Blank Texas 25 104 PDF Form

Blank Texas 25 104 PDF Form

The Texas 25-104 form is an essential document for surplus lines agents and purchasing groups registered in Texas, as it is used to report insurance premiums and calculate taxes owed. This form must be submitted annually, even if no tax is due, and it helps ensure compliance with state regulations. To get started on filling out the Texas 25-104 form, please click the button below.

The Texas 25-104 form is a critical document for surplus lines agents and purchasing groups registered in Texas, serving as the Annual Insurance Tax Report. This form must be filed regardless of whether any tax is due, emphasizing the importance of compliance in the insurance industry. It captures essential information, including taxpayer details, premium amounts, and tax calculations for both Texas and non-Texas premiums. The form is divided into several sections, each designed to address specific reporting requirements. Section I focuses on Texas premiums, distinguishing between taxable and non-taxable amounts, as well as premiums allocated to other states. Section II allows agents to select their tax base—either premium-written or premium-received—while Section III outlines the reporting methods and clarifies that the premiums reported may differ based on the chosen method. Section IV addresses the obligations of purchasing groups, ensuring they understand their tax responsibilities. With a due date of March 1 for the preceding tax year, timely submission is crucial to avoid penalties and interest. Understanding and accurately completing the Texas 25-104 form is vital for maintaining compliance and ensuring the smooth operation of insurance practices in the state.

Document Sample

25-104 (Rev.1-14/21)

a. T Code

71120

c. Taxpayer number

b.

under Chapters 552 and 559, Government Code, to review, request and correct inf rmati n we have on file about you. Contact us at the address or phone number listed on this form.

d. Fili peri d

e.

 

f. Due date

 

 

 

 

Taxpayer name and tax

mailing addr (Make neces ary name and address chang s b low)

g.

h. IMPORTANT

Blacken this ox if your mailing

 

address has changed. Show changes

1.

esi e the preprinted information.

 

 

 

 

i.

j.

SECTION I -

A. Texas premiums

A.

 

 

B. Texas premiums

B.

 

 

C. Non-taxable premiums

C.

 

 

D. Other states' premiums

D.

Not subject to LSOT repor ing

 

 

 

E. Non-taxable premiums

E.

 

 

F. Other states' premiums

F.

 

 

Total premium as ag nt of record

G. $

 

 

 

 

SECTION II - Tax Ba Elect on

 

 

 

 

 

 

 

Pr mium-wri ten basis

2

 

Premium-received basis

SECTION III -

 

 

 

 

 

 

 

The premiums eported

his se

will

ot nece rily m ch the premiums shown SECTION I. SECTION III premiums should refl the premiums subject to tax on

 

the basis of taxation method

d, .e.,

emium-received or prem -writ en.

 

1.

Texas premiu

s

 

 

1.

 

 

 

2.

Texas return

d pr

m s

 

2.

 

 

 

3.

Taxable p emiums

 

 

3.

 

 

 

4.

Premium tax due

 

 

4.

 

 

 

 

 

 

 

 

 

 

 

SECTION IV -

 

 

 

 

 

 

 

5.

Texas premiu

s

 

 

5.

 

 

 

6.

Texas return

d pr

 

 

6.

 

 

 

7.

Taxable premiums

 

 

7.

 

 

 

8.

Premium tax due

 

 

8.

 

 

 

 

 

 

 

 

 

 

9. Total taxes due

 

 

 

9.

 

 

10. Prepayment amount

 

 

10.

 

 

11. Total amount due

 

 

 

11.

 

 

Form 25-104 (Rev.1-14/21)

12.Penalty and interest

13.TOTAL AMOUNT DUE AND PAYABLE

Taxpayer name

12.

13.

k.

l.

T Code

Taxpayer number

Period

Make the amount in Item 13

Mail to: COMPTROLLER OF PUBLIC ACCOUNTS

payable to:

P.O. Box 149356

STATE COMPTROLLER

Austin, TX 78714-9356

 

 

I declare that the information in this document and all attachments is true and correct to the best of my knowledge and belief.

Authorized agent

Preparer's name (Type or print.)

Daytime phone

Date

(Area code & number)

 

 

 

For information about Insurance Tax, call 1-800-252-1387 . Details are also available online at www.window.state.tx.us.

Form 25-104 (Back)(Rev.1-14/21)

Inst uctio

f r Completing the Texas Annual Insurance T x Report

Who Must File

 

All surpl lines ag ts licen ed Texas and a

purchasi gr ups registered in Texas must file this report, even if no tax is due.

When to File

he report and payment are d on March 1 of the year following the tax year.

Section I

he Non-admitted and Rein urance form Act of 2010 went into effect July 21, 2011. This Act created a split year for tax-reporting purposes to reflect busine s under T xas law rior to July 21 and changes in Texas law to comply with the federal law for policies effective on or after July 21, 2011.

Item A - Texas Pr miums - Enter the total Texas premiums for policies that were effective prior to July 21, 2011 (net of return premiums) that were reported to the SLSOT during the tax year. Enter the total amount of premiums for policies that were effective on or after July 21, 2011 (net of return premiums) that have been reported to the SLSOT where Texas is the home tate of the insured.

Item - Texas Pr miums - Enter the total Texas premiums for policies that were effective prior to July 21, 2011 (net of return premiums) that have NOT YET been reported to the SLSOT during the tax year. Ent r he total amount of premiums for policies that were effective on or after July 21, 2011 (net of return premiums) that have NOT YET been reported to the SLSOT where Texas is the home state of the insured.

Item C - Non-taxable Premiums - Enter the total non-taxable premiums for policies that were effective prior to July 21, 2011 (net of return premiums) that cover a risk located

entirely Texas and the non-taxable Texas premiums for a multi-state policy. Both of these categories must be reported to the SLSOT. Enter the total amount of remiums for polices that were effective on or after July 21, 2011 (net of return premiums) where Texas is the home state of the insured and that are non-taxable: either

the premiums are exem t from taxation or are preempted from taxation.

Item D - Oth r States' Premi ms - Enter the total premiums for policies that were effective prior to July 21, 2011 (net of return premiums) allocated to all other states from a multi-state policy that includes coverage for Texas. This category must be reported to the SLSOT. For multi-state policies in which Texas is the home state of the ins r d that have an effective date on or after July 21, 2011, report the total policy premium as Texas premium in Item A. Report to the SLSOT the amount of the policy remium that is applied to risks located outside of Texas, using the new category called "Breakdown of States Summary." This will ensure that Texas tax is charged on

100% of the policy premium, but also allows the monitoring of the amount of non-Texas premium for multi-state policies when Texas is the home state of the insured. Item E - Non-taxable Premiums - This category does not apply to policies that are effective on or after July 21, 2011. For policies that are effective prior to July 21, 2011,

enter the premiums (net of return premium ) that are 100% exempt or pre-empted and cover risks entirely in states other than Texas.

Item F - Oth r States' Premi ms - This category does not apply to policies that are effective on or after July 21, 2011. For policies that are effective prior to July 21, 2011, enter the to al taxable premiums (net of return premiums) allocated to other states for policies that exclusively cover states other than Texas.

Section II

lines agents who received a license during the reporting year must elect one of the tax base options shown.

Rle 34 TAC, Sec. 3.822, provides specific information on the requirements for reporting surplus lines tax. Agents have the option of reporting tax using a premium-written or premium-receiv d basis and may change their election every four years. An agent who changes from a premium-received to a premium-written basis will owe taxes on all outstanding rec ivables as of January 1 of the year of the change. If an agent fails to file the election, the agent will be subject to tax on a premium-written basis.

Section III

These premiums will not necessarily match the premiums shown in Section I, because they are based on the reporting method chosen. The term "premium" includes all

premiums, premi m deposits, membership fees, registration fees, assessments, dues and any other consideration for surplus lines insurance. Texas premiums include: premiums written or received for policies that are effective prior to July 21, 2011 that cover risks in this state;

premiums written or received for new or renewal Texas or multi-state policies that are effective on or after July 21, 2011 when Texas is the home state of the insured and any endorsements on these policies.

Exempt premiums are premiums for a surplus lines policy that covers risks or exposures that are properly allocated to federal waters, international waters, or risks or exposures that are under the jurisdiction of a foreign government. Effective Jan. 1, 2014, premiums on risks or exposures under ocean marine insurance coverage of sto ed or -transit baled cotton for export are exempt from surplus lines premium tax.

Feder l preemptions to state taxation for surplus lines insurance include premiums for policies that are issued to the following entities:

the Federal Deposit Insurance Corporation (FDIC), when it acts as the receiver of a failed financial institution that holds the property being insured; the National Credit Union Administration;

a federally chartered credit union; and

Indian Tribal Nations (see Publication 94-142).

Texas returned premiums - Report the unearned portion of the premium that is credited or refunded to a policyholder as a result of cancellation or premium adjustment prior to the policy expiration. An age t reporting on the premium received basis will not have returned premiums.

Endorsements and audits on surplus lines insurance policies must be reported based on the date of the endorsement or audit, not the date of the original policy. The tax for endorsements and audits that generate return premiums due a policyholder must be calculated using the tax rate that was originally charged.

Section IV

Purchasing groups obtaining coverage from insurers licensed in Texas or surplus lines agents licensed in Texas do NOT owe tax on this report, but must a zero report. Purchasing groups obtaining coverage independently through negotiations and procurement occurring outside Texas are subject to tax on the premiums paid for coverage of their members located in Texas.

Check this box if insurance was obtained from a licensed insurance company or a licensed or registered risk retention group.

Check this box if insurance was obtained from a surplus lines agent licensed in Texas.

Specific Instructions

Item 12 - Penalty and interest

If tax is paid 1-30 days late: Enter penalty of 5% (.05) of Item 11.

If tax is paid 31-60 days late: Enter penalty of 10% (.10) of Item 11.

If tax is paid over 60 days late: Enter penalty of 10% (.10) of Item 11 plus interest. Calculate interest at the rate published online at www.window.state.tx.us or call the Comptroller at 1-877-447-2834 for the applicable interest rate.

Electronic reporting nd payment options are available 24 hours day, 7 days a week. Have this form available when you log on.

File Specifics

Fact Name Description
Form Purpose The Texas 25-104 form is used for reporting surplus lines insurance premiums and paying the associated taxes.
Who Must File All surplus lines agents licensed in Texas and purchasing groups registered in Texas must file this report, even if no tax is due.
Filing Deadline The report and payment are due on March 1 of the year following the tax year.
Governing Laws This form is governed under Chapters 552 and 559 of the Texas Government Code.

How to Use Texas 25 104

Completing the Texas 25-104 form requires careful attention to detail and an understanding of your insurance premiums. This form is essential for surplus lines agents and purchasing groups registered in Texas. Once the form is filled out, it will need to be submitted along with any required payments to the appropriate state office.

  1. Begin by entering the taxpayer name and tax mailing address in the designated fields. Make sure to update any necessary changes below this section.
  2. If your mailing address has changed, blacken the box provided to indicate this change.
  3. In Section I, fill out the premiums information:
    • Item A: Enter total Texas premiums for policies effective before July 21, 2011.
    • Item B: Enter total Texas premiums for policies effective on or after July 21, 2011.
    • Item C: Report non-taxable premiums for policies effective before July 21, 2011.
    • Item D: Enter premiums allocated to other states for policies effective before July 21, 2011.
    • Item E: Report non-taxable premiums for policies effective before July 21, 2011, covering risks outside Texas.
    • Item F: Enter taxable premiums allocated to other states for policies effective before July 21, 2011.
  4. Proceed to Section II and select your tax base option (premium-written or premium-received basis).
  5. In Section III, provide the premiums reported based on your chosen method:
    • Item 1: Texas premiums.
    • Item 2: Texas returned premiums.
    • Item 3: Taxable premiums.
    • Item 4: Premium tax due.
  6. Move to Section IV and complete the necessary fields regarding purchasing groups and tax obligations.
  7. In Item 12, calculate any penalties and interest if applicable. Use the guidelines provided for late payments.
  8. Finally, in Item 13, sum up the total amount due and payable. Make sure this amount is accurate.
  9. Sign and date the form, providing your name and daytime phone number as the preparer.
  10. Mail the completed form along with payment to the address specified on the form.

Your Questions, Answered

What is the Texas 25-104 form?

The Texas 25-104 form is an annual insurance tax report that must be filed by surplus lines agents licensed in Texas and purchasing groups registered in Texas. This form is used to report premiums collected and to calculate the tax due for the previous tax year. Even if no tax is due, filing the report is mandatory.

Who is required to file the Texas 25-104 form?

All surplus lines agents licensed in Texas must file the Texas 25-104 form. Additionally, purchasing groups that are registered in Texas are also required to submit this form. It is important to file even if there are no taxable premiums to report.

When is the Texas 25-104 form due?

The Texas 25-104 form and any associated payments are due on March 1 of the year following the tax year. For example, if you are reporting for the tax year 2022, the form must be submitted by March 1, 2023.

What information is required on the Texas 25-104 form?

The form requires various details, including:

  • Your taxpayer name and number
  • The total Texas premiums for policies effective before and after July 21, 2011
  • Non-taxable premiums
  • Other states' premiums
  • Returned premiums
  • Taxable premiums and the total tax due

Ensure that all information is accurate and complete to avoid penalties.

What are the penalties for late filing or payment?

If the tax is paid late, penalties apply as follows:

  1. If paid 1-30 days late, a penalty of 5% of the total amount due is assessed.
  2. If paid 31-60 days late, the penalty increases to 10% of the total amount due.
  3. If paid more than 60 days late, the penalty remains at 10% plus interest calculated at the applicable rate.

It is advisable to file and pay on time to avoid these additional costs.

Common mistakes

  1. Incorrectly Reporting Premiums: One common mistake is misreporting the total premiums. Ensure that you accurately enter the total Texas premiums for policies effective before and after July 21, 2011. Failing to distinguish between these two categories can lead to significant errors.

  2. Ignoring Non-Taxable Premiums: Many individuals overlook the non-taxable premiums section. It is crucial to report any non-taxable premiums correctly, especially those that are exempt from taxation. This oversight can result in unnecessary tax liabilities.

  3. Missing the Filing Deadline: Timeliness is essential when submitting the Texas 25 104 form. The report and payment are due on March 1 of the year following the tax year. Missing this deadline can lead to penalties and interest charges.

  4. Failing to Update Contact Information: If your mailing address has changed, it is vital to update this information on the form. Not doing so can lead to missed communications regarding your tax obligations or penalties.

Documents used along the form

The Texas 25-104 form is an essential document for surplus lines agents and purchasing groups operating within Texas. It serves as a comprehensive report for the Texas Annual Insurance Tax, detailing premiums and tax obligations. Along with this form, several other documents are commonly utilized to ensure compliance and accurate reporting. Below is a list of these forms and documents, each playing a vital role in the process.

  • Form 25-105: This form is used for reporting the Texas surplus lines tax. It provides detailed information about the premiums collected and taxes owed, ensuring that agents fulfill their tax responsibilities.
  • Form 25-106: This document is utilized to report any changes in the agent's information, such as address or contact details. Keeping this information current is crucial for communication and compliance.
  • Form 25-107: This form is necessary for reporting exemptions from surplus lines tax. Agents must submit this document to claim any applicable exemptions on their premiums.
  • Form 25-108: Used for requesting a refund of surplus lines taxes paid in error, this form allows agents to recover funds they may have overpaid.
  • Form 25-109: This form serves to report non-admitted insurance policies. It provides details on policies that do not meet Texas's admission requirements, ensuring proper tax treatment.
  • Form 25-110: This document is used for audit purposes. It helps in tracking and verifying the accuracy of reported premiums and taxes, assisting both agents and the state in maintaining compliance.
  • Form 25-111: This form is for reporting any penalties and interest accrued due to late payments. It helps agents understand their financial obligations and avoid further penalties.
  • Form 25-112: This is a declaration form that agents must sign, affirming that all information provided in their reports is accurate and complete. It holds agents accountable for their submissions.
  • Form 25-113: This form is used to request clarification or guidance from the Texas Comptroller’s office regarding surplus lines tax reporting. It is a valuable resource for agents seeking assistance.

Understanding these forms and their purposes can significantly streamline the reporting process for surplus lines agents in Texas. By utilizing the Texas 25-104 form alongside these additional documents, agents can ensure compliance and maintain accurate records, ultimately fostering a smoother operational experience.

Similar forms

The Texas Form 25-104 is similar to the IRS Form 1040, which is the individual income tax return form used by U.S. taxpayers. Both forms require individuals to report financial information, such as income and deductions, to determine tax liability. Just as the Texas form focuses on insurance premiums and taxes owed, the IRS form centers on income and tax obligations. Both documents serve as essential tools for tax compliance and must be filed annually by their respective deadlines.

Another document similar to the Texas Form 25-104 is the California Form 100, used for corporate income tax reporting in California. Like the Texas form, it requires detailed reporting of specific financial data. Both forms aim to collect taxes owed to the state, ensuring compliance with tax laws. The California form also allows for adjustments and corrections, similar to the provisions found in the Texas form for reporting changes in taxpayer information.

The Texas Form 25-104 can also be compared to the New York State Form CT-3, which is used for corporate tax purposes. Both forms require taxpayers to report their financial activities and calculate taxes owed based on that information. They serve as official records of tax reporting and compliance, and both require a declaration of accuracy from the taxpayer or authorized agent. This shared requirement emphasizes the importance of honesty and transparency in tax reporting.

Lastly, the Texas Form 25-104 is akin to the Florida Form DR-15, which is used for reporting sales and use tax. While the Texas form focuses on insurance premiums, both documents require taxpayers to report specific financial data and calculate the corresponding taxes. They both have designated sections for reporting various categories of taxable and non-taxable items, ensuring that taxpayers provide comprehensive information to the state authorities.

Dos and Don'ts

When filling out the Texas 25-104 form, there are several important guidelines to follow. Here are five things you should and shouldn’t do:

  • Do double-check all preprinted information for accuracy.
  • Don't leave any required fields blank; ensure all necessary information is provided.
  • Do use black ink to fill out the form to ensure clarity.
  • Don't submit the form late; be aware of the March 1 deadline for filing.
  • Do keep a copy of the completed form for your records.

Following these guidelines will help ensure that your submission is processed smoothly and accurately.

Misconceptions

Misconceptions about the Texas 25-104 form can lead to confusion and potential errors in reporting. Here are seven common misconceptions, along with clarifications:

  • Only agents with taxable premiums need to file the form. All surplus lines agents licensed in Texas must file the Texas 25-104 form, even if no tax is due.
  • The due date is flexible. The report and payment are due on March 1 of the year following the tax year, with no extensions provided.
  • All premiums reported are taxable. Non-taxable premiums must also be reported, as they are relevant for accurate record-keeping and compliance.
  • Filing a zero report is unnecessary. Purchasing groups that obtain coverage from licensed insurers in Texas must still file a zero report, confirming no tax is owed.
  • Premiums from all states are reported the same way. Premiums from other states are categorized differently and must be reported based on specific criteria outlined in the form.
  • Late payments incur the same penalty. Penalties vary based on how late the payment is, with different percentages applied for different time frames.
  • Changes to the form are not allowed. Taxpayers can and should make necessary changes to their name and address directly on the form to ensure accurate processing.

Understanding these misconceptions can help ensure proper compliance and accurate reporting when using the Texas 25-104 form.

Key takeaways

Key Takeaways for Filling Out and Using the Texas 25-104 Form:

  • All surplus lines agents licensed in Texas must file the Texas 25-104 form, even if no tax is due.
  • The report and payment are due on March 1 of the year following the tax year.
  • Section I requires you to report Texas premiums for policies effective before and after July 21, 2011.
  • Non-taxable premiums must be reported for policies covering risks entirely in Texas or for multi-state policies.
  • Agents must choose between a premium-written or premium-received basis for reporting taxes, with changes allowed every four years.
  • Returned premiums, which are unearned amounts credited to policyholders, must be reported accurately.
  • Purchasing groups using licensed insurers in Texas do not owe tax but must file a zero report.
  • Penalties and interest apply for late payments, with specific rates for different time frames of delay.

For assistance, the Texas Comptroller’s office can be contacted at 1-800-252-1387 or through their website.