Oklahoma Tax Commission - Home - OK.gov 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the quarter ending date in the designated field at the top of the form.
3. If applicable, mark the box for 'Amended Report' to indicate that this is a revised submission.
4. Fill in your Federal Employer Identification Number and the Name of Carrier in their respective fields.
5. Provide your Street Address, City, State, and Zip Code accurately to ensure proper processing.
6. In section 1, input the gross direct premiums for Workers’ Compensation insurance for the current quarter.
7. Next, enter any deductions in section 2 as outlined on the reverse side of the form.
8. Calculate and write down the total in section 3 by subtracting deductions from gross premiums.
9. Finally, compute the Insurance Premium Assessment (1% of line 3) and enter it in section 4.
10. Sign and date the form as an authorized representative before submitting it to the Oklahoma Tax Commission.

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