Form Ig255 - Nonadmitted Insurance Premium Tax Return For Direct Procured Insurance - 2012 Page 3
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42012 Form IG255 Instructions
For insurance tax laws, see Minnesota Statutes, Chapter 297I at
Instructions
You must complete and file Form IG255,
G. Gross Premiums Paid
Statement of Insurance Placed with Nonad-
Include all premiums paid by any insured
Check Boxes
mitted Insurers, if you are a person, firm,
with a home state of Minnesota.
At the top of the form, check if the return is:
corporation or purchasing group buying
H. Return Premiums
• an Amended Return: Check only if you
insurance directly from a nonadmitted
are amending a previously filed return for
company.
Enter all return premiums received.
the same period. Include all original and
Include a note indicating on which return
For 2012, the tax is 2 percent of the gross
corrected policies on the amended return.
the original policy was reported.
premiums paid. (M.S. 2971.05)
• for No Activity: Check only if you did not
Payments
Filing Requirement
purchase any insurance from unlicensed
companies in 2012.
Electronic Payments
Effective on July 21, 2011, the NRRA (The
If your total insurance taxes and surcharges
Nonadmitted and Reinsurance Reform Act
IG255 Page 2 Instructions
for the last 12-month period ending June 30
of 2010) permits only the insured’s home
is $10,000 or more, you are required to pay
state to require the payment of premium tax
Complete page 2 BEFORE page 1.
your tax electronically.
for nonadmitted insurance.
A. NAIC Number
You must also pay electronically if you’re
When Minnesota is the home state of the
Enter the NAIC number.
required to pay any Minnesota business tax
insured, as provided under section 297I.05,
B. Name of Insurer
electronically, such as sales or withholding
subd. 7, 100 percent of the gross premiums
List the insurers. Include policies for
tax.
are taxable in Minnesota with no allocation
insurance companies without NAIC
of the tax to other states.
To pay over the Internet, go to the depart-
numbers.
ment’s website at
“Home state” means the state in which an
C. Policy Number
and login. If you don’t have Internet access,
insured maintains its principal place of
call 1-800-570-3329 to pay by phone. You’ll
business, or in the case of an individual, the
The policy number (modified by the
need your ID number, and bank rout-
individual’s principal residence.
month and year that the policy was
ing and account numbers. When paying
issued) is the controlling number for
If 100 percent of the insured risk is located
electronically, you must use an account not
reporting direct-procedured insurance
outside of the state, then the insured’s home
associated with any foreign banks.
policies and any subsequent activity dur-
state is the state to which the greatest per-
ing the policy period, i.e., endorsements,
If you use other electronic payment methods,
centage of the insured’s taxable premium for
audits and/or cancellations.
such as ACH credit method or Fed Wire,
that insurance contract is allocated.
instructions are available on our website or
D. Date of Coverage
Form change. Form IG255 has been up-
by calling our Business Registration Office
Enter the policy coverage date.
dated to reflect the NRRA requirement.
at 651-282-5225 or 1-800-657-3605.
E. Insurance Type Code
Due Date
Check Payments (Form PV58)
Enter the appropriate insurance type code
You must file Form IG255 and pay any tax
If you are not required to pay electroni-
for each policy:
due by March 1 of the following year. (M.S.
cally and choose to pay by check, complete
297I.30, subd. 1)
1. Fire
a PV58 payment voucher and mail it with
your check. Write your Minnesota tax ID
2. Extended Coverage/Allied Lines
The U.S. postmark date, or date recorded or
number on your check.
marked by a designated delivery service, is
3. Homeowners/Commerical M.P.
considered the filing date (private postage
When you pay by check, your check autho-
4. Inland/Ocean Marine
meter marks are not valid). When the due
rizes us to make a one-time electronic fund
5. Accident/Health
date falls on a Saturday, Sunday or legal
transfer from your account, and you may
6. Liability
holiday, returns and payments electronically
not receive your canceled check.
made or postmarked on the next business
7. Auto
Penalties and Interest
day are considered timely. When a return
8. Fidelity/Surety
Late payment. If you don’t pay all the tax
or payment is late, the date it is received at
9. Burglary/Theft
the Department of Revenue is treated as the
due by the due date, a late payment pen-
date filed or paid.
alty is due. The penalty is 5 percent of the
10. Boiler/Machinery
unpaid tax for any part of the first 30 days
11. Other (Specify)
Extension for Filing Return. If good cause
the payment is late, and 5 percent for each
exists, you may request a filing extension.
F. Amount Insured
additional 30-day period, up to a maximum
of 15 percent.
Enter the amount insured.
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