Instructions For Form M-11a - Fire Insurance Tax
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1Instructions for Form M-11a
Line 4
Minnesota ID number
Interest
Fill in 7 percent of total auto physical
Your Minnesota ID number is the seven-
When interest is due, it is computed on
damage or:
digit number assigned to you by the
the unpaid tax plus any penalties.
4a. 19 percent for comprehensive fire,
Department of Revenue. It’s important to
theft and miscellaneous (excluding
put your Minnesota ID number on your
Information and assistance
collision).
return so that any payments you make
If you need additional forms, informa-
4b. 35 percent for comprehensive fire,
are properly credited to your account.
tion or help to complete your return or
theft and miscellaneous with
If you do not have a Minnesota ID
supporting schedules, call (651) 297-2139
deductible (excluding collision).
number, you must apply for one. Call
or 1-800-657-3619.
4c. 75 percent for fire and theft
(651) 282-5225 or 1-800-657-3605.
combined.
Forms are also available from our
4d. 50 percent for fire, theft and
It is also important to fill in your federal
website at or
miscellaneous.
ID number and NAIC company number
from our St. Paul office at 600 North
4e. 100 percent for fire.
on your return, but not in place of your
Robert Street near the state capitol.
4f. Collision and others.
Minnesota number.
TTY users may contact the department
The latest available percentages devel-
through the Minnesota Relay Service at
Due dates
oped by casualty rating bureaus autho-
1-800-627-3529; ask for 1-800-657-3619.
Form M-11a must be filed for each
rized in Minnesota may be used instead
We’ll provide information in an alterna-
calendar year on or before March 1 of the
of the above percentages.
tive format upon request to persons with
following year.
disabilities.
The total auto physical damage premi-
The U.S. postmark date, or date recorded
ums listed by breakdown (a through f)
Line instructions
or marked by a designated delivery
should equal total auto physical damage
service, is considered the filing date
premiums on page 14 of your annual
On each line, fill in the amounts for fire
(private postage meter marks are not
statement.
premiums or use the following
valid). When the due date falls on a
percentages, whichever is the greater
Saturday, Sunday, or legal holiday,
Line 5
amount.
returns postmarked on the next business
Fill in 10 percent of aircraft physical
day are considered on time. When a
Line 1
damage.
return is filed late, the date it is received
Fill in 100 percent of fire premiums
at the Department of Revenue is treated
Line 6
written.
as the date filed.
Fill in 25 percent of nuclear energy
Line 2 (a, b and c)
physical damage insurance premium,
Penalties
1 percent of growing crops and/or crop
Fill in 35 percent of homeowners, farm
Late-payment. A penalty is due if part or
hail with fire, and/or fire portion of all
owners and commercial premiums
all of the tax is not paid by the due date.
other floater policies.
written.
The penalty is 5 percent of the unpaid tax
These percentages must be used unless
for any part of the first 30 days the
Line 2 (d)
the insurer can show that, according to its
payment is late and 5 percent for each
Fill in the greater of 40 percent of total
records, the percentage is actually
additional 30 days, up to 15 percent.
special multi-peril or 55 percent of the
different. Attach a detailed supporting
Late-filing. A late-filing penalty is added
Section 1 premiums (from line 5.1,
schedule.
to the late payment penalty and assessed
Minnesota state page 15).
on any unpaid tax if you file your return
after the due date.
Line 3
The late filing penalty is 5 percent of the
Fill in 15 percent of inland marine
unpaid tax. When added to the late
premiums.
payment penalty, the maximum com-
bined penalty is 20 percent.
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