Form Dr-908 - Insurance Premium Taxes And Fees Return - 2014
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12DR-908
Florida Department of Revenue
R. 01/15
Insurance Premium Taxes and Fees Return
Rule 12B-8.003
For Calendar Year 2014
Florida Administrative Code
Effective 01/15
DOR USE ONLY
POSTMARK OR HAND-DELIVERY DATE
Florida
FEIN
Business Partner No.
Code
Original Return
Final Return
Name
Amended Return
Address
City/St/ZIP
Reason for amended or final return: _______________
_______________________________________________
Computation of Insurance Premium Taxes and Fees
US Dollars
Cents
,
,
1.
Total Premium Tax Due (Schedule I) .....................................................................................................
1.
,
,
2.
Credits Against the Tax (Schedule III) ...................................................................................................
2.
,
,
3.
Net Premium Tax Due (If Line 1 minus Line 2
equals less than zero, enter zero) .........................................................................................................
3.
,
,
4.
State Fire Marshal Regulatory Assessment (Schedule X) ......................................................................
4.
,
,
DR-908
5.
Wet Marine and Transportation Tax (Schedule XI) .................................................................................
5.
,
,
6.
Firefighters’ Pension Trust Fund (Schedule XII) .....................................................................................
6.
,
,
7.
Municipal Police Officers’ Retirement Trust Fund (Schedule XIII) ..........................................................
7.
,
,
8.
Retaliatory Tax (Schedule XIV) ...............................................................................................................
8.
,
,
9.
Filing Fees (Note:
Prepaid limited health service organizations, legal expense insurance corporations, and fraternal
9.
....................................
benefit societies must report and pay all filing fees to the Office of Insurance Regulation)
,
,
10.
Commercial/Residential Policy Surcharge (Schedule XVI)
10.
plus Payment Due from Refund (Schedule XVII) ....................................................................................
,
,
11.
11.
Total Tax Due (Sum of Line 3 through Line 10) ......................................................................................
Form DR-908 is a machine-readable form. Please follow the hand print or machine print instructions. Use black ink.
0 1 2 3 4 5 6 7 8 9
If hand printing this document, print your numbers as shown
If typing this document, type through the boxes and type all
0123456789
and write one number per box. Write within the boxes.
of your numbers together.
Payment Coupon 2014 Insurance Premium Taxes and Fees
Do not detach coupon.
DR-908
R. 01/15
To ensure proper credit to your account, enclose your check with tax return when mailing.
DR-908
Return is due March 1, 2015
Check here if you transmitted funds electronically
Enter name and address, if not pre-addressed:
US Dollars
Cents
,
,
Total amount due from
Line 16
,
,
Overpayment to be
Name
Refunded from Line 17
Address
FEIN
City/St/ZIP
Enter FEIN if not pre-addressed
Business Partner
Number
Do not write in the space below.
9100 0 20149999 0016045031 7 3999999999 0000 2
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