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Blank Texas 25 104 Form

The Texas 25 104 form is an essential document used for reporting surplus lines insurance premiums in Texas. This form is required for all surplus lines agents licensed in the state, ensuring compliance with tax obligations under Texas law. Filing is necessary even if no tax is due, making it crucial for agents to understand its components and deadlines.

Outline

The Texas 25-104 form plays a crucial role in the annual reporting of insurance premiums for surplus lines agents and purchasing groups registered in Texas. This form requires detailed information about premiums, including Texas premiums, non-taxable premiums, and premiums from other states. It is essential for agents to accurately report both taxable and non-taxable amounts, as well as any returned premiums due to policy cancellations or adjustments. The form is divided into several sections, each addressing specific reporting requirements, such as the method of taxation—premium-written or premium-received. Completing the 25-104 form correctly is vital, as it helps ensure compliance with state regulations and avoids penalties. Agents must also note any changes in mailing addresses and are encouraged to reach out to the Comptroller’s office for any clarifications. Filing is due by March 1 of the year following the tax year, even if no tax is owed, making it important for agents to stay organized and proactive in their reporting efforts.

Sample - Texas 25 104 Form

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

a. T Code

71120

c. Taxpayer number

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)

h. IMPORTANT

Blacken this ox if your mailing
address has changed. Show changes		1.
esi e the preprinted information.

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.

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.

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Form Information

Fact Name	Description
Governing Law	The Texas 25-104 form is governed by Chapters 552 and 559 of the Texas Government Code.
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.
Penalty for Late Payment	If tax is paid late, penalties range from 5% to 10% of the total amount due, depending on how late the payment is.

Detailed Guide for Filling Out Texas 25 104

Completing the Texas 25-104 form requires careful attention to detail. Ensure that all information is accurate and reflects your tax obligations. Follow these steps to fill out the form correctly.

Begin by entering your Taxpayer number in the designated field.
Fill in your Taxpayer name and tax mailing address. If your mailing address has changed, blacken the box provided and show the changes below.
In SECTION I, report the Texas premiums. Enter the total amounts for each category:
- A. Texas premiums
- B. Non-taxable premiums
- C. Other states' premiums
- D. Not subject to LSOT reporting
In SECTION II, select your tax base election: either premium-written basis or premium-received basis.
Move to SECTION III. Here, report the premiums based on your chosen reporting method. Ensure that the figures align with the information provided in SECTION I.
In SECTION IV, complete the necessary calculations for Texas premiums, returned premiums, taxable premiums, and the total taxes due. Include any prepayment amounts.
In item 12, calculate any applicable penalties and interest based on the timeliness of your payment.
Finally, sign and date the form, ensuring you include your daytime phone number and the name of the authorized agent or preparer.

After completing the form, mail it to the address provided, ensuring that the payment is made out to the Comptroller of Public Accounts. For any questions or clarifications, you may contact the Comptroller's office or visit their website for further assistance.

Obtain Answers on Texas 25 104

What is the Texas 25 104 form used for?

The Texas 25 104 form is primarily used for reporting surplus lines insurance premiums. It is required for all surplus lines agents licensed in Texas and purchasing groups registered in Texas. This form helps ensure that the appropriate taxes are reported and paid for the insurance premiums collected during the tax year.
When is the Texas 25 104 form due?

The report and payment for the Texas 25 104 form are due on March 1 of the year following the tax year. This means that if you are reporting for the tax year 2023, your form and payment would be due on March 1, 2024.
Who must file the Texas 25 104 form?

All surplus lines agents licensed in Texas and purchasing groups registered in Texas are required to file this report. This requirement stands even if no tax is due. It is essential to comply with this filing to avoid potential penalties.
What happens if I file the Texas 25 104 form late?

If you file the Texas 25 104 form late, you may incur penalties and interest. For example:
- If the tax is paid 1-30 days late, a penalty of 5% of the total amount due will apply.
- If paid 31-60 days late, the penalty increases to 10% of the total amount due.
- If the payment is over 60 days late, a 10% penalty plus interest will be charged.
To avoid these penalties, it is crucial to submit your form and payment on time.

Common mistakes

Filling out the Texas 25-104 form can be straightforward, but mistakes can lead to delays and complications. One common error is neglecting to update the taxpayer's mailing address. If your address has changed, it is crucial to blacken the box indicating this change. Failing to do so may result in important communications being sent to the wrong address, which could lead to missed deadlines and penalties.

Another frequent mistake involves incorrectly reporting premium amounts. Section I requires accurate reporting of Texas premiums, non-taxable premiums, and other states' premiums. Many filers mistakenly mix up the amounts for policies effective before and after July 21, 2011. This confusion can result in inaccurate tax calculations, which may trigger audits or additional tax liabilities.

Additionally, some individuals overlook the importance of selecting the correct tax base option in Section II. New agents must choose between a premium-written or premium-received basis. Failing to make this election means the agent will automatically be taxed on a premium-written basis, which might not be the most beneficial option for their specific situation. This decision can have significant financial implications.

Lastly, many filers forget to include penalties and interest in Section IV if they are submitting their form late. If the tax payment is delayed, penalties apply based on how late the payment is. It is essential to calculate these amounts accurately to avoid further complications. Being diligent about these details can save time and money in the long run.

Documents used along the form

The Texas 25-104 form is essential for surplus lines agents and purchasing groups in Texas to report their insurance premiums and related taxes. When filing this form, several other documents may also be required to ensure compliance with state regulations. Below is a list of commonly used forms that complement the Texas 25-104.

Form 25-101: This is the Texas Surplus Lines Tax Report. It provides detailed information about the surplus lines premiums collected during the reporting period. Agents use this form to report all premiums, including those exempt from taxation, ensuring accurate tax calculations.
Form 25-102: Known as the Texas Surplus Lines Affidavit, this document is used to affirm that the insurance policy is indeed a surplus lines policy. It must be completed and submitted for each policy that falls under this classification, helping to maintain transparency in premium reporting.
Form 25-103: This is the Texas Surplus Lines Broker's Report. It summarizes the activities of surplus lines brokers and includes information about the policies placed, premiums collected, and any returned premiums. This form aids in tracking the overall performance of surplus lines brokers in Texas.
Form 25-105: This form is the Texas Premium Tax Payment Voucher. It is used to submit payment for the premium taxes owed as reported on the Texas 25-104 form. This voucher ensures that payments are correctly attributed to the corresponding tax filings.

These documents are integral to the filing process and help ensure compliance with Texas insurance tax regulations. Properly completing and submitting all required forms will facilitate a smoother reporting experience and minimize the risk of penalties.

Similar forms

The Texas 25-104 form is similar to several other documents used for tax reporting and compliance. Below are five documents that share similarities with the Texas 25-104 form:

IRS Form 1040: Like the Texas 25-104, this form is used for reporting income and calculating tax liabilities. Both require accurate reporting of financial information to determine tax obligations.
Texas Franchise Tax Report: This document is similar in that it requires businesses to report their revenue and calculate taxes owed to the state. Both forms serve to ensure compliance with state tax laws.
California Form 100: This corporate income tax return requires detailed reporting of income and expenses, akin to the Texas 25-104’s requirement for reporting premiums and taxes due.
New York State Insurance Tax Return: This form is used by insurance companies to report premiums and calculate taxes, similar to the Texas 25-104, which is specifically for surplus lines agents in Texas.
Florida Form DR-908: This is the Florida surplus lines tax return. Like the Texas 25-104, it requires reporting of premiums and determining tax liabilities for surplus lines insurance.

Dos and Don'ts

When filling out the Texas 25-104 form, it is important to follow specific guidelines to ensure accuracy and compliance. Here are nine things to keep in mind:

Do read the instructions carefully before starting. Understanding the requirements will help you avoid mistakes.
Don't ignore preprinted information. Always verify that the details are correct and update them if necessary.
Do include all relevant premiums. Make sure to report both taxable and non-taxable premiums as required.
Don't submit incomplete forms. Ensure all sections are filled out completely to prevent delays.
Do check the due date. Be aware that the report and payment are due on March 1 of the year following the tax year.
Don't forget to sign and date the form. An unsigned form may be considered invalid.
Do keep copies of the submitted form and any supporting documents for your records.
Don't overlook penalties for late payments. Familiarize yourself with the penalties and interest rates associated with late filings.
Do contact the Comptroller’s office if you have questions. It’s better to ask for clarification than to guess and make mistakes.

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

Misconceptions

Misconceptions about the Texas 25-104 form can lead to confusion and potential issues for those required to file it. Here are eight common misunderstandings, along with clarifications to help you navigate the process more effectively.

Misconception 1: Only agents who owe taxes need to file the form.

This is incorrect. All surplus lines agents licensed in Texas must file the Texas 25-104 form, even if no tax is due. This requirement ensures compliance with state regulations.

Misconception 2: The filing deadline is flexible.

The deadline for submitting the form and any associated payments is March 1 of the year following the tax year. Missing this deadline can result in penalties.

Misconception 3: All premiums reported on the form are taxable.

Not all premiums are subject to tax. The form distinguishes between taxable and non-taxable premiums, so it is essential to categorize them correctly when reporting.

Misconception 4: The form is the same every year.

The Texas 25-104 form may undergo revisions. Always ensure you are using the most current version to avoid discrepancies in your filing.

Misconception 5: You can change your tax base option anytime.

Once you select a tax base option (premium-written or premium-received), you can only change it every four years. Planning ahead is crucial to avoid unexpected tax liabilities.

Misconception 6: Penalties for late filing are minimal.

Penalties can accumulate quickly. If tax is paid late, penalties range from 5% to 10% of the total amount due, depending on how late the payment is. Interest may also apply.

Misconception 7: Only Texas-based policies need to be reported.

Policies from other states that cover risks in Texas must also be reported. This includes multi-state policies where Texas is the home state of the insured.

Misconception 8: You can report premiums based on the original policy date.

When reporting endorsements and audits, you must use the date of the endorsement or audit, not the original policy date. This detail is important for accurate tax calculations.

Understanding these misconceptions can help ensure that you complete the Texas 25-104 form accurately and on time. Staying informed about the requirements will help you avoid unnecessary penalties and maintain compliance.

Key takeaways

Key Takeaways for 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. This includes purchasing groups registered in Texas.
The report and payment are due on March 1 of the year following the tax year. Ensure timely submission to avoid penalties.
Section I requires detailed reporting of Texas premiums, including those effective before and after July 21, 2011. Be thorough in differentiating between taxable and non-taxable premiums.
Agents can choose between a premium-written or premium-received basis for tax reporting. This choice can be changed every four years, but it is crucial to understand the implications of each method.