Surplus Annual Tax Form - State Of Alabama Department Of Insurance

ADVERTISEMENT

ID-15
STATE OF ALABAMA
SL
DEPARTMENT OF INSURANCE
Surplus Lines Brokers
For the Period Ending ____________________________
Broker No. _________________
Surplus Lines Broker ____________________________________________________________________
Name of Brokerage Company
___________________________________________________________
Address _______________________________________________________________________________
E-Mail Address__________________________________________________________________________
GROSS
RETURN
NET
PREMIUM
PREMIUM
PREMIUM
$
$ ____________________________
Net Tax Due for this Report
Less: Exam fee Deduction **
**Please attach documentation
$ ____________________________
Total Amount of Tax Due for this Report
Total No. of pages in this Report _______________
Surplus Lines Broker
Sworn To and Subscribed Before Me
This __________ Day of ________ , 20_____
SEAL
____________________________________
POSTAL SERVICE
COURIER OR EXPRESS SERVICE
Alabama Department of Insurance
Alabama Department of Insurance
c/o Compass Bank
c/o Compass Bank
P.O. Box 830691
701 South 32nd Street
Birmingham, AL 35283-0691
Birmingham, AL 35233

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Form T69 - Declaration Of Surplus Lines Broker Estimated Tax Form - State Of Rhode Island Form T69 - Declaration Of Surplus Lines Broker Estimated Tax Form - State Of Rhode Island Financial
Form M-20a - Monthly Return Of Liquid Fuel Tax (state And County) And Environmental Response Tax Form - State Of Hawaii - Department Of Taxation Form M-20a - Monthly Return Of Liquid Fuel Tax (state And County) And Environmental Response Tax Form - State Of Hawaii - Department Of Taxation Financial
Form Tol-2210 - Statement And Computation Of Penalty And Interest For Underprayment Of Estimated Toledo Tax Form - State Of Ohio Form Tol-2210 - Statement And Computation Of Penalty And Interest For Underprayment Of Estimated Toledo Tax Form - State Of Ohio Financial
Form 78-499 - Motor Vehicle Lease Tax Form - State Of Iowa Form 78-499 - Motor Vehicle Lease Tax Form - State Of Iowa Financial
Form Q-1 - Quarterly Statement For Payment Of Estimated Tax Form - State Of Ohio Form Q-1 - Quarterly Statement For Payment Of Estimated Tax Form - State Of Ohio Financial
Schedule Ct-945-a Back - Annual Record Of Withheld Connecticut Income Tax Form - State Of Connecticut Department Of Revenue Services - 2004 Schedule Ct-945-a Back - Annual Record Of Withheld Connecticut Income Tax Form - State Of Connecticut Department Of Revenue Services - 2004 Financial
Lodging Or Room Tax Form - State Of Alabama Lodging Or Room Tax Form - State Of Alabama Financial
Application For City Taxes Form - State Of Alabama Application For City Taxes Form - State Of Alabama Financial
Multi-purpose Combined Excise Tax Form - State Of Washington Department Of Revenue Multi-purpose Combined Excise Tax Form - State Of Washington Department Of Revenue Financial
Employer's Annual Reconciliation Form - State Of Ohio Employer's Annual Reconciliation Form - State Of Ohio Financial

Related Categories

Parent category: Legal
Download
Go