Form 306 - Estimated Premium Tax Report For New Mexico - 2012

Download a blank fillable Form 306 - Estimated Premium Tax Report For New Mexico - 2012 in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form 306 - Estimated Premium Tax Report For New Mexico - 2012 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

NEW MEXICO PUBLIC REGULATION COMMISSION
2012 Estimated Premium Tax Report for New Mexico
Filing Status:
Company Name: ______________________________________________________
Address: ______________________________________________________
______________________________________________________
Name or Address change
)
(Please note changes
NM Company Code: ______________
NAIC #: _____________
AMENDED return
Contact Person: ______________________________________
Phone: _____________________________________________
Email _____________________________________________
Filing Period:
st
th
Instructions
1
Quarter Due April 15
nd
th
2
Quarter Due July 15
* Make one check payable to “NMPRC Insurance Division”
rd
th
ue Oct.
3
Quarter D
15
th
th
* Do not inter-mingle premium tax credits with surtax credit
4
Quarter Due Jan. 15
* Complete form in blue or black ink
* Current New Mexico Premium Tax rate is 3.003%
For each Column enter the following:
Life/Health
Casualty
Property
Vehicle
54
54
78
78
1. 25% of tax due in preceding calendar
year............................................................
2. 80% of current tax due this quarter...........
3. Tax credit to be applied.............................
(This line is not to report your company’s credit balance)
4. Amount to be paid
(Greater of 1 or 2, minus 3).......................
Health Insurance Premium Surtax: See NMSA 1978, 59A-6-2 as amended, effective June 17, 2005.
All health insurers and plans shall complete the following:
Surtax
53
1. 25% of tax due in preceding calendar year..............................................
2. 80% of current tax due this quarter..........................................................
3. Tax credit to be applied............................................................................
4. Amount to be paid (Greater of 1 or 2, minus 3).......................................
UNSIGNED REPORTS WILL BE RETURNED
Check Number ______________
Signature of Preparer ___________________________
Check Amount $_____________
Date________________ Phone __________________
For Financial Audit Use
Form 306

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go