General Information For Rct-121b Page 2

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General Information for RCT-121B
RCT-121B-I (11-13)
Page 2 of 6
Report Due Date
This report is due April 15 for the preceding year ended Dec. 31. If April 15 falls on a Saturday, Sunday or holiday, the report is due the
next business day. A penalty for late filing will be imposed as follows and assessed at the time of filing: 10 percent of the first $1,000 of tax
liability, 5 percent of the next $4,000 of tax liability and 1 percent on any tax liability in excess of $5,000.
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.
Correspondence to Preparer
Enter “Y” in the block on Page 1 if all correspondence (notices and requests for additional information) is to be sent to the preparer’s address.
If “Y” is entered, the address recorded on Page 2 will be used.
Amended Report
Enter “Y” in the block on Page 1 if you are filing an amended report to add, delete or adjust information. Provide documentation to support
all changes being made. An amended report should only be filed if an original report was filed previously for the same period.
An amended report must be filed within three years of the filed date of the original report. The department may adjust the tax originally
reported based on information from the amended report. The taxpayer must consent to extend the assessment period. If the amended report
is timely filed and the taxpayer consented to extend the assessment period, the time period in which to assess tax will be the greater of
three years from the filed date of the original report or one year from the filed date of the amended report.
When filing an amended report, record the amended tax liability on Page 1, Lines 1a & b or Lines 1c & d. REV-1175, Schedule AR, must be
included when filing an amended report.
First Report
Enter “Y” in the block on Page 1 if this is the taxpayer’s first PA gross premiums tax filing.
Electronic Payment
Enter “Y” in the block on Page 1 if the taxpayer has made any electronic payments using e-TIDES.
KOZ/EIP Credit
Enter “Y” in the block on Page 1 if the corporate taxpayer is claiming the Keystone Opportunity Zone Credit, the Keystone Opportunity
Expansion Zone Credit or the Employment Incentive Payment Credit. For these and all other restricted credits, complete Line 4 on Page 1.
The following credits are available against gross premiums tax:
• Neighborhood Assistance Program Tax Credit
• Educational Improvement Tax Credit
• Employment Incentive Payment Credit
° Employment incentive payment credits are not posted to the account prior to assessment, therefore the account review state-
ment will reflect a debit balance until the credit is approved. Schedule W must be attached to claim this credit. Check the appro-
priate box if the corporate taxpayer is claiming the employment incentive payment credit.
• PA Life and Health Insurance Guaranty Association Credit
° To claim a credit for a PA Life and Health Insurance Guaranty Association Assessment, submit a copy of the assessment invoice
certificate of contribution for the first year the credit is claimed. Submit all pages. Include a copy of the Pennsylvania Business
Page, Schedule T for the year immediately preceding the year of the assessment and a schedule of all credits claimed for each
type of assessment (i.e. life insurance, accident and health insurance annuity). Note, this credit is only allowed for policies that
guarantee premium rates without increase.
• PA Property and Casualty Insurance Guaranty Association (PIGA) Credit
• Research Enhancement and Protection Tax Credit
Retaliatory Information Schedule
Retaliatory fees are imposed on foreign insurance companies under Section 212 of the Insurance Company Law of 1921 (P.L. 682, No.
284). Such fees are reported and remitted to the Department of Revenue.
Foreign insurance companies must complete the Retaliatory Information Schedule on Page 3 of RCT-121B, furnishing sufficient detail
to enable the Department of Revenue to calculate the retaliatory fee. For each premiums-based tax, show the tax rate and all items
used in determining the taxable amount, including gross premiums, return premiums and dividends to policyholders. Include reinsur-
ance assumed from unlicensed insurers if your state of domicile imposes a base tax on net direct premiums plus reinsurance assumed
from unlicensed insurers.
Any retaliatory fee in excess of the amount submitted and due with the filing of the report is due when the debtor receives a copy of
the assessment. If your state of incorporation imposes a franchise or income tax, submit a copy of the tax report as filed in your
state, along with a copy of the tax report on which Pennsylvania totals are substituted for your state totals. Please submit this infor-
mation to Pennsylvania within 30 days of filing in your state.
Payment for renewal of certificate of authority and filing fees should be made using a separate check only after a bill is received from
the Pennsylvania Insurance Department.
Include with the Retaliatory Information Schedule, a copy of the Pennsylvania Business Page, Schedule T filed with the Pennsylvania
Insurance Department and all supporting documentation.

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