General Information For Rct-123 (Page 4 of 4) in pdf

RCT-123 – Line-by-Line Instruction

RCT-123-I (11-13)

Page 4 of 4

RCT-123 should be completed in the following order:

Step 1 - Complete the taxpayer information section and any applicable questions at the top of Page 1.

Step 2 - Enter the Revenue ID number and other taxpayer information in the designated fields at the top of each page.

Step 3 - Complete Page 3, Schedule B, Branch Offices.

Step 4 - Complete Page 2, Schedule A, Taxable Premiums.

Step 5 - Complete the Calculation of Tax at the top of Page 2.

Step 6 - Complete Page 1, Tax Liability, Payment and Overpayment sections.

Step 7 - Complete the corporate officer information section, sign and date at the bottom of Page 1.

Step 8 - Complete the preparer information section, sign and date at the bottom of Page 2, if applicable.

Step 9 - Mail the completed report and any supporting schedules to the PA Department of Revenue.

Step 10 - File a signed copy of all three pages of the RCT-123 tax report and the monthly 1620 reports electronically with the PA Surplus

Lines Association in the Electronic Filing System (EFS).

Page 3 - Schedule B - Branch Office

Complete Schedule B if the producer has multiple branch offices filing under the same FEIN.

Note: You are required to file a copy of each monthly 1620 report for each branch office that is reported on this schedule.

Customer Number - Enter the number assigned by the Pennsylvania Surplus Lines Association for each branch.

Address - Enter the address of each branch office.

Total Gross Premiums - Enter the total yearly gross premiums for each branch. This total MUST include returned and/or exempt premi-

ums; these adjustments are made in the next two columns.

Less Total Returned Premiums - Enter the total returned premiums for each branch.

Less Tax Exempt Premiums - Enter the total exempt premiums for each branch.

Gross Premiums Taxable - Enter the difference of total gross premiums less returned premiums less tax exempt premiums for each

branch. Taxable gross premiums cannot be less than zero.

Grand Totals - Enter the sum of all gross premiums taxable. This figure must reconcile to the total as reported on Page 2, Schedule A.

Tax Amount - Multiply the gross premiums taxable column by 0.03.

Grand Totals - Enter the sum of all tax amounts. This figure must reconcile to the total as reported on Page 2, Line 2.

Location of Risk - Enter the location(s) the risk will cover.

Note: If the policy involves risk located in multiple states which includes Pennsylvania, the taxable premium shall be levied as follows:

If Pennsylvania is the “home state” of the insured, the gross premiums 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.

Page 2 - Calculation of Taxable Gross Premiums

Schedule A - Taxable Gross Premiums

Monthly Premiums

Enter the taxable premiums as reported on the monthly 1620 reports for each of the 12 months. If there are multiple branches, this

will be the sum of all monthly 1620 reports for the respective month.

Revised

Check the appropriate box if a revised monthly 1620 report is included for any month.

Note: If the revised monthly 1620 report was submitted to the PSLA prior to filing the original RCT-123, provide the latest documents

and figures. If the original RCT-123 has been submitted prior to the revised monthly 1620 report, an amended RCT-123 must be filed

indicating what month(s) have been revised. The revised monthly 1620 report must be provided.

Multiple

Check the appropriate box if the producer has multiple branches in which multiple monthly 1620 reports are being filed for any month.

Total

Enter the sum of the taxable premiums for January through December. This must reconcile to the grand total gross premiums taxable

from Page 3, Schedule B.

Line 1-Taxable Premiums

Enter the total from Schedule A.

Line 2-Tax

Multiply Line 1 by 0.03. Carry the tax to RCT-123 Page, 1 Line 1.

General Information For Rct-123 Page 4

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