Form Ipe-2 - Estimate Of Insurance Premium Tax - 2005
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1Detach This Voucher and Mail to
Form IPE-2
VOUCHER 3
Nov. 30, 2005
Vermont Department of Taxes
on or Before Due Date.
State of Vermont
2005 ESTIMATE OF INSURANCE PREMIUM TAX
Vermont Department of Taxes, 109 State Street, Montpelier, VT 05609-1401
Tax Paid with Voucher is
Actual
Estimated
Annual Estimated Tax $ _________________
Company Name and Address
1. Estimated or Actual
Tax (September Quarter) . . . $ __________________
2. Amount of This Payment . . $ __________________
I hereby certify this return is true, correct, and complete to the best of my knowledge.
_____________________________________________________
___________________________________________________
Signature of Preparer Other Than Taxpayer
Date
Signature of Responsible Officer
Date
Form IPE-2
Detach This Voucher and Mail to
VOUCHER 2
Aug. 31, 2005
Vermont Department of Taxes
on or Before Due Date.
State of Vermont
2005 ESTIMATE OF INSURANCE PREMIUM TAX
Vermont Department of Taxes, 109 State Street, Montpelier, VT 05609-1401
Tax Paid with Voucher is
Actual
Estimated
Annual Estimated Tax $ _________________
1. Estimated or Actual
Company Name and Address
Tax (June Quarter) . . . . . . . $ __________________
2. Amount of This Payment . . $ __________________
I hereby certify this return is true, correct, and complete to the best of my knowledge.
_____________________________________________________
___________________________________________________
Signature of Preparer Other Than Taxpayer
Date
Signature of Responsible Officer
Date
Form IPE-2
Detach This Voucher and Mail to
VOUCHER 1
May 31, 2005
Vermont Department of Taxes
on or Before Due Date.
State of Vermont
2005 ESTIMATE OF INSURANCE PREMIUM TAX
Vermont Department of Taxes, 109 State Street, Montpelier, VT 05609-1401
Tax Paid with Voucher is
Actual
Estimated
Annual Estimated Tax $ _________________
Company Name and Address
1. Estimated or Actual
Tax (March Quarter) . . . . . . $ __________________
2. Amount of This Payment . . $ __________________
I hereby certify this return is true, correct, and complete to the best of my knowledge.
_____________________________________________________
___________________________________________________
Signature of Preparer Other Than Taxpayer
Date
Signature of Responsible Officer
Date
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