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Accounting Division Phone: (501) 371-2605 Fax: (501) 682-6679 |
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TO FILE QUARTERLY 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: 1st
Quarter: Due May 15 2nd
Quarter: Due August 15 3rd
Quarter: Due November 15 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 2012 QUARTERLY PREMIUM TAX
FORMS
FORM AID AC EST-Q ESTIMATED
INSURANCE PREMIUM TAX ONLY
LIFE & HEALTH, PROPERTY & CASUALTY, HMO, FMAA, HM, & TITLE
INSURERS ARE
REQUIRED TO FILE THIS FORM. CAPTIVES,
RISK RETENTION GROUPS, & SURPLUS LINES INSURERS DO
NOT FILE THIS FORM. 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. MUST BE WET SIGNATURE IN BLUE INK. FORM AID AC FPRF-Q ESTIMATED FPRF
PREMIUM TAX ONLY PROPERTY &
CASUALTY INSURERS FILE THIS FORM. LIFE & HEALTH, HMO,
FMAA, HM, TITLE, CAPTIVES, RISK
RETENTION GROUPS, & SURPLUS LINES INSURERS DO NOT FILE THIS FORM. 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. MUST BE WET SIGNATURE IN BLUE INK. |
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