INSTRUCTIONS FOR FILING THE VIRGINIA DECLARATION OF ESTIMATED LICENSE TAX AND ESTIMATED ASSESSMENT

THESE INSTRUCTIONS APPLY TO EACH QUARTER:

Please read and follow these instructions carefully. Questions regarding declarations may be directed to Jan Stephens (804) 37l-9239 or Joyce Jones (804) 37l-9096.

l. Filing of the declaration and payment of estimated license tax and/or estimated assessment is required if the company's annual license tax and/or assessment is expected to exceed $3,000. NOTE: The Assessment portion does not include the Fraud, Fire Programs Fund, Flood Prevention & Protection Assistance Fund, HEAT Fund nor the MCHIP Assessment.

2. Payments are recorded using the company's NAIC number and the Form I.D. When payments are posted to the wrong NAIC number or the wrong quarter, penalties and interest could result during the annual tax report audit and in the "additions to the tax" calculations. NOTE: The Form I.D defines the declaration form required to be filed each quarter. To ensure the proper crediting of your payments, please use the correct form for the quarter that you are filing. For example, if you are filing Quarter 1, the Form I.D. is 601121 (60 represents the form type, 1 represents the quarter and 12 represents the year) and Quarter 2 is 602121. DO NOT USE COPIES OF PRIOR QUARTERLY FORMS as the Form I.D. block changes each quarter.

ALL FORMS SHOWING THE INCORRECT FORM I.D. WILL BE RETURNED WITH ANY PAYMENT THAT WAS SUBMITTED. RETURNED FORMS AND PAYMENTS POSTMARKED AFTER THE DUE DATE WILL BE CONSIDERED LATE AND SUBJECT TO LATE PAYMENT INTEREST THAT WILL BE BILLED AT A LATER DATE.

3. Declarations must be dated and signed by a company officer. Line 2, the estimated amount, MUST be completed with an amount greater than zero if a payment is being made. Line 5, Col. l plus Line 5, Col. 2 must equal the Total Amount Due, on Line 6, which must equal the check submitted with the form. BE AWARE that software packages may be using more than two decimal places to calculate the amounts for Line 5. This practice may cause the addition of Line 5, Cols. 1 and 2 to be inconsistent with Line 6. If using a software package to complete the Declaration, please make sure the amounts on Line 5, Cols. 1 and 2, add correctly to the amount on Line 6 and that the check amount matches Line 6. Checks may not be postdated.

SEND ONE CHECK FOR EACH COMPANY. DO NO SUBMIT THE ANNUAL "PAYMENT VOUCHER" WITH THIS PAYMENT

4. Payments are considered timely filed if postmarked on or before midnight of the due date. If the due date falls on Saturday or Sunday, the following Monday is considered timely filed.

5. ALL FORMS ARE TO BE MAILED TO THE FOLLOWING LOCKBOX ADDRESS:

6. Overpayments from a previous year MAY NOT be applied to quarterly declaration payments. Overpayments are refunded in accordance with the appropriate Virginia Code sections as soon as practicable after the March l tax/assessment filing date.

7. License tax and assessment are two separate accounts in Virginia and should be treated as separate entities. DO NOT NET ONE ACCOUNT FROM THE OTHER. Be sure to allocate your estimates to the appropriate column. Requests for transfers of payments between accounts must be made in writing no later than December 3l of the applicable taxable/assessable year.

8. TAX ADDRESS & CONTACT INFORMATION: If any portion of your tax/assessment address and contact information has changed, you must update the Bureau's records via our website: Update Tax/Assessment Address and Contact Information. Enter your company's unique Login Code and make the necessary changes in the information.

I ACKNOWLEDGE THAT I HAVE READ THE INSTRUCTIONS FOR FILING THE VIRGINIA DECLARATION OF ESTIMATED LICENSE TAX AND ESTIMATED ASSESSMENT. I UNDERSTAND AND WILL ACCEPT THE RAMIFICATIONS OF SUBMITTING AN INCORRECT FORM, AS EXPLAINED IN ITEM 2 OF THE INSTRUCTIONS.

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Please select the appropriate form below:

Note: When making a payment, LINE 2, your estimate, MUST BE COMPLETED with an amount greater than zero!
QTR 1 (due 4-15)	QTR 2 (due 6-15)	< QTR 3 (due 9-15)	QTR 4 (due 12-15)