QUARTERLY PREMIUM TAX RETURN INSTRUCTIONS

Pursuant to W.S.§ 26-4-103(k) ↗ any insurer authorized to transact business in the state of Wyoming shall pay estimated premium taxes quarterly. Failure to do so shall result in the suspension or revocation of the insurer's certificate of authority.

Taxes are to be paid on a retaliatory basis. Each quarterly payment shall not be less than 25% of the total premium tax paid during the preceding calendar year.

Wyoming's tax rates are as follows:

Prior year credits are not to be taken until notification from the department is received confirming the amount. Please attach a copy of the notification when applying the credit.

If filing via mail, please remit this statement each quarter to the Wyoming Insurance Department. If payment is due, please make checks payable to the Wyoming State Treasurer.

Due dates are: April 30, 2024; July 31, 2024; October 31, 2024. Filing all three quarters at one time is permitted. If filing all three quarters at one time, please fill in each box with the amount due each quarter. Please note the 3 boxes must equal the total remitted amount. You must file a completed form even if your tax liability is zero.

The Wyoming Department of Insurance strongly prefers that premium taxes be filed via the NAIC OPTins ↗ platform.

2024 Quarterly Premium Tax Return Filing Form*

Premium Tax Return Line-by-Line Instructions*