Instructions For Form Rct-122 - Gross Premiums Tax Report

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General Information for RCT-122
RCT-122-I (1-15)
Page 1 of 5
NEW FOR 2014
The penalty imposed for failure to file timely reports is now a minimum of $500, regardless of the determined tax liability, plus an addition-
al 1 percent of any determined tax liability over $25,000
REMINDER
• All payments of $1,000 or more must be made electronically.
• Use only whole dollars when preparing tax reports.
• Taxpayers may request a 60-day extension to file this report by filing REV-426.
NOTE: The automatic PA extension provided by Act 52 of 2013 to those with valid federal extensions DOES NOT apply to this tax.
• Revenue ID: A corporation’s Revenue ID is a unique 10-digit number assigned by the department to a taxpayer, separate from any
federally issued identification number(s) or Pennsylvania license number(s).
• Use ONLY the most current, non-year-specific tax form and instructions for filing ALL tax years. If an amended report must be
filed, taxpayers must use the most current, non-year-specific tax form, completing all sections of the form. REV-1175,
Schedule AR (explanation for amending), must be included when filing an amended report.
• RCT-122 is available as a fill-in form on the department’s website at
• A signed copy of the RCT-122 tax report must be sent to the Pennsylvania Surplus Lines Association on behalf of the Pennsylvania
Insurance Department, to 180 Sheree Blvd., Ste. 3100, Exton, PA 19341.
• One extension coupon (REV-426) will be used for all specialty taxes. The coupon and the tax report will no longer be mailed. These
forms are available as fill-in documents on the department’s website at The REV-426 extension coupon can
be filed electronically through e-TIDES at ww.etides.state.pa.us. However, electronic filing of the tax report is not available. The
report should be completed using the computer-based fill-in form, printed and submitted by mail to the department. The form can
be saved electronically for your records.
• The tax liability reported on RCT-122 cannot be less than zero; instead the taxpayer must file a petition for refund.
Annual Report Checklist: Make sure you include the following to file your annual report properly and completely:
• Negative amounts must be written using a minus sign preceding the number. Do not use parentheses.
• Complete RCT-122, Gross Premiums Tax Report, for premiums paid to unauthorized foreign insurance companies, associations,
exchanges, etc.
• Separate schedule identifying any premiums returned on cancelled policies
• Corporate officer’s/insured’s signature on Page 1 and preparer’s signature and PTIN on Page 2, if applicable
• A signed copy of the RCT-122 tax report must be sent to the Pennsylvania Surplus Lines Association on behalf of the Pennsylvania
Insurance Department, to 180 Sheree Blvd., Ste. 3100, Exton, PA 19341
Imposition, Base and Rate
Gross premiums tax for premiums paid to unauthorized foreign or alien insurance companies is imposed on the insured rather than on the
insurance carrier. Anyone who enters into a contract of insurance or reinsurance with a foreign or alien insurer not licensed to do business
in Pennsylvania is subject to the tax on insurance premiums. The tax is imposed at 2 percent of life insurance and annuity gross premiums
and 3 percent on premiums for all other types of insurance. The tax must be remitted to the Pennsylvania Department of Revenue when
the insured enters into the insurance contract and makes a periodic payment. Insurance companies authorized to do business in
Pennsylvania are subject to a tax on gross premiums of reinsurance when the reinsurance is with companies not authorized to do business
in Pennsylvania. For more information, see Act of July 6, 1917, P.L. 723, as amended by the Act of Jan. 24, 1966.
Location of Risk
If the policy involves risk located in multiple states including Pennsylvania, the taxable premium shall be levied as follows:
If Pennsylvania is the home state of the insured, the gross premium shall be taxable to Pennsylvania. For more information see 40 P.S. §
991.1602, 40 P.S. § 991.1621 and 40 P.S. § 991.1622.
Revenue ID, Federal Employer Identification Number (FEIN), Parent Corporation FEIN, Name and Address
The Revenue ID number, FEIN, name and complete mailing address must be provided. If the taxpayer is a subsidiary of a corporation, the
parent corporation’s FEIN must be provided. Also provide the telephone number and email address of the taxpayer.
Tax Year
Enter month and year (MM/YYYY) for tax year end.
Report Due Date
The report is due within 30 days after the last day of the month in which the insurance was procured. If multiple purchases of such insur-
ance are expected to occur more than once during a particular month, only one tax report should be prepared summarizing each day’s trans-
action and submitted upon closing of the month. The beginning date of all policies must be the same as the file month indicated. The penal-
ty imposed for failure to file timely reports is now a minimum of $500, regardless of the determined tax liability, plus an additional 1 per-
cent of any determined tax liability over $25,000.
Address Change
Enter “Y” in the block on Page 1 if the address of the corporation has changed from prior tax periods. The current mailing address should
be reflected on the report.

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