Form Ipe-2 - Estimate Of Insurance Premium Tax
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1Detach this voucher and mail to Vermont
Form IPE-2
VOUCHER 3
Nov. 30, 2007
Department of Taxes on or before due date.
State of Vermont
Instructions on reverse.
2007 ESTIMATE OF INSURANCE PREMIUM TAX
Vermont Department of Taxes, 133 State Street, Montpelier, VT 05633-1401
FID # _______________________
NAIC # ______________________
Annual Estimated Tax $ ___________________
See reverse for instructions
Company Name and Address
1. Estimated or Actual
Tax (3rd Quarter) . . . . . . . . . $ __________________
2. Amount of This Payment . . $ __________________
Make checks payable to: VERMONT DEPARTMENT OF TAXES
I hereby certify this return is true, correct, and complete to the
best of my knowledge.
Signature of Preparer Other Than Taxpayer
Date
Signature of Responsible Officer
Date
Preparer’s Printed Name
Preparer’s Telephone number
Detach this voucher and mail to Vermont
Form IPE-2
VOUCHER 2
Aug. 31, 2007
Department of Taxes on or before due date.
Instructions on reverse.
State of Vermont
2007 ESTIMATE OF INSURANCE PREMIUM TAX
Vermont Department of Taxes, 133 State Street, Montpelier, VT 05633-1401
FID # _______________________
NAIC # ______________________
Annual Estimated Tax $ ___________________
See reverse for instructions
Company Name and Address
1. Estimated or Actual
Tax (2nd Quarter) . . . . . . . . $ __________________
2. Amount of This Payment . . $ __________________
Make checks payable to: VERMONT DEPARTMENT OF TAXES
I hereby certify this return is true, correct, and complete to the
best of my knowledge.
Signature of Preparer Other Than Taxpayer
Date
Signature of Responsible Officer
Date
Preparer’s Printed Name
Preparer’s Telephone number
Form IPE-2
Detach this voucher and mail to Vermont
VOUCHER 1
May 31, 2007
Department of Taxes on or before due date.
Instructions on reverse.
State of Vermont
2007 ESTIMATE OF INSURANCE PREMIUM TAX
Vermont Department of Taxes, 133 State Street, Montpelier, VT 05633-1401
FID # _______________________
NAIC # ______________________
Annual Estimated Tax $ ___________________
See reverse for instructions
Company Name and Address
1. Estimated or Actual
Tax (1st Quarter) . . . . . . . . . $ __________________
2. Amount of This Payment . . $ __________________
Make checks payable to: VERMONT DEPARTMENT OF TAXES
I hereby certify this return is true, correct, and complete to the
best of my knowledge.
Signature of Preparer Other Than Taxpayer
Date
Signature of Responsible Officer
Date
Preparer’s Printed Name
Preparer’s Telephone number
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