2019 Premium Tax Forms and Instructions
Premium Tax Forms are now available in MS-Excel (MS-Excel) format. Instructions, and Information are in Microsoft-Word format (MS-Word). Each may be downloaded to your computer. If your current software does not support these formats, you may download the Web App by visiting our Free Document Readers page.
Contact our Premium Tax Audit Unit if you need Assistance completing or reading these forms.
Calendar Year 2019 Tax Forms, Instructions, and Information
All Classes | Home | Life Companies | Ocean Marine | Pre-Payment | Surplus/Special Lines | Title
All Classes - Except Ocean Marine, Life, Title, And Home Protection
All Classes of Insurance Tax Return Form - Except Ocean Marine, Life, Title, And Home Protection
(CDI FS-001 MS-Excel) Revised 01/2020
All Classes of Insurance Tax Return Instructions (Except Ocean Marine, Life, Title, And Home Protection)
(MS-Word) Revised 10/2019
Bulletin 137 - Premium or Undertaking of Bail
(MS-Word)
Life Companies - Including Accident and Health Insurance
Life Companies Tax Return Form
(CDI FS-002 MS-Excel) Revised 10/2019
Life Companies Tax Return Instructions
(MS-Word) Revised 10/2019
Life Companies Tax Return Attachment A
(MS-Excel)
Life Companies Tax Return Attachment B
(MS-Word)
Title Insurance
Title Insurance Tax Return Form
(CDI FS-003 MS-Excel) Revised 10/2019
Title Insurance Tax Return Instructions
(MS-Word) Revised 10/2019
Home Protection
Home Protection Tax Return Form
(CDI FS-004 MS-Excel) Revised 10/2019
Home Protection Tax Return Instructions
(MS-Word) Revised 10/2019
Ocean Marine
Ocean Marine Insurance Tax Return Form
(CDI FS-005 MS-Excel) Revised 10/2019
Surplus Lines - Special Lines
Surplus Line Broker and Special Lines Surplus Line Broker Tax Return Form
(CDI FS-006 MS-Excel) Revised 10/2019
Surplus Line Broker and Special Lines Surplus Line Broker Tax Return Instructions
(MS-Word) Revised 10/2019
Surplus Line Broker and Special Lines Surplus Line Broker Tax Calendar
(MS-Excel) Revised 10/2019
Zero Tax Return Surplus Line Broker and Special Lines Surplus Line Broker Form
(CDI FS-006-0 MS-Excel) Revised 10/2019
Zero Tax Return Surplus Line Broker and Special Lines Surplus Line Broker Form Instructions
(MS-Word) Revised 10/2019
Surplus Line Broker's Monthly Tax Payment Voucher Form
(CDI FS-007 MS-Excel) Revised 10/2019
Tax Pre-Payment Voucher & EFT
Premium Tax Voucher for the 1st Quarter Prepayment Form
(CIA-T-4 MS-Excel) Revised 10/2019
Premium Tax Voucher for the Quarterly Prepayment Form
(CIA-T-4A MS-Excel) Revised 10/2019
Electronic Funds Transfer Program Information Guide for Tax Payments
(PDF) Revise 01/2019
