Form In-1183 - Statement Of Premiums And Fees For Taxation - Health Maintenance Organizations - 2010 Page 3

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TENNESSEE STATUTES APPLICABLE TO PREMIUM TAXES
Tax on Premiums _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Tenn. Code Ann. § 56-32-124
Annual Statement Fling Fee _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Tenn. Code Ann. § 56-32-119
Renewal of Certificate of Authority Fee _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Tenn. Code Ann. § 56-32-119
Failure to File Tax Return Within Time Prescribed _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Tenn. Code Ann. § 56-4-216
HMO Annual Form Rev 12/2010
Page 3 of 3
FORM IN-1183

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