Instructions for Form RCT-122 Gross Premiums Tax - Premiums Paid to Unauthorized Foreign Insurance Companies

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Pennsylvania Department of Revenue
Instructions for RCT-122
Gross Premiums Tax - Premiums Paid to Unauthorized Foreign Insurance Companies
RCT-122 I (04-16)
Department, to 180 Sheree Blvd.,
Imposition, Base and Rate
GENERAL INFORMATION
Ste. 3100, Exton, PA 19341.
Gross premiums tax for premiums paid
to unauthorized foreign or alien insur-
REMINDER
One extension coupon, REV-426,
ance companies is imposed on the
THE RCT-122 REPORT CANNOT
will be used for all specialty taxes.
insured rather than on the insurance
INCLUDE MORE THAN ONE
The coupon and the tax report will
carrier. Anyone who enters into a
MONTH
no longer be mailed. These forms
contract of insurance or reinsurance with
are available as fill-in documents on
All payments of $1,000 or more
a foreign or alien insurer not licensed to
the
department’s
website
at
must be made electronically or by
do business in Pennsylvania is subject to
www.revenue.pa.gov. The REV-
certified or cashier’s check remitted
the tax on insurance premiums. The tax
426 extension coupon can be filed
in person or by express mail
is imposed at 2 percent of life insurance
electronically through e-TIDES at
courier.
and annuity gross premiums and 3
www.etides.state.pa.us. How-
Use only whole dollars when
percent on premiums for all other types
ever, electronic filing of the tax
preparing tax reports.
of insurance. The tax must be remitted
report is not available. The report
should be completed using the
to the Pennsylvania Department of Rev-
Taxpayers may request a 60-day
computer-based fill-in form, printed
enue when the insured enters into the
extension to file this report by filing
and submitted by mail to the
insurance contract and makes a periodic
REV-426.
department. The form can be saved
payment. Insurance companies author-
NOTE: The automatic PA ex-
electronically for your records.
ized to do business in Pennsylvania are
tension provided by Act 52 of
subject to a tax on gross premiums of
The tax liability reported on RCT-
2013 to those with valid federal
reinsurance when the reinsurance is with
122 cannot be less than zero;
extensions DOES NOT apply to this
companies not authorized to do business
instead the taxpayer must file a
tax.
in Pennsylvania. For more information,
petition for refund.
The penalty imposed for failure to
see Act of July 6, 1917, P.L. 723, as
Annual Report Checklist: Make sure
file timely reports is now a minimum
amended by the Act of Jan. 24, 1966.
you include the following to file your
of $500, regardless of the deter-
Location of Risk
annual report properly and completely:
mined tax liability, plus an additional
If the policy involves risk located in
1 percent of any determined tax
Negative amounts must be written
multiple states including Pennsylvania,
liability over $25,000.
using a minus sign preceding the
the taxable premium shall be levied as
number. Do not use parentheses.
Use ONLY the most current, non-
follows:
year-specific tax form and instruc-
Complete RCT-122, Gross Premiums
If Pennsylvania is the home state of the
tions for filing ALL tax years. If an
Tax Report, for premiums paid to
insured, the gross premium shall be
amended report must be filed,
unauthorized foreign insurance com-
taxpayers must use the most
taxable to Pennsylvania. For more infor-
panies, associations, exchanges, etc.
current, non-year-specific tax
mation see 40 P.S. § 991.1602, 40 P.S.
Complete Schedule A and Schedule
form, completing all sections of
§ 991.1621 and 40 P.S. § 991.1622.
B (Include any cancelled policies)
the form. REV-1175, Schedule
Revenue ID, Federal Employer
AR (explanation for amending),
Corporate officer’s/insured’s signa-
Identification Number (FEIN),
must be included when filing an
ture on Page 1 and preparer’s
Parent Corporation FEIN, Name
amended report.
signature and PTIN on Page 2, if
and Address
applicable
RCT-122 is available as a fill-in form
The Revenue ID number, FEIN, name
on the department’s website at
and complete mailing address must be
A signed copy of the RCT-122 tax
www.revenue.pa.gov.
provided. If the taxpayer is a subsidiary
report must be sent to the Pennsyl-
of a corporation, the parent corporation’s
vania Surplus Lines Association on
A signed copy of the RCT-122 tax
FEIN must be provided. Also provide the
report must be sent to the Pennsyl-
behalf of the Pennsylvania Insur-
telephone number and email address of
vania Surplus Lines Association on
ance Department, to 180 Sheree
behalf of the Pennsylvania Insurance
Blvd., Ste. 3100, Exton, PA 19341
the taxpayer.
www.revenue.pa.gov
RCT-122
1
Pennsylvania Department of Revenue
Instructions for RCT-122
Gross Premiums Tax - Premiums Paid to Unauthorized Foreign Insurance Companies
RCT-122 I (04-16)
Department, to 180 Sheree Blvd.,
Imposition, Base and Rate
GENERAL INFORMATION
Ste. 3100, Exton, PA 19341.
Gross premiums tax for premiums paid
to unauthorized foreign or alien insur-
REMINDER
One extension coupon, REV-426,
ance companies is imposed on the
THE RCT-122 REPORT CANNOT
will be used for all specialty taxes.
insured rather than on the insurance
INCLUDE MORE THAN ONE
The coupon and the tax report will
carrier. Anyone who enters into a
MONTH
no longer be mailed. These forms
contract of insurance or reinsurance with
are available as fill-in documents on
All payments of $1,000 or more
a foreign or alien insurer not licensed to
the
department’s
website
at
must be made electronically or by
do business in Pennsylvania is subject to
www.revenue.pa.gov. The REV-
certified or cashier’s check remitted
the tax on insurance premiums. The tax
426 extension coupon can be filed
in person or by express mail
is imposed at 2 percent of life insurance
electronically through e-TIDES at
courier.
and annuity gross premiums and 3
www.etides.state.pa.us. How-
Use only whole dollars when
percent on premiums for all other types
ever, electronic filing of the tax
preparing tax reports.
of insurance. The tax must be remitted
report is not available. The report
should be completed using the
to the Pennsylvania Department of Rev-
Taxpayers may request a 60-day
computer-based fill-in form, printed
enue when the insured enters into the
extension to file this report by filing
and submitted by mail to the
insurance contract and makes a periodic
REV-426.
department. The form can be saved
payment. Insurance companies author-
NOTE: The automatic PA ex-
electronically for your records.
ized to do business in Pennsylvania are
tension provided by Act 52 of
subject to a tax on gross premiums of
The tax liability reported on RCT-
2013 to those with valid federal
reinsurance when the reinsurance is with
122 cannot be less than zero;
extensions DOES NOT apply to this
companies not authorized to do business
instead the taxpayer must file a
tax.
in Pennsylvania. For more information,
petition for refund.
The penalty imposed for failure to
see Act of July 6, 1917, P.L. 723, as
Annual Report Checklist: Make sure
file timely reports is now a minimum
amended by the Act of Jan. 24, 1966.
you include the following to file your
of $500, regardless of the deter-
Location of Risk
annual report properly and completely:
mined tax liability, plus an additional
If the policy involves risk located in
1 percent of any determined tax
Negative amounts must be written
multiple states including Pennsylvania,
liability over $25,000.
using a minus sign preceding the
the taxable premium shall be levied as
number. Do not use parentheses.
Use ONLY the most current, non-
follows:
year-specific tax form and instruc-
Complete RCT-122, Gross Premiums
If Pennsylvania is the home state of the
tions for filing ALL tax years. If an
Tax Report, for premiums paid to
insured, the gross premium shall be
amended report must be filed,
unauthorized foreign insurance com-
taxpayers must use the most
taxable to Pennsylvania. For more infor-
panies, associations, exchanges, etc.
current, non-year-specific tax
mation see 40 P.S. § 991.1602, 40 P.S.
Complete Schedule A and Schedule
form, completing all sections of
§ 991.1621 and 40 P.S. § 991.1622.
B (Include any cancelled policies)
the form. REV-1175, Schedule
Revenue ID, Federal Employer
AR (explanation for amending),
Corporate officer’s/insured’s signa-
Identification Number (FEIN),
must be included when filing an
ture on Page 1 and preparer’s
Parent Corporation FEIN, Name
amended report.
signature and PTIN on Page 2, if
and Address
applicable
RCT-122 is available as a fill-in form
The Revenue ID number, FEIN, name
on the department’s website at
and complete mailing address must be
A signed copy of the RCT-122 tax
www.revenue.pa.gov.
provided. If the taxpayer is a subsidiary
report must be sent to the Pennsyl-
of a corporation, the parent corporation’s
vania Surplus Lines Association on
A signed copy of the RCT-122 tax
FEIN must be provided. Also provide the
report must be sent to the Pennsyl-
behalf of the Pennsylvania Insur-
telephone number and email address of
vania Surplus Lines Association on
ance Department, to 180 Sheree
behalf of the Pennsylvania Insurance
Blvd., Ste. 3100, Exton, PA 19341
the taxpayer.
www.revenue.pa.gov
RCT-122
1
Tax Year
amended, taxpayers must use the most
Preparer’s Information
Enter month and year (MM/YYYY) for
current non-year-specific tax form,
Paid preparers must sign and date the
tax year end.
completing all sections of the report.
tax report. If the preparer works for a
This includes those sections originally
firm, provide the name, FEIN and
Report Due Date
filed and those sections being amended.
address of the firm along with the
The report is due within 30 days after
All tax liabilities should be recorded on
name, telephone number, email address
the last day of the month in which the
Page 1.
Taxpayers must check the
and PTIN/SSN of the individual prepar-
insurance was procured. If multiple pur-
Amended Report check box on Page 1
ing the report. If the preparer is an
chases of such insurance are expected
and include Schedule AR, REV-1175,
individual without any association to a
to occur more than once during a
with the report.
firm, provide the name, address, tele-
particular month, only one tax report
phone number, email address and
should be prepared summarizing each
First Report
PTIN/SSN of the individual preparing
day’s transaction and submitted upon
Enter “Y” in the block on Page 1 if this is the
the report.
closing of the month. The beginning
taxpayer’s first PA gross premiums tax filing.
date of all policies must be the same as
Extension Request Due Date
Electronic Payment
the file month indicated. The penalty
To request a due date extension of up
Enter “Y” in the block on Page 1 if the
imposed for failure to file timely reports
to 60 days to file the report, you must
taxpayer has made any electronic
is now a minimum of $500, regardless
file an extension request, REV-426, by
payments using e-TIDES.
of the determined tax liability, plus an
the original report due date. However,
additional 1 percent of any determined
Final Report
an extension of time to file does not
tax liability over $25,000.
NOTE: If you wish to remain active,
extend the deadline for payment of tax,
Address Change
do not mark the report as final.
and an extension request must be
Enter “Y” in the block on Page 1 if the
accompanied by payment of taxes owed
Do not file a final report if you wish
address of the corporation has changed
for the taxable year for which the exten-
to remain active. Rather, file a zero
from prior tax periods. The current
sion is requested. Mail the extension
report accompanied by a statement
mailing address should be reflected on
coupon separately from all other forms.
indicating no policy or policies were
the report.
A taxpayer using an electronic method
purchased or renewed during this
Correspondence to Preparer
to make a payment with an extension
period.
Enter “Y” in the block on Page 1 if all
request should not submit the extension
If this report will be the final report
correspondence (notices and requests
coupon. Do not use the extension
filed with the department, enter Y
for additional information) is to be sent
coupon to remit other unpaid liabilities
in the block on Page 1 and indicate
to the preparer’s address. If “Y” is
within the account.
the effective date of the event as
entered, the address recorded on Page
Payment and Mailing Information
MMDDYYYY.
2 will be used.
All payments of $1,000 or more must be
Include a letter with the tax report
Amended Report
made electronically or by certified or
Enter “Y” in the block on Page 1 if you
verifying no policy or policies were
cashier’s check remitted in person or by
are filing an amended report to add,
placed or renewed and no other
express mail courier. Failure to make a
delete or adjust information. Provide
insurance policy was obtained from
payment by an approved method will
documentation to support all changes
a company not authorized or admit-
result in the imposition of a 3 percent
being made. An amended report should
ted by the Pennsylvania Insurance
penalty of the tax due, up to $500. For
only be filed if an original report was
Department.
more information on electronic filing
filed previously for the same period.
options, visit www.etides.state.pa.us.
Include a copy of the regulatory
An amended report must be filed within
Payments under $1,000 may be remit-
authority’s approval of the merger,
three years of the filed date of the orig-
ted by mail, made payable to the PA
dissolution, plan of reorganization
inal report. The department may adjust
Department of Revenue.Mail payments,
and/or
articles
of
merger,
if
the tax originally reported based on in-
extension requests and Tax Report,
applicable.
formation from the amended report.
RCT-122, to the following address:
Provide the Revenue ID and FEIN of
The taxpayer must consent to extend
PA DEPARTMENT OF REVENUE
the surviving entity, if applicable.
the assessment period. If the amended
327 WALNUT ST FL 3
report is timely filed and the taxpayer
Corporate Officer Information
PO BOX 280407
consented to extend the assessment
A corporate officer/insured must sign
HARRISBURG PA 17128-2005
period, the time period in which to
and date the tax report. The signature
assess tax will be the greater of three
Current Period Overpayment
must be original; photocopies or faxes
years from the filed date of the original
If an overpayment exists on Page 1 of
will not be accepted. Print the first and
report or one year from the filed date of
the RCT-122, the taxpayer must instruct
last name, title, Social Security number,
the amended report.
the department to refund or transfer
telephone number and email address of
Regardless of the tax year being
the corporate officer/insured.
overpayment as indicated below.
www.revenue.pa.gov
RCT-122
2
Refund: Identify the amount to refund
Requests for transfer of credit may
PAGE 3
from the current tax period overpay-
be faxed to the Accounting Division
ment. Prior to any refund, the depart-
at 717-705-6227.
SCHEDULE A AND/OR SCHEDULE B
ment will offset current period liabilities
If you have questions regarding
Complete Schedule A for life insurance
and other unpaid liabilities within the
extensions, call the Extension Unit at
and annuities and Schedule B for all
account.
717-705-6225 (Option 4). Requests
other types of insurance.
Transfer: Identify the amount to
can be faxed to 717-705-6227.
Name of Insurance Company - Enter
transfer from the current tax period
If you have questions regarding tax
the name of the unauthorized foreign or
overpayment to the next tax period.
assessments, determinations or fil-
alien insurance company used to
Prior to any transfer, the department
ing requirements, call the Specialty
procure the policy.
will offset current period liabilities and
Tax Unit at 717-783-6031 (Option
other unpaid liabilities within the
7, then Option 2).
Location of Risk - Enter the location(s)
account.
the risk will cover.
If you have general business tax
NOTE: If no option is selected,
questions, call 717-787-1064.
Note: If the policy involves risk
the department will automatically
located in multiple states includ-
If you have questions regarding
transfer any overpayment to the next
ing Pennsylvania, the taxable premium
filing a copy of this report to the
tax year after offsetting current period
shall be levied as follows:
Pennsylvania Surplus Lines Associa-
liabilities and other unpaid liabilities
tion, call the Pennsylvania Surplus
within the account.
If Pennsylvania is the home state of the
Lines Association at 610-594-1340 or
insured, the gross premium shall be
A tax period overpayment summary will
visit their website at www.pasla.org.
taxable to Pennsylvania. For more infor-
be mailed to the taxpayer confirming
mation see 40 P.S. § 991.1602, 40 P.S.
the disposition of the credit.
LINE INSTRUCTIONS
§ 991.1621 and 40 P.S. § 991.1622.
Requests for Refund or Transfer of
RCT-122 should be completed in
Policy Number - Enter the policy number.
Available Credit
the following order:(Page instruc-
Requests for refund or transfer of
Beginning Date of Policy and Term
tions start with Page 3 below.)
available credit from prior periods can
- Enter the beginning date and term of
Step 1 - Complete the taxpayer infor-
be faxed on company letterhead, signed
the policy. The beginning date of all poli-
mation section and any applicable
by an authorized representative, to
cies must be the same as the file month
questions at the top of Page 1.
717-705-6227.
indicated on Page 1 of RCT-122.
Step 2 - Enter the Revenue ID and other
Requests can also be submitted in writ-
Type of Insurance - Enter the type of
taxpayer information in the designated
ing to the following address:
insurance being procured, life or annu-
fields at the top of each page.
ity, in Schedule A only, and all others in
PA DEPARTMENT OF REVENUE
Step 3 - Complete Page 3, Schedule A
Schedule B.
PO BOX 280701
and/or Schedule B.
HARRISBURG PA 17128-0701
Amount of Insurance - Enter the
Step 4 - Complete Page 2, Calculation
amount of the insurance policy.
Please do not duplicate requests for
of Tax.
refund and/or transfer by submitting
Gross Premiums - Enter the amount
Step 5 - Complete Page 1, Lines 1
both
RCT-122
and
written
of gross premiums on the policy.
through 10.
correspondence.
Total - Enter the total amount of insur-
Step 6 - Complete the corporate officer
CONTACT INFORMATION
ance and gross premiums for each
information section, sign and date at
To
make
payments
and
file
schedule.
the bottom of Page 1.
extensions
electronically,
visit
e-TIDES at www.etides.state.pa.us.
Include cancelled policies in the Policies
Step 7 - Complete the preparer infor-
For additional information and as-
Cancelled section of Schedule A and/or
mation section, sign and date at the
sistance with electronic payments
Schedule B.
bottom of Page 2, if applicable.
and extensions, call 717-705-6225
Step 8 - Mail the completed report and
PAGE 2
(Option 6).
any supporting schedules to the PA
To confirm account payments, call
Department of Revenue.
CALCULATION OF TAx
1-888-PATAXES (1-888-728-2937).
Step 9 - Send a signed copy of the RCT-
LIFE INSURANCE AND ANNUITIES
If you have questions regarding
122 to the Pennsylvania Surplus Lines
Line 1 - Total Gross Premiums on
payments or refunds, call the Ac-
Association on behalf of the Pennsylvania
counting Division at 717-705-6225
Life Insurance and Annuities
Insurance Department, to 180 Sheree
(Option 5, then Option 1).
Blvd., Ste. 3100, Exton, PA 19341.
(Schedule A)
www.revenue.pa.gov
RCT-122
3
Enter the total gross premiums on life
ALL OTHER TYPES OF INSURANCE
Line 7 - Taxable Gross Premiums
insurance and annuities reported on
(OTHER THAN LIFE INSURANCE
on All Other Types of Insurance
Page 3, Schedule A.
AND ANNUITIES)
Subtract Line 6 from Line 5.
Line 2 - Total of Premiums
Line 8 - Tax on Taxable Gross
Line 5 - Total Gross Premiums on
Returned on Cancelled Policies of
Premiums on All Other Types of
All Other Types of Insurance
Life Insurance and Annuities
Insurance
(Schedule B)
Enter the total premiums returned on
Multiply Line 7 by 0.03.
Enter the total gross premiums on all
cancelled policies of life insurance and
other types of insurance reported on
Line 9 - Total Tax
annuities. A schedule identifying the
Page 3, Schedule B.
Enter the sum of Lines 4 and 8. Carry
name of the insurance company, location
to RCT-122, Page 1, Line 1.
Line 6 - Total of Premiums Returned
of risk, policy number, beginning date of
on Cancelled Policies of All Other
policy, date of cancellation, type of insur-
Tax liability cannot be less than zero.
Types of Insurance
ance and amount of cancellation for each
Enter the total premiums returned on
cancelled policy of life insurance and an-
cancelled policies of all other types of
nuities must be provided. Adjustment for
insurance. A schedule identifying the
cancelled policies cannot reduce taxable
name of the insurance company, loca-
gross premiums to less than zero.
tion of risk, policy number, beginning
Line 3 - Taxable Gross Premiums
date of policy, date of cancellation, type
on Life Insurance and Annuities
of insurance and amount of cancellation
Subtract Line 2 from Line 1.
for each cancelled policy of all other
types of insurance must be provided.
Line 4 - Tax on Taxable Gross
Adjustment for cancelled policies cannot
Premiums on Life Insurance and
reduce taxable gross premiums to less
Annuities
than zero.
Multiply Line 3 by 0.02.
www.revenue.pa.gov
RCT-122
4

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