Form Ig255 - Nonadmitted Insurance Premium Tax Return For Direct Procured Insurance - 2017 Page 3
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42017 Form IG255 Instructions
For insurance tax laws, see Minnesota Statutes, Chapter 297I at
Payments
• a No Activity Return: Check only if you
You must complete and file Form IG255
if you are a person, firm, corporation, or
did not purchase any insurance directly
Electronic Payments
purchasing group buying insurance directly
from unlicensed companies in 2014.
If your total insurance taxes and surcharges
from a nonadmitted insurance company.
for the last 12-month period ending June
IG255 Page 2 Instructions
If you are working with an insurance broker,
30 is $10,000 or more, you are required to
the broker is responsible for filing the
Complete page 2 BEFORE page 1.
pay your tax electronically in all subsequent
surplus lines tax return for nonadmitted
A. NAIC Number
years.
insurance (Form IG260).
Enter the NAIC number.
You must also pay electronically if you’re
Filing Requirement
required to pay any Minnesota business tax
B. Name of Insurer
Effective on July 21, 2011, the NRRA (The
electronically, such as sales or withholding
Nonadmitted and Reinsurance Reform Act
List the insurers. Include policies for
tax.
of 2010) permits only the insured’s home
insurance companies without NAIC
To pay electronically, go to the department’s
state to require the payment of premium tax
numbers.
website at and
for nonadmitted insurance.
C. Policy Number
log in. If you do not have Internet access,
When Minnesota is the home state of the
call 1-800-570-3329 to pay by phone. You’ll
The policy number (modified by the
insured, as provided under section 297I.05,
need your ID number, and bank rout-
month and year that the policy was
subd. 7, 100 percent of the gross premiums
ing and account numbers. When paying
issued) is the controlling number for
are taxable in Minnesota with no allocation
electronically, you must use an account not
reporting direct-procedured insurance
of the tax to other states.
associated with any foreign banks.
policies and any subsequent activity dur-
“Home state” means the state in which an
ing the policy period, i.e., endorsements,
If you use other electronic payment methods,
insured maintains its principal place of
audits and/or cancellations.
such as ACH credit method or Fed Wire,
business, or in the case of an individual, the
instructions are available on our website or
D. Date of Coverage
individual’s principal residence.
by calling our Business Registration Office
Enter the policy coverage date.
at 651-282-5225 or 1-800-657-3605.
If 100 percent of the insured risk is located
outside of Minnesota, then the insured’s
E. Insurance Type Code
Check Payments
home state is the state to which the greatest
Enter the appropriate insurance type
If you’re not required to pay electronically
percentage of the insured’s taxable premium
code for each policy:
and are paying by check, visit our website
for that insurance contract is allocated.
at and click on
1. Fire
Due Date
“Make a Payment” and then “By check” to
2. Extended Coverage/Allied Lines
create a voucher. Print and mail the voucher
You must file Form IG255 and pay any tax
3. Homeowners/Commercial M.P.
due by March 1 of the following year. (M.S.
with a check made payable to Minnesota
297I.30, subd. 1)
Revenue.
4. Inland/Ocean Marine
5. Accident/Health
The U.S. postmark date, or date recorded or
When you pay by check, your check autho-
marked by a designated delivery service, is
rizes us to make a one-time electronic fund
6. Liability
considered the filing date (private postage
transfer from your account, and you may
7. Auto
meter marks are not valid). When the due
not receive your canceled check.
8. Fidelity/Surety
date falls on a Saturday, Sunday or legal
Note: If no amount is due or if you pay elec-
9. Burglary/Theft
holiday, returns and payments electronically
tronically, do not send in a voucher.
made or postmarked on the next business
10. Boiler/Machinery
day are considered timely. When a return
Penalties and Interest
11. Other (Specify)
or payment is late, the date it is received at
Late payment. If you do not pay all the tax
the Department of Revenue is treated as the
F. Amount Insured
due by the due date, a late payment pen-
date filed or paid.
alty is due. The penalty is 5 percent of the
Enter the amount insured.
unpaid tax for any part of the first 30 days
Extension for Filing Return. If good cause
G. Gross Premiums Paid
the payment is late, and 5 percent for each
exists, you may request a filing extension.
additional 30-day period, up to a maximum
Include all premiums paid by any in-
Instructions
of 15 percent.
sured with a home state of Minnesota.
Check Boxes
Late filing. Add a late filing penalty to
H. Return Premiums
At the top of the form, check if the return is:
the late payment penalty if your return is
Enter all return premiums received. In-
not filed by the due date. The penalty is
• an Amended Return: Check only if you
clude a note indicating on which return
5 percent of the unpaid tax. When added
are amending a previously filed return
the original policy was reported.
to the late payment penalty, the maximum
for the same period. Include all original
combined penalty is 20 percent.
and corrected policies on the amended
return.
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