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Click ‘Get Form’ to open it in the editor.
Begin by entering your Revenue ID and Federal ID (FEIN) at the top of the form. Ensure you use all caps and avoid dashes or slashes.
Fill in the Tax Year Begin and End dates using the MMDDYYYY format, followed by the Due Date which is April 15.
Complete the Taxpayer Name section, checking if there’s a change of address or if this is an amended report.
Provide your address details including First Line, Second Line, City, State, and ZIP code.
Proceed to complete Page 2 by entering gross premiums tax amounts as instructed for each line item.
Continue filling out Pages 3 and 4 as required, ensuring all calculations are accurate and documented.
Finally, sign and date where indicated before submitting your completed form electronically through our platform.

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Versions	Form popularity	Fillable & printable
2023	4.3 Satisfied (22 Votes)
2022	4.8 Satisfied (117 Votes)
2019	4.8 Satisfied (43 Votes)
2019	4.1 Satisfied (33 Votes)
2016	4.3 Satisfied (106 Votes)
2014	4.4 Satisfied (185 Votes)
2012	4 Satisfied (31 Votes)

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Use eSignature to fill out a PDF form and sign it Flat forms are non-interactive forms that require extra effort and extra steps to be completed. An interactive form contains fields that you can select or fill in, eliminating the need to print the form and complete it by hand.

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Simply choose the file, open the document, select the fields and fill out your PDF by typing directly onto the page. You can also fill in and sign the form using Power PDFs electronic signature tools. Save a new copy of the document with your completed information and send it back to the appropriate party.