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Accounting Division

Phone: (501) 371-2605

Fax: (501) 682-6679

Email: insurance.accounting@arkansas.gov

TO FILE ANNUAL PREMIUM TAX WITH A CHECK,

PLEASE DO THE FOLLOWING:

CLICK THE APPROPRIATE LINK BELOW, COMPLETE THE FORM ONLINE,

PRINT OFF, SIGN, & SEND WITH YOUR CHECK. PLEASE SIGN FORM IN

BLUE INK. ALL BLANKS ON THE FORM MUST BE COMPLETED.

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

We do not accept software company forms.

You must complete our form on our website.

Send form & payment to: Arkansas Insurance Department

Accounting Division

1200 West Third Street

Little Rock AR 72201-1904

2011 ANNUAL PREMIUM TAX FORMS

FORM AID AC LD-T

INSTRUCTIONS & FORM FOR FOREIGN LIFE & ACCIDENT & HEALTH INSURERS

FORM AID AC PC-T

INSTRUCTIONS & FORM FOR FOREIGN PROPERTY & CASUALTY INSURERS

FORM AID AC FPRF

INSTRUCTIONS & FORM FOR P&C INSURERS

FORM AID AC PC-T(D)

INSTRUCTIONS & FORM FOR DOMESTIC PROPERTY & CASUALTY INSURERS

FORM AID AC LD-T(D)

INSTRUCTIONS & FORM FOR DOMESTIC LIFE & ACCIDENT & HEALTH INSURERS

FORM AID AC HMO-T

INSTRUCTIONS & FORM FOR HEALTH MAINTENCE ORGANIZATIONS

FORM AID AC FMAA-T

INSTRUCTIONS & FORM FOR FARMERS MUTUAL AID ASSOCIATIONS

FORM AID AC HM-T

INSTRUCTIONS & FORM FOR HOSPITAL/MEDICAL SERVICE CORPORATIONS

FORM AID AC TI-T

INSTRUCTIONS & FORM FOR TITLE & AVIATION TITLE INSURANCE COMPANIES

FORM AID AC CI-T

INSTRUCTIONS & FORM FOR CAPTIVE INSURERS

FORM AID AC RRG-T

INSTRUCTIONS & FORM FOR REGISTERED RISK RETENTION GROUPS

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