Form Ld-T - Annual Report Of Premiums,taxes And Fees Of Foreign Life And Accident And Health Insurance Companies - 2011

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2011 LD-T INSTRUCTIONS
ACCOUNTING DIVISION
STATE OF ARKANSAS
DEPARTMENT OF INSURANCE
FOREIGN LIFE, ACCIDENT AND HEALTH COMPANIES
IMPORTANT INFORMATION************************************************
It is necessary to include your 5-digit NAIC number in the spaces provided. Do not use the federal identification
number in place of your NAIC number.
If you are expecting a refund, please mark “REFUND DUE” on top of page 1.
You are required to file a copy of: 1) the Jurat’s Page 2) Annual Statement Direct Business Page reflecting Arkansas
premiums 3) Schedule T from the annual statement and 4) Proof of credits taken on filing.
GENERAL FILING INFORMATION & CHECKLIST
Completing the return:
The return must be typed or legible print on our forms. No Exceptions, we do not accept software company
forms or substitutions.
Forms
NO AUTHORITY EXISTS FOR GRANTING ANY EXTENSION OF TIME FOR FILING OR PAYMENT.
print on 8 ½ x 11 sheet of paper.
Sending in the return:
Mail your return and check to:
Arkansas Insurance Department
Attn: Accounting Division
1200 West Third Street
Little Rock, AR 72201-1904
If you overnight your return, use the same address. Do not include the instructions with your return and
remittance.
Contact Information: Phone: 501-371-2605
Website:
Filing Period:
For calendar year ending 12/31/11 the Annual tax forms, related premium taxes and filing fees are due on or before
March 1, 2011.
Postmark Dates:
The Arkansas Insurance Department does not accept the postmark date for filing requirements. All tax
forms must be received in our department on or before 03/01/12. If your company uses a carrier other than the U.S.
Postal Service, the Department still expects the filing on or before 03/01/11. All tax forms are subject to penalty ($100
a day) in accordance with ACA. 26-57-607.
DO NOT INCLUDE WITH THE PREMIUM TAX FILINGS:
CORPORATE FRANCHISE TAX
Remit to the Office of the Secretary of State, Attention: Lisa Bruno,
1401 Capitol Ave., Victory Bldg., Suite 250, Little Rock AR 72201.
MAIL TO ADDRESS ON THE FORM
MANDATORY L&H GUARANTY
If you have any questions, direct inquiries to (501) 371-2776 or
FUND INFORMATION SHEET
, click on Divisions, then Liquidation.
MAIL TO ADDRESS ON THE FORM
MANDATORY ARKANSAS
If you have any questions, direct inquiries to (501) 370-2659 or
COMPREHENSIVE HEALTH INS
POOL (CHIP)
MAIL TO ADDRESS ON THE FORM
1

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