Form 74a101 - Insurance Premiums Tax Return - Commonwealth Of Kentucky - 2001 Page 2

SECTION II—REPORT OF PREMIUMS PAID TO AUTHORIZED REINSURANCE COMPANIES

Name of Authorized

Amounts of

Address

Reinsurance Company

Premiums Paid

Total Premiums Paid to Authorized Reinsurance Companies During Calendar Year 2001 .............

INSTRUCTIONS

•

This return must be filed by every Domestic Mutual, Domestic Mutual Fire or Cooperative and Assessment Fire Insurance Company

pursuant to KRS 299.530 and KRS 304.4-030.

•

Complete Section I by listing the name, address and amounts of premiums paid to each unauthorized reinsurance company during the

preceding calendar year.

•

Compute your tax liability by multiplying Total Premiums in Section I by 2 percent (.02).

•

Complete Section II to report premiums paid to authorized reinsurance companies during the preceding calendar year.

•

File this return on or before March 1, 2002.

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For additional information, contact the Revenue Cabinet at (502) 564-4810.

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