Form Lgt 140 - City, County, Or Urban County Government Insurance Premium Tax Annual Reconciliation Page 2

Download a blank fillable Form Lgt 140 - City, County, Or Urban County Government Insurance Premium Tax Annual Reconciliation 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 Lgt 140 - City, County, Or Urban County Government Insurance Premium Tax Annual Reconciliation 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

SECTION I (Continued)
Established
Premiums
Tax Payable
Collection Fee
Collected from
Additional Tax Due or
Tax Rate %
Collected
Retained
(Overpayment)
[(1) x (2)]
Policyholders
(1)
(2)
(4)
(6)
(3)
(5)
RD
3
QUARTER
Casualty
Fire & Allied Perils
Inland Marine
Life
Motor Vehicle
All Other Risks
Health (1)
Note
(1)
> Include only premiums received in the Metro Louisville Urban Service District (formerly the City of Louisville) on the Health Line.
Credits
(Form LGT 142)
Total
TH
4
QUARTER
Casualty
Fire & Allied Perils
Inland Marine
Life
Motor Vehicle
All Other Risks
Health (1)
Note
(1)
> Include only premiums received in the Metro Louisville Urban Service District (formerly the City of Louisville) on the Health Line.
Credits
(Form LGT 142)
Total
ANNUAL TOTALS
Casualty
Fire & Allied Perils
Inland Marine
Life
Motor Vehicle
All Other Risks
Health (1)
Note
(1)
> Include only premiums received in the Metro Louisville Urban Service District (formerly the City of Louisville) on the Health Line of
Insurance.
Credits
(Form LGT 142)
Total
SECTION II - COMPUTATION OF ADDITIONAL PAYMENT DUE
(Do not complete if no additional tax is due for any quarter.)
Quarter
Tax Balance Due
Annual Interest Rate
Interest Due
Total Tax and
Date Tax
Interest Due
Was Paid
1st
nd
2
3rd
4th
Total

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Form Lgt 140 - City, County, Or Urban County Government Insurance Premium Tax Annual Reconciliation Form Lgt 140 - City, County, Or Urban County Government Insurance Premium Tax Annual Reconciliation Financial
Form Ins 4 - Insurance Premium Tax Annual/reconciliation Return - 2002 Form Ins 4 - Insurance Premium Tax Annual/reconciliation Return - 2002 Financial
Form Ins-4 - Insurance Premium Tax Annual/reconciliation Return - 2003 Form Ins-4 - Insurance Premium Tax Annual/reconciliation Return - 2003 Financial
Form Lgt 141 - City, County, Or Urban County Government Quarterly Insurance Premium Tax Return Form Lgt 141 - City, County, Or Urban County Government Quarterly Insurance Premium Tax Return Financial
Form Ins-7 - Surplus Lines Premiums Tax Annual / Reconciliation Return - 2006 Form Ins-7 - Surplus Lines Premiums Tax Annual / Reconciliation Return - 2006 Financial
Form Ins-7 - Surplus Lines Premiums Tax Annual / Reconciliation Return - 2005 Form Ins-7 - Surplus Lines Premiums Tax Annual / Reconciliation Return - 2005 Financial
Form Ins-7 - Surplus Lines Premiums Tax Annual Reconciliation / Return - 2008 Form Ins-7 - Surplus Lines Premiums Tax Annual Reconciliation / Return - 2008 Financial
Form Ins-7 - Surplus Lines Premiums Tax Annual / Reconciliation Return - 2009 Form Ins-7 - Surplus Lines Premiums Tax Annual / Reconciliation Return - 2009 Financial
Form Ins-7 - Surplus Lines Premium Tax Annual / Reconciliation Return - 2004 Form Ins-7 - Surplus Lines Premium Tax Annual / Reconciliation Return - 2004 Financial
Form Ins-7 - Maine Revenue Services Surplus Lines Premiums Tax Annual Reconciliation / Return - 2010 Form Ins-7 - Maine Revenue Services Surplus Lines Premiums Tax Annual Reconciliation / Return - 2010 Financial

Related Categories

Parent category: Financial
Download
Go
Page of 5