tax forms are available to print or download.
Secure Email: Use our iFile Secure Message Center.
INSTRUCTIONS FOR 2018 FORM 800ES
DECLARATION OF ESTIMATED TAX FOR THE INSURANCE PREMIUMS LICENSE TAX
FILING REQUIREMENTS - Any company with annual direct gross premiums license tax liability that is expected to exceed
$3,000 (after tax credits) is required to file estimated payments. Declarations must be dated and signed by a company officer.
For more information, call (804) 404-4163.
WHERE TO FILE AND PAY - You can file and pay online at www.tax.virginia.gov. For paper filing, file the declaration with
the Virginia Department of Taxation, P.O. Box 26179, Richmond, VA 23260-6179. The declaration must be accompanied
by a check or money order made payable to the Virginia Department of Taxation for the amount of the installment due.
WHEN TO FILE AND PAY - Insurance companies should follow the declaration and payment schedule shown in the table
below.
FAILURE TO PAY - Underpayment of estimated insurance premiums license tax will generally result in an addition to the
tax from the due date of the install ment until paid, or until the due date for filing the annual return, whichever is earlier. If the
company has an underpayment of estimated tax and believes an addition to the tax should not be assessed, Form 800C,
Underpayment of Virginia Estimated Premiums License Tax, must be enclosed with the company’s premiums license tax
return along with schedules that support the applicable exception.
OTHER INQUIRIES - Call (804) 404-4163 or write Virginia Department of Taxation, P.O. Box 715, Richmond, VA
23218-0715. Do not mail returns to this address.
DECLARATION AND PAYMENT SCHEDULE
The date the declaration is to be filed and the number and amount of installments to be paid is determined in accordance with
the following table.
The following percentages of the estimated tax must be
The number of
If the requirements are first
The declaration must be
paid on or before the 15th day of —
installments to be paid
met—
filed on or before—
is—
April
June
September
December
before the 1st day of the 4th
4
April 15
25%
25%
25%
25%
month of the taxable year
after the last day of the 3rd month
3
and before the 1st day of the 6th
June 15
.......
33 1/3%
33 1/3%
33 1/3%
month of the taxable year
after the last day of the 5th month
2
and before the 1st day of the 9th
September 15
.......
.......
50%
50%
month of the taxable year
after the last day of the 8th month
1
and before the 1st day of the 12th
December 15
.......
.......
.......
100%
month of the taxable year
Va. Dept. of Taxation 2616001 Rev. 11/17
Page 1
Estimated Tax Worksheet
(This is your record ‑ retain for your files)
Estimated Direct Gross
Rate
Initial Premiums
Premiums
License Tax
LIFE & ACCIDENT and HEALTH INSURANCE COMPANIES:
Life
$
.00
X 2.25% =
$
.00
Disability & Double Indemnity
$
.00
X 2.25% =
$
.00
Accident & Sickness
$
.00
X 2.25% =
$
.00
Industrial Sick Benefit
$
.00
X 1.00% =
$
.00
TOTAL
$
.00
$
.00
FIRE, CASUALTY, and TITLE INSURANCE COMPANIES:
All lines of insurance (except Workers’ Compensation) less divi-
dends to policyholders of Mutual Insurance Companies.
$
.00
X 2.25% =
$
.00
1. Complete the Estimated Tax Worksheet below to compute your estimated tax for 2018.
A. Estimated tax payable this year from above worksheet. Enter this amount on Line 2 of the voucher ..................... 1A. $
.00
B. If first filing is on or before:
April   15, 2018 enter 1/4 of Line 1A here.
June 15, 2018 enter 1/3 of Line 1A here.
Sept. 15, 2018 enter 1/2 of Line 1A here.
Dec. 15, 2018 enter amount on Line 1A here. ......................................................................................................... 1B. $
.00
2. Enter the estimated payment amount from Line 1B (above), on Line 3 of the first voucher.
3. The amount of SUBSEQUENT installment payments due (to be shown on Line 2 of the appropriate voucher) will be the amount shown
on Line 1B (above).
HOW TO COMPLETE THE FORM 800ES VOUCHERS
1. Enter your Virginia tax account number.
2. Enter the federal employer identification number, NAIC / license number, name, address, city, state, and ZIP Code on each voucher.
3. Enter on Line 2 of the voucher the amount shown on Line 1A of the worksheet.
4. Enter on Line 3 of the voucher the amount of your payment shown on Line 1B of the worksheet.
5. Sign the first voucher you file and detach. You need not sign SUBSEQUENT vouchers UNLESS you are amending your estimate.
6. Enclose a check or money order made payable to the Virginia Department of Taxation to the voucher and mail it to the Virginia Department
of Taxation, P.O. Box 26179, Richmond, VA 23260-6179. PRINT YOUR VIRGINIA TAX ACCOUNT NUMBER ON YOUR CHECK OR
MONEY ORDER. Fill in the following Estimated Tax Payment Record for your own personal tax record.
7. For each SUBSEQUENT installment, enter your payment on Line 3 of the voucher, enclose your check or money order before mailing
it. Be sure to print your Virginia tax account number on your check or money order.
HOW TO AMEND FORM 800ES
If it is necessary to amend Form 800ES, follow these steps:
1. Fill out the Amended Computation schedule below.
2. Enter the revised amounts of estimated tax and payment from Line 4 below on the NEXT voucher due.
3. File online or sign the voucher, detach, and mail with required payment on or before required due date.
4. For each subsequent installment, enter the payment on Line 3 of the voucher, and enclose a check or money order before mailing. Be
sure to print your Virginia tax account number on your check or money order.
Amended Computation
(Use if estimated tax is changed after declaration has been filed.)
AMOUNT
1.
Amended estimated tax. (Enter here and on Line 2 of the
.00
next voucher due.) ................................................................
$
2.
Payments made or credits applied against 2018
.00
declaration .............................................................................
$
3.
Unpaid balance (Line 1 minus Line 2) ..................................
.00
$
4.
Amount to be paid (Line 3 divided by number of remaining
installments). Enter here and on Line 3 of the next
voucher due...........................................................................
.00
$
Page 2
2018 ESTIMATED TAX PAYMENT RECORD
CHECK OR MONEY
AMOUNT OF CREDIT
DATE
AMOUNT
TOTAL AMOUNT PAID
ORDER NO.
APPLIED
PAYMENT MADE
WITH DECLARATION
$
00 $
00 $
00
SECOND PAYMENT
$
00 $
00 $
00
THIRD PAYMENT
$
00 $
00 $
00
FOURTH PAYMENT
$
00 $
00 $
00
TOTALS
$
00 $
00 $
00
Please cut along dashed lines below.
File Vouchers in Number Sequence
Order 1, 2, 3, 4.
Do not submit this entire page.
Virginia Insurance Premiums License Tax
2018
VOUCHER 2
Form 800ES
Estimated Payment Voucher
Due 6/15/2018
(DOC ID 800)
Virginia Department of Taxation
P.O. Box 26179, Richmond, VA 23260-6179
If you file electronically, do not
(804) 404-4163
Office Use
file this voucher.
/
/
0000000000000000 8008888 000000 02
39-
VA Account Number
2018
1. Taxable Year
FEIN
NAIC/License #
Company Name
2. Estimated tax
.
00
for the year ...... $
Address (Number and Street)
3. Amount of this
l
.
00
payment ........... $
City, State, and ZIP Code
— Do not write below this line. —
I declare that this declaration has been examined by me and to the best of my knowledge and belief, is true, correct, and complete.
Signature
Date
Phone
Virginia Insurance Premiums License Tax
2018
VOUCHER 1
Form 800ES
Estimated Payment Voucher
(DOC ID 800)
Due 4/15/2018
Virginia Department of Taxation
P.O. Box 26179, Richmond, VA 23260-6179
If you file electronically, do not
(804) 404-4163
file this voucher.
Office Use
/
/
0000000000000000 8008888 000000 01
39-
2018
VA Account Number
1. Taxable Year
FEIN
NAIC/License #
2. Estimated tax
Company Name
00
.
for the year ...... $
Address (Number and Street)
3. Amount of this
l
.
00
payment ........... $
City, State, and ZIP Code
— Do not write below this line. —
I declare that this declaration has been examined by me and to the best of my knowledge and belief, is true, correct, and complete.
Page 3
Signature
Date
Phone
Please cut along
dashed lines below.
File Vouchers in Number Sequence
Order 1, 2, 3, 4.
Do not submit this entire page.
Virginia Insurance Premiums License Tax
2018
VOUCHER 4
Form 800ES
Estimated Payment Voucher
Due 12/15/2018
(DOC ID 800)
Virginia Department of Taxation
P.O. Box 26179, Richmond, VA 23260-6179
If you file electronically, do not
(804) 404-4163
Office Use
file this voucher.
/
/
0000000000000000 8008888 000000 04
39-
2018
VA Account Number
1. Taxable Year
FEIN
NAIC/License #
Company Name
2. Estimated tax
.
00
for the year ...... $
Address (Number and Street)
3. Amount of this
l
payment ........... $
.
00
City, State, and ZIP Code
— Do not write below this line. —
I declare that this declaration has been examined by me and to the best of my knowledge and belief, is true, correct, and complete.
Signature
Date
Phone
Virginia Insurance Premiums License Tax
2018
VOUCHER 3
Form 800ES
Estimated Payment Voucher
Due 9/15/2018
(DOC ID 800)
Virginia Department of Taxation
If you file electronically, do not
P.O. Box 26179, Richmond, VA 23260-6179
(804) 404-4163
file this voucher.
Office Use
/
/
0000000000000000 8008888 000000 03
39-
2018
VA Account Number
1. Taxable Year
FEIN
NAIC/License #
2. Estimated tax
Company Name
00
.
for the year ...... $
Address (Number and Street)
3. Amount of this
l
payment ........... $
.
00
City, State, and ZIP Code
— Do not write below this line. —
I declare that this declaration has been examined by me and to the best of my knowledge and belief, is true, correct, and complete.
Page 4
Signature
Date
Phone

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