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Accounting Division

Phone:  (501) 371-2605

Fax:  (501) 682-6679

Email:  insurance.accounting@arkansas.gov

 

TO FILE BY HARD COPY WITH A CHECK

CLICK THE APPROPRIATE LINK BELOW

FORMS CAN BE COMPLETED ONLINE AND PRINTED OFF TO SEND WITH YOUR CHECK

 

2011 QUARTERLY PREMIUM TAX FORMS

 

EST-Q    ESTIMATED INSURANCE PREMIUM TAX

             (FOR USE BY ALL INSURERS THAT ARE REQUIRED TO FILE QUARTERLY)

 

If an insurer is writing no business in the State of Arkansas, you may file all 3 quarters with the 1st quarterly

filing when it is due.  Photocopied signatures not allowed.

 

  

FPRF-Q    ESTIMATED FPRF PREMIUM TAX

               (FOR USE BY PROPERTY/CASUALTY INSURERS ONLY)

 

If an insurer is writing no business in the State of Arkansas, you may file all 3 quarters with the 1st quarterly

filing when it is due.  Photocopied signatures not allowed.

 

 

Forms & payments are due:         1st Quarter: Due May 15       

      2nd Quarter: Due August 15

      3rd Quarter: Due November 15

  

Mail form & payment to:      Arkansas Insurance Department

                                                    Accounting Division

                                                    1200 West Third Street

                                                    Little Rock AR  72201-1904

  

2010 ANNUAL PREMIUM TAX FORMS

 

Forms & payments are due by March 1st each year.

 

Mail form & payment to:      Arkansas Insurance Department

                                                   Accounting Division

                                                   1200 West Third Street

                                                   Little Rock AR  72201-1904

 

LD-T         INSTRUCTIONS & FORM FOR FOREIGN LIFE & ACCIDENT & HEALTH INSURERS

 

PC-T         INSTRUCTIONS & FORM FOR FOREIGN PROPERTY & CASUALTY INSURERS

 

FPRF        INSTRUCTIONS & FORM FOR P&C INSURERS

 

PC-T(D)    INSTRUCTIONS & FORM FOR DOMESTIC PROPERTY & CASUALTY INSURERS

 

LD-T(D)    INSTRUCTIONS & FORM FOR DOMESTIC LIFE & ACCIDENT & HEALTH INSURERS

 

HMO-T     INSTRUCTIONS & FORM FOR HEALTH MAINTENCE ORGANIZATIONS

 

FMAA-T    INSTRUCTIONS & FORM FOR FARMERS MUTUAL AID ASSOCIATIONS

 

HM-T       INSTRUCTIONS & FORM FOR HOSPITAL/MEDICAL SERVICE CORPORATIONS

 

TI-T         INSTRUCTIONS & FORM FOR TITLE & AVIATION TITLE INSURANCE COMPANIES

 

CI-T         INSTRUCTIONS & FORM FOR CAPTIVE INSURERS

 

RRG-T      INSTRUCTIONS & FORM FOR REGISTERED RISK RETENTION GROUPS

 

 

2010 ANNUAL CONTINUATION FEES

  

Forms & payments are due by March 1st each year.

 

 

Mail form & payment to:      Arkansas Insurance Department

                                                   Accounting Division

                                                   1200 West Third Street

                                                   Little Rock AR  72201-1904

 

 

FBS    INSTRUCTIONS & FORM FOR LICENSED FRATERNAL BENEFIT SOCIETIES

 

SLI-T  INSTRUCTIONS & FORM FOR APPROVED FOREIGN SURPLUS LINES INSURANCE COMPANIES

 

 

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