Form Ipe-2 - Estimate Of Insurance Premium Tax
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1Vermont Department of Taxes
Miscellaneous Tax Division
133 State Street; PO Box 547; Montpelier, VT 05601-0547
Phone: (802) 828-2551
F
orm
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ESTIMATE OF INSURANCE PREMIUM TAX
ermont
IPE-2
For tax year ___________
Company Name
FID #
Address
NAIC #
Annual
City, State, ZIP Code
$
Estimated
Tax
Filing period (select only one)
1st Quarter
2nd Quarter
3rd Quarter
(Due May 31)
(Due August 31)
(Due November 30)
1. Estimated or Actual Tax for this quarter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1.__________________________
2. Amount of this payment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.__________________________
Make checks payable to “Vermont Department of Taxes”
All companies, associations, or societies whose aggregate tax liability reasonably may be expected to exceed $500.00 for the
calendar year must make quarterly payments. Quarterly payments are due on or before the last day of the second calendar
month following the quarters ending March, June, September, and December. As provided in 32 V.S.A. §8553, the December
quarterly remittance shall be made annually and filed on the final reconciliation tax return (Form IP-1) on or before the last
day of February.
Companies, associations, or societies with an annual tax liability which may be reasonably expected to be less than
$500.00 are required to file VT Form IP-1 annually on or before the last day of February.
Please fully complete this form to ensure proper credit against your liability. If your tax liability is less than $500.00, you
may remit it along with the corresponding annual return.
I hereby certify that this return is true, correct, and complete to the best of my knowledge.
Signature of Responsible Officer
Printed Name
Date
Signature of Preparer (Other than Taxpayer)
Preparer’s Printed Name
Date
Telephone Number
PE
Form IPE-2
Rev. 10/11
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