Looking for a Pennsylvania Tax Forms And Templates? Download it for free!

Instructions For Rct-123 - Gross Premiums Tax - Surplus Lines Agents - Pennsylvania Department Of Revenue Page 4

Revised

have been revised. The revised monthly

Line 1 - Taxable Premiums

Check the appropriate box if a

Enter the total of taxable premiums

1620 report must be provided.

revised monthly 1620 report is

from Schedule A.

Multiple

included for any month.

Line 2 - Total Tax

Check the appropriate box if the

Multiply Line 1 by 0.03. Carry the tax to

NOTE: If the revised monthly

producer has multiple branches in which

multiple monthly 1620 reports are being

RCT-123 Page, 1 Line 1.

1620 report was submitted to the

filed for any month.

PSLA prior to filing the original RCT-123,

Tax liability cannot be less than zero.

provide the latest documents and fig-

Total of Taxable Premiums

ures. If the original RCT-123 has been

Enter the sum of the taxable premiums

submitted prior to the revised monthly

for January through December. This

1620 report, an amended RCT-123

must reconcile to the total of the

must be filed indicating what month(s)

monthly 1620s included with this report.

RCT-123

Instructions For Rct-123 - Gross Premiums Tax - Surplus Lines Agents - Pennsylvania Department Of Revenue Page 4