Form Rct-121-C - Gross Premium Tax - Pennsylvania Department Of Revenue - 2009 Page 4
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4RCT-121-C (I)
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Page
1213009401
PIGA CALCULATION WORKSHEET
INSURANCE COMPANY NAME: _______________________________________________ CORP TAX ACCOUNT ID: _______________
12/31/2009
FOR THE YEAR ENDING
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Basis for credit is the 2008 P&C Guaranty assessments paid less 1 percent of the 2005 assessment base.
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The assessment base is the portion of net direct written premiums used in calculation of the assessment.
SECTION A CALCULATION OF THE BASE
SECTION B ASSESSMENTS PAID
According to information from the Pennsylvania Property & Casualty Insurance
According to information from the Pennsylvania Property & Casualty Insurance
Guaranty Association, there were no assessment billings in 2008.
Guaranty Association, there were no assessment billings in 2008.
Amount
Date
Amount
1. Total Premiums Less Dividends
1. Assessments Other
2. Assessments Other
2. Less Auto Premiums (Less Dividends)
3.
3. Other Premiums (Less Dividends)
4. Total Paid Assessments Other
4. Exempt Premiums (Less Dividends)
5. Less: 1% of Assessment Base
a. Multiple Peril Crop (2.2)
(Section A, Line 7)
b. Federal Flood (2.3)
6. Total Credit
c. Mortgage Guaranty (6.0)
d. Ocean Marine (Line 8)
7. 20% per year (Line 6 X 0.2)
e. Financial Guaranty (Line 10)
f. Accident & Health (Lines 13-15.7)
g. Workers Compensation (Line 16)
SECTION C GUARANTY ASSOCIATION REFUNDS
h. Fidelity (Line 23)
Amount
i. Surety (Line 24)
j. Credit (Line 28)
1. 2006 Carry-Forward from 2008 report
k. Warranty
2. 2008 refund issued 12/22/2008
5. Total Exempt Premiums Other Less Dividends
3. Total
6. Total Premiums Less Dividends Other
7. 1% of Assessment Base
SECTION D
Please fill in prior year credits being carried forward.
Assessments Paid
2008
2009
2010
2011
2012
2013
2003
2004
2005
0
0
0
2006
0
0
0
0
2007
0
0
0
0
0
2008
0
0
0
0
0
Totals
Max credit allowed is limited to 2 percent of tax.
PIGA Credit
LESS REFUND TOTAL FROM SECTION C
REDUCTION CAN NOT EXCEED PIGA CREDIT.
NET PIGA CREDIT
CANNOT BE LESS THAN ZERO.
1213009401
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