Office of Insurance and Safety Fire CommissionerRalph T. Hudgens
Commissioner
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Domestic Life, HMO and Non-Profit Companies - 2014

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Form #2014 Dates To Remember This is in the Adobe Portable Document format (pdf)\nDivision: Premium TaxPublished: 2014
Title: Reminders
2014 Dates To Remember
PID:1064-SID:2738-FN:Reminder ONLY_rev_10092013.pdf

Form #GID-012-PT This is in the Adobe Portable Document format (pdf)\nDivision: Premium TaxPublished: 2014
Title: Annual Premium Tax Return
Annual Premium Tax Return
PID:1116-SID:2898-FN:GID-012-PT Annual PremiumTax Return_rev11122014.pdf

Form #GID-012A-PT This is in the Adobe Portable Document format (pdf)\nDivision: Premium TaxPublished: 2014
Title: Statement Of Quarterly Premium Tax
Statement Of Quarterly Premium Tax. Includes filing reminder dates.
PID:1070-SID:2775-FN:GID-012A-PT StmtQrtlyPremTaxWithReminder_rev_10092013.pdf

Form #GID-012V-PT This is in the Adobe Portable Document format (pdf)\nDivision: Premium TaxPublished: 2014
Title: Payment Voucher
When FILING quarterly or annual premium tax returns ELECTRONICALLY, complete this form and mail with your payment or payment ACH information. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us.
PID:1063-SID:2735-FN:GID-012V-PT Payment Voucher Only_10092013_rdr.pdf

Form #GID-014-PT This is in the Adobe Portable Document format (pdf)\nDivision: Premium TaxPublished: 2014
Title: Calculation for Abatement of Gross Premium Tax.
Calculation for Abatement of Gross Premium Tax.
PID:1105-SID:2858-FN:GID-014-PT CalcAbatementGrossPremTax_rev10212014.pdf

Form #GID-017A-PT This is in the Adobe Portable Document format (pdf)\nDivision: Premium TaxPublished: 2014
Title: Municipal License Fees Form.
Municipal License Fees Form.
PID:1107-SID:2864-FN:GID-017A-PT Municipal License Fees Form_rev10212014.pdf

Form #GID-050-PT This is in the Adobe Portable Document format (pdf)\nDivision: Premium TaxPublished: 2014
Title: Life and Health Guaranty Fund Tax Credit
Life and Health Guaranty Fund Tax Credit
PID:1108-SID:2866-FN:GID-050-PT 2014 Life and Health Guaranty Fund Tax Credit_rev10212014.pdf

Form #GID-203-PT This is in the Adobe Portable Document format (pdf)\nDivision: Premium TaxPublished: 2014
Title: Reconciliation Statement Annual Premium Tax Return.
Reconciliation Statement Annual Premium Tax Return.
PID:1111-SID:2875-FN:GID-203-PT 2014 Reconcil Stmt Annl Prem Tax Ret_Rev10152014.pdf

Form #GID-205-PT This is in the Adobe Portable Document format (pdf)\nDivision: Premium TaxPublished: 2014
Title: Insurance Premium Tax Credits.
Insurance Premium Tax Credits.
PID:1110-SID:2872-FN:GID-205-PT 2014 Ins Prem Tax Credits_rev10152014.pdf

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